Kachoo! Darn!! Your underwear is wet again–and maybe even your outer garment.

The problem lies in your pelvic floor. This is a group of muscles that form a sling or hammock across the opening at the bottom of your hip bones. These muscles keep the bladder, intestines, uterus (or prostate) in place and functioning properly.

Damage, trauma, and scar tissue can disrupt the pelvic floor muscle tone and cause incontinence of the bladder, or even the rectum. Age, pregnancy, childbirth with its muscle tearing or episiotomy, family history, and hormonal status all contribute to incontinence. Approximately one-third of U.S. women experience bladder leakage sometime in their lives.

You may have heard that part of the pelvic floor, your Kegel muscles, can control this bladder leakage. The problem is you have to remember to tighten them before you sneeze or cough, which is not always the first thought when those reflexes hit you. The better plan is to make the Kegel contractions a natural reaction that you don’t have to think about.

This natural response is accomplished through exercise. The routine is a tightening of the Kegel muscles, followed by their relaxation, and then a pushing outward of them.

“The problem with doing this on your own,” says Amie Stoddard with Barbieri Manual Physical Therapy, “is that people tend to instead contract their gluteal muscles or adductors (butt cheeks or rectal muscles).” If you cannot cut off your urine flow in midstream, you may need a professional to coach you. Sometimes the whole pelvic floor is in constant constriction so it may be necessary to do some therapeutic release work on the muscles to alleviate their cramping. This work is much like a vaginal exam and is pretty up close and personal, but its reward is obviously worth it.

In addition to, or even instead of incontinence, there are other signals that the pelvic floor muscles are constantly “frozen.” Since these muscles attach to the ilia, they can move these hip bones from their natural position. This can prevent you from having a flowing, easy walking gait, or a feeling of awkwardness, or having “two left feet.” This imbalance of the pelvis puts pressure on leg nerves, causing tightness of the leg muscles to the point of serious cramping. Pressure on these leg nerves can also result in real nerve pain. There may also be a sensation of cervical cramping between menses periods.

Men are affected with incontinence also, primarily due to prostate surgery. This operation can leave scar tissue that is inflexible and therefore the Kegels cannot “pinch off” the urinary tract. Sometimes nerves are damaged so that tightening messages are not received by the muscles.

Peter Barbieri says there are other contributing factors, such as a man’s occupation. A job that calls for prolonged sitting and twisting can cause muscle tension in the pelvic area, thus upsetting the pelvic floor’s muscle balance. Physical therapy once again includes locating the Kegels and then exercising them properly. Should pelvic floor muscle release be called for, the therapist utilizes an alternate port of entry than that used for women.

There are many qualified therapists who can help you regain confidence in public. The financial trade off is no more pads or diapers, plus the stress of wondering whether their absorption will be adequate next time.

References:

1. Amie Stoddard, P.T. D.P.T., Barbieri Manual Therapy

2. Peter Barbieri, P.T., Barbieri Manual Therapy

JeanAnn is a free-lance writer for health and metaphysics. Her four e-books are available at Amazon.com and BarnesNoble.com. She also does handwriting analysis and numerology.

Today, one out of three Americans will get cancer, which is the 2nd leading cause of death in the US. You don’t have to be a statistic. Boost your immune system to help prevent illness and disease, including cancer. If you are already having health challenges, having a strong immune system will maximize your body’s healing potential.

In Part I: Don’t Be a Cancer Statistic, the importance of how to detoxify/cleanse toxins from the body, and then how to rebuild with proper diet, nutrition and supplements were discussed. Detoxification and rebuilding are both crucial to health, healing at the cell level and in building a strong immune system. Reducing toxic exposure and stress reduction are also important to assure a strong immune system for vibrant health.

REDUCE YOUR TOXIC EXPOSURE: A recent report by the Columbia University School of Public Health estimated that 95 percent of cancers are caused by diet and environmental toxicity.  Studies show that there are over 287 chemicals present in a newborns’ blood with 180 of these known to cause cancer!

Here are some startling statistics:

• There are over 80,000 chemicals produced in North America

• There are over 3,000 chemicals added to our food supply.

• There are over 10,000 chemical solvents, emulsifiers and preservative used in food processing.

• There are over 1,000 new chemicals introduced each year.

Chemicals are toxic, foreign invaders to the body; they activate the immune system. The more toxins we put into the body, the harder the immune system must work. An overworked immune system eventually becomes ineffective in fighting disease and cancer. Eliminating the number of toxins that we ingest, breathe in, put on our skin or come in contact with will take stress off of the immune system. Here are some steps that can be taken to decrease your exposure to toxins.

• Water: Install water filters, both for drinking and bathing. Our water is polluted with agricultural, factory and automobile pollution chemicals, prescription and over-the counter drugs, heavy metals and human waste. All these make their way into our lakes, rivers and ground water, only to be pumped back out of the ground and be treated with more chemicals (chlorine) to purify it for safe drinking water. According to the U.S. Council of Environmental Quality, “Cancer risk among people drinking chlorinated water is 93 percent higher than among those whose water does not contain chlorine.” When you take a shower, you breathe in chlorine fumes and absorb it through your skin.

• Personal Care Products: Buy products made from natural ingredients, herbs and essential oils that are preservative free: Most toothpaste, deodorants, cosmetics, soap and shampoos, feminine hygiene products and hair dyes are filled with hundreds of chemical toxins and will increase your risk of cancer. Check out the ingredients of your toothpaste.  You may be starting your day with a hefty dose of chemicals that go directly into your bloodstream.

• Reduce Exposure to Electromagnetic Frequencies: EMFs create changes in the body on a cellular level and can cause tumors, cancer and memory problems. Use cell phone protectors & dirty electricity blockers in your home.

• Food: Eat organic whenever possible including all meats and dairy. Avoid processed foods genetically modified and irradiated foods. In other words, buy healthy whole foods and prepare meals at home as much as possible.

• Eliminate non-stick cookware: They emit toxins from the synthetic lining and usually have aluminum as their base, which will help your Alzheimer’s along. Use stainless steel.

