Category Archives for "exercises"

Mobilizing the Thoracic Spine

A tight upper back may be attributed to stiffness in the shoulder, neck, or back muscles surrounding the thoracic spine. Rounded or slump shoulders, having sway in the lower back, or a forward head position due to weak back extensor muscles, short and tight chest muscles, or weak abdominal muscles may result in an individual having poor posture. Poor posture can place tension in the upper back and may result in irritation or pain. Sports, weightlifting, irregular sleeping positions, or car accidents may also cause tightness in the upper neck and back region. Mobilizing and strengthening the muscles surrounding the thoracic spine may relieve an individual of stiffness or pain, while improving an individual’s range of motion and functioning. Remember to have a balanced, upright posture by standing tall, bringing the shoulders down and back, tuck your chin, and keep a neutral spine to work on better posture.

EXERCISES FOR A TIGHT THORACIC SPINE

1) Thoracic Rotations: 

Lie sideways on a mat or on the floor with both arms extended to one side and hands together. Bend the knee of the top leg to form a 90 degree angle. Place a long foam roller underneath the bent knee if you are unable to touch the ground with this top knee. Keeping your lower body in this position, twist your upper back by bringing the top arm over your body to the other side to touch the floor. Repeat 10-12 times, then lie on the other side and complete the same movement.

2) Cat-Cow: 

Begin in a table-top position with your knees hip-width apart and wrists shoulder-width apart on a mat or on the floor. Keep a neutral spine and head position. Move into the “cow” pose by inhaling as you drop your belly down towards the mat as you lift your chin and chest up to gaze toward the ceiling. Then move into the “cat” pose by exhaling as you draw your belly into your spine and round your back toward the ceiling. Repeat 10-15 times.

3) Seated Lateral Flexion: 

Begin seated in a chair with both feet planted on the floor or seated on the floor. Raise one arm up towards the ceiling. With your arm raised above your head, slowly bend to the opposite side. Return to the start position and lower your arm. Then raise the other arm and slowly bend to the opposite side. Repeat 5-10 times on each side.

4) Thoracic Extension with a Foam Roller: 

Place a long foam roller perpendicular to your spine on a mat or on the floor underneath your shoulder blades. Interlace your fingers and place your hands behind your head to support the weight of your head. Slowly push with your feet to roll the foam roller up and down the thoracic region. Maintain a neutral spine and engage your abs.

5) 4-Point Walk-Out: 

This exercise helps to re-train muscle activation in the shoulder blades and mobilizes the muscles surrounding the thoracic spine for a better functional recovery. Place your hands and knees in a four point or table-top position with a neutral spine. Engage the inner core and start by walking one hand out to one side, then back to the centre, and then to the other side, then back to the centre again. Put full equal weight each time you place your hand down. Maintain a neutral spine throughout the exercise. Repeat for 30 seconds for 3 sets.

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What is Cuboid Syndrome?

Ever feel pain or swelling on the side of your foot? These symptoms may be due to a condition called Cuboid Syndrome, also known as cuboid subluxation or lateral plantar neuritis. In addition to pain in the lateral mid-foot, redness and a restricted range of motion in the ankle may be present. This syndrome is typically associated with an inversion sprain of the ankle. This is when the foot is forced inwards causing the cuboid bone to sublux, or partially dislocate. The cuboid bone is located near the mid-point of the outer side of the foot and is one of the seven tarsal bones that make up the arch of the foot. It connects the foot and ankle as well as provides stability to the foot.

The peroneus longus muscle is a muscle that runs along the outer side of the lower leg and attaches to the lateral side of the foot. Repetitive strain of this muscle due to activities such as ballet, jumping, or running, may place tension on the cuboid bone. Commonly found in athletes, Cuboid Syndrome may also occur in sports such basketball, football, or soccer. Weight-bearing, uneven pavement, or quick changes in direction that occur in sports may aggravate symptoms. A third cause of this syndrome may be an individual’s altered foot biomechanics. Athletes who have over-pronated feet, also known as flat feet, may be more prone to cuboid subluxation.

