Whether it be because they’re undiagnosed or because their doctor just prescribed pain medication for the symptoms, many people with sciatica fail to realize that a physical therapist can actually help relieve the discomfort, pain, and weakness in their leg with manual therapy, therapeutic exercises and education.
BY ASHLEY HELLER, PT, MPT, RAUSCH PHYSICAL THERAPY
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If you suffer from sciatica, don’t just manage the symptoms with products or pills.
Call (949) 276-5401 to schedule an evaluation*. We’ll determine the specific cause of YOUR sciatic symptoms and design a specific treatment plan that addresses the root of the problem for long-term relief.
*You do not need a doctor’s referral to be treated by a physical therapist.
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Sciatica is a general term used to describe painful sensations and/or weakness down the back of the leg–where the sciatic nerve runs–due to nerve irritation or compression. Sciatica can radiate down the buttock or back of the thigh, and it may even travel below the knee into the calf and foot.
(Image Author: K. D. Schroeder [CC BY-SA 4.0], via Wikimedia Commons)
The sciatic nerve is actually a group of nerves that exit at the lumbar spine; these nerves are responsible for supplying the legs with both sensory and motor function. People with sciatica may experience muscle weakness or uncomfortable sensations (e.g. pain, numbness, tingling or burning) down their leg.
Where and how your symptoms appear will vary depending on the specific nerve root affected, as well as the underlying pathology and its severity.
Common causes of sciatica
While there are several factors that can cause nerve irritation or compression, the most common pathologies, or “root of the problem,” are disc injuries.
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- A disc bulge happens when there’s increased pressure on the disc, which causes it to bulge to one side. Sciatica can develop when this bulge compresses one of the nerves going down into the sciatic nerve. Disc bulges can develop from simple wear-and-tear as we age, which can weaken the outer portion of the disc. You can visualize a disc bulge by thinking of a water balloon being squeezed.
- A disc herniation occurs when a disc bulge ruptures, causing the inner nucleus of the disc to extrude (think toothpaste being squeezed out of the tube.) Both disc bulges and herniations may result in sciatic symptoms because they increase nerve irritation or compression.
- Degenerative changes in the spine, such as degeneration degenerative disc (DDD) and arthritis of the facet joints, may cause nerve root compression leading to sciatica.
- A condition known as Spondylolisthesis refers to a vertebral defect that results in a fracture. Vertebral defects may fracture under heavy or repetitive loads of the spine, which is commonly seen with teenagers starting to lift weight or in gymnasts. This type of fracture may result in spinal instability and nerve compression.
How your physical therapist can relieve sciatica symptoms
Many people with sciatica have no idea that a physical therapist can identify the specific cause of their sciatica and get rid of those uncomfortable symptoms with great manual therapy, targeted therapeutic exercises and education.
The discomfort, pain or weakness usually radiates down the buttock or back of the thigh, but it can even travel below the knee into the calf and foot. Peripheralization refers to the symptoms moving further down the leg away from the spine (bad), whereas centralization refers to symptoms moving out of the leg towards the spine (better.) The goal in physical therapy is to centralize sciatic symptoms to decrease pain in the leg.
Physical therapists have a number of manual therapy techniques in their toolbox to help achieve centralization, such as:
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- Increasing flexibility without stretching out the nerve
- Decreasing pressure in the disc to alleviate nerve irritation
- Decrease stiffness between the vertebrae to improve mobility and decrease movement restriction
- Increase lumbopelvic stability to help stabilize the spine
- Educate on proper lifting mechanics to reduce risk of traumatic or “wear-and-tear” injury
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Conclusion
If you suffer from sciatica, don’t just manage the symptoms with products or pills. Call us right now at (949) 276-5401 to schedule an evaluation*; we’ll determine the specific cause of YOUR sciatic symptoms and design a specific treatment plan that addresses the root of the problem for long-term relief. With a few weeks of manual therapy and therapeutic exercise, we CAN relieve your pain, discomfort or weakness in your back or leg so you can get back to doing life pain-free.
*You do not need a doctor’s referral to be treated by a physical therapist.
Ashley Heller, MPT is a licensed physical therapist at Rausch Physical Therapy & Sports Performance. She received her Masters of Physical Therapy degree at California State University, Long Beach and is passionate about working with patients with shoulder, knee and ankle injuries. With background in orthopedic-related injuries and post-operative rehabilitation, Ashley believes that the combination of manual therapy and personalized therapeutic exercise program is vital to recovery. Known as the Water Sports PT, Ashley says her goal is to help her patients better understand their injuries and the plan for their road to recovery.
Click to learn more about Ashley and our other physical therapists »
Let’s talk! We are here to help. Give us a call for an initial evaluation and assessment. We would love to meet you.
Did you know there’s no prescription needed from a doctor to see us – but we will communicate your progress and treatment to your doctor if you’d like us too!