• Reduce/eliminate use of Microwave Ovens: Microwaves cause molecular & chemical changes in the food which is detrimental to your health. It also destroys food nutrients.

• Packaging: Carcinogenic, toxic substances are transferred from plastic, aluminum foil, aluminum cans, and Styrofoam into our food and body.  Choose glass bottles, paper bags, cardboard containers and canned goods with protective enamel linings.

• Purchase environmental friendly cleaning products: Go green to get clean! Just breathing in those toxic fumes is detrimental to your health!

REDUCE EMOTIONAL & PHYSICAL STRESS: “The natural healing force within each one of us is the greatest force in getting well.”

The saying “Stress Kills” is true; it sets in motion your “fight or flight response,” to prepare the body for action. Unfortunately, many of us are continually in this stress response mode, which eventually can have a devastating effect on your physical health.

Research has now shown, beyond any reasonable doubt, that human emotions have a direct influence on the way our cells function in our body and on our DNA! Emotions can affect your health in a positive or in a destructive way, depending on the emotion; they can cause physical imbalance and make you sick or they can make you well! The energy associated with the emotion of anger will have a very different affect on your physical body compared to the emotion of joy or gratitude.

Here are a few suggestions for reducing stress and improving physical and emotional well-being:

• So-Sound Therapy: Relaxing and healing both physically and emotionally! Lie on a So-Sound table and experience a musical massage that not only feels great, but breaks the stress cycle and changes brainwaves to a meditative state and begins to balance cell energies. Certain musical tones have been proven to repair DNA! Backed by research.

• SomatoEmotional Release: Reconnect with yourself by processing emotional or physical trauma from the central nervous system. A gentle hands-on therapy that is meditative and relaxing.

• Quantum Indigo Biofeedback: Reduces stress and re-trains the body energetically while you relax on a sound table. Balances erratic body frequencies, which occurs with emotional stress, illness, injury and can help boost the immune system. Maximizes your healing potential and promotes health and well-being.

• Massage Therapy: Relaxing and both emotionally and physically healing. Try an oncology or lymphatic massage; which reduces anxiety, improves energy stimulates the lymphatic system, improves metabolism, promotes the removal of bodily toxins and waste, and encourages a healthy immune system.

• Exercise: Exercise not only improves your physical health in many ways but also helps to reduce mental tension and stress. Exercise, even just walking, also improves lymph flow which will boost your immune system.

• Yoga: Heals and balances on all levels, physically, mentally and spiritually.

• Meditation/Prayer: Quiets the mind, relaxes and reduces stress.  Settle into your heart and connect to your higher self.

• AN ATTITUDE OF GRATITUDE!

References:

1. Fitzgerald, Patricia, M.D. The Detox Solution. Illumination Press. May, 2001.

2. Bollinger, Ty. Cancer, Step Outside the Box. Infinity 510 Squared Partners. July, 2006.

3. Wolfe, David. The Longevity Now Program. www.longevitynowprogram.org.

4. Braden, Gregg. The Devine Matrix. Hay House. January, 2008.

For more info, contact Sierra Sports and Spine Healing Center at (530) 587-9355 or visit online at www.sierrahealing.com.

by Tony Jensen, D.C. |

Proper care of your nervous system can give you a head start in ensuring health and the highest level of functionality to the immune system.

In a research article entitled, “The Winsor Autopsies,” by Dr. David Winsor, studies at the University of Pennsylvania were conducted on 75 humans and 25 cat cadavers to determine if any of the causes of diseased organs were related to pinched nerves. It was found that 221 organs were diseased. In all cases, there was nearly 100 percent correlation between “…minor curvatures or pinched nerves of the spine and diseases of the internal organs.”

Pinched nerves have a recognized effect on diseases of the stomach, lung, liver, gallblader, pancreas, spleen, kidney, prostrate, bladder, the uterus and all other tissues. Your brain and nervous system control the body and immune system; they must function at 100 percent in order to fight off hits from viruses and bacteria to which you are exposed daily.
When nerve blockage occurs, the interference of messages sent to the brain might be similar to an individual trying to speak to another with a hand held over their mouth while talking. Needless to say, the person on the listening end will not receive the message clearly, only hearing muffled or distorted sounds. The presence of nerve interference in the body decreases communication between the brain and those body parts that the nervous system controls…i.e., stomach, heart, liver, lungs, and kidneys, as well as other organs, extremities and the immune system, causing a decrease in function…and with time, physical symptoms.

For example, if the communication or nerve reception going to the stomach and intestinal region is decreased, one must question how effectively the food will be digested and if it is going to deliver optimal nutritional benefits. Due to nerve interference, the stomach may require additional acid in order to properly digest or break down the food that has been consumed. However, the communication will be disrupted, leaving the brain incapable of hearing the exact message from the body. Of course, one can opt for medicinal solutions, but if the problem is a result of nerve interference, that problem is not going to be resolved, the symptoms are simply going to be masked. This allows the cycle to continue…more pills for temporary relief, but no “fixing” of the problem. If the condition is chemical in nature, medication might correct the digestive problems and they may never return. However, if the symptoms persist, the problem is most likely physical, and should be treated with a physical solution by correcting the nerve interference.

Most people are unaware that they have pinched nerves or subluxation degeneration problems. There are four phases of subluxation degeneration: Phase One Subluxation Degeneration is seen in subluxations that have been present for up to twenty years. This phase is characterized with a loss or change in the normal curve in the spine. Segmental motion may be abnormal but overall motion is not affected. More than 80 percent of people with Phase One Subluxation Degeneration have no pain. When subluxations occur and are left uncorrected, ongoing, relentless changes occur which result in damage to the structure and function of the spine, along with nerve damage and the resulting problems caused from improper nerve supply. Without correction, degeneration continues to Phases II through IV with the possibility of fusion of the diseased spinal segments.

If you or someone you care about are experiencing pain, stiffness, soreness, aching, numbness or tingling anywhere in the body, do not put off addressing the problem. Including Chiropractic Care to your health regime is a great option for proper care of your nervous system.

References:

1. Sympathetic Segmental Disorders, by Dr. Henry Winsor, November 1921
2. Phases of Subluxation Degeneration from Renaissance from 1970’s by Felessia & Riekeman.

