From a single flagship location in Hunt Valley, to 9 different clinics throughout Maryland and Virginia, FX Physical Therapy has experienced immense growth in the 5 years since it started. Check out owner Jerod Felice’s message in the video below!
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“Ice or Heat?” Recovering from Injury the Right WayWhen it comes to rehabilitation and recovery, one of the most common questions our PTs are asked is “Should I use ice or heat?” Knowing the appropriate time to use each one may be beneficial in decreasing pain and speeding up the recovery process.
Ice works by decreasing the local temperature of the tissue within your body. This results in a decrease in blood flow, swelling, muscle tone, metabolic rate, and nerve conduction. It can also help increase the body’s pain threshold. Ice can be applied for 15-20 minutes at a time. Ice should not be applied right before activity as it may decrease your performance.
Use caution with application of ice for people with cardiac failure, hypertension, infected tissues, and damaged or at-risk skin. It should not be used if you have an active DVT, near chronic wounds, open wounds, cold hypersensitivity (Raynaud’s, cryoglobulinema, hemoglobulinemia), cold urticiaria (cold allergy or hypersensitivity), impaired circulation, or over regenerating nerves.
Heat works by increasing the local temperature of the tissue within your body. This results in an increase in blood flow to the area, capillary permeability, collagen extensibility, metabolic rate, nerve conduction velocity, and pain threshold. Heat can be applied for 15-20 minutes at a time. Be sure to perform skin checks frequently to prevent burns.
Heat should not be used for people with arterial disease, bleeding or hemorrhage, peripheral vascular disease, thrombophlebitis, over cancerous areas or within 24-72 hours of muscle/ligament/tendon trauma.
If you have had pain for an extended period of time with no range of motion loss and significant
swelling = Ice first, then Heat
Want to find more ways to reduce pain and injury? Make an appointment with one of our Doctors of Physical Therapy here!
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In the current landscape of the world, many companies have shifted their companies from working remotely. It is difficult to see when, if ever, many companies will bring back their employees to working in an office setting. Companies, like Twitter, who have announced employees will be working from home for life, are taking progressive steps to ensure the safety of everyone.
While working from home is advantageous in many aspects, it is also important to note the ergonomic deficiencies that can be caused by setting up an office on your kitchen table or couch.
Here are a few basic tips on setting up your workstation:
There are also a few easy-to-remember concepts that will allow you to feel better while working from home.
Remember to keep moving and stretching throughout the day, this will help to reduce pain and make you more productive and less distracted at work. If you need further follow up, reach out, and contact your PT ASAP!
For a customized therapy plan to address your specific needs – Call our team today at 443-595-7798 or click here to request an appointment.
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Two primary areas we focus on in yoga are mobility and stability. Mobility is defined as the ability to move freely and with ease. Stability is defined as the ability to maintain control of joint movement or position. It is important to focus on both aspects equally, as too much of one can be bad for your body.
I am sure many of you recall the childhood song “dem bones”, and it is no lie that the entire body is connected. Injury or dysfunction in one area can absolutely affect another area of the body. For example, something like an overhead stretch requires mobility from the thoracic spine. When we have issues with that mobility, we begin to look for more motion from our shoulder blade. However, that joint traditionally holds a stability role. As you can see, this compensation can cause some trouble.
We often see people chasing flexibility when in fact, they already have great joint motion and actually need stability. If we continue stretching muscles around joints that are hypermobile (outside of the normal range), it can cause dysfunction. We then transfer that load to the ligaments, which are supporting our joints, instead of the muscle. This is not the natural physiological role of those ligaments and can lead to injury. Yoga can be a great form of stability training due to the prolonged static holds of various poses.
So how do we know when we should focus more on stability or mobility? And how do we know if our pain is being caused from compensation? In physical therapy, we begin our patient evaluations with a full body screen and assessment to observe your movement. It is important that your physical therapist does this, because although you might be coming in with shoulder pain, that does not mean that the shoulder is the problem child. Per our example above, it could simply mean that your shoulder is working overtime to compensate for that reduced motion that you have in your thoracic spine. We identify your mobility joint-by-joint and test stability in order to create individualized plans to improve movement patterns and prevent injury, as well as keeping you engaged with whatever workouts you enjoy.
Here we have listed a couple of our favorite mobility and stability exercises, specifically in relation to yoga:
Mobility is defined as the ability to move freely and with ease.
