Back Clinic Mobility & Flexibility: The human body retains a natural level to ensure all its structures are functioning properly. The bones, muscles, ligaments, tendons, and other tissues work together to allow a range of movement and maintaining proper fitness and balanced nutrition can help keep the body functioning properly. Great mobility means executing functional movements with no restrictions in the range of motion (ROM).
Remember that flexibility is a mobility component, but extreme flexibility really is not required to perform functional movements. A flexible person can have core strength, balance, or coordination but cannot perform the same functional movements as a person with great mobility. According to Dr. Alex Jimenez’s compilation of articles on mobility and flexibility, individuals who don’t stretch their body often can experience shortened or stiffened muscles, decreasing their ability to move effectively.
I have been travelling through Athens and now Istanbul. My 11 year old is a Percy Jackson nut and has been filling me in with the who’s who of Greek mythology and I am learning Latin words every day. Quite an education!
I looked up the word syndesmosis and the Latin translation is “(New Latin, from Greek sundesmos) bond, ligament, from sundein, meaning to bind together”. As sports injury professionals, we know syndesmosis to be the joint articulation between the tibia and the fibula bones around the ankle. These two bones are �bound’ together with very firm and strong ligaments.
Syndesmosis comes to mind after I saw a girl sprain a syndesmosis at the Archaeological Museum in Istanbul today. This poor girl was preoccupied by the hundreds of cats and kittens running all over the place and did not see the uneven cobblestones on which she placed her foot. At the same time, she turned to change direction. This is a common mechanism of injury for a syndesmosis – a forced dorsiflexion and rotation on a fixed foot.
Rehab Masterclass Issue 140 Of Sports Injury Bulletin
Of all the ankle injuries, injury to the syndesmosis is the biggest pest to sports physios and the like. And unlike simple garden variety ankle sprains that heal quickly, the syndesmosis takes a LONG time to heal properly. If you deal with athletes that are susceptible to syndesmosis sprains, I’m sure you will agree that these are harder injuries to manage because of the severe consequences if done badly.
I go into a fair bit of detail in my Sports Injury Bulletin piece about syndesmosis injuries, detailing how they happen, how to identify them and then manage them. What I would like to highlight here are the implications of mismanaging a syndesmosis sprain.
In the current issue of The Journal of Sports and Physical Therapy, a group of Japanese researchers discovered that individuals who had chronic ankle instability (CAI) had a distal fibula that was positioned more lateral compared with healthy individuals with no CAI. In effect, those who had suffered serious syndesmosis injuries in the past and ended up with a wider distance between the fibula and the tibia, suffered more ongoing ankle pain than those without a tibfib separation.
Research shows that even a 1mm displacement of the talus within the mortise (due to a wider placed fibula) can reduce the contact area in the talocrural joint by 42% (Ramsey and Hamilton 1976). Mismanaged syndesmosis injuries, resulting in an excessive amount of opening, can lead to early onset arthritic changes and chronic ankle instability. The talus bone bounces around in the now wider tibfib articulation.
A Widening Of The Fibula Is Due To One Of The Following:
Poor initial management, whereby the athlete is allowed to weight bear too early and this weight bearing forces the fibula away from the tibia as the syndesmosis ligaments are trying to heal.
The degree of damage is so severe that proper tightening of these ligaments is not possible without surgical intervention such as a screw or similar being placed between the two bones to �force’ them together.
The key for a sports injury practitioner, is to properly identify a regular ankle sprain from a more serious syndesmosis injury. If you get this part wrong and allow the athlete to get back to weight bearing too early, then expect some complaints about a chronically painful ankle some time down the track.
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Kobayashi et al (2014). �Fibular malalignment in individuals with chronic ankle instability.’ JOPST. 44(11); pp 841-910.
Ramsey and Hamilton (1976). J Bone and J Surgery Am. 58(3); 356-357.
Strengthening the spinal muscles is essential for health and fitness. Functional kettlebell training is resistance training that strengthens the spine. Kettlebell training is an extremely effective type of exercise to increase functional strength, ballistic power, endurance, and flexibility in the entire body, especially the spinal and core muscles.
(Exercise shown is Anchor Squats.)
What Exactly Are Kettlebells?
Kettlebells are round cast iron weights with a single handle. Picture a cannonball with a u-shaped handle. Kettlebells are manufactured in a wide range of weights, for all strength levels.
Muscles Used in Kettlebell Training
Kettlebell training incorporates large functional movements. Multiple muscle groups work in synergy to complete the exercises. The spinal muscles function as either the primary mover or assist the primary mover in every kettlebell exercise. The spinal muscles also stabilize the body during functional kettlebell training, thus developing the smaller supporting structures.