For more info, contact Dr. Tony Jensen, DC of Jensen Chiropractic at (775) 323-1222.

by Cheryl Kiraly |

As the holidays draw to a close, we can look back over the past three months at what is probably the most unhealthy quarter of the year. Halloween: candy. Thanksgiving: food gorging (Guess on which day the largest number of Americans die of heart attack?). Thanksgiving to Christmas to New Year: office parties, dinners, meat and cakes and alcohol. The average American gains five to eight pounds in the fourth quarter of every year. Because of all the social obligations and visiting relatives, many also suspend whatever exercise regimen they may have been following. Net result? We’re heavier and more out of shape at the start of every new year.

It’s unknown who invented the New Year’s Resolution, but the practice clearly reflects a widespread understanding that we end the year badly in terms of our health and need a fresh start. Now comes the time we promise to lose weight, to join a health club, or get to the gym more if we have a membership. People try to reverse three months of decline in three hours. Whatever exercise they choose to do, most will overdo. Result? Pain, stiffness, and a willingness to give up. If you have not exercised in weeks or months, the key is to start slowly. Do something easy like walking for twenty minutes every other day. Build up your cardio slowly. Then go to the gym or start a home exercise program for toning or strength training.

Perhaps the most important component of keeping exercise pain to a minimum is massage therapy. Many people exercise, few get massage therapy. Did you know that US Olympic teams have full-time massage therapists on staff for the run-up to the Olympics and during the Olympics? Before a competition, massage loosens muscles so that they perform better, and afterward, massage squeezes toxins out of muscles, reducing much of the stiffness and pain that might otherwise result. Massage therapy will reduce the negative effects that might deter you from continuing with your exercise program. Experts say, if people make a regular commitment to massage therapy, they well experience an amazing sense of wellness and health.

Another way that frequent massage can improve our health and quality of life is by alleviating stress. More than 90% of disease is stress-related and nothing ages us faster, inside or outside, than stress. Stress-related diseases claim more lives every year. The deadly role that stress plays in modern-day life is clear. If you are able to receive stress-relieving bodywork with consistency, not only does your body benefit by releasing its aches and pains, your mind will have time to wash away the stresses of life and you learn to relax. Both are critical pieces for living long and well. You will emerge in better spirits and able to embrace whatever life presents.

References:

1. Beck, Mark F., Milady’s Theory and Practice of Therapeutic Massage, 3rd edition, Milady Publishing, Albany, NY.
2. www.wikapedia.org/wiki/massage
3. Braun, Mary Beth and Simonson, Stephanie., Introduction to Massage Therapy, Lippencot Williams & Wilkins, 2007

For more info, contact Cheryl Kiraly at (775) 772-9101.

by Dr. David Rovetti |

What happens when you have rotator cuff shoulder surgery and you cannot proceed with your planned activities and adventures such as golf, swimming, tennis, rafting and waterskiing? A torn supraspinatus tendon simply will not grow back to the insertion on the humerus by itself so the recovery period is very important. And, it can be quite painful and can hurt more each day without proper rest. Calendaring out the season’s activities, if you could heal a bit quicker than what was presented as the “average” healing time for arthroscopic* surgery, you just might be able to catch the tail end of your plans.

Plans for your healing regime can include:

• Chiropractic therapy, which is designed to expedite healing time
• Protylitic enzymes would help dissolve the tissue debris from the surgery and help clear it out of the body.
• Spinal adjustments to keep the spine stress-free and the spinal nerves working correctly.
• Omega-3 fish oil to help the cell membranes be more permeable, which also helps get more healing nutrition inside the cell.
• Fairly aggressive daily doses of Multi-Vitamins and trace minerals to make sure the body is getting all the healing building blocks.
• A fresh/raw fruit and vegetable diet.
• Low Level Laser therapy to stimulate the mitochondria in the cells to produce more ATP (cell energy).
• Every-other-day 15-minute aerobic exercise. Too much exercise can stress an already stressed body; a small amount (15 minutes, three times per week) would stimulate and increase circulation.

Another effective treatment that gives quick-recovery benefits is the Hyperbaric Oxygen Therapy (HBOT). It is a chamber that provides 1.5 atmospheres of pressure and 95-percent pure oxygen. HBOT has been shown to increase stem cells in the body, hyperoxygenates the red blood cells, plasma and all fluids of the body, provides rapid growth of new capillaries, significantly reduces inflammation, and kills bacteria. Tissues need oxygen to heal. HBOT is FDA approved for slow (i.e. diabetic) wound healing. Spending one hour in the chamber four hours before the surgery, and three one-hour daily sessions after the surgery per week is ideal. This is the HBOT protocol many plastic surgeons practice.

This treatment facilitates a strong, moving fully, and almost pain-free shoulder. This is a quick healing recommendation for anyone concerned about surgical complications and/or who wants to get back to an active life quickly after surgery.

* Arthroscopic is defined as examination of the interior of a joint, such as the knee, using a type of endoscope that is inserted into the joint through a small incision. *Orthroscopic is defined as an instrument for examining the internal structures of the eye through a layer of water that neutralizes the refraction of the cornea.

References:
1. American Journal of Physiology-Heart and Circulation Physiology, April, 2006
2. www.hboinfo.com/cosmetic_surgery.htm

For more info contact Dr. David Rovetti, DC at (775) 324-3700.

The term pelvic floor refers to the sling of muscles, ligaments, and fascia that span from the front of the pelvis at the pubic bone to the posterior pelvis at the tailbone. The purpose of this musculature is to support the pelvic organs (uterus, colon, and bladder), allow for control of the outlets (urethra and rectum) and provide tone for sensation for the sexual functions. It is important for this area to have proper muscle tone. Excess tone of the muscles can cause difficulty sitting, pain during intercourse, hip and low back pain or retention. Diminished tone may lead to incontinence, organ prolapse and possibly decreased sexual response.

