Unlock the Hidden Potential of Your Health Insurance: A Year-End Wellness Revelation!

Unlock the Hidden Potential of Your Health Insurance: A Year-End Wellness Revelation!

As we approach the culmination of another year, reflections on resolutions made linger in the air. Some aimed for weight loss, others sought to embrace the present moment. But in the pursuit of a healthier lifestyle, one often-overlooked ally stands ready to assist - your health insurance.

Within the realm of insurance, there are three distinct types, each with its unique approach to coverage. Some demand a deductible before covering health expenses, while others allow you to allocate a portion of your earnings for health services. Then there's the heavyweight, a prominent contender (it rhymes with Shmedicare) which allocates a specific yearly budget for your health needs.

The pivotal moment arrives now, when deductibles are met or dwindle to a mere whisper. This is your golden opportunity to bask in the benefits rightfully yours. With your deductible fulfilled, the cost of seeking medical attention is either entirely waived or reduced to a fraction.

For those whose insurance allocates a portion of their income towards medical visits, it's worth investigating whether unused funds can carry over into the coming year. Let no part of your hard-earned wages languish in neglect. Seize the opportunity to utilize the financial provisions earmarked for your well-being.

Lastly, if your insurance allots a specific sum for healthcare, be aware that it's a 'use it or lose it' scenario. Your insurer has set aside a dedicated budget for vital services, from doctors' appointments to occupational and physical therapy sessions. Don't let this valuable resource slip through your fingers.

For many, persistent pain becomes an insurmountable barrier to fitness aspirations. Are your lower back or knee discomforts sabotaging your commitment to daily walks, a promise you made to yourself this year?

Embark on a transformative journey by scheduling a physical therapy appointment. Take the first step towards unlocking your full health potential. Click on the link below to embark on this empowering path! 

CLICK HERE TO BOOK YOU APPOINTMENT

Muscle Strain

 What is a “pulled” muscle? 

We’ve all been there, we lift something in a weird way and we “pull” a muscle, this might be the first time it happens or it might be the tenth time it happens. 

When we feel that muscle pain, what’s happening to the muscle on the inside? 

Our muscles are made up of muscle fibers that will contract and shorten when activated. Shortening of the muscle alone will not cause injury, combined with excessive stretching, it can lead to the tearing of these fibers, causing an injury1.

Muscle fiber injuries are generally classified under five (5) grades of severity2:

• Grade 0: indicating muscle soreness without physical changes to the muscle finers. 

• Grade 1: less than 10% cross-sectional area involvement (tearing or separation). 

• Grade 2: 10-50% cross-sectional area involvement (tearing or separation).

• Grade 3: greater than 50% (but less than 100%) cross-sectional area involvement (tearing or separation).

• Grade 4: 100% cross-sectional area involvement (tearing or separation).

The degree of tearing or separation can be seen with an ultrasound or MRI (magnetic resonance imaging). 

So what should we do when we “pull” a muscle?

The soft tissue of our bodies, meaning the tendons, muscles, and ligaments, take approximately six to eight (6-8) weeks to heal, which means that your body is working to either regenerate the tissue or lay down scar tissue3. During the initial 6-8 weeks after injury, you generally want to continue to move in a gentle appropriate manner so as to not interfere with healing, but you do want to get blood pumping into the area because your blood contains nutrients that help repair injured tissue and it helps flush out by-products such as inflammation3.

Finding a physical therapist that understands your injury is crucial to fully recovering and preventing future episodes from happening. Click this LINK to schedule an appointment and receive the treatment you deserve!

References

1. Garrett, W. E. (1996). Muscle Strain Injuries. THE AMERICAN JOURNAL   OFSPORTS MEDICINE, 24(6), S2-S8. https://doi.org/10.1177/036354659602406S02

2. Grass, A., Quaglia, A., Canata, G. L., & Zaffagnini, S. (2016). An update on the grading of muscle injuries: A narrative review from clinical to comprehensive systems. Joints, 4(1), 39–46. https://doi.org/10.11138/jts/2016.4.1.039

3. Tidbal, J. G. (2014). Inflammatory processes in muscle injury and repair. Am J Physiol Regul Integr Comp Physiol, 288(2), R345-R353. https://doi.org/10.1152/ajpregu.00454.2004

Shin Pain- Why Does It Happen?

Pain in the front of your lower leg (shin) can happen for a variety of reasons. Some of the most common reasons include ankle joint stiffness or anterior tibialis muscle weakness. 

The largest muscle at the front of your shin is the anterior tibialis muscle. This muscle helps point your foot up to the sky. 

