Rhode Island runner and OrthoCore patient Kaela O'Neil during one of her marathon runs.Read More
I just had a friend text me and ask a very familiar question for this time of year. “Ian, my feet and shins are killing me. What can it be?” After a couple of questions back and forth trying to E-heal my friend, I simply asked how old her shoes were that she was walking in. She texted me back, “I don’t know, 3 months? Why does that matter?” I went on to explain how footwear can affect someone with a lot of walking if they get old, but her shoes were well within the realm of normal. After a little bit of a pause, she texted back again. “Um, I haven’t worn those in about a month, I’ve been wearing flats, and flip-flops to walk in.” Ta-Da, we figured out the root of the problem.
I know, I know, it’s summer time and we have all been waiting months to free our feet from the confines of shoes. Those perfect little flats that go great with that outfit. Those flip-flops that are so easy to slip on. Those bedazzled sandals that are just killer when you go out. I get it...but your feet don’t. I have started to evaluate more and more “summer foot” (that’s my phrase, not medical at all) in the clinic lately because of the nice weather. So what is summer foot and how do you fix it?
Summer foot is any pain in the foot associated with wearing horrible footwear. Some people get plantar fascitis, some get ankle pain, some get toe and bunion pain. No matter where the pain is, it is all from the same root cause - poorly supportive footwear that leads to bad alignment of the foot and ankle, and pain. You might be thinking, “Ian, not everyone gets summer foot though – why is that?” Well, not everyone has the same type of foot. Some people have a normal arch (they are the lucky ones) which allows them to wear unsupportive footwear without an issue. If you are like most of us though you have either too low of an arch (pronated) or too high of an arch (supinated).
If you have too low of an arch you will get more benefit from strengthening your foot and hip. Try these exercises:
They will help to strengthen your foot, and hip, and give you a little more arch support when you wear those summer shoes.
If you have too high of an arch, you aren’t as lucky as your low arch counterpart. A high arch means you have a very stiff bony structure. Although that is how you are built, you will still get some benefit from stretching your ankle and hip. Try these stretches to loosen your muscles and take some pressure off your arch:
The best way to make your feet feel better in the summer months is to wear those flats and flip-flops sporadically. If you do find yourself wearing them more than you should and your feet start to bother you, try the exercises. Hopefully they help you get through the nice weather with a pain free flip-flop tan.
At OrthoCore Physical Therapy, we can’t say it enough: we love what we do and who we work with. Since we have so many amazing patients, we decided to share their stories every month. This month, our patient spotlight shines on Nancy.
Nancy came to OrthoCore as a patient of Ian’s for a variety of issues that arose from a previous work accident and current exercise injuries. From then, “Ian has helped me regain movement without pain on both shoulders (rotator cuff impingements), unlocking my jaw muscle from a dental procedure and hip/glute pain and issues,” says Nancy.
“I have been to three other PT offices in Rhode Island. The biggest difference,” she explains, “is the one-on-one treatment that I receive at OrthoCore. On the rare occasion that I witness another client’s rehabilitation, I have noticed that strategies and exercises are individualized. We do not have the exact same ailments, so why should we all be doing the same treatment and exercises?”
“My treatment has been the use of heat and the TENS electrode machine. That is the pleasant part of my visits,” she jokes. “Then Ian moves to manipulation (which is painful but beneficial) with a short massage of the area manipulated.”
When asked if she has any physical therapy “homework,” Nancy explains, “homework is usually between 5-8 home exercise printouts clearly stating how to do different strengthening exercises, along with the number of reps. I also use the guidance on proper form that he explains during my session in my weight training to improve technique issues and protect myself from further injuries.”
Nancy has definitely noticed her injury and discomfort has reduced. “My discomfort is improved every single time. The knowledge Ian passes onto me through explanation and visual tools of my bones and joints has kept me active in Cross Train weight lifting and kettlebells. I have been able to correct my ailments and ‘injuries’ while still maintaining the activities that I love to do.”
If you’re considering physical therapy, Nancy recommends that you call Amanda in our OrthoCore office “immediately and make an appointment! She will take care of all administrative work needed quickly and competently for you to start your program. I hand out a lot of OrthoCore’s business cards,” Nancy laughs. “I always have a supply on hand.”
We asked Nancy what about her experience at OrthoCore she enjoys the most. She laughed and said, “This will go straight to Ian’s head, but his knowledge, level of care, actual results and sense of humor have made my experiences enjoyable. Amanda’s wit lends to the overall professional and supportive atmosphere. I can’t and don’t understand why people live in pain when the BEST physical therapy practice is OrthoCore right here in North Kingstown.”
Thank you for the kind words, Nancy! To read more about our awesome patients like Nancy, check out our blog! And contact OrthoCore today at 401-667-0131 for more information about any of our services!
This week, our awesome trainer Adam shares his story about how he lost fat and gained weight. He also shares suggestions about how you can get your ideal body without falling off-track.
Unlike some other trainers, I am very open about how I’m by no means a perfect example of physical perfection. I’m not the trainer who has always been in great shape. In fact, I’m the opposite. I was never athletic growing up, I let myself become dangerously obese, I lost weight in an unhealthy way, my powerlifting career was ended by injuries built up from poor habits and misunderstanding proper progression, and since those injuries I’ve struggled to find a balance in keeping myself strong, lean, and happy.