(Exercise shown is Push Press.)
High Reps Of High Importance In Kettlebell Training
Kettlebell training employs high repetitions, momentum, and centrifugal force. Momentum works the spinal muscles as the weight is raised and lowered. High repetitions combined with momentum and full body movement build strength and endurance in the entire musculoskeletal and cardio-vascular systems. Kettlebell training delivers aerobic and anaerobic benefits.
(Exercise shown is High Pulls.)
Always Learn From A Qualified Kettlebell Instructor
Perfect technique is mandatory during exercise. Correct exercise technique maximizes benefit and lowers injury risk. Poor exercise form increases the possibility of injury and diminishes results. Kettlebell exercises are learned motions, so you should learn proper training technique from a qualified kettlebell trainer. The trainer should demonstrate, instruct, and supervise your training and develop your routine.
(Exercise shown is Turkish Get-up.)
So Many Possibilities
The kettlebell�s shape allows for a wide variety of exercises. This resourceful exercise tool is used for basic exercises like squats (shown in slide 1), cleans, swings, high pulls (shown in slide 4), snatches and push presses (shown in slide 3). The versatility of the kettlebell is demonstrated with exercises such as renegade rows (a combination of push-ups and rows�shown in slide 6), suitcase swings, woodchoppers (a combination of lunges and oblique twists), windmills, and Turkish get-ups (shown in slide 5)
(Exercise shown is Renegade Rows.)
Kettlebell’s Benefits For The Spine
Functional kettlebell training is a rare type of exercises that increases aerobic and anaerobic health simultaneously. The benefits to the spine include increased strength, power, endurance, flexibility, function and mobility.
Physical therapists (PT’s) are healthcare professionals who treat patients of all ages with back or neck ailments. Your spine surgeon, physiatrist, orthopedist, primary care physician, neurosurgeon and your chiropractor may refer you to a physical therapist as portion of your non-operative plan of treatment. An organized physical therapy plan may be an intrinsic portion of your after-care following back surgery. PT’s practice in a variety of settings for example hospitals, outpatient clinics, rehabilitation centers, and nursing homes. �Myself, I am a Chiropractor. �There are clear differences that sometimes creates confusion, and for that reason I have posted this in order to create conversation regarding the similarities and contrasts.
Goals of Physical Therapy
The primary goals�of physical therapy include: maintain practical skill and improve, build endurance and physical strength, increase flexibility, reduce pain, and prevent impairment. PTs also instruct patients the best way to exercise to enhance overall physical fitness, move about safely (biomechanics and ergonomics), and injury prevention. Physical therapists also help patients with long-term physical incapacity (eg, spinal cord injury).
Physical therapy may contain passive modalities; the individual is administered to treatments by the PT. Modalities include myofascial release, different types of massage, ultrasound, ice or heat. Some of these treatments could be administered before lively therapeutic exercise.
Rebuild endurance, flexibility and strength after back surgery, also as specific physical needs associated with surgical aftercare.
Coordinated Care
Your physical therapist may work directly for or with your physician, therapist, chiropractor and other healthcare providers to organize aspects of your physical treatment. For instance, your doctor may send the physical therapist pertinent parts of your graph, such as present medications, your analysis, and results of imaging studies.
During the first consultation, the physical therapist talks with you about symptoms, analysis, and your medical history. Many patients with a back or neck ailment experience pain that is severe, chronic, and/or episodic. Severity the location, type, and variables that decrease or increase pain are significant, and the PT will ask you many questions regarding pain.
Education and Clinical Training
Physical therapists are healthcare professionals who passed a state licensing examination and have completed an accredited physical therapy program. The program includes medical ethics academic learning, and evidence-based medicine with clinical use outside the classroom. After graduation, a PT may advance experience and knowledge by participating in areas of their interest. Now all physical therapists graduate with a Doctor of Physical Therapy (DPT) degree.
Through the American Board of Physical Therapy Specialties, a PT can eventually be a board certified specialist in a specific area such as orthopaedics, pediatrics, or geriatrics. There are various areas of specialization.
Selecting A Physical Therapist
Many states permit you to attend a physical therapist without a physician�s referral. What questions should you keep in mind about picking out a physical therapist, even though you can definitely ask your physician for a recommendation? Listed below are some questions to consider.
What is the physical therapist�s training and educational history?
Does the physical therapist frequently treat patients with my difficulty?
How many times per week do I need physical therapy?
Will I Be provided by the physical therapist with a customized home exercise plan?
Am I comfortable with a female or male physical therapist?
