In June Momentum Sports Rehab will be offering Intramuscular Manual Therapy(IMT)/Trigger point Dry Needling(TDN). This is a treatment that utilizes acupuncture needles applied to trigger points to reduce pain, spasm and restore function. Acupuncture and dry needling techniques are similar, but their rationale and use in treatment are different. IMT is therefore not to be confused with traditional acupuncture.
The best holistic treatment for non operative orthopedic injuries, is your body’s natural healing ability. The difficulty with that treatment is that it takes time, patience, and discipline. Time for your body to repair the injured area, patience because of that time, and discipline to avoid activities that further irritate the injured tissues.
Unfortunately most of us are not that patient, or disciplined, to allow that time or to avoid activities that irritate the injured areas. Our busy lives get in the way, as do our reliance on medication. We take medications to allow us to do the things we want to do. The problem is medications often do not heal the injury they just control the symptoms.
What can we do other than just give it time? Well that is where PT comes in to place, particularly the PT we do at Momentum Sports Rehab. Through exercises, manual techniques and activity modification we assist the healing process by optimizing joint position, biomechanics and efficiency of movement. By doing this we increase function, mobility while allowing the body to heal the damaged tissues.
The hardest part is having the patience it takes to give your body time to heal and the discipline to avoid the movements or activities that cause irritation. I repeated that statement because that is how difficult it is to do. Its best not to look for shortcuts or solutions that takes the least amount of effort as they will likely yield lesser long term results.
2012 is here and many of us have made resolutions and a majority of them will have to do with working out/losing weight. So, I thought I might list several ways to help in keeping those resolutions and meeting those goals.
First the best way to make the process of losing weight the easiest is to increase your metabolism. A few ways to do that…
1) Eat high metabolic demand foods such as berries.
2) Eat a small handful (~7) almonds an hour before a meal. Almonds help increase your metabolism and are a natural appetite suppressant.
3) Break up your cardio workouts to twice per day. Studies show that 2 twenty minute bouts of cardio exercise stimulate greater weight loss than one 40 minute bout.
Cutting Calories
1) Do not skip breakfast. People who skip breakfast typical snack more and take in more calories per day than people who eat breakfast.
2) Don’t just eat one breakfast, eat two. Eat a boiled egg and piece of toast then in an hour or two eat some yogurt and berries.
3) Eat a salad before lunch and dinner. Those who eat a salad before a meal consume 15-20% fewer total calories.
Often we are lead to believe that fancy equipment or elaborate exercises are necessary for state of the art rehabilitation. While the shine of a new toy or gadget is intriguing it leads me to consider Occam’s Razor. The simplest solution is most often the correct one. Now fancy PT equipment or machines won’t inhibit your progress but it won’t significantly speed it up either.
What do you need then? The thing that is essential, is an astute understanding of joint mechanics and the mechanics of the movements that are restricted, impaired or no longer able to be performed. Once you compare how things are currently working with how they need to work it becomes a matter of simply improving the deficits. Whether that it is strengthening weak muscles, stretching tight muscles or decreasing scar tissue or adhesions.
Once identified things are straight forward and fairlly easy to remedy assuming patient compliance and the absence of significant predisposing medical problems that may inhibit healing. For strengthening resistance training can be achieved with weight lifting equipment, body weight , resistance bands etc.
I opt typically to use exercises that utilize body weight resistance. This way the patient is able to replicate the same exercises at home, work or wherever. Also the patient does not become dependent upon the PT or facility to be able to continue progressing toward their ultimate rehab goal(s).
It has always been my opinion that the most important Physical Therapy equipment needed for the best possible care is the PT him or herself. Look for that person versus fancy machines or gadgets. Also consider that the best PT care is not always the closest. Don’t choose your PT facility solely based on proximity. In the long run it will cost you much more than the extra few miles you may have to drive initially.
My words of wisdom for the start of 2012.