However, I hope that being open about my past helps the people I work with because I can relate to their struggles. In 2013 and 2014 respectively, I sustained a shoulder and lower back injury. While these injuries introduced me to the importance of learning about movement, mobility, and injury prevention before hitting the weights, they were also huge blows to my ego and my overall motivation. After being sidelined from lifting for a year, when I got back into it, my competition lifts went down hundreds of pounds. Old movements I used to enjoy were now either difficult, or downright painful. I was hit with a reality that I may never compete again. I went from being excited to train, to dreading it.
The worst of this culminated in 2015. I was depressed about my decrease in performance and motivation. My eating habits became very unhealthy, and my training was incredibly infrequent. Finally I had hit a point where I knew if I let that get any worse, well, I would have no business telling other people how to live healthy active lifestyles. So I set out to get stronger again, to increase my training frequency, and to eat lean and healthy again. My overall goal was to get back down to around 205-210lbs. Well, I can tell you by how my physique has changed over the last year and a half, I’ve lost a decent amount of fat. But on the scale, I weigh around 240lbs. So much for weight loss.
So, what happened? Well part of why I was able to stay so light and lean when I was powerlifting was because I was younger and had never been injured. I used to push myself so hard in the weight room that I didn’t need any kind of cardio to drop from 220lbs to 195lbs to make competition weight. Today however, I just can’t do that without hurting myself. That’s not to say I can’t push myself or lift heavy. But 90 minute gym sessions filled with dropsets and high rep ranges with 300lb barbells just isn’t happening.
My other advantage was at the time I was living at home. The weightlifter diet is real cheap when you’re not paying for your food. I was eating tons and tons of vegetables every day and loads of meat and eggs. I also worked at a protein shake bar, so I could easily get in a calorie controlled protein packed meal there 5-7 times a week. I ate a LOT, but it was very low calorie foods that kept me in check. Now that I’ve joined the rest of the average adult world, I’ve learned just how expensive truckloads of vegetables are. Temptation is more abundant, even if it’s just the times you decide you don’t feel like cooking and want to order out. Oftentimes, higher fat foods and denser carbohydrates are easier to eat and take with you as well. Meal prepping works. But you literally can spend an entire day off dedicating yourself to it. And honestly, I just don’t have the motivation to do that. I like my Sundays.
So what happened this last year? How did I gain weight but lose fat? I appropriately split up my training schedule to a 5 day routine. I needed an extra day dedicated to shoulder and arm rehabilitation anyway, and this ensured that to hit this routine properly I would be in the gym 3-5 days a week and at least 4 on average. That would prevent me from those lazy weeks where I lifted twice and mostly just practiced. I also made sure certain workouts were done at a different gym than the performance center. Now there’s NOTHING that prevents me from getting everything I need done at OrthoCore, however as it’s an environment I’m in 5 to 6 days a week, sometimes a change of scenery helps me focus. I tend to get distracted during certain workouts there, forcing myself to go the local gym helps make sure I don’t waste time and am only there to lift and leave. The point I’m making here is, make sure the training environment you’re in is one that you’ll be focused and motivated in. Sometimes that means being alone, sometimes it means being around other people, sometimes it means having a workout buddy to keep you accountable. But wasting time when training can have a noticeable effect (or lack thereof) in your results.
Now to the really important part (and tricky part), what was I eating? Well simply the difference between how I ate now and the diet I described to you above, is that I just stopped worrying about carbs so much. Part of that is because that I’ve found a good mindset in really not caring if I ever compete again. I’m happy enough to help my clients avoid the mistakes I made in this journey. I found other hobbies to occupy my time outside the gym and now treat training the way most of my clients do anyway. I train to keep my body strong and moving well so that when I’m older, I’m not weak and in pain. This seems like an immediate sidetrack from the nutrition portion here but mindset is huge in reaching your goals. And it’s often why when people are trying to lose fat, they end up falling off track so quickly. So I want you first off, to be happy with who you are, what you do, and accept that it’s always a journey that may have setbacks to reach your goals.
Okay, let’s finally get back to the food. So no matter what your goals are, your number one focus should always be on protein. This is what builds, repairs, and maintains your body. Adequate protein intake is essential for staying lean and muscular. Next is the hot button issue, carbs. So as a general rule I still suggest avoiding simple sugars whenever possible. The exception would be an instance where you have not eaten in a while and need some quick energy for your training session. But try to avoid that scenario too. However, I used to be of the mindset that avoiding all starchy carbs was the best route. Even whole grains. When competing the heaviest carbs I ate were oats and sweet potatoes. Every other carb was vegetables. But that takes a level of discipline that can be very hard for people to maintain, especially jumping into it. It’s why I don’t recommend diets like “keto” for the average person trying to lose weight. SO what I did was make sure that I got an appropriate amount of vegetables in every day, dinner was usually easiest. And then I started eating a lot more heavy carbs than I have before. If I had a bagel for breakfast, so be it. I didn’t worry about it. I always had a loaf of sprouted grain bread ready for peanut butter sandwiches. They’re easy to make and the bread even contains complete proteins. I would cook quinoa and red lentil pasta often to get both my carbs and protein in easily (this was a great post workout dinner). And I treated myself often. Probably once a week I went out for Chinese food (my favorite). I however would usually try to get dishes of meat and veggies and avoid fried sugar sauce foods and rice. For fats, the amount of natural peanut butter I eat combined with how I cook everything in avocado oil, I’m always getting my good fats in.