Commonly, people associate pelvic floor dysfunction with incontinence, a condition where you are unable to control the evacuation of the bladder and bowels. However, there are a myriad of diagnoses that fall under this category such as overactive bladder, pelvic pain, prolapsed uterus, painful periods (dysmenorrhea), interstitial cystitis, coccyx pain, painful intercourse, and many others. Symptoms may limit a man or woman’s ability to perform daily activities, cause a change in exercise habits and create embarrassment.

Many physical therapists have specialized training that can benefit men and women with issues of the pelvic floor. These therapists utilize every aspect of their physical therapy training to evaluate patients and to provide intervention to overcome these dysfunctions. Treatments may consist of a combination of many techniques. Exercises, such as “Kegels,” strengthen the pelvic floor and greatly enhance muscle function when performed properly. Relaxation techniques may be utilized to assist with decreasing tone and pain.

Manual techniques, such as Myofascial Release and soft tissue massage are often used to relieve tension. Biofeedback is used to increase awareness of proper muscle recruitment or to quiet overactive muscles. Electrical stimulation may be used to recruit and train pelvic floor musculature or to relieve pain. Joint mobilizations are often utilized to restore pelvic alignment and motion. In addition, patient education can assist with prevention of dysfunction.

Physical therapy for the pelvic floor dysfunction is relatively new and not widely known by many medical professionals in the USA. There are only a handful of physical therapists who are trained in Pelvic Floor therapy in northern Nevada. Pelvic Floor Dysfunction is common. Numerous surgeries are advocated as an answer for many pelvic floor issues. Many are unsuccessful.

Physical therapy can provide tremendous relief for Healthcare consumers who want to take control of their symptoms and overcome them without the use of long-term drugs or surgeries.

When choosing a physical therapist for treatment of a pelvic floor dysfunction, it is important to inquire of their training, certifications, experience and outcomes to ascertain if they are qualified to treat this area. The Section on Women’s Health of the American Physical Therapy Association offers training and mentoring leading to a certificate program called the Certificate of Achievement in Pelvic Physical Therapy (CAPP). Approximately 150 PT’s have received the CAPP to date. To find a Physical Therapist who is trained to work with Pelvic Floor Dysfunction, one can contact the Section on Women’s Health of the American Physical Therapy Association.The web site is www.womenshealthapta.org. The website provides articles and resources for consumers to learn more. One can also log onto www.northtahoept.com for further information and treatment options.

References:

1. Bo, K, Sherburn M. Evaluation of Female Pelvic-Floor Muscle Function and Strength. Physical Therapy, Vol 85 ,no. 3. March 2005, 269-282.
2. Dockert, M, Abraham, K, Coe, J, Boissonnault,J. Technical Report of Specialty Practice in Women’s Health Physical Therapy. J of Section on Women’s Health Physical Therapy, 32:1, Spring 2008,13-25.

For more info, contact North Tahoe Physical Therapy at (775) 831-6600 or go to www.essencerelease.com.

Written by Sally LeDuc, PT |

Every one of us enjoys a process made simple. If we need to see a physical therapist, chances are we need some help and guidance now, not in a week or two. If the process of getting to a therapist becomes too complicated, we might forego the care and succumb to the deep-seated belief that it will just get better in time.

Most insurance companies will cover physical therapy when your doctor has made a referral to the therapist, in writing. However, depending upon your plan and carrier of that plan, getting to the therapist can sometimes become complicated. Variable obstacles quickly become a factor – therapy visits may need to be pre-authorized and you may be limited  on who you can visit. Once it has been authorized and you have worked within the limits of your health care provider list, there is still the chance your bill will not be paid in full.

For those that are not insurance driven, paying for a massage or chiropractic visit becomes routine when dealing with pain. Physical therapists, though, have more extensive training than other avenues you may seek – minimum of seven years basic education in anatomy, kinesiology, physiology, disease process, signs and symptoms, precautions, and so on. They are the musculo-skeletal experts; physical therapists treat patients who have functional limitations resulting from injury, disease, or other causes that result in disabilities or changes in health status. Therapists have the skills to differentially diagnose and to refer to the appropriate professional if necessary.

In Nevada, you can see a physical therapist without a referral and even without a pre-authorization. The law allows you to see a therapist when and if the need arises, immediately. When you have incurred a sudden sprain, strain or need some advice right away, you need to see a therapist. If you experienced that ski fall this season, slipped, fell or lifted a heavy object incorrectly, you may want to go directly to an expert.

Every clinic has its own policies and procedures, but almost every clinic will see you – just call and make an appointment. Is having to deal with insurance instead of paying out of pocket really worth it – another sleepless night and time off from work when you can quickly make an appointment?

There is no need to waste days or even weeks moving through a long process anymore. Depending on your immediate needs, whether you can do without insurance will determine which route you take. Rest assured that you now have options.

Reference:

1. http://ptboard.nv.gov

For more info, contact Sally LeDuc, PT of Body Wisdom Physical Therapy at (775) 827-3777.

By Kirk Sachtler, DPT, OCS, CMPT, CSCS |

Many common misconceptions are out there about taking care of an injury. Here are some simple tips that will speed your recovery from life’s bumps in the road.

Two Simple Acronyms to Remember:

• PRICE

• PAROM

PRICE stands for Protection, Rest, Ice, Compression, Elevation.

PAROM stands for Pain-Free Active Range of Motion.

Protection – prevent further injury by using a brace or staying off the injured part.

Rest – decrease or stop the activity of the injured part to fairly minimal levels.

Ice – cool the injured area for 20-30 minutes. Continue using ice until the pain and swelling begin to subside. Use ice for pain, heat for stiffness. Don’t reapply ice or heat until the body part has returned to its normal temperature.

Compression – using an elastic wrap can help reduce the swelling, reduce pain, protect the part, and provide needed stability for life’s activities.

Elevation – using pillows, a table, or a couch, raise the injured part until it is significantly above your heart. Do this for 10-30 minutes at a time.

Pain-Free Active Range Of Motion – while supporting the injured part, on a table for example, slide it back and forth without any strain or pain. The key is to move the joint or muscle without resistance, which will help reduce swelling, encourage natural motion, reduce pain, and speed healing.

What about anti-inflammatory medications? My recommendation is to minimize them unless the injury is disturbing your sleep. They do not actually help you heal, they block some of the pain and reduce some swelling but remember, swelling is a natural part of the healing process, and is only a problem when it persists continuously.

