Active Care Rehab

Squats, Not Kegels for Pelvic Floor Dysfunction

images6X49OM13Most pregnant women have probably been told they need to strengthen their pelvic floor and do their kegel exercises. Today I would like to share an article that shines a new thought on this concept. The author suggests that preforming a deep squat will actually lengthen and help women become aware of how to actually use their pelvic floor.

Stop Doing Kegels: Real Pelvic Floor Advice For Women (and Men)

It is important for all women (pregnant or not) and men to address the pelvic floor if pelvic pain is present. For more info on pregnancy related pain and treatment see my article and exercises.

Active Care Rehab

Suffering From Shin Splints?

thSuffering From Shin Splints?

If you are suffering from shin splints try this exercise (link above). This will help strengthen your Tibialis Anterior the main muscle on the front of your shin and the muscle responsible for flexing your foot (opposite of pointing your toes). For more info on shin splints see my article here.

Active Care Rehab

Lower Cross Syndrome and Anterior Hip

LCSLower cross syndrome is named for the crossing tightness and weakness that occurs in the lower back, core, and hip muscles.  In LCS, tightness of the low back muscles crosses with tightness of the iliopsoas (hip flexors) and rectus femoris (main quad muscle). Weakness of the deep abdominal muscles crosses with weakness of the gluteus maximus and medius.

This pattern of imbalance creates joint dysfunction, particularly in the lumbar spine, pelvis, hips, and knees. Specific postural changes seen in LCS include anterior pelvic tilt, increased lumbar curve, and knee straightening. Stress is increased on the low back and hips due to tight muscles and can cause pain in the low back when running, walking, and standing for long periods of time.

LCS is common in females, individuals that sit for most of the day and individuals that perform repetitive activities such as running and jumping. Many common injuries that plaques the active person can stem from LCS. Treatments for lower cross syndrome consist of postural training, Active Release/Graston on overactive muscles, and rehab exercises for underactive muscles. Additional home treatments for Lower Cross are foam rolling the quad and anterior hip muscles, Nature Made High Potency Magnesium 400 mg – 150 Liquid Softgels
for overactive and sore muscles, and anti-inflammatory nutrition for proper healing. Anti-inflammtory book.

Foam Roll

In Lower Cross Syndrome the anterior hip is chronically tight and lacks motion due to muscle overactivity and posture. If one can not move through the anterior hip, the low back has to become hypermobile or have too much motion. This can lead to low back pain and inhibition or weak core muscles.

The anterior hip consists of the large muscle of the quadriceps, Rectus Femoris, and the large hip flexor, Psoas. When these muscles become chronicalant hiply tight, the anterior hip capsule or ligaments begin to shorten. Now the hip can not translate or move through its proper range of motion and the gluts are put into a weakened, elongated state. The lumbar spine compensates by increasing its curve which causes the core muscles to weaken and shut off.

This process leads to overuse of the low back and pain, glut and core weakness, and hip impingements. If you have hip or low back pain, and/or Lower Cross Syndrome the click here to see this weeks exercises.

Yours in health

Dr. Justin Hildebrand

Active Care Rehab

Cervical Disc and Neck Pain

Dr. Justin Hildebrand

This week we are going to discuss the cervical (neck) disc herniations. The cervical spine or neck consists of seven vertebrae and five disc which allow the spine to be flexible.

When the discs (much like the Lumbar Spine) become irritated they can begin to migrate posterior or backwards and cause pain. When the disc migrates it can become a bulge or herniation.

A herniated disc usually is caused by wear and tear of the disc. Today, we speed this process up due to postures such as rolled shoulders and forward head posture. These positions place a large load on the lower neck and place the disc under increased pressure.  Herniated discs are much more common in people who smoke, Cervical or Lumbar.

Herniated discs in the neck can cause pain, numbness, or weakness in the neck, shoulders, chest, arms, and hands. Early signs are pain in…

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Active Care Rehab

Shin Splints and Ankle Injury Prevention

http://www.mdguidelines.com/shin-splints
http://www.mdguidelines.com/shin-splints

With the the new year approaching and many new years resolutions to be active, injury prevention should be on everyone’s mind. Many lower extremity conditions can develop through training, competition and overuse. Some common lower extremity conditions that plague the weekend warrior and even the avid runner are shin splints, plantar fasciitis, IT band syndrome, and various bursitis’.

These conditions commonly share biomechanical dysfunctions: weak foot intrinsic muscles, ankle instability, overactive calves, and weak glutes are just a few. Shin Splints, also known as medial tibial stress syndrome, result from too much force being placed on the shin and connective tissues that attach the muscles to the bone.  Symptoms are pain and tenderness along the inside of the shin during activity and at first generally calms down after exercise.  In chronic or long-standing cases, pain may persist after the activity.

Risk-factors for shin splints are tight calves, unstable ankles, weak anterior tibialis and having flat feet. Running on hard surfaces and participating in activities with sudden starts and stops may increase your risk for developing shin splints. Treatments for shin splints consist of stretching, Active Release and/or Graston, and functional rehabilitation of the feet, ankles and leg muscles. One can prevent this leg pain by choosing the correct shoe wear for their feet, cross training and varying their running surface. Strengthening insoles  can be helpful.

