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.

These should not cause any shoulder pain! 

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. 

Give Swimming a Try!

I was never a "water baby" - that is - I was never a kid that jumped into water whenever I saw it. I only wanted to get wet if I was dirty, sweaty, or super hot. This followed me into adulthood, so choosing swimming as a workout was not something that happened for me. That is until I was forced to. By age twenty I had injured my knee significantly twice. These ACL knee injuries (anterior cruciate ligament) had ended my soccer career prematurely. I had to wait a few months for ACL surgery, but wanted to stay active, so I did early morning walks with arm motions to get a whole body workout and I started swimming. 

I hated swimming. I hated it as I packed my swimsuit & towel, traveled to the pool, dressed, walked onto the pool deck, jumped in, and swam the first lap.  Do you see the trend? I hated it. But by the second lap it wasn't so bad. It was a quick and very intense workout for me. 20 minutes and I felt like jelly afterwards. All without any impact or pain to my knees! The workout was, in fact, so difficult for me that my cheeks tingled afterwards. Anyone else? Probably not. 

Flash forward to over a decade later and swimming is high up there on the things that I really miss about LA. Swimming laps outside midday on a sunny day is one of the most meditative and mind clearing experience I have. I get a whole body, no impact workout to balance out my running, hiking, biking leg workouts with inclusion of arm and abdominal conditioning and my mind gets to wonder through future ideas and possibilities as well as reflecting back on experiences and relationships. Oh and my cheeks don't tingle anymore.

So give swimming a try! 

Want to make sure you're healthy while swimming? Wonder what swim strokes are right for you? Wonder if you're stroke technique could lead to an injury? Wonder how much to do? Necessary stretches and strengthening? Let's chat. (Also possible future blog post topic - what do you think?)

Already swim? Where is your favorite place to swim?

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!

What Stretches are Right for After Running?

We frequently get the question of: What stretches should I do before versus after a run? No one solution is right for everyone and every situation, but a dynamic cool down is very appropriate for after a run when your muscles are very warmed up, but have shortened from repetitive use.

This quick one to two minute routine should reduce the soreness, stiffness, and tightness you feel after a run. Muscles only know how to shorten and this happens over and over with running, we have to make them lengthen through their full range.

In this video, demonstrates a quick 1 minute stretch routine to be done to stretch the thighs and hips - that is - glutes, quads, hamstrings, and hip flexors after a run. (Note: you will need to stretch the calves/gastroc/soleus separately).

Happy trails and happy stretching!

As always, comment with any questions and any suggestions for future videos. Subscribe to the YouTube channel to not miss out on any videos. 

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!

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!

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!

Climbing clinic: Upper Body Strengthening

An Upper Body Strengthening Clinic for Climbing Injury Prevention and Performance

Sound interesting? Join Liz tonight at Stronghold Climbing Gym in Los Angeles for an interactive clinic on upper body strengthening for injury prevention, performance, and longevity for climbers. Climbing can lead to overuse problems and muscle imbalance injuries. In this clinic you will learn principles and specific strengthening exercises for shoulders, elbows, and hands, to reduce the likelihood of such injuries occurring and to learn safe ways to strengthen.

7:30-9:00pm

Do you say sorry too often?

I came across this blog post via some friends on Facebook. It's specifically from the perspective of a mountain biker, but it's a good universal principle and good attitude shift towards appreciation versus self deprecation. This switch could make a big change in your physical fitness and health goals and even throughout your life. The jist? Don't apologize for being slow, instead thank your companions for their patience.

http://www.sydschulz.com/mountain-biking/stop-saying-sorry

What is Manual Therapy & Why is it so Effective for Pain?

Liz Bottrell, PT, DPT, FAAOMPT, manual physical therapist and owner of Artisan Physical Therapy in the Echo Park neighborhood of Los Angeles, CA explains what manual therapy is.

Manual therapy, or "hands on," evaluation and treatment improves motion, mobility, decreases stiffness, tightness and pain, as well as improving circulation and speeding healing. The healing hands lead to areas of injury and work them out. It is a place where science and art meet.

Do you want to get better as soon as possible? Do you want to see an expert? Have you not seen the results that you hoped for with prior physical therapy. Maybe your therapist wasn't highly skilled in manual therapy. Liz is a fellow of the American Academy of Orthopedic Manual Physical Therapist (FAAOMPT) - her specialized manual therapy training and skills set her apart from other physical therapists.

See a manual therapy specialist and experience the difference in your day to day - the ease of movement, the reduced pain and stiffness, and improved muscle activation (read strength, coordination, and balance). All of this helps you sleep, walk, run, stand, reach overhead, and so on more easily and with less pain.

Combine quality and focused physical therapy with your needed exercises and necessary modifications and get ready for amazing results beyond what you though possible!

Free Personal Advice!

Come out this Saturday, Feb 13th for your free 15 minute consultation with a movement & injury rehabilitation specialist. This is the next installment of "PT Days with Liz Bottrell" at Fleet Feet - a great and friendly running store in Burbank, California. If you're keen, join in the weekly 3 or 5 mile run beforehand. To sign up, use this link from their website.  Liz is looking forward to venturing out of Echo Park to chat it up with the running community.

Can't make it? Subscribe to the newsletter by Sunday the 14th and get your free transformative Runner's Stretching Guide delivered directly to your inbox.

Let's show ourselves some self-love this month & spend a little extra time taking care of our physical health.

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!

2 Simple Exercises for a Healthy Rotator Cuff

Want to have healthy shoulders and rotator cuff? Want to prevent injury when swimming, doing yoga, while weightlifting or crossfit? Want to rockclimb better? Want to play tennis and volleyball for years? Then take a couple minutes and learn a few strengthening exercises for the rotator cuff using an exercise band. The exercises are simple and easy to do wherever you are! No fancy or expensive equipment needed!

Have lingering shoulder pain, a prior rotator cuff tear, aching or weakness? Try these as some basic strengthening.

The rotator cuff is extremely important for basically all arm movement and certainly all shoulder motions. Make sure your rotator cuff is strong and has a lot of endurance to prevent injury!

For recommendations specific to your situation and body, contact Liz in Los Angeles or your neighborhood physical therapist. We are the movement specialist.

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

Until next time,

Liz

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!

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