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The Benefits of Dry Needling

The Benefits of Dry Needling 2560 1707 ResilientRx

Have you ever had a deep tissue knot in your shoulder or back? Or perhaps you’ve had a muscle strain or even a herniated disc that was causing you significant pain. Others may even experience nerve pain in parts of their body that physical therapy and exercise don’t seem to relieve. Rather than using different exercises or manual therapy to treat these problems alone, many PTs are turning to dry needling to help their patients recover faster and restore mobility to the body.

Dry needling can mitigate pain caused by a number of issues – arthritis, nerve pain, trigger points, ligament strains, headaches, muscle spasms, and more. Before we dive into the benefits of dry needling, though, let’s start with the basics of what dry needling actually is.

What is Dry Needling?

Dry needling can be used as a part of a comprehensive plan to help restore movement and function in the body. It’s a skilled practice that uses filiform needles to penetrate the skin and stimulate trigger points. A trigger point is a place of muscular dysfunction, causing pain and impacting mobility. They can be tender to the touch and difficult to eliminate as these tight bands of skeletal muscle can cause pain to permeate into other parts of the body. 

How do trigger points form? Inflammation builds up in muscles that are injured or overused, causing tension and depriving the muscles of oxygen which occurs from the impaired blood flow. This causes the muscle to be taut, limiting normal movement of the muscle.

How Dry Needling Works

To perform dry needling, a PT will insert super-thin needles into the skin. The needles stimulate the myofascial trigger points, creating twitches and muscle reflexes. These reflexes decrease muscle tension, reducing irritation and pain while improving flexibility. This increases blood flow to the area to promote healing.

By using dry needling, a Doctor of Physical Therapy can target these areas and stimulate them in a way they can’t do with regular physical therapy techniques. It can be painless but most people say the cramping is more of the sensation which can be slightly painful for some. Some patients also report some soreness around the needle sites for around 24-48 hours, while others don’t feel any soreness.

Benefits of Dry Needling

By inserting needles into trigger points on the body, the muscles relax, boosting blood flow, diminishing inflammation, and triggering an immune system response. There are four specific benefits to dry needling:

Relief of pain

Looking for immediate pain relief? Pain improves as blood flow is restored, moving acidic wastes away from the muscle and providing those areas with oxygen and nutrient-rich blood. Many people report immediate relief after one session, but some do require additional sessions.

Improving mobility

When you have tight knotted muscles, the tendency is to stop moving and limit your mobility and movement to avoid pain. By combining dry needling with physical therapy, strength and mobility are restored and future trigger points can be avoided.

Quicker Recovery 

Regardless of the injury or pain, restoring movement is the best way to heal and recover. While physical therapy can be the main component of treatment, adding dry needling to the treatment plan can help speed up your recovery time. 

Assists with Chronic pain

Dry needling specifically helps with chronic conditions such as back or neck pain. This can result in trigger points and tenderness. Patients with chronic pain who have had dry needling report significant pain improvement. It helps to increase blood flow to these areas that are impaired and help improve mobility

Dry Needling vs. Acupuncture 

While both dry needling and acupuncture use the same filiform needles, they are vastly different practices. Acupuncture is based on eastern medicine principles, and it’s focused on different points and meridians throughout the body. Needles are used superficially to assist with the flow of energy. Based on western medicine, dry needling inserts needles into a specific part of the muscle that is causing dysfunction and pain. 

Is Pain Holding You Back?

Are you limited in mobility and function because of pain impacting daily activities? We can evaluate your movement, strength, and function to form a plan of care, whether that’s dry needling, PT, or home exercises, that can get you back to doing the things you love. If you are struggling with pain or an injury, our physical therapists can help! Start moving again with help from ResilientRx. Book a consultation online today!

How Stress and Anxiety Affect Pain

How Stress and Anxiety Affect Pain 2560 1707 ResilientRx

Anxiety disorders, commonly associated with chronic stress, are the most common mental illnesses in the United States. In fact, anxiety disorders affect nearly 40 million adults each year. People suffering from anxiety are three to five times more likely to visit the doctor than those without anxiety disorders.

The reason?

Stress and anxiety do not just have an impact on the mind. Together, they cause or enhance chronic pain. Many of us forget that anxiety or worry can cause several painful physical symptoms — chronic fatigue, heart palpitations, muscle aches and weaknesses, headaches, and more. 