So after about 6 weeks or so, a crazy thing happened. I looked in the mirror and for the first time in years I had abdominal definition poking through. I could already tell by my face and neck I was leaner, but abs showing is huge for me. That takes a lot of work. I rushed to the scale to see how much weight I lost, and that’s when I found out I was packing on weight instead. But it made sense, my arms and chest were bigger, my back was wider, and I was getting crazy strong again in some lifts. I decided then, I really don’t care what the scale says. I never really have too much and always stress to clients not to worry about it. But having one of those moments again myself where in my mind I was thinking that weight loss would just be an inevitable byproduct of leaning out from my weight gain, I ended up surprised from proving myself right essentially. So again, toss your scale in the trash. It means essentially nothing. What matters more is how you look, how you feel, and how you feel about how you look.
Finally, to wrap this all up, I want you to try this. In 6 weeks it’ll be August. That may mark the closing month of summer for many, but there’s still time to work on that beach body to shine for a moment of glory. Starting right now I want you to devise a 4 or 5 day workout split. Something that will get you in the gym a minimum of 3 times a week. Gear it towards whatever goals you want to see (strength, endurance, muscle mass). And then eat. Eat without worrying so much about calories and macronutrients and cheat meals. Just eat. Make the majority or what you’re eating healthy foods, and don’t fear carbs, they’re an efficient source of energy and greatly help with the muscle building process. Without so much restriction and monitoring of your nutrition, you may find that you’re much less likely to binge or fall off tack. You should feel like you’re getting to eat what you want while you get the results you want. And should you start to lose focus, it’s even easier to adjust what you’re eating to get right back where you want to be. With all of that said enjoy your summer and achieve your goals. Here’s a suggested list of foods to help along the way.
Carbs - Tier 1: Sweet potatoes, whole grain brown rice, quinoa, whole oats, veggies (steamed/grilled)
Tier 2: Sprouted grain bread, sprouted grain pasta, brown rice products (bread/pasta)
Tier 3: Whole Grain Bread, Whole Grain Wraps, Whole Grain Pasta
Protein: Chicken breast, lean red meat (steak, ground meat), turkey (ground or baked), lean fish (tuna), fatty fish (salmon), whole eggs and egg whites, cottage cheese (skim, 1%, 2%), Protein powder (Whey, Casein, Blends)
Fats: Olive oil (cold pressed, extra virgin), nuts (almonds are my go-to), avocado and avocado oil, fish oil (caps/liquid form), peanut/almond butter, flax seeds/oil
According to the CDC, falls are the number one cause of injury and death to older adults (65+). Wow, what a way to start a blog post – doom and gloom. Well, I’m posting this for two reasons. For one, this statistic is near and dear to my heart; it is actually the reason why my grandfather passed years ago. Second, OrthoCore PT is pleased to offer a solution to prevent falls in older adults – the Otago Exercise Program.
I’m sure some of you are reading this thinking, “falls? Really? I fall all the time.” This may be true, but unfortunately as we age we don’t exactly bounce back from a fall the way we used to. From the death perspective, it may not be the fall that causes death. It is usually the associated loss in activity and the hospital stay that leads to death unfortunately. So yes, people fall, but no, it’s not okay or normal.
OrthoCore’s solution is to improve a patient’s strength, flexibility, and balance using the Otago Exercise Program (OEP) to prevent falls from happening in the first place. The OEP is a 6-8week exercise program that has been statistically proven to help improve a patient’s balance and decrease fall risk. The best part about the OEP is that it can be covered under Medicare when conducted with a Physical Therapist. We’re here to help people prevent falls, and keep someone’s mom, dad, grandmother, or grandfather around just a little bit longer (even if they can be cranky sometimes).
Contact us if you or someone in your family is interested in the OEP program at OrthoCore Physical Therapy. Give us a call at 401-667-0131 or contact us here.
- Ian at OrthoCore Physical Therapy
So by now most (if not all) of you know that we are certified in dry needling at OrthoCore. What some of you may not know is the difference between dry needling and traditional acupuncture. Before I get into the differences let me start with the similarities. Both acupuncture and dry needling use a fine filament, non-injectable, needle. Well, that was easy because that is where the similarities end. Now let's get into the differences.
Traditional acupuncture is based off meridians and qi (chi) flow. The goal of acupuncture is to place the needles along the meridian lines at specific points to improve the qi flow. The needles are typically left in for a longer period of time (15-45 min). I don’t want people to get the wrong idea thinking that I don’t like or respect practitioners who practice acupuncture. They are highly skilled individuals who help a lot of people. I have recommended that certain patients try acupuncture in the past. That being said, it just isn’t dry needling.
Dry needling uses the acupuncture needle to treat trigger points. A trigger point is a tight band within your muscle tissue. They can cause pain and can lead to restrictions in movement. The dry needling treatment releases the trigger point therefore, lowering pain sensation and improving joint movement. The treatment is extremely effective for any type of pain (acute or chronic), rehabilitation from an injury, and also injury prevention. Dry needling is usually a very quick treatment. The longest we would leave the needles in place is around 1-5 min.
Here is a more practical application to show the differences between the treatments. Let’s say, for example, a patient comes in with low back pain. If that patient goes to an acupuncturist they might get some needles placed in their back at the site of pain, but they may also get some along the specific meridian line that is being treated. Other points along that line may include the hand, the foot, the face, etc. The goal of the treatment being to align the qi flow. If that same patient came to us for dry needling, they would get treatment to the low back, and possibly the hips (if their joint movement is restricted). That is it, nothing in the hands or at other areas not directly leading to the painful trigger points. Once the dry needling is completed, the patient will be instructed in corrective movement to use the new mobility that is created with the treatment. This helps to improve the patient’s movement but also helps correct the underlying cause of pain.
