Morning Mindful Mobility

It’s been a long time coming, but I’m pleased to launch a view into my personal healthcare routine. My goal is to help you live your healthiest life (to LYHL). To do this, movement is key and doing it with presence and awareness. Our body is part of us and not to be used nor abused.

Have you wanted to know how to have a regular whole-body stretching routine? A whole-body active mobility? Have you been wanting a quick, helpful routine to start your day and incorporate your mind, body and spirit? Do you sense you have muscle imbalances and weakness, but aren’t sure how to identify them? Then this series is for you!

On the APT YouTube channel, you can now find episode 1 of “Morning Mindful Mobility.” You can follow along as Dr. Elle Bottrell uses her 25 years of study of the human body and applies her physical therapy knowledge to guide through helpful body movement to ensure you aren’t unnecessarily getting stiff and developing poor posture, weaknesses, and limitation from your daily life. Our body is very adaptable so we need to be conscious about these adaptations and put in thoughtful challenges.

Dr. Elle (aka Dr. LYHL) has found that many of her patients, clients, and people she meets don’t know how to do basic things like stretching and mobility work AND it’s not their fault. They were not properly taught in gym class or on their sports teams or in their movement groups.

Seeing people needlessly in pain or moving poorly is frustrating, so Dr. Elle is turning the camera on herself to show you what she does (hint - it’s different every day, but with common threads). She responds to what her body tells her and she wants to teach you to do the same - some days are more gentle and laying down, some are bigger movements and require more muscle activation and lead to strength gains.

Let her know what you think and send to someone you know who may benefit from this:

May you always see the blessing.

Dr. Elle (Dr. LYHL)

Clean Eating Test Run

In this video, Elle discusses the intersection of clean eating, running, and overall health.

You will want to watch this video for tips, insights, encouragement, and positivity for your health journey. Learn how nutrition helps with pain, inflammation, exercise, headaches, energy, focus, healing, fitness, wellness, running and beyond. APT's goal is to partner with you to live your healthiest life. LYHL!

Sorry for the 2 week lag in getting it here on the blog and APT website. Leave a comment or question below. How healthy do you eat? What does healthy eating look like for you? Did you run? Trail or mountain run?

Coaching is available worldwide to help you live your healthiest life.

Join us on Instagram: @artisanphysical and @theellebottrell or on Facebook: @artisanphysical and @theellebottrell

See more from Elle at www.theellebottrell.com

Preventing Rock Climbing Hand & Tendon Injuries: Part 3 - Dynamic Hang Boarding - Bottom Up

How do you hangboard? Are you a long-time rock climber who wants to climb for a lifetime? A beginner climber who wants to train right and train smart to prevent injury? Are you currently side-lined due to a tendon or pulley injury in your hand and want to know how to rehabilitate it? Are you scared by witnessing your friends get sidelined from finger injuries for months or years and you want to do what you can so this doesn’t happen to you?

https://youtu.be/NuPYYDr0MB8

This is a long-awaited Part 3 to our video series about preventing rock climbing finger, pulley, and tendon injuries in the hand. Make sure to watch videos Part 1 & Part 2, if you haven't already, in which Dr. Elle explains why injuries commonly occur in the hand and tendons/pulleys of the hand, how your technique may be contributing to this, and why strengthening your hand, not just your forearm is important for preventing this and rehabilitating injuries here.

In this climbing training video, Dr. Elle addresses a common training error in hang board training - when climbers only hang statically. Climbing is not static and the abrupt movements in climbing are associated with injury, especially when projecting a route or problem, when fatigued, and when under-trained - all of which are common. You need to bridge that gap in your training. Here is a bottom up way to improve your hangboard training to include more dynamic load to your fingers and make them more resilient to injury.

Comment below with any questions and let Dr. Elle know what questions you have. This shelter-in-place is a great opportunity to train weaknesses and correct imbalances in your body to get you climbing healthy for a lifetime.

Make sure to subscribe to our YouTube channel to not miss any of our educational videos.

