Physical Therapy

PT Better Than Surgery for Shoulder Impingement and Subacromial Pain

New guidelines for management of shoulder impingement are strongly in favor of physical therapy and away from surgery! These recent guidelines were posted in the BMJ (British Medical Journal) and you can read more here. This is exciting news supporting conservative treatment that physical therapy provides versus more invasive techniques such as surgery.

As the research was examined, the findings revealed: decompression surgery resulted in no significant differences from other approaches—including PLACEBO surgery! The lack of difference was long-term, remaining at 6-month, 2-year, and 5-year follow ups.

Shoulder impingement occurs when structure that pass through your shoulder get pinched between the humerus and acromion that compose part of your shoulder joint. This can lead to irritation, pain, and wear and tear to structures such as the bursa (bursitis), supraspinatus (rotator cuff strain, tears, tendonitis, and tendinopathy), biceps (long head of biceps strain, tears, tendonitis, and tendinopathy).

The following helpful schematic visuals presents the findings for how to management shoulder pain from rotator cuff disease/dysfunction (RCD) and subacrominal pain syndrome (SAPS).

PT better than SAD.jpg

The fact that physical therapy is the ideal way to treat these pain syndromes is not surprising given that the shoulder joint is a complex joint comprising of 4 separate joints and myriad muscles that must coordinate well. Tightness, weakness, poor endurance, control, or posture at any of these points including at the shoulder blade (scapula) can lead to narrowing at the subacromial space and thus impingement. Reversing these problems can then increase the space and reduce the strain, pain, and irritation.

Bottom line?

Having shoulder pain? Come to PT before a surgeon! Please note that these findings are for overuse and non-traumatic shoulder injuries present for more than 3 months.

Thanks for following along as we journey to: Get to the Source, and TOGETHER, get moving.

Liz

Daily Dose of PT (#dailydoseofpt)

Yep, I made a hashtag #dailydoseofpt. Why? Because everyday for 2019 I’ve committed to myself, for my own personal health to do at least one physical therapy exercise. I’m not going to limit myself to one, but I will do at least one.

After some thought, I thought": “why not bring others along?” 365 exercises is a lot and sharing them is a lot, so the daily dose of PT will be shared just on one platform. For ease of use, I’ve chosen Instagram and the live story. It’s not that you won’t find any excerpts or references anywhere else - blog, Facebook, Youtube, Google+, or newsletter, but the journey will be unfolding and evolving on Instagram live and then kept up on the story for 24 hours.

Daily dose of PT - climbing gym edition

Daily dose of PT - climbing gym edition

My hope is that my quest for personal health and well-being will be educational and motivational for you and those that stumble across it. At the time of the writing of this blogpost, I am 9 days into the challenge, with 356 to go. There are lots of opportunities to participate. To not miss out, make sure you follow @artisanpt on Instagram and even allow notifications for live posts from me.

The focus to-date of the #dailydoseofpt has been primarily shoulder, neck, shoulder blades (scapula), and postural stability. Over the course of the year, the whole body will get covered, as needed by my own personal PT intervention needs. If there are regions or parts of the body, that you would like me to focus on, let me know and I’ll do my best to incorporate them sooner rather than later.

Thanks for joining on this journey to optimize health and wellness.

Together, let’s get moving!

Liz

Awesome, Effective Advanced Shoulder Stability Exercise

Looking for an excellent, if not awesome, way to strengthen your shoulder.? We've got an exercise for you including a video demo! Here is one of Liz's favorite exercises that she is incorporating into her March daily fitness challenge - which is alternating between the hip and shoulder stability and strength.

The shoulder joint is a "ball and socket" joint. It has a lot of freedom to move in a variety of directions, which is means it needs stability and strength in multiple directions. This exercise is a constant isometric force into external rotation pushing out with the wrists which strengthens and challenges two of the rotator cuff muscles, in particular, the teres minor and the infraspinatus. As you push constantly out through the band you will simultaneously raise your arms overhead which works additional shoulder muscles including shoulder blade (scapular) muscles responsible for upwardly rotating it. These muscles include the serratus anterior and the lower trapezius, which when weak can lead to shoulder impingement, bursitis, and rotator cuff tears and injury. 

