For hundreds of years, people have known that massage helps ease their pain—but until recently, no one has understood the physiological mechanism of why it helps.  In February, an article was published in the journal Science Translational Medicine that helps explain the effect that massage has on the muscular system.  The authors explain that unlike medications that only decrease the inflammation, massage decreases inflammation and also promotes healing at the cellular level within the muscle.

Lead author Justin Crane and colleagues took biopsies of healthy subjects before and after vigorous exercise, both with and without massage.  They found that massage affects both mitochondria (the power plants of a cell that generate ATP, or chemical energy) and cytokines, which are both factors in chronic inflammation.  Previously, it was thought that massage may help by pushing out the lactic acid and waste products generated by a muscle, but the mechanism seems to be much more complex.

For athletes, this may be a very important finding—there have been some theoretical concerns that the common practice of taking non-steroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen after exercise may create a maladaptive response.  This reduces pain and swelling, but may also suppress healing.

For the general public, this means that people will have another understood method for decreasing pain, inflammation and promoting healing.  Massage may be a more widely accepted method for treating pain and inflammation.  Additionally, massage has fewer side effects than common medications, making it a good alternative for those wary of the risks associated with taking medications.

Daniel Pasiak, PT, MS, OMPT

Photo credit: relaxyoudeservit.com

Citation: J. D. Crane, D. I. Ogborn, C. Cupido, S. Melov, A. Hubbard, J. M. Bourgeois, M. A. Tarnopolsky, Massage Therapy Attenuates Inflammatory Signaling After Exercise-Induced Muscle Damage. Sci. Transl. Med. 4, 119ra13 (2012).

Gardening is one of the most popular hobbies in America.  Now that spring is here, many people are out in their gardens pulling weeds and planting new bulbs and flowers.  It is an exciting time, but gardeners often forget to watch their posture and mechanics—this often results in sore muscles, a sore back and sometimes even worse injuries.

Here are some tips to remember while gardening:

1.  Bend at the hips and knees rather than bending from the spine when picking up objects/weeding.

2.  Tighten your stomach muscles when lifting objects (such as bags of dirt) to protect your back.

3.  Keep your spine straight.  Avoid twisting your spine while weeding—turn your body by using your feet to change positions.

4.  Use a stool to sit for longer projects while keeping back straight and hinging from hips.

5.  If kneeling, use a pad or cushion to prevent irritation/bruising at the knees.

6.  In order to lessen your load, use gardening tools that can help limit bending over/reaching for objects (such as a wheelbarrow) when moving mulch or piles of weeds.

The aforementioned gardening tools can be found at local hardware stores such as Home Depot and Lowes, as well as such stores as Target and Brookstone.   The websites www.gardners.com and www.downtownhomeandgarden.com also offer many products for proper home gardening posture and mechanics.

Remember to protect your body and to take breaks while you garden.  If a repetitive movement is hurting your body, then stop or make modifications.  Taking a few extra steps or preventative measures can save your body in the long run!

Rebecca Peshkin, PT, DPT, CIMT

The weather is warming up, and so are the races!

The Burns Park Run is this Sunday, May 6th, at 8:30 am.  The race will start and finish at the corner of Baldwin and Wells.

Be sure to come by and visit us at the Probility tent for your free injury assessment!

Every first and third Thursday of the month, Probility Physical Therapy holds a runner’s clinic at our State St. location (2058 South State St.) from 6-8 PM.    The next clinic is this Thursday, May 3rd.

Come join us for your free assessment!  No appointment necessary.

Questions? Call 734-913-0300.

We look forward to seeing everyone there!

Most commonly, people who experience vertigo describe it as a sensation of either themselves or the room appearing to spin. Vertigo is a symptom that can occur due to various conditions or disease processes.  Vertigo is often  accompanied by nausea, vomiting, lightheadedness and difficulty with balance and walking.  It often occurs with specific triggers such as positional changes of the head or movement. There are several causes of vertigo, and its treatment depends on what area of the inner ear or brain has been affected.

A common cause of vertigo is due to inner ear problems. The inner ear is defined as the area of the ear that senses position and movement of the head via movement of crystals in a fluid within the semicircular canals and vestibule. The vestibular nerve then senses this movement, and transmits information to the rest of your brain/body as to where your head is positioned.