Tuesday Tune-up: Non-weightbearing Gluteus Medius Conditioning superset

Really want to get your hips strong for walking, hiking, running and any sports that require you to be on one leg? These exercises are for you! Injured and limited in your running abilities? Do these to be ready to hit the ground running? Want to fatigue less easily and be less likely to get injured while running? This superset of gluteus medium non-weightbearing endurance and motor control exercises will get you well on your way. Bonus it will also work on your back stability, strength, conditioning, control, and endurance! Yes!

Be aware, this is not a beginner exercise, but helpful for those looking to take their health to the next level of endurance and more thorough strength. Reach out to Artisan PT for a remote wellness consultation via video or schedule a wellness or physical therapy visit at our Los Angeles office to see what exercises are best for you, at this moment of time.

We are currently doing Tuesday Tune-ups on our Instagram feed and IGTV. Follow us at @artisanphysical to make sure you don’t miss out. As appropriate, we will do our best to also upload to our Artisan Physical Therapy YouTube channel as well. Make sure to subscribe to our YouTube channel to get notifications about new videos on how to live your healthiest life. Don’t miss out.

That’s our goal at Artisan PT: to partner with you to optimize your health for a lifetime.

Thank for reading and watching,

Elle

(owner, doctor of physical therapy, fellow in orthopedic manual PT)

(PS: These hip abduction/abductor exercises are helpful for preventing pain and improving tolerance to running, walking, hiking, skateboarding, soccer, ultimate frisbee, basketball, volleyball, triathlon, mountain biking, yoga, dancing, and anything else you spend time on one leg!)

Sleep Hygiene? Part 2 of 2

Not sleeping well is a detriment to healthy living and healing. Now that you have considered the concept of sleep hygiene from Part 1 of this 2-Part series, consider the following list of habits to develop in order to improve your quality of sleep, allowing you body to heal, recover, and reenergize:

1. Exercise daily - but not too close too bedtime. It varies, but exercising too late at night can disrupt sleep, if performed 1-2 hours before trying to sleep.

2. Limit screen use (TV and social media) before bed - Neither allows you to focus and declutter your mind nor control the imagery and messages you let in. Being on the screen is also often about productivity and on social media easily brings us to envy and comparison, both of which do not promote rest. The blue light from the screen is not good for you. You can have your phone dim and switch to orange or black/white light later in the evening to assist you in this regard.

3. Prepare things for the next day ahead of time, so that your mind does not need to focus on them - e.g. set a reminder in your calendar so you remember to email that person and don't have to worry about keeping it in your mind. As you do this, move more slowly, so your body gets the cue to slow down.

4. Meditate or contemplate 10-20 minutes - in contemplation you have an affirming mantra/phrase that you keep repeating bringing your mind towards as it wanders.

5. Limit talking - decreasing your motor output will help you slow down and unwind both physically and mentally.

6. Read with low light:

   • Something engaging, but not upsetting

   • Consider something about positive human potential

   • Try not to read something so light that your mind doesn't have to focus

7. Stop being productive - don't work or study right up until sleeping, instead create a buffer zone. 

8. Practice being in the present moment - pay attention to your body, your breath, enjoy physical being with your family/partner/roommate. This is a perfect time for cuddles and getting cozy with pillows and blankets!

9. Breathe - work on slow breaths from your abdomen to ensure your diaphragm is properly facilitating your breathing and thus promoting the parasympathetic system to be active (which is your "rest and digest" system).

10. Turn lights low as you prepare for sleep and then fully dark to optimize deeper sleep states

11. Rest in bed before attempting to sleep

12. Sleep in a cool room. Too much heat can be disruptive to sleep.

13. Create quiet environment: Use ear plugs or head phones to limit outside distractions & silence your phone

14. Listen to calming, quiet music; podcasts, talks, or books that are quiet as well as affirming and positive about the human potential. Use a timer to have this turn off after 15, 30, 45, or 60 minutes, depending how long it typically takes you to drift into a dream state. I bookmark my starting point in books so that I can easily come back to where I started from - some days it takes a whole 30 minutes for me to fall asleep, sometimes I am no longer listening within 5 minutes!