Here’s a deeper look into the impact chronic stress and anxiety have on the body.

Man really feeling how stress and anxiety affect pain

How can stress and anxiety impact pain response? 

Have you ever noticed that your muscles hurt more when you’re worried about work or family? Do you get headaches more as you think about something too much? These are all small signs of how anxiety and stress can impact our body’s pain levels.

Research has also proven that stress and anxiety can influence pain perception (how we perceive pain). Some people, when their cortisol levels spike, experience stress-induced analgesia — which suppresses our sensation of pain. 

Stress-induced hyperalgesia, on the other hand, occurs when stress, anxiety, or even fear, are already present, elevating pain and increasing intensity and duration. 

The fight or flight response affects pain

We all know the “flight or fight” response our bodies experience when we undergo stress. When our bodies activate this response, it dumps higher levels of cortisol into the bloodstream which spikes our blood sugar. Your body also experiences an increased heart rate and adrenaline output. Over a period of time, this influx of cortisol can harm your body and cause you to be more susceptible to injury and pain. 

In the fallout of this response, people tend to feel exhausted, which can heighten mental and physical ailments and decrease their immune system response. 

The nervous system and stress

Stress is very closely aligned to the nervous system. Your body’s reaction to stress can tip off pain perception in the body and, because the nervous system extends into the brain, can impact the way your body responds to pain. Over time, your body may develop a more sensitive nervous system reaction to stress and anxiety, which could be the cause of chronic pain. 

Woman sits at computer looking very stressed out and anxious because of how stress and anxiety affect pain

Common physical symptoms of stress and anxiety

The longer a person experiences chronic stress and anxiety the more intense the symptoms may be. You could equate it to heart health — the longer you eat fatty, high-sugar, and highly processed foods, the greater your chances are for heart disease. So, the more often you’re stressed, the more vulnerable your body becomes because of the wear and tear that results. 

Symptoms of stress and anxiety often go unnoticed or are mistaken for something minor. However, consistently experiencing the following systems can wear out your body. 

Fatigue

This is the most common symptom associated with stress and anxiety. Because the mind is in a constant state of alertness, it tires out much faster than the mind of someone who may not often experience stress and anxiety. Even after healthy sleep, people can still feel exhausted because of mental fatigue or the physical symptoms that come along with prolonged high-cortisol levels in the body. 

Heart palpitations

Having heart palpitations can be distressing, which may cause a continued increase in cortisol levels and can increase heart rate. Heart palpitations feel as though your heart is pounding too fast and skipping beats. 

Muscle aches and weakness

Tension is usually to blame for muscle and joint pain caused by stress and anxiety. Prolonged periods of these emotions cause muscles to tense up and leave you feeling stiff. A high level of stress consistently can impact immune system functions, making it more difficult for your body to fight off inflammation. 

Muscles also tend to become weak, especially in the legs and arms. During a fight or flight response, blood flow is increased to the limbs to make it easier to take action against a perceived threat. After the adrenaline response has ended, muscles can become sore and painful. 

Woman laying down clutching her head and stomach feeling sore from stress and anxiety

Headaches

Headaches and migraines are other common results of chronic pain and anxiety. Because other systems, such as teeth grinding, tension in the face, and poor posture often accompany stress and anxiety, prevalent headaches and migraines that are extremely painful are likely. Sharp pain or dull aches accompanied by pressure in the head and eyes are usually the headaches caused by stress and anxiety. 

Find relief for your pain

Stress and anxiety are common ailments in the U.S., but if you’re experiencing pain that you believe is associated with stress, it’s time to get help — for both your brain and your body. The key is to manage daily habits to ensure this type of pain does not get out of hand. 

If you are experiencing pain that is impacting your daily life, our team can help. With extensive training in treating patients with chronic stress and anxiety disorders, we can get you back on track to feeling calm, relaxed, and healthy in no time. 

To find relief from your chronic pain, book a free consultation today!

Understanding Insurance

Understanding Insurance 1080 1080 ResilientRx

When searching for the right physical therapy clinic, many prospective patients will want to know whether or not that practice takes their insurance. 

In fact, it’s such a common question that we receive at ResilientRx, we thought we’d make this video to help you gain a better understanding of how the insurance process typically works with PT.

What is covered anyway?

