Physical Therapy After Breast Surgery

Physical Therapy after Breast Surgery. New Heights Physical Therapy in Vancouver WA and Portland OR.

October is breast cancer awareness month, and for women who have had breast surgery, coping with issues that arise from surgery scars can be trying and difficult.  It is important to know that although the development of scar tissue is a part of the normal healing process after breast surgery, it isn’t necessary to suffer with scars that cause pain or reduce function.

Scar remodeling is a gentle physical therapy technique that can help decrease pain, improve range of motion, and restore normal mobility and function.  Scar remodeling therapy is especially helpful for women who have had breast surgery, such as breast reconstruction, reduction, mastectomy, biopsy, or lumpectomy.

After Breast Surgery Scar Tissue Physical Therapy With Gema Sanchez - New Heights Physical Therapy
Gema Sanchez, PT

New Heights Physical Therapist Gema Sanchez specializes in scar remodeling for women who have had breast surgery.  Women who are concerned about the appearance or mobility of post-surgery scarring, or who have limited shoulder shoulder motion, will benefit from receiving therapy with Gema, who has over 25 years outpatient therapy experience.

Gema is passionate about helping women return to their full, normal lives without pain and with the best appearance and mobility of reconstruction and surgical scarring possible.

Free consultations are available.  Call today to schedule an appointment with Gema.

Five Tips for Making the Most of Your Physical Therapy Experience

Making the Most of Your Physical Therapy Experience. New Heights Physical Therapy in Vancouver WA and Portland OR.

We’re at about mile 18 on the new clinic marathon, and while our efforts are yielding some beautiful results, there’s still some distance to go. At this point in the project, New Heights owners Kevin Poe and Donna Gramont have to dig deep and call upon the lessons they’ve learned in physical therapy to see them through the daily grind. Turns out rehabbing a building isn’t much different than rehabbing a body, it requires the same grit and determination. They offer up these five tips for turning pain into gain to help you reach your recovery goals.

 

Tip #1: Begin with the end in mind.

Donna and Kevin envisioned a bigger space for patients and staff to work their recovery, which led them to purchase the former Montavilla Sheet Metal building, a treasure trove of raw materials. In their mind’s eye, they pictured the rubble of lumber not laid to waste, but instead transformed into desks, tables, cabinets, and other furnishings for the beautiful new clinic. 

Having A Good Physical Therapy Experience - New Heights Physical Therapy - Portland OR Vancouver WA

What do you imagine for your recovery? If you’re rehabilitating a broken ankle, picture yourself on campus walking to class or taking a hike with a friend. A powerful first step is placing yourself at the finish line having achieved your goal.

Tip #2: Learn some new skills.

Kevin didn’t know how to weld and Donna had never built furniture before, but both knew that they were capable of learning. Yes, they were operating outside their comfort zone, but they also knew the furniture wouldn’t build itself. They asked friends and family for help, and with some trial and error, they gained the necessary skills to make the furniture.

What new skills do you need to learn to reach your goal? Pilates? Strength training? Our therapists excel at educating patients about their injury or condition. Lean on them and bank some knowledge that will help you achieve your goal.

Tip #3: Show up and do the work.

Every.darn.day. Donna and Kevin realize they can’t carry this heavy load forever, but until the new clinic opens in December they have committed to working hard every day in order to realize their dream of a new clinic.

Recognize that physical therapy can be hard, challenging work. But it’s a matter of fact: you’ll realize your recovery goals sooner if you commit to your therapy plan and do your home exercises. Sometimes life just doesn’t offer shortcuts!

Tip #4: Find the Zen in the work.

Planing, sanding, joining, and staining a thousand board feet of lumber would be enough to drive anyone mad, but Donna resists the urge to resist, and settles into the work itself. By finding a peaceful zone in which to work she ensures that she isn’t expending unnecessary energy that would be better spent accomplishing her goal.

 

Pay attention to when you feel overwhelmed and frustrated during your recovery. Try to accept your current reality and work with what is, not what isn’t. You may find that things will soften and shift, ultimately moving you closer to your goal.

