Latest Physical Therapy News

It's April in the Rockies and Time to Work Out the Winter Kinks!


April 11, 2018

Springtime: April showers, digging in the yard, hiking, biking, climbing, running, skateboarding, soccer, baseball, park days…..that time of sliding out from under the winter blahs and back into all those outdoor activities. It’s that time for those activities that Colorado affords us the opportunity to do 6 months out of the year by providing us clear skies and the perfect temperature. Of course, if you are a true Coloradan, you have already had the shorts, t shirts and sandals out for months.

Whether you are an extreme outdoor enthusiast or a casual admirer of CO’s beautiful weather, there are steps you should take to shake off the winter cobwebs. Jumping head first into your favorite spring activities can lead to soreness or even muscle and joint injuries. It’s a story we hear all the time here at Body Image Physical Therapy and Fitness. Here are a few exercises that can help with full return to activity and which can also lessen the possibility of needing to see your orthopedist or PT anytime soon:

Back bends:

Back injuries are both common and can be very serious. Dealing with pain from a back injury can take you out of commission for a significant period of time. It is important to take the necessary preventive steps to make sure you aren’t wasting any of your spring days stuck laying down on the couch. Back bends are especially important after bending over in the garden or spending an extended time in a forward bent posture, come back up to erect position slowly, while squeezing the butt muscles isometrically, and then gently bending slightly backwards a few times. This helps with realignment of the spinal segments and encourages the muscles to pull you back into a fully erect position more comfortably.

Pectoral stretches and scapular squeezes: 

We also spend so much time with our arms in front of us (think driving, computer work, knitting, holding a book, holding any electronic device, etc) that our chest muscles tend to get short and the postural muscles get too long and ineffective. Spend at least 60 seconds a couple times per day, putting your hands on your doorframe about eye level and leaning your body gently through the doorway to stretch the chest muscles. Then drop your arms at your sides and pull the shoulder blades gently down and together to help activate the postural muscles. This is a subtle motion and the arms should not move when you do this; just pull from the blades.

Quad and Hamstring stretching:

Another 60 seconds on each leg for the quads and the hamstrings will go a long way in loosening up the rest of the body. To stretch your quads, stand erect and bend a knee, bringing your heel to your butt. Keep the knees in line with each other and hold your foot with the hand on the same side as the bent knee. Place your other hand on a stable object in order to brace yourself for balance if you are struggling to hold the position. Next you will want to work on loosening the hamstrings. Simply begin by facing a chair (or any flat surface of a similar height), stepping back away from the chair, keeping all toes pointing forward, and placing one heel on the chair with the knee straight. Keep your body upright, and lean forward but all the way not down (like trying to keep your nose above water).
 

Calf Stretches: 

Calf stretches can be especially important for hiking. Calf cramps are zero fun and can happen easily if you don’t take the time to loosen them up. To stretch your calf you will want to find a wall or some other stable upright structure of some sort. Face the wall and step backward with your right foot, bringing your right heel all the way to the ground. Be sure you are keeping the toes of both feet pointing forward toward the wall. Your right foot should be stepped back far enough to where your left knee bends. Place your hands on the wall for balance. You want to be in a comfortable position, yet still feeling the stretch in your right calf. Hold this stretch for 30-60 seconds. After, switch the position of your feet to stretch your left calf.

Groin Stretches: 

When you have tightness in your groin and inner thighs, you may experience pain in both your hips and lower back. The following simple stretch is another great warm up for nearly any outdoor activity. The first step is to stand upright with your feet spread apart and toes pointed slightly outward. You will want to slowly lunge or bend your knee to one side until your knee is roughly over your foot. After holding the position for 30-60 seconds, stand back upright, and repeat the move to the other side.

Taking a few minutes to stretch is a much better option than taking a few days, weeks, or months to heal after damaging your body. Remember to stretch about a minute (watch the clock, please) as your muscles need time to understand they are being required to lengthen. Do not only stretch before engaging in physical activities. Also be sure to stretch after activities to re-lengthen the muscles and do dynamic warm up before activities to get the blood circulating for action.