15. Journal to process thoughts and concerns from the day to limit them from looping in your mind

Do you have other things you practice and find helpful? Comment below.

Oh! FYI - You shouldn't have pain with waking up from sleep. This may indicate you need help from a physical therapist, but it may also mean that you need to sleep with different pillows or mattress to obtain more healthy and restful sleep.

Happy sleeping!

Elle

Sleep Hygiene? Part 1 of 2

Sleep hygiene. Sleep hygiene? Where did I first hear that phrase? I don't recall. Possibly a TED Talk? I do know that when I mention it to my patients and clients they are intrigued by it. It's a novel phrase and a novel concept. I certainly didn't come up with it, but now it's something I live by.

Do you struggle with insomnia and/or getting good sleep at night? Do you wake up not feeling rested, but rather tired and fatigued? Have you ever thought about your patterns leading up to sleep? Did anyone teach you good patterns?

The World Health Organization defines hygiene as the "conditions and practices that help to maintain health and prevent the spread of diseases." Woah! When you think about it this way SLEEP HYGIENE starts to make a lot more sense and is something we should all consider and develop healthy habits because sleep is so important to our wellbeing.

We are to spend 1/3 of our day, week, month, years, and lives sleeping. Yet, for the most part we just expect sleep to come. But often it doesn't. It is shy and elusive. We expect our mind and body to go from 60 to 0. It just doesn't happen. Most of us can’t just lay in bed, let our head hit the pillow and be out. How fortunate are those folks!

To have healthy teeth and gums and non-odorous breath and thus prevent things like cavities, root canals, gingivitis, and offending those we come into close contact with, we practice oral hygiene. We brush our teeth multiple times a day, we floss, we might use breath mints or mouth wash. We don't expect it just to happen. We are taught this from a young age from our guardians, and dentists, and do our best to follow through with it, for our own benefit throughout our lives.

Body hygiene is another thing we practice daily. We wash our hands, our hair, our body. We use soap and deodorant, we wash our clothes and sheets - all this to limit the spread of harmful germs and undesirable smells. It takes effort, but it's worth it for our quality of life. Again, we are taught this from a young age.

We need the same for sleep. We need to transition from the busyness of the day - with emphasis on productivity, planning, navigating and nurturing relationship - into rest, enoughness, and stillness. We need to do this to optimize our health, to allow the body to heal, and to prevent disease. It's something we should take seriously in the same repetitive, committed focus that we wash our mouth and our armpits!

What are ways we can do this? Comment below for ideas you have and practices you suggest.

Stay tuned for our next blog post to see a list and discussion of practices to incorporate in your nighttime routine.

Let’s get to the source, and TOGETHER, let’s get moving,

Elle (Liz)

PT Better Than Surgery for Shoulder Impingement and Subacromial Pain

New guidelines for management of shoulder impingement are strongly in favor of physical therapy and away from surgery! These recent guidelines were posted in the BMJ (British Medical Journal) and you can read more here. This is exciting news supporting conservative treatment that physical therapy provides versus more invasive techniques such as surgery.

As the research was examined, the findings revealed: decompression surgery resulted in no significant differences from other approaches—including PLACEBO surgery! The lack of difference was long-term, remaining at 6-month, 2-year, and 5-year follow ups.

Shoulder impingement occurs when structure that pass through your shoulder get pinched between the humerus and acromion that compose part of your shoulder joint. This can lead to irritation, pain, and wear and tear to structures such as the bursa (bursitis), supraspinatus (rotator cuff strain, tears, tendonitis, and tendinopathy), biceps (long head of biceps strain, tears, tendonitis, and tendinopathy).

The following helpful schematic visuals presents the findings for how to management shoulder pain from rotator cuff disease/dysfunction (RCD) and subacrominal pain syndrome (SAPS).