Tip #5: Prepare to Celebrate!

You better believe there is a big party planned in early 2015 to celebrate the opening of our new clinic, we can hear the champagne corks popping now! We want to share this with you, our valued patients, whose health and well-being is the reason all of this is hard work is happening.

We recommend that you celebrate every small achievement you gain during your recovery! It’s easy to lose sight of how far you’ve travelled and the ground you’ve regained. Take a moment to pat yourself on the back for all the hard work you’ve put in and the results you’ve achieved. Let the sparks fly!

Construction news!

Toasting at the Christmas Party. New Heights Physical Therapy in Vancouver WA and Portland OR.

The Dog Days of Summer have not slowed the new clinic construction one bit!  In fact, we’re on schedule and keeping our fingers crossed it stays that way.   Here’s the latest from 5736 NE Glisan St.:

The concrete ramp into the gym has been poured,

the gym floor has been prepped with rebar and insulation,

and the concrete is pouring today!

The roof has been sheeted and 12 skylights cut in.

Kevin and Donna have been going gangbusters… making cabinets, tables, desks, well, basically they’re building all the furniture to go in the new clinic!  But really, who could let all that beautiful old growth fir go to waste?

Up next: Framers will build new support for  the exterior walls and interior walls of the treatment rooms, then the roof and electrical!

The big move is still planned for sometime in November. We’ll keep you posted about plans for toasting, but it will be in the New Year!

 

A General Guide to Running Injuries — and what a good Physical Therapist can do to help

Physical Therapy Procedure. New Heights Physical Therapy in Vancouver WA and Portland OR.

Trent Corey Physical Therapist Vancouver WA

By Trent Corey, PT, DPT     New Heights Physical Therapy Plus, Vancouver, WA

In the line of work that I do, I am very fortunate to be able to treat people who have a variety of physical ailments, ranging from ankle sprains and lower back pain to cervical whiplash.  Though all of my patients bring a set of challenges, there is something very different about the runners that I treat.  As I myself have been a runner for over 20 years, with much of that time spent injured, I know how hard it is when an injury prevents me from getting out on the trail or roads.

It is estimated that 82% of all runners suffer injuries during their running career.   Though I don’t claim to know everything about the subject of running injuries and mechanics, I certainly know enough to help most of my runners get back to full capacity.  Here are a few “take home” tips that if each injured runner actually listened to and followed, would significantly reduce the number of commonly occurring running injuries.

  • Pay attention to what got you injured. 

    This may sound elementary, but some runners actually have no idea what they did that brought them to my clinic.  Usually it’s due to a “Training Error”, a term that basically means too much too soon: Ramping up speed, distance, or both at a rate their body was unable to handle.

  • Back off the running for a little while.

    Focus more on your imbalances, muscle weakness and tightness instead of plugging along on the same old run.  I frequently see people continue to run the same distance and pace, wondering why they aren’t getting any better.   Now, if you do not hurt during or after your run, or things are not getting worse with longer runs, then fine, you are on the right path.  However, there is an element of addiction in running (and other endurance sports) that is unlike anything I’ve seen with other injuries.  Runners need their fix, and no matter how often I tell them to slow down or cut back, they keep coming back for more of the very thing that injured them in the first place.  A physical therapy evaluation will identify patterns to work on; the key is to replace the old habits with new ones that make you stronger and more aligned as a runner, so you will be able to run for the months and years ahead.  Isn’t that worth a brief decrease in mileage in the short term?

  • Get your hips and butt working for you.

    I would say that about 90% of the runners I treat have weakness and/or tightness in the hips (usually both). This compromises your ability to stand on one leg as you transfer your weight forward during gait.  There is a great article about this in the April 2014 issue of Running Times magazine. I have an awesome routine that I give to patients that will get those butt muscles firing, as well as get all major muscle groups lengthened such as hip flexors, gluteals, adductors, quads, and hamstrings.

  • Do your core work. 

