Think there’s nothing you can do about arthritis? Great news! You can act right now. Some of the ideas here are simple, one-time actions. Others are first steps toward longer-term goals. All can directly or indirectly improve your health, outlook or pain level, and can generally make life with arthritis a little easier.
• Pay attention to symptoms, see your doctor and get an accurate diagnosis
• Start early -- The earlier an accurate diagnosis is made and treatment started, the better.
Protect your joints -- Avoid excess stress on your joints.
• Get moving -- Exercise helps lessen pain, increases range of movement, reduces fatigue
and helps you feel better overall. A well-rounded workout routine for people with arthritis includes flexibility exercises to increase range of motion, aerobic exercises to improve endurance and decrease fatigue, and strengthening exercises to improve muscle fitness. Your doctor, a physical therapist, or other specially trained health professionals can show you range-of-motion exercises and strengthening exercises that are good for arthritis.
• Pick, pour or peel – Recent research has shown the importance of vitamin C and other antioxidants in reducing the risk of osteoarthritis and its progression.
• Play it safe in the sun – Protect yourself when you go out into the sun — wear sunglasses, a hat and sun screen.
• Resolve to reduce – Lose weight. You won’t just look better, you’ll feel better, too.
• Bone up – Stock up on your favorite source of calcium.
• Begin with breakfast – Like you’ve always heard, a healthful breakfast is a great way to start the day.
• Try this on for size -- A well padded, well-fitting shoe with plenty of room for your toes can make a world of difference in the way your feet feel.
• Take a hike -- Choose your favorite spots (indoors and out) and make plans to walk them at least once a week.
• Sit, soak and soothe – A warm bath before bed can relieve muscle tension, ease aching joints and help you get a good night’s sleep.
• Treat your muscles – Find a certified massage therapist and treat yourself to a good rub down.
• Stretch your legs, arms, body -- Stretching is a simple way to keep joints and muscles flexible. It relieves stress and can help enable you to maintain your daily activities.
• Take the plunge – Exercising in the water can build strength and increase range of motion, while the water’s buoyancy reduces wear and tear on sore joints.
• Make an ice pack -- When joints are hot and inflamed, applying something cold can decrease pain and swelling by constricting blood vessels and preventing fluids from leaking into surrounding tissues.
• Enjoy Your Exercise -- Take the work out of working out. Sign up for a class that makes exercise fun

For more information about treating arthritis, please visit the arthritis.org website. Excerpts from arthritis.org collected by licensed Physical Therapist David E. Larson, MSPT

“Wait, what?  How many did you say?”

Usually, this comment is accompanied by a raised brow and a surprised look.  “Yup.  That’s right.  You’re going to be doing a x reps...but over y-z number of sets.”  

That’s the answer that usually follows.  The reason this is so surprising for some people is that x is usually somewhere in the range of 75-100 and y-z is anywhere from 3-5.  That’s a lot you say?  Well, after reading this, it may make a little more sense.

Coming to physical therapy usually means there is some sort of injury, movement, or posture that needs to be addressed or corrected.  For the most part, this is concurrent with having a strength deficit, a muscular imbalance, a decrease in endurance, or even compensation for pain with a certain movement pattern.  To address these issues, we, as physical therapists, have to develop treatments for 1) increasing endurance, 2) pumping up strength and building muscle, and 3) reteaching proper neuromuscular movement patterns.

Each therapist has his or her own bag of tricks to cater to each and every one of these needs, because there are hundreds of different exercises/activities to reach these goals.  However, there are only a handful of parameters that are the most efficient to achieve them.

For the most part, research has shown that performing high repetitions with low weights is a great way to increase endurance.  It helps to increase circulation for healing purposes and also begins to push away the inflammatory chemicals produced by recently injured tissues.  Repetitions range from 15-25 reps, with the amount of weight dependent on the body part being exercised.  The amount of repetitions should be set so that one is pain free and able to complete them without being totally spent after a set. The number of sets ranges from 3-5 sets, depending on endurance and intensity.  Rest breaks are on the shorter end, around 15-30 seconds.