The fact that physical therapy is the ideal way to treat these pain syndromes is not surprising given that the shoulder joint is a complex joint comprising of 4 separate joints and myriad muscles that must coordinate well. Tightness, weakness, poor endurance, control, or posture at any of these points including at the shoulder blade (scapula) can lead to narrowing at the subacromial space and thus impingement. Reversing these problems can then increase the space and reduce the strain, pain, and irritation.

Bottom line?

Having shoulder pain? Come to PT before a surgeon! Please note that these findings are for overuse and non-traumatic shoulder injuries present for more than 3 months.

Thanks for following along as we journey to: Get to the Source, and TOGETHER, get moving.

Liz

Daily Dose of PT (#dailydoseofpt)

Yep, I made a hashtag #dailydoseofpt. Why? Because everyday for 2019 I’ve committed to myself, for my own personal health to do at least one physical therapy exercise. I’m not going to limit myself to one, but I will do at least one.

After some thought, I thought": “why not bring others along?” 365 exercises is a lot and sharing them is a lot, so the daily dose of PT will be shared just on one platform. For ease of use, I’ve chosen Instagram and the live story. It’s not that you won’t find any excerpts or references anywhere else - blog, Facebook, Youtube, Google+, or newsletter, but the journey will be unfolding and evolving on Instagram live and then kept up on the story for 24 hours.

Daily dose of PT - climbing gym edition

My hope is that my quest for personal health and well-being will be educational and motivational for you and those that stumble across it. At the time of the writing of this blogpost, I am 9 days into the challenge, with 356 to go. There are lots of opportunities to participate. To not miss out, make sure you follow @artisanpt on Instagram and even allow notifications for live posts from me.

The focus to-date of the #dailydoseofpt has been primarily shoulder, neck, shoulder blades (scapula), and postural stability. Over the course of the year, the whole body will get covered, as needed by my own personal PT intervention needs. If there are regions or parts of the body, that you would like me to focus on, let me know and I’ll do my best to incorporate them sooner rather than later.

Thanks for joining on this journey to optimize health and wellness.

Together, let’s get moving!

Liz

Finding the Perfect Pillow

Neck pain is a real problem for many people. Unfortunately for many people, their pillow is a main contributing factor. Also unfortunate is the fact that pillows are confusing. In desperation, many people will pay ridiculous amounts for a “perfect” pillow that promises to miraculously reduce their neck pain, improve sleep, and allow them to move their neck better throughout the day. All you need to do is spend $80-$200. However, many of the designs behind these pillows are flawed.

What should you look for in a pillow? You want a pillow that helps to keep your neck in neutral position. What is neutral position? Neutral position is a position that reduces the stress on your joints, muscles, ligaments, and tendons. Each joint has this ideal position. For your neck this means that when you lie on your pillow you shouldn't feel like your head is dropping down, or rotating, or getting forced up.

Find Neutral Position

This woman pictured has too much pillow & is straining her neck as she sleeps. The midline of your head should be straight with the midline of your torso to reduce stress on your body and prevent neck pain or arm numbness/pins & needles.

I suggest getting an inexpensive, soft, yet supportive pillow. Soft, yet supportive, is tricky. You want soft, but sufficiently full so that it gives support. Get a pillow too fully packed and it's no longer soft and adaptable to your head and your body position. Get a pillow that's too flat and it will not be appropriate for lying on your side. To get your neck and corresponding joints into their neutral position, you need the pillow to be just right, so do not be surprised if it takes time to find the right pillow for the size and weight of your head and the proportion of your body. For example, when lying on your side, you need the pillow to be the right size to take up the space between your head and the bed, created by your shoulder and torso. Too big relative to your body and your head will get pushed up, compressing the top side of your neck and pulling the lower side. Too small and your head will dip down, similarly causing strain to your neck but in the opposite pattern of too big a pillow.

I have a little trick for how to take any garden variety pillow from your favorite inexpensive store and make a winner, comfortable, soft, yet supportive pillow and look forward to sharing that with you in a future post and possibly even in video format. In the meantime, please save your money and don't buy that expensive pillow promising to save the world, starting with curing your neck pain and insomnia.

Questions? Comments? I'd love to hear them.

