The core is the most integral component for building full body functional movement patterns. The terms ‘core’ and ‘stability’ are tossed around in our health and fitness world and the meanings are sometimes misconstrued. For starters, you can imagine the true deep ‘core’ as four muscles forming a canister around the thorax. The core is bordered superiorly (on top) by the diaphragm, anteriorly (front) by the transverse abdominis, inferiorly (on the bottom) by the pelvic floor, and lastly posteriorly (back side) by the multifidus. Although it might sound like I completely made up a few of these muscles, that is because they are some of the deepest muscles lying in this region and sometimes go unmentioned. Regardless we must all appreciate the functions each of these muscles have and how recruiting them appropriately will improve your quality of movement while reducing the likelihood of injury. According to the Panjabi Model there are 3 contributing factors to spinal stability as shown below.

Although I will be discussing more of the active subsystem or musculature involved in this interaction, it should be noted that our passive spinal column and neuromuscular components should ultimately be addressed to optimally ensure this desired spinal stability.

Lumbar Multifidus

This muscle was originally thought to have had some function in producing lumbar extension but more recent studies have suggested a strong stabilizing role. Being composed primarily of type I or tonic muscle fibers we hypothesize that there is more of a postural role being played (Sirca & Kostevc, 1985). Aside from helping control the spine in its neutral zone, the lumbar multifidus tensions the thoracolumbar fascia further stabilizing the core and spine.

Transverse Abdominis (TrA)

The TrA is the deepest abdominal muscle with fibers that run horizontally. This muscle is unique because it has a feed-forward loop in which it naturally fires to stabilize the spine prior to any body movement. For example every time you are bringing an arm overhead to stroke while paddling on a surfboard the TrA is firing to stabilize the spine. Over time if we practice compensatory movement patterns such as allowing our global muscles (rectus abdominis and obliques) to “over fire” we can lose the ability to recruit TrA and in turn lose some of our stability. As neuroscience research has indicated those movement patterns that we do not use, we lose (Kleim, 2008). Therefore it is crucial to re-train our TrA to function optimally to promote a healthy spine.

Pelvic Floor

Although it is an easily undermined area of focus, the pelvic floor muscles play an integral role in promoting core stability. These muscles resist increases in intra-abdominal pressure, which helps our core manage more complex movement patterns where many muscles are firing at once. Whether we recognize it or not, these muscles of the pelvic floor are contracting countless times throughout our day and when facilitated in conjugation with the TA, multifidus, and diaphragm can help keep the spine in its most stable position (neutral zone).

Diaphragm

Aside from its vital role of managing our breathing, the diaphragm is the largest contributor to our spinal stability through intra-abdominal pressure. According to Hodges et al. 1997, this muscle is needed to prevent displacement of abdominal viscera so that the TrA can increase its tension. This is important for our understanding moving forward as we should practice appropriate breathing techniques while exercising to further strengthen this muscle.

These muscular components discussed above can help improve spinal stability by incorporating simple exercises to your workouts. In most cases minor adjustments can be made to exercise technique to promote further recruitment of these local stabilizing muscles.

• Prior to participating in sport activities, ask yourself if your body is as prepared as it should be and…
• If you have already experienced some back discomfort consider how you can modify your training to focus on complete core stability to better prepare you to prevent injury.

Dr. Bryce Parrish

Physical Therapist

If you find yourself in discomfort or think you could benefit from a personalized exercise plan, talk to a Physical Therapist.

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One of the most common questions that patients ask their physical therapist is “so, should I ice it or heat it?”. The answer to this question differs for each injury and each patient. Icing and heating are two very useful, cost-effective, and rational ways that my patients can manage their pain when out of the clinic. Because they are key to pain management and essential to the rehabilitation process, I find myself (as the PT) explaining to each patient the difference between icing and heating. Aside from the obvious – ice being cold and heat being warm – ice and heat differ in use and therapeutic effects on the body.

When should I ice or heat?

Ice is used for any acute injury. This means that ice is best for a new injury. Think of a swollen, red, and irritated knee – this kind of injury is the perfect match for ice. Ice has been known to decrease pain while also reducing inflammation and swelling. So when my patients walk into the clinic with a swollen, inflamed, or irritated injury, I will apply ice to the injury.