Imaging such as x-rays, MRIs, and CT scans can be used to rule out other causes of pain. However, a cuboid subluxation can be difficult to diagnose and therefore, must be carefully assessed by a general physician or other health care professional.

STRENGTHENING

Daily strengthening and mobility exercises should be performed on a pain-free basis to prevent the foot and ankle from becoming weak or stiff. Watch the videos below on how to properly perform strengthening exercises:

Use a resistance band tied to a stable anchor and wrap it around the unaffected leg. With the affected ankle, stand either in front of the band or inside while keeping your posture tall and inner core engaged. Hike the foot with the band wrapped around the leg up off of the ground and slowly push the leg out to the side and then slowly return it back to the middle while keeping the foot off of the ground the entire time. Resist the movement with the standing leg by squeezing the butt muscles. Repeat this 10 times for 3 sets daily.
Start by putting your weight on the side of the affected ankle and hike the opposite foot up off of the ground. Remember to keep your inner core tight below the belly button. Then with the foot that’s off of the ground touch the first point in front of the ground, then to the side and then behind you, and then cross over to the other side of the body. Repeat the 4 points of contact (front, left side, back and right side) for 30 seconds 4 sets 4 times per day. As you get stronger increase it to 60 seconds 4 sets 4 times per day. If you have a fracture as a result of your injury or you are unsure if this is the right exercise for you to do, consult your physiotherapist before starting this exercise.
Starting with tall posture, engage your core muscles below the belly button by drawing the lower abs inwards toward the spine. Avoid arching the low back. With arms in a ready position do a one-legged squat with your body weight distributed equally over the foot. Don’t go any lower than a ninety degree bend in the knees, keeping your knees in alignment with your second toe and over your heel as much as possible. Hold for a good long second and then straighten back up with your butt muscles to the start. Do three sets of ten repetitions daily. 

TREATMENT

Other treatment options include foot support such as padding, taping, or orthotics to help stabilize the bones of the midfoot or correct for over-pronation. Rest from repetitive, weight-bearing actions such as jumping or running may help alleviate pain. Ice affected area for 10 minutes at a time to reduce swelling and inflammation. Consult your family physician, physical therapist, or podiatrist to perform a manipulation if the cuboid bone is suspected to be dislocated.


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Quick Recovery for Finger Sprains

Finger sprains commonly occur in sports and every day activities that involve heavy lifting or repetitive hand motions. Falls or contact sports such as football may even force a finger out of its normal joint position resulting in a dislocation. The force to the finger may cause joints in the finger to hyperextend or move sideways. Sprains of the finger are classified according to the extent of injury or damage.

Classification:

1) Grade I – Mild: A first degree sprained finger is present when the ligaments are only stretched but not ruptured. There may be localized swelling, slight pain, and slight reduction in range of motion, but strength remains unaffected. An individual may continue to engage in an activity. Taping of the injured finger may be more effective. Recovery is immediate.

2) Grade II – Moderate: A second degree sprained finger occurs when there is partial ligament tears, a greater reduction in range of motion and some loss of strength with more swelling and pain. The joint capsule may also be damaged. Recovery will take longer.

3) Grade III – Severe: A third degree sprained finger involves complete rupture of the ligament, complete loss of range of motion and typically dislocation of the finger. Significant pain and swelling is present. X-ray is required for diagnosis and surgery may be indicated.

Treatment:

In the first 48 to 72 hours after the sprain, the individual should protect the finger by taping it to the adjacent finger or by using a finger brace. Apply ice for about 15 min every two hours with a small ice pack wrapped in a dry towel or use a large cup filled with cold water and some ice for immersion.

Once swelling has gone down, the individual may begin light range of motion exercises by placing a soft object such as a tennis ball or rolled sock in the palm of the hand and gently squeezing the object.  Repeat 10 times and stop if any pain arises. Surgery may be indicated for third degree sprains. Consult a physician for the appropriate diagnosis.

Strengthening:

1) Ball Grip: Hold a ball in the palm of the hand with all fingers enclosing the ball and gently squeeze. Hold, then relax.

