6 Effective Tips to Less Back Pain with Sitting

Do you have difficulty completing work due to back pain with sitting?

Does your low back pain limit your social life with things like sitting at a restaurant, driving, and sitting through a movie.

Low back pain with sitting is common with disc and muscle injury.

To get yourself feeling better, try these 6 simple tips:

1. Use the back rest on your chair
   • Sitting up is hard! 
   • Give those muscles a rest by allowing your back to use the support of the backrest.
   • Don't sit at the front of your chair
   • Keep your chair close to what you are working on, so you can stay all the way back in the chair.
2. Use an extra and portable back support
   • Chairs are often not designed ergonomically for ideal posture.
   • Chairs are not one size fits all! Our bodies differ wildly in shapes and sizes from one person to the next.
   • You should maintain the same amount of curve in your back while sitting that you have while standing.
   • To assist with this, I recommend some thing like the Wonder Roll, which you can find online at www.wonderroll.com. It changes support quickly and easily while being portable, yet can stays in place on your chair with a simple strap.
3. Take frequent breaks
   • Let your body heal and get stronger, by planning and not sitting longer  that your back can tolerate. 
   • If it starts every 30 min, get up every 25 minute, etc.
4. Make sure your hips are flexible
   • Remember the song you sang about the human body? "The back bone's connected to the hip bone, the hip bone's connected to the thigh bone..." (You get the point).
   • Stretch the back side of your hips both the muscle and joint, so your back isn't being strained.
5. Increase the strength and endurance of your low back muscles
   • If your back muscles are tired, they will do one of two things.
     1. They will start to complain and be your source of pain.
     2. They will stop working and let you go into poor posture thus putting bad stress onto the passive structures in your back: discs, ligaments, and joints.
6. Watch your posture
   • If you saw your posture from an outside perspective, you might be horrified!
   • Set regular reminders in your calendar and alarms on computer and phone to remind you even when caught up in tasks and projects requiring your full mental attention.
   • Give permission to those around you to remind you when you are sitting with poor posture, so you spend less time there and thus strain your disc, ligaments, and muscles less.

Thanks for reading. If we get enough interest, we will make some videos about how to sit with less back pain. Leave a comment about how it works for you and what tips you use.

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

Climbing clinic: Upper Body Strengthening

An Upper Body Strengthening Clinic for Climbing Injury Prevention and Performance

Sound interesting? Join Liz tonight at Stronghold Climbing Gym in Los Angeles for an interactive clinic on upper body strengthening for injury prevention, performance, and longevity for climbers. Climbing can lead to overuse problems and muscle imbalance injuries. In this clinic you will learn principles and specific strengthening exercises for shoulders, elbows, and hands, to reduce the likelihood of such injuries occurring and to learn safe ways to strengthen.

7:30-9:00pm

Do you say sorry too often?

I came across this blog post via some friends on Facebook. It's specifically from the perspective of a mountain biker, but it's a good universal principle and good attitude shift towards appreciation versus self deprecation. This switch could make a big change in your physical fitness and health goals and even throughout your life. The jist? Don't apologize for being slow, instead thank your companions for their patience.

http://www.sydschulz.com/mountain-biking/stop-saying-sorry

What is Manual Therapy & Why is it so Effective for Pain?

Liz Bottrell, PT, DPT, FAAOMPT, manual physical therapist and owner of Artisan Physical Therapy in the Echo Park neighborhood of Los Angeles, CA explains what manual therapy is.

Manual therapy, or "hands on," evaluation and treatment improves motion, mobility, decreases stiffness, tightness and pain, as well as improving circulation and speeding healing. The healing hands lead to areas of injury and work them out. It is a place where science and art meet.

Do you want to get better as soon as possible? Do you want to see an expert? Have you not seen the results that you hoped for with prior physical therapy. Maybe your therapist wasn't highly skilled in manual therapy. Liz is a fellow of the American Academy of Orthopedic Manual Physical Therapist (FAAOMPT) - her specialized manual therapy training and skills set her apart from other physical therapists.

See a manual therapy specialist and experience the difference in your day to day - the ease of movement, the reduced pain and stiffness, and improved muscle activation (read strength, coordination, and balance). All of this helps you sleep, walk, run, stand, reach overhead, and so on more easily and with less pain.