This is not an exercise to perform when your shoulder is very weak. For that you want to exercises that place less demand on your shoulder. If you missed it, a video we created for that is this:

Mixing things up with "easy" and "hard" exercises is good for a healthy shoulder. I've been doing exercises from each of these videos as I seek to have an even stronger and healthier shoulder than I already have.

Have you started a daily fitness challenge? If so, what are you trying?

Not started yet, but thinking about it? What are you considering? Even the considering, is a step forward and progress! The planning stages count for fitness and health.

Stay tuned for next month's daily fitness challenge which will be headstands and handstands! April is almost here. Would you like to join me? At this time, May is scheduled to be ankle and foot stability, so reach out with any questions or suggestions for that if that provokes some interest from you. This is particularly meaningful for those of you with "weak" ankles, foot and ankle pain, history of ankle sprains or foot/ankle fractures (broken bones). 

Let's Get to the Source, and TOGETHER, Let's Get Moving

Liz

March Daily Fitness Challenge - Hip & Shoulder Stability

I'm pleased to say that the daily fitness challenge that began in October of last year has continued, with a different theme every month. So far we have attempted daily running, seven minute workout, pull-Ups, 8 minute abs, and now.... drum roll please...

BOSU overhead ball toss.jpg

This challenge this month, as the title of the blog post indicates, is hip and shoulder stability. I'm excited about this month because they are very important and foundational to so many activities and preventing injury as well as rehabilitating injuries. I've had my fair share of injuries over the years and they have left they're mark. Now if I had been better about doing all my rehabilitation exercises for these various injuries, I don't think I'd be in the same place. I'm excited of the possibility that the asymmetries I have from side-to-side could diminish, and even, completely resolve!

 Doing all the exercises that your body needs is a lot of work. Can I get an amen? It takes a lot of time, a lot of motivation, and a lot of knowledge. I have the knowledge and a good bit of motivation, but not always enough time in the day. Anyone else have a hard time finding enough time in the day? These monthly-themed daily exercises that I'm exploring are an avenue for me to rotate throughout the body and pay attention to each area and hopefully be better off than the intermittent and sporadic exercise provided otherwise.

Unstable hips or, in other words, hips that lack the strength, endurance, and coordination to control themselves in space, can lead to problems from the low back all the way down to the big toe. Yes, even the big toe! You think you inherited that bunion from your family? Where you born with it? Is it rather from how you've moved and used your body over time? Let's take a look at your hip stability and then let's talk about it.

Knee injuries ranging from patellofemoral pain, runner's knee, ACL tears, meniscal injuries can all arise from a lack of hip stability. Lack of hip strength and control or endurance can also lead to ankle injuries such a sprained ankles and fractures and down the chain into the foot with overpronation, plantar fasciitis, shin splints, or achilles or posterior tibialis tendonitis or tendinopathy.

Shoulder stability is also really important and isn't straightforward. Think of all the motions that your shoulder can do and that is a sign that keeping it healthy will similarly take a lot of work. The shoulder joint or complex is actually made up of four joints: 

  • Glenohumeral joint
  • Scapulothoracic joint
  • Acromioclavicular joint
  • Sternoclavicular joint

All of these are controlled by muscle. So once again the strength, the endurance, and the coordination of these muscles results in the control surrounding those joints. In terms of stability, the most important muscles are the rotator cuff and scapular muscles. You can think of your shoulder blade, or scapula, as the foundation of your shoulder. If the foundation is crooked or unstable, this has consequences for the areas attached to it.

As I work on shoulder stability this month, I am emphasizing the rotator cuff - all four of the rotator cuff muscles - and the scapula thoracic muscles - think rhomboids, trapezius, serratus anterior - as well as the scapulohumeral muscles. If these muscles are strong, can work for long periods of time, and can turn on and off at the right time, there should not be clicking in my shoulder with movement, nor am I very likely to injure myself. Bear in mind that as I strengthen these muscles, I will also need to stretch them because strengthening increases the tone of the muscles and often the stiffness of the muscles and sometimes shortens the length of the muscles. And tight muscles can lead to injury and dysfunction.

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Because it is unwise to strengthen the exact same area day after day, I will alternate between hip stability and shoulder stability, doing one one day and the next the other day. Want to learn a great routine to do for these areas, reach out and we can schedule either a visit or a remote consultation for you fitness, wellness and health goals.

