Sports Therapy

Preventing Rock Climbing Hand & Tendon Injuries: Part 3 - Dynamic Hang Boarding - Bottom Up

How do you hangboard? Are you a long-time rock climber who wants to climb for a lifetime? A beginner climber who wants to train right and train smart to prevent injury? Are you currently side-lined due to a tendon or pulley injury in your hand and want to know how to rehabilitate it? Are you scared by witnessing your friends get sidelined from finger injuries for months or years and you want to do what you can so this doesn’t happen to you?

https://youtu.be/NuPYYDr0MB8


This is a long-awaited Part 3 to our video series about preventing rock climbing finger, pulley, and tendon injuries in the hand. Make sure to watch videos Part 1 & Part 2, if you haven't already, in which Dr. Elle explains why injuries commonly occur in the hand and tendons/pulleys of the hand, how your technique may be contributing to this, and why strengthening your hand, not just your forearm is important for preventing this and rehabilitating injuries here.

In this climbing training video, Dr. Elle addresses a common training error in hang board training - when climbers only hang statically. Climbing is not static and the abrupt movements in climbing are associated with injury, especially when projecting a route or problem, when fatigued, and when under-trained - all of which are common. You need to bridge that gap in your training. Here is a bottom up way to improve your hangboard training to include more dynamic load to your fingers and make them more resilient to injury.

Comment below with any questions and let Dr. Elle know what questions you have. This shelter-in-place is a great opportunity to train weaknesses and correct imbalances in your body to get you climbing healthy for a lifetime.

Make sure to subscribe to our YouTube channel to not miss any of our educational videos.

TELEHEALTH for You!

Let’s get right to the point. The world is changing. Our health and the people around us are the most important thing. Even with social distancing and shelter in place or even quarantining if you are having mild COVID-19 symptoms, you can advance your health.

At Artisan Physical Therapy & Wellness, we offer both physical therapy and injury prevention programs. For physical therapy we help athletes and regular folks get back to their favorite sports and fitness routines, but can also help you if your goal is to get through the day sitting with back pain or you want to get rid of that heel and arch pain during those first few steps of the day or that shoulder pain in those certain positions reaching overhead and behind you. We have the expertise for all this and can work on multiple areas within one session.

While our physical therapy is limited to California and Oregon residents only, we offer wellness and injury prevention education and services for folks throughout the US and even globally.

Yes, we can help you live a healthier life even if you live in the Midwest, Pacific Northwest, New Zealand, Brazil, or Ireland. We offer wellness consultation worldwide! We do this specifically for rockclimbers and runners, but we can make sure you are healthy to get in a lifetime’s worth of laps at the pool, chasing your kids or grandkids, hiking the El Camino, or playing competitive ultimate frisbee. We are movement analysis experts and exercise prescription and can do this over video remotely. A good portion of the injuries we see come from good intentions, but lack of knowledge. We can give you the knowledge to prevent injuries before they even occur! Healthy for a lifetime. As our seasons of life change and physical goals and demands change, our self-care and fitness routines need to change too in order to optimize our health. Bring us your questions and let us help you answer them!

Honored to partner with you to keep you healthy for a lifetime.

Elle

Tuesday Tune-up: Non-weightbearing Gluteus Medius Conditioning superset

Really want to get your hips strong for walking, hiking, running and any sports that require you to be on one leg? These exercises are for you! Injured and limited in your running abilities? Do these to be ready to hit the ground running? Want to fatigue less easily and be less likely to get injured while running? This superset of gluteus medium non-weightbearing endurance and motor control exercises will get you well on your way. Bonus it will also work on your back stability, strength, conditioning, control, and endurance! Yes!

Be aware, this is not a beginner exercise, but helpful for those looking to take their health to the next level of endurance and more thorough strength. Reach out to Artisan PT for a remote wellness consultation via video or schedule a wellness or physical therapy visit at our Los Angeles office to see what exercises are best for you, at this moment of time.

We are currently doing Tuesday Tune-ups on our Instagram feed and IGTV. Follow us at @artisanphysical to make sure you don’t miss out. As appropriate, we will do our best to also upload to our Artisan Physical Therapy YouTube channel as well. Make sure to subscribe to our YouTube channel to get notifications about new videos on how to live your healthiest life. Don’t miss out.

That’s our goal at Artisan PT: to partner with you to optimize your health for a lifetime.

Thank for reading and watching,

Elle

(owner, doctor of physical therapy, fellow in orthopedic manual PT)


(PS: These hip abduction/abductor exercises are helpful for preventing pain and improving tolerance to running, walking, hiking, skateboarding, soccer, ultimate frisbee, basketball, volleyball, triathlon, mountain biking, yoga, dancing, and anything else you spend time on one leg!)

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

Headstands & Handstands - April Daily Fitness Challenge

Routines are good for our life, and are healthy. But our body and our mind also thrives with some variety. Neuroplasticity is a concept in phenomenon increasingly studied the demonstrates how the brain is always changing. It changes for the Better or For Worse depending on the inputs that we put in.

The daily fitness challenge that I have been taking part in since October is a mix of both these. There has been the daily routine of consistently challenging the body, but also variety as how the body is challenged each day varies and also there has been a different theme each month - running, abdominal and core strengthening, hip and shoulder stability, pull-ups, and this month is something else.

So trying new things is good for the muscles and the joints, ligaments and tendons, but also for the mind and the spirit. At the beginning of this year I set out an overall theme for the year. This year I'm focusing on theme of produce, which basically means working on moving forward and creating, without too much of the limiting mindset that can stop you from creating and participating and sharing. So I brainstormed what are some things that I might like to learn this year and some challenges I'd like to take on. Enter headstands and handstands. I haven't given them much thought before and I've never tried to do them. But I thought why not try and learn this new skill and just see how I do.

