Fitness Matters

Community Newsletter from New Heights Physical Therapy Plus, Inc.

In this issue:

Events & Announcements
Injured Muscles - How mobilization at the right time can improve function long-term.
Back Pain - Thinking about recurring back pain the right way will lead to better treatment and better long-term results.

Events & Announcements

Evening Walks

Get Moving! During the month of October New Heights will be sponsoring Evening walks with Donna Garmont PT in Portland and Jodie Adams PT in Vancouver. All participants will receive a free pedometer so you can track how much you’re “moving” during the month. Please call your clinic of choice to sign up. We will be walking rain or shine! Walks will be 30-60 minutes. There is no charge.

Portland, Mondays 6:15 PM, starting October 4th with Donna Gramont, PT
Vancouver, Wednesdays 6:00 PM starting October 6th with Jodie Adams PT

Pilates workshops

Are you ready? Realize your true fitness potential with Pilates Circuit Training.

Pilates toned arms, buns, and thighs

Get ready for a challenging, non-stop workout. Alternate between exercises on the Mat, Reformer, BOSU®* Balance Trainer, Foam Roller and other smaller props. You will progress through a circuit of dynamic exercises designed to tone and sculpt arms, glutes, and thighs while strengthening deep core muscles resulting in greater agility, coordination and balance, and a decreased risk of injury in day-to-day life. This class is best suited for those who feel comfortable with Essential level exercises and would like to add challenge to their workout.

Instructor: Nicole Cuevas

Call New Heights Physical Therapy Plus to register: 503-236-3108

Injured Muscles

To Move or Not To Move

It’s probably happened to you in the past, and it’s likely to happen to you in the future – muscle injury. How you handle the next muscle injury you see affects how quickly the muscle regains strength and movement, and it may even affect how well the muscle will function for the rest of your life. The tricky part is that resting the muscle helps at first and harms the muscle just days later.

Whether you pull a muscle so hard that it partially tears or a blunt force strikes your muscle so hard that the muscle is injured, skeletal muscles tend to heal in consistent patterns. So, we can provide some general advice about when and how to use movement during muscle healing. First understand that we are discussing skeletal muscles. This means the muscles that attach to the skeleton and provide movement (e.g. hamstrings, biceps, gastrocnemius). This discussion does not apply to other types of muscles.

Immediately after a muscle is injured, athletes typically want to apply P.R.I.C.E.
P – Protect the injured muscle by restricting movement and avoiding pressure on it
R – Rest the injured muscle and avoid activity that can further damage it
I – Ice the injured area to reduce swelling.
C – Compress the muscle (i.e. elastic bandage)
E – Elevate the muscle above the level of your heart to improve circulatory drainage in the injured area

Protecting and resting an injured muscle for the correct amount of time helps especially during the acute phase when there is a lot of swelling in the area. This is called the active bleeding stage. At this stage movement is limited only to decrease this swelling. If getting up to use the bathroom increases the swelling then that is too much movement. For example if you can walk normally on an acute ankle sprain for 15 minutes and the swelling goes down, that is the right amount of movement.

Here’s the rub. If you protect and/or rest a muscle a few days too long, you start causing a number of problems. In the best circumstances, movement should be applied to injured muscles as early as three to five days post injury. However, it is very important to note that 3-5 days is not a hard and fast rule. People can do a number of things that change the timing of muscle healing. Getting in a hot tub can cause problems that delay the healing process or unwittingly re-injuring the muscle can change the timeline. What you should be doing about your muscle injury depends entirely on what your body is doing at the time. If you have a serious muscle injury or are concerned about making a muscle injury worse, consult a health care professional.

Timely mobilization of injured muscles has been shown to:

• improve the tensile strength of injured muscles
• facilitate faster strength recovery
• limit the size of the permanent scar on the muscle
• encourage more rapid and intensive capillary growth into the injured area
• facilitate the proper alignment of muscle fibers

When a skeletal muscle is injured, your body rushes in with “workers” that lay down repair tissue. We must keep in mind that the “workers” do not have a blueprint for how the repair tissue should be applied. Like the fabric in an elastic cuff on your coat, the repair tissue should have a pattern. When an injured muscle is in motion, the motion actually guides the patterns of the new repair tissue. When an injured muscle rests too long, the repair tissue lays down in counterproductive patterns that can interfere with movement long term.

After the acute phase when most of the swelling is gone – 5 days to couple of weeks, then physical therapy treatment will include manual work to make sure your joint movement is normalized, increasing range of movement of the injured muscle, increasing force on the injured muscle. At New Heights, we use each patient’s pain response as our guide in how quickly we can progress the rehabilitation. If you have a serious muscle injury or if you simply desire the fastest, safest return to normal activity, call us for a physical therapy assessment.

Is Back Pain Really an Injury?

In this edition of Fitness Matters, we discuss the healing patterns common to muscle injuries, the use of rest, and the use of movement. Recurring back pain is an example of a problem that can be treated sub-optimally when treated as a traditional injury. Some have argued that chronic back pain is no more an injury than a heart attack is an injury. Using the right treatment model creates greater chance of long-term success.

Here’s what they mean when they say chronic back pain is not an injury. From a treatment perspective, an injury is caused by a single, reasonable insult such as a car hitting you or falling off your bike at 20 miles per hour. Once the injury is healed and the muscles are strengthened back to their original state, the job of the health care professionals is done.

Because chronic back pain does not result from a single injury, simply returning a patient to a previous state does not correct the problem. Chronic back pain is actually caused by cumulative microtrauma. Cumulative microtrauma means your back suffers many smaller insults on a routine basis (e.g. sleeping in a bad posture, sitting on a wallet, bending over to pick up the children, carrying your briefcase on the same side every day). Ideally, the strength and conditioning of your back enables you to absorb these insults or heal quickly enough that there is no problem. Occasionally, the accumulation of these smaller injuries overcomes your strength and conditioning to create an acute episode of back pain.

Think about how often people with back pain report that the pain started with an activity they do every day. “I picked up this piece of paper, bent over incorrectly, and injured my back,” one might say. This is technically incorrect. This person began the process of injuring his or her back a long time ago.

Truly correcting a chronic back pain problem requires a different mind set than thinking of the back pain as an injury. Getting rid of the pain for now is not the solution, because the back pain most often returns and sometimes gets worse. Real treatment for back pain involves giving you a back that is stronger, more conditioned, and better prepared for the cumulative microtrauma of your life. New Heights Physical Therapy Plus can give you the guidance and knowledge you need to truly overcome back pain long-term. If you know someone with chronic back pain, please have him or her get in touch with New Heights Physical Therapy Plus.

Get more information on overcoming back pain on this page of our website:
http://www.newheightstherapy.com/what-we-treat/back-pain