Liz

Is Your World Spinning?

Are you having the unfortunate experience of vertigo caused by BPPV (benign paroxysmal positional vertigo)? We can help! It’s a mouthful to say, but we can treat it quickly and efficiently. With our extremely short wait times to be seen for your evaluation, you can been evaluated and treated within just a few days. We can’t promise, but you’ll likely feel markedly better that same day, which is great news! The effective of the treatment is typical dramatic and fast, usually within one visit. We wish we could say that for all diagnoses. Don’t hesitate to schedule, if you have this problem!

Awesome, Effective Advanced Shoulder Stability Exercise

Looking for an excellent, if not awesome, way to strengthen your shoulder.? We've got an exercise for you including a video demo! Here is one of Liz's favorite exercises that she is incorporating into her March daily fitness challenge - which is alternating between the hip and shoulder stability and strength.

The shoulder joint is a "ball and socket" joint. It has a lot of freedom to move in a variety of directions, which is means it needs stability and strength in multiple directions. This exercise is a constant isometric force into external rotation pushing out with the wrists which strengthens and challenges two of the rotator cuff muscles, in particular, the teres minor and the infraspinatus. As you push constantly out through the band you will simultaneously raise your arms overhead which works additional shoulder muscles including shoulder blade (scapular) muscles responsible for upwardly rotating it. These muscles include the serratus anterior and the lower trapezius, which when weak can lead to shoulder impingement, bursitis, and rotator cuff tears and injury. 

This is not an exercise to perform when your shoulder is very weak. For that you want to exercises that place less demand on your shoulder. If you missed it, a video we created for that is this:

Mixing things up with "easy" and "hard" exercises is good for a healthy shoulder. I've been doing exercises from each of these videos as I seek to have an even stronger and healthier shoulder than I already have.

Have you started a daily fitness challenge? If so, what are you trying?

Not started yet, but thinking about it? What are you considering? Even the considering, is a step forward and progress! The planning stages count for fitness and health.

Stay tuned for next month's daily fitness challenge which will be headstands and handstands! April is almost here. Would you like to join me? At this time, May is scheduled to be ankle and foot stability, so reach out with any questions or suggestions for that if that provokes some interest from you. This is particularly meaningful for those of you with "weak" ankles, foot and ankle pain, history of ankle sprains or foot/ankle fractures (broken bones). 

Let's Get to the Source, and TOGETHER, Let's Get Moving

Liz

Pull-ups!! - January Daily Fitness Challenge

Pull-ups. Pull-ups can be an arch nemesis for some, yet pull-ups are essential to advancing rock climbing potential. 

This January I've been continuing my daily fitness challenge, that I began in October of 2017. The first month I ran, the next month I did abdominal exercises everyday, and December I did and 7 minute body weight exercise routine, and in January, right now, everyday I'm doing pull-ups.

I've been able to do pull ups for a long time. Meaning I have had the strength to do pull ups for a long time. But strength is different than endurance. If I want to climb long or hard I need to have the endurance to sustain myself. So my pull-up challenge this month is important for my performance while climbing. 

But first and foremost I'm using it as a transition from not climbing for almost a year back into climbing. The progressive loading through my finger flexor tendons my joints, my finger pulleys, my lats, my shoulders, and my rotator cuff will be essential to the health of those tissues as I transition back into climbing. (Let's be honest: gripping to the edge of a cliff for dear life is not the most normal thing for the human body, but it sure is fun!) The body does the best with slow sequential loading, with time for recovery, and time for the body to rebuild and remodel. While I have the strength and ability to climb brief bursts of climbing at the level I did when I stopped a year ago, my tissues haven't been repeatedly loaded over that time and are vulnerable. This is a common mistake that people make that leads to injury. People often want to start off where they left off, regardless of the time that has transpired since their last participation in the activity. What I encourage my patients and clients to think of when they're deciding their activity level is not - what did they do the last time they did it - but rather - how much of those movements and activity and similar loading of the joints and muscles and tendons have you done in the past few days, weeks, and months. This should be your guide. Increase slow from what you've  done recently. In this way you're building your body to be healthy for a lifetime.