In traditional, insurance-based PT clinics, also known as in-network clinics, there can often be limitations depending upon the specific carrier and plan a patient has.

For example, there may be certain situations where some services are not covered. You could receive additional bills long after you’ve completed physical therapy or only a certain number of visits authorized by the insurance company.

And when certain services aren’t covered, or visit counts are limited, there are many times when the physical therapist has to get on the phone with someone from the insurance company, to justify medical necessity for continued services. 

This takes precious time away from what matters most: caring for our patients.

Transparent Pricing 

Since ResilientRx is out of network with all insurance carriers, we have the ability to have transparent pricing. There are no surprise bills that you’d ever receive later on. 

And we have the freedom to work with our clients on their own time, without the insurance company placing restrictions on services or the number of visits.

Deductibles

Let’s talk briefly about deductibles. A deductible is a specific amount of money that the patient must pay before an insurance company will pay for a claim. 

If you have a high deductible plan, let’s say $5000, then you may be paying out-of-pocket anyway for each visit during your entire course of PT.

Let’s say your copay (the amount you owe every visit) is $50. 

In the traditional in-network model, you are often coming 2-3 times per week and spending $100-$150 weekly.

And we’d argue that if you are not seeing a physical therapist 1:1, your visits tend to be less efficient and it may take you longer to get better.

More Efficient care

Since we only offer 1:1 care with Doctors of Physical Therapy, we feel our visits tend to be more efficient. This means our clients come less often and get better faster.

Less expense in the long-run

Less time away from work or home

Better quality care.

What’s the main takeaway?

We work for YOU and not the insurance company.

We hope you found this video to be helpful in answering any questions you may have about insurance.

Feel free to reach out to us and we’ll be happy to walk you through this process and answer any questions you may have.

How We’re Different

How We’re Different 1080 1080 ResilientRx

We’re ResilientRx- a physical therapy practice here in Austin Texas. We’ve helped hundreds of people just like you get back to doing what they love to do- while keeping them away from pain medication or surgery.

We’d like to take a moment to tell you how we’re different than your typical physical therapy practice. First, we need to take a look at how traditional PT clinics are run.

Traditional Physical Therapy

Traditional, “big box” physical therapy clinics that accept health insurance are very common in our healthcare system. Most clinics in the United States that accept insurance are designed to accommodate a high volume of patients, in order for the business to stay profitable.

The big reason these PT clinics need to see a high number of patients is because the amount that insurances reimburse these clinics for their services is often low and inconsistent.

So what tends to happen is your case is assigned to a physical therapist who can be double, triple, or quadruple booked.

They are managing multiple patients and other responsibilities all at once, which requires the use of Rehab assistance or technicians. 

Working with Rehab Assistance or Techs

Techs will spend anywhere from 30-40+ minutes with patients while the supervising physical therapist cycles through their patients for the hour, perhaps spending only 10-20 minutes with each of them.

Technicians are often high school educated with “on the job training” who hold no professional license or advanced clinical training.

Let’s think about that for a second…

The bulk of your direct care is in the hands of someone who is not a formally trained healthcare professional. Even under the watchful eye of the physical therapist in a busy clinic setting, is this something you feel you should be paying for and are comfortable with? We sure don’t think so.

Less direct care, more cost over time

What this system results in is that patients spend less time receiving direct skilled care, which usually means that more visits are required to get them feeling better and meeting their goals. 

And more visits means more cost to you in the long run, even if you have a copay.

Most patients will attend at a frequency of 2-3 times per week.

That’s 3 hours of PT per week, not counting the driving and waiting room times.

And even if you have a low-ish copay, that adds up quick.

How we’re different

Here’s where we are different: At ResilientRx, it’s just you and your Doctor of Physical Therapy. That’s it. 

No unskilled providers and no other patients sharing YOUR time.

The majority of our clients only attend PT once a week. Because you have one on one skilled care for a full hour, our treatments are more efficient and client-specific. 

You are making the effort to be here, investing your time and money to get better. Therefore we feel it is YOUR hour, not to be shared by anyone else, and to be fully customized to YOUR needs.

We offer high-quality, customized treatments and leave the filler stuff out

That means, no generic exercise sheets, no annoying egg timers going off telling you when it’s time to stop an exercise, and no more wasting time on things you can easily be doing at home. 

This may sound like a bad business model (trust us, it’s not)…but our goal is to work ourselves out of a job -to get you better as quickly as possible.