Building strength moves towards the other end of the spectrum - lower reps, higher weights.  With great strength comes great responsibility...wait...that's Spider-Man.  What I meant to say was that building strength comes a with greater exercise intensity.  Here, weight and load are increased, and repetition ranges from 8-15.  To build more strength and muscle, more load has to be moved.  Since the weight is higher, the number of sets are lower, around 3-4.  It also comes with a longer recovery period between sets, around 30-45 seconds.  

Reeducation of a compensated movement pattern runs a similar gauntlet as endurance training - just beat it up with high repetition.  A compensation happens if a certain motion is painful.  The body is very efficient in moving itself in the most pain free way, even if it is not the most efficient way.  The way to overcome this is to teach the body that it has to move back into its normal movement pattern.  This can only occur if we are able to work a client in a pain free/decreased pain range of that certain motion.  Once that is achieved, just getting the body to perform that movement over and over, repetition upon repetition, is the way to go.  It is essentially telling the body, “Hey, this is a better and more efficient way to do this.”  When this is figured out, the body will automatically adopt that pattern.

So that’s why you have to do 100.  There is a pretty good foundation of for doing all of those repetitions.  I’m not just trying to be mean...usually
 ;-)

Let me know what you guys think!  This is a pretty generalized overview of these topics.  To really get a good individualized plan for you, give us a shout.  You can email me at sancho@jointventurespt.com or if you live out of town, you can contact your doctor or local therapist!

Daily Human Dilemma
The vast majority of humans are struggling from sore necks. One favorite area of disgruntled discontent is just between the shoulder blade and the spine, the "Rhomboids." When the rhomboids are in working order, they assist with retraction of the scapulae (shoulder blades). Hence, they give the shoulder girdle stability. When they are weak, the other muscles of the shoulder suffer, leading to complaints of neck pain.

The issue at hand (and shoulder)
They come to me. As a massage therapist, I see them often. The issue is the same, over and over, and over again. These same muscles, the same pattern of tension and the same pattern of strain. Why?

Hint: Shoulder bag. 8 ounce mouse.

Primary Causes
The gravitational pull downwards upon the top of the shoulder affects not only that area at the top, but also affects further downwards, causing strain to these Rhomboids. 8 hours of slouching ever so slightly forward using using the muscles in front of your shoulder to move that 8 ounce mouse - creates weakness to the muscles opposite, these muscles in between the shoulder blades.

The Martial Struggle
And you thought you were alone? Martial Artists struggle in a similar manner, though typically not from shoulder bags, but forward thrusts and fists extended outwards, towards their opponent. The same result: weakness to the opposing muscle groups - commonly the rhomboids.

You do not need to suffer.

Strength Training
Often people are training in the gym and are drawing the arm back, though the elbow is outward, away from the body (right.) This works beautifully for White Crane Shaolin Kung Fu, though it does not train the Rhomboid muscles. The proper form for training and strengthening weakened Rhomboids is demonstrated in the photo at the left.

Jim Knoble, above, instructor from Yang's Martial Arts Association www.ymaa.boston.com demonstrating Shaoling White Crane Kung Fu and Rhomboid training using a theraband. (Information taken from John Bondlow our massage therapists blog @  http://integratedtherapy.blogspot.com/

Through my years of practice in physical therapy, I have come to terms with the mentality of the “Weekend Warrior.”  Whether it’s a less active individual inspired to get off the couch in late fall and rake leaves for 8 hours, or the former college athlete, who hasn’t been out on the court in a few months and thinks her body is invincible, returning to the sport she grew up playing, weekend warriors are everywhere.  A great number of my patients feel participating in a sporting activity once a week is enough exercise, and they don’t think about preparing their body for the return to activity after a period of time off.