    I don’t care if it’s Pilates, Yoga, planks, or P90X, this is a crucial part of stability in gait.  If you are weak in your core, then you set yourself up for a whole host of problems throughout your system.  We need to start thinking of ourselves as athletes, not just sedentary people who run.   My runners get a healthy serving of core stability exercises that start from the most basic “neutral spine” positions to more dynamic stability movements on the ball, foam roller, or other unstable surfaces.

  • Get better at standing on one foot.

    I heard once from an online running coach that all runners should be able to stand on one leg for at least 3 minutes.  Try it.  It’s hard to do if your feet and hips are not strong.  Also, it’s amazing how bad people’s awareness of their bodies are, especially the injured ones.  Practice single leg balance for at least 2 minutes while brushing your teeth is a great way to improve body awareness and alignment for running.

  • Check yourself out on video.  

    This doesn’t have to be complicated, and since having a video camera is so common, it’s very easy to capture.  All you need is about 30 seconds (or less) of running at normal pace viewed from the side and from the back. Even without training in biomechanics, you are usually able to see things about your stride that don’t look quite right.  By doing the exercises and body focuses that we work on in therapy, you can recheck your form again in a month or so to see if you notice a difference.  Of course, we also do some basic video analysis in the clinic using an iPad so you can see what we see in your stride and what needs work.  A  good article about this was written in the Jan/Feb 2011 issue of Running Times.

IMG_0056_448w

  • Feel the Chi:

    I highly recommend the book Chi Running, by Danny Dreyer. Its simple approach to running stride is less about force and more about flow.  The basics include posture focuses such as leveling your pelvis, then leaning yourself forward while picking your feet quickly off the ground, not pressing.  The stride rate, or number of strides per minute is usually more than you’re used to, but it helps take pressure off the muscles and joints, since you are using gravity to pull you into a controlled fall forward.  These are just the basic concepts, but it can help you run further with much less effort.  Chi Running also has an App on iPhone that you can use to get your mind around this new concept.

  • ASTYM: 

    Runners who develop chronic tendonitis (now officially classified as a tendonosis), may benefit from a type of therapy called ASTYM.   Tendonosis is the break down in connective tissue strength and elasticity due to repetitive loading and inflammation cycles.  ASTYM uses special instruments to help stimulate growth factors in chronically inflamed and scarred down tissues, helping to remodel new tissue growth that will be stronger once healed.  What’s great about ASTYM to runners is that it is important to exercise regularly to load the tissue, because this helps your body to stimulate a new stronger tendon or muscle.Astym Therapy For Improving Running Performance - New Heights Physical Therapy - Portland OR Vancouver WA

  • Work out your tissue yourself. 

    ASTYM can be painful, but very effective, and so is massage if you can afford to go regularly. Another tool to become familiar with and use frequently is a foam roller.  In general, the more sensitive an area is, such as your calf or butt muscle, the more you need to massage it.NewHeights0312sm-11-300x207

  • Persistence, persistence, persistence!!!! 

    One of my greatest challenges as a physical therapist is managing patients’ expectations about recovering from an injury.  When patients come back after a week or two, or even at the second visit, and wonder why they aren’t any better, I usually remind them that this problem has been brewing for quite a while so a couple of quick exercises will not be enough to snap them right into perfect running form with no more injuries.  There are important things that must be done in therapy, and it takes up to   6000 repetitions of any movement for it to become ingrained as a habit without conscious focus. Keep in mind the three goals of therapy: To improve muscle strength and flexibility, develop balance in the right places,   and most importantly, train your nervous system to work correctly by feeling the optimal way to put one foot in front of the other.  This is like running to the horizon—you may never get to the ideal, but keep working at it by tuning into your body.  Your body will be glad you put the effort in to gain healthy new habits to keep you running for a long time.

Recommended reading:

Anatomy for Runners, by Jay Dicharry, MPT

The Runner’s Guide to Yoga, by Sage Rountree

www.chirunning.com

 

 

Exciting news…. we’re moving!

Photo of Construction. New Heights Physical Therapy in Vancouver WA and Portland OR.