When you incorporate a routine of pre and post stretches surrounding physical activity, you are doing more than helping to prevent injuries. Increasing blood circulation to muscles, improving your posture, acquiring a greater range of flexibility,  reducing overall soreness resulting after strenuous activity are all health benefits of stretching. However, there is no foolproof protection against sustaining an injury. If you do get hurt during your spring adventures, contact Body Image Physical Therapy & Fitness to help get you back in action in the shortest amount of time possible.
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Spring Cleaning - Advice on How to Properly Maintain Your Sports Equipment


March 14, 2018

With the first day of Spring quickly approaching, many people are dusting off their athletic equipment to use in the warmer weather. But what many don’t realize is that a simple spot shine won’t do the job of properly maintaining their gear. As with our bodies, proper maintenance of our athletic equipment can go a long way towards ensuring that you are getting the maximum benefit and investment from your bikes, skates, skateboards, snowboards, skis, rackets, running shoes and those ever so expensive orthotics.

Body Image PT, would like to remind you about the need to clean and maintain the many tools you may choose to use to keep yourselves active and healthy. Here are a few tips for you to follow as you start to take your equipment out of storage, and get them back into fighting shape.

Bikes

It may seem like a daunting task, but if you maintain all the parts of a bike you can rest assured that it will operate smoothly and efficiently for years to come. Before every ride it is important to inspect your bike. A good rule of thumb is to remember you ABCs! A for air, B for Brakes, and C is for chain.

When checking the tire pressure, it is important to the know the psi (pounds per square inch) for your tires. Narrow bike tires need more pressure than wider ones. Road bike tires require anywhere from 80 to 130 psi, hybrid tires need 50 to 70 psi, and mountain bike tires from 25 to 35 psi. When out for a ride it is important that you have a patch kit and a air pump with you incase you lose air or get a flat.

For brake inspections, make sure that they engage when you squeeze both the front and back levers. As for the chain, ensure that it is well lubricated and everything is clean. This will ensure that the gears shift easier and will help the parts last longer.  

Snowboards and Skis

Winter weather sports is slowly winding down but it is still important to keep your equipment in good condition for next season.

To start with, it is important that your skis or snowboard have a protective layer of wax, to keep them from drying out and to provide you with a smoother ride. While new equipment may come with “factory wax” already applied, many riders agree that giving them a hot wax treatment will go a long way in extending the life of your gear. Tools of the trade include wax, an iron and a scraper. While they sell designated irons for this purpose, any iron will suffice: but never use the iron on clothing afterwards as it would ruin your garments. It’s important to note that waxing isn’t a one-and-done step, but will need to be conducted from time to time.

When dealing with gashes caused by exposed rocks or other abrasive materials on the slopes, deal with them sooner rather than later. If it’s just a small nick, you can apply hot wax to the area, but if it is much deeper you’ll need to take it to a shop or you can repair it yourself with a P-Tex candle.

After each and every ride, remember to dry your equipment thoroughly as any moisture left on your board could rust the metal components. If you’re ready to hang up our skis or snowboard for good this season, give it a good wipe down and thick layer of wax that you can scrape off next year; and store it in a cool, dry place where it is not at risk of getting knocked around.

Skates and Skateboards

While skates and skateboards differ in their specific maintenance, the overall theme towards maintaining them is to tighten their components, keep them out of temperature extremes, and make sure that the wheels are well oiled to provide for a smoother ride.

Having the tools available can help you check the wheels, trucks, bearings and more without having to take your gear to the shop each time.  

Skates, skateboards, snowboards and skis all need upkeep as well.  Replacing worn parts (do the wheels roll smoothly and do your bindings release properly?)  will go a long way toward making your upcoming season a smooth, active, injury free one. There are many resources online that provide exceptional details towards skate and skateboard maintenance, so be sure to conduct your research when taking your things out of storage.