So'm getting back to climbing, but not before I begin with some progressive loading off the wall. Because of my baseline strength, pull-ups are sufficiently safe, but for others starting with partial weight gripping and pulling would be much more appropriate. I started with 10 pull-ups per day and added 10 pull-ups per week until the end of the month. Always mixed in with in my workouts is common sense and listening to my body. I'm always having a conversation with my body to determine whether I should do something or not and I modify as needed to stay healthy. No fitness challenge should lead you to unhealth. 

P.S. Going now to stretch these lats that are getting overloaded through pull-ups, and soon, climbing!

Let's Get to the Source - and TOGETHER - Let's Get Moving

Liz

8 Minute Abs

Last month I did a daily physical challenge of running every day - with the goal of being healthy. Success! This month the physical challenge is "8 min abs". I've spent everyday of November (one day to go) targeting abdominal strength, endurance and control for 8 minutes. Now this isn't about aesthetic or beach body abs. Being able to do crunches and sit-ups are important but have been over-emphasized in the fitness industry for years. Having healthy appearing abdominal muscles - a 6 pack - doesn't mean you are in fact healthy. More specifically, it doesn't mean you are preventing injury. Abdominal strength and stability in combination with low back and hip strength and control make up what we physical therapists call "lumbopelvic stability" or "lumbopelvic control." This is something we emphasize in helping and rehabilitating persons with low back pain, sciatica, SI joint (sacro-iliac joint) pain, lumbar radiculopathy, herniated discs, DJD (degenerative disc disease), arthritis in the joints of the back, and stenosis. The back is connected to the pelvis, which is connected to the hips/thigh/femur. I often sing  to my patients and clients about the wisdom of the children's song: "the back bone's connected to the hip bone. the hip bone's connected to the thigh bone" (They love it, as you can imagine).

So me spending on this focused time on this region wasn't just sit-ups and crunches. In fact, it was much more perform leg and arm motions without letting my back move. I spent 8 minutes each day this month emphasizing a variety of challenges to lumbopelvic stability to promote and preserve a healthy back. I brainstormed a list of exercises and invited a friend to join me with this month's challenge. My list is long and varied. I challenged my abdominal muscles - all of them (rectus abdominus, internal and external obliques, and very importantly the transverse abdominus). I rotated through 48 different exercises these 30 days! There's no reason to get bored. And as we strongly recommend here at Artisan PT - variety is good and very healthy for us. 

Want an example of how to train the transverse abdominus? The transverse abdominus is the most important abdominal muscle to prevent back injury and recover from a back injury or back pain. Learn more in our video on a starter transverse abdominus exercise. PS - Side effects of this exercise include flatter stomachs! PPS - I won't be posting pre- and post- 8 min ab challenge photos, but will be enjoying the results.

Watch should the next challenge be? December is right around the corner!

Let's Get to the Source, and TOGETHER, Let's Get Moving!

Liz

3 Simple Strengthening Exercises to Prevent Climbing Shoulder Injuries

Today we have a guest post from a friend and fellow colleague on preventing shoulder climbing injuries. Dr. Jared Vagy - The Climbing Doctor - out of Los Angeles, California works with high level climbers and teaches at USC. The following is an excerpt from his blog post. 

"It is the end of the day. You are tired and beat, but you decide to give it one last go on your project. You get to the crux move and give it everything you’ve got. Suddenly you feel a sharp pain in your shoulder. You know that you likely injured your shoulder. What happened and what could you have done to prevent this?

The tendons in the shoulder slide through a very narrow passageway and attach to the shoulder bone. Impingement occurs when the space between the bones in this passageway is reduced. This can occur from repetitively moving the shoulder into a stressful or suboptimal position. When this occurs, the bones in the shoulder pinch down on the tendons and cause shoulder impingement. You should be aware of the dangerous movements that can lead to shoulder impingement. These movements include hanging on your arms during rest stances, climbing with a hunched posture and strenuous overhead reaching."