Be Smart and Be Well!

For more info call Kirk Sachtler at 775-787-3733.

Elongate With Stretches

By Kirk Sachtler, DPT, OCS, CMPT, CSCS |

While a common belief is that stretching before exercise will prevent various injuries, research challenges this notion. In fact, studies show that the primary time stretching prevents injury is when your range of motion is insufficient for the activity you are attempting. What does, in fact, prevent injury is improving your balance and agility, two skills that can be improved for benefit at any age.

How It Works

Balance and agility rely on three systems in your body that are coordinated by the brain. These three systems are the: Visual, Inner Ear (vestibular), and Proprioceptive Systems. The rarely talked about Proprioceptive System is a system of neurologic receptors found in joints and muscles that give feedback to the brain about their position and motion, and, is simple to train.

Studies

One study examined the effects of pre-exercise stretching on lower limb injuries during an 11-week training period with 1,538 Australian army recruits. A control (non-stretching) group and a stretching group were compared and found to have the same amount of injuries.

Another study looked at marathon runner injuries. In this review of 1,543 high level runners, 47% who stretched regularly were hurt during a one year period while only 33% of those who didn’t stretch suffered injuries.

Finally, systematic reviews of sports medicine literature showed again and again that stretching is not an antidote for injury. Much research has been done in this area and is easily accessed via the internet.

Preventing Injuries

The research shows that warm-up activities should begin with dynamic maneuvers to elevate one’s heart rate, jumping jacks for example. This should be followed by brief (5-10 second) stretches of the muscles you’ll be using, which are then followed by balance drills that warm-up your Proprioceptive System. Lastly, perform some dynamic stretches, which are maneuvers similar to your event or activity, e.g., repetitive throwing motions for a quarterback or baseball pitcher.

Consider the professional bicyclists who spin their bike for 30 minutes or more just before the start of a time trial, or the runners performing various sprinting drills before the event. Just because these people are world class athletes does not mean that you can’t use the same techniques! A great example comes from the Japanese National Volleyball Team. After running and jumping for several minutes they practice balance drills that you can do too!

Balance Drills You Can Do

Begin by standing on one leg with the goal of holding this position quietly for 30 seconds. As you improve, increase the challenge by doing this barefoot. Once you can do this, put your shoe back on and stand on a soft surface like a pillow or plush carpet. Again, to increase the challenge, do this barefoot. For a really extreme challenge try doing these drills with your eyes closed! The important part is to keep the ankle still and gradually progress the time of practice.

When To Stretch

Stretching is a fantastic, healthy activity. In fact, it is one of the best means to counteract the effects of gravity on our body. Gravity is the main reason we shrink as we age, and why our posture and joints deteriorate. The tremendous benefit of stretching is that it elongates our muscle system, which takes pressure off of our joints. This allows our body to attain better alignment and handle the stresses of gravity more efficiently.

Consider stretching as a workout of and by itself, so set aside a specific time for flexibility training. Anywhere from one to four workouts per week can give you significant gains in flexibility. And the best time for stretching is anytime when you can ensure that your body is warmed up. If you are stretching as part of athletics, stretch AFTER the event or activity.

Good Luck and Be Well!

References:

1. Thacker, Stephen et al., “The impact of Stretching on Sports Injury Risk: A systematic review of the literature.”, Medicine and Science in Sports and Exercise, 36(3):371-378 March 2004

2. “A Randomised Trial of Pre-Exercise Stretching for Prevention of Lower Limb Injury,” Medicine and Science in Sports and Exercise, Vol.32(2), pp.271-277, 2000

3. Injuries in Australian Army Recruits, Part III: The Accuracy of a PreTraining Orthopedic Screen in Predicting Ultimate Injury Outcome”, Military Medicine, Vol.162, pp.481-483,1997

4. “New Study Links Stretching with Higher Injury Rates”, Running Research News, Vol.10(3), pp.5-6, 1994

For more information call Dr. Sachtler at 775-787-3733.

A ‘Jawbreaking’ Experience

By Sally LeDuc, PT |

Telltale signs of possible Temporal Mandibular Joint (TMJ) Dysfunction (TMD) include: radiating facial, jaw, ear, or neck pain; jaw muscle stiffness; limited jaw movement or locking upon opening or closing; painful jaw clicking, grating, or popping; and headaches which often time occur after eating chewy-type foods. Interestingly enough, headaches are one of the most common reasons people seek care and can account for one-third of the outpatient visits at a neurologist’s office. One cause of headache is from clenching or grinding the teeth due to stress or jaw muscle tension.

What is the incidence of TMD?

According to the National Institute of Dental and Craniofacial Research, nearly 10 million Americans are affected by TMD with women much more likely to be affected than men; ratios from 3:1 to 9. And, about half the population report at least one telltale sign at one time or another. If signs and symptoms are ignored, the problem can become serious.

Anatomy and Physiology:  The lower jaw bone or mandible is literally suspended from the skull and articulates to the skull at the TMJ, a joint just in front of the ear. How it ‘hangs’ or how your teeth approximate to one another top to bottom and side to side is often due to muscular length and tightness. Tightness, lack of muscle tone, and ‘too much flexibility or instability’ are key contributors to dysfunction. The muscles of the head and neck as well as the muscles in the chest, shoulders, and back can contribute to imbalances that can cause TMD. In addition, almost every individual with TMD is a ‘shallow-breather’ and does not perform enough diaphragmatic breathing during the course of a day.

Today, most clinicians agree that surgery should be a last resort. There are many things that can be done to resolve and prevent TMD. Don’t ignore possible signs and symptoms. After all, managing them quickly and effectively can return you to a healthy and happy lifestyle sooner than you might think, but if left unmanaged you could have a progressively worsening condition.

A Few Simple Self-Care Tips:

1. Adhere to “Pain-free Eating” – “If it hurts to eat it, don’t eat it. Note that the pain or headache may not come on for an hour or so after you finish eating.