Tennis is just one example of a lifelong sport that people often revisit through life.  It has been the sport that’s always played a role in my life.  My participation started as a child, playing recreational tennis in my hometown growing up, then playing for my high school (boys!) tennis team, and, surprisingly, making my college team.  After college, I continued to play regularly, and not until this past year did I stop. I moved to a new city, was starting a new life, and finding a new outlet to play tennis wasn’t high on the priority list.  Recently, I started back up, dusting off the racquets, getting back out there, and enjoying the game.  I forgot how much I loved playing. BUT….my first time out, after a long 90 min session with an instructor, I realized: I had turned into a Weekend Warrior!

I do exercise regularly, stretch, strengthen, and find different cardio activities to keep me feeling good, but I did not prepare enough for the return to tennis. Nothing to prepare me for the critical components of playing (serves, strokes, and quick accelerations to the ball) you take granted when you’re doing it 4-5 times a week.  After about 10 months off, my mechanics of all those components changed, and I was putting myself at risk for injury.  To compete at any level includes preparing motor skills such as power, strength, agility, speed, explosiveness, and coordination. Another important area of returning to participation in sports is flexibility.

Over the years of my participation in the sport, warming up for tennis has changed.  Coaches have different philosophies, team captains lead warm ups differently, and recreational teams sometimes don’t warm up at all. New studies have shown the importance of dynamic stretching and sport specific warm ups. Tennis players of all levels should consider the following steps for proper warm up:

1. Cardiovascular warm up: A general warm up lasting between 3-5 minutes such as jumping rope, jogging, or jumping jacks.
2. Dynamic stretching including: Walking knee to chest with a heel raise, Grapevine or Carioca, Forward walking lunge with trunk rotation, Gradual small to large arm circles, Jogging “butt kick,” Lateral gallop, and Serving Circles.
3. Agility foot drills: Running the lines forward, back, and laterally, and Spider Drill from the base line.
4. The above basic warm up is a good way to get started before full participation on the court with a hitting warm up:
5. Mini-tennis from the service line. Mini-tennis cross court.
6. Pop-up volleys.
7. Baseline rally. Cross court rally.
8. Volley feed.
9. Overheads.
10. Serves.

Core Sta...what?
Core stability.  That's right.  Core S-T-A-B-I-L-I-T-Y.  The concept is often overlooked in the rehab setting and almost completely lost and misunderstood in the everyday gym world. 
I often get a lot of questions about core stability at the clinic. From the types of questions my clients ask me, it is clear that the understanding of the public just nips at the fringes of this concept.  It can range anywhere from "I've never heard of that before" to "Isn't that your abs?" and "I do crunches for that."

The complexities of the subject can make everyone's head spin.  Today, I want to share a very basic intro into what core stability is.
Core stability describes the function of the region from the diaphragm, abdominal wall, lower back and the pelvis.  The stabilizers of the body basically consist of passive structures, which are your connective and other inert tissues, and active components, which consist of your muscles.  The active muscles include the transverse abdominal muscle, the diaphragm, and other deep postural muscles like the deep lumbar erectors and stabilizers.  These muscles form a natural body belt from the front of the abdomen circling around to the lumbar spine.  Contrary to popular belief, the core muscles ARE NOT THE SUPERFICIAL ABDOMINALS.  They are all the muscles beneath them who are doing all the behind-the-scenes work.  What do they do?  Well, these muscles help to reinforce posture and form during every task and function one performs in everyday life.  The core muscles tense the body in response and preparation to movement.  In doing so, they keep the body in an effective posture to transfer the energy of movement, so that all your movements are as efficient as possible.  If you think about it, when you try to pick up a bag of groceries, it is easier to perform when your midsection and low back are tense, rather than relaxed.  
 
I usually tell clients that the core is like the foundation to a house.  A good strong foundation makes for easier additions and building, whereas a weak foundation will result in a collapse as more stress is place on the building.  Another one I tell clients is that having a good stable core is like running on concrete.  You get good propulsion with each step because of the firm surface to push from.  When your core is weak, it's like running in sand, where each step is very inefficient.  That's because the sand is not able to push back in response, but instead, it absorbs the energy of your push off.  
 
