Do it yourself PT
by Julie R. Keen
As a physical therapist, I get asked a lot of questions about eliminating pain. Most are from regular active folks who have everyday stressors (physical and otherwise) that are contributing to suboptimal mechanics and abnormal mobility/stability, ultimately leading to pain. Although many conditions do need treatment from a qualified professional, there are many things that one can do at home with minimal equipment to enhance normal mobility, improve stability, restore normal movement patterns, and reduce or eliminate pain. So if you don’t have a specific injury, but have aches and pains in various locations, then these tips are for you.
1. Stretch
Recently there has been a backlash against static stretching. Research shows that if it is done prior to activity/sport/weightlifting it decreases power output from the muscle. Okay … but that doesn’t mean that static stretching shouldn’t be a part of your overall fitness routine? We don’t throw the baby out with the bathwater, right?
Many people have shortened muscles because of the way we live our lives. We commute 30 minutes for work, driving a car. We sit at a desk for 8 hours per day. Then another 30 minutes to get home. Add things like sitting for meals, sitting on the toilet, surfing the internet, sitting to watch TV at night and that adds up to a LOT of sitting.
Consequently, things like hamstrings and hip flexors get “tight” (short is a better term physiologically, but since most refer to muscles as “tight” we’ll go with that for now). We are on the computer, with our arms in front of us, and most of us are probably slouching for at least some of the time. Much of our time is spent reaching forward, so pectorals get tight.
I could go on and on here with various muscles. The point is that muscles will lose length if they have no reason to work through that length. This is where static stretching can help overcome this shortening. Yes, dynamic stretching is superior prior to a workout/sporting event to preserve optimal performance, but 5-15 minutes of dynamic work is generally not enough to overcome the effects of the rest of our daily activity. This is where static stretching comes into play.
- If you have muscles that limit your range of motion, then they need to be stretched.
- If your posture is sub-optimal, then you have muscles that need to be stretched.
- If you are having pain/stiffness, then you have muscles that need to be stretched.
In my fifteen years as a physical therapist, I have yet to find anyone who did not need to stretch at least one muscle. But, keep in mind, just because a muscle feels “tight” does NOT mean that it needs to be stretched. What determines a muscle’s need to stretch is its length. Common muscles needing to be stretched include: hamstrings, hip flexors/TFL, rectus femoris/quads, piriformis/glutes/deep hip rotators, pectorals, calves (gastroc and soleus), adductors, suboccipital muscles, and lats.
2. Posture, posture, posture
Your mother was right. Sit up straight. Don’t slouch. There are numerous reasons for this, the most primary related to performance being that if you are not in optimal posture, you will not have optimal movement patterns. Over time, your joints and muscles will adapt to the suboptimal posture, and that brings about a whole host of other issues.
Easier said than done though, right?
I have a simple trick to help you “remember” to maintain good posture. All it takes is a friend and a roll of athletic tape.
Step 1: Take off your shirt, and stand up tall. Don’t worry about chest out, belly in or any of that malarkey. Just imagine yourself stretching up as tall as you can be. Rotate your palms outward as much as you can (with your arms hanging by your sides). Hold your shoulderblades in this position, then relax your arms again.
Step 2: Have your friend place a strip of tape from the top of your shoulder to the top of your buttock, along the right side of your spine. Repeat on the left side of your spine.
Step 3: Put your shirt back on.
Trust me, you will feel this when you forget to maintain good posture!
Editors note: It F*%king hurts
3. Foam Roll
Yup. It’s been said many times before, everywhere you look on the internet. Get yourself a foam roller and roll. Better yet, get a foam roller, a tennis ball, a lacrosse ball, and the book The Trigger Point Therapy Workbook by Clair Davies. Find your tender spots (trigger points) and work on them. Some need a roller; some need something smaller, like a lacrosse ball (or a tennis ball if you are a wimp). The key to remember is that muscles shouldn’t be tender. If they are, then the muscle is not functioning optimally. These trigger points also refer pain to other areas, so work on tender spots that might not necessarily be close in location to your aches/pains.
4. Breathe
I know it seems silly. I mean, not breathing is not compatible with life, right? Many people don’t breathe properly though. Deep diaphragmatic breathing has many benefits from stress reduction to improving shoulder function.
Here’s a quick test to help you know if you are breathing diaphragmatically.
Step 1: Lie on your back in a comfortable position.
Step 2: Place one hand on your lower belly (just below your navel). Place the other on your chest, just below your throat.
Step 3: Breathe. Which hand is moving?
Ideally, your belly hand is moving, and your chest hand is staying still. If this is not the case, then there are some simple fixes.
Practice, practice, practice!
That’s right, you need to practice breathing. Follow the steps above, and focus on making your belly hand move. Keep your shoulders, neck, and chest relaxed. If you find that you can’t do it, flip over onto your belly. Fold your hands up by your forehead, and rest your forehead on them. Concentrate on filling your belly “balloon” and feeling it press into the floor. Imagine that your belly is a giant balloon and you are filling it with air, starting at the bottom and moving upward. Fully exhale after each breath by pulling your navel in toward your spine. Concentrate on the breathing and let all other thoughts float out of your head. Perform for 5 or so minutes.
5. Build Core Strength and Stability
I really hate the term “core,” but I haven’t found a suitable substitute. To give a “definition” so that we are all on the same page, your core is the center of your body. Your trunk. The muscles that surround your core include the abdominals (all four layers), back muscles (deep and superficial), pelvic floor muscles, and hip muscles (all – glutes, hip flexors, adductors, deep rotators, etc.).
Believe it or not, many chronic pains can be attributed to poorly functioning core muscles. If your back hurts and you haven’t sustained any injury, I’d bet your glutes are not functioning properly. I’d also bet that your abdominal muscles are involved as well. If your knee hurts, you guessed it, your core muscles are involved again. Your shoulder? Yup. Glutes, abdominals, adductors, it’s all tied together.
Many poor movement patterns are also tied to core function. Can’t squat? Yes, could be hip or ankle mobility, but also could be core strength/stability. Trouble with pushups? Core.
Think of it this way. One job of our trunk is to provide a base for the extremities. If the trunk is stable, then the arms and legs have a solid base from which to provide movement. If the trunk is unstable, the arms and legs lose efficiency, and excess strain on the joints and muscles occurs, over time causing pain and dysfunction. It’s like walking a straight line,easy to do on a firm, level, hardwood floor; but not quite as easy on a moving fun-house floor.
These are my five favorite core strengthening/stability exercises:
1. Woodchop – in tall kneeling or half kneeling.
2. Reverse woodchop – in tall kneeling or half kneeling.
3. Turkish Get-Up. Dumbbell or Kettlebell.
4. Pushup variations – start with what you CAN do and progress. If you start too difficult, you will create issues instead of fixing them.
5. Overhead DB/KB walking. Snatch a KB or DB overhead, then walk. Aim for duration versus distance. Do both sides to stay balanced.
There you have it. Follow these five tips and you’ll have less pain in no time, moving more freely, and gaining in your workouts. If not, please see a qualified professional.
A University of Connecticut graduate, Julie is a licensed physical therapist and personal trainer who specializes in corrective exercise and injury treatment/prevention. She is certified as a personal trainer through the National Strength and Conditioning Association. Find out more about Julie at her website http://www.keenfitness.com You can also reach Julie at JulieKeenPT@gmail.com
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