New Heights is excited to announce that the Portland clinic is moving to a new location in late Fall 2014! Just a few miles from our current location, the new clinic at NE 58th and Glisan is twice the size of our current facility, offering more space and amenities to help you on your road to recovery.

What can you expect to find in our new clinic?

  • The gym will double in size, with no foot traffic through the area to distract you from your workout.
  • Skylights will fill the space with natural light.
  • Treatment rooms will be larger with better lighting.
  • Better area parking and indoor bike parking.
  • Eco-friendly construction with not a lick of waste: We are hard at work repurposing the old growth timber and metal found on site into desks, doors, cabinets, shelving, and tables.
  • Easy access off I-84 Eastbound.
  • Most importantly, our same great staff will continue to deliver excellent care!

Even more exciting? We plan on offering classes and events to promote wellness in the community. Let us hear from you, we’d like to learn what you’re interested in seeing in our new space! Acupuncture? Yoga? The possibilities are endless! And, since we’re all about pain reduction, please let us know what we can do to make this transition as pain-free as possible.

Visit www.newheightstherapy.com/Glisan, and answer our short three question survey to give us your feedback.

newsletter pic

New Heights owners Donna Gramont and Kevin Poe enlisted their spouses Phil and Nicole to help with the project. They have been working every weekend for months…check out their work! Better yet, subscribe to our blog and we’ll keep you updated on the construction progress and let you know when our Grand Opening celebration will be!

donna kevin nicole phil
The fearsome foursome: Donna, Phil, Kevin, and Nicole. They have worked every weekend for months deconstructing the building to repurpose, recycle & reuse the materials.

phil w desk frame

The old growth timber and metal found on site is being repurposed into desks, tables, bookshelves, and cabinets.

Donna planes

Donna planes the wood flooring to restore its original beauty.

 

It takes vision to see promise in this mess!

It takes vision to see promise in this mess!

Low Back Pain: Treatment Considerations

by Maureen Lefere, PT, ASTYM Certified

Maureen Lefere

Low back pain, or LBP, is something most people will experience at some point in their lives.   In fact, 50% of working Americans will have back pain during their career.  It is the leading cause of disability in Americans under 45 years of age, it costs employers $7.4 BILLION dollars a year, and it is the third most expensive health condition in the US, second only to cancer and heart disease.  The costs in decreased quality of life, family disruption, depression, and general health are immeasurable.  If you are the person suffering from low back pain, the statistics don’t mean much, you just want a solution.    

There are many different approaches to treating low back pain and unfortunately,  no universal solution that works for everyone.  A research study performed in 1994 looked at 98 people with no complaints of LBP.  They completed MRIs on all individuals and found that 52% of these patients did in fact have positive disc bulges in their lumbar spines.  This demonstrates that a positive finding on an MRI, x-ray, or CT scan does not mean it will always be associated with pain.  In addition, several studies have shown the same statistical decrease in disability in individuals who underwent a lumbar fusion vs. those who received back care education and exercises.

lbp

So, how does one decide how to treat their low back pain?

Number one:  recognize that if this is your first injury, there is a very good chance that you will spontaneously recover without professional intervention.    We have a wonderful mechanism in our body called homeostasis where our body is always trying to restore itself to normalcy.    Often, just having this knowledge will decrease the stress response  which will often decrease the pain response without intervention.

Second, don’t stop moving.   The human body heals by moving white blood cells into damaged tissue, and then removing waste.   With immobilization comes stasis, or stagnation,  of fluid, swelling, muscle inhibition, and nerve irritation.    That does not mean continue doing activities that increase pain, but rest combined with graded, low intensity movement is best for promoting healing.   

Third, evaluate if you need a health care professional’s guidance.    When back pain is accompanied by leg symptoms such as numbness and burning, you should seek medical attention.    If back pain is accompanied by urinary frequency or loss of control of the bladder, you should go to the ER.    If back pain has not improved in one to two weeks with ice, rest, graded movement, and over the counter medication, you should see your health care professional.   

WHO TO SEE?   