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Stay tuned for April's daily fitness challenge of headstands and handstands...

Let's Get to the Source - and TOGETHER - Let's Get Moving

-Liz

Arm Strengthening for Climbers: Hand Sloper Strengthening with Rotator Cuff and Scapular Stability

Are you a long-time rock climber who wants to climb for a lifetime? Do you want to train right and train smart to prevent injury? Do you wish your hand strength was better for slopers and other open-handed grips while rock climbing?
In this video, Dr. Bottrell introduces a quick series of exercises that strengthens your hand and forearm in open hand positioning for slopers while simultaneously strengthening and increasing the stability of the rotator cuff and scapular (shoulder blade) muscles and joints. Incorporating exercises such as these present the opportunity for better performance & longevity of climbing of a lifetime, decreased likelihood of injury.


Bear in mind these are general recommendations, and a certain amount of strength and fitness are needed.
Interested in what weighted ball uses in this video? It's the Gymnic Heavymed 2 kg weighted ball for resistance.

8 Minute Abs

Last month I did a daily physical challenge of running every day - with the goal of being healthy. Success! This month the physical challenge is "8 min abs". I've spent everyday of November (one day to go) targeting abdominal strength, endurance and control for 8 minutes. Now this isn't about aesthetic or beach body abs. Being able to do crunches and sit-ups are important but have been over-emphasized in the fitness industry for years. Having healthy appearing abdominal muscles - a 6 pack - doesn't mean you are in fact healthy. More specifically, it doesn't mean you are preventing injury. Abdominal strength and stability in combination with low back and hip strength and control make up what we physical therapists call "lumbopelvic stability" or "lumbopelvic control." This is something we emphasize in helping and rehabilitating persons with low back pain, sciatica, SI joint (sacro-iliac joint) pain, lumbar radiculopathy, herniated discs, DJD (degenerative disc disease), arthritis in the joints of the back, and stenosis. The back is connected to the pelvis, which is connected to the hips/thigh/femur. I often sing  to my patients and clients about the wisdom of the children's song: "the back bone's connected to the hip bone. the hip bone's connected to the thigh bone" (They love it, as you can imagine).

So me spending on this focused time on this region wasn't just sit-ups and crunches. In fact, it was much more perform leg and arm motions without letting my back move. I spent 8 minutes each day this month emphasizing a variety of challenges to lumbopelvic stability to promote and preserve a healthy back. I brainstormed a list of exercises and invited a friend to join me with this month's challenge. My list is long and varied. I challenged my abdominal muscles - all of them (rectus abdominus, internal and external obliques, and very importantly the transverse abdominus). I rotated through 48 different exercises these 30 days! There's no reason to get bored. And as we strongly recommend here at Artisan PT - variety is good and very healthy for us. 

Want an example of how to train the transverse abdominus? The transverse abdominus is the most important abdominal muscle to prevent back injury and recover from a back injury or back pain. Learn more in our video on a starter transverse abdominus exercise. PS - Side effects of this exercise include flatter stomachs! PPS - I won't be posting pre- and post- 8 min ab challenge photos, but will be enjoying the results.

 

Watch should the next challenge be? December is right around the corner!

Let's Get to the Source, and TOGETHER, Let's Get Moving!

Liz

Why Does My Foot Hurt in the Morning?

"Why does my arch hurt?" 

"I get a sharp pain in my heel every morning I get out of bed.

"When I've been on my feet too long, the bottom of my foot hurts so bad."

Do you say these things? You may have plantar fasciitis.

The plantar fascia is a ligament that helps support the arch of your foot and gets stretched when you put weight on it and every step you take.

"Itis" is Latin for inflammation, so plantar fasciitis is a diagnosis of inflammation of the plantar fascia. Inflammation takes place when you have an injury and the body is trying to heal. Research is showing that most cases of plantar fasciitis is not an "itis" but is instead an "-osis" which reflects degeneration. This is why rolling on a frozen bottle might not make your symptoms go away.