(949) 276-5401
Disclaimer — All the information that you find on our blogs and social media pages are for informational purposes only and are not intended to be used as your personal professional diagnosis, or treatment. Come and see us for your excellent, personalized care! https://staging.rauschpt.net/
Exercises You Should Always Do After Age 50
You may have seen a social media post sharing an article, “14 Exercises to Never Do After Age 50.” While the article has since been removed, it caused a huge uproar from physical therapists and other professionals in the sports medicine community. Diana Wang, PT, DPT, ATC breaks down why this article is total fake news and shares what people 50 and older should really be doing to live longer and better.
BY DIANA WANG, PT, DPT, ATC, RAUSCH PHYSICAL THERAPY
@combatphysiodocs
If you’re on Facebook, you may have seen a post in September by CBS, sharing an article published by Reader’s Digest, “14 Exercises to Never Do After Age 50.”
Some of the exercises listed in the article included:
- Push-ups
- Squats with weights
- Bench press
- Pull-ups
- Deadlifts
While the article has since been removed, it caused a HUGE uproar from physical therapists (including me!), as well as athletic trainers, strength and conditioning coaches, and other professionals and experts in the sports medicine community.
If it’s not clear yet, let me tell you in no uncertain terms that the information in those articles/posts is absolutely FALSE. If this author’s logic were true, then after we turn 50 we must avoid ALL of these daily activities:
- Picking up your grandkids or pets
- Lifting grocery bags off the floor
- Holding onto anything while you sit to stand
Honestly, when you put it into an average, daily perspective, all I can say is… unbelievable. The fact is, people 50 and older should be doing these strength training exercises even MORE!
If you don’t use it, you lose it
It’s no secret that as we get older our bodies break down, but many research studies have actually shown a correlation between muscle loss and weakness to a shorter life span. Therefore, it’s important as you age to engage in MORE strength training to not only improve bone density, independence, and stability, but also to reduce your risk of osteoporosis and chronic diseases such as heart disease and diabetes.
Basically, strength training is not just a choice for a better life, but rather a NECESSITY for a better life.
Our bodies are much more resilient than some people might try to make them out to be. With the proper direction, programming and loading, our bodies can do ANYTHING, at any age. Spreading correct information about how strong our bodies actually are is the first step in changing perspectives in the U.S. healthcare system. And if a healthcare practitioner ever tells you to NEVER do something, do yourself a favor and look for treatment someplace else—you deserve better.
Conclusion
So whether you’re 50 or 80 years old, NOW is the time to get strong and start living better. If you’re not sure where to start, get on my schedule at Rausch Physical Therapy or make an appointment with your local physical therapist for a baseline assessment and screen; your PT can develop a strengthening program tailored to your own personal needs and goals to keep you living well for longer.
[framedbox]References:
- The benefits of strength training for older adults
- American College of Sports Medicine Position Stand. Exercise and physical activity for older adults
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Diana Wang graduated from the University of the Pacific with a bachelor’s degree in Athletic Training. Following graduation, she knew she wanted to pursue her love for sports rehab further and received her Doctor of Physical Therapy degree in 2017 and began her career at Rausch Physical Therapy & Sports Performance. With her extensive sports background, Diana’s goal is to provide the best, most innovative care to get athletes back in the game faster and stronger than ever.
Learn more about Diana and our other physical therapists »
Let’s talk! We are here to help. Give us a call for an initial evaluation and assessment. We would love to meet you.
Did you know there’s no prescription needed from a doctor to see us – but we will communicate your progress and treatment to your doctor if you’d like us too!
(949) 276-5401
Disclaimer — All the information that you find on our blogs and social media pages are for informational purposes only and are not intended to be used as your personal professional diagnosis, or treatment. Come and see us for your excellent, personalized care! https://staging.rauschpt.net/
Five Easy-to-Remember Run Cues to Help You Stay Injury-Free
Ever feel overwhelmed by all the running advice out there? PT Max Biessmann shares his five key things to focus on to improve your run form and help stave off injuries (and hopefully become a little faster along the way!)
BY MAX BIESSMANN, PT, DPT, RAUSCH PHYSICAL THERAPY
USAT LEVEL I COACH, ASCA LEVEL I COACH, USA SWIMMING COACH
@shiftendurancecoach
Despite what some may think, there’s much more to running than simply throwing on your shoes and heading out the door. To run at your most efficient and remain injury-free, there are so many factors runners try to keep in mind while running, it can easily become overwhelming and too complicated to do correctly.
To keep things simple and effective, here are my five key things to focus on to improve your run form and help stave off injuries.
#1 – Keep your head up and chin tucked
The posture of your head can have a huge impact on your run form. Your head weighs about 10 lbs, and if that weight is not centered and stacked, it can throw off your entire posture and balance. Focus on keeping your chin slightly tucked and stay tall through the top of your head in order to maintain proper posture.
Tip: Be very aware of what you prefer to do once you get tired as that is when the posture will begin to fall apart
#2 – Shoulder blades back and down
Similar to head position your upper back and arms have a big impact on where your head and neck are. Keep your shoulder blades down to avoid strain/stress through your upper shoulders and neck.
Tip: Think of tucking your shoulder blades into your opposite back pocket
#3 – Ribs and hips connected
Many people forget the true purpose of your core: to help transmit strength and movement from upper limbs to lower limbs and visa versa. Don’t forget to keep your core engaged in order to help the cross body extension of opposite arm and leg.