Chris Hohmann, MPT
I have recently been asked to review a potential alternative medicine treatment. I will not mention which one in particular. As I began researching I found numerous claims and lots of testimonials on the treatment. The substance of the treatment is basically a secret. As a clinician I also have to pay for the information about the treatment. The only way anyone can find out what the actual treatment is, is by paying for it. There isn’t any research available to support the treatment.
The moral to this story is that if a treatment claims extraordinary results but offers no proof, be very skeptical.
Another way to check quickly if there is any evidence to support a treatment, check with your insurance company. They usually have a ruling on most treatments. It is not a hard and fast rule that if your insurance company will not pay for the treatment that it is not a viable treatment. Using that information and your own research, if the treatment in question raises suspicion then it is likely it is very questionable and not worth the money you will have to pay out of pocket.
Well Summer is upon us and so are the high temps. With high temps and low humidity dehydration is a quick little beastie that will sneak up on us. If you are outside for more than 30 minutes you should be ingesting at least 8 ounces of water. If you are exercising or doing yard work, double it!
Another thing to think about particularly during the summer is your diet. This can help significantly with fighting that beastie dehydration. Fruits and vegetables are chock full of water and good carbohydrates not to mention they are good for you.
A high protein diet will make you much more prone to dehydration than a balanced diet. Protein requires water in order to break it down from its complex form to the amino acid form your body can use. Therefore if you eat a high protein diet you will need to drink even more water than a person with a balanced diet.
In a previous post I gave readers a simple recipe for making their own inexpensive sports drink. I will post it again with just a slight variation. If you can tell me what that variation is you may claim a Momentum Sports Rehab water bottle with the sports drink in its original recipe.
1.75 cups of sugar
4 ounces of lemon or lime juice, fresh squeezed is the best, but out of the bottle is fine too
3/4 to 1 teaspoon of Morton’s Lite Salt (trademarked)…to desired taste.
1 gallon of water
This is a healthy and cheap way to provide sports drinks to the baseball, football, volleyball, soccer or any other teams you or your kiddo’s are on. Not to mention it is far more environmentally friendly than having all those plastic sports drink bottles lying on the ground. I typically have a plethera of plastic reusable cups on hand for the kids. The other option is tell them in advance to bring their own water bottles full of water and once empty they can refill with your sports drink. Another way to encourage them to stay hydrated.
Food, or more aptly water for thought.
The other night we went to a major league baseball game. In the middle of the game a thunderstorm rolled in and we got soaked. With a 30 min delay already under our belts and the thunder and lightning persisting we decided to call it a night and walk back to the Jeep.
As you might suspect there were numerous puddles and wet feet were inevitable. As we walked I began to wonder if my wet feet combined with the long walk and no socks was going to produce blisters. From the centerfield bleachers all the way around the stadium and out to the parking lot not a single blister was formed.
The other thing I discovered was that even with being a leather shoe it dried incredibly fast. In the 30 minutes it took to drive home the shoes had dried half the way. By half way I mean the only wet portions of leather were around the toes. Ten minutes of sitting under the ceiling fan and they were dry. It was actually pretty incredible how quickly they dried.
There are a few differences between the two brands. The main similarity is that they are both minimalist type shoes that encourage forefoot landing at initial contact versus a traditional shoe in which the heel contacts the ground first.
The Fila Skeletoes differ from the Vibram’s with their EZ slide feature. This is basically a compartment that fits the 4th and 5th toes. Consequently these are the most difficult toes to get into the Vibram’s.
I purchased a pair of Fila’s for my son who had been begging for the “toe shoes,” as he calls them, long before I decided to try out the Five Finger Vibram’s. One thing I noticed is that they did not breath as well as the Vibram’s and within a week or so they definitely developed some distinct foot odor. After having the shoes for less than two weeks the footbed began to separate from the material that covers the top of the foot. We took them back and exchanged them for a new pair. Sadly the same problem arose within a week of daily use by my son.