There are many people who can help with your back.  Since I am a PT, I am going to share what we do.    This doesn’t mean there aren’t other professionals who can help you.    The questions that you should expect ANY provider to answer are:

  1. What do they believe is the primary problem?
  2. What will the provider do to address your problem?  
  3. Approximately how long does the provider expect to see you?   This is sometimes a difficult question as back pain is complicated, but the provider should be able to give you a general idea.  

Physical therapists will conduct a thorough evaluation which will include looking at range of motion, strength, posture, neurological function, general tissue health, and endurance.     They will ask you about your pain, your past medical history, current medications, level of activity, sleep, work, and what your specific goals are. 

Therapists evaluate the entire system and may find areas of involvement away from your low back including your feet, hips, neck, or mid back.   Once the therapist has completed their examination, they will explain why you are having pain, their treatment plan, any precautions you may need to take to prevent re-injury, and will give you specific instructions for what you can do at home to manage your condition.    

This piece, to help you to self-manage your condition, is crucial to the long term success of your treatment.     Therapists empower patients with knowledge so that patients can treat themselves.    In this way, you are in charge of your health, and not dependent on a practioner or technique for pain relief.   

In the initial stages of therapy, when the primary goal is to decrease pain, therapists will use a variety of techniques, each specific to your condition.    These may include:

  • manual therapy techniques, such as  joint mobilization/manipulation if you have a segment or segments that are not moving functionally or to promote fluid movement within a joint
  • soft-tissue mobilization, to address muscle and fascia restrictions and to allow optimal muscle function
  • nerve mobilization, to improve circulation and mobility in the nervous system itself
  • microcurrent, to decrease inflammation and speed healing
  • exercise, initially to improve circulation and facilitate endorphins and to prevent muscle atrophy and promote normal movement patterns.     

Exercise can also be used to restore range of movement (ROM) and to inhibit pain.  As your pain decreases, exercise becomes even more important as you re-build strength and endurance in the muscles that stabilize your spine and work on specific functional activities for your work and home life.    

STEP

Therapists at New Heights use primarily the STEP exercise concept which stands for Scientific Therapeutic Exercise Progressions.   This involves dosing your exercise regimen to the specific tissue that is injured as well as using appropriate resistance to the stage of recovery that you are in.     There is considerable evidence to support the STEP concepts and many times patients are surprised that they do not have a significant increase in soreness during or after exercise, in fact most often they have less pain.    

In addition to hands on treatment and exercise, your therapist will also communicate with other health care professionals on your team, make suggestions for additional resources (for example, nutritionists, chiropractors, acupuncturists, naturopaths, and physician specialists ) if needed, and communicate with your workman’s compensation representative if your injury occurred on the job.    

During your course of treatment, your therapists will be updating your home program and when you complete therapy you will have all the information you need to prevent re-injury and to maintain your low back health and function.    Your therapist will also provide their email information for future questions.    

A physical therapist’s primary purpose is to help your body return to the most optimal state possible and to restore the majority of your pre-injury function.   Our job is to make you not need us, and we are pretty good at it!!    A back injury or chronic low back pain does not need to be a lifelong condition, appropriate care and your commitment to your home program is the key to solving this common injury.   

Maureen “Mo” Lefere, PT , ASTYM Certified, works at New Heights Physical Therapy Plus, Vancouver Clinic 

Professionals Working Together: A Patient’s Perspective

New Heights values the collaborative relationships it shares with other healthcare providers because we believe a team treatment approach pays big dividends for both patient and practitioner alike. By working cooperatively with practitioners in other disciplines, we are able to share treatment perspectives and use complementary coordinated care to improve our patients’ health.

New Heights physical therapist Brooke Floode enjoys just such a professional collaboration with Portland acupuncturist Boynn McIntire of All and One Acupuncture.  Together they are co-treating a patient who suffers from low back pain. Below, Ryan S. shares his moving account of  how great minds working cooperatively have addressed his health issues and helped him look forward to his treatments and workouts.