We make it easy too!

We will provide a structured plan for you, but also provide you the flexibility needed in scheduling. Life get’s hectic outside of physical therapy – we get it. We’ll meet you wherever you are at and come up with what works best for you!

Our goal is to provide you with the highest quality experience,  using a modern, evidence-based approach. 

Come experience for yourself, why we’re different.

The Benefits of Pilates

The Benefits of Pilates 4241 2810 ResilientRx

Have you tried Pilates? It could be the perfect complement to your current workout regime, or the start of one. 

Pilates may be a bit intimidating, especially when you see the equipment available in most studios. But that doesn’t mean Pilates is out of reach for you —  it’s great for people of any fitness level! With the right instructor, you can actually see a number of benefits. But first…let’s clear something up: What exactly is Pilates? And why would you want to give it a try?

What is Pilates?

Founded by Joseph Pilates in the early 1900s, Pilates was originally created for dancers and athletes. Today, though, Pilates is for everyone! That’s because Pilates focuses on lengthening and stretching all major muscle groups, centered around the core then working outward. The exercises bring the body and mind together to improve flexibility and strength throughout the entire body. 

Benefits of Pilates

Pilates is both a therapeutic and preventative exercise, perfect for anyone who wants a great workout or who is looking to recover from an injury. It brings awareness back to the breath and body, while strengthening muscles, starting in smaller areas that “normal” workouts don’t necessarily hit. We also love Pilates because it can help you elongate your spine muscles and body as a whole, which can improve posture, reduce pain, strengthen muscles, and (of course!) improve mood. 

But let’s dig into all of the technical benefits of this amazing exercise method:

Flexibility and mobility

Flexibility is the amount of stretch in a muscle, whereas mobility is the range of motion in a joint. We strive for mobility in the body, but you must have a balance of flexibility and strength to really improve your mobility overall. The great news is that Pilates helps to address both. The slow, yet fluid and controlled movements in Pilates exercises combine both strength and stretching at the same time. Plus, it feels amazing!

Core strength

When you think of your core, most of us think about just our abs, but your core is so much more than that. The core muscles include the diaphragm, deep muscles of the back and abdominals, and pelvic the floor. They support a strong back, good posture, and every movement of the body. 

With its emphasis on the core, Pilates helps to improve core strength which then has a cascading impact on every other muscle in the body. Core strength has been shown to be vital in reducing back and hip pain, pelvic floor dysfunction, and supporting “explosive movements,” like running or jumping. 

Muscle tone

As you strengthen your core with Pilates work, you will notice its impact on other parts of your body, too. For example, lower back pain which can be reduced or relieved through Pilates workouts.

Of course, this also means that you’ll notice more definition in your muscles, from your arms and legs, to smaller muscles along your side, on your shoulders, and more. It’s not just about “ripped muscles,” though. With Pilates, improving overall muscle tone can make such a difference in your daily experience — creating a body that is stronger and more flexible, reducing overall pain and improving mobility.

Injury prevention and rehabilitation

Keeping the body well-balanced is crucial for all injury prevention. Pilates helps to balance the body’s muscles so they are supple and strong. For athletes specifically, research has shown that Pilates is effective for reducing sports injuries during play, as it focuses on dynamic strength that is necessary for quick movements. 

The movements in Pilates are also considered low-impact, thanks to equipment like the reformer and the cadillac, which absorb most of the weight of the body. This means that people with joint and muscle pain or past injuries can heal without additional irritation. What’s more: as your core and strength overall improves through practicing Pilates, increased stability in the body helps to protect joints while running, jumping, or simply doing activities of daily living. This makes Pilates the perfect addition to a physical therapy regimen.

At ResilentRx, we integrate Pilates into our practice with each and every client who comes to us for physical therapy. Our Pilates instructor, Amberly Jayde, has the unique opportunity to work with our clients, knowing their past injuries and history with PT, which helps her address their specific needs during Pilates sessions. 

Sleep and stress reduction

Quality sleep is something we talk about a lot at our practice, as it is a huge factor in preventing injury and helping the body recover. Practicing Pilates regularly has been shown to lead to better sleep along with helping reduce overall stress, taking you out of that “fight-or flight” feeling.  