Taking Charge
Bear in mind a physical therapist is a precious healthcare professional and member of your medical team. While physical therapy may be challenging or demanding at first, you are offered many benefits by a PT. It’s an opportunity to take charge of your back or neck pain, while building a stronger more resilient body.
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Source:
American Association of Physical Therapists. www.apta.org
There are 3 primary parts of exercise: cardiovascular exercise, strengthening exercises, and flexibility training. And let�s face it�those first 2 typically get more emphasis. Cardiovascular exercise (running, for example�anything which gets your pulse up) and strength training (lifting weights) come with some rather immediate outcomes. They help us build muscle and lose weight , all while helping us be more fit. It takes longer to see those advantages.
But here�s the deal: flexibility becomes more significant as you grow old. Being limber can help battle those aches and pains related to aging; stretching can help you maintain better joint health. It can also make those daily jobs�carrying groceries, going up and down stairs etc. much easier.
However, you can�t wake up when you�re 64 and unexpectedly be equally as adaptable as you were when you were 24. It�s much better and even more efficient to work flexibility training into your workout routine throughout your own life.
(Rest assured: if you are 64 and were hoping to regain some of that youthful flexibility, you can start working it in your workout routine now. Simply be realistic concerning the outcomes. You will, most likely, never be as flexible as you once were, but working on flexibility at any age is rewarding.)
Talk To Your Physician Or Physical Therapist Before Beginning A New Workout Plan
They could help you establish realistic targets and create a plan that best suits your life. You may want to think about working with a personal trainer to assist you ease into the brand new routine.
Flexibility Training Is More than Doing A Few Stretches
After a run is yes, better than nothing, doing a couple of hamstring stretches, but you won�t find as many long-term gains as you’d see from a flexibility plan that is more developed.
To get the most benefit from flexibility training, you should have a personalized program, one that takes into account your body and demands. As stated earlier, a personal trainer or physical therapist is able to help you develop the best plan for you.
And remember: the more time and attention you give to flexibility training, the more gains you�ll see�especially those long term gains.
Take Your Actions Into Account
Think, also, about your daily life: does your job involve a lot of sitting or lifting?
A personalized flexibility training program is able to help you enhance your freedom (how well your joints move) and stability (keeping good posture and body alignment during actions in order for your body isn�t under undue strain). It can allow you to excel in sports or your activities, in addition to help you take good attention to your body on a daily basis.
Give Special Focus To Muscles That Feel Tight
The shoulders, chest, hamstrings, and hips are often tight, but you may find tightness in other regions depending on harms, pressure in your lifetime, or how rough a particular workout was. By tailoring your flexibility training to your body, you�ll prevent overstretching muscles�or muscles that are lost that need consideration.
Your Body Knows What�s Best for It
Listen to your body, and don�t push it too much when you�re stretching. Instead, ease into a stretch when you�ve reached the limit of what you are able to do at that point, and understand.
Also, you need to prevent ballistic stretches�that sort of extending where you bounce in and out of the stretch. That strategy isn�t as successful holding the stretch for about 10 to 30 seconds and then as slowly stretching your muscles.
You Can Be Creative With Stretching
Within the plan that was developed for you, you can use resistance balls, towels, or other props that’ll allow you to go deeper in your stretches. Assortment will also make you more likely to stay with your flexibility training plan.
Warm Up For Stretching
You may be a bit confused�isn�t stretching a warmup? How do you warm up for stretching? This is where a brisk walk or short jog can help: get your heart pumping and your muscles limber before stretching.
Take A Flexibility Course In The Fitness Center
Assess your gym�s class program; it may be that they have a few flexibility or stretching classes. Sometimes these courses combine cardiovascular work, strength training, and flexibility work�all 3 parts of exercise in one class! Or you may take a class that�s exclusively focused on stretching.
Your Mind Can�Stretch
Pilates and yoga are outstanding flexibility training trainings. Plus, they teach you about relaxation, meditation, and other head-body techniques�ways to help calm your body and emotions, which can, subsequently, make your body more receptive to being stretched.
Stretching Is Significant for Everyone
Maybe you’ve got this bogus organization with extending�that only individuals in rehabilitation do it or that it�s only for individuals who aren�t actually in shape (that’s: it’sn�t �real� exercise). Well, it�s time to go past that misconception. Everyone should stretch. Look for inspiration or proof at Olympic and professional athletes: they know that flexibility training is a key section of peak performance.
You Must Be Consistent
It needs to be part of your routine, for stretching to be as effective as possible. This isn�t something which you do for a few weeks and after that move on. Regular stretching and flexibility work�along with cardiovascular exercise and strength training �will assist you to take good care of your own body for years to come.