I have not been terribly satisfied with the quality of the Fila’s and have decided to purchase him either a pair of sport sandals or see if I can find a pair of more reasonably priced Vibram’s. My advice is that if you are truly interested in giving the minimalist shoes a try, bite the financial bullet and go with the Vibram’s. They are 1.5x’s the cost but are likely more than twice the quality based on my brief experience with both shoes.
Well I have had the opportunity to experience coaching pony league baseball in the vibrams. It was ok. Felt strange particularly while demonstrating proper hitting mechanics. The part that was odd was pivoting on my back foot. My toes had a tendency to for lack of a better word drag more while pivoting than in a traditional shoe.
I realize this may not be what these shoes were originally intended for but I, like many people, expect a pair of shoes to be used for numerous activities not just walking or trekking.
My foot conformed to the uneven terrain of the practiced field. This was not a good or bad thing. Part of me liked the increased contact and sensory information and part of me did not. I would imagine this is something you would need to get accustomed to before making a definitive like or unlike decision.
I have worn these shoes for 2 weeks and can say that I am pleased with their performance. My feet do not hurt any more than they did with wearing traditional shoes. Maybe even a bit less. I have had many people ask my assessment of the shoes…people I did not even know.
A final observation before I sign out is that these shoes do not provide much protection or padding to the top of your foot. As one of the boys inadvertently stepped on my foot last night with his baseball cleats I remembered that these are minimalist shoes. In previous practices this has occurred with traditional shoes it still was uncomfortable but there was definitely much more protection afforded my foot from the cleats.
Again these shoes were not designed for this activity specifically but an observation worth noting if you decide to give these shoes a try.
The Vibram FiveFinger shoes handled camping fairly well, but I encountered several definite and deal breaking shortcomings of the Vibram’s. While walking on the uneven terrain and over the irregular rocks the shoes responded well and I did not have the foot discomfort I would have expected before this trial.
However, as for the negatives, the biggest and most important reason I prefer traditional hiking boots to the Vibram’s for camping and hiking is for protection against snakebites. Hiking boots afford greater protection to the foot and ankle as compared to the Vibram’s. When walking on rocks and through grass there is a definite risk for disturbing a resting or hidden snake. As common sense will tell you a snakebite can easily be a life threatening event. This is the biggest negative of the FiveFinger shoe that I have come across. A hiking boot does not guarantee that you will not get bitten by a snake but it reduces the risk significantly greater than do the Vibram’s.
Secondly, the hiking boot also protects the foot and ankle from thorns, exposure to poison ivy/oak, ticks and chiggers better than the Vibram FiveFinger shoes. The high top design better keeps the brush, grass and poisonous plants from contacting the skin.
Thirdly, a traditional boot keeps your feet dry far better than the FiveFingers when walking through wet grass, shallow creeks and puddles. The Vibram’s do dry out quickly, but wet feet can become life threatening due to the risk of hypothermia. Anyone who has taken outdoor survival and first aid realizes that hypothermia can occur at any time during the year, not just in winter. During this weekend the temperature dropped rapidly as a storm system blew in during the middle of the night. The temps went from the 80′s in daytime to the 40′s overnight. Having my traditional hiking boots to keep my feet dry and warm made things more comfortable and safer. We were car camping and hypothermia was not a real risk. We could get into the Jeep and warm up whenever we needed but if we had been backpacking it may have been a different story. To be fair you can buy socks specifically for the FiveFinger shoe but as for keeping them dry in creek crossing and wet grass you run into the above stated shortcoming of the shoe.
From the perspective of handling the terrain in and around the camping area, the shoes did well but, because of the shortcomings I encountered I would say that the FiveFingers have their practical limitations for use with backpacking and hiking. I am not returning them to the store but I am also not throwing out my reliable hiking boot. My hiking boot will be my shoe of choice on our next trip hiking and camping.
More to come later on my experiences and observations with these shoes…