One specific cause of vertigo is a condition called Benign Paraoxysmal Peripheral Vertigo (or BPPV for short).  It can occur after head trauma, ear/neck surgery, repetitive head movements, or from no specific origination.  BPPV occurs when the crystals become dislodged and freely float through the semicircular canals. This results in “mixed signals” being sent to the brain, demonstrated by the dizziness/nausea.  Most often, people who suffer from BPPV report symptoms with certain movements of their head, such as tipping their head back to wash their hair or getting out of bed and turning their head in a certain direction. The good news is, these crystals can be reabsorbed by our system, and the dizziness/nausea can resolve on its own within 2-3 weeks. In some cases, however, the crystals do not reabsorb.  Under this circumstance, trained professionals (such as  neurologists or trained physical therapists) can perform repositioning exercises or habituation exercises to either help relocate the crystals, or allow the body to get used to the crystals’ new position so patients can function without dizziness.

Other causes of vertigo are more centrally located due to a dysfunction of how the brain interprets the signals coming from the inner ear. This often results after a viral infection, head trauma, stroke, or due to medication side effects. This is known as a central vestibular hypofunction. Symptoms are often similar to those of BPP–however,  they do not resolve on their own and require intervention through a trained physical therapist. Treatment involves exercises that retrain the central nervous system to interpret signals from our inner ear, known as habituation exercises. Balance exercises are often included, as our ability to maintain balance and control with movement does, in part, rely on our vestibular system.

Medications can also be used in conjunction with treatment to reduce the intensity of the dizziness/nausea associated with vertigo.  However, they often come with side effects and simply mask the symptom rather than treat the underlying source.

Heather LaHaie, PT

Epic Races will be holding a swim clinic this Sunday, April 15th from 12pm-2pm.   They will be offering the following sections:

Newbies
This is the final clinic of the series. We will continue where we left off in clinic two, but those newbies who did not attend the first or second clinic will be able to jump right in. We will continue our swimming instruction, you will receive our “special” race day checklist, we will talk about realistic goal setting, and making your workouts meaningful. Participants will receive a 12-week sprint triathlon training plan.

Special Topic
“Changing a flat tire” with our Epic Bike Specialist David Palan – Presentation with Q & A (approx. 1 hr)
Followed by swim instruction with Mojo in the pool

Swim Only
This clinic will offer you two hours in the pool with Epic Coach Mojo Isaac focusing on stroke technique, swim workout design and practice, and you will be able to take a “test ride” on the Halo swim bench under the guidance and coaching of it’s inventor Craig Askins.

The event will be held at

Skyline High School
2552 North Maple Road
Ann Arbor, MI 48103

Be sure to check out the link below for registration and more details!

http://epicraces.com/clinics.html#ifatfirstyoudontsucceed

Work station setup is very important for reducing stress and strain on many areas of the upper body–specifically the neck, upper back, shoulders, hands and wrists.  With technology playing such a huge roll in today’s economy, a greater number of people have jobs that require them to spend longer hours working on a computer than in previous decades.  Below are some tips to optimize your work station setup to ensure you are doing everything in your power to prevent pain and dysfunction in the work place.

An adjustable chair is a must.  Ideally your hips and knees should both be in ninety degrees of flexion (bending) with your feet flat on the floor.  A small towel roll (or adjustable lumbar support built into your chair) should be in place to help maintain neutral, supported mid back (thoracic spine) and neck (cervical spine) alignment.  If your chair has arm rests, they should be low enough to fit underneath your desk so you are not reaching far out in front of you to use your mouse or keyboard.

If you can work on a desktop instead of a laptop this is optimal, as the keyboard and monitor placement can be adjusted individually.  If you are forced to work on a laptop, an external keyboard that can be plugged in through a USB port is a great idea, so that the screen height and keyboard height can be adjusted individually.

The monitor should be positioned so that the top of the screen is at eye level, when your chair is adjusted according to the recommendations above.  The keyboard should be positioned close enough to your body so that your arms are resting comfortably at your sides or just in front of your body without much more than ninety degrees of flexion (bending) in your elbows.  Your mouse should be positioned so that you don’t have to reach excessively forward.  If the keyboard and mouse are positioned too far away, it can result in forward shoulder posture and onset of upper back and neck pain. For a picture reference see first image above.