Combine quality and focused physical therapy with your needed exercises and necessary modifications and get ready for amazing results beyond what you though possible!

Free Personal Advice!

Come out this Saturday, Feb 13th for your free 15 minute consultation with a movement & injury rehabilitation specialist. This is the next installment of "PT Days with Liz Bottrell" at Fleet Feet - a great and friendly running store in Burbank, California. If you're keen, join in the weekly 3 or 5 mile run beforehand. To sign up, use this link from their website.  Liz is looking forward to venturing out of Echo Park to chat it up with the running community.

Can't make it? Subscribe to the newsletter by Sunday the 14th and get your free transformative Runner's Stretching Guide delivered directly to your inbox.

Let's show ourselves some self-love this month & spend a little extra time taking care of our physical health.

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

5 Best Neck Posture Exercises

Have you noticed a prominence or lump developing in your upper back and wondered what it was, and if you can do anything about it?

A friend of mine last week asked a question. What is this lump on the back of my neck? When I heard the word "lump," I was not hopeful that this was something a physical therapist could help with. A quick examination revealed that his spine was changing shape over time and he was developing a bony prominence where his neck and upper back meet. Why? This often takes place from repeated stress on the area over time. The forward slouched sitting posture so many of us find ourselves throughout the day while we are doing activities such as studying, working on the computer, driving, and reading.

Think about the elderly person with the stooped posture and rounded upper back. This didn't happen over night but was from poor sustained postures that resulted in progressive stiffness and weakness that eventually prevented them from sitting and standing with a straight back and neck. I like to say the body adapts to what we do to it and the spine is like wet cement that is hardening - what position do you want it to stiffen into?

(Disclaimer: Some people with stooped postures (aka excessive kyphosis) have pathological conditions in their spines that lead to these deformities, not simply due to impaired posture).

What can be done about it? My friend wanted answers! He might not be able to change his "lump" that is already there due to bony changes that have already occurred but maybe we can help it from increasing by working on some posture exercises to improve the flexibility of the thoracic and cervical spine and improve the strength of the muscles that hold these positions. Fortunately for him, His condition isn't painful yet. Doing some simple posture exercises can prevent painful conditions from forming in his neck and shoulders and even reduce headaches.

Subscribe to the blog and get access to the to 5 Best Neck Posture Exercises delivered to your inbox! Who doesn't love free professional advice?

Comment below for any questions you have for a physical therapist and Liz may answer your question in a future blog post!

Chasing Your Goals

How 'bout them New Year's Goals?

It's been a busy summer transition into fall here at Artisan PT and in life in general. The seasons are changing even though here in Southern California it doesn't always feel like it. We have (hopefully!) made it to fall (finally!).  The Weather Channel app is telling me just a high of 74 deg, so I'm going to risk it and say: "we made it!" Here's to wearing layers, enjoying hot beverages, having comfortable workouts, and eventually enjoying falling leaves.

It's been 6 months since the last post about one of my goals: To do a race this year. September 19th, 2015, it happened. I competed in the Nautica Malibu International Distance Triathlon. 1.5 km swim, 40km bike, and 10 km run in the books!

As a special bonus, I got to race with good friends. Nothing makes it more fun than to create memories together!

It's been 9 months since I started training for the race. I was even training for the race 4 months before I signed up! Someone might ask - isn't 9 months a bit excessive for training for an Olympic distance triathlon? After all, it's nowhere near the length of an Ironman! My answer would be that it depends how you think about it. Starting in January of this year, I joined a local gym, which was my first traditional gym membership in the past 5 years. I hadn't lifted weights, for at least that many years, and I hadn't been running for at least 2 years. As a physical therapist, I wanted to be healthy and decided to practice what I preach.

One of my PT mantras is that: Your body WILL change, but change takes time!