At Artisan Physical Therapy, your PT will try to figure out a few distinct things in your evaluation - what tissue is injured or irritated and then the why it is injured/irritated/painful. Often both need to be treated the sore tissue needs to be calmed down and then that factors that led to the injury need to be changed and/or alleviated otherwise it will be perpetually irritated.

Common factors that lead to plantar fasciitis or fasciosis include:

  • Insufficient arch support - going barefoot, wearing flip flops, or shoes without arch support or very flexible soles
  • Tight ankles and calve muscles
  • Weak hip (gluteal muscles)
  • Excessive body weight
  • Increasing activity too quickly (deciding to train for a marathon or get in shape drastically from prior level of activity)
  • Weak foot muscles or inappropriate muscle use/activation

Just because you have arch or heel pain, it doesn't mean you have plantar fasciitis. It could be a tendinitis or tendinopathy of a foot or ankle muscle or an issue in the joints of your foot. A quality physical therapy exam will clarify this for you.  As mentioned above knowing which tissue is irritated allows for specific, targeted treatment to get rid of your pain and get you back to pain free walking, running and whatever else you love and need to do.

Think you might have plantar fasciitis? Take the first step towards health and get a PT evaluation to get quality manual therapy to temporarily decrease the pain in your foot and learn exercises to keep it away by learning how to reduce the stress to the plantar fascia and learn what activities to avoid a do instead to allow it to begin healing today.

Let's Get to the Source - and TOGETHER - Let's Get Moving!

Preventing Rock Climbing Hand & Tendon Injuries: Part 2 - Techniques For Open Grip Strengthening

People are often injured by trying to progress too quickly and this is very prevalent in rock climbing. People fall hard for the sport and enjoy the challenge of pushing their limits, but lack the knowledge needed to stay healthy, prevent injury, and thus climb for a lifetime and not have to take months and month off due to tendon or pulley injuries in their hands or forearms.

In this video you'll learn the how-to principles of hand strengthening to cross train to improve open grip strength and reduce hand pulley and tendon injuries for rock climbers. Climb better, climb harder, climb longer. Climb for a lifetime.

For a personalized assessment, contact us at our Portland office.

If you have injured this area, make sure to give sufficient rest and see your local PT who specializes in manual therapy & treating climbers to learn how to get back to your prior level and incorporate this open hand strengthening to improve your grip and reduce compensatory strategies that overload your pulleys. Also find out how shoulder weakness, for example, can influence which grip you choose. 

This is Part 2 of a 2 Part series, with the possibility of a Part 3 adapted to interest, questions, and feedback from the first 2 Parts. Watch Part 1 to learn why hand strengthening matters to prevent injury and the important of incorporating into your climbing routine. Questions? Should we do a Part 3?

Let's Get to the Source, and TOGETHER, Let's Get Moving!

Quick Yoga Sequence for Runners: Stretching with Some Core

New video out!

In this video, Doctor Elizabeth (Liz) Bottrell PT, DPT, FAAOMPT of Artisan Physical Therapy in Los Angeles, CA demonstrates a quick and effective yoga sequence for runners. Whether running your first 5k, training for a marathon, triathlon, or an ultra, you need to stretch. Stretching takes time and knowledge. In this video, you'll learn a quick vinyasana or flow yoga sequence that efficiently stretches your hamstrings, calves (gastrocnemius & soles), and hip flexors (Iliotibial band and iliopsoas) to maximize your time, as well as incorporating abdominal strengthening and control and cross training strengthening for the pectoral muscles and triceps. This fast routine, also trains balance, breathing, and improves motion in your back and abdominal muscles!

You can repeat and hold longer as needed. Do not hold your breath!

Pay attention in the video because you need to make sure you know which muscles to stretch. Follow-up videos will show specifics for a few other essential muscle groups for runners to stretch.

Try it and let us know what you think.

Car accident blues

Were you in a auto accident? Rear-ended? T-boned? Don't relinquish control of your health!

One of the biggest mistakes we see people make after automobile accidents is not taking responsibility for their health. Waiting on payment from insurance and settlements before receiving professional medical care to rehabilitate from whip lash, pulled, strained, and sore, achy muscles, joints, and ligaments is common and results in prolonged injuries, negative outcomes, side effects, and chronic pain.