 

“I am one of many who suffer from lower back pain causing mild to intense pain for long durations.  Some days I cannot physically move, and even worse, cannot be a playful dad with my son.   I did the standard routine and saw my doctor, then a few more doctors, none of which had any helpful medical advice so I became a “suffer in silence” patient.  Since I had no empirical evidence but my word and a clean x-ray, I tired quickly from the feeling of being herded like livestock through the clinic, all for a ten minute visit with a pre-determined out-come: nothing.  My eyes started opening up to the realization that something, anything, had to be done before my symptoms took over my life and become permanent.

After concluding the clinical route was not a reliable option for me, through my search for a better quality of life I heard experiences from close friends and colleagues about alternative medicine called acupuncture.  I remember being at work in serious pain when a friend told me about his acupuncturist.  I joked around about the subject being naive, however, my friend told me it helped him for over two years until he medically needed double hip surgery.

Many people could not explain to me the process of acupuncture, but all had the same outcome, it worked.  I tossed aside my ignorance and began doing my research for an acupuncturist starting with internet searches, reviews, and ratings.  Over a few weeks of deciding if acupuncture was an alternative medical route I wanted to try, all my research and word of mouth kept leading me to All and One Acupuncture by Boynn McIntire, LAc, MAcOM.  Since acupuncture is not invasive, I had nothing to lose, and my pain was not going to treat itself.  I booked my first appointment.

I had no idea what to expect, I watched YouTube videos and heard stories told, yet, my experience was unlike anything I was expecting.  I had my summary and symptoms listed, just like I had told time and time again at the clinic.  I was ready for my first consultation.  I met with Boynn, quickly gave her the highlights of my back pain and was ready to be on my way.  What I did not expect was her taking time to ask me questions, follow-up questions, and inquire about my previous and current health history.  I got to explain myself without feeling judged or rushed, an unusual experience and a perplexing feeling at first, seeing Boynn take my symptoms seriously.

I have been a patient of Boynn for almost a year and see her weekly, I am amazed every time at her warmth, attentiveness, and professionalism, which is just the starting point to what Boynn brings to the medical community.  Her knowledge of treating the body as a whole instead of pieces promotes the best environment to feel comfortable, voice my opinion on treatment, and give my feedback, thus each visit truly astounds me.  Even better for me, I leave pain free and feel like I’m ready to move boulders.

In January of 2014 I was telling Boynn that my goal for the year was to get my back healthy, starting with gaining insight into the underlying cause of my back pain.  Boynn suggested I try physical therapy, and gave me a couple of options.  I live in Vancouver Washington, and since I found such great care in Oregon I decided it is well worth the travel for good care, so I booked an appointment at New Heights Physical Therapy Plus with Brooke Flood, DPT, COMT, BikeFit Pro Certified, at their Portland clinic.  I assumed I knew more about physical therapy than I did acupuncture being a former weight lifter, I figured resistance training, isometrics, some body weight exercises, no problem.  I was wrong again.

Meeting Brooke showed me how attentive, receptive, and knowledgeable she is in her profession, just to name a few of the many desired qualities in a medical professional.  Brooke walked me through my first exercises, which were completely different than a weight lifter’s mentality.

Brooke is fantastic at explaining and visually demonstrating muscle movements for how my body needs to adjust in order to complete my exercises properly and safely.  

She does a great job of reining me in by preventing me from hurting myself when I try to extend muscle movements full range like a weight lifter.  I am learning a new mentality of thinking smaller but activating a targeted muscle or muscle groups, for instance, all that may be required is a two to four inch resistance stretch, I am not trying to lift a car.  I am constantly learning new exercises, body mechanics, and core stability from Brooke, who is very thorough making me feel better about my exercise program every time I see her.

Boynnleft to right: Dave Murphy, Ryan S., and Boynn McIntire, LAC, MAcOM at New Heights Physical Therapy Plus

Recently Boynn and Brooke were able to schedule a time to sit in with me and observe each other’s methodology for treating my lower back.  For both of these medical professionals to take this kind of interest and dedication in a patient by an on-site face-to-face visit in an effort to co-treat is something I would have never thought possible.  I am still amazed that Boynn and Brooke were able to arrange this and it is hard to describe how grateful I am to both of these women for their time, effort, and inspirational personalities.