While general exercise helps reduce stress as it increases endorphins, Pilates also utilizes breath control. Not only does breath work address stressful feelings in the moment, but it balances the body’s autonomic nervous system which reduces the development of anxiety or depression. By integrating breath work with movement, taking time to practice Pilates can really improve your overall mental wellbeing.

Let us help

Remember, everyone’s health journey is different, but Pilates can be beneficial for you — no matter your athletic ability or fitness level.

If you are having pain that limits you in your day to day life, reach out to us for support. Our team of PTs have extensive training that addresses anything from athletic injuries and pelvic floor dysfunction to knee and hip pain. Combined with our in-studio Pilates, you’ll find whole-body care and relief. Book a free phone consultation today!

Namaste

Sleep and Athletic Performance

Sleep and Athletic Performance 1200 799 ResilientRx

Quality sleep is an important consideration when it comes to pain, injury and recovering after a workout. Research supports that individuals who get a bad night’s sleep (especially those with chronic sleep issues, insomnia, etc.) are more likely to have pain the subsequent day. In fact, two thirds of people with chronic pain suffer from sleep disturbances.

Sleep influences our pain experience and internal function.

Studies suggest that disturbances in sleep may hinder key physiological processes in the body that contribute to the development and maintenance of chronic pain, including your body’s ability to inhibit or regulate pain. A recent review showed the role poor sleep patterns can play in causing acute injury to transitioning into chronic pain in adolescents. Many of the substances in our bodies that help regulate our sleep-wake cycles such as serotonin also regulate pain signals (Andreucci, et. al, 2021). So if we constantly are in a depleted state due to lack of sleep, this can disrupt the balance of these processes in our bodies and therefore lead to persistent pain and inability to recover from an injury in a reasonable amount of time.

Poor sleep, especially over time, can also have negative impacts on things like cognitive function, emotions, immune function, energy conservation and synthesis, immune function, and cardiovascular health (Wei, et. al., 2019).

Injury Risk in the Athletic Population

Even for patients without chronic pain, the risk for overuse injury increases with lack of quality sleep. A recent 2020 study showed that less than 7 hours of sleep led to an increased injury risk in endurance athletes (Johnston, et. al., 2020). They found that there was a 2 week delay from the period of poor sleep to the time of the new injury!

Oliver, et. al. in 2009 found that for athletes with 30 hours of total sleep deprivation, they experienced a 2.9% decrease in running performance. Another study looked at 2 groups of endurance athletes performing a stationary cycle test to failure. One group had normal sleep and the other group was sleep-deprived. The athletes in the sleep-deprived group showed a 9% reduction in endurance (Temesi, et. al., 2013).

How about effects on weightlifting performance? One study showed that limited sleep to 3 hours per night for just 2 nights, reduced lifting performance in multiple upper and lower body exercises (Reilly & Piercy, 1994). Other important factors such as motor control, coordination, and athletic response time have also been shown to be negatively impacted due to lack of quality sleep, all of which can lead to injury (Mah, et. al., 2019).

The take-home message for the above examples is that with poor sleep not only are you at increased risk for injury, but your athletic performance will suffer.

Adequate sleep can increase athletic performance.

A great example of what consistently good sleep can do for you can be found in Stanford’s men’s basketball team. The players participated in a 2011 study by Mah, et. al. where they increased their sleep an average of 2 hours per night for 5-7 weeks, with the goal of getting about 10 hours of sleep per night. As a result, the team saw a 10% increase in sprint performance and 9% increase in 3-point and free-throw accuracy!

Helpful Sleep Tips
  1. Go to bed and wake up at the same times every day
  2. Go to bed and wake up at the same times every day
  3. Keep your bedroom dark and cool
  4. Limit screen time – no cell phone or TV 30-60 minutes prior to bed
  5. Keep caffeine intake to early in the day
  6. Meditation/mindfulness practices

If you are struggling with pain or an injury, physical therapy can help! We can evaluate your movement, strength, and function and come up with a plan to help get you out of pain and back to doing what you love!