2. Apply ice packs to the jaw area at least 2x per day for 10 minutes.

3. Improve your Posture – You probably slouch so “Sit-up and Stand Tall.”

4. Reduce Life Stress – Avoid those and that which causes you to clench your jaw.

5. Don’t be too quick to use an over-the-counter Night Guard – it may cause more harm than good. A night guard should be designed to position the jaw so as to decrease muscle activity, not increase it, such as one with a rubbery consistency.

6. An anti-inflammatory medication may help.

7. Be careful when you yawn so that you don’t open too wide.

8. Quit gum chewing!

9. Seek guidance from a specially trained provider sooner than later.

References:

1. Hilton, L. (2007). “TMJ Therapy” retrieved from www.todayinpt.com.

2. Headache Fact Sheet. Lifting the Burden. Available at www.l-t-b.org/pages/18/index.htm.

3. National Institute of Dental and Craniofacial Research – access at www.nidcr.nih.gov.

4. Issa, T.S and Huijbregts, P.A. (2006). Physical Therapy Diagnosis and Management of a Patient with Chronic Daily Headaches: A Case Report. The Journal of Manual & Manipulative Therapy. 14(4). pp. 88-121.

For more info, call Body Wisdom Physical Therapy 775-827-3777.

DPT, CMPT, OCS, CSCS

By Sara Piccola |

There are two clearly defining qualities about Kirk Sachtler, PT, MS, DPT, OCS, CMPT, CSCS. The first is his extensive education – consisting of a masters and doctorate in physical therapy alongside board certifications in manual physical therapy and strength and conditioning specialties. The second is the depth of his experience and knowledge of athletics.

Kirk himself is the quintessential competitive athlete. He’s been a semi-pro tennis player, he is an avid skier, a cyclist, a sailor, and recently has discovered the rush of sailplanes. As a result, Kirk knows first hand the pain and disability that physical therapy patients experience. He is also a certified orthopedic specialist.

Therapeutically, Kirk’s advanced methods combine manual applications with exercise systems and the use of unique healing modalities. One of Kirk’s specialties is microcurrent and cold laser therapy. A microcurrent is an electric stimulation below the level of sensation, which helps the body heal on a cellular level. This procedure is a tissue healing technique, not pain relief. However, pain relief can occur as a result. Microcurrent therapy can be used in treating cartilage, tendons, ligaments, and muscles. And instead of masking pain, it helps to heal the injury at the level of damage. The cold laser therapy stimulates the cells to produce and increase levels of energy, speeding up the healing process and reducing inflammation.

Many of Kirk’s clients have long-standing chronic pain or unresolved injuries. Such conditions necessitate a more thorough examination of the neurological and biomechanical systems to determine what other abnormalities may be playing a role in the problem. In his practice Kirk studies and treats the body as a whole, knowing that the solution does not always lie directly where the source of pain is.

Kirk has recently re-located to a new, large office where he is able to incorporate new services and value added advancements for his clientele. The services include traditional rehabilitation therapies; new wellness based services that will not require a doctor’s request; seminars for coaches and athletes; and health and fitness classes.

The health and fitness classes will cover a wide variety of topics and are unique in their format. Classes will be shorter than an average fitness class and will include extensive education. Kirk’s objective is for his students to gain the ability to continue their exercises and treatments without an instructor. To do this, every patient needs to be highly knowledgeable about their specific situation and the process required for recovery.

As physical therapy has evolved over the years, the education process has become more and more rigorous. The internet has had a profound and beneficial impact on this educational process. Kirk notes that many of his clients now come in to his office with very good information about their conditions because of the extensive information available on the Internet.

As a result, Kirk has evolved as a practitioner as well. He has been a physical therapist for 20 years and still learns something new with every patient. Although injuries repeat themselves, the human body is always much more complicated. Kirk evaluates every patient individually with the intention that each patient will leave his care more knowledgeable than when they came in, whether the problem was resolved or not. The fact that Kirk can focus on the individual allows him to build relationships with his clients, something he truly enjoys about his career.

He first became interested in physical therapy while studying engineering and working part time in a physical rehabilitation hospital. Although Kirk was on a different path, he was immediately enticed by the personal interaction between the physical therapists and their patients, something he knew he would not experience in the engineering profession.

In addition to his passion for physical therapy, Kirk has been a volunteer ski patrol member for the last 20 years at Alpine Meadows Resort. He moved west specifically to come to the Lake Tahoe area and continues to enjoy everything the Tahoe region has to offer.

Through his personal experiences and his love for his job, Kirk improves the lives of his patients on a daily basis. He takes the issue of health very seriously; he believes in nutrition above all things, and has himself evolved alongside the alternative health industry. It is in this arena that he has chosen to focus and expand his knowledge and services, and to build his practice.

By Sally LeDuc, PT |

Could the experience of a particular pain in the abdomen, which often times feels vague but sharp, come from the vital organs located inside the abdomen?

Sure. The organs of the body (the viscera) should be soft and pliable; they should not elicit pain or feel rigid when palpated when they are functioning well. When you visit a doctor, he or she usually probes or palpates specific areas of your belly to determine whether or not an organ may be causing a problem. He or she usually asks whether or not you feel pain or tenderness. In addition to your response, the doctor is feeling for the ‘softness’ or ‘hardness’ of the organ itself.

Could tightness in the stomach, liver, gall bladder, small intestine, colon, and even the bladder and prostate cause pain?

Yes. Organs are surrounded by connective tissue called fascia and some of the organs contain smooth muscle. Muscle can cramp or spasm and fascia can tighten. As a result, the organ becomes rigid, squeezed, and its sensitive nerve structures send pain impulses to various parts of your body and to your brain. For example, the liver and gall bladder can refer pain to the right shoulder region; the spleen, stomach, and pancreas to the left shoulder region; the sigmoid colon to the left low back and sacroiliac region, and the prostate to the sacrum. Chronic or longstanding irritations can cause inflammation, disease, and lead to significant dysfunction if not treated.

Besides medication, can anything else be done to help reduce tightness and alleviate spasm?

Yes. A gentle hands-on technique administered by a specifically trained and skillful therapist can help alleviate restriction, free the organ of tightness, and allow it to expand, contract, and function more normally again; blood, lymph, and the organ’s enzymes, hormones, and necessary drainage can be restored. The technique used to treat the organs of the body is called Visceral Mobilization.