The best thing to do is to receive professional care as soon as possible, and what better, than a physical therapist? Physical therapists are EXPERTS in musculoskeletal movement dysfunction and rehabilitation.

Make sure to rest, limit extremes of body range of motion and speed, let your body recover, and take steps to reduce inflammation in your body. Don't put off take care of your health. It is your livelihood. It is your life. First get the quality, personal, and focused care you need to deal with your motor vehicle accident (MVA).

At Artisan Physical Therapy, you don't get generic treatments such as lying on hot packs, getting electrical stimulation, and ultrasound. Instead you get quality and focused manual therapy specifically suited to your needs to reduce swelling, inflammation, pain, stiffness and tightness so that you can get back to doing what you love and when you want to do it. We give you things to put you in control of how you feel - education on the specifics of what to do and what not to do in your daily activities and active body movements and therapeutic exercises.

It's not uncommon that people through care with Artisan Physical Therapy can learn more than they even knew about their bodies and live healthier lives than they did even BEFORE their car accident.

6 Effective Tips to Less Back Pain with Sitting

Do you have difficulty completing work due to back pain with sitting?

Does your low back pain limit your social life with things like sitting at a restaurant, driving, and sitting through a movie.

Low back pain with sitting is common with disc and muscle injury.

To get yourself feeling better, try these 6 simple tips:

  1. Use the back rest on your chair
    • Sitting up is hard! 
    • Give those muscles a rest by allowing your back to use the support of the backrest.
    • Don't sit at the front of your chair
    • Keep your chair close to what you are working on, so you can stay all the way back in the chair.
  2. Use an extra and portable back support
    • Chairs are often not designed ergonomically for ideal posture.
    • Chairs are not one size fits all! Our bodies differ wildly in shapes and sizes from one person to the next.
    • You should maintain the same amount of curve in your back while sitting that you have while standing.
    • To assist with this, I recommend some thing like the Wonder Roll, which you can find online at www.wonderroll.com. It changes support quickly and easily while being portable, yet can stays in place on your chair with a simple strap.
  3. Take frequent breaks
    • Let your body heal and get stronger, by planning and not sitting longer  that your back can tolerate. 
    • If it starts every 30 min, get up every 25 minute, etc.
  4. Make sure your hips are flexible
    • Remember the song you sang about the human body? "The back bone's connected to the hip bone, the hip bone's connected to the thigh bone..." (You get the point).
    • Stretch the back side of your hips both the muscle and joint, so your back isn't being strained.
  5. Increase the strength and endurance of your low back muscles
    • If your back muscles are tired, they will do one of two things.
      1. They will start to complain and be your source of pain.
      2. They will stop working and let you go into poor posture thus putting bad stress onto the passive structures in your back: discs, ligaments, and joints.
  6. Watch your posture
    • If you saw your posture from an outside perspective, you might be horrified!
    • Set regular reminders in your calendar and alarms on computer and phone to remind you even when caught up in tasks and projects requiring your full mental attention.
    • Give permission to those around you to remind you when you are sitting with poor posture, so you spend less time there and thus strain your disc, ligaments, and muscles less.

Thanks for reading. If we get enough interest, we will make some videos about how to sit with less back pain. Leave a comment about how it works for you and what tips you use.

Let's Get To the Source, and TOGETHER, Let's Get Moving!

 

 

A Simple & Effective Exercise to Minimize Headaches

A new video from Liz went live earlier this week! Do you have headaches or know someone with headaches who would like to reduce their frequency or intensity and even eliminate them entirely?

In this video Dr. Elizabeth (Liz) Bottrell, PT, DPT, FAAOMPT, manual physical therapist and movement specialist, demonstrates a simple but effective exercise to reduce the frequency and intensity of headaches.

Many people have cervicogenic headaches - headaches arising from tight muscles and joints in the neck or poor posture - but think they are migraines or other types of headaches. This basic, easy exercise will stretch your neck muscles and reduce referred pain to your head. It is also effective for neck pain after a car accident or whiplash.

Try this exercise, 3 sets of 10, without pain or just to the point of pain.

If you have more questions about what other exercises to do for your condition or would like hands-on, manual therapy to improve joint range of motion, reduce pain, improve circulation, enhance muscle flexibility, and increase ease of movement and maintaining good posture, contact Artisan Physical Therapy to schedule an appointment for your physical therapy evaluation and treatment session.