Parking yourself in front of the TV may make you as likely to develop dementia as people genetically predisposed to the condition, a Canadian study suggests. In a study of more than 1,600 adults aged 65 and older, those who led a sedentary life seemed to have the same risk of developing dementia as those who carried the apolipoprotein E (APOE) gene mutation, which increases the chances of developing dementia.
Conversely, people who exercised appeared to have lower odds of developing dementia than those who didn’t, the five-year study found.
“Being inactive may completely negate the protective effects of a healthy set of genes,” said lead researcher Jennifer Heisz, an assistant professor in the department of kinesiology at McMaster University in Hamilton, Ontario.
However, the study didn’t prove that lack of exercise caused dementia risk to increase. It only found an association between the two.
Prevalence of Dementia Due to Inactivity
The APOE mutation is the strongest genetic risk factor for vascular dementia, Lewy body dementia, Parkinson’s disease and, especially, Alzheimer’s disease, the researchers said. People with a single APOE “allele” may have a three to four times increased risk of dementia than non-carriers, the study authors said. How exercise may reduce the risk for dementia isn’t known, Heisz said.
These study results, however, suggest that your physical activity level can influence your dementia risk as much as your genetics, Heisz said. “You can’t change your genes, but you can change your lifestyle,” she added.
The kind of exercise that’s best isn’t known, although the people who were physically active in the study reported walking three times a week, Heisz said.
“Which means you don’t have to train like an Olympian to get the brain health benefits of being physically active,” she said.
The report was published Jan. 10 in the Journal of Alzheimer’s Disease.
Dr. Sam Gandy directs the Center for Cognitive Health at Mount Sinai Hospital in New York City. He said the study findings aren’t “really a surprise, but it is good to see it proven.” Other scientists showed some years ago that people with the APOE mutation could virtually erase the risk of developing amyloid plaques in the brain if they became regular runners, Gandy said. Amyloid plaques are one of the hallmark signs of Alzheimer’s.
“That was an amazing report that, I believe, has been underpublicized,” Gandy said.
However, this new study suggests that if you are blessed with genes that lower your risk for Alzheimer’s, you could lose that benefit if you don’t exercise, he said.
“I cannot understand why the fear of dementia is not sufficient to induce everyone to adopt a regular exercise program,” Gandy said. “I tell all my patients that if they leave with one, and only one, piece of advice, that the one thing that they can do to reduce their risk of dementia or slow the progression of dementia is to exercise,” he said.
About 47.5 million people around the world are living with dementia, the researchers said, and that number is expected to surge to 115 million by 2050. With no known cure, there’s an urgent need to explore, identify and change lifestyle factors that can reduce dementia risk, the study authors said.
SOURCES: Jennifer Heisz, Ph.D., assistant professor, department of kinesiology, McMaster University, Hamilton, Ontario, Canada; Sam Gandy, M.D., Ph.D., director, Center for Cognitive Health, Mount Sinai Hospital, New York City; Jan. 10, 2017, Journal of Alzheimer’s Disease
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Additional Topics: Chiropractic Care for Older Adults
Chiropractic care is an alternative treatment option which focuses on the diagnosis, treatment and prevention of injuries and/or conditions associated with the musculoskeletal and nervous system, primarily the spine. Chiropractic utilizes spinal adjustments and manual manipulations to treat a variety of injuries and conditions. As people age, degenerative injuries and conditions can commonly occur. Fortunately, chiropractic treatment has been demonstrated to benefit older adults with spinal degeneration, helping to restore their original health and wellness.
Regular exercise is potent medicine for older adults with heart disease, a new American Heart Association scientific statement says.
Physical activity should be a key part of care for older adults with heart disease who want to reduce their symptoms and build their stamina, said geriatric cardiologist Dr. Daniel Forman. He’s chair of the panel that wrote the new statement.
“Many health-care providers are focused only on the medical management of diseases — such as heart failure, heart attacks, valvular heart disease and strokes — without directly focusing on helping patients maximize their physical function,” Forman said in a heart association news release.
Yet, after a heart attack or other cardiac event, patients need to gain strength. Their independence may require the ability “to lift a grocery bag and to carry it to their car,” said Forman, a professor of medicine at the University of Pittsburgh Medical Center and VA Pittsburgh Healthcare System.
“Emphasizing physical function as a fundamental part of therapy can improve older patients’ quality of life and their ability to carry out activities of daily living,” he added.
And, no one is too old to get moving. “Patients in their 70s, 80s and older can benefit,” Forman said.
Cardiac rehabilitation is a crucial tool for elderly patients, providing exercise counseling and training to promote heart health, and manage stress and depression. But Forman said it’s not prescribed often enough.
