Category Archives: rehabilitation

Opening Your Heart to Change

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Change is difficult, eye opening, and most of the time arrives when you least expect or desire it.

However if we open our heart to shifts in our day to day, a new level of awareness suddenly enters. Sometimes, we get into these patterns or ruts.

carmel valley

Visualize a dirt path with deep, well worn groves. For awhile this rut may serve us, enabling us to travel down a worn road with little resistance. Over time, this groove limits us to expand beyond it’s directed path, and physically may cause us pain.

motivating pelican

Usually what limits us from leaving the comfort of the directed path is fear. Our minds question the uncertain future when we step into uncharted roads. This is the time to listen to the heart. Put, your intentions and focus on where you want this new path to lead.

open heart sequence2

Maybe take a few minutes to practice some heart and chest opening stretches, while visioning where you want your new path to lead. When done consistently over a matter of weeks you will begin to notice how deeper your breaths are, more confidence in your decisions, and an ease of movement in your body.

refeclted wheel

 

What is Lumbar Stenosis?

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Unfortunately in our society Low back pain, and its associated problems, are very common stated by the National Health Institute and several research articles published in the Physical Therapy Journal. If you look on NIH’s site, you will notice there are a variety of reasons as to why Low back pain occurs. One common diagnosis is Spinal Stenosis of the low back.

Broken down, the word Stenosis means narrowing. When applied to the spine, Stenosis means a decrease of space in the spine.

lumbar spineThis narrowing of the spine typically occurs over time due to anything deceasing the space between the vertebrae and spinal canal. Some examples include: disc herniation, vertebrae stiffening, ligament thickening, bone spurs, arthritis, postural changes,  muscle strength and length imbalances.

Pain is caused by the stiffening into this position, and occasional pinching or irritation of the nerves and discs or vertebrae.

What can you do if you have Stenosis? See a Physical Therapist where you can learn exercises, to lengthen and strengthen muscles as well as assist you in getting your vertebrae moving more freely again.

To prevent it is best to start performing a daily stretching program, especially if you sit frequently, lengthening your hip flexors to avoid an anterior tug on the pelvis and spine.

For further details, and more pictures, visit NIH for their article on Spinal Stenosis.

 

New Year Brings Changes

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Hope all of you had a relaxing holiday. I enjoyed some down time with my husband and his family. The  mini break was appreciated since the first half of the year is going to be a busy one.

Berry Happy BodiesMany of you know Yoga has been a passion of mine for over a decade now. I am honored I now will have the opportunity to share my experiences and knowledge with others in a nwe way. Starting in mid January I will also be working at Embody Physical Therapy and Yoga. You can schedule an appointment with me for Physical Therapy,  Massage and soon Yoga. This clinic is very unique since we utilize Yoga and Physical Therapy techniques to help heal from pain. Please visit the website for more information on the unique and effective treatment techniques available at the clinic.

I am also starting a Yoga Teacher Training the beginning of this year, as well as additional Training’s with Rachel the owner of Embody combining Yoga and Physical Therapy for effective rehabilitation.

beach heart

 

I look forward to sharing new information and experiences in 2013, however posting might be at a slower pace depending on  time available. I will try my best to keep it consistent though.

Thank you for all the support, and Happy New Year!

Check in: What’s the status of your Hamstrings and Hip Flexors?

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During our day most of us perform repetitive motions, or sit in static positions. By itself this can can cause problems in the body. Adding to the issue, is when we then force our body to move. Usually we move with good intentions, to loose weight,  keep in shape or reduce stress for example. However, the spine and pelvis sometimes get caught in the middle of a tug of war between the hamstrings and hip flexors.

Why? First, let’s look at sitting. The Hamstrings are in a shortened position due to flexion of the knee. Your Psoas (hip flexor) is also in a shorten position because of flexion in the hip. The Rectus Femoris (hip flexor) because it crosses two joints, the pelvis and knee can tug at the pelvis, as well as place compression on the knee. Opposing forces on both sides of the body.

Now let’s look at the same person who was sitting Monday-Friday without reversing the shortened muscles throughout the week. It is Saturday morning, and with good purpose they decide to run. These shorten muscles can be a problem, especially if this individual wishes to lengthen their stride, or increase their pace.  Now during every impacting step the spine and pelvis are yanked from the front and then the back, and the opposite with the other leg. No wonder there are so many low back and knee injuries.

One way to prevent this is to reverse the static sitting throughout the day, by getting up and walking at least every hour. Also, you can add stretches throughout the day if this is available to you. If you do not feel comfortable at work stretching in your clothes. Stretch when you arrive home, or before you go to bed.

Here are some stretches for the front and the back:

Hamstrings: Important tips: Keep both legs engaged (squeeze the muscle on the front of the thigh). It does not matter how high you lift your leg, form is more important. You should not feel numbness or pain in your calf. If you do, lower your leg. You should feel the stretch in the back of the leg above the knee.

.Psoas: Important tips: Keep your abdominal muscles engaged and avoid arching through your back. You should feel the stretch in deep in your front hip on the kneeling leg. You can keep both arms on your hips, or for an additional stretch lift one arm.

As with any exercise, if you feel pain stop. For more about the hip flexors, click the link for an old post.

If you have pain running, or sitting it is best to seek out a Health Care Provider.

What happens after a Lumbar Fusion?

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There are many factors which can lead to requiring a Lumbar Fusion. In most cases Conservative Care, like Physical Therapy, is tried before surgical intervention. Some cases that can lead to Lumbar fusion are: spinal instability, continuous nerve injury, failed lami, disectomy, as well as the inability to manage severe pain.

After deciding surgery is required the next step is to decide with the surgeon on the type of surgery. The surgeon can reach the spine through either a posterior (through the back) or anterior approach. If you know the surgeon specializes in one technique, this is usually the way to go. Commonly, part of the Illiac (hip) bone is grafted for use on the spinal vertebrae to help with solidification of the components. Typically, patients complain the area of the hip is more sore than their back following surgery.

Hospital stay following the surgery can be 3- 7 days, or more, if there are complications. PT in the hospital includes learning to transfer in the bed, and rolling out of the bed in a safe manner in order to avoid disrupting the fusion. Next is sitting, and standing and then walking to a chair and around the hospital floor safely. As you heal, walks around the hospital with the therapist, will progress in length, as you can tolerate them. Before you leave the hospital you will also learn how to dress safely, take off and put on the spinal brace, and proper mechanics to move about your house when you are discharged.

After being discharged, you will not be able to drive, sit for long periods, bend, lift or twist. Remember avoid BLT. 6-10 weeks following surgery is Phase II. At this point, you should still be avoiding, BLT, and no lifting more than 10lbs.

Commonly, Physical Therapy begins 6 weeks to 3 months following surgery. PT is important to learn spinal stabilizing exercises. In both the anterior and posterior approach the spinal stabilizing muscles are retracted to gain access to the spine. It is important to strengthen these muscles for functional activities. The research is controversial on this topic but, the fusion can place additional wear and tear on the vertebrae above and below. One way to avoid that excessive movement is to perform proper mechanics and keep your spinal stabilizing muscles strong.

In phase II your walking and activity tolerance will continue to build. At PT you will continue to strengthen and lengthen any muscles that were restricted, as well as monitor you body mechanics. During this time  if you had pain down your leg it should be continuing to heal.

During phase III (12-18 weeks) you will continue increasing your activities, movement and strength. However, you will still need to avoid flexion (bending forward) and twisting.

Again, it is best to avoid this surgery in the first place because it is a long rehabilitation, and can place extra stress on the vertebrae above and below. However, if you do require surgery physical therapy can help you return back to work and your life.