Visceral Mobilization uses manual therapy (light hand contacts) specific to particular body points to treat restriction and dysfunction. Treatment can reduce an organ’s surrounding connective tissue tightness, free the organ, and reduce the pulling-force (to other parts of the body) produced by an organ in a state of dysfunction. These forces can affect how the skeleton works and even the body’s posture.

Treatment of the viscera can reduce pain and restore the normal mobility, tone, and motion of the organ itself. Pain, felt in various regions of the body, may not be caused by the internal organs of the body. However if other types of treatment did not offer relief, an examination of the viscera may be helpful in resolving a nagging and persistent irritation.

Can digestive problems be improved with Visceral Mobilization?

Indigestion, constipation and bloating, as well as pain are symptoms that can come from restricted organs or surrounding connective tissue. If your doctor’s examination and testing has not revealed a pathologic condition for these symptoms, hands-on treatment may be helpful.

References:

1. Weiselfish, S. & Giammatteo, T. (2007). DCR Dialogues inContemporary Rehabilitation. Center for Integrative Manual Therapy and Diagnostics: Bloomfield, CT.

2. Integrative Therapeutics. Materials retrieved on 12/2/2007 from www.integrativetherapeutics.com.

For more info, call Body Wisdom Physical Therapy 775-827-3777.

What is it?

By Caren Schatz, MSPT |

Contrary to popular opinion, your Vestibular System can become injured or inflamed and Vestibular Rehabilitation Therapy (VRT) may be all that is needed. The vestibular system, or balance system, is the sensory system which provides information about your movement and sense of position. The system consists of the inner ear (small circular canals called the labyrinth), specific nerves, and a portion of the brain called the cerebellum.

A symptom associated with vestibular system dysfunction is the sense of spinning or vertigo; either you have the sense that you or your environment is spinning and you feel dizzy. Signs of injury or vestibular system inflammation may be abnormal eye movements (nystagmus), blurred vision during head movements, and a loss of balance. In addition, movement of your head will often time make the spinning or sense of dizziness worse.

Vestibular Neuritis or Neuronitis (VN) and Benign Paroxysmal Positional Vertigo (BPPM) are the two most common conditions in need of VRT. BPPV occurs when small pieces of calcium break off within the inner ear and begin to move around the circular canals of the labyrinth. These pieces move when the position of the head changes. Often times, this condition can be easily corrected by a trained professional who uses a very specific sequence of head and body positional changes to move the calcium to a place where it no longer causes dizziness. VN is usually viral and causes inflammation which produces nystagmus, nausea, and sometimes vomiting.

Following the effective use of medication, VRT involves balance and movement-coordination training, postural re-education, hands-on soft tissue mobilization, and overall body conditioning. For BPPV, a trained professional can perform the hands-on Epley(2) Maneuver to re-position the small pieces of calcium. Exercise-wise, and early on in therapy for BPPV and VN, the simple Cawthorne-Cooksey Exercises (3,4)  are most often performed; these are a progressive series of exercises which combine eye, head, and body movements in a sequence in order to re-train your balance system. When appropriate, more complex exercises involving the eyes while the head and body are moving are used to re-tune the vestibular system. These are necessary in order for you to return to such recreational activities like golf, bowling, tennis, ping-pong, driving, and bike riding.

In order to avoid vestibular system dysfunction or to fully rehabilitate your system after injury or inflammation, you may need to incorporate specific activities and even change your lifestyle. Dance, Tai Chi, Yoga, and the Martial Arts are great ways to keep your vestibular system operating well. VRT is an effective non-surgical intervention which can help you re-gain your sense of balance, restore coordination, and resolve dizziness.

References:

1. The published works of Dr. Timothy C. Hain MD, professor of Neurology, Otolaryngology, and Physical Therapy/Human Movement Science at Northwestern University Medical School, Chicago, IL.

2. Fujino, A. et. al. (1994). Vestibular Training for Benign Paroxysmal Positional Vertigo. Arch Otolaryngol HNS. 120:497-504.

3. Cawthorne, T. (1946). Vestibular Injuries. Proc R Soc Med. 39:270-272.

4. Cooksey, F.S. (1946). Rehabilitation in Vestibular Injuries. Proc R Soc Med. 39:273-275.

For more information call Body Wisdom Physical Therapy 775-827-3777.

It’s More Than Just Your Abs!

By Kirk Sachtler, PT, DPT, OCS, CMPT, CSCS |

Core Training is one of the latest buzz-words in a haze of spin designed to engage the public interest (and pocketbooks) in the world of fitness and alternative medicine. There are devices and offerings galore on TV and the Internet advertised to shape, beautify, and strengthen your core. Devices such as: the “Ab-Lounge, Ab Roller, Ab-Rocker, Abdominizer”, and programs such as P90x, 6 minute Abs, Pilates, and more abound. If you haven’t noticed (how could you not?), all of the models demonstrating these programs and products are beautiful, lean, and have chiseled abdominal muscles. The implication being that if you buy this program or that device, you will look like them!

Now don’t get me wrong, I am all for abdominal training, I just wish to clarify some important misconceptions about “Core Training”. Core Training is actually more about functional training than muscle training. In other words, it is more about the stability and control of the Abdomino-Pelvic and Lumbo-Pelvic regions during life activities, than it is about a 6-pack!

Let’s take a look at some information available to personal trainers. The NESTA (National Exercise and Sports Training Association) website offers these comments for personal trainers:

“What muscles are involved in the core?”

“The deep trunk muscles, Transversus Abdominis (TA), multifidus (MF), Internal Oblique (IO), paraspinal, pelvic floor, are key to the active support of the lumbar spine. The co-contraction of these muscles produce forces via the “thoracolumbar fascia” (TLF) and the “intra-abdominal pressure” (IAP) mechanism which stabilize the lumbar spine, and the paraspinal and MF muscles act directly to resist the forces acting on the lumbar spine.”

Unfortunately, they are leaving out many important muscles that are part of the core. In fact, nearly All the hip and thigh muscles are part of the core, and thus need to be part of one’s program.