Stability is defined as the ability to maintain control of joint movement or position:
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“No Pain, No Gain.” We’ve all heard it from old coaches or trainers, for better or for worse. While the quote does have some merit…maybe…it often makes me, as a physical therapist, cringe to hear it when people describe their exercise habits. There is truth in the phrase. To make changes, i.e. gain strength, your body needs to be pushed to its limit in order to come out stronger. This is where soreness comes into play. Many of us have felt that good soreness after a workout. That’s science coming into play. Wolff’s Law, to be exact-the body adapts to the changes put upon it.
So that’s great, right? No pain no gain must be true? You need to stress tissue for it to adapt and come back stronger, correct. However, too much pain can be detrimental to that tissue. This is where overuse and overload injuries occur. When the muscle cannot tolerate the load placed on it, what happens then? The answer is injury and pain.
Navigating the seas between pain and gain is a tough and choppy journey. You can ask any physical therapist, personal trainer, exercise physiologist, chiropractor, strength coach, etc. and they will tell you that they have been asked numerous times, “How do I know when it’s too much? When should I stop?” Many will give you different answers, depending on what field they are in and what the clients’ goals are. But, there is one specific analogy out there that I find to be extremely helpful in how to think about this. You’ve seen it everyday all over Baltimore.
The Stop Light
Green means go; Red means stop. Yellow (well that depends who you ask) means slow down. We’re going to use these signals as a way to think about when to keep going on an exercise, and when to hit the breaks.
First, you need to ask yourself this, how bad is my pain right now? Rate that answer 0-10, 0 being no pain at all, 10 being I need to go to the emergency room it hurts so bad. Your number is your number-be honest with yourself. Don’t compare that number to what you think others may feel, just go with your gut. That number will guide you through this analogy.
Green Light (0-3/10 Pain): Green light means continue on. This may feel like typical soreness or achiness on a low level. When doing an exercise that causes this low of pain, you are most likely safe to continue with it. This level of pain is healthy and may be promoting the changes you are looking for when working out.
Yellow Light (4-6/10 Pain): Yellow light means slow down. It does not mean stop (yet), but it definitely does not mean hit the gas and blow through the light. 4, 5, or 6 out of 10 pain is pretty significant, so what you should be thinking is, “What can I do to get back to a green light?” The answer may be a few things. First, check your technique. Make sure posture and form are correct. You can also lighten up your weight, change grip, or take a short break and return to the exercise afterwards. If you are able to return to the exercise following the modifications you made and the pain has dropped into our “Green Zone” you can continue on. If you cannot, you should stop the exercise and attempt to do something else. If it continues to linger you should make an appointment with a physical therapist to be assessed and find out how to turn your pain around.
Red Light (7-10/10 Pain): Red light means stop. Your pain has now reached a level where it is likely unsafe to continue this exercise. This is especially important if your pain has become sharp, burning, numbness or tingling. You’re in the danger zone where injury can occur. Your next step should be making an appointment with one of our doctors of PT in order to be assessed and figure out why this pain is happening when you’re exercising.
Hopefully, this analogy helps gives you some guidance and clarity when navigating the choppy seas between pain and gain. There are always exceptions to these types of rules, so feel free to contact any of our doctors of physical therapy for further guidance on how to avoid injury and reach your goals.
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Foam Rollers. Lacrosse balls. Massage guns. Heat. Ice. Stretch. Don’t stretch. Rest, but not too much rest. Got that?
The world of ‘recovery’ is a confusing and at times overwhelming area of health and wellness that can make it difficult to actually understand what you should be doing to ensure you’re balancing the natural push/pull of breaking your body down through working out and building it back up through your recovery regimen.
So let’s take a step back and understand what recovery actually means.
When you workout you (ideally) challenge yourself to the point where your body has to respond in some way to better prepare it for the next time you hit the gym. Too little (or too infrequent) and your body won’t receive the stimulus needed for it to improve. Too much (or too frequent) and you risk over training your body and finding yourself set back by injury. For example, after a heavy strengthening workout you’ll naturally break down muscle fibers (leaving you temporarily “weaker”) but your body will rebuild “stronger” than before. This recovery process requires time and nutrition. Without enough of either of these, your body will actually be less prepared for your next workout because it hasn’t properly recovered from your last bout. If you just keep squatting heavy back to back days, you’ll find out that you can’t keep up with the same workout because your body isn’t getting the chance to recover.
So how do we handle recovery?
Don’t worry, it’s not as hard as it seems (we’ll get to the gizmos later)
First, let’s look at short term recovery.
Short term recovery (for the purposes of this blog) is referring to your weekly workout routine. It’s important to give muscles time (approximately 1-3 days depending on the intensity of your workout, the level of your conditioning, and how “used” you are to your current programming) to recover before hitting them again. The heavier you go the more time your body will need. The newer you are to working out the more time your body will need. If you’re starting a completely different type of programming than you are used to, you’re likely going to need a little more time as well.