Written by Nick DiSarro, PT, DPT, OCS

Sources: Wei, Y., Blanken T.F., Van Someren. Insomnia really hurts: Effect of a bad night’s sleep on pain increases with insomnia severity. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30210367/

Finan, P., Goodin, B., & Smith, M. (2013, December). The association of sleep and pain: An update and a path forward. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4046588/

Johnston, R., Cahalan, R., Bonnett, L., Maguire, M., Glasgow, P., Madigan, S., . . . Comyns, T. (2019, November 01). General health complaints and sleep associated with new injury within an endurance sporting population: A prospective study. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S1440244018308545

Oliver, S. J., Costa, R. J., Laing, S. J., Bilzon, J. L., & Walsh, N. P. (2009). One night of sleep deprivation decreases treadmill endurance performance. European journal of applied physiology, 107(2), 155-161.

https://www.academia.edu/download/43130932/One_night_of_sleep_deprivation_decreases20160227-2241-1o288ei.pdf

Andreucci, A., Groenewald, C. B., Rathleff, M. S., & Palermo, T. M. (2021). The Role of Sleep in the Transition from Acute to Chronic Musculoskeletal Pain in Youth—A Narrative Review. Children, 8(3), 241.

https://www.mdpi.com/2227-9067/8/3/241/pdf

Temesi, J., Arnal, P. J., Davranche, K., Bonnefoy, R., Levy, P., Verges, S., & Millet, G. Y. (2013). Does central fatigue explain reduced cycling after complete sleep deprivation. Med Sci Sports Exerc, 45(12), 2243-53. http://karen.davranche.free.fr/pub/Temesi,%20Arnal,%20Davranche_et_al_MSSE_2013.pdf

Reilly, T., & Piercy, M. (1994). The effect of partial sleep deprivation on weight-lifting performance. Ergonomics, 37(1), 107-115. https://pubmed.ncbi.nlm.nih.gov/8112265/

Mah, C. D., Sparks, A. J., Samaan, M. A., Souza, R. B., & Luke, A. (2019). Sleep restriction impairs maximal jump performance and joint coordination in elite athletes. Journal of sports sciences, 37(17), 1981-1988. https://pubmed.ncbi.nlm.nih.gov/31122131/

Mah, C. D., Mah, K. E., Kezirian, E. J., & Dement, W. C. (2011). The effects of sleep extension on the athletic performance of collegiate basketball players. Sleep, 34(7), 943-950. https://academic.oup.com/sleep/article/34/7/943/2596050?TB_iframe=true&width=370.8&height=658.8

Sleep for Rehab; YouTube video presentation by E3Rehab https://www.youtube.com/watch?v=OAaAnWB-3jY

Hamstring Stretch

What Causes Tight Hamstrings?

What Causes Tight Hamstrings? 1200 799 ResilientRx

Why do my hamstrings feel tight?

Is it because the muscle length is actually in a shortened state?

What about for those of us who have stretched our hamstrings regularly, but there isn’t much change in pain, how tight they feel or improvements in flexibility?

Complaints of tightness in the hamstrings and not being able to bend over and touch the toes, for example, is one of the most common complaints I’ve heard patients report in my clinical practice over the past 10 years.

Stretching can be good in some of these cases, especially if it helps alleviate pain. However, I’d estimate the majority of people with tight-feeling hamstrings don’t have a true muscle length issue, but rather, are feeling tightness for a completely different reason: their hamstrings are underloaded and hypersensitive.

Brief Hamstring Anatomy Review

The hamstrings are actually 4 muscles combined: the biceps femoris (long & short head), semimembranosus, and semitendinosus.

The hamstrings are a 2-joint muscle, originating at the ischial tuberosity of the pelvis (the bone you sit on), and inserting into the tibia and fibula bones of the lower leg. They are innervated by the sciatic nerve (more on this below).

The basic actions of the hamstrings are knee flexion and hip extension. Since the hamstrings attach to the pelvis, pelvic positioning and control can influence how the hamstrings feel and function. For example, if the pelvis tilts anteriorly excessively due to poor lumbar spine control during a weightlifting exercise, it may irritate the hamstrings or sciatic nerve.

What is Neurological Tightness?

A muscle that is truly shortened or lacking length is different from tightness that the muscle is holding due to a neurologic reason. This neurologic, or perceived tightness, happens when the nervous system is alerted to the “threat” from an injury or feels the need to continue to guard the body due to factors such instability, weakness or pain. This protective response comes 100% from the brain.

Neural structures like the sciatic nerve can be responsible for persistent hamstring tension, since its pathway lays within the hamstring bed of muscle tissue. So when there is any sort of stretch or pressure, the sensitized tissue will cause you to feel tension, pain, or even numbness & tingling.