#4 – Quiet feet
When running, especially when fatigued, make sure to try to land softly. Don’t be over concerned with what part of your foot is hitting the ground, just that your foot is soft and supple as it lands. Use the sound of impact to help guide you to find the right spot to land.
Tip: The other marker you can use to monitor this is your cadence, increasing cadence has been shown to reduce strain through the joints while running.
#5 – Cross-body extension
Your body works in spirals. As you run, your right arm extends, elbow back, as your leg extends. This cross body extension is a key component to good run form. As you fatigue, focus on maintaining your shoulder extension by pushing your elbow back; this will help maintain your hip extension as you run.
Conclusion
Master these five cues and you can continue enjoying running for a long time (and hopefully become a little faster along the way!) Ultimately, bad running form causes improper stress on tissue, joints and muscle, which can lead to an otherwise avoidable injury. So if you need some extra help with your run form, come in for a Run Right Gait Analysis with me at Rausch Physical Therapy.
Max Biessmann, DPT is a licensed physical therapist at Rausch Physical Therapy & Sports Performance. He received his Doctorate of Physical Therapy degree at the University of St. Augustine, San Marcos in 2016 and started his career at Rausch PT. Max is passionate about helping people achieve their goals through physical therapy and innovative rehab technologies. As the Endurance Sports PT, Max says he’s lucky to be able to combine his professional coaching experience and PT knowledge to help his patients achieve their personal bests in sports and daily life.
Understanding Chronic Pain and How to Avoid It
If injury equals pain, you’d think that once an injury is healed, the pain would go away. So what about pain that lasts longer than the initial injury itself? PT Chris Scott explains how to keep acute injury from turning into chronic, debilitating pain.
BY CHRIS SCOTT, PT, DPT, RAUSCH PHYSICAL THERAPY
Just about everyone has felt pain at some point in their life. Whether it be a stubbed toe, a papercut or a sprained ankle, pain is the sensation that your body feels to alert you that something is wrong. If injury equals pain, you’d think that once the injury is healed, the pain would go away. So what about the pain that lasts longer than the initial injury itself?
Chronic pain is any pain lasting more than 10 weeks. Chronic pain may arise from an initial injury, or there may be an ongoing cause, such as dysfunctional movement patterns. Other times, there may also be no clear cause. Other variables, such as fatigue, sleep disturbance, decreased appetite, and mood changes, often accompany and can add to an individual’s chronic pain feeling.
Recurring injuries that become chronic conditions, such as chronic low back pain, can be a challenge for many reasons. Often times chronic pain limits a person’s movements, which can reduce flexibility, strength and stamina. This can then lead to someone avoiding important occupational or enjoyable activities, and some people can even adopt the mentality of disability and despair secondary to their fear avoidance behaviors.
How Fear Factors into Pain
Kinesiophobia, or fear avoidance beliefs, is defined as excessive, irrational and debilitating fear of physical movement and activity resulting from a feeling of vulnerability to painful injury or re-injury.
Broken down, kinesiophobia can be split into two factors:
- Harmful factors which reflect the patient’s belief that something is seriously wrong with their body
- Activity avoidance factors which represent the belief that avoiding exercise/activity will prevent an increase in pain
For example, if Patient A first sustained back pain when bending over to garden, he is more likely to avoid that activity because he believes pain will occur. In combination, that feeling catastrophizes as patient will in turn believe that they are in more pain secondary to the inability to participate in that activity. This newly adopted mindset leads to a vicious cycle. Over time, the inactivity that stems from this fear leads to physical and psychological consequences.
Your body does an amazing job of adapting to whatever stimulus it’s provided; with a constant feeling of pain or a continuous internal message of harm/danger, the body’s response is molded to fit accordingly. A person with kinesiophobia experiences physical changes, their sensory neurons become more sensitive, their pain sensors stay open longer, and eventually more sensors are produced. The area of your brain that is devoted to sensation actually becomes larger, and begins to overlap with surrounding areas of the cortex. That simple back strain has now transformed into a much more serious condition, all because of fear avoidance belief.
How to Combat Chronic Pain
While this all might sound like a scary, snowballing issue impossible to overcome, chronic pain is reversible—when approached properly. A great physical therapist can help their patient conquer the physical and psychological hurdles. At its core, physical therapy does an exceptional job of empowering patients to make physiological changes to eliminate physical pain. However, if you do not address the mental aspect of it, you will find yourself running into a wall.
The first step on the road to a successful rehabilitation journey is re-introducing movement patterns without pain or limitations. To achieve this, your physical therapist will design a treatment plan that combats the body’s newfound hypersensitivity using appropriate pacing and graded exposure. While you’ll most likely struggle shifting to a painless paradigm, it is essential to develop a new baseline tolerance for tasks you can perform without a flare up. Carefully increasing your threshold for discomfort will help reverse those changes so you can resume a normal activity and a pain-free life as soon as possible.