If this muscle is weak, when you start running it'll fatigue quickly due to the repetitive need to pull your foot up so you don't kick the ground and trip. 

The second most common reason for ship pain is ankle joint stiffness. Ankle stiffness can happen after an injury or because of tight calf muscles. The ankle joint being stiff will require the anterior tibialis muscle to pull harder in order to bring the foot up, you can think of it like driving with the brakes on, you'll have to press the pedal harder to try to move the car. 

To fix these problems you can stretch, mobilize, and strengthen the ankle. 

It's a good idea to start by stretching your calves. Pictured above, we are stretching the left calf. Standing at a wall with your legs in a wide stance, push your heel down using your body weight and hold for 30-60 seconds, and repeat 3 times, then perform the stretch on the right side. 

After stretching, perform some mobility exercises. Pictured above, you will be increasing the amount of motion you have in the dorsiflexion direction (foot pointing up to the sky). Start by kneeling at a wall with your foot pointing forward and about 6 inches away from the wall. Next, try to touch your knee to the wall slowly while keeping your heel down. You can add variability to this by veering to the right and left when touching your knee to the wall. Repeat 3 sets of 10 with each side. 

Lastly, you want to strengthen your anterior tibialis muscle. Since this muscle helps to point your foot up toward your nose, we will be strengthening in that direction. Using a resistance band you can attach it to the foot of a chair or something that will not move, then you will point your foot up and down, as pictured above. You can perform 3 sets of 10 and repeat on each side. 

If you don't have something sturdy to attach a resistance band, you can loop it around your other foot as pictured above. You can start by pointing your foot up and then pulling your knee to your chest. You can do this laying on your back, in a plank, or standing up against a wall. Again, you'll perform 3 sets of 10 and repeat on each side. 

Adding these exercises into your routine exercises and performing them 3-5 times a week will improve your shin pain so you can walk and run without pain. 

Click the LINK HERE to schedule your one-on-one appointment with Dr. Oliveros to get you moving without pain sooner!

How to Tackle Low Back Pain and Sciatica

Waking up with low back pain and pain shooting down your leg can be a rude wake-up call that you may need to stretch more, but do you know what to do? 

As a physical therapist, I am frequently asked what I do to keep aches and pain away. When I say that I stretch almost every morning I get a look that says, "yeah... I don't have the time or energy for that". BUT, I do all my stretches in bed. 

Rather than trying to get myself out of bed, change into stretching clothes, and then start my routine, I like to stay in bed where it's warm and comfortable. 

Below is a list of exercises to keep your back healthy and happy.

Double Knees to Chest: To start, bringing both knees towards your chest allows stretching of the glute muscles but also opens up your spine allowing for an increase in space between each vertebral bone. Hold this position for about 30 seconds and repeat 3 times.

Lower Trunk Rotations: With your arms out to the side and your legs bent to about 90 degrees you'll allow your knees to fall to the side. Remember to scoot your hips to the opposite side when your knees land and look away from your knees to increase the twist. In the example above, the knees fall to the right, so I scooted my hips to the left and I am looking to the left. Hold here for about 30 seconds and repeat 3 times to each side. 

Sciatic Nerve Glide: Holding on to the back of your leg you will then point your toes up to the sky, this will slacken the tension from your Sciatic nerve. 

You will point and flex your toe while on your back repeatedly. When your toes are pointing towards your nose, you will increase the tension on your Sciatic nerve. Repeat pointing and flexing your foot 10-20 times (as tolerated), and perform 3 times on each leg. 

Advanced Sciatic Nerve Glide: if you performed the above sequence a few times and did not feel a flare up of the sciatica symptoms then you can progress to a more aggressive way to move the sciatic nerve. The difference now will be that you are holding your head up the entire time as you point and flex your foot. By lifting your head up you will pull your nerves from the opposite end and will increase the tension felt, this is a good progression after you've practiced 

Getting out of bed from a resting position without warming up is like jumping into a soccer game without stretching, your muscles will be stiff and sore and you may not be able to reach peak performance. Starting your day with these exercises will help relieve your low back pain and decrease shooting pain from sciatica. 

For a FREE 30 minute consultation click HERE and see how physical therapy can improve your life!

Hypertonic Pelvic Floor Muscles

 Hypertonic Pelvic Floor Muscles

The pelvic floor is a group of muscles located inside the pelvis. These muscles help hold the weight of your organs and they are the gatekeepers for bowel movements and urination.