One important thing to note about this neurologic or perceived tightness is that it is STILL tightness and not all in your head (Kuilart, et al., 2005).

Strengthen To Lengthen

  • Toe-touch progression (test/retest)
  • Reverse toe-touches
  • RDL (loaded)
  • Kickstand RDL
  • SL RDL
  • Dead Bug (to improve lumbopelvic position and control which influences the anterior and posterior muscles of the pelvis)

All of these exercises are demonstrated and explained on our YouTube channel.

Written by Nick DiSarro, PT, DPT, OCS

Sources:

Kuilart, K., Woollam, M., Barling, E., & Lucas, N. (2005, September 09). The active knee extension test and slump test in subjects with perceived hamstring tightness. Retrieved February 02, 2021, from https://www.sciencedirect.com/science/article/abs/pii/S174606890500060X

Disclaimer:

The content in this post is intended for educational purposes only. No information in this post is to be taken as medical or health advice. See a healthcare professional if you have any questions about your individual needs

Pelvis

Postpartum Urinary Incontinence

Postpartum Urinary Incontinence 1200 799 ResilientRx

Will I ever get back to working out without leaking?

“Why did I just pee all over myself after exercising?”

”I want to get back in shape after just delivering my baby!”

”Will I ever get back to working out without peeing myself?

These questions are all too common when we speak to our postpartum patients and their sentiments are completely valid! We’ve some exciting news- YES! You can get back to working out without peeing yourself!

It is critical to know that pregnancy and delivery may affect pelvic floor function, including urinary incontinence.

Particularly, the abdominal and pelvic floor muscles are stretching throughout pregnancy and during labor, which can lead to weakness and incoordination of the muscles. Due to these changes, returning to certain activities and getting around in your new postpartum body may lead to urinary leakage. Overall, the pelvic floor and core musculature may not be functional enough to support activities that increase pressure on the bladder, like running or jumping.

Types of Urinary Incontinence:

STRESS URINARY INCONTINENCE:

This is the involuntary loss of urine due to increased pressure on the bladder. This pressure can come from coughing, sneezing, jumping, running, etc. With stress incontinence, the pelvic floor muscles have to be strong enough to withstand increases in pressure.

In the clinic, I notice some clients who may think they have strong pelvic floor muscles, however they are actually over-activating or tightening their muscles and in return, the muscles become weak. It is important to note that your pelvic floor muscles need to be able to fully relax in order to fully contract. Additionally, holding your breath during physical activity also increases pressure on the abdominopelvic system which is another cause of leaking urine- don’t forget to breathe!

URGE INCONTINENCE:

This is a sudden urge to urinate and involuntary loss of urine. These urges can be associated with exposure to the cold, running water, walking by a bathroom or putting a key in a lock. Often, the muscles of the bladder contract and relax and result in urinary leakage. Urge incontinence can also be associated with frequent bad bladder habits such as going to the bathroom “just in case”. Doing this a lot can lead to mixed signals with the brain and the bladder thinking that you have to pee even when your bladder isn’t full with urine. Urge incontinence can be associated with urinary frequency or urinary urgency.

MIXED INCONTINENCE:

This is a combination of stress and urge incontinence mentioned above.

Urinary incontinence after delivering a baby is common, but that doesn’t mean you have to continue to endure this for the rest of your life.

Whatever your activity level was, is or could be, pelvic floor physical therapy can support you in getting to where you want to be. It’s all about baby steps!

If you continue to have persistent incontinence after 6 weeks from delivery, it may be a good idea to get evaluated by a pelvic floor physical therapist in order to educate yourself on your pelvic floor and learn what you can do to exercise without leaking again.

Written by: Dr. Michelle Andoy, PT, DPT,

Weight Wall

How many sets per workout?

How many sets per workout? 1200 799 ResilientRx

Are you confused on how many repetitions you should be doing when you are working out? How much weight is too much weight? Should I be doing higher repetitions or more weight?

Many people work out regularly and wonder why they aren’t getting the results they want. How do you figure it out? Well, the big question that needs answering is: what are you trying to accomplish? Depending on your answer, you will change the way you train.

The different ways to progress or begin an exercise program are based upon two things: weight + repetitions.

The below image is the Holten curve which describes how to gauge your weight and repetitions:

Strength training is based upon 1 repetition max. This is the amount of weight that you can lift once before you experience max fatigue. It is hard to do this without causing potential injury if you have not lifted heavy before.