Don’t let acute injury turn into chronic, debilitating pain. Make an appointment with your physical therapist today, they’re the movement experts. Not sure where to start? Stop living in fear and come in to Rausch Physical Therapy, you can call (949) 276-5401 to get on my schedule for an evaluation today.
Chris Scott, PT, DPT is a licensed physical therapist at Rausch Physical Therapy & Sports Performance. He received his Doctor of Physical Therapy degree at University of Texas – Southwestern in 2017 where he worked in a variety of outpatient settings. Chris has the experience and foundational knowledge base to tackle any patient case thrown his way, from teaching patients with neurological disorders how to walk again to returning professional athletes to the field or court. Chris says his ultimate goal is to arm his patients with the knowledge and tools to correct dysfunction and prevent re-injury or new injuries, leaving you feeling better than ever before.
Click to learn more about Chris and our other physical therapists »
Bikes & Bagels: Monthly Mountain Bike Ride
Join Rock N’ Road Cyclery and #TeamRauschPT for a fun, free social mountain bike ride for beginners and intermediate riders every 2nd Saturday of the month!
Meet here at Rausch PT (30100 Town Center Dr #Y/Z, Laguna Niguel, CA 92677) at 8 AM, ride leaves at 8:30 AM. Post-ride bagels & beverages + awesome giveaways & raffle prizes.
Let us know you’re riding with us!
Go to the Facebook Bikes & Bagels Event page and click “Going.” Be sure to share with your MTB friends while you’re there!
[button link=”https://www.facebook.com/events/725966817753250/” size=”large” color=”blue” align=”center” target=”_blank” ]Event Page RSVP[/button]
Help Us Support Challenged Athletes Foundation
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Join Team Rausch PT as we support CAF!
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The Challenged Athletes Foundation (CAF) raises money to help people with physical challenges pursue an active lifestyle through physical fitness and athletics. CAF’s mission is clear: give those with the desire to live active, competitive lifestyles every opportunity to compete in the sports they love.
This year #TeamRauschPT will be participating in the CAF Thrive 5K Walk, and we want YOU to join our team. We’ll be fundraising at the clinic all October long, but if you’re interested in joining our team at the 5K on Sunday, October 21, please click the button below to go to our team page, then click the JOIN TEAM button. Can’t make it to the race? Show your support by making a donation now.
By making a donation towards our team fundraising goal you will provide individuals with physical challenges with the tools necessary to find success in sports—and in life!
[button link=”https://www.challengedathletes.org/events/5k/” size=”large” color=”blue” align=”center” target=”_blank” ]JOIN OUR TEAM[/button]
When registering, Click the “Would you like to associate your participation with a Fundraising Group?” box and choose “Rausch PT” to help our fundraising goal!
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About CAF & San Diego Triathlon Challenge
Established in 1997, the Challenged Athletes Foundation (CAF) recognizes the athletic greatness inherent in all people with physical challenges and supports their athletic endeavors by providing unparalleled sports opportunities that lead to success in sports — and in life.
The Aspen Medical Products San Diego Triathlon Challenge is one of the most highly-regarded and motivational events in the triathlon world. Since its first event 20 years ago, the Tri Challenge has been instrumental in raising the funds that have allowed more than 9,500 challenged athletes around the world to make it to the starting line and inspired a new generation to realize they have no limits.
Picnic Bench Stretch Series for Outdoor Runners
Everyone knows it’s more fun to run outside, the same thing goes for stretching! PT Ashley Heller shows how you can use picnic benches to help reduce running pain, avoid chronic injury, and improve recovery time while you’re out on a run.
BY ASHLEY HELLER, PT, MPT, RAUSCH PHYSICAL THERAPY
I’m an outdoor gal when it comes to working out. Although I am not competitive runner, running is my go-to outlet for keeping in shape and cross training. For me, running outdoors allows me to recharge, connect with nature, and is one of my favorite ways to cross train and maintain a healthy and active lifestyle.
Whether I’m exploring new trails or running the beach trail, I always make the time to do some dynamic stretches. Dynamic stretching before working out can help improve recovery by minimizing overstrain to tight muscles, as well as improve joint mobility to enhance proper muscle recruitment and minimize compensation that can lead to tissue breakdown and injury. Frequently, I will also stop about one mile into my run to help loosen up even more before finishing the end of my run. Incorporating a few stretches after warming up can be helpful for minimizing discomfort for the duration of the run, improving hip drive while running, and improving overall recovery time.
Since I am usually exercising outside, I love stretching on picnic tables. They offer a good surface for stretching with a variety of heights useful for multiple stretches, plus they are convenient since they are virtually everywhere!
Ashley’s Picnic Bench Stretch Series
Here are my five go-to stretches when I’m running outdoors:
#1 – Quad/Hip Flexor Stretch
Glutes are the driving power for running and propelling the body forward. Lack of hip extension results in decreased running efficiency. Tight hip flexors will limit the ability for the hip to extend and use the glutes. A good hip flexor/quad stretch will allow you to engage your glutes more efficiently.
Cue: Tilt the pelvis like you’re tucking your tail under. Gently squeeze your glute to help relax the psoas and gain a better stretch.