Bent over T's, Y's, and L's:

Dirtbag tip - use items you have around: cans, bottles to provide the weight.

These should not cause any shoulder pain! 

Climb INJURY-FREE

Dr. Vagy just released another book! 

You can find it on Amazon now.

Thanks, Dr. Vagy for the helpful content.

Any questions? Comment below. 

Why Does My Foot Hurt in the Morning?

"Why does my arch hurt?" 

"I get a sharp pain in my heel every morning I get out of bed.

"When I've been on my feet too long, the bottom of my foot hurts so bad."

Do you say these things? You may have plantar fasciitis.

The plantar fascia is a ligament that helps support the arch of your foot and gets stretched when you put weight on it and every step you take.

"Itis" is Latin for inflammation, so plantar fasciitis is a diagnosis of inflammation of the plantar fascia. Inflammation takes place when you have an injury and the body is trying to heal. Research is showing that most cases of plantar fasciitis is not an "itis" but is instead an "-osis" which reflects degeneration. This is why rolling on a frozen bottle might not make your symptoms go away.

At Artisan Physical Therapy, your PT will try to figure out a few distinct things in your evaluation - what tissue is injured or irritated and then the why it is injured/irritated/painful. Often both need to be treated the sore tissue needs to be calmed down and then that factors that led to the injury need to be changed and/or alleviated otherwise it will be perpetually irritated.

Common factors that lead to plantar fasciitis or fasciosis include:

• Insufficient arch support - going barefoot, wearing flip flops, or shoes without arch support or very flexible soles
• Tight ankles and calve muscles
• Weak hip (gluteal muscles)
• Excessive body weight
• Increasing activity too quickly (deciding to train for a marathon or get in shape drastically from prior level of activity)
• Weak foot muscles or inappropriate muscle use/activation

Just because you have arch or heel pain, it doesn't mean you have plantar fasciitis. It could be a tendinitis or tendinopathy of a foot or ankle muscle or an issue in the joints of your foot. A quality physical therapy exam will clarify this for you.  As mentioned above knowing which tissue is irritated allows for specific, targeted treatment to get rid of your pain and get you back to pain free walking, running and whatever else you love and need to do.

Think you might have plantar fasciitis? Take the first step towards health and get a PT evaluation to get quality manual therapy to temporarily decrease the pain in your foot and learn exercises to keep it away by learning how to reduce the stress to the plantar fascia and learn what activities to avoid a do instead to allow it to begin healing today.

Let's Get to the Source - and TOGETHER - Let's Get Moving!

What Stretches are Right for After Running?

We frequently get the question of: What stretches should I do before versus after a run? No one solution is right for everyone and every situation, but a dynamic cool down is very appropriate for after a run when your muscles are very warmed up, but have shortened from repetitive use.

This quick one to two minute routine should reduce the soreness, stiffness, and tightness you feel after a run. Muscles only know how to shorten and this happens over and over with running, we have to make them lengthen through their full range.

In this video, demonstrates a quick 1 minute stretch routine to be done to stretch the thighs and hips - that is - glutes, quads, hamstrings, and hip flexors after a run. (Note: you will need to stretch the calves/gastroc/soleus separately).

Happy trails and happy stretching!

As always, comment with any questions and any suggestions for future videos. Subscribe to the YouTube channel to not miss out on any videos. 

Let's get to the source, and TOGETHER, let's get moving!

Preventing Rock Climbing Hand & Tendon Injuries: Part 2 - Techniques For Open Grip Strengthening

People are often injured by trying to progress too quickly and this is very prevalent in rock climbing. People fall hard for the sport and enjoy the challenge of pushing their limits, but lack the knowledge needed to stay healthy, prevent injury, and thus climb for a lifetime and not have to take months and month off due to tendon or pulley injuries in their hands or forearms.

In this video you'll learn the how-to principles of hand strengthening to cross train to improve open grip strength and reduce hand pulley and tendon injuries for rock climbers. Climb better, climb harder, climb longer. Climb for a lifetime.