Tennis and Racquetball Rackets

Have you had your tennis /racquetball rackets restrung in the last decade?  Do the handles fit your hands properly? Or are you just itching to come to physical therapy with tendinitis created by an ill- fitting racket? Chances are, if you play hard with your rackets, they might need to be replaced or repaired.  

Running and Walking Shoes

Running and walking shoes are an item that some people are meticulous about replacing properly, and many more are not so good about replacing.  You know which one you are. If you fall into the second category, you are not doing your feet, knees, hips or back any favors by trying to slide through one more year in a pair of worn shoes.  A shoe is support for your feet so that they hit the ground properly, and propel you forward with ease and proper body mechanics. An orthotic being used in worn shoes will not substitute for having a proper shoe in which to put the orthotic.  

So let’s talk about orthotics.

Due to the expense of a molded orthotic, we tend to think they should last forever.  As our feet change shape pretty much constantly throughout our lives, this theory can be lacking in truth.  Your feet may no longer work with the orthotic you bought even 3-5 years ago. That ache you have been developing in your back could be related to the old orthotics in your shoes.  Start with a good shoe that supports your feet properly, then determine if you need an orthotic to assist you further.

Do some Spring cleaning to start your year off right.  It will help you play better and feel better.
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Dry Needling in Denver: What is Trigger Point Dry Needling, also known as TPDN, TDN, or IMS (Intra Muscle Stimulation)?


February 14, 2018

Have you ever wondered what those nasty little knots are that appear in your muscles and cause you pain?  They may be active trigger points in your muscle or connective tissue. Physical therapist that are trained in treatment of trigger points through trigger point dry needling. Trigger point dry needling can treat these points to provide relief of even chronic pain symptoms. The term ‘dry needling’ was coined to differentiate it from ‘injection needling’ where a substance (medication or otherwise) is injected into tissue with a hypodermic syringe.

Trigger points occur when there is too much electricity trapped in the muscle fibers.  This can happen through injury, misuse or overuse of a muscle. Trigger point dry needling is a technique where acupuncture needles are inserted into a myofascial trigger point, muscles or connective tissues to help release trapped electricity and, essentially, deflate the trigger to relieve pain.  It is known that the use of trigger point dry needling activates a ‘local trigger response’, an involuntary spinal cord reflex, although some of its biochemical and neurophysiological effects are still being studied.

While trigger point dry needling utilizes the same solid filiform needles, typically .16-.31 mm in thickness, that the Traditional Chinese Medicine of acupuncture utilizes, its science and research is based off western medicine principles and large body of research of the human muscular system.  The effects and mechanisms of dry needling are complex though research suggests that the local twitch response elicits a response from the brain in the area of pain or discomfort. There is a growing body of scientific evidence that supports the positive effect inserting a needle has on the electrical and chemical communications that take place in our nervous system, including the natural release pain relieving chemicals as well as the transmission of pain signals in our spinal cord. 

Trigger point dry needling can also be utilized as a diagnostic tool for physical therapists as the local twitch response would not be stimulated within healthy muscle tissue.  Trigger point dry needling may be heavily utilized near the beginning of a treatment plan as a means to break the cycle of pain.  After the technique is applied to a particular area, the muscle then needs to undergo re-education through exercise to help it learn how to work normally again.  This will help reduce recurrence of these trigger points, and help provide long term relief from pain.

Why does trigger point needling work?

The most widely accepted theory as to the reason trigger point dry needling works to help treat muscle spasms and reduce further muscle damage is that a muscle spasm creates a cycle of pain which further inhibits blood flow, oxygen and nutrients to the muscle tissue.  By introducing a needle and disrupting this cycle, the muscle is allowed to relax and repair itself while allowing further treatment using standard physical therapy practices.