Finally, it is important to support your wrists when typing.  You may have seen pads that are to be placed directly in front of your key board.  These are a great buy for anyone logging long hours typing away on their computer.  These pads work by decreasing stress placed on the finger flexor tendons which run through the carpal tunnel, thus preventing pain, numbness and tingling in the thumb and first two fingers, which are symptoms of carpal tunnel syndrome.

Following the above guidelines will hopefully help keep you out of your local physical therapist’s office and on your way to enjoying your life again!

Kimberly Huck, PT, DPT, CIMT

Being a father of two very VERY active boys (2 and 3 year olds) has been a blessing.  I think I learn as much from them as they learn from me on a daily basis.  But being inducted into the Fraternal Order of Parenthood has inevitably resulted in what can best be described as “subtle life changes”.  For example, rather than waking up and trying to decide whether to go to the gym for 3 hours, mountain bike all morning, or complete a bike/run cross-train routine, I wake up in the morning trying to decide whether to go to the park with the boys, play in the yard with the boys, or play in the family room with the boys.  I’ve learned that being a parent still comes with choices and options… just not the choices and options I had grown accustomed to.

With the upward spiraling cost of baby sitting and gym memberships, it is unlikely that most parents of young children can afford to exercise at the gym several times each week.  And, amid the flurry of diaper changes, meal preparations, and unanticipated but completely expected “disaster clean-ups” that comes with being a parent, it is easy to loose focus on personal fitness.  But I would argue that there are ways to squeeze exercises and activities into the daily routine.

My wife and I invested in a jogger stroller three years ago and upgraded  two years ago to a “double wide” to herald the arrival of our second son.  This has been the single best purchase decision we made for several reasons.  It provided us with an opportunity to exercise at convenient times that did not conflict with nap schedules or inclimate weather.  It exposed the boys to fresh air and stimulating interactions with nature, the neighbors, or ducks at the local pond.  And it has been a way to interact with the boys even if the interaction was nothing more than the boys directing me to “run faster” as I was struggling up and down hills while pushing 65 pounds worth of children, sippy cups, animal crackers, and all of the other luxuries which the boys have come to expect while out on their daily run.

I have discovered that, even when not using the jogger stroller, exercising thoughout the day with young children can be interactive and not cost anything at all.  Maybe it’s completing lunges and squats while picking up toys or laundry on the floor.  How about completing sit ups while your child is sitting in your lap facing toward you, or possibly completing planks or sit ups while your child is playing near you.  I have found that my three year old son likes to get into the act and perform push ups and planks with me.

The bottom line is this.  Few parents have large blocks of time available to dedicate to a regular exercise routine.  But there is always time to complete smaller groupings of exercises throughout the day.  Metaphorically speaking, it’s kind of like grazing thoughout the day at the local buffet rather than eating just one large meal.  Be creative and look at your daily activities at home as more than just chores.  See these activities for what they are, potential avenues for exercise.

Jim Herman, PT MPT CIMT

Click on the image for the source

Kinesio tape was developed by Dr. Kenzo Kaze around 1979.

Physical Therapists will often use kinesio tape in conjunction with other treatment methods to re-educate the neuromuscular system, decrease pain and inflammation, improve soft tissue and joint mobility, relax overused or tired muscles, and improve circulation and healing.

As a Physical Therapist working in an outpatient orthopedic setting, I have used kinesio tape with multiple clients.  I have applied the taping concept with gymnasts’ hyperextension elbow injuries. The kinesio tape helps to prevent hyperextension but allows for normal elbow mobility (i.e. the gymnasts can still attain full elbow straightening to allow for continued practice and performance).    I have also applied kinesio tape to clients who have undergone mastectomy have resultant edema/swelling in their arm.  The taping techniques help to draw fluid out of the arm so it can be more effectively absorbed back into the lymphatic system.   The quicker the swelling is decreased the faster active range of motion and strength will return.
Why we may choose to use kinesio tape versus regular sports tape. 