Common mistake: Leaning forward. This results in back extension, not hip extension, which is a common way runners injure their backs.
#2 – Hamstring Stretch
Hamstring tightness is often a contributing factor to back pain or hamstring strains. Hamstring tightness can pull the pelvis into a posterior rotation, which deactivates your abs while running and can lead to back pain over time. Adequate hamstring flexibility will also reduce the amount of tension placed on the sciatic nerve and reduce the risk of hamstring strains while running.
Cue: This can also be done as a long duration stretch for 30 seconds to 1-3 minutes.
Common mistake: Over rounding the back when leaning forward.
#3 – Calf Stretch/Prancing
This dynamic stretch is important for both ankle mobility and the elasticity of the calf complex. Calf flexibility is important in preventing calf strains while running. Stiff ankles result in poor shock attenuation can result in injury from the foot up to the back. Poor dorsiflexion mobility will shorten the calf and Achilles complex prematurely and can result in calf strain, Achilles Tendon or plantar fascia injury.
Cue: Start by standing on a curb or bench, hang the heels off and slowly lower the heel below neutral while bending the opposite knee to raise heel. Alternate dropping the heels to ‘prance’ to improve ankle mobility and calf flexibility.
Common mistake: Excessive pronation or flattening of the foot arch.
#4 – Standing Pigeon Stretch
The standing pigeon stretch opens the hip capsule and hip rotators. This will help promote glute activation and hip drive running.
Cue: Begin with one leg crossed over opposite leg. The thigh should be perpendicular to the body while the knee is bent at 90 degrees. Holding onto the table, lean back into a partial squat position while maintaining a flat back. This stretch can also be performed lying supine on picnic table by cross leg over opposite knee, hold thigh behind the non-stretching knee and pull towards chest.
This stretch can also be performed lying supine on picnic table by cross leg over opposite knee, hold thigh behind the non-stretching knee and pull towards chest.
Common mistake: Pain in knee. If there is discomfort in the knee, modify by performing stretch on your back.
#5 – Adductor Side Lunge
This stretch targets the adductors, which are important for medial knee stability. Adductors can be overlooked when stretching but are important to stabilize the knee to prevent injury.
Cue: Using the table, place your foot of the stretching leg on the bench. Lunge away by bending the knee to about 90 degrees, keep your knee stacked over your ankle.
This can also be done as a dynamic stretch without the picnic bench by alternating lateral lunges. Alternate to stretch each side 5 times, hold 2-3 seconds before alternating.
Common mistake: Going too deep. Knee not stacked over ankle.
Ashley Heller, MPT is a licensed physical therapist at Rausch Physical Therapy & Sports Performance. She received her Masters of Physical Therapy degree at California State University, Long Beach and is passionate about working with patients with shoulder, knee and ankle injuries. With background in orthopedic-related injuries and post-operative rehabilitation, Ashley believes that the combination of manual therapy and personalized therapeutic exercise program is vital to recovery. Known as the Water Sports PT, Ashley says her goal is to help her patients better understand their injuries and the plan for their road to recovery.
Click to learn more about Ashley and our other physical therapists »
The Best Pillow Position for Avoiding Morning Neck Pain
Do you wake up with a stiff or aching neck every morning? Your pillow could be the culprit! PT Amanda Hurst breaks down pillow position 101 and shares her fluffy recommendations so you can get your best sleep and better morning.
BY AMANDA HURST, PT, DPT, ATC, RAUSCH PHYSICAL THERAPY
Do you wake up with a stiffness, pain or discomfort in your neck? It could be due to the position of your pillow. That’s right, your pillow is your friend and deserves to be used correctly! The purpose of a pillow is to support the weight of your head, which on average weighs about 11 lbs.
When your head is properly supported by your pillow, your neck muscles are allowed to relax or turn off, which means no muscle tension or pain in the morning. Here’s a simple four-step pillow check to help you rest easy:
- If your shoulders are ON the pillow, your head will be NOT be supported! This creates increased neck extension shortening or tightening of the neck muscles, nerve impingement, and stiffness in the vertebral joints.
- Tuck your pillow into the crevice of your neck and fully relax into it.
- Your head should be in a neutral position, not too extended or too flexed forward (have someone check or take a picture for you.)
- If your pillow does not allow your head to be in neutral, either go buy a new one or fluff that sucker up!
What is the best pillow?
If you like your pillow and it doesn’t cause pain once you make sure you’re using it correctly, then keep it! If you make the adjustments above and you’re still waking up with stiffness, nerve symptoms or pain, it’s time to try a new pillow.
- Down or alternative-down is recommended
- Avoid foam pillows; they have a natural resistance that can cause your neck muscles to activate to combat that resistance while you’re sleeping
- No, you do not need to spend your life savings on the newest, fanciest pillow. There are some great, affordable options that won’t break the bank and will still help you achieve that neutral position you need for a great night’s sleep and pain-free morning.