This is a technique that should only be performed by someone who has been trained, and your physical therapist may be that person.  Physical therapists will typically utilize trigger point dry needling as a single tool within its larger treatment plan for any given condition.  Release of trigger points may provide relief from pain that has been present for short or long periods of time.  Some patients may feel soreness immediately following and even a few days after in the area of treatment and some may even see signs of bruising.  Most of the symptoms of trigger point dry needling are mild and will only last a few days, depending on the patient and in comparison to the pain usually experienced caused by the condition, the pain will be much less.

What can be treated by trigger point dry needling?

Trigger point dry needling can help with a variety of common conditions including headaches, shoulder pain, neck pain, back pain, knee pain, sciatica, Achilles tendonitis, plantar fasciitis, tennis elbow, golfers elbow, hip pain, gluteal pain, muscle strains, ligament strains, muscle spasms, jaw pain, sore muscles, tight muscles and more.

How is trigger point dry needling different from acupuncture?

As mentioned above there are some similarities between the Ancient Chinese Medicine of acupuncture and trigger point dry needling including the disposable, sterile needles used in each, however acupuncture largely is used as a method to treat ailments internally such as stress, insomnia and digestive problems.

With a session of acupuncture the needles inserted into a patient are done so along meridian lines and often left in for around 30 minutes.  The meridians lines represent the body’s organ systems.  By inserting needles along the meridian lines, acupuncturists attempt to rebalance and restore energy flow throughout the body.

In comparison, trigger point dry needling can oftentimes be finished in a few minutes depending on the condition, size of area and complexity of the problem.

Example of trigger point dry needling successes

Recent patient experiences include individuals suffering from muscles spasms in a patient’s back caused from a strain in one of the major shoulder muscle groups.  The strain of this muscle cause the body to use muscles which were much weaker causing them to contract beyond a point of function.  In order to restore function to the area, trigger point dry needling was done to these muscles.  Once the patient had relief from the pain, additional strengthening therapy was prescribed in order to teach the muscles how to properly function.

Who licenses and regulates dry needling in Colorado?

In Colorado, the Department of Regulatory Agencies and State Physical Therapy Board has regulated the use of trigger point dry needling in 4 CCR 732-1.  In the United States, Medical Doctors, Osteopaths, Physical Therapists, Chiropractors, Naturopaths and Acupuncturists are utilizing Dry Needling.

If stretching, massage, or just plain ignoring the pain has not worked for you, consider trying trigger point dry needling. Consult Body Image Physical Therapy to understand and discuss if trigger point dry needling may be a good option for you and your condition.
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Another Year…Another Elephant to Eat


January 17, 2018

So how long is your list of promises to yourself this year?  I know why I sometimes veer off my path when pursuing this list.  It contains large promises that quickly mold themselves into an elephant sized task list. Then, with the best of intentions, I make my plan of attack that includes  eating that entire elephant in one bite.  What’s the old saying? Something about one bite at a time, I think.

Promises we make to ourselves about our health may tend to become that elephant.  Whether we are too fat or too thin, eat too much or too little, or when we just eat the wrong things for the wrong reasons, making those large promises to ourselves may create a task that is just too big to tackle all at once. So how do we take the first bite?

Taking the First Bite and Establishing Routines

Just take the first bite, chew well, swallow, and repeat.  The repeating part is the hardest and the most important. Building a routine means sticking to a routine. It is physical and mental training that takes time to establish. On the other side of the coin, breaking down our current routines is an equally challenging task.

So what’s the solution here? Instead of tearing down the old and building up our day to days from scratch, we can make smaller, more palatable alterations to our routine. Perhaps instead of promising to start in the gym 5 days per week, how about we begin, this week, with 1 or 2 days, and a specific program in hand so that we are more efficient and effective when we walk into the gym.