Let's get to the source, and TOGETHER, let's get moving!

5 Best Neck Posture Exercises

Have you noticed a prominence or lump developing in your upper back and wondered what it was, and if you can do anything about it?

A friend of mine last week asked a question. What is this lump on the back of my neck? When I heard the word "lump," I was not hopeful that this was something a physical therapist could help with. A quick examination revealed that his spine was changing shape over time and he was developing a bony prominence where his neck and upper back meet. Why? This often takes place from repeated stress on the area over time. The forward slouched sitting posture so many of us find ourselves throughout the day while we are doing activities such as studying, working on the computer, driving, and reading.

Think about the elderly person with the stooped posture and rounded upper back. This didn't happen over night but was from poor sustained postures that resulted in progressive stiffness and weakness that eventually prevented them from sitting and standing with a straight back and neck. I like to say the body adapts to what we do to it and the spine is like wet cement that is hardening - what position do you want it to stiffen into?

(Disclaimer: Some people with stooped postures (aka excessive kyphosis) have pathological conditions in their spines that lead to these deformities, not simply due to impaired posture).

What can be done about it? My friend wanted answers! He might not be able to change his "lump" that is already there due to bony changes that have already occurred but maybe we can help it from increasing by working on some posture exercises to improve the flexibility of the thoracic and cervical spine and improve the strength of the muscles that hold these positions. Fortunately for him, His condition isn't painful yet. Doing some simple posture exercises can prevent painful conditions from forming in his neck and shoulders and even reduce headaches.

Subscribe to the blog and get access to the to 5 Best Neck Posture Exercises delivered to your inbox! Who doesn't love free professional advice?

Comment below for any questions you have for a physical therapist and Liz may answer your question in a future blog post!

 

Chasing Your Goals

How 'bout them New Year's Goals?

It's been a busy summer transition into fall here at Artisan PT and in life in general. The seasons are changing even though here in Southern California it doesn't always feel like it. We have (hopefully!) made it to fall (finally!).  The Weather Channel app is telling me just a high of 74 deg, so I'm going to risk it and say: "we made it!" Here's to wearing layers, enjoying hot beverages, having comfortable workouts, and eventually enjoying falling leaves.

It's been 6 months since the last post about one of my goals: To do a race this year. September 19th, 2015, it happened. I competed in the Nautica Malibu International Distance Triathlon. 1.5 km swim, 40km bike, and 10 km run in the books!

As a special bonus, I got to race with good friends. Nothing makes it more fun than to create memories together!

As a special bonus, I got to race with good friends. Nothing makes it more fun than to create memories together!

It's been 9 months since I started training for the race. I was even training for the race 4 months before I signed up! Someone might ask - isn't 9 months a bit excessive for training for an Olympic distance triathlon? After all, it's nowhere near the length of an Ironman! My answer would be that it depends how you think about it. Starting in January of this year, I joined a local gym, which was my first traditional gym membership in the past 5 years. I hadn't lifted weights, for at least that many years, and I hadn't been running for at least 2 years. As a physical therapist, I wanted to be healthy and decided to practice what I preach.

One of my PT mantras is that: Your body WILL change, but change takes time!

Body composition takes time to change, as does developing muscle strength and hypertrophying (i.e. increasing the size of your muscles), so does endurance, and cardiovascular adaptations. I don't want you to think that in those 2-5 years I was inactive, I wasn't. I'm a firm believer in activity and varied activity; I was simply doing other exercise. The first few years of those 5 years I climbed a lot and hiked. Then I got back into biking and would do that whenever I could with some swimming sprinkled in there. My enjoyment of swimming while in LA has taken birth. Prior to living here, I worked it into my routine simply because I new it was good for me or 10 years ago because I needed to in order to perform reasonably well in my triathlon races, not because I enjoyed it. Here, I've grown to love it, particularly during the sustained Indian Summer months that we just survived through, yet again.