2) Pinch: Place a ball between the thumb and index finger. Gently squeeze, then relax.

3) Opposition: Hold a ball with the thumb and pinky finger. Gently squeeze the ball using the two fingers, then relax.

4) Side-Squeeze: Place a ball between any two fingers and gently squeeze, then relax.

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7 Easy Exercises with a Towel

Home exercising can be just as effective as going to the gym by using household items such as a medium-sized towel. Check out the exercises below for a full body work-out:

1) Plank Walks: 

In a plank position with a towel under both feet and maintaining a neutral spine, walk forwards by placing one hand in front of the other for 10 to 20 steps.

2) Neck Rotation: 

Find where the hairline ends to locate a noticeable “bump” on the back of your neck. This is the spinous process for your 2nd cervical vertebrae. Place the edge of an unrolled towel on this spot, then cross your hands over, making sure the top hand is on the same side as the direction of rotation (e.g. right arm will pull towel downwards towards the middle of the chest if you are turning LEFT). Complete a pain-free rotation 3 times in each direction per day.

3) Knee Tucks: 

Start in a plank position with a towel under both feet and keep a neutral spine, then engage the lower abs below the belly button to pull the knees in toward the chest. Extend the legs back to starting position and repeat for 10 reps. 

4) Reverse Lunge: 

Place one foot in front and a towel underneath the other foot that is slightly behind. Slide the rear foot backwards until the knee of the front leg is at a 90 degree angle. Press the rear leg back into standing position by engaging the glutes and hamstrings. Repeat 10 times on each leg. 

5) Rotator Cuff Holds: 

Step into a door with the left foot and throw a towel over to the back of the neck with the left hand and reach with the right arm to grab the other end of the towel. Prop the right shoulder on the edge of a doorway and hold this position for 20-30 seconds while maintaining a neutral spine. 

6) Single-Leg Hamstring Curls: 

Get into a bridge position by lying flat on your back, hands to the either side of your body and knees bent. Place a towel under one foot, then slide this leg forward while keeping the other leg in the bent position. Slide the extended leg back into starting position. Remember to engage the core and glutes. Repeat 10 times on each side.

7) Back Extensions: 

Lie flat on your stomach and place a towel under each hand, then extend both arms forward so that your chest and chin are near the floor. With the core engaged, slide both hands towards your body and lift your upper body off the floor. Repeat 10 times. 
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How to Reduce Interscapular Pain

Persistent pain between the shoulder pains, or interscapular pain, may arise from a number of varying causes. The scapula is the bone that connects the humerus (upper arm bone) with the clavicle (collar bone) on either side of the body. The intrinsic muscles of the scapula include the subscapularis, teres minor, supraspinatus, and infraspinatus, all of which make up the rotator cuff. The major muscles surrounding the scapula that make up the interscapular region include the rhomboids, trapezius, and levator scapulae.

The rhomboids are two quadrate-shaped muscles that originate from the lower cervical vertebrae and upper thoracic vertebrae and attach to the medial border of the scapula. The rhomboids work to retract and rotate the scapula downwards. The trapezius muscle extend from the occipital bone of the skull to the lower thoracic vertebrae and attach to the scapular spine. Its action is to elevate and rotate the scapula upwards. Likewise, the levator scapulae run from the upper cervical vertebrae to the superior portion of the medial border of the scapula and works to elevate the shoulder blades.

CAUSES

One of the common causes of interscapular pain may be due to a muscle strain of one of the muscles described above from poor posture, lifting, or twisting motions from activities such as golf or tennis. Other causes may include trauma such as dislocations or rotator cuff tears, cervical or thoracic herniation, arthritis, heart conditions, cancer, gallbladder disease, scoliosis, or gastroesophageal acid reflux.