The same applies to our diet. Don’t promise yourself that you are going to eat salad for every meal for seven days a week for the whole year, if it’s a promise that you are likely to break. It’s going to be hard to keep that promise when it’s the weekend and you’re driving by your favorite restaurant or if the smell of bacon is in the air. If you aren’t consistent, you aren’t developing a lasting positive habit. Try starting with a plan that includes cutting out snacks, eating salads for lunch, and sticking to a smaller portioned dinner.



Your goals should be relative to your current lifestyle. Take your existing plan and make moderate improvements. Once these improvements have been ingrained and comfortable, it is time to implement the next step toward your goals. A plan that takes 3 months to bolster is far more sturdy than a plan that falls apart after 3 weeks.

Finding the Right Path to Your Goals

There is more than one way to eat healthy. There is more than one way to get exercise. Sure, there are some hard rules when it comes to health and different practices typically will carry their own pros and cons. However, you can reach your fitness and health goals by a number of different paths. Ultimately, the best path is often the one that you are most comfortable with.

It seems like there is always some new diet trend popping up or some new power food that is all the rage. Soy milk, almond milk, skim milk, cashew milk - what milk is the best for you!? Do you cut out calories, carbs, meat, or fat? The sea of available (and sometimes contradictory) nutrition information can make trying to eat healthy more convoluted that it need to be. Some generally agreed upon things are the benefits of reducing and/or eliminating processed sugars, alcohol, and tobacco. Many other parts of these specific diet plans like the atkins, ketogenic, vegetarian, etc. seem to be in hot debate.

All of these diets have worked for different people. While there is science behind the potential benefits and consequences of each, the common factor of success is sticking to the plan. Consistently controlling and moderating your eating habits will eventually provide you results, no matter what form that diet takes.

This same principle applies to how you get your exercise. People often equate fitness with running on a treadmill and lifting weights. Many people enjoy such activities and consider it a hobby. Maybe the gym is not for you.  How about biking, hiking, walking, climbing, yoga, skiing, snowshoeing, walking in the mall, or taking a class? 1 mile…1 floor of the mall…1 class…1 bite.



There are certain considerations, of course. Are you trying to bulk up, trim down, or just improve wellbeing? What existing injuries and physical limitations do you have? Do you need a more convenient activity? The bottom line remains, especially in Colorado, there are many options worth exploring. Exercise and fun do not have to be mutually exclusive.

Thinking of Your Goals as Resolutions

New Year’s resolutions can be a very effective way of jump starting your often procrastinated and abandoned self promises. It helps to give a definitive start date to your efforts. Once these efforts are underway, it is time to drop the “New Year’s” off of “New Year’s resolutions”.

This will help you establish a long term mindset. Just because you’ve slipped does not mean it is time to abandon your plan. If you’ve made it a few months into the year, don’t let that vindicate your desire to pick up bad habits again. If either of these situations occur, you will probably find yourself making the same New Year’s resolutions year after year. Instead, try to imagine to pride and satisfaction of having improved your health for the whole year.

If you are not sure what you can do to meet your goals for the year, have old injuries, or pain that is not just muscle soreness after activity, you may need to seek assistance in building the right program specifically for you.  Trainers working together with physical therapists to build this program will help ensure your success.  Need help? Call us: 720-870-8900.  We are well versed in elephants.
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Had Joint Replacement and Still in Pain? Physical Therapists in Denver Can Help


December 20, 2017

Total joint replacement is a surgery that has provided pain relief for many people who have suffered with hip, knee or shoulder discomfort and pain.  Ads often times show patients who have undergone total joint replacement mid-run, smiling and--for all intent and purposes-- enjoying life again. The decision to undergo a complex procedure is not one to take lightly, but as physical therapists in Denver, we are happy to see someone make that decision to have the surgery when all signs are pointing toward a life limiting disability without the replacement.

Reasons for Replacement

Dealing with pain associated with joint movement is a symptom that could be the indication of something far more serious. Causes of joint pain can be anything from arthritis to infection even cancer in extremely rare cases.