1. It allows for stretch of approximately 55% of its resting length to support muscles in movement.
2. Tape is effective for 3-5 days
3. The thickness of the tape is approximately the same as the epidermis of the skin allowing pt to be unaware of tape after the tape has been applied for 10 min
4. The tape is comprised of partial cotton fibers which allows for evaporation of sweat/water
5. Latex free
6. Heat activated
7. Minimal to no residual glue following removal

References

1. Kase, Kenzo., Wallis, Jim., and Kase Tsuyoshi. Clinical Therapeutic Applications of the Kinesio Taping Method. Tokyo: Ken Ikaie Co, 2003.

2. http://munfitnessblog.com/how-to-relieve-shoulder-pains-like-kerri-wash-with-kinesio-tape/

Since then Kinesio tape has been used as treatment for medical and sports professional athletes including:

Kerri Walsh in the 2008 Beijing Olympics

http://www.livewelltwincities.com/?p=524

David Beckham

http://www.livewelltwincities.com/?p=524

Serena Williams 

http://www.livewelltwincities.com/?p=524

 As the days start getting shorter and the temperatures get cooler, I’ve heard numerous people mention their hesitation for the upcoming winter.  Why do we dread the colder weather?  Why are we so sad to see fall end?  I think it is because people start hibernating in their home and forget all the good things winter has to offer.  When February and March feel like they are going to stretch on forever, consider these ideas to help ward off the winter blues.

• Get outside and take advantage of the snow!
  • Make a snowman or snow angels
  • Go for a hike around the Botanical Gardens or the Arboretum
  • Warm up by the fireplace with hot chocolate and family/friends

• Keep working out!      
  • Find a workout buddy to meet to work out at least 1 to 2 days a week
  • Running
    • Winter running – stay DRY!
      • “Winter Wise -Get over your fears and enjoy winter running.” http://www.runnersworld.com/article/1,7120,s6-238-267-589-13389-0,00.html
      • http://www.runnersworld.com/article/1,7120,s6-240-320–12187-0,00.html
      • Do a local road run
        • http://www.runningfit.com/
  • Cross training – Swimming
    • Community Pool
      • http://www.wlps.net/~ced/pool.htm
  • Join a gym!
    • Liberty Athletic Club http://www.libertyathletic.net/
    • One on One http://www.1on1club.com/
  • Do a snow shoe race
    • Register for the race by a fire place and bundle up!
    • Traverse City on January 28^th, 2012
    • Rent snow shoes or bring your own
    • http://www.runsnow.com/

• Take up a winter sport
  • Ice fishing
  • Downhill skiing
    • Mt Brighton – http://www.mtbrighton.com/
  • Cross Country skiing
  • Ice skating
  • Hiking
  • Snow shoeing
  • Snowmobiling

• See a movie
  • State Theatre  http://michtheater.org/state
  • Michigan Theatre http://michtheater.org
  • Quality 16 http://www.gqti.com/

• Take a class
  • Ann Arbor Recreation and Education
    • http://www.aareced.com/reced.home/rec___ed_home

• Catch up with friends at a restaurant or coffee shop
  • Amer’s Deli and coffee shop  http://www.amersdeli.com/
  • Jolly Pumpkin  http://www.jollypumpkin.com/
  • Zingerman’s Deli http://zingermansdeli.com/

• Plan a vacation
  • Weekend trips
    • Grand Rapids http://www.experiencegr.com/
    • Chicago http://www.explorechicago.org/city/en.html
  • Warm weather vacations
    • Florida
    • Caribbean
    • Hilton Head, South Carolina
  • Cold weather trips
    • Up north skiing and winter fun
      • Boyne Highlands
        • http://www.boyne.com/
        • Frankenmuth for Snowfest
          • http://www.zehnders.com/zehnderssnowfest/
        • Romantic getaway?
          • the Petoskey experience, take a sleigh ride while here http://www.staffords.com/

• Make use of what the area has to offer
  • Restaurant week in Ann Arbor http://annarborrestaurantweek.com/
  • Ann Arbor Art Museum http://www.umma.umich.edu/
  • Natural History Museum http://www.lsa.umich.edu/ummnh/
  • Hands On Museum http://www.aahom.org/
  • The Ark http://theark.org/
  • Kelsey Museum of Archeology http://www.lsa.umich.edu/kelsey/
  • Tour the Zingermans Creamery http://www.zingermanscreamery.com/
  • Tour Chelsea’s Jiffy Factory http://www.jiffymix.com/

By Sarah Reese, PT