The ankle is a joint primarily made up of 3 bones and many ligaments. The muscles of the lower leg and feet act to stabilize the ankle along with their primary functions. When imbalances occur in these muscles ankle stability is lost and the chance of injury greatly increases. Commonly, the calf becomes overactive, weakening the anterior tibalis and changing the arches of the foot. Dorsiflexion or foot rising is lost causing the toe raising muscles to be recruited. These overactive muscles begin to produce extra stress on the shin. Over time stress pulls on the tibia leading to pain.

As the muscle imbalance grows the ankle becomes more unstable. The ankle ligaments are continuously stretched and pushed to their limits. At this point, ankle sprains and strains can occur. So if you are dealing with shin splints or “weak ankles,” click here to see exercises that maybe beneficial to you.

Yours in health,

Dr. Justin Hildebrand

Active Care Rehab, Manual Therapy

Shoulder Impingement and Rolled Shoulders

shoulder_impingement_intro01The shoulder joint consist of the shoulder blade, the humerus, and many muscles and ligaments. The key muscles are the rotator cuff (supraspinatous, infraspinatus, subscapularis, and teres minor), scapula stabilizers (serratus anterior and low-mid traps), and the pec muscles. When these muscles become imbalanced limitations and injury can persist.

Shoulder pain occurs in nearly ¼ of the general population and shoulder impingement is the most prevalent diagnosis in these cases. Shoulder impingement is also called supraspinatus syndrome, swimmer’s shoulder, and thrower’s shoulder and occurs when the tendons of the rotator cuff muscles become irritated and inflamed as they pass through the joint. The rotator cuff muscles become compressed during movement and the body has to adjust to perform movements.

Symptoms of shoulder impingement are pain with raising arm from the side, weakness in lifting the arm, and loss of range of motion in the shoulder joint. This occurs due to incorrect repetitive motion and faulty posture. These faulty movements and postures tend to cause overuse of the pec muscles, levator scapulae, upper trap, and some of the supraspinatus.  At the same time, weakness of the mid and lower trap occurs. These imbalance leads to increased faulty movement patterns of the shoulder and injury occurs.

 (Photo: erikdalton.com)
(Photo: erikdalton.com)

In today’s society, rolled shoulders or forward shoulders are occurring more and more. This occurs due to computer/desk jobs and the fact that we sit for most of our day.

Commonly when the shoulder rolls forward the pec, upper trap and levator scap muscles become overactive. As a result the shoulder blade elevates and the arm rotates inward. This position places the shoulder stabilizers in a long, weak position. When imbalances occur in these muscles stability is lost and the chance of injury greatly increases.

As the imbalances and faulty posture continues, increased stress is placed on the shoulder, especially the supraspinatus. Due to the rolling and shoulder blade position the space the supraspinatus tendon runs through is lost and the tendon becomes impinged. Over time this compression leads to irritation and inflammation and pain follows.

Treatment for shoulder impingement consist of stretching, Active Release and/or Graston, and functional rehabilitation of the shoulder blade stabilizers, thoracic spine, and rotator cuff muscles. So if you are dealing with shoulder pain see this weeks exercises by clicking here.

Yours in Health,

Dr. Justin Hildebrand

Active Care Rehab

Lumbar Disc Injury Prevention

The low back consist of five lumbar vertebrae and the sacrum or “tail” bone. Between these vertebrae are discs that act as ligaments and allow the spine to be flexible. A disc is a little like a jelly donut, with a softer center encased within a tougher exterior. When the discs become irritate they can begin to migrate posterior or backwards and cause pain. When the disc migrates it can become a bulge or herniation.

Many factors play a role in disc herniation. The most common are flat-back posture (plumber’s crack), prolonged sitting, working in a slumped position, and incorrect lifting/bending posture. All of these factors place increased pressure on the disc and can lead to irritation and possible herniation.

The symptoms of disc irritation or herniation are pain in the low back, buttock or hip (most common) and radiating pain down one leg. Pain is generally worse in the morning and subsides with movement, increases with sitting or driving, and is irritated with changing of position such as sitting to a standing and rolling over in bed.

According to the Mayo Clinic “Conservative treatment… relieves symptoms in nine out of 10 people with a herniated disk. Many people get better in a mo

http://www.jandacrossedsyndromes.com/
http://www.jandacrossedsyndromes.com/

nth or two with conservative treatment.” Treatments consist of correcting seated posture, adjusting activities of daily living, corrective exercise, and treating dysfunctions with manipulation, Active Release, and anti-inflammatory nutrition.

The classic disc presents with the symptoms: pain in the low back and/or buttocks area that may or may not travel down one leg. The pain is generally in the SI joint or back of the hip. It will increase with sitting or being slumped over.

The disc patient generally has a flat low back and tight posterior muscles. The hamstrings are tight so the patient can not generally bend down and touch their toes easily and the “piriformis” muscles are tight so sitting in a cross legged position is not comfortable. This presentation generally looks as if the back is rounded and the buttocks is clinched while standing.

Most disc presentations state “I just bent over to pick something up and had pain in my back.” Repetitive flexion (bending) or rotation movements set up the low back for injury.

So if you are dealing with disc-like symptoms click here to see rehab exercises.

Yours in health,

Dr. Justin Hildebrand