Purpose of Nerve Glides

What are nerve glides?

  • Nerve glides (also known as neural flossing or nerve stretching) are exercises that aim to restore mobilization of our peripheral nerves.  When a nerve is injured it won’t be able to glide normally through the surrounding sheath which can cause a sharp pain.  Similar to muscles, nerves can be stretched carefully to reduce this inflammation or compression and ultimately allow the nerves to glide normally.
  • The most common peripheral nerves affected are the median nerve, ulnar nerve, radial nerve, and the sciatic nerve.  The median, ulnar and radial nerve are located in the arms and the sciatic nerve starts in the low back and travels down the legs into the foot.
ulnar radial median nerve                sciatic nerve

How do I know if I injured a nerve?

  • Nerves can be injured very easily and it is usually pretty easy to tell when this has happened.  If you feel a sharp, shooting, stabbing, or numbing pain in the areas explained above, then there is a good chance that nerve is not gliding normally through its sheath.  This is usually caused by either the nerve being compressed or inflamed.  The most common reasons for a compressed or inflamed nerve is usually by injury or post-surgery.

Common conditions nerve glides are useful for:

Carpal Tunnel Syndrome

  • Carpal tunnel syndrome is a common disease that can cause numbness or tingling in the hand and wrist due to increased pressure on the median nerve.  By using nerve glides specific to the median nerve, you can help alleviate some of the pressure and overall reduce pain in the wrist.  Below is an example of how to perform a nerve glide for the median nerve.

median nerve glid

Start with your arm up and out to the side with a straight elbow as shown.  Your palm should be facing upwards.  Next, bend your wrist upwards as you bend your head to the side away from the target arm.  Then, bend your wrist downward as you bend your head towards the side of the target arm.

Sciatica

  • Sciatica is a common disease that causes a sharp pain that starts from the lumbar spine and travels down either one or both legs.  This sharp pain is caused by compression of the sciatic nerve located around the L4 and L5 vertebrae.  Below is an example of a nerve glide exercise that can help reduce the compression on the sciatic nerve.

sciatic nerve glide

Start by lying on your back and holding the affected leg at your knee in the air.  Then, attempt to straighten your knee.  Lastly, hold this position and then bend your ankle forward and back as shown in the photo above.

These are just two common diseases that nerve glides can be affective for.  There many different injuries and diseases that nerve glides can help treat and rehabilitate.  There are also many different ways to preform these types of nerve glides so anyone can perform them.  So, if anyone is having discomfort and thinks it is due to a compressed/inflamed nerve come get physical therapy and we can help you out!


Get Physical Therapy First!

Most of us think that physical therapy really only benefits those with orthopedic or sports related injuries, but that’s certainly not the case! Physical therapists work with patients of all ages and abilities from pediatric to geriatric and those suffering from chronic pain, disorders like Parkinson’s or Alzheimer’s, stroke, respiratory, or cardiac issues.

One of the biggest benefits to physical therapy is direct access! So you probably ask, what is direct access?

  • All 50 states in the US allow for a form of direct access, meaning that you do not need to see a family doctor before starting physical therapy…. even more reason to get physical therapy first! 
  • *It is important for you to also check with your insurance provider. Certain insurances (Medicare and Medicaid) will not pay for physical therapy without a physician referral. Your physical therapist will be able to help you with this when you call for an appointment.*

What is Physical Therapy? How can it help me?

  • Physical therapy will help you to improve your function, meet your personal goals, and get you back to the life you want to live. No matter the case or injury, PT’s are here to help!
  • PT’s will use a variety of exercise, modalities, education, and manual therapy to help you feel the best possible.

PT

Why should you get physical therapy first?

  • Getting you moving and feeling better is our number one priority. Whether you’re struggling with simple daily activities of living or want to improve your balance, posture, or optimize your workouts, we are here to help and spend full one on one time to tailor your exact needs.
  • PT’s will take a full hour during your first evaluation, assessing your complete medical history and your future goals to come up with an extensive plan for YOU to help YOU get back on track AND give you the necessary tools and education to maintain your healthiness and well-being.

