Skip page content
Skip page content

Yoga as an Adjunct to Physical Therapy

Yoga

Yoga is a practice that focuses on stretching, breathing and meditation.  Many people are drawn to it because they want to work on relieving stress, get in shape, become more flexible, decrease pain and increase core strength.

There are different kinds of yoga:

  • Hatha: One of the most popular types of yoga, hatha yoga is meant to achieve balance between the mind and body. It includes traditional yoga postures for all levels, and is often a general term used to describe a collection of yoga styles.
  • Ashtanga and Power Yoga: This involves a fast-paced, flowing sequence of postures that gradually increase in difficulty.
  • Forrest: A more contemporary type of yoga that makes you work up a sweat. It involves deep breathing, core strengtheners and holding postures for a longer time period. It is meant to purify and strengthen the body, along with promote the release of negative emotions and pain.
  • Vinyasa: A gentle yoga practice in which breathing is synchronized with the poses.
  • Bikram: A series of 26 poses are performed in a heated room (the temperature can be anywhere from 90-100 degrees F) to make your body sweat. The heat in the room is meant to increase your body’s flexibility, reduce the risk of injury and help you to detoxify.
  • Kundalini: Kundalini yoga is meant to awaken a powerful energy that is located at the base of the spine. The energy, once released, is said to bring a great sense of well-being and awareness.
  • Bharata: Bharata yoga helps to align the spine to increase mobility and improve posture.
  • Ananda: Includes a series of gentle hatha yoga poses designed to send energy toward the brain to prepare the body for meditation. This type of yoga is meant to promote spiritual growth and self-awareness.
  • Anusara: Meaning literally “to step into the current of divine will,” anusara is meant to promote awareness and well-being along with body alignment.
  • Iyengar: This is a practice geared strongly toward bodily alignment. Poses are held for longer periods (as opposed to “flowing” from one into the other).
  • Jivamukti: A physically intense yoga series that also involves chanting, meditation, and spiritual teachings.

I will typically refer people to yoga when I feel that flexibility, posture and stress are significant causes of their pain.  We have a number of staff members who do yoga regularly for both the flexibility and the strength aspects.  It is something that some people go to simply to have a time of peace in their day or week and that is a rare and precious thing these days!

No matter what the reason is that a person may go to yoga, my personal thought is that it is a wonderful practice and that it has many positive benefits for a person’s physical and psychological health.

A Romantic Dinner For Your Valentine.

sanvalentine

Valentine’s Day is a time to show that special someone in your life how much you care, and what expresses that more than a well planned, elegant dinner for two? It is suggested that if you are setting the mood for love, that you should keep the meal light, the portions small, and surround yourself with scented flowers and candlelight. I have created two complete menus for Valentine’s Day, one for those who prefer seafood, and another for those who would rather have meat. You can of course mix the courses, and have a little of each. This menu utilizes many foods said to have aphrodiasic powers. So…….. set the mood, plan your dinner and tell the one you love, “Ti voglio bene”.

Seafood Menu

An unique flavor combination that is delicious.
This pasta has a delicate lemon flavor that is delicious topped with grilled seafood. It is also a perfect first course served before a second course of seafood.
A very romantic main course that can be shared by two!
Is there anything more indulgent than a slice of rich, chocolate cake?

Meat Lovers Menu

These small tasty tidbits are packed full of flavor and can be prepared in advance.
A light, flavorful risotto to begin your meal.
How could anyone resist this wonderful recipe consisting of chicken and mushrooms in a creamy marsala wine sauce? Serve with garlic mashed potatoes.
Fennel is said to be another food that enhances romance. Baking it this way creates tender, sweet stalks, with a light crunchy outer texture.
Panna cotta is light, creamy and delicate, making it the perfect choice when entertaining after you have already consumed a couple of courses. Chocolate is always a great flavor for romance!

Buon Appetito!
Deborah Mele 2010

Chi Mangia Bene, Mangia Italiano (Those Who Eat Well, Eat Italian)

Please visit: http://www.italianfoodforever.com/

Are Running Shoes Bad for Your Knees?

Running Shoes

Let’s start off with the answer to that question – it is both a small “Yes” and a big “No”.  Read on t0 learn more. . . .

Recently there was a story written about a research study done that showed that running shoes increase the torque on your knee joints even more than high heels do – wow!

The article was written by Rachel Rettner, with LiveScience.com, and was a good article – www.livescience.com/health/running-shoes-joint-strain-injury-100112.html.  The article it references is:

The effect of running shoes on lower extremity joint torquesKerrigan DC, Franz JR, Keenan GS, Dicharry J, Della Croce U, Wilder RP. PM R. 2009 Dec;1(12):1058-63.