Body composition takes time to change, as does developing muscle strength and hypertrophying (i.e. increasing the size of your muscles), so does endurance, and cardiovascular adaptations. I don't want you to think that in those 2-5 years I was inactive, I wasn't. I'm a firm believer in activity and varied activity; I was simply doing other exercise. The first few years of those 5 years I climbed a lot and hiked. Then I got back into biking and would do that whenever I could with some swimming sprinkled in there. My enjoyment of swimming while in LA has taken birth. Prior to living here, I worked it into my routine simply because I new it was good for me or 10 years ago because I needed to in order to perform reasonably well in my triathlon races, not because I enjoyed it. Here, I've grown to love it, particularly during the sustained Indian Summer months that we just survived through, yet again.

Having not run in so long, I knew that my hip strength, in particular, would be limited and this would in turn affect my running and my mechanics during running. If not addressed, I would run a much higher chance of becoming injured. If I wanted a healthy race, I needed a healthy base. I think it's noteworthy that at that time I didn't even know what race I was going to do yet alone what distance, sports, or time of year I'd be competing. I simply knew that I needed to start with the basics. So I worked on leg, core, and upper body strength, I stretched, and worked on all the imbalances that I knew I have. I worked on exercises that combine single leg balance and strength. 

We all have our issues and we all need to do our best to stay on top of them! I spent 3 months focusing on weight-training, stretching, and doing my "PT" exercises. Any runs I did were very short and focused on good form. Any leg pain? I would immediately stop. Any break down in form? I would stop.

I followed up that 3 month phase with cardio that built up all the way to my race. My goal was to do cardiovascular exercise - working in biking, swimming, and running - for one hour per day. As I got closer to race day, I started combining workouts (bricks) and doing 2 workout days to get the endurance for the multiple hours required for the race.

I had an almost unspoken goal of 3 hours for my race. I calculated this by simply combining my individual time from workouts for each portion of the triathlon. It was mostly "unspoken" because it was a dream time. I didn't know if I could do it all back to back that fast.

Well, I raced and I'm happy to report that I did it in 3 hours and 6 minutes. So close to my unspoken dream goal!

Most importantly, I was healthy the whole time and, in fact, my muscles and joints felt better than they had prior to my commencing training. I finished the race motivated to compete again, knowing that with the knowledge I gained from my training, I could reach my goal. Goals are important. Setting high goals are important. It helps you expand yourself and growth, whether you obtain the goal or not! Part of my purpose with the race, was not just the physical. I wanted to train my mental fortitude, too, in a way that I wasn't able to when I competed in triathlons previously in my 20's. I focused and learned from leaning into the discomfort that accompanies continued on when things get hard.

Don't wait until the pain comes, schedule a physical therapy visit with Liz at Artisan Physical Therapy to learn how to reach your goals healthily!

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

Stayed tuned for future blogs to read about how to tweak my training from what I learned from the experience. Let me know any questions you might have.

Liz

The 10% Rule. Do You Use It?

Have you heard of the 10% rule? Maybe you have but you still haven't put it to use. Maybe you have no idea what I'm talking about.

The 10% is a golden rule in health and fitness training to prevent injury, but it also applied to rehabilitation and recovering from an injury. Simply put: in a given week, you shouldn't increase the challenge you put on your body by more than 10%.

The wonderful thing is that our body changes and always contains that capacity in some form! Spend time on the couch and your body gets good at it. Work on stretching and your body will get more flexible. Work on strengthening and your body will get stronger. Start running and then running will get easier over time.

The hard part is that change takes time. We are often too greedy or impatient with our bodies or we give in to peer pressure of group workouts (boot camps, gym classes, yoga class, running groups, etc). Our desire is beyond what our body can do. This is commonly were injuries enter the scene. We push our bodies too hard, too fast without sufficient recovery time, we start to move in less ideal ways, and things start to rub in the wrong way and then our body sends messages to our brain to try to get us to stop. We perceive these messages as pain. Pain should motivate us to slow down or even stop for a period of time. (Now there's a difference, between good pain and bad pain, but that's a topic for a whole other blog post, or two, and a whole conversation to have with your physical therapist if you haven't learned the difference yet. Teaser - it's not about just being mentally tough.)

So if you are running and what to build up the mileage, don't increase by more than 10% per week.  So if you run 3 miles, 3x/week (9 miles total) and want to increase it, the next week you can add in another mile. That could look like 3.3 miles, 3x/week or 2 runs of 3 miles and 1 - 4 miles run. The 10% should also apply to speed, frequency, intensity (e.g. hills), etc.