TREATMENT

Treatment begins by identifying possible underlying causes contributing to the pain between the shoulder blades. Poor posture occurs when the head is forward and shoulders are rounded. This stretches the rhomboid muscles excessively and causes the muscle to weaken. Correcting poor posture by taking frequent breaks from sitting, bringing your shoulders down and away from the ears, as well as evenly distributing your body weight to all sides may help relieve upper back soreness.
Active release, moist heat therapy, and intramuscular stimulation with a physiotherapist are effective ways to release tension in the back muscles.
Consult a physician or specialist to assess for gastrointestinal, pulmonary, and cardiac-related conditions as they may cause referred pain in the upper back region.
Watch the following videos below on how to stretch and strengthen key muscles in the shoulder region:

Rotator Cuff / Shoulder Impingement Rehabilitation:

Advanced Strengthening for Weak Shoulder:

Scapular Muscle Strengthening / Activation:

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3 Key Exercises to Improve Balance

Why is it important to include balance training in your regular exercise program?


Balance is needed for just about everything you do on a daily basis from carrying groceries to putting on your shoes. Balance training involves strengthening exercises that target your entire body, especially the core. This not only reduces the risk of injury, but may improve motor coordination (Oliveira et al., 2017). At least 3 days of balance training per week is recommended for inactive and active older adults (> 65 yr). Activities such as pilates, yoga, tai chi, dance, or brisk walking are suitable for improving one’s balance. Implements such as bosu balls, balance boards, or foam pads can be used to add variety to your exercises. 

Try the Following Exercises Below:

1) Step-ups

a.     Stand in front of a box with a tall posture
b.     Step up with one leg, then bring the other leg up so that both feet are on the box
c.      Step down one leg at a time and repeat 10 times for each leg
d.     Increase the difficulty by using a taller box or increase your step up pace

2)  One Legged Squat

a.     Stand with a tall posture
b.     Bend your right knee and lift your right foot off the floor
c.      Keep your chest upright and arms extended to the front, slowly lower your body to the floor by pushing your hips back and down
d.     Slowly push up to the starting position and switch feet
e.     Remember to keep your knee in line with your second toe as you squat
f.      Repeat 10 times on each leg
3)  Single Leg Dead Lift

a.     Stand on your right foot, enagage the core, and slowly bend forward at the hips
b.     Reach towards the floor with the left hand and lift the left leg straight behind you
c.       Hold for 1-2 seconds and squeeze your butt muscles as your return to the starting position
d.     Switch sides and repeat 10 times on each leg
e.     Optionally: hold a light dumbbell in one hand as you reach toward the floor

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5 Exercises for Stronger Scapulas

Weak scapular muscles can lead to an array of injuries including shoulder impingement, rotator cuff tears, and other shoulder-related pains. Pain may be followed by a restricted range of motion and may severely worsen if left untreated. Strengthening the scapular muscles can provide long-term benefits for rehabilitation and performance. Try the five following exercises below:

LYING DUMBBELL PRESS:

1. Lie down flat on a bench with a light dumbbell in each hand.

2. Hold the dumbbells on either side of your chest with the palms facing away from your shoulders and your elbow at a 90 degree angle.

3. Push your arms upwards and feel your shoulder blades separate. Remember to keep the dumbbells parallel to each other until the very top of the press.

3. Inhale and slowly bring down both dumbbells to the sides of your chest until you reach the 90 degree angle at the elbow. Breathe out on your next rep. Perform 3 sets of 10 reps.

WALL PUSHUP:

1. Stand a few steps away from a wall, then place your hands on the wall so that they are slightly more than shoulder-width apart and arms are locked out.

2. Maintain a neutral back and neck, then slowly lean towards the wall by bending your elbow.

3. Squeeze your shoulder blades together as you lower yourself and hold this forward position for 2-3 seconds.

4. Slowly straighten your arm and relax your shoulder blades. Repeat 10 times.

BAND PULL APARTS:

1. In a comfortable standing position, hold a light band in between both hands about shoulder-width apart.

2. Pull the band as wide as you can, then slowly bring the arms back to the starting position. Perform 3 sets of 10 reps.