For those who are experiencing chronic pain that is not caused by illness or infection, the most likely cause of said pain is essential the joint wearing down which has caused the bones to rub against one another.
The bones of the joint are typically covered in a substance called articular cartilage near their ends that allow them to easily glide against each other. In between the bones is another substance called synovial fluid which acts like oil in a car to lubricate the joint further. If either the cartilage, or fluid is damaged or diminished, problems can develop and lead to stiff and painful joint movement.

What Happens When a Joint is Replaced

Typically when people think of joint replacement, the knee and hip are what come to mind, but there are other less common areas where replacement surgery can help. The shoulder, ankle and even the finger joints can all be replaced to better help the patient live a regular, functional life.

When a joint is replaced by a surgeon, what essentially happens is the worn or damaged parts are removed and replaced with prosthesis that are fitted to the area and allow the joint to behave as it normally would in a healthy individual.
  • Before
    • Since joint replacement involves anesthesia, except for finger joint replacement which can be done as an outpatient procedure, your surgeon will require a physical examination. In some cases they may require more examinations to be performed such as blood tests, X-rays, and MRIs.
  • During
    • Depending on the area which is being replaced, you will be placed either under general anesthesia or have a spinal block, which numbs the lower half of your body and is typically for knee and hip replacements. During the procedure, your surgeon will remove the infected or damaged areas and fit your bone to the prosthesis which will replace the joint.
  • After
    • Once your surgery is complete, you’ll be taken to a recovery room where you’ll be monitored as the effects of the anesthesia wear off. From there you’ll be placed in a hospital room where you’ll be under supervision for the first few days afterwards to ensure no complications arise. Complications include:
      • Infection
      • Blood clots
      • Joint Stiffness or further pain if your body rejects the prosthesis
      • Dislocation
      • Loosening
One of the biggest risks after surgery is blood clots developing. In order to combat this you’ll be required to walk or move the area the day of, or after your surgery. You may also be required to take blood thinners and have a compress on the area to further deter clots from forming.

Physical Therapy to Ensure Your Back to 100% Functionality

The overall objective of the surgery is to help return the recipient to full activity without the underlying joint pain they have experienced for so long by ensuring that the bones connected to the joint in question don’t rub against each other.  

So the question is, if it is such a wonderful procedure, then why do some people still have pain and dysfunction after going through the discomfort of the surgery? The answer sometimes can be that something needs to be addressed by the surgeon, but more often than not, the answer tends to be a little more simple.  There is generally still work that the patient has to do post-operatively to make the joint replacement a total success.  

In physical therapy, we see the end result of many years of limited use of the limb in question; decreased range of motion, decreased muscle tone and strength, and an overall loss of ability to balance.  When a joint is painful, we just do not use it fully anymore, leading to all of these issues.  The replacement of the joint surfaces takes away the pain of bone rubbing against bone, which generally is the most direct cause of the pain, inflammation and swelling.  Once the new joint is in, now attention has to be turned to regaining all that was lost over the time when the joint was used on a limited basis.  


Unfortunately, just walking, riding a bike or swimming will not get back full motion, strength, or full functional capability.  Some people are just glad to have the majority of the pain resolved with the surgery, and simple functional capability returned, and really are not interested in anything beyond that.  
A much larger number of people, however, want to regain what they have lost over the years of joint dysfunction.  Your physical therapist is trained to test for loss of not only muscle strength, but also joint mobility and balance.  A program is then designed for each individual, taking into consideration what they personally have lost along the way.  

The lesson here is this….You may not be stuck with whatever you were left with post operatively, no matter what the surgery.  There are exercises specifically aimed at functional return for every body part, including those areas you thought were going to be an issue forever.  Not sure? The physical therapists in Denver at Body Image PT can discuss your issues and compile information and a schedule for you to regain more function in your limbs. Whether it’s knee pain or your experiencing chronic pain associated with your surgery, the skilled team at Body Image PT can help. Call today at 720-870-8900.  
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