If you have been dealing with pain, or painful movement, dry needling should be able to help. I am one of the few physical therapists offering dry needling in Rhode Island, and I have been doing it for the longest in the state, so you’re in good hands! If you have any questions or want to schedule your dry needling appointment, contact OrthoCore today at 401-667-0131.
At OrthoCore Physical Therapy, we can’t say it enough: we love what we do and who we work with. Since we have so many amazing patients, we decided to share their stories every month. This month, our patient spotlight shines on Jim.
Jim came to OrthoCore from a referral from an orthopedic doctor who told him there was not much they could do for him after an injury to his left knee. His doctor referred him to Kristi, knowing Kristi’s expertise in cycling and physical therapy. “I was experiencing pain underneath the kneecap,” said Jim. “I had finally found a sport I loved (cycling), and I was crushed when it seemed I might not be able to continue riding.”
Kristi led Jim through a series of strength training and stretches of selected muscles in the legs. “These were designed to compensate for movement in my knee cap,” Jim said. “Essentially, we were strengthening the other muscles to bring the kneecap into alignment.”
Jim was assigned physical therapy “homework” consisting of exercises and stretches, which he diligently followed. “I was told this routine of sticking to the plan was one of the main reasons my recovery went so well, and so quickly. I was back riding my bicycle in 8 weeks. Then in 6 months I was riding 70 miles per day on a 500 mile trip from Rhode Island to Ohio, camping along the way.” Way to go, Jim!
Jim continues with the exercises to strengthen his leg muscles. His injury has not returned, and he rides about 4 times a week. At the age of 58, Jim has completed his first Triathlon last September. “I never would have done that without my treatment at OrthoCore,” Jim remarked.
“The staff is friendly and professional, likeable and competent. They know what they are doing. Combine that with a personal interest in who you are as a person, and it’s an awesome combination. Only go to OrthoCore if you want to get better, feel stronger, and be active again. If you’d rather stay in pain, then it’s probably not worth it!”
The local golf season has finally started. With the start of golf season comes the phone calls from golfers in pain from playing the game we all love. If you are like most of my golf clients, the pain you are dealing with now is the same pain you were experiencing last season. You didn’t do anything about it over the offseason because you weren’t playing golf and, surprise surprise, you didn’t have any pain. Now you are back to playing and, guess what, the problem is still there. Contrary to what most of the other people you are playing with will tell you, playing in pain is not normal. I’m here to help though with some useful tips for the most common golf injuries.
Back pain is by far the most common injury in golf. I’ve dealt with it myself at times. The most common area of back pain is trail side back pain (right low back pain in right handed golfers). Golfers get back pain when they play because of swing faults. Golfers have swing faults because of weakness in the core and tightness in the hips and thoracic spine (rib cage). There are a couple of swing faults that can lead to back pain as well. Reverse spine angle and hanging back can both lead to increased pressure on the back, and pain when you swing. Reverse spine angle is when your body is leaning towards the target at the top of the backswing. Hanging back is when your body leans away from the target at impact. Neither are great for your back (or your golf swing, really).
After the back, elbow pain is the second most common area of injury when it comes to the golf swing. Where do you think “golfer’s elbow” got its name from? When it comes to elbow injuries, the problem usually isn’t in the elbow. The symptoms are in the elbow, but the problem is somewhere else. Elbow pain with golf is usually caused by casting in the golf swing. “Casting” is when you release the head of the golf club before impact (like casting a fishing rod). The reason why golfers cast is because they don’t rotate their body enough through impact. That forces the player to release the club early to make contact with the ball. There are a number of reasons why the body stops rotating early. No matter what the cause is, if you want to fix your elbow pain, you need to fix your body rotation issue first.
So what is the best way to fix your pain and make sure that it doesn’t come back? Come and see me, of course! I always do a full evaluation of all of my golfers’ restrictions. As you can see in the elbow example, pain in one area may be caused by a problem in another area. We want to make sure we’re getting to the root of the problem. I also like to get the player on the K-vest system to see where their swing is deficient. Fix the body, then fix the swing. That means no more pain with your golf swing (which is actually normal).
Don’t hesitate to contact us and we can get you started on the road to recovery if you’re experiencing any of these issues. And in the future, we’d be happy to work with you before the injuries set in to work on preventative measures. Contact us at 401.667.0131, or visit our website!
- Ian at OrthoCore
The weather is getting warmer, the snow is melting, and the runners are hitting the streets. If you were one of the many participants in the Boston marathon, you have been training all winter. For most of us the marathon is an inspiration to lace up the New Balances and start pounding the pavement. For me, that means in about a month or so I will start seeing patients with shin splints. Shin splints (or anterior tibialis tendinitis in the medical world) is by far the most common injury in the running world. The good news for you runners out there is that they aren’t hard to fix which, will keep you racking up the miles for years to come.
A shin splint (or anterior tibialis tendinitis) is an inflammation of the muscle on the front of your tibia (shin bone). Sometimes it is just the muscle, sometimes it is the muscle pulling away from its bony attachment, and sometimes it is both. No matter what is going on, it’s treated the same way. Before we get to treatment, let’s talk about why runners get shin splints in the first place.
Shin splints are usually caused by tightness in your calf, weakness in your hip/core, and poor running form. Two of these things are easy to fix, and one takes more time and is more complicated. A tight calf causes shin splints because the front of your shin (anterior tib) has to pull against a tight calf to lift the foot to clear the leg when running. The harder it has to pull, the more stress that it puts on the muscle and can lead to the tiny tears. Here’s a great stretch you can do to stretch out your calf muscles and help prevent shin splints:
Weakness in your hip/core leads a greater impact on your foot when it hits the ground. It also leads to poor leg alignment when you are landing. Think of how many times your foot hits the ground when you are running. Those reps add up and any little mal-alignment can lead to a big problem over time. Here are my two favorite hip/core exercises for runners.