Here are some of my personal favorites:
- Allied Home MicronOne Anti-Allergen (synthetic down) 2-pack Pillow from Costco, $34.99
- Downlite Hotel & Resort European White Goose Down Pillow collection from Costco, $44.99
- Amazon also has a large variety of synthetic down or goose down pillows, keep the price low and check the return policy in case the pillow does not work for you
Amanda Hurst, PT, DPT, ATC graduated from Concordia with her degree in Exercise and Sports Science and became a certified athletic trainer in 2010. She went on to receive her doctorate in physical therapy in 2013 from Chapman University and has been practicing as a licensed physical therapist for the past five years in a variety of physical therapy settings, including hospital and private practice outpatient, acute care, and lab assisting. Her love of sports led her to Rausch Physical Therapy & Sports Performance, where her goal is to return all her patients back to their sport, recreational activity or hobby, and to keep our community active, healthy and happy.
Making the Summit: How I Conquered Altitude Sickness While Hiking Mount Whitney
As a life-long outdoor enthusiast and doctor of physical therapy, PT Sean Swopes knows how dangerous and difficult high-altitude hiking can be for many people. Sean shares the unique way he prepared his body to battle the elements (and dreaded altitude sickness) while crossing off an item from his bucket list: summiting Mount Whitney.
BY SEAN SWOPES, PT, DPT, CSCS, RAUSCH PHYSICAL THERAPY
On July 16, I sought out to make a journey into the wild with my brother and father. The plan was to spend five days and four nights hiking our way north through the Eastern Sierras. Our experience would peak at the summit of Mount Whitney, reaching an ultimate elevation of 14,508 feet.
Anyone who’s done any amount of physical activity, whether it be hiking or cycling, will tell you that being at altitude changes everything. I’ve seen some of the most aerobically fit people fall apart once they’re at altitude. Having taken many trips to the Sierras throughout my life, I’ve learned this fact the hard way.
The months leading up to the hike, my main concerns were the distance and elevation. My main training modality was casual and competitive mountain biking, and while it did give me a big push for my cardiovascular training, I knew that alone wouldn’t prepare me for the 50+ miles I’d be walking with 50 pounds strapped to my back at 10,000+ feet.
Training Your Body to Adapt to Stress
Fortunately, during this trip, I felt great with no major signs of altitude sickness. I attribute this to not only mountain biking, but competitive mountain biking. The key difference is the extreme of how competition pushes the body to its limits. I hadn’t done any extensive altitude training within the weeks leading up to the trip, however I had taken my body—physically and aerobically—to it limits by racing at the Over the Hump series nearly every week this summer. That’s exactly what I was going to be putting my body through summiting three, 14,000+ feet mountains: Mount Langley, Mount Muir and Mount Whitney.
As a physical therapist, I like this concept of pushing your body to its limits as a training philosophy. I view the body as an instrument with a threshold of tolerance. As people age, their body tends to develop imbalances, weakness and stiffness, which decreases their body’s threshold for biomechanical stress (i.e. running, jumping, climbing, etc.) Consistent competitive racing forced my body to adapt and increased my body’s threshold, which enabled it to withstand more physical and aerobical stressors on my hike.
Still, there was one large unknown variable to conquer: altitude.
At high elevation, less oxygen can be inhaled per breath, which can cause hikers to experience early onset fatigue, or worse, altitude sickness. For most people, this takes effect when they get above 12,000 feet. To ensure my success at altitude, I got to the mountains three days early and went on two training hikes at 9,000-11,000 feet and slept at 8,000 feet; this allowed my body to acclimate.
The Challenge of Summiting Mount Whitney
If you look at Mount Whitney from the city of Lone Pine, just below the mountain range you’ll see two small peaks with a large peak just to the right. At the base of the two smaller peaks you are roughly at an elevation of 13,500 feet with 1,000 feet of elevation to gain over a distance of two miles. This is where most people feel the extreme effects of altitude, including my brother. He was hit with nausea, fatigue and a pounding headache, forcing him to turn around and head back to base camp.
With even more determination now, my father and I continued our ascent. It wasn’t until the last half-mile that he was met with his final challenge. The altitude was taking its effect on him, but luckily he wasn’t experiencing any other symptoms other than extreme fatigue. His body would feel fine at rest, however any physical exertion would drain his energy instantly. It was slow-going that last half-mile while he was forced to take breaks every 10 feet of hiking the variable rocky terrain, but in the end we both prevailed, reaching the summit and our goal destination at 14,508 feet.
The toughest endeavors always make the most memorable experiences. Think of your body as an instrument you are constantly fine tuning. Preparing for those tough, yet memorable life adventures to the top of any “mountain” in your life.
Nothing in the world is worth having or worth doing unless it means effort, pain, difficulty… I have never in my life envied a human being who led an easy life. I have envied a great many people who led difficult lives and led them well.
― Theodore Roosevelt
Sean Swopes, PT, DPT, CSCS graduated from CSU Fullerton with a bachelor of science in kinesiology. He went on to receive his doctorate in physical therapy in 2015 from University of St. Augustine, and began his career here at Rausch Physical Therapy and Sports Performance. Sean is also a certified Strength and Conditioning Specialist. As a physical therapist, Sean’s goal is to help his patients understand their musculoskeletal impairments and work together to improve them.