“When treating cardiac patients in their 70s, 80s and 90s, health-care providers often stress medications and procedures without considering the importance of getting patients back on their feet, which is exactly what cardiac rehabilitation programs are designed to do,” he noted.
Daily walking and tackling more chores at home also can be helpful, Forman said. Resistance training and balance training can help prevent falls. Tai chi and yoga employ strength, balance and aerobic features, he explained.
The statement also outlines ways for heart doctors to assess patients’ levels of physical functioning.
The statement was published March 23 in the journal Circulation.
Heart disease in older Americans is a growing concern because the number of people 65 and older in the United States is expected to double between 2010 and 2050.
News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services.
Exercise Beats Weight Loss At Helping Seniors Hearts
Seniors who want to give their hearts a healthy boost may want to focus on exercise first, a new study suggests.
The research found that getting active may do more for cardiovascular health in older adults than losing weight does.
“Any physical activity is positive for cardiovascular health, and in elderly people of all weights, walking, biking and housework are good ways to keep moving,” study author Dr. Klodian Dhana said in a news release from the journal European Journal of Preventive Cardiology. The findings were published in the journal on March 1.
In the study, Dhana’s team tracked 15-year outcomes for more than 5,300 people. Participants were between 55 and 97 years old, and free of heart disease when the study started.
Over the 15 years of follow-up, 16 percent of the participants developed heart problems.
In this group of older people, the researchers found no link between their body mass index (BMI) alone and heart disease. BMI is an estimate of body fat based on weight and height — the higher the number, the more fat.
However, the study did find that physical activity was tied to a lower risk of heart disease, no matter what a person’s BMI was.
“Overweight and obesity is associated with a higher risk of cardiovascular disease and it is recommended to lose weight,” said Dhana, who is a postdoctoral researcher at Erasmus University Medical Centre in Rotterdam, the Netherlands.
However, “in the elderly this is slightly different because weight loss, especially unintentional, is associated with muscle loss and death,” the researcher explained.
She said the study’s authors aren’t refuting the idea that overweight and obesity can raise heart risk in the general population.
But, “our results show that physical activity plays a crucial role in the health of middle age to elderly people,” Dhana said. “Those who are overweight and obese without adequate physical activity are at higher risk of developing cardiovascular disease.”
Expert guidelines currently recommend 150 minutes a week of moderate intensity physical activity to decrease the risk of heart disease, she said.
News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services.
Ice fishing may seem like a relaxing pastime, however, it can result in broken bones, concussions and other types of injuries, according to surgeons from the Mayo Clinic.
“Ice fishing has become more popular in the last few years, and, with this, we have seen an increase in ice fishing-related injuries,” study author Dr. Cornelius Thiels, a surgical resident, said in a hospital news release. “What is even more concerning is that ice fishing injuries tend to be more severe than injuries associated with traditional fishing,” Thiels said.
“We hope this research will bring awareness to the safety issues that surround this pastime and help prevent similar incidents,” he said.
Ice Fishing Injury Prevalence
For the study, the researchers examined ER records of visits that occurred between 2009 and 2014. Overall, they identified 85 people treated for injuries sustained while ice fishing. Ironically, burns are among the most common ice fishing injuries, the study revealed. Four of the anglers included in the study fell into the frigid water, but just as many suffered burns.
“Falling through the ice is the most feared risk of ice fishing,” Thiels said. “However, it turns out that burns are just as common, but rarely discussed. Ice fishing huts often contain rudimentary heating systems, and we have seen injuries from fires and carbon monoxide inhalation,” he said.
Nearly 50 percent of the injuries, however, were broken bones, sprains and strains. Roughly 30 percent of these ER visits involved minor trauma, including cuts, scrapes, punctures and fishing hook injuries, the study found. People hurt while ice fishing were more likely to have been drinking alcohol. They were also commonly under 40 years old, the study showed.
Most of patients treated for injuries didn’t have to stay overnight in a hospital. But at least five people had serious injuries, including concussions, loss of a limb, and organ damage.
The study was published recently in the American Journal of Emergency Medicine.
SOURCE: Mayo Clinic, news release, Feb. 14, 2017
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Additional Topics: Preventing Sports Injuries
Many athletes largely depend on chiropractic care to enhance their physical performance. New research studies have determined that aside from maintaining overall health and wellness, chiropractic can also help prevent sports injuries. Chiropractic is an alternative treatment option utilized by athletes to improve their strength, mobility and flexibility. Spinal adjustments and manual manipulations performed by a chiropractor can also help correct spinal issues, speeding up an athlete’s recovery process to help them return-to-play as soon as possible.
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