Heat is for chronic injuries. Heat is most useful when the pain has been ongoing over several days/weeks/months. Think of that dull achy back pain that has been present for months. The heat has been known to decrease pain while improving blood circulation to the heated muscle. I will apply heat to my patients that walk into the clinic with muscle aches, stiffness, or those with chronic pain.

When should I avoid ice or heat?

There are specific scenarios when you should not ice or heat. You should never use ice or heat when you have impaired sensation, as you will not be able to feel if the ice or heat is burning you leading to tissue damage. Ice should also not be used if you have Raynaud’s disease, hypertension, rheumatoid arthritis, history of vascular impairments, and another medical history. Heat should not be used if you have had a recent hemorrhage, thrombophlebitis, impaired mental awareness, malignant tissue, and another medical history. Consult with your doctor if you have any past medical issues or have had any reactions to using ice or heat in the past before applying either ice or heat.

Bottom Line

Ice and heat are two simple, easy, and cost-effective ways to manage pain outside of the clinic and between your PT appointments. Ice is generally used when the tissue is irritated and swollen. Heat is generally used when the muscle is stiff or painful for several days.

CAUTION: Both ice and heat can cause burns and tissue damage so be careful and take the ice/heat off if causing more pain, too hot, or too cold.

If you find yourself in discomfort or think you could benefit from a personalized exercise plan, talk to a Physical Therapist.

Let’s talk! We are here to help. Give us a call for a complimentary assessment.
Did you know there’s no prescription needed from a doctor to see us?
(949) 443-0713

In an effort to prevent the spread of the 2019 Novel Coronavirus (COVID-19), many spectator and participation sports have been postponed.

While this may be especially disappointing if you were looking forward to events – such as college basketball’s March Madness – it’s an important step in minimizing the impact of COVID-19 in our communities.

Pack PT is here to help during this unique time, which is why we’re providing you 8 tips for staying active during the COVID-19 pandemic.

The good news is there are plenty of ways we can maintain our sports connections, even within social distancing guidelines. And, staying active during the COVID-19 pandemic is important for both our physical and mental well-being.

The coronavirus is spread through respiratory droplets, such as a cough or sneeze, and can travel several feet. However, as long as you don’t have a fever and are feeling well, there’s no need to stay on the couch while you practice social distancing. As always, be sure to wash your hands with soap for 15 to 20 seconds before and after any activity with others.

Staying active during the COVID-19 pandemic

If you are healthy, try these eight tips for safely exercising while maintaining social distance during the COVID-19 pandemic.

1. Exercise outdoors.

Most public gym facilities are likely closed but if yours is still open, we recommend avoiding it until public health officials say otherwise. Instead, take your fitness into the fresh air outside. Consider hiking a new path or trying a water-based activity like kayaking, if the weather permits.

Younger athletes can also benefit from outdoor play by themselves or in small groups. Be sure to supervise kids playing in small groups or alone, and discourage the use of sporting equipment or jungle gyms to minimize direct contact with each other and surfaces.

2. Exercise by yourself, with a friend, or in small groups of less than 10.

If you’re heading outside, consider bringing your family or a friend to keep you company, but keep the U.S. Centers for Disease Control and Prevention (CDC) guidelines in mind. Choose activities that allow you to maintain an appropriate distance between each other, such as hiking or biking. Do your best to minimize direct contact and save your high-fives and fist bumps for another day.

If you are going to exercise with a small group of friends, plan to meet up at the destination to avoid close quarters like carpools, and consider outdoor activities rather than fitness studios.

3. Engage in non-contact activities that allow spacing of 6 feet between participants.

Limiting physical contact is one of the best ways to prevent the spread of coronavirus—and any other virus. Social distancing guidelines recommend maintaining six feet of space between people, and there’s plenty of activities that allow for this, such as biking or tennis.

Other group activities, such as running, bodyweight workout routines, and fitness videos allow for additional spacing. If you’re using any equipment, be sure to thoroughly clean and disinfect it before and after use, even if you’re the only one using it.