Physical Therapy in a multitude of settings:

Most of us believe physical therapy to benefit those who are post surgery or strictly orthopedic injury, but here are the many settings in which physical therapy plays an important role:

  • Pediatrics
  • Geriatrics
  • ICU
  • Respiratory care
  • Cancer patients
  • Aquatic/water therapy
  • Pregnancy

There are certainly many options for seeing specialists, a family doctor, or other healthcare providers. But our goal is to help you understand why physical therapy can benefit you greatly and why you should get physical therapy first!

 


Functional Movement Screen

As a physical therapist, it’s important to utilize different methods to test a person’s strength, find their imbalances, and correct or adjust any impairments to maximize gains, thereby reducing the risk of injury. The Functional Movement Screen, also known as FMS, is a great tool to assess this with a series of different exercises.

Why FMS?

  • Many of us have a limitation or left versus right side imbalance, even with simple exercises given to us. With these imbalances at just a basic level, it’s likely that they will also affect training, conditioning, competitive events, and other advanced fitness activities which can limit our true potential.
  • FMS will simplify any concept of movement and the effect it has on the body
  • Determine the “weak links” in a person’s movement and provide corrective exercises

Five Key Words in FMS

  1. Communication – Uses very simple language to make it easy for anyone to use, as well as for therapists to communicate progress and future treatment plans
  2. Evaluation – This screen accurately identifies imbalances or limitations without the need for extensive testing
  3. Standardization – Has a functional baseline which is easy for noting advances made and easy for noting progress
  4. Safety – Quickly will identify any dangerous movement patterns to be address right away
  5. Corrective strategies – This test can be used at any fitness level to correct movement patterns and identifies particular exercises based on the individual’s score. This gives a very customized treatment plan to promote great progress

How the FMS is Scored:

  • 0 = If at any point the individual has pain with the exercise
  • 1 = unable to complete the movement pattern or get into the position to perform the exercise
  • 2 = able to complete the movement, but has to compensate in any way
  • 3 = the individual performs the exercise without any compensation

What Exercises are Used for Testing?

  1. Deep squat – assesses bilateral and symmetrical mobility of the hips, knees, and ankles. The dowel used overhead will assess the mobility of the thoracic spine and shoulders.
  2. Hurdle step – assess bilateral mobility and stability of the hips, knees, and ankles
  3. In-line lunge – assess bilateral mobility and stability, along with ankle and knee stability
  4. Shoulder mobility – assess bilateral shoulder range of motion with internal rotation and adduction, followed by external rotation with abduction
  5. Active straight leg raise – assess active hamstring and gastroc/soleus flexibility all while maintaining a stable pelvis
  6. Trunk stability push-up – assess trunk stability in a sagittal plane with a symmetrical upper extremity motion
  7. Rotational stability – used to assess multi-planar stability with a combined upper and lower extremity motion

Below, you will see a photo of examples of the exercises explained above:

 

fmsscreen

 

 


An A+ On Backpack Wearing Means An A+ For Your Posture

With only a week left before school starts, it’s a race to finish all that back to school shopping for clothes and supplies! But, the most important purchase is the backpack that your child will use every day and the proper way to wear it. There are over 40 million children in America who carry backpacks every day, but many of these students have an overloaded bag or don’t wear it properly. This can lead to neck pain, muscle spasms, tingling hands, headaches, back pain, and lead to poor posture and spine development. According to the Consumer Product Safety Commission, there were about 21,000 reports of emergency room visits for backpack related injuries.

But have no fear! The National Posture Institute has provided us with several tips for choosing backpacks and how to wear them; be sure to check them out below!

How to choose the right backpack:

  • Choose a padded bag to minimize direct pressure on the back
  • Make sure the bag is wide padded shoulder straps which will not affect circulation to the arms to cause numbness or tingling
  • Use waist and chest belts to transfer weight from back and shoulders to the trunk and pelvis
  • Multiple compartments to distribute the weight in the backpack

How to load the backpack:

  • 15% weight maximum! Ex. A child weighing 100 pounds should not wear a backpack heavier than 15 pounds
  • Load the heaviest items closest to the child’s back
  • Pack items only needed for that particular day
    • If the books and materials needed exceed the 15% weight maximum, use a book bag on wheels.