Do You Care More About Your Car Than Your Health?
If we have no problem spending the time or money to take our cars in for a tune-up on a regular basis, why do so many people struggle doing the same for their body? PT Ruth Meltzer explains why putting your body on a maintenance program will benefit you in the long run.
BY RUTH MELTZER, PT, DPT, OCS, RAUSCH PHYSICAL THERAPY
Do you own a car? Do you take it in for regular tune-ups? Even if there aren’t any glaring issues, I bet you do take your vehicle in to the shop every x-amount of miles to get the tires aligned, change the oil, and have an expert take a peek under the hood to ensure everything is running how it should be.
We all know that proper maintenance helps avoid costly breakdowns, long-term mechanical problems, or *gasp* having to go days without a car while it’s getting fixed. So if we have no problem spending the time or money to care for our cars on a regular basis, why do so many people struggle doing it for their body? Do you really value a car more than your health!?
We need to change the way we think about our health and wellness and finally take charge of our bodies. “Wellness” is defined as “the quality or state of being healthy in body and mind, especially as the result of deliberate effort.” We need to deliberately make the choice to get healthy and stay that way. By being your own advocate and putting your body on a maintenance program—just like you do with your car—you can keep your (musculoskeletal) parts oiled, aligned and moving correctly to avoid costly breakdowns (injuries).
Direct Access and #FastPassPT
Let’s say you’ve signed up for a triathlon, but during your second week of training you notice your shoulder bothers you after every swim. However, you’re determined to keep training, so you ignore it for weeks until the pain has become so bad that you finally decide to go see your doctor. You wait weeks to get in to see her, just to have her tell you to schedule a physical therapy appointment. By this time, months of neglect have turned a minor issue into a major injury that will now take more time, money and energy to address.
This is just like an easily avoidable car breakdown. Your check-engine light comes on (first twinge of pain), but you ignore it because of time or money or just plain negligence. You keep trucking along, until that fateful day when you break down on the side of the road (injury). Now you have to wait hours (weeks) for a tow truck (doctor’s appointment) and pay for that. Then you have to pay the mechanic to figure out the problem and fix it (PT)! Your car (body) is out of commission for weeks, and you’re stuck Ubering around (putting your training on hold) thinking how all this could have been easily avoided with better care and maintenance.
It doesn’t have to happen like this! If you live in California or any other state with Direct Access laws, now is the time to take charge of your health and come in to physical therapy for regular tune ups before you get injured or at the first inkling of pain, no doctor prescription necessary.
What Does a Wellness “Tune-Up” Look Like?
At Rausch Physical Therapy, we call tune-ups “Wellness Checkups,” and we recommend one every six months. At your checkup, a doctor of physical therapy will do a quick assessment of your body’s flexibility, strength, control, and movement to identify and address any dysfunctions. You leave with an individualized plan of care and strength and stability exercises to do at home to help prevent any potential issues down the road.
As musculoskeletal experts, physical therapists treat the body as a whole; when you come in with knee pain, we know to look at your hip, pelvis, spine and foot to see how they might be affecting your knee joint. Getting regular tune-ups with your physical therapist will help keep your alignment in check to guarantee all your parts are working like they should be. Of course, if injury does happen, you can come DIRECTLY in to see your PT as soon as you feel it. The longer you wait, the more time your muscles have to create imbalances and cause long term dysfunctions.
I hope this summer you decide to start keeping up the maintenance on your body like you keep up your car. With proper care and upkeep, you can ensure your body is always able to continue doing what you love to do and ready to handle anything life throws your way. Come see me at Rausch PT, and I’ll help you get started on a successful wellness program!
Ruth Meltzer, PT, DPT, OCS is a licensed physical therapist at Rausch Physical Therapy & Sports Performance. She received her Doctorate of Physical Therapy degree at Loma Linda University in 2012 and received her orthopedic specialization in 2015. Ruth enjoys looking at functional movements and tailoring exercises and programs to help her patients as an individual not just a body part.
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To Throw or Not to Throw this Offseason?
Baseball season is tough enough on a young athlete’s body, should you really be throwing in the offseason? PT Jonathan Meltzer explains what you should do in the offseason to set yourself up for a successful, healthy upcoming season.
BY JONATHAN MELTZER, PT, DPT, RAUSCH PHYSICAL THERAPY
Baseball demands a lot out of a young athlete’s body through the course of a season. It’s the only sport that plays on consecutive days in a week, multiple weeks throughout the year. The ability to make it through the season healthy takes time, effort and diligence. As The Baseball PT, the questions I always ask my patients at the end of the season are:
- Did you stretch, foam roll and warm up properly before and after every practice and game?
- Did you perform your rotator cuff and scapular strength exercises?
- Did you let your coach, trainer or physical therapist (me) know if you were struggling with pain or an injury?
The answer should be a resounding, “Yes!” to all these questions. If your answer is, “I’ll just deal with it/recover in the offseason,” guess what? It’s the offseason and your arm is sore, your legs and back feel tight, but then club/college teams are asking you to jump on their team! Should you do it? Is it smart? Are you risking your arm health?