If you are weight training, the 10% rule applies as well. It applies to the amount of weight, the number of sets, the number of reps, the number of days you lift, the number of exercise you do, the speed at which you lift.

The 10% rule applies whether you're a triathlete, yogi, walker, swimmer, tennis player, rock climber, soccer player or any other activity. Make it your rule and start incorporating it into you routine.

You body will change. Just be patient! Take the long view of it for long term health!

The same is true of rehabilitation and injury recovery. Just because you want to be back playing soccer, biking, running, or joining your yoga class next week, does not mean your body is ready for it. I spend a lot of time helping patients understand the need for slow incremental steps for optimum outcomes. Going back too early can lead to worse injury or for some constant pain.

This is simple, but it's not common sense. To get specific help on how to meet your physical goals, contact Liz. I'm on your side!

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

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

Race Goal for the Year

My first blog post of the year highlighted some of the goals I had for the year. How are your goals coming along? Typing this question, alone, is making me want to stop and go back to recheck on all my goals and see what progress I'm making & if I'm forgetting anything!

The goal on the forefront of my mind currently is my goal to train and participate in a race this year. I'm so pleased to report I reached a milestone! I signed up! "What race?" you ask. Well, I am opting for a triathlon - the Nautica Malibu International Distance Triathlon - to be precise. Now I'm excited and nervous. I got a lot to learn about ocean swimming and I've got some training to do to hopefully "race" it.

What do I mean by "race" it? It has to do with your fitness level. I am fit right now in terms of overall health and wellness in disease reduction activity lifestyles and with respect to my body weight and composition. I could participate in the triathlon event and complete it, possibly even this week, but it wouldn't feel good. I want not to simply finish it - although I think it is a great feat. I want to prepare, train, and give it my all - to go fast - that is, to "race" it. Let's be clear when I say race or fast, I mean my fast (not going to be winning any races here)!!

I'd love to hear about what your training for in life, how you're learning to persevere and be disciplined, and elevate what you think you're capable of. For me this all fits into the bigger picture of learning to live more WHOLE-HEARTED (my theme for the year) and even helping people living healthier, more satisfying lives with my work at Artisan Physical Therapy. Also let me know what training questions you have!

Together - Let's Get Moving!

Liz

Iliotibial (IT) Band Tightness/Syndrome - Anatomy, the Why, & the What

Iliotibial band or IT band tightness effects a large segment of the population and can manifest itself in many negative ways. It can get tight in the sedentary (aka non-active) population but is a common problem with runners, bikers, and cross fit participants or those regularly lifting weights.

Liz created a 2-part video series to help you understand the issue and what to do about IT band tightness and IT band syndrome. In this first segment, Liz talks about what the IT band is and why it becomes problematic. Then discusses some general ways to manage or prevent it. The follow-up to this video will go through specific stretching and strengthening exercises that are beneficial for minimizing IT band tightness.

Subscribe to the blog and the Artisan Physical Therapy YouTube channel to benefit from free advice and education from a movement specialist including part 2 of the IT band tightness series to get the exercise recommendations and demonstration.

Together, Let's Get Moving!

Liz

Injury Prevention for Cycling - Giving Back

A couple week ago, I spent some time teaching some injury prevention exercises for Team in Training coaches/mentors as they prepare to train others to ride 100 miles in "Americas Most Beautiful Bike Ride" to raise funds for lymphoma and leukemia ‬ research. I am so grateful and had so much fun giving to folks who are also giving. Definite paying it forward! Not only are they making their own life better by taking on the physical challenge to properly train for an 100 mile bike ride this June, they are doing it for a fantastic cause.

What I did was give them an overview of stretching and common areas such as the hip flexors, iliotibial band, and neck muscles that become tight due to use and position while on the road bike. We also discussed common alignment or positioning problems that people have when on the biking or pedaling.

Interested in what I suggested? Leave a comment and join the RSS feed for the blog and I'll send you the pdf of the exercises.

‪Thank you Team in Training - Los Angeles for the opportunity to help with this great cause.

To learn more about Team in Training visit the Team in Training website. To learn more about the Leukemia & Lymphoma Society visit the Leukemia & Lymphoma society website.