Each brings their unique skill sets to complement one another, for instance, I finished a great lower back session with Brooke aimed at activating the smaller muscles (multifidus) then followed up the next day with Boynn where she applied acupuncture to the muscle groups used during physical therapy.  In my experience this process, physical therapy followed by acupuncture, relieved the pain and pressure built up from sore muscles that were activated during physical therapy exercises and aided in a more comfortable recovery time.

With Boynn McIntire of All and One Acupuncture and Brooke Flood of New Heights Physical Therapy Plus I feel I have an immensely knowledgeable, and incredibly capable team, which I am continuously amazed at how well they complement and enrich each other’s abilities.  It is an incredible feeling to get excited for an acupuncture treatment or an exceptional lower back workout.”

 –Ryan S.

Brooke and MasonNew Heights Physical therapist Brooke Flood and her dog Mason

Morgan Heads to Haiti!

Morgan with supplies

Thanks to everyone who very generously donated medical supplies and shoes for Morgan to take to Haiti today!  Morgan will deliver 150 pounds of donated supplies and volunteer her awesome physical therapy skills to the people living in one of the poorest regions of Haiti.

This is Morgan’s third trip to Haiti.  She travels with the group Phoenix Rising for Haiti , a multidisciplinary team of medical professionals that treats thousands of people in the city of Port-de-Paix on the Northwest coast. The population there is completely underserved and has very limited, if any, access to healthcare of all types.

The team delivers a variety of medical services, including the casting and fitting of artificial limbs and orthotics, and treating musculoskeletal injuries.  Morgan will spend her time over the next two weeks teaching patients how to walk with their new legs, treating children with neurologic conditions such as cerebral palsy and muscular dystrophy, and helping patients recovering from work-related falls and injuries.

Morgan says, “The weeks (volunteering) are amazing and deeply moving. We all work harder than ever, beat ourselves up, lose sleep, get sick, and feel great!  It’s shocking how much we can help these people, via hands on treatment, information, training, and simple equipment.”

Best of luck and safe travels, Morgan!

Morgan's truck

Happy Trails: Bike Safety Tips!

By Morgan Denny, DPT

Morgan Denny Physical Therapist at New Heights Physical Therapy Portland Oregon

I love to ride my bike. It is one of the most convenient, fun, healthy ways to get around the city and stay fit. I ride in the sun, the wind, the rain, the sleet and sometimes even the snow. I’m nearly as reliable on my wheels as the postal service! As a physical therapist and bike advocate, there is a phrase I hear all the time: I would really like to ride my bike more, but I just don’t feel safe on the road.

So, this post is devoted to safety tips, planning strategies, and awareness elements that will keep you safe and confident while riding your bike. These tips are geared toward both the novice biker who is currently dusting off his wheels in preparation for the spring AND the experienced cyclist, who is just waiting for the day she can remove her fenders and gortex shoe covers!

The main elements we need to address are: visibility, comfort, and respect for the road and all those who use it.

 

Tip #1: VISIBILITY!

There is no better way to be safe on the pedal than by being seen. This doesn’t mean you have to sing opera with wild hand gesticulations or wear only neon colors head to toe, though neither would hurt. It does mean that you should avoid wearing dark colors at night. It also means using appropriate lighting. When cycling at night, during dusk, or when it’s raining, bikes should have at least one white headlight in the front and one red tail-light in the rear. Law requires this at night, but remember the goal is to be seen, so use them whenever visibility is compromised (eg. when it’s raining and people’s windshield wipers may not be perfectly clearing each droplet from their windshields).

Be sure to place your blinkers in visible areas. Often lights attached to back pockets or bike bags can be covered accidentally by clothing or placed to far to the side, making them less visible to cars directly behind you. Additionally, a light on your wheel spokes, so that you are visible from the side, is quite helpful. And while you can also wear reflective vests, a cheaper and more creative solution is to decorate the back of your jacket, pants, bike, or bag with reflective tape. This cannot be underestimated; reflectors are magic when car headlights are applied!