The fact is that playing summer ball or going to college recruitment is a top priority if you want to advance your baseball career, and I agree that you should take advantage of those opportunities. However, I have specific recommendations for my players, especially pitchers, to help them be smart about offseason play.
#1 – Take a four to six-week break
Immediately after the season ends, I recommend you take four to six weeks off from throwing completely. The shoulder and elbow need about a month for the tissue to calm down, regenerate and recover from the season-long wear and tear. Consider this time as an “active rest,” defined by:
- Cross Training with a different sport or activity
- Recovery with soft tissue work and stretching
Once you have completed the recommended four-to-six week break, begin a return-to-throwing program—slow and steady.
#2 – Get strong in the summer
Summer is the time to lift and get really strong so you can improve the dynamic stability and rotational strength you need to return to play. Implementing specific strength exercises, such as lunges, deadlifts, and rotational med ball toss, as well as agility training and plyometric exercises, are crucial during this time.
Conclusion
So, to throw or not to throw? Both! Take that initial four to six weeks off to let the tissue heal, then progress into an interval throwing program. If you’re confused on how to do this, make an appointment with me at Rausch Physical Therapy & Sports Performance; I’ve developed a return-to-throwing program that will get you where you need to go. If you use the offseason to develop good recovery habits, train hard and expand your strength, you can set yourself up for a successful upcoming season.
Jonathan Meltzer graduated from the University of Redlands with a bachelor of arts in biology and a minor in physical education. Following graduation, Jonathan discovered his passion for physical therapy while working as a Physical Therapy Aide. After graduating top of his class from Loma Linda University in 2012 with a Doctorate in Physical Therapy, Jonathan began his career at Rausch Physical Therapy and Sports Performance. Jonathan’s goals are to identify limitations and treat his patients with the most recent and innovative techniques in order to maximize functional independence and obtain his patients’ individual goals.
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The Forgotten Disciplines of Triathlon
PT Kevin Capata shares why its not the lack of mileage that you put into your training schedule that has kept you from reaching your PRs, staying injury-free, or conquering plateauing, but the often forgotten aspect of cross training.
BY KEVIN CAPATA, PT, DPT, CSCS, RAUSCH PHYSICAL THERAPY
If you’re an amateur triathlete like me, you’re probably often stressed trying to juggle all the tasks of daily life with a set training plan, strict dietary guidelines, and recovery efforts. So maybe you’ve already heard about the benefits of adding cross training to your plan, but you’ve always thought, “I just don’t have time. When am I supposed to get to the gym to lift weights or attend weekly Yoga class?” “How the heck am I supposed to cram in even more training?”
All good questions, and trust me, I get it! But I challenge you with one of my own. Have a 25-mile ride planned for Monday morning? Why not make it 22 miles, and use that extra 15 to 20 minutes to do some single-leg pistol squats, burpees, plank bird dogs, and pull ups?
It’s not the lack of mileage that you put into your training schedule that has kept you from reaching your PRs, staying injury-free, or conquering plateauing. More likely than not, it’s that you haven’t unlocked your true athletic potential by adding strength and mobility to your priority list.
The Forgotten Fourth and Fifth Disciplines of Triathlon: Strength and Mobility
Many triathletes fail to realize that by developing strength, power and mobility through cross training, they can enhance their ability to maintain that high-elbow position throughout their swim stroke, keep that high-power output during the last climb before heading into T2, or prevent the dreaded “bonk” associated with form breakdown midway through the run.
Yes, specificity of training is of utmost importance and you have to get in that swim, bike and run mileage to work toward your goals. However, to perform your best—and STAY performing your best—you also have to dedicate time to keeping your body in optimal shape.
To help, here are my top strengthening and mobility exercises. Try incorporating this exercise routine into your training plan, and I think you’ll see a dramatic difference in your performance that will finally shift your mindset on the importance of cross training once and for all.
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Top 10 Strengthening Exercises
- Squats (back and front)
- Deadlifts
- SL squats (swiss ball)
- Pistol squats
- Push ups
- Pull ups
- Planks
- Plank bird dogs
- Burpees
- Resisted monster walks with OH shoulder press
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Click here to access Kevin’s Tri Strength Exercise Program on homeprograms.net
Your Patient Login information:
Your Email: tri.strength@rauschpt.net
Your Clinic ID: 1006
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Top Four Mobility Exercises
- Foam Roll
- Yoga/Pilates
- Dynamic stretching (pre) & static stretching (post)
- Avoidance of prolonged postures
Kevin Capata, PT, DPT, CSCS is a licensed physical therapist at Rausch Physical Therapy & Sports Performance. After receiving his Doctor of Physical Therapy degree at Columbia University, Kevin started his career at Rausch PT, where he used to work as a physical therapy aide. Now, Kevin enjoys helping his patients recognize and fix movement faults to help them overcome their injury or pain, as well as empowering them with the knowledge and tools to prevent re-injury or potential new injuries.
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