For a personalized assessment, contact us at our Portland office.

If you have injured this area, make sure to give sufficient rest and see your local PT who specializes in manual therapy & treating climbers to learn how to get back to your prior level and incorporate this open hand strengthening to improve your grip and reduce compensatory strategies that overload your pulleys. Also find out how shoulder weakness, for example, can influence which grip you choose. 

This is Part 2 of a 2 Part series, with the possibility of a Part 3 adapted to interest, questions, and feedback from the first 2 Parts. Watch Part 1 to learn why hand strengthening matters to prevent injury and the important of incorporating into your climbing routine. Questions? Should we do a Part 3?

Let's Get to the Source, and TOGETHER, Let's Get Moving!

Preventing Rock Climbing Hand & Tendon Injuries: Part 1 - Why Hand Strengthening is Important

Are you a long-time rock climber who wants to climb for a lifetime? A beginner climber who wants to train right and train smart to prevent injury? Are you currently side-lined due to a tendon or pulley injury in your hand and want to know how to rehabilitate it?

In this video, Liz explains why injuries commonly occur in the hand and tendons/pulleys of the hand, how your technique may be contributing to this, and why strengthening your hand, not just your forearm is important for preventing this and rehabilitating injuries here.
This is Part 1 of a 2 Part series, with the possibility of a Part 3 adapted to interest, questions, and feedback from the first 2 Parts. Watch Part 2 to learn specific techniques, strategies, and exercises to incorporate into your climbing routine.

The weather is warming up and it's time to climb!

We can take it to the next level and help you with focused and personalized examinations in our downtown Portland location or with mobile therapy throughout the Portland, Oregon area. 

Quick Yoga Sequence for Runners: Stretching with Some Core

New video out!

In this video, Doctor Elizabeth (Liz) Bottrell PT, DPT, FAAOMPT of Artisan Physical Therapy in Los Angeles, CA demonstrates a quick and effective yoga sequence for runners. Whether running your first 5k, training for a marathon, triathlon, or an ultra, you need to stretch. Stretching takes time and knowledge. In this video, you'll learn a quick vinyasana or flow yoga sequence that efficiently stretches your hamstrings, calves (gastrocnemius & soles), and hip flexors (Iliotibial band and iliopsoas) to maximize your time, as well as incorporating abdominal strengthening and control and cross training strengthening for the pectoral muscles and triceps. This fast routine, also trains balance, breathing, and improves motion in your back and abdominal muscles!

You can repeat and hold longer as needed. Do not hold your breath!

Pay attention in the video because you need to make sure you know which muscles to stretch. Follow-up videos will show specifics for a few other essential muscle groups for runners to stretch.

Try it and let us know what you think.

Is What You Are Eating Keeping You Hurting?

What you eat has a big influence in how you feel. Not too many people will disagree with this statement, however many are not aware the extent that this is true.

Your diet could be perpetuating your back pain, our contributing to your achy knees, or be prolonging that car accident our recent injury pain.

What do we know?

AVOID eating refined carbohydrates, french fries and other fried foods, soda and other sugar-sweetened beverages, red meat (burgers, steaks) and processed meat (hot dogs, sausage), and margarine/lard.

EAT MORE tomatoes; olive oil; green leafy vegetables - spinach, kale, and collards; nuts like almonds and walnuts; fatty fish like salmon, mackerel, tuna, and sardines; fruits such as strawberries, blueberries, cherries, and oranges.

Eating this way helps reduce diseases associated with inflammation: e.g. heart disease and cancer. You can read more about this at http://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation.

But eating this way will also contribute time reduce your musculoskeletal and orthopedic pain. (Read -  less pain in your muscles, discs, joints, fascia, and ligaments). Sounds great, right?

If you're not seeing the consistent pain reduction you want from changes in posture, strength, stiffness, and flexibility, consider taking that next step to reduce what my be stagnant inflammation in your body and change your diet to tips towards anti-inflammatory in addition to all the good work your doing with exercise, position, rest, icing, etc.

Every little step towards healthier living counts!