Female pelvic floor model

The pelvic floor muscles are positioned in a way that they counter the pressure coming from above when the abdominal muscles are activated. Having strong pelvic floor muscles helps create core muscle stability. The bladder, the sex organs, and the rectum are all located inside the pelvis, surrounded by the pelvic floor muscles. The pelvic floor and the bladder work opposite of each other - as the bladder is filled it relaxes and expands to contain more fluid; simultaneously, the pelvic floor muscles will contract to prevent any liquid from escaping. Once you decide to urinate, the pelvic floor muscles relax and the bladder gently contracts to allow passage of liquid. A similar process occurs with bowel movements. The rectum is the location where feces is stored until ready to be expelled, when having a bowel movement the pelvic floor muscles will relax to allow passage of feces. This is a simplified way of thinking about how the body controls our bowel and bladder, however, it allows us to explore the complications that can happen which may lead to urinary incontinence, diarrhea, constipation, pain during sex, and painful bladder, amongst other issues.

Hypertonic pelvic floor muscles occurs as result of the pelvic floor muscles being contracted and having a hard time relaxing. Hypertonic pelvic floor muscles can cause pain with sex, constipation, urinary urgency, pelvic pain, and tightness of the surrounding muscles of the hip (like the hamstrings and piriformis). Hypertonic pelvic floor muscles can occur for many reasons such as trauma to the muscles from childbirth, continued breath-holding (like with exercising or with stress), or prolonged “tummy sucking”, according to the Pelvic Floor First website, a leader in pelvic health awareness. This can also happen from holding your bladder for long periods of time. Some people who have developed hypertonic pelvic floor muscles reported holding their urine because of a busy work schedule not allowing them bathroom breaks (ie. school teachers, nurses, commercial drivers, etc.) or those who wait to use their private bathroom rather than public bathrooms. 

Hypertonic pelvic floor muscles symptoms may also present as: 

• Sciatic nerve pain

• Pelvic pressure

• Hip pain

• Low back pain

• Pain with menstruation 

• Difficulty with urination and/or bowel movements

According to the International Journal of Sports Physical Therapy, physical therapists are considered the movement experts in the medical field. Physical therapists analyze movements and positions that can help or could be worsening your pelvic floor hypertonicity, allowing for a better understanding of what is going on,  which is crucial for addressing the problem. Speaking with a pelvic health therapist is helpful to receive a personalized plan to address your symptoms, understand the root cause, provide helpful bowel and bladder advice, and guide you to the level of activity you want to have. Treatment might include a combination of stretching, teaching proper diaphragmatic breathing, contraction of the core muscles (this includes the pelvic floor and diaphragm) with lifting, return to sport training, and pelvic floor relaxation techniques. Pelvic health therapists provide education about the function of the pelvic floor muscles to help you gain a deeper understanding.

The following are the top 3 stretches I recommend for hypertonic pelvic floor muscles, they are meant to be completed gently. These stretches are not intended to replace speaking with a pelvic health therapist.

1. Bent Leg Modified Downward Facing Dog

2. Straight Leg Modified Downward Facing Dog

3. Glute and Hip Flexor Combination 

Bend both knees, point your toes and knees in, push your hips back and arch your back. Hold this position for 15 seconds for 3 repetitions. You should expect to feel a gentle pressure across your sit bones. Slowly increase the amount of time you hold until you are able to perform this stretch for 30 seconds, after that try to repeat 5 times. 

poin

Keep your knees straight and point your toes in, push your hips back, and arch your back. Hold this position for 20-30 seconds and repeat 3-5 times. You should expect to feel a gentle pressure across your sit bones. As previously mentioned, slowly increase the hold time and repetitions with the goal being to hold for 30 seconds 5 times. 

Keep your tailbone tucked in, don’t allow your back to arch. Hold this position for 20-30 seconds and repeat 3-5 times. You should expect to feel a gentle pull along the front of hip of the standing leg and a along the buttock of the leg on the chair. Slowly increase the hold time and repetitions with the goal being to hold for 30 seconds 5 times. 

Also, pelvic health therapists often refer to these yoga poses that encourage pelvic floor muscle awareness, activation, and relaxation. 

• Happy Baby

• Pelvic Tilts  

According to the Mayo Clinic Proceedings Journal, other non-therapy-related treatments include neuropathic modulating medication such as amitriptyline, nortriptyline, gabapentin, and pregabalin. Tricyclic antidepressants are also prescribed, but should not be the first step towards managing the symptoms as it can lead to an increase in bladder/bowel symptoms. Trigger point injections with the use of Botulinum Toxin Type A, corticosteroids, or anesthetic medication also may help with symptoms. 

Contact your doctor if you are feeling symptoms that may lead you to believe you have hypertonic pelvic floor muscles to get started on your path to recovery and wellness. Feel free to contact me regarding questions you may have and to see if pelvic floor rehabilitation is right for you.