How to wear the backpack:

  • Wear both straps at all times! This will evenly distribute the weight and promote aligned posture
  • Tighten the straps so that the bag fits snugly to the child’s back, but still allowing the backpack to be put on and taken off easily. A bag that hangs loosely will strain the back muscles and pull the child backwards
  • Wear the bag over the strongest mid-back muscles and make sure it rests evenly in the middle of the back where the center of gravity is.

 

Posture is impacted by a number of factors which can include great muscle control, strength, and flexibiltiy, so get your children involved in activities that promote good posture! Sitting is a significant factor which leads to slouching. Always make sure your child sits in a correctly sized chair. Try sitting on a physio ball while completing homework or working on the computer. This instability of the ball forces the core to work and promotes great postural maintenance.

If you or your child are affected by a long school day or being stuck in that uncomfortable office chair, try these stretches!

          

Pilates and Athletes

Most people may think that athletes only work out and train during the season specific to the sport they play. But that’s certainly not the case! Pre-season workouts are extremely important for athletes and we have the answer: PILATES!

“What professional dancers discovered years ago, the NFL, NBA, MLB and more are discovering now – that Pilates is one of the best forms of conditioning a top-tier athlete can participate in.” So why is this?

  • According to Balanced Body, “Pilates’ integration of the trunk, pelvis and shoulder girdle and emphasis on proper breathing, correct spinal and pelvic alignment and smooth flowing movement allow athletes to access each part of the body individually, and become familiar with the functional mechanics.”
  • Reduces the frequency and severity of injury
    • Low back pain is frequently caused by instability of the low back, usually from an anterior pelvic tilt caused by tight hip flexors. This will shorten the lower back muscles and pull the hamstrings into a stretched position which may lead to increased injury. Pilates is an extremely successful way to release the tight hip flexors and bring the hips to a neutral position to reduce the strain on the back.
  • Pilates will increase body control
    • The reformer is designed to challenge the body in a variety of different ways, but requires a great amount of body control. Reformer Pilates gives more feedback to the athlete than traditional weights, machine-based or mat workouts. This in turn raises awareness of proprioception (where the limbs are in relation to the rest of the body) and how to correct their position when moving. Pilates will also build awareness of which muscles are working and how to activate the ‘correct’ muscles to provide movement and stability. “These motor patterns are fine-tuned through repetition over time, and are directly transferable to the gym, pitch, court course or track.”
  • Pilates will increase power output
    • The body cannot generate powerful movements from a position of instability. Increased core stability is one of greatest benefits of Pilates to allow athletes to maximize their power in the most effective way.
    • The extra stability through the hips and core that Pilates develops can allow athletes to generate power. Many Pilates exercises are unilateral, generating strength and control in unstable positions even through an athlete’s ‘weak’ side.

So, as you can see, Pilates is extremely beneficial and important for athletes especially during pre-season training, but also throughout the entire year. Below you will see this work in action with Emily who is gearing up for her soccer season beginning in a few weeks. Emily is completing a plank series and some scissor kicks to strengthen her core. Click the links to view the videos.

Scissor Kicks

Plank Series

 


Great beach workout!

Feeling guilty because you’re missing out on that workout for a beach day instead? Now you don’t have to! Follow this great beach workout so you don’t have to feel guilty for soaking up some sun and catching some waves!

1) The Beach Crawl
How to do it: On soft, dry sand, lower into a plank position. Then crawl forward on your hands and feet for 30 to 60 seconds.
Why it works: The slippery sand destabilizes your hands and feet, activating your hamstrings and glutes.

2) 10-20 Drill
How to do it: On a stretch of soft, dry sand near the water, take 10 quick running steps, followed by 20 slower running steps. Then jog back to the starting point on the hard, wet portion of the sand right along the water. Repeat two to three times.
Why it works: This simple-sounding drill activates your inner abdominal wall and works your feet, ankles, hamstrings, and glutes to steady each step and keep your body upright on soft sand. Go farther away from the water, where the sand is harder to walk on, to challenge yourself even more.