Y-RAISES:

1. Lie on your stomach on a bench or Swiss ball with a light dumbbell in each hand.

2. Straighten your arms so that the dumbbell is in front of your head.

3. Lift the dumbbells up, keeping your arms straight, to make a “Y” shape with your torso.

4. Slowly lower them down. Perform 3 sets of 10 reps.

ISOMETRIC DUMBBELL HOLDS:

1. Hold a very light dumbbell straight in front of you at approximately 45 degree angle.

2. Maintain this position for about 10 seconds.

3. Then, slowly lower the dumbbell to the side of your body. Perform 10 holds on each side.

BONUS: Watch this video to learn an extra exercise for the scapula muscles!

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10 Easy Foam Rolling Techniques

Foam rollers have become a widely used tool for muscle recovery. In response to working out hard during training, the collagen and elastin fibers in the connective tissues surrounding the muscles become more dense and rigid forming strong adhesions commonly known as knots. Building knots can prevent normal muscle contraction and cause pain. The role of foam rolling in self-myofascial release has been known to break down these adhesions, which can improve range of motion, mobility, posture, and muscle recovery. A few important tips: engage your core throughout rolling, relax, remember to breathe, avoid rolling directly over your bones, joints, neck and lower back. Below are TEN great foam rolling exercises to target the entire body (source: http://www.mensfitness.com). Slowly roll on the targeted area until a tender spot is found and remain on that spot between 30 to 90 seconds.

1. Upper back roll

Lie down with your back on the floor. Place a foam roller underneath your upper back and cross your arms in front of you, protracting your shoulder blades. Raise your hips off of the ground, placing your weight onto the roller. Shift your weight to one side, rolling the upper- to mid-back. Alternate sides.
2. Calf roll

While seated, place a foam roller underneath your lower leg with the other leg placed on the floor supporting some of your weight. Place hands at sides or just behind you, and press down to raise your hips off of the floor, placing your weight against your calf muscle. Roll from below the knee to above the ankle. Repeat on opposite leg.

3. Groin roll

Lie face down with one leg on top of a foam roller so it’s against your inner thigh. Shift as much weight onto the foam roll as can be tolerated. While trying to relax the muscles of the inner thigh, roll over the area between your hip and knee. Repeat on opposite leg.
4. IT band roll

Lie on your side with bottom leg placed onto a foam roller between the hip and the knee, and top leg crossed in front of you. Place as much of your weight as is tolerable onto your bottom leg. Roll your leg over the foam from your hip to your knee. Repeat on opposite leg.

5. Hamstrings roll

While seated, extend your legs over a foam roller so that it is positioning on the back of the upper legs. Place your hands to the side or behind you to help support your weight. Using your hands, lift hips off the floor and shift your weight on the foam roll to one leg. Relax the hamstrings of the leg you are stretching. Roll over the foam from below the hip to above the back of the knee. Repeat on opposite leg.

6. Quadriceps roll

Lie face-down on the floor with your weight supported by your hands or forearms. Place a foam roller underneath one leg and keep that foot off the ground. Shifting as much weight onto the leg to be stretched as is tolerable, roll from above the knee to below the hip. Repeat on opposite side.

7. Lats roll

While lying on the floor, place a foam roller under your back and to one side, just behind your armpit. Keep the arm of the side being stretched to your side as you shift your weight onto your lats, keeping your upper body off the ground. Repeat on opposite side.

8. Glutes roll

Sit with your butt on top of a foam roller. Bend your knees, and then cross one leg so that the ankle is over the knee. Shift your weight to the side of the crossed leg, rolling over your glutes until you feel tension. Repeat on opposite side.

9. Lower back roll

In a seated position, place a foam roller under your lower back. Cross your arms in front of you and protract your shoulders. Raise your hips off the floor and lean back, keeping your weight on your lower back. Now roll over back and forward, keeping your weight off the spine and on the muscles to one side of it. Roll over your lower back. Repeat on the other side.

10. Chest roll

Place a foam roller on the floor. Lie face-down with the foam roller at shoulder height and extend one arm forward. With the foam roller just below your armpit, press your chest into the foam and roll in small movements and release tension in your chest. Roll back and forth on your chest, then extend your other arm and repeat.

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