The last reason for getting shin splints is poor running form. Don’t be offended. There are a lot of recreational runners out there who are doing it wrong. I’ve worked with elite runners who are doing it wrong. The good thing about making these changes is that it will help to heal your shin splints, and make you a more efficient runner. Win-win. Two common form issues lead to shin splints in runners. One is overstriding and the other is vaulting.
- Overstriding is when your foot lands too far in front of your body when you are running. This can lead to shin splints because you have to slow your body down before you can speed it up again to propel yourself forward. What is the muscle that slows your body down? You guessed it, your anterior tib. Here's a video to help you understand what overstriding looks like and how you can fix it.
- Vaulting, or what some sources refer to as "up and down," is when your body raises in the air too much in between strides. Sir Newton told us a long time ago, what goes up must come down. The higher in the air you go the more impact you are going to have when you land. That impact pressure translates up the shin and can also lead to shin splints. For vaulting, I like to have my runners pick a point on the horizon. Try to keep your head level with that spot and that will help to prevent vaulting.
If you experience any running-induced injuries, don’t hesitate to contact us and we can get you started on the road to recovery. And in the future, we’d be happy to work with you before the injuries set in to work on injury preventative measures. Contact us at 401.667.0131, or visit our website.
- Ian at OrthoCore PT
Do you have pain during or after biking and think it is normal? I am here to tell you that it’s not normal, and could be placing you at increased risk for injury while slowing you down on the bike! Numbness in the hands, hip pain, low back pain, knee pain, or saddle numbness can greatly affect your performance on the bike and can be effectively resolved with a proper bike fit, which we offer here at OrthoCore PT.
Now, I know you are probably thinking, “Why would I go to a physical therapist for a bike fit?” Physical therapists are actually one of the best resources for a proper bike fit, as they are experts in anatomy, biomechanics, and physiology. During a bike PT fit, you will be evaluated on and off the bike. Off the bicycle, a bicycle-specific musculoskeletal exam will be performed looking at posture, strength, balance and flexibility. Next, your bike will be placed in a trainer and a biomechanical evaluation similar to a gait evaluation and will be performed with you on your bike. Special attention will be focused on pedal position, seat position, and handlebar position. Recommendations and adjustments will be made to alleviate pain and increase performance. You will also be provided with bicycle-specific rehabilitation exercises to address strength, flexibility, and postural deficits, if any are identified.
One of the first things I look at as a bike PT is your saddle. Just like a pair or running shoes, your saddle gets worn down and needs to be replaced. I am always amazed by how many cyclists are riding on a worn saddle - or even more common - the wrong sized saddle, which leads to many issues. My clients are often amazed at how much better they feel when riding on a saddle that fits properly.
In most cases the adjustments I make are slight… in fact, most are just millimeters but they go a long way! Often, making adjustments to one’s cleats makes all the difference by changing the knee angle. This not only helps to decrease strain to the knee, hip, and back but significantly improve one’s pedal stroke!
So weather you are a triathlete, century rider, mountain biker, commuter, or simply enjoy riding with friends, OrthoCore Physical Therapy can help you reach your cycling goals and ride pain-free!
-Kristi at Orthocore
At OrthoCore Physical Therapy, we can’t say it enough: we love what we do and who we work with. Since we have so many amazing patients, we decided to share their stories every month. This month, our patient spotlight shines on Ron.
Ron came to OrthoCore two years ago to rehabilitate two shoulders with surgically repaired rotator cuffs. We’ve worked with Ron to return strength and full range of motion to each shoulder, tailoring his treatment for both routine and specific circumstances unique to his lifestyle and goals.
“Without question,” says Ron, “I have recovered full use of both extremities. Under Ian’s guidance, encouragement, and treatment, I have resumed virtually all activities.”
Ron has visited other physical therapists but has noticed the difference with OrthoCore. “I worked with another PT office after my first shoulder repair. While visiting OrthoCore for an unrelated matter, Ian noticed my range of motion was limited. I agreed to treatment and, in short order, I was using my arm without difficulty. Suffice it to say, I was alternately impressed and grateful!”
“What sets OrthoCore apart from other practices is their competence and interpersonal approach. The practice models a professional and client-centered approach to all patients. Patients are treated with respect and personalization. Each OrthoCore member exudes empathy, expertise and genuine interest in each client’s recovery. When I worked with Kristi, there was a seamless transition and familiarity with my treatment protocol.”
Not only has Ron received top of the line physical therapy expertise, Ian has integrated “sophisticated golf instruction” into his treatment plan. “I’ve also found the office atmosphere inviting. Everyone is pleasant and supportive, which makes the rigors of treatment more manageable. Now, if my golf game improves as well as my shoulder recovery, I may be a candidate for the Senior PGA Tour! Thank you, Ian, and OrthoCore!”
Contact OrthoCore today at 401.667.0131 for more information about any of our services!
It’s getting to be my favorite time of year, golf season. The PGA tour is starting to heat up with bigger tournaments and people are already talking about The Masters. In New England, we’re starting to get glimpses of nicer weather. It can also be one of the most frustrating times of year for me professionally though. Why you ask? Now that the weather is getting nicer, I’m starting to get golfers calling saying they want to get ready for the upcoming season. It is great that people are looking to get better, and I love helping my golfers. The problem is that the season starts in two weeks. Where were you for the past 3 months when you couldn’t play golf and were stuck inside? The truth is, you already missed the boat if you truly want to be ready for the start of the season. Fear not though my golfing friends, there is still plenty that you can do to improve your golf game for next season.
