Posts tagged "physical therapy"

Does posture cause pain?

August 28th, 2018 Posted by Wellness 0 thoughts on “Does posture cause pain?”

The effects of posture on pain is misunderstood. To answer the question, posture does not cause pain alone.

The body has a tremendous ability to adapt. It adapts by responding to whatever load or stress that is placed on it. That is why a bodybuilder can curl weights to grow his biceps over a period of time. Strength training as it relates to muscle building is a common example of how a body responds to load.

Other structures adapt as well in various predictable patterns. Simply put, as you sit and slump, your posture will respond accordingly. Pain can occur if you load your body in a way that it is not used to.

Real-World Example

Here is a common example that might make things a bit clearer. Take a person that works at a desk such as an administrator. As the administrator is slouched in their chair, their back may round and the shoulders may come forward.

The rounded (or forward-flexed) back and forward shoulders make it less advantageous to do things that require you to extend your back say as with an individual reaching over-head.

That can manifest itself in that same administrator if they decide to paint a room in their house one day, or throw a ball with a friend or family member. Reaching overhead can increase stress on the low back since it is not accustomed to that position.

How about the forward shoulders? That puts the shoulder — and shoulder blade — in a disadvantageous position. This can make reaching overhead stressful on the shoulders. Higher demand activities such as throwing a ball can pain or tissue damage with limited range of motion that can result from poor posture.

So as you can see, it isn’t necessarily the posture that effects people however being in one position for too long can create muscle imbalances across the body. Static postures can make other activities more difficult or, place you at a higher risk of injury.

How to avoid this?

Ultimately, staying active while varying your exercise type is the best way to maintain fitness and prevent risk for injury. Challenge yourself with exercises in different positions and postures. This will keep you physically prepared for any and all tasks you enjoy doing.

Remember, your body responds to whatever load and stress you give it. If it is in one posture and doing the same activity every day, your body will start accommodating to form its body to handle that task. A seated, slumped posture is not a good training position for much else other than sitting.

Next week’s post will address common stretches to perform for those that find themselves having to sit a lot.

Getting an evaluation by a physical therapist will help determine areas that can be improved upon to prevent or recover from injury as well as help design the right program for you.

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The above is not a substitute for medical advice and does not take place for seeking a healthcare provider.

Top 3 Reasons Why Your Knee Hurts When You Squat

August 23rd, 2018 Posted by Blog 0 thoughts on “Top 3 Reasons Why Your Knee Hurts When You Squat”

I hear this a lot from people that come to my clinic for help with their knee pain during or after they squat. I first would like to start by saying that squats are one of the best exercises an individual can do. The health benefits are tremendous and far exceed just leg strength. I will save those details for another post. Also, squatting is not bad for your knees and is a common misconception. In fact, not squatting is more likely the cause of generalized knee pain.

With the importance of squats emphasized, what do you do if you have knee pain with squatting? Pain with squats can arise from many different sources however I will discuss three of the most common ones I see with people I treat at my clinic, RISE Rehabilitation and Fitness.

Weak Hips

This is the most common issue I come across. The hip, specifically the gluteal muscles, don’t support the knee sufficiently to allow for a proper squat. The knee is a ‘hinge joint’ and just wants to bend and straighten essentially. When the hips can’t keep the knee steady in place, the knees can cave-in. Doing this repeatedly will cause knee pain and, with enough load, may cause tissue damage.

It looks a bit like the image below:

The photo above shows on the right, an individual that would likely have weaker hips than the individual on the left.

THE FIX! A great way to fix this is to strengthen the gluteal muscles. That includes the series of exercises below.

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Hip Thrusters 💪👌 _ Perfect for finishing off the glutes at the end of a leg workout😅 _ 🧐Glutes tend to be a hard muscle for people to generally feel/work/engage. If that is you, give these a try. _ ⁉️How: back of shoulders up on a bench or box, heels down, glutes in the air, bar resting (with cushion) in front of hips, squeeze the glutes together and lift 👆💪 _ Troubleshooting 1️⃣: if you feel this more in your hamstrings (back of the thigh) keep the weight on your heels and focus on squeezing your glutes together. _ Troubleshooting 2️⃣: if you feel “pinching” in your low back — 🛑 stop 🛑 – Fix this by tightening your core and make sure the movement is coming from your glutes and *not* the low back _ Glutes are powerful muscles and can handle high work loads so either: ✅Go lower weight with higher rep ranges (12-15reps) or heavier weight in a lower rep range (5-8 reps)✅ _ #RiseRehabFit #Fitness #Workout #Training #strength #beastmode #PT #DPT #SPT #physicaltherapy #wellness #health #exercise #exerciseismedicine #womenwholift #stability #legday #glutes

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Limited Ankle Mobility

You might not even realize this but the ankle is critical to a proper squat. Many people pay close attention to the hip as well as strengthening the muscles of the thigh to improve the squat. While these are all important, if the ankle does not have sufficient mobility, no amount of strength will allow proper form and range of motion to have a complete squat.

Here you can see the range of motion needed for a proper squat.

THE FIX! A skilled manual therapist can help do various mobilization techniques to the ankle. At RISE Rehabilitation and Fitness, I work with individuals to target specific tissue or joint restrictions with my hands-on, manual therapy techniques. That essentially works on improving the mobility of the ankle joint.

Poor Form

I would say if you have knee pain with squatting, your form is likely not optimal. Granted there can be exceptions to that but we can review a couple key points.

  1. As we mentioned above, we never want your knees to collapse inward toward each other. You always want a stable base for your legs with your knee/thigh tracking in-line with your toes, or even slightly lateral/outside of your toes — never inward.
  2. We also want you to squat as if sitting back in a chair. Too often people do not bend at their waist to sit back and rather go forward with their knees. This creates tremendous stress on the patellar ligament in the front of the knee (see image below on right). This could be the cause of your pain for those that have excruciating, sharp pain, in the front of the knee. Often, this is diagnosed as patellofemoral pain.









Above you see the knees travel well-beyond the toes and the heels are elevated. Some individuals (say, with long thigh bones) can have their knees safely pass the toes, however, the heels should always stay firmly on the ground. This much pressure through the front of the knee can be dangerous and could contribute to your knee pain (aka, patellofemoral pain).

THE FIX! I find a great way to improve technique with the squat is to do box squats. To execute a box squat you want to be about 8–12 inches away from a box, bench, or chair that is tall enough to allow you to sit on it while keeping your feet firmly planted on the floor (no heel elevation).

Here you see a properly executed box squat

If the above does not work, it is advisable to seek out the help of a physical therapist. Physical therapists at RISE Rehabilitation and Fitness are board-certified orthopedic specialists that focus on manual therapy techniques as well as other approaches to help you improve your function. Book an appointment or just speak with a therapist through

The above is not a substitute for medical advice and does not take place for seeking a healthcare provider.

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