In physical therapy, core stability is a very important concept.  Weak stability often results in back pain.  The core helps to protect the lower back with the tension it produces during lifting and bending activities.  If it doesn’t activate correctly or on time, then the lower back is at risk for injury and increased strain.

There's a quick overview of core stability. I would like to hear your ideas, comments, concerns, etc, or if you would like to learn more, you can email me at - sancho@jointventurespt.com

Hey Ladies!  What are you doing this Wednesday and Thursday? Joint Ventures will be at StyleFixx Girls’ Night Out May 12-13, 2010, giving free massages! Join Boston’s most fashion-forward women for two nights of dream shopping, featuring over 55 cutting-edge designers and brands. Indulge in complimentary makeovers, hair treatments, cocktails, manicures, massages, Swag Bags and more!  www.StyleFixx.com

This is a really fun night to go out and shop with the girls!  We have been part of StyeFixx for several years now, and it is always a good time!  Some of the highlights include:Meet Project Runway Designer Kara Janx and shop her Spring 2010 line!
Sip complimentary Champagne, cocktails, Stella Artois®, and BareFoot Wine.
Enjoy complimentary hair treatments by Enzo Milano®.
Pamper yourself with free makeovers by Motives® Cosmetics.
Score our famous Swag Bag stuffed with goodies! (New Totes)
Relax with a Free Joint Ventures Massage!

Purchase your tickets at www.StyleFixx.com.

  

The elbow joint is made up the humerus, ulna, and radius. Together these long bones form a hinge joint which allows the elbow to rotate, flex and extend.  The lateral or outer portion of the elbow is called the lateral epicondyle which originates from the humerus.  Tendons attach at this point and can be injured. One of the many injuries that can occur is tennis elbow.

Causes

  Tennis elbow is characterized as soreness, pain, and inflammation that is located on the lateral or outer side of the elbow. It is caused by an overuse injury by repeatedly using the wrist and forearms muscles of the involved arm.  The repeated stress may cause inflammation, soreness, pain, and in extreme cases tiny microscopic tears in the tendons that attach the forearm muscles to the bone. Typical motions that can cause tennis elbow include tennis, painting, plumbing, postural problems, and overall poor technique with activities that require a backhand stroke.

Physical Therapy

A physical therapist can diagnose and treat tennis elbow. He/She will evaluate the biomechanics of the upper arm, elbow, and wrist, range of motion, strength of surrounding muscles and any postural problems. Treatments may include manual therapy to promote an increase in painfree range of motion, stretching to lengthen any tight musculature of the upper extremity, modalities to promote healing and possible technical changes to specific sport or work related activates that are causing postural problems.  A physical therapist will put you through a stretching and strengthening exercise program to eliminate the pain felt by the elbow and return you to your normal everyday lifestyle without pain as quickly as possible.  Your Joint Ventures physical therapist can perform all of these treatments to assist in the recovery of tennis elbow.

Some good resources I’ve found are the Science Daily Website, and the website for the Harvard University Skeletal Biology Lab:

http://www.barefootrunning.fas.harvard.edu/index.html

Happy Running!

Jessica@jointventurespt.com

Listen to your body.

Know what works for you… It may not be the same as what works best for your friends, but if you have a successful run/race, you did it correctly!

 If your body hurts then rest, cross train, and or talk to a professional/coach about it.

 You don’t get strong by running; you must be strong to run!

 Your feet affect every aspect of running.  If you have pain somewhere in your body and there is no known injury to that body part, look to your feet (or better yet, have a PT/Podiatrist/MD look at them, too!)

If everything is okay with your feet (including shoe fit/wear mileage), look at your hips.  Stability through your pelvis is KEY!

Common Running Injuries:

(All of these may result from the biomechanical problems described below, overtraining, or a combination of factors!)