In its conclusion, the article states:

“The findings at the knee suggest relatively greater pressures at anatomical sites that are typically more prone to knee osteoarthritis, the medial and patellofemoral compartments. It is important to note the limitations of these findings and of current 3-dimensional gait analysis in general, that only resultant joint torques were assessed. It is unknown to what extent actual joint contact forces could be affected by compliance that a shoe might provide, a potentially valuable design characteristic that may offset the observed increases in joint torques.”

The study had 37 women and 31 men who ran at least 15 miles/ week, recreationally.  The comparison was of barefoot running versus running with a typical modern running shoe and measured the torque at the knee, hip and ankle joints.  It also measured the amount of bodyweight force created, using a foreplate under the treadmill (basically a scale under the treadmill).

The author, Rettner, states:  “The researchers found an increase in the torque for the knees, hips and ankles when the participants were wearing running shoes as compared with when they were running barefoot.”

Specifically, they saw a 38 percent increase in torque in areas of the knee where osteoarthritis develops.  This was greater than what is created while wearing high heeled shoes, which showed a 20-26 percent increase.

Even though the increased force can lead to damage in the joint, it is not recommended that you stop wearing your running shoes.  Today’s running shoes absorb shock very well from the hard running surfaces that people run on today and that is a significant issue.  They also support the foot and help to prevent things like shin splints.

A key question at this point, obviously, is whether running and running shoes are “good” for you or not.  There are significant benefits from running, specifically – cardiovascular, weight, emotion, balance, bone strength, and on and on.  It should be recognized that there is increased stress on your joints with running – and now apparently specifically from running shoes and I think it is interesting that the higher heel of a running shoe impacts your joints negatively.  Having said this, you shouldn’t stop running and, as the article says, you shouldn’t ditch those shoes – like most things in life, they some positive effects as well as some potential negatives. . . .

Comments on the Recent NY Times Article About PT

There was a recent article written in the NY Times about Physical Therapy which I thought brought up some very interesting issues and I thought I would share my view on it with everyone.  The article spoke of the worthiness of therapy, how much of it is evidence-based and how some parts of it are “Voo Doo”.  The title of the article is “Treat Me, But No Tricks Please” and was written by Gina Kolata.  The link is: http://www.nytimes.com/2010/01/07/health/nutrition/07best.html.

One of the most significant points that it speaks about is how classic (what I would call low-level and old fashioned Physical Therapy)  is not very beneficial.  Therapy such as this is primarily focused on modalities such as Ultrasound, Heat, Electrical Stimulation and Ice and is considered “Voo Doo” by many physicians.  It does not focus on what is causing the symptoms and  how to decrease these symptoms.  Most pain, muscle spasms (“knots” in a muscle) and limitations of motion are due to limitations in the mobility of a joint or overworking of specific muscles.  If you fix the underlying “drivers” of a person’s pain, the inflammation, pain, muscle spasms, etc all go away.

The author of the article makes some interesting comments on the use of modalities.  A quote from the article:

When I’ve gone to physical therapy, the treatments I’ve had — ice and heat, massage, ultrasound — always seemed like a waste of time. I usually went once or twice before stopping.

My doctor at the Hospital for Special Surgery in New York, Joseph Feinberg, seems to share my opinion. “Very often, I think the hot packs, cold packs, ultrasound and electrostimulation are unnecessary,” he said, adding, “For sure, in many cases these modalities are a waste of time.”

I agree thoroughly with most parts of this article, including where we need to have more evidence to back up what we do in therapy.  Unfortunately, there is a definite side of therapy that is difficult to measure and “prove” in a research study.  This side  is significant, however, in why patients get long-term improvement with treatment.  The American Physical Therapy Association wrote a response to the article listed above (link is:  http://www.apta.org/AM/Template.cfm?Section=Letters1&CONTENTID=67938&TEMPLATE=/CM/ContentDisplay.cfm) and they make a fantastic statement in the response that I’d like to share:

But evidence alone cannot heal a patient. With the best available evidence at hand, a health care provider must use their evaluative skills, clinical judgment and assessment of a patient’s needs to develop a plan of care.

Evidence is essential, but it must be combined with a health care provider’s unique knowledge and understanding of an individual patient.

Physical Therapy, just like much of medicine including Orthopedic Surgery, is a combination of science and art.  A good therapist will treat their patient keeping these two things in mind.  Therapists who simply focus all of their treatment on exercise are basically glorified Personal Trainers and clinics that recommend every patient be treated with heat, cold, electrical stimulation and ultrasound are places that give Therapy a bad name.  A great PT clinic finds the source of a person’s pain and treats the source. Taking it one step further, a great PT will teach the patient how to treat themselves with specific exercises for strength and flexibility which will address postural issues that a person may have.  And, only if needed, the use of modalities to settle inflammation down along with everything else.

 
Return to the homepage