So how do you know when you’re sufficiently “recovered?”
There are some cues your body will give you to let you know. Still sore from the last workout? Give yourself a rest, workout a different area of your body, or back off the intensity. Are you no longer sore but the weight you lifted a few days ago feels a lot heavier today? Your body is telling you it needs a bit more rest. Are you feeling fatigued and not as ready as you usually are? You likely need to check in with your body before progressing your workouts. This can be frustrating, but understand that your nutrition, your hormones, your mood, your sleep, all these things play into your recovery so if you haven’t been sleeping well or you’re more stressed than usual, you may find that it’s harder to squat the same weight you did last week….if that’s the case, pushing yourself to lift even heavier is probably not the right answer. Listen to your body, drop the weight to a difficult but tolerable challenge, get a good workout, eat a healthy meal, get some sleep and come back next time ready to push.
*Caveat* As your body adapts to consistent exercise, you may find that you may need less recovery than you used to. Seasoned athletes can handle practice 4-5x a week. Seasoned Crossfit athletes are sometimes hitting the gym 5x/week. High level athletes, however, typically also have trainers, mico and macro training cycles, monitored nutrition and sleep. So before you put yourself through that kind of gauntlet, make sure you’ve given your body the time, nutrition, and consistency it needs to have adapted to that level of training.
Long-term Recovery (for the purposes of this blog) refers to the rest breaks you’ll take every couple months to give your body a good chance to fully recover from the punishment you’ve been putting it through on a consistent basis. Think of this as your clean slate. As noted above, challenging the body forces it to adapt. Eventually, you’ll likely get to the point where your body is “plateauing” and you’re finding that making big gains isn’t coming as quickly as it used to. This is a cue that A) it’s probably time to change your programming and B) it’s likely time to take a week off (note: taking a week off doesn’t mean only binging Netflix and eating bonbons.) Active rest for a week could entail any of the following – your typical workout at about 50% intensity / volume, moderately challenging yoga, or even just engaging in some low-level recreational activities such as bike riding or walking.
As for the gizmos?
Do you need to spend 30 minutes after every workout hitting the foam roller, lacrosse ball and massage gun? Probably not. Sometimes in PT we may use these for specific issues revealed by an in-depth evaluation but foam rolling your whole body after you’re done squatting is likely overkill. Are you hurting yourself by using them? No. Do they feel good? Absolutely. If you feel like they help you perform better – go for it.
The big takeaway here is to push yourself consistently and gradually, listen to your body, eat well, sleep well, take rest days throughout the week and take a week off every 2-3 months.
*As always, everybody is different. This discussion on recovery talks about general rules of thumb broadly applicable to the general public. Some people require tweaks to this approach so If you have any questions, ask your friendly PT at FX Physical Therapy and we’ll make sure you’re on the right track.
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Throughout quarantine, I have heard of so many people coming in with neck pain because they work from home. Poor ergonomic setups in home offices are finally starting to take their toll. When a joint faces prolonged stresses in the same position all day long, muscles and structures will eventually become aggravated. Much like any other joint in the body, the neck can be treated with exercise and movement.
The goal is not to be the posture police, but to describe why posturing is important. In an ideal posture position, each segment of the body is appropriately stacked over one another. This allows forces to be dispersed throughout the body evenly. When we sit in a stereotypical position such as the one below, certain segments of the neck must absorb all forces while other areas do not. This creates excess strain in one or two areas, which will cause that nagging neck pain you feel when hunched over your computer during the workday. Notice how the weight of the head is dangling in front of the body, causing our muscles and joints to work overtime in order to stop our head from succumbing to gravity. My philosophy has always been “work smarter, not harder”. By keeping in mind this principle when it comes to positioning all day, we can save our bodies a lot of wear and tear.
Left: (red shows gravity going directly through the neck)
Right: (red shows the weight of the head in front of the neck. Blue shows gravity stressing the bottom of the neck/top of the upper back)
So how do we get rid of this dull ache? The answer is simple: movement. Our bodies crave movement in all directions. If we are stuck in one position all day, certain areas of the joint move while others stay completely still. Just by taking standing breaks throughout the day, we can greatly reduce the chance of getting pain in our necks. Here are a few exercises that promote movement in areas that are stereotypically limited:
Tests to see if you are limited in your neck range of motion:
Although these exercises are generally good exercises, they might not be exactly what you need. This is when we recommend seeing a physical therapist. Any movement is good for the body. However, if you want to get better faster, have a professional assess the movements YOU need.
For a customized therapy plan to address your specific needs – Call our team today at 443-595-7798 or click here to request an appointment.
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