4. Rethink recess.

With children home from school and focusing on distance learning, don’t forget recess. Physical activity is an important part of the school day and helps children not only with fitness but with mental focus and concentration as well.  Be sure to include a combination of structured and unstructured physical activity into every day your child is home.

5. Work on improving your general fitness.

Having a strong core and aerobic fitness level is necessary for good fitness. You can work on strengthening your core and cardiovascular condition without compromising the safety of those around you by using:

• Home gyms
• Home-based video workouts
• Web-based exercise programs

In fact, many fitness-related instructors and organizations are currently offering free online workout classes and routines for new users as a way to encourage activity and improve morale throughout the country.

6. Clean and disinfect any equipment you use alone or with others.

The virus may remain active on untreated surfaces for an extended period, so be sure to follow the CDC guidelines for cleaning and disinfecting surfaces and any equipment you use by yourself or with others. Using a cleaning solution that contains at least 70% alcohol is important, even if you and your family are using your own in-home facilities.

7. Exercise using your body weight.

Using your own body weight with a circuit-type program can be an effective way to maintain strength and aerobic health in a short period of time. Bodyweight workouts can incorporate a variety of movements that don’t require equipment, including:

• Burpees
• Squats
• Lunges
• Pushups
• Yoga

Remember that with any exercise program, you should gradually increase frequency, intensity, and duration to avoid overuse injuries. If it hurts, stop doing it.

8. Stay in touch with your fitness community online.

Whether you’re a competitive athlete or a weekend warrior, stay in touch with your friends and teammates through appropriate social media channels. Consider sharing your thoughts about this situation and hopes for returning to normal activity as soon as safely possible. Consider on-line challenges for steps, or stationary bike rides, or even run a “virtual race” together and compare times.

What to do if you’re sick

If you or a family member has a fever, cough, or shortness of breath, stay home and avoid interacting with others. Consult with your primary care physician regarding when to resume activity and follow the CDC’s recommendations to minimize the spread of COVID-19 when you do get moving.

As you resume activity, you should:

• Practice social distancing
• Avoid handshakes, high-fives, and hugs
• Maintain a distance of six feet from strangers and anyone with cold and flu symptoms
• Avoid using public surfaces and shared equipment
• Adhere to appropriate hand and personal hygiene

Stay active, but be safe. Stay hopeful, but be helpful. You’ll be back in action soon!

Reference: {https://www.medstarhealth.org/medstar-blog/8-tips-for-staying-active-during-the-covid-19-pandemic/}

If you find yourself in discomfort or think you could benefit from a personalized exercise plan, talk to a Physical Therapist.

Let’s talk! We are here to help. Give us a call for a complimentary assessment.
Did you know there’s no prescription needed from a doctor to see us?
(949) 443-0713

Zetta first came to me back in September of 2019. Essentially she was one of my very first patients as a new graduate physical therapist, which is very meaningful to me. She initially had a significant low back injury that resulted in drop foot of her left foot. Drop foot is a concerning dysfunction, because it means the patient cannot fully lift their toes while walking, which causes a tripping hazard. With hard work and diligence on her part and with careful consideration of my recommendations, Zetta has made incredible progress since September. As you can see in the picture, we use electrical stimulation as a treatment approach to activate the nerve to muscle connection. With that among other treatments such as manual therapy, therapeutic exercise, and the laser modality, Zetta now has a functional left foot. I am very pleased with her recovery because although the nerve can regenerate, it doesn’t always. It is also a very slow going rehabilitation process so I give credit to Zetta for her determination and patience with her recovery. She is an excellent patient spotlight because of her positive outlook and should serve as an inspiration to other patients.

When asked about her experience at Rausch Dana Point, here is what she wrote. “I’m very fortunate to be working with Sarah Troicky. Sarah’s passion, knowledge, and patience is evident in her approach and treatment of patients she works with. Together we are a team and work toward the same goal. I’ve made tremendous progress and I owe that to Sarah and the staff of professionals at Rausch who have assisted in my recovery.” -Zetta Tsukamoto

Let’s talk! We are here to help. Give us a call for a complimentary assessment.
Did you know there’s no prescription needed from a doctor to see us?
(949) 443-0713