Liz's baseline attempts at headstand with her watchful assistant and spotter.

Liz's baseline attempts at headstand with her watchful assistant and spotter.

Trying a new physical skill might mean some preparation is needed in order to do this healthily. Thankfully as a physical therapist, I have good insight into the strength needed and the flexibility needed to be able to put weight through my shoulders.

In trying this new skill I'm excited for the new opportunities that this presents for my body to grow, and strengthen, and learn new balance and ways to control itself. Some of my Approach will involve trying the overall skill, but I will also break it down into small parts to allow my body to have the best chance for success. I look forward to learning from others who are skilled in the area of handstands and headstands and learning some techniques. I plan to try some of the techniques described in this well done instructional video from the UK.

This month a focus on headstands and handstands I hope to be fun as I learn a new skill that I'm not good at. But I also know this will be a good compliment two activities that I like to do that strengthen my body in the other direction, namely, climbing and swimming. Both climbing and swimming are pulling motions and really activate muscles such as the latissimus dorsi and teres major which pull your arm down into more of a handcuff position. Pressing away in pressing overhead will be new challenges for me that have been overlooked and are often overlooked in rock climbers and swimmers, including triathletes, and lead to muscle imbalances, which put increasing strain on joints, tendons, ligaments, and muscles. The strain overtime can lead to pain and dysfunction and difficulty doing the activities we love.

I'll be posting videos primarily on Instagram so follow us there @artisanphysical, but also intermittently on Facebook and here on the blog.

Want to join in on this challenge? I'd love to have you join in and share your successes and challenges. Arr you going to try a different daily fitness challenge? I'd love to hear about that too. Have ideas and suggestions for Liz's next daily fitness challenge? I'd love to hear that too.

Let's get to the source, AND 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

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

3 Simple Strengthening Exercises to Prevent Climbing Shoulder Injuries

Today we have a guest post from a friend and fellow colleague on preventing shoulder climbing injuries. Dr. Jared Vagy - The Climbing Doctor - out of Los Angeles, California works with high level climbers and teaches at USC. The following is an excerpt from his blog post

"It is the end of the day. You are tired and beat, but you decide to give it one last go on your project. You get to the crux move and give it everything you’ve got. Suddenly you feel a sharp pain in your shoulder. You know that you likely injured your shoulder. What happened and what could you have done to prevent this?

The tendons in the shoulder slide through a very narrow passageway and attach to the shoulder bone. Impingement occurs when the space between the bones in this passageway is reduced. This can occur from repetitively moving the shoulder into a stressful or suboptimal position. When this occurs, the bones in the shoulder pinch down on the tendons and cause shoulder impingement. You should be aware of the dangerous movements that can lead to shoulder impingement. These movements include hanging on your arms during rest stances, climbing with a hunched posture and strenuous overhead reaching."

Bent over T's, Y's, and L's:

Dirtbag tip - use items you have around: cans, bottles to provide the weight.

Dirtbag tip - use items you have around: cans, bottles to provide the weight.

These should not cause any shoulder pain! 

Screen Shot 2017-09-25 at 12.53.07 PM.png

Climb INJURY-FREE

Dr. Vagy just released another book! 

You can find it on Amazon now.

Thanks, Dr. Vagy for the helpful content.

Any questions? Comment below. 

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!

Preventing Rock Climbing Hand & Tendon Injuries: Part 1 - Why Hand Strengthening is Important

Are you a long-time rock climber who wants to climb for a lifetime? A beginner climber who wants to train right and train smart to prevent injury? Are you currently side-lined due to a tendon or pulley injury in your hand and want to know how to rehabilitate it?

In this video, Liz explains why injuries commonly occur in the hand and tendons/pulleys of the hand, how your technique may be contributing to this, and why strengthening your hand, not just your forearm is important for preventing this and rehabilitating injuries here.
This is Part 1 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 2 to learn specific techniques, strategies, and exercises to incorporate into your climbing routine.

The weather is warming up and it's time to climb!

We can take it to the next level and help you with focused and personalized examinations in our downtown Portland location or with mobile therapy throughout the Portland, Oregon area. 

 

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.

Is What You Are Eating Keeping You Hurting?

What you eat has a big influence in how you feel. Not too many people will disagree with this statement, however many are not aware the extent that this is true.

Your diet could be perpetuating your back pain, our contributing to your achy knees, or be prolonging that car accident our recent injury pain.

What do we know?

AVOID eating refined carbohydrates, french fries and other fried foods, soda and other sugar-sweetened beverages, red meat (burgers, steaks) and processed meat (hot dogs, sausage), and margarine/lard.

 

EAT MORE tomatoes; olive oil; green leafy vegetables - spinach, kale, and collards; nuts like almonds and walnuts; fatty fish like salmon, mackerel, tuna, and sardines; fruits such as strawberries, blueberries, cherries, and oranges.

Eating this way helps reduce diseases associated with inflammation: e.g. heart disease and cancer. You can read more about this at http://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation.

But eating this way will also contribute time reduce your musculoskeletal and orthopedic pain. (Read -  less pain in your muscles, discs, joints, fascia, and ligaments). Sounds great, right?

If you're not seeing the consistent pain reduction you want from changes in posture, strength, stiffness, and flexibility, consider taking that next step to reduce what my be stagnant inflammation in your body and change your diet to tips towards anti-inflammatory in addition to all the good work your doing with exercise, position, rest, icing, etc.

Every little step towards healthier living counts!

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