What are the two most important things to focus on? Good mobility and good stability. Simple right? What that really means is you need good mobility of your hips, ankles, shoulders, and neck. For stability you need strength in your core, chest, hips, and shoulders. That is just to develop a good foundation. If you really want to hit the ball farther, you need to work on power development. That is a whole extra level of strength and speed training. Are you starting to see why you need at least 3 months to make a change in the off season? I’m going to do my best to simplify it for you to get you up and running for the season. Just remember that next season you need to call me in December, not March.
The biggest restriction that I see in amateur golfers is shoulder turn – most don’t have enough. This restriction places a lot of strain on your back and shoulders. It can also limit the power you can produce in your swing. My favorite way to improve shoulder turn is the open book exercise. Perform 10 repetitions, with a 3 second hold, twice a day.
Most amateurs are seriously lacking in the stability category. The reason is, most people sit all day at their job and then during their commute to and from work. The glutes and abdominals are the two big players in producing stability. The unfortunate thing is that when we are sitting, both of these muscles are taking a break. That means that in a normal work day the two most important players in producing stability in the golf swing are on vacation. I’m not telling you to quit your job and find one that doesn’t require you to sit all day. I’m just trying to give you an idea of what an uphill battle it is to build the proper stability that is required in the golf swing. One of the best exercises to help increase both glute and abdominal strength at the same time is the bridge with kick. Perform 3 sets of 10 repetitions, twice daily.
Performing those two exercises will get you started on the right track. It isn’t ideal but it’s better than nothing. The take home message? Golf season doesn’t start in March or April. It really starts 2-3 months before that. Make sure you get started a little bit earlier next season to make it your best. Happy golfing!
- Ian at OrthoCore
A little while ago we covered some essential home gym equipment. While the general reasoning as to why they are essential was explained, now I would like to go over some of the exercises you should make sure you’re doing with each piece.
There are many others we won’t cover today, but these specific exercises are some of the most important in any training program, and your equipment will allow for them to be done effectively.
1. Dumbbell Bench/Chest Press – Okay, this is a little bit of a cheat as we’re going to focus on 2 pieces of equipment here. But this exercise is a major part of why you needed both weights, and a sturdy bench or stability ball. This is a major pushing motion that anyone should be able to do with appropriate weight. Since many people can’t do a push up, the bench press is a great way to build strength in that muscle group until they can. This can be done with either a bench or the stability ball like so.
2. Dumbell Front Squat/Goblet Squat – Here’s one of the other reasons you needed weights. Squats are a great motion for your entire body, not just your legs. But to get the most out of your squats, you’re going to need to move some weight. Sooner or later you will adapt to bodyweight squats and they won’t challenge your legs, core, and back the way weighted squats will. Enter the dumbbell front squat. A simple way to challenge yourself at home.
3. Suspension Trainer Inverted Rows – It is worth whatever you paid for your suspension trainer to do this one exercise alone. If pull ups and chin ups are the king of bodyweight pulling exercises, then inverted rows are queen. This movement will do wonders for developing back strength, bicep strength, grip strength, and core strength. Very few people can do a pull up. This exercise is the next best bet. It’s easily modified for beginners by having a bend in the knees. The more parallel you are to the ground and the straighter your knees are, the tougher it gets.
4. Band Overhead Press – Many people (myself included) have some kind of previous shoulder injury or current shoulder pain. Motions that push and pull overhead can be very tricky sometimes to perform pain free with weights. Luckily resistance bands are very forgiving on the joints. If pressing overhead with weight bothers your shoulders, give this variant a try. In fact, even those of you with strong shoulders should be able to challenge yourself with a band pressing routine.
5. Lat Rolling – Your foam roller will be key in mobility and flexibility of many muscles. But one of the biggest will be your lats. That big thick muscle on each side of your back. It’s an incredibly thick and powerful muscle and can prove difficult to stretch more than just the outermost portion. The roller will attack them deep beyond the spots you can normally hit with static stretching. Beware, this is usually the rolling exercise that clients feel the most tightness and related pain while doing. Start with about 30 seconds each side until you loosen up and build some tolerance to it.
So you have it! 5 basic, but key exercises for you to incorporate into your routine with all of your fancy new home gym equipment! Practice these until you’re comfortable enough to add weight or increase the amount of sets and reps you perform. If you have any other questions on exercising in or out of the gym feel free to contact me at AdamD@OrthoCorePT.com.
- Adam at OrthoCore
Let’s face it, nobody has enough time anymore. It’s the number one reason that we hear from our patients as to why it takes them so long to get started on a rehabilitation program. Once people do start on a program, they finally commit to getting better. The thing that makes us crazy, though, is when people throw all of their hard work away by not sticking with their program once they are discharged. Why do patients fall off the wagon once they are done with treatment? Time, not enough time.
We’re here to offer some solutions for people who are looking to stay on top of their program and stay pain-free especially during this busy holiday season.
1. You don't have to do every single exercise, every single day.
Rehabbing from an injury is a huge commitment. You usually have to go to PT 1-2x/week for about an hour per visit. When you are not at PT you have "homework" that you are supposed to do at least once per day. It all starts to add up. Patients think that once they are discharged they need to keep up with the pace of doing everything once a day. Add that to everything else that people have to do during the day and it starts to get overwhelming.