1)      Runner’s Knee/Chondromalcia Patella/Patellar tendonitis:

The space behind the kneecap or the tendon attaching the kneecap to the shinbone becomes irritated and painful.  Generally, the quadriceps muscle is not strong enough to handle the load/impact from each step you take, or the foot is collapsing too much and the impact is being transferred to the knee.

• Quad strength – Straight Leg Raise, Single Leg Balance, Double and single leg squats

• Glute Strength – Side lying leg raise, sidestep, BOSU/balance exercises, 4-way kick

• Custom or Over the Counter Inserts/Changing Shoes

2)     Stress Fractures

Although a stress fracture is not a full fledged fracture, it can sideline you!  Runners typically see them in the tibia (shinbone), but the can occur anywhere.

• Try some non-weight bearing exercises to cross train, like aqua jogging, swimming, cycling, etc

3)     Iliotibial Band Syndrome

Pain on the outside of hip or knee is generally caused by weakness on the inside of your quadriceps muscle and the outside of the hip/glutes.  This tendon runs from the top of your hip to the outside of your knee and is not very flexible.  When you rely on it more than the muscles in your thigh, it gets irritated!

• Stretch the ITB

• Strengthen quads and glutes as above

• Wear the appropriate shoes

4)     Shin Splints
Irritation of the tissue that connects the muscle in the front of your shin (anterior tibialis) to the shinbone (tibia) can result from improper footwear, or tight calves.

5)   Plantar Fascitis

The plantar fascia is very tough connective tissue that covers the bottom of your foot (arch).  Pain in the heel or arch, especially when you first get up in the AM is a hallmark sign of this problem!  Can be caused by; a loss of arch height, increase in activity, tight calves, and or improper footwear.

• Stretch the calves and bottom of your foot

• Strengthen the bottom of your foot

• Change shoes/inserts

6)     Achilles Tendonitis

Typically pain in the lower part of your calf, usually results from tight calves, poor mechanics at the foot, poor calf strength

• Stretch and strengthen calves

• Change shoes/inserts

7)     Muscle Pulls

Micro tearing of the muscle tissue, usually when you ask a muscle to do something it is not ready for.  (I.E. running without a proper warm up or sprinting across the street to avoid being hit by a car)

You need to give the tissue time to heal before stressing it with running

8)    Ankle Sprains

We’ve all done it! Be careful about pot holes, curbs and ice!  If you twist your ankle, keep your shoe on until you are somewhere you can get ice on it.  The shoe will help stop some swelling. RICE!

• Single leg balance, eyes open and closed, 4-way kick

• BOSU balance ex

9)     Dizziness/Nausea

Hydrate but don’t over hydrate!  80z fluid per 20 min of running is generally enough.  When you find a drink/water/gel combo that works for you don’t mess with it!  Some people can tolerate solid food and others can’t.  Know what works for you.

10) Blisters

Proper fit of shoe/insert and drywick or wool socks that don’t allow moisture to accumulate on your skin.

If you have any questions about any of these injuries or are experiencing any of these symptoms, please feel free to contact one of the physical therapists at Joint Ventures or your doctor.

Joint Ventures Physical Therapy and Fitness is proud to introduce the Grand Opening of their 6^th location in the Boston area. The new office is conveniently located in Kendall Square.  We have partnered with Equilibrium in the Watermark Building at 350 Third Street.  This connection continues to expand our relationship with the EQ to provide you with all around fitness and wellness. We currently have 5 individual treatment rooms offering 1-on-1 physical therapy services, massage therapy, acupuncture and spa services.

Joint Ventures is excited to continue to grow and offer state-of-the-art quality care and wellness services to the Cambridge community.  Please stop by our new location anytime for a tour of the facility.

To schedule an appointment for any of our services in Kendall Square, please contact us at 617-536-1161.

Joint Ventures Physical Therapy

Located at Watermark Building

350 Third Street

Cambridge, MA 02142