TELEHEALTH for You!

Let’s get right to the point. The world is changing. Our health and the people around us are the most important thing. Even with social distancing and shelter in place or even quarantining if you are having mild COVID-19 symptoms, you can advance your health.

At Artisan Physical Therapy & Wellness, we offer both physical therapy and injury prevention programs. For physical therapy we help athletes and regular folks get back to their favorite sports and fitness routines, but can also help you if your goal is to get through the day sitting with back pain or you want to get rid of that heel and arch pain during those first few steps of the day or that shoulder pain in those certain positions reaching overhead and behind you. We have the expertise for all this and can work on multiple areas within one session.

While our physical therapy is limited to California and Oregon residents only, we offer wellness and injury prevention education and services for folks throughout the US and even globally.

Yes, we can help you live a healthier life even if you live in the Midwest, Pacific Northwest, New Zealand, Brazil, or Ireland. We offer wellness consultation worldwide! We do this specifically for rockclimbers and runners, but we can make sure you are healthy to get in a lifetime’s worth of laps at the pool, chasing your kids or grandkids, hiking the El Camino, or playing competitive ultimate frisbee. We are movement analysis experts and exercise prescription and can do this over video remotely. A good portion of the injuries we see come from good intentions, but lack of knowledge. We can give you the knowledge to prevent injuries before they even occur! Healthy for a lifetime. As our seasons of life change and physical goals and demands change, our self-care and fitness routines need to change too in order to optimize our health. Bring us your questions and let us help you answer them!

Honored to partner with you to keep you healthy for a lifetime.

Elle

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

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

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!

A Simple & Effective Exercise to Minimize Headaches

A new video from Liz went live earlier this week! Do you have headaches or know someone with headaches who would like to reduce their frequency or intensity and even eliminate them entirely?

In this video Dr. Elizabeth (Liz) Bottrell, PT, DPT, FAAOMPT, manual physical therapist and movement specialist, demonstrates a simple but effective exercise to reduce the frequency and intensity of headaches.

Many people have cervicogenic headaches - headaches arising from tight muscles and joints in the neck or poor posture - but think they are migraines or other types of headaches. This basic, easy exercise will stretch your neck muscles and reduce referred pain to your head. It is also effective for neck pain after a car accident or whiplash.

Try this exercise, 3 sets of 10, without pain or just to the point of pain.

If you have more questions about what other exercises to do for your condition or would like hands-on, manual therapy to improve joint range of motion, reduce pain, improve circulation, enhance muscle flexibility, and increase ease of movement and maintaining good posture, contact Artisan Physical Therapy to schedule an appointment for your physical therapy evaluation and treatment session.

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

2 Simple Exercises for a Healthy Rotator Cuff

Want to have healthy shoulders and rotator cuff? Want to prevent injury when swimming, doing yoga, while weightlifting or crossfit? Want to rockclimb better? Want to play tennis and volleyball for years? Then take a couple minutes and learn a few strengthening exercises for the rotator cuff using an exercise band. The exercises are simple and easy to do wherever you are! No fancy or expensive equipment needed!

Have lingering shoulder pain, a prior rotator cuff tear, aching or weakness? Try these as some basic strengthening.

The rotator cuff is extremely important for basically all arm movement and certainly all shoulder motions. Make sure your rotator cuff is strong and has a lot of endurance to prevent injury!

For recommendations specific to your situation and body, contact Liz in Los Angeles or your neighborhood physical therapist. We are the movement specialist.

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

Until next time,

Liz

Exercise recommendations for Minimizing IT (iliotibial) Band Tightness

Did you watch the first video in my 2-part series about IT (iliotibial) band tightness and have been waiting ever since for video 2? Well, wait no longer, for that moment has finally arrived! In part 1, I explained the anatomy of the IT Band and how it can become tight and problematic. It is often muscle imbalances that lead to this or sometimes just shear volume of activity and training.

In this video, I detail some of the practical, basic stretching and strengthening exercises that I recommend for people's whose IT Band and tensor fasciae latae (TFL) are tight, particularly due to the TFL/ITB serving as an "overachiever" muscle in the hip.

Enjoy the video.  Contact me with any questions and/or suggestions for future video topics.

Let's get to the source, and together, get moving!

Liz