The best way to determine this is how many repetitions you can complete before your maximum fatigue (i.e. when you physically cannot do it anymore).

For example, if you can complete 20 repetitions, you are more focused on endurance and if you can complete only 8, then you are focusing on building strength.

We will dive into this more below:

Higher repetitions and lower weight: targets endurance and improves blood flow (vascularity)

This is ideal If you are starting a new exercise routine. First, you want to make sure you can perform the exercise properly without any weight.

It is important to master the form because adding load (weight) to the exercise can increase the potential for injury.

In this case, you would do higher repetitions (like 20 repetitions) with lower weight. As you can see on the curve, you are targeting more endurance while focusing on your form.

Higher weight and lower repetitions: builds strength

Once you have mastered your form, moving on to strength building is ideal. For example, if you can perform a proper squat without limitations, you could start add weight.

It’s important to note that even when you add weight to your exercises, the switch from high repetitions (endurance) to low reparations (strength building) isn’t a sprint! When you are ready, add weight on little by little. With that weight added, it can still be good to first start with higher repetitions until you can reassess and can lock down proper form with your new weight.

Once you have done that, you can continue to load heavier and you will slowly shift from endurance training to strength training.

For example, if you max fatigue at 8 repetitions, you are in your ideal zone for building strength.

Keep in mind, everyone is different. If you are having any concerns about your exercise form or experiencing limitations in your exercise program, reach out to us. We have extensive experience in helping people return to their normal fitness routines safely.

Written by Mary Grimberg, PT, DPT, OCS

Self Care

Why is Self Care Important?

Why is Self Care Important? 1200 799 ResilientRx
Surprise– eating clean and exercising doesn’t make you a “healthy” person.

Healthy living is beyond exercising.

Living healthily is a conscious effort to take care of your physical body and mental health. “Self-care” is a phrase you have probably heard often, especially lately, and with good reason! Self-care addresses your physical health- lack of sleep, limited exercise, diet, etc., as well as mental health- stress, relationships, life changes, etc.

We have two main automatic regulatory nervous systems (autonomic nervous system):

  • the sympathetic nervous system
  • parasympathetic nervous systems

These systems help to regulate breathing, digestion, heart rate, etc. without a conscious effort. In other words, these things happen without us thinking about them or deciding they will happen.

The sympathetic nervous system is known as the stress response. You may have heard of this as the “fight or flight” response. The parasympathetic is the “rest and digest” response- the system that calms you down.

Here is an example of how the sympathetic nervous system works:

Imagine being stuck in traffic when you are late to work. You might start to clench your jaw or grip your steering wheel. In that moment you are feeding your body stress.

This stress activates the sympathetic nervous system and causes the body to tense up and release cortisol. Cortisol is released during any stressful event from the adrenal glands that sit above the kidneys.

Whether you are stuck in traffic or being chased by a tiger, bodies react in the same way.

Chronically stressing our bodies, can cause:

Keep this in mind if you are experiencing chronic pain. It could be caused by stress and not just misalignment. Although there are many things that are out of our control, you can use some of the tips below to help manage your stress.

Tips on reducing stress:

  • Diaphragmatic breathing: Place your hand on your chest and your lower belly/ribs. As you inhale, feel your lower belly and ribs expand. This helps to activate the parasympathetic nervous system
  • Planning ahead: Try to avoid running late when possible. This gives you ample time to get you’re your destination without being stressed by traffic and other factors that you cannot control.
  • Mindfulness: Check in with yourself, do you feel tense in your body? Take a minute to breath and ask yourself why you are tense and focus on relaxing the muscles that feel tense.
  • Avoid foods high in sugar: Try to maintain your blood sugar levels. Eating too much sugar and caffeine can spike your cortisol levels.
  • Exercise: Go on a 15 to 20-minute walk outside in the sun. This will help to calm your sympathetic nervous system. (Zankert S., Kudielka, B., Wust, S., 2020)

Of course, this just scratches the surface and we are here to help along the way! Stress can also exacerbate issues with your physical body that you might already have. In our office, we look at our clients holistically to see how all elements can add or take away from feeling your best. Ready to start feeling better? Book an appointment with us now!

Written by: Mary Grimberg PT, DPT, OCS

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