“As a fitness professional, why is this important?”

“Before you develop any type of fitness program, your client must have a strong core foundation to eliminate or reduce any chance of injury. A strong core is essential for power transfer from the lower to upper body and upper to lower body during all physical activities. A weak core, and lack of understanding of how core function affects movement and sports performance, will lead to diminished results and a greater likelihood of injury.”

Unfortunately, there is no research to back up the comments regarding injury, but it Is true that a lack of understanding of core function affects movement performance.

What Really Is The Core?

The “Core” of the human body is actually the center of mass, roughly 1-2 inches below the belly button. It is the midpoint of weight distribution between the upper and lower sections of the body. Functionally, it is defined as the area between the pelvis and ribcage, on all sides. It includes the pelvis, ribs, spine, the femurs (thigh bones) and all the muscle units that attach to them. So, aside from the back and abdominal muscles, we also include the muscles of the hip and thigh. Muscles like the Adductor group, the Gluteals, the Hamstrings, the Iliopsoas, the Rectus Femoris, the Quadratus Lumborum, the Latissimus Dorsi.

What Does It Do?

Ah, here lies the rub and why it is so important. The significance of the core is that it must enable the body to maintain the posture that facilitates the most efficient bi-pedal locomotion. Boy, what a mouthful! That means that when one is walking your hips don’t flop up and down like a runway model or forward and back like when riding a horse. Why is this significant? Because when the pelvis flops around as described, the lumbar spine (lower back) moves excessively. The lower back and pelvis are not supposed to, they are designed to be a platform for the upper and lower parts of the body.

So How To Train “The Core”?

It’s really not that difficult and it won’t cost you three easy payments. In fact, you can use any program or equipment you already have if you add a bit of knowledge to it. The key is to eliminate any movement of the pelvis while doing any leg lift or sit-up/crunch/trunk exercise. This, of course, demands that you concentrate on the quality of the movement and stop when you can no longer maintain the right form. What is the right form? It is something we Therapists refer to as Neutral Spine. This is Not a flat back, it is the natural curve of the lower back, what we call lordosis. Understand that when the pelvis is rocking, so is the lumbar spine and this is incorrect. Whatever exercise you are doing, you must keep the pelvis still and a small curve in the lower back. If you are lying down, a small rolled up towel under the back works great.

Another critical area to address is the range of motion of the hip joints. If you have stiff hips you will be unable to adequately control the Lumbo-Pelvic motion during exercise. One must have flexibility in all directions of hip motion. So, can you sit cross-legged without slouching? Can you perform a “Lunge Maneuver” without the pelvis twisting? If not, you have work to do.

A Simple Technique

Actually, we want those chiseled abs to be of benefit, don’t you? The best way to benefit from stronger abdominal muscles is to practice to engaging them during real-life activities. How to do this? It’s very simple. Engage the abdominal muscles by pulling the belly button inward. Oops, no lifting the shoulders or sucking in your breath please! If you do this correctly, straight back, your waistband should loosen. Try maintaining this position for 5 seconds and then work up to 20 seconds. Try also to do this while walking, running, or lifting things. And yes, you do need to breathe, but that’s a subject for another article!

References:

1. NESTA website

2. Gray’s Anatomy

3. “Functional Relationships of the Lower Half,” by Richard Jackson, DPT.

4. Functional Anatomy by Pamela Levangie, PhD

For more info, contact Kirk Sachtler at Performance Physical Therapy, 775-787-3733.

Stretching is natural to all of us. Have you ever sat for a long period of time and noticed that you stretched upon rising almost unconsciously?  Stretching feels good and to stretch after prolonged sitting, standing, or bending is a way to ‘sort of re-align’ your skeleton and lengthen any tightening that occurred.

Types of Stretching

There are two basic types of stretching: 1) Static, or when you hold a stretch for 30 to 120 seconds and 2) Dynamic, or when you actively contract and then stretch a muscle group repeatedly 5 to 15 times. To effectively perform a dynamic (sometimes called ballistic) stretch it is best to use a Theraband or a large elastic band that can provide you with resistance as well as help you perform the stretch. Generally speaking, dynamic stretching should be reserved for those who have been stretching for quite some time, understand the sense of stretch, and who are free of injury.

Why Should You Stretch

Regular stretching should be a part of any exercise program. Stretching increases flexibility, improves joint range of motion, increases circulation, promotes better posture, helps prevent injury, and helps relieve stress while promoting relaxation.

When, Where, and How to Stretch

You can stretch anytime anywhere. However, it is best to warm-up prior to stretching in order to prevent injury. Although stretching can aid in the prevention of injury, it is the warm-up itself that has been shown to reduce the risk of injury (3). If you have an injury (a muscle strain) or a chronic, painful condition, modify your hold time or the intensity of your stretch so you don’t aggravate the condition. Most people do well holding stretches for 30 seconds, however some people need to hold the stretch longer. The long-term effects of stretching on range of motion have shown that those who held their stretches for 30 seconds, rather than 15 seconds, had significantly greater gains.

When you begin, stretch daily. After you have reached your intended goals, stretching every other day may be enough to maintain your flexibility.

To get the most out of your stretching, stretch until you feel a slight pulling sensation without feeling pain. If stretching is painful, the muscle is being pulled too far (too much). While you hold the stretch, the pulling sensation will subside and you will feel the muscle relax and lengthen. Always hold the stretch long enough (30-120 seconds) so that you can feel this lengthening and maximize your benefits. Last, but certainly not least, remember to breathe while you are stretching – it will help greatly!

Here’s to treating your muscles with care and improving your overall flexibility!

References:

1. Appleton, B. From Stretching and Flexibility-How to Stretch. Retrieved from www.bradapp.net.

2. The MayoClinic Foundation for Medical Education and Research (MFMER) retrieved from www.mayoclinic.com.

3. Quinn, E. (2006) from Your Guide to Sport Medicine. Retrieved from www.pubmed.gov on 9/23/2007.

4. The Stretching Guide from www.sparkpeople.com.

For more information contact Body Wisdom Physical Therapy at 775-827-3777.