We always try to educate our patients that rehabilitating is different from maintaining. When a patient is rehabilitating, they are working on correcting whatever strength, flexibility, or motor pattern issues that are leading to their pain. It takes more repetitions to make those changes, and that’s why we usually ask the patient to perform their program daily.
Once they make those changes and are now pain free, the patient transitions to the maintenance phase. During the maintenance phase patients only have to perform the exercises 1-2 times/week. What a relief! Think of all that extra time you will have on your hands. 1-2 times/week is all that is needed to maintain that new strength and flexibility you have worked so hard to obtain.
2. You don’t have to do all the exercises at once.
Most patients’ rehabilitation "homework" consists of at least 5-6 exercises that you are supposed to do multiple repetitions of. That can add up to a lot of time in one sitting. Instead of trying to carve out a block of time to perform the whole program you can do each exercise at least once per day. If you have a free couple of minutes, do one of the exercises. If your program consists of some exercises that have you lying down you have two opportunities during the day where you start and end in that position (yes, we’re talking about sleeping, people!). Take a little extra time to do those exercises when you are already in the starting position. That way you can get to the whole program throughout the day, rather than feeling like you need "extra" time to perform the whole thing at once.
3. You probably don't have to do every exercise on your program for the rest of your life.
If you feel like your program is really extensive by the end of your rehabilitation, you are probably correct. If you truly feel like you can't do every exercise then be honest with your therapist. We always try to work our programs around what the patient is willing to commit to. Sometimes that is only two exercises. If that is all you can commit to, it just means you have commitment issues and that’s fine (…or is it?). In all seriousness, we would rather give someone a couple of exercises that will highlight the biggest areas of dysfunction vs. a program that is aimed at fixing everything that they won't stick to.
4. Pain sucks, so why would you want it to come back?
It drives us CRAZY when patients come back with the same injury. This drives us up a wall because the typical answer as to why their pain returned is because they didn't stick with the program. It’s like failing a test that you have the answers to.
One of the best ways that we've found to keep people on track is setting a schedule. Set reminders on your phone, place sticky notes around your house, whatever reminders you need to stick to the schedule. That will give you the best opportunity to stay on track and live pain free!
I’m often asked what the best home gym equipment is. Even today I was asked by a new client if he should get weights for his home. Many people, whether due their budget or schedule, choose to work out at home rather than in a gym that requires a membership. This is totally doable, the issue is however that your home often isn’t equipped anywhere near as well as your local gym. However, you would be surprised how much equipment at the gym is either unnecessary or non-essential to strength training.
So to save you some space (and hopefully some money), here are my top picks for home gym equipment.
1. Weight Bench/Stability ball – Okay, I’m cheating a bit by including two items here. But in this case they’re both going to be used for the same thing, that thing being a surface for free weight exercises. A stability ball can be substituted for many exercises requiring a bench. You can bench press, overhead press, dumbbell row, seated row, and split squat on a stability ball. Using a stability ball will also add an extra element of core training (hence stability ball). Stability balls are also easier to store than a bench and allow for unique core exercises and squats that can only be done with a stability ball. However a solid bench will be better for overall strength. While it will be bulkier, it will provide a more stable surface for training with heavier weights (allowing you to really focus on strength), and will assist in many lower body exercises such as step ups and box squats that a stability ball cannot. So take your pick as to which suits your home and goals best.
2. Adjustable Dumbbells- So your ultimate goal usually in home training is to save money and space. The best way to do this is focus on dumbbell training over barbells. They’re easier to store and won’t also require a squat rack to train with. There’s all manner of adjustable dumbbells. Vinyl sets sell for pretty cheap, often going from 5-25lbs for $20-$30 a set. There’s the standard spinning screw lock dumbbells which can come in sets of anywhere from 25 to 100lbs. These are usually a more affordable way to lift heavier weight, just always be sure to check that the screw is fastened tight. Then there are the more expensive and popular brand name sets. These each offer their own strengths and weaknesses too and come in sets that range from anywhere to 45lbs, 55lbs, 75lbs, 90lbs, 120lbs, and even 165lbs! The set we have at OrthoCore I chose for its durability and design. They were a pretty penny but they are shaped like traditional dumbbells, and made from interlocking iron plates and flat steel screws. When my studio was smaller, this allowed me to use dumbbells from 5-120lbs and take up incredibly little room. So find a set that fits your goals and budget!
3. Suspension Trainer- Some people refer to these as “TRX”, however the name of the piece of equipment is a suspension trainer. TRX just happens to be a popular brand for this equipment. However, the TRX is pricey. The clinic at OrthoCore and my old studio uses a variant that is just as versatile and more than half the price. A suspension trainer is great for the way it challenged stability in the rotator cuff when you use it for inverted rows and for suspended pushups. It can also be used for a number of unique core exercises. The reason I like them the most is for their ability to help people learn squat and lunge technique by doing assisted versions of them on the suspension trainer. This is especially useful for people with poor ankle and hip stability.
4. Resistance Bands- I don’t use resistance bands much anymore now that I train at OC Performance. But they were invaluable to me at my old studio and when I trained clients in home. The reason is that they best allow simulation of cable machine exercises. Seated rows for example, won’t be possible without either a machine or by hooking a resistance band around something that you can use to pull it from. By putting resistance bands at different heights, they can be used to simulate cable rows and presses, overhead presses, chops, twists, deltoid raises, arm isolation, and so much more. Resistance bands come in all sizes and tension levels so you can perform entire workouts with them if you so chose. I would save them for specific exercises, however, as resistance bands will wear over time and you never have an exact idea of how much resistance they are actually giving you.