Having not run in so long, I knew that my hip strength, in particular, would be limited and this would in turn affect my running and my mechanics during running. If not addressed, I would run a much higher chance of becoming injured. If I wanted a healthy race, I needed a healthy base. I think it's noteworthy that at that time I didn't even know what race I was going to do yet alone what distance, sports, or time of year I'd be competing. I simply knew that I needed to start with the basics. So I worked on leg, core, and upper body strength, I stretched, and worked on all the imbalances that I knew I have. I worked on exercises that combine single leg balance and strength. 

We all have our issues and we all need to do our best to stay on top of them! I spent 3 months focusing on weight-training, stretching, and doing my "PT" exercises. Any runs I did were very short and focused on good form. Any leg pain? I would immediately stop. Any break down in form? I would stop.

I followed up that 3 month phase with cardio that built up all the way to my race. My goal was to do cardiovascular exercise - working in biking, swimming, and running - for one hour per day. As I got closer to race day, I started combining workouts (bricks) and doing 2 workout days to get the endurance for the multiple hours required for the race.

I had an almost unspoken goal of 3 hours for my race. I calculated this by simply combining my individual time from workouts for each portion of the triathlon. It was mostly "unspoken" because it was a dream time. I didn't know if I could do it all back to back that fast.

Well, I raced and I'm happy to report that I did it in 3 hours and 6 minutes. So close to my unspoken dream goal!

Most importantly, I was healthy the whole time and, in fact, my muscles and joints felt better than they had prior to my commencing training. I finished the race motivated to compete again, knowing that with the knowledge I gained from my training, I could reach my goal. Goals are important. Setting high goals are important. It helps you expand yourself and growth, whether you obtain the goal or not! Part of my purpose with the race, was not just the physical. I wanted to train my mental fortitude, too, in a way that I wasn't able to when I competed in triathlons previously in my 20's. I focused and learned from leaning into the discomfort that accompanies continued on when things get hard.

Don't wait until the pain comes, schedule a physical therapy visit with Liz at Artisan Physical Therapy to learn how to reach your goals healthily!

Let's get to the source and, TOGETHER, let's get moving!

Stayed tuned for future blogs to read about how to tweak my training from what I learned from the experience. Let me know any questions you might have.

Liz

Exercise recommendations for Minimizing IT (iliotibial) Band Tightness

Did you watch the first video in my 2-part series about IT (iliotibial) band tightness and have been waiting ever since for video 2? Well, wait no longer, for that moment has finally arrived! In part 1, I explained the anatomy of the IT Band and how it can become tight and problematic. It is often muscle imbalances that lead to this or sometimes just shear volume of activity and training.

In this video, I detail some of the practical, basic stretching and strengthening exercises that I recommend for people's whose IT Band and tensor fasciae latae (TFL) are tight, particularly due to the TFL/ITB serving as an "overachiever" muscle in the hip.

Enjoy the video.  Contact me with any questions and/or suggestions for future video topics.

Let's get to the source, and together, get moving!

Liz

Race Goal for the Year

My first blog post of the year highlighted some of the goals I had for the year. How are your goals coming along? Typing this question, alone, is making me want to stop and go back to recheck on all my goals and see what progress I'm making & if I'm forgetting anything!

The goal on the forefront of my mind currently is my goal to train and participate in a race this year. I'm so pleased to report I reached a milestone! I signed up! "What race?" you ask. Well, I am opting for a triathlon - the Nautica Malibu International Distance Triathlon - to be precise. Now I'm excited and nervous. I got a lot to learn about ocean swimming and I've got some training to do to hopefully "race" it.

What do I mean by "race" it? It has to do with your fitness level. I am fit right now in terms of overall health and wellness in disease reduction activity lifestyles and with respect to my body weight and composition. I could participate in the triathlon event and complete it, possibly even this week, but it wouldn't feel good. I want not to simply finish it - although I think it is a great feat. I want to prepare, train, and give it my all - to go fast - that is, to "race" it. Let's be clear when I say race or fast, I mean my fast (not going to be winning any races here)!!

I'd love to hear about what your training for in life, how you're learning to persevere and be disciplined, and elevate what you think you're capable of. For me this all fits into the bigger picture of learning to live more WHOLE-HEARTED (my theme for the year) and even helping people living healthier, more satisfying lives with my work at Artisan Physical Therapy. Also let me know what training questions you have!

Together - Let's Get Moving!

Liz

Liz Bottrell - Artisan Physical Therapy - biking