3) Sand Lunges
How to do them: Step forward with one foot. Keeping your front knee above your ankle, lower to the ground so that your back knee brushes the sand. Then push up through the front foot, lift your back foot off the ground and use it to step forward into a second lunge.
Why they work: Because the sand isn’t perfectly level, you’ll inevitably land on the inside or outside of your front foot. To keep yourself from keeling over, you’ll activate the muscles in your entire lower body.

4) Towel Wave

Grab the corners of your towel with both hands. Stand tall with your feet shoulder-width apart and your knees slightly bent. Keeping your chest up and your core braced, wave the towel up and down as if you were trying to get the sand off of it. Make the waves quick and powerful for 30 seconds.

5) Burpees

 These are a great way to get your heart rate up and also build core and upper- and lower-body strength. Keep your feet shoulder-width apart and crouch down to the sand. With your hands shoulder-width apart, jump your feet back into a plank position with your core tucked in and a flat back and neutral spine. Come down to the bottom of a push-up, push back up to plank, jump your feet forward to your original squat position, then jump up.

Keep these few tips in mind:

  • Try exercising with bare feet to give your feet and ankles a workout. But, if you have a history of weak ankles, wear shoes.
  • Always wear sun protection.
  • Don’t forget a water bottle!
  • Check your training area for any sharps or other hidden rocks.

Why Stretching is Just as Important as Exercise

Muscles, just like other tissues in our body, require proper circulation and for us to keep them healthy! We spend most of our day in the same posture. Let’s face it, most of us aren’t conscious of our posture 100% of our work day.  By not stretching, we continue to overuse and fatigue our muscles, making them short and tight.  Consequently, our body forms adhesions and connective tissue that is not needed, decreased circulation, decreased flexibility, and increased aches and pain. Stretching can help both your body and your mind and soul!

usa-olympic-athletes-stretching-05222012-03-580x435

For the body:

  • Improve your flexibility and range of motion
  • Corrects posture by lengthening tight muscles that pull areas of the body away from their intended position. Because so many of us spend time looking at computer screens or looking down at your phones, many of us have tight chest muscles which pulls the shoulders and head forward, leaving us with a hunched shoulder look
  • Potential to reduce the risk of injury by preparing muscles for work before activity
  • Increases blood and nutrient supply to the muscles to reduce muscle soreness

For the mind:

  • Just a simple, short break (5-15 minutes) of stretching can ease and calm the mind to allow your body to recharge and increase your energy level for the rest of the day
  • Pilates offers you a chance to spend an hour releasing tension, both physically and mentally

Key Tips for your Weekly Stretching

  • Focus most of your stretching after your workout. Begin your workout with a dynamic warmup to warm your muscles. Stretch hamstrings, piriformis, and quads for one minute each after the workout when your muscles are already warm
  • Include one long-duration flexibility session each week – choose your own at home flexibility program or a program such as Pilates for 45-60 minutes each week
  • Foam rolling!

Try this program and note the difference in how much healthier and amazing your body feels! 


What is Dry Needling?

Dry needling is a great way to reduce myofascial pain related to trigger points. You might ask, “how do I know what a trigger point is or if I’m a candidate for dry needling?” Trigger points are those irritating hard “knots” in a muscle that may cause pain over a large area. When a trigger point is touched, it can also cause pain in nearby areas of the body. Dry needling aims to improve this by releasing the tight muscle bands associated with these trigger points which leads to decreased pain and increased function.

Dry needling is a treatment in which a very thin needle is pushed through the skin to stimulate a trigger point. You’ll notice instant improvements in your range of motion, ease of movement, and decreased symptoms. It is also very common to experience a “twitch” in the muscle when the needle is inserted into the trigger point, which indicates that the treatment will be helpful and relieve pain.

Below, you will see a photo of Tara who received dry needling treatment for lateral epicondylitis. The needles are also connected to wires for intramuscular electrical stimulation. Intramuscular stimulation (IMS) is grounded in Western medical science and is extremely effective to release shortened muscles and treats the underlying neuropathic conditions that cause pain. IMS has a great success rate.

IMG_8660

 

Both Samantha and Mark are certified in dry needling. If you think you may be a candidate for dry needling, please ask us for more information!