5. Foam Roller- With everything I listed above, you actually have enough equipment now to perform hundreds, more likely thousands of exercise variations that target the entire body. But how are your muscles feeling? Are they tight in some areas? Do you get knots and trigger points in them often? If you don’t, you’ll start to now that you’re strength training regularly. Stretching will help, and like certain exercises, all you’ll need to stretch is your body and know how. But to really help mobility and to work through tightness, you’ll want a good foam roller. Foam rollers attack area in the muscle deeper than a lot of static stretching will hit. This is especially important for big muscles like your lats, glutes, calves, and quads. Your lower back will love it too. Add a tennis ball to your roller to hit the small spots like under the shoulder blade.
So there you are! That’s all it takes to have your own home gym. Now obviously, more standard equipment will make your training experience even better, but say you want to be ready for days you can’t make your gym, or you’re stuck inside due to the weather, this will be more than enough equipment to give even an Olympic athlete enough to challenge themselves with. Make sure you have a good surface to exercise on too, even if it’s just a yoga mat. If not, a basement or garage setup may be ideal to prevent damage to the floors as you jump around and drop weights everywhere.
But no matter where you set up your personal training space, just make sure you don’t let all of these items gather dust. These pieces of equipment are investments in your health, so use them to make sure you have a good healthy return from them.
Keep an eye out for our blog with great exercises for this equipment!
- Adam at OrthoCore
At OrthoCore Physical Therapy, our patients are what make our jobs so rewarding. Since we have so many amazing patients, we decided to start a monthly blog highlighting some of our patients’ stories. This month, our patient spotlight shines on Tuni of Wickford, RI.
Tuni came to OrthoCore after being involved in a car accident. “I was stopped at a red light when someone rear-ended me. The air bags didn’t deploy so I didn’t think it was that bad! And though I hit my face on the steering wheel (with tea cup in hand) and had cuts/bleeding/loose front teeth, I was very surprised by the amount of pain in my neck and lower back that started the morning after the accident. Knowing of Ian Manning and OrthoCore’s stellar reputation I called them right away.”
What exactly does her treatment entail, you might ask? “I went twice a week for the first couple of weeks and now I go once a week. He starts of with some heat and stim (pulsating electrical charge through strategically placed conduits on my neck and lower back) which helps lower my pain levels. That’s followed by a massage of the affected areas.” Tuni finds the massages one of the most helpful aspects of her treatment. “I have had many professional massages and have to say Ian is SO good at the massage part, and that brings me the most relief!”
Physical therapists and school teachers alike are notorious for assigning ‘homework.’ The difference is – PT homework is often enjoyable for patients, and the benefits are noticeable! “Ian goes through a series of exercises meant to stretch and relax my neck around the affected vertebrae so the healing can begin.”
When asked if Tuni has noticed her injury or discomfort reduced, she responded with “Absolutely! I didn’t feel better right away. It took a couple of visits but then I started to feel better and was able to wean myself (with Ian’s help) off of my daily ibuprofen.”
“I had never been to PT before,” Tuni notes. “I had been to chiropractors and thought maybe they were similar but it’s really very different. I get much more than a simple adjustment at OrthoCore – I learn how to move better, and how to avoid future injury.”
Tuni has really reaped the benefits of physical therapy at OrthoCore. “After the accident, even doing the treadmill at the gym was painful for the first couple of weeks. With OrthoCore, I started to feel better and it got easier. The worst part of this injury though was difficulty sleeping and that ended up affecting everything; my mood, my productivity at work and so on. I’m now able to sleep through the night and actually feel like working with Ian has helped me get in better shape, so that’s an extra bonus!”
“OrthoCore is awesome,” Tuni said. “Whether it’s an acute situation like mine, or a chronic issue, to their different specialty areas (golf, cycle fitting, performance center), I HIGHLY recommend the entire OrthoCore team!”
Contact OrthoCore today at 401.667.0131 for more information about any of our services!
The New Year is in full swing and that means that people are well into their resolutions (…and some have probably already fallen off the wagon). People always make resolutions for fitness and weight loss, which is great. I personally don’t think that enough people make resolutions for their general health. Fitness and weight loss are part of it, but the body is far more dynamic than that.
How many of you are “dealing” with pain? That nagging shoulder or back that has been going on for longer than you can remember. How many of you are starting to notice pain if you are starting a new regiment trying to get “healthier?” You don’t have to deal with, or put up with pain. Pain is your body’s way of saying, “HEY! There is something wrong here.” Maybe it’s time to start listening. I’m proposing that you invest in yourself and live pain free for 2017.
Now that all sounds fine and dandy but how do you get started? Where do you go and who do you talk to? I think OrthoCore is a great place to start (I may have a slight bias). Start with a PT evaluation to see why you are getting pain. We can take a look at your whole body and see what muscle, joint, or nerve imbalances might be leading to your pain. We can then come up with a plan to fix it and help your pain magically disappear. Most insurance companies don’t require a doctor’s prescription to start so just give us a call – 401-667-0131.
If you don’t have any pain and one of your resolutions is to get back into the gym, I still think that OrthoCore is the right place to start. Just having a movement screening will tell you what imbalances you have that you don’t know about. If you start a program and work around those imbalances, you will definitely have a break down which will lead to pain eventually. It’s a guarantee unfortunately. It may not be this week or next but if you continue to work around restrictions, the tissue will break down and you will have inflammation and pain in the future.
Don’t run that risk. Find out what you really need to work on before you get started. We can give you some exercises specifically designed to correct those imbalances so you can achieve your fitness and weight loss goals without running the risk of developing an injury.