Another aspect of visibility is awareness of whether or not you are seen. Attempt to always make eye contact with drivers, other cyclists, and pedestrians before proceeding to turn or making your way through intersections, even when you have the right of way. Making eye contact establishes the fact that both commuters actually see each other and takes the guess work out of making a safe crossing.

Lastly, be aware of your surroundings; this includes the type of road you’re on, whether or not you are in a bike lane, and what type of other people/vehicles are around you. Most cyclists who are injured by vehicles are hit when cars are making right turns and do not see the biker.

TIP TO REMEMBER: when proceeding through any intersection, ALWAYS position yourself at least a few feet
behind the bumper of the car in front of you. Though they may not have a turn signal blinking, they may
intend to make a right hand turn or decide to at the last minute. If you are next to them, you will be
in their blind spot and in a dangerous situation. If you are behind them, you will be able to see their
intentions more clearly and hit your brakes to slow down if you need to. This positioning also places you
directly in front of the car behind you (VISIBILITY) so that they are aware of your presence.
 

Tip #2: COMFORT

…ahhh yes. Many times I have heard people say, I would like to ride my bike, but it’s uncomfortable and the weather isn’t always great. Numero Uno: Welcome to the Pacific Northwest. But moving beyond the fact that Oregon (and many other states) does not provide windless sunny days with the consistency some might hope for, there are heaps of ways and strategies that will keep you comfy on your bike, no matter what the circumstances!

First of all, if your bike is uncomfortable, you may simply need to have changes made to your bike’s set up. It could be as simple as moving your seat, changing the angle of your handlebars, or learning the correct position on your bike. Luckily, there are skilled physical therapists (and you might know a few) who are trained to do cycle fits and can make changes to your bike to appropriately fit your anatomy or teach you exercises to improve your position, comfort, or efficiency when pedaling!

If you are pedaling frequently, the importance of having a good fit can not be overstated.

Preparing appropriately for the weather, or the possibility of weather, is another key factor in being comfy cozy on your bike! First and foremost, dress in layers! Nothing beats the elements of hot and cold like variety. It may be 10 degrees cooler in the hills than it is in the valley and you should plan accordingly.

Secondly, purchase, borrow, or find in a free box some good rain gear. It’s truly amazing how impervious to wet Gortex can be; and how much easier it is to get your pedal on in the rain when you know you’ll still be dry once you strip off your waterproof layer upon arrival. Additionally, you can bring extra clothes with you to change into or leave a spare set at your common destinations. For example, I leave my work clothes at work, along with an extra pair of dry shoes…never mind that half the time I opt for barefoot status…but that’s another story.

Being comfortable on your bike also includes an amount of confidence in yourself on the road. If you feel hesitant to ride your bike amidst cars, there are simple steps you can take to be sure you have a comfortable and safe route. For one thing, improving your visibility to cars (see above) will give you confidence that everyone knows you’re there. Also, take bike routes or side streets anytime it’s possible. If you live in lovely Ptown, you’ll find no shortage of preferred marked bike routes and bike lanes; most outdoor or bike shops sell maps that specifically detail these. Mapping your routes accordingly will dramatically decrease the number of cars you get close to while pedaling and you will get to see more fantastic bike commuters like yourself!

If you don’t feel confident about your balance on a bike, particularly at intersections when a stop is required, try these tips:

  • When you stop at an intersection, DO NOT try to continue sitting on your seat with both your feet touching the ground on either side. This is a precarious position full of terrible teeter totter possibilities. INSTEAD, bring your seat off your saddle and place one foot (or both) on the ground. Lean your bike slightly down towards the foot you have placed on the ground (the other may be on the pedal still). This will give you a more stable gravitationally affected triangle AND it will have you in the ready position to push down on your pedal and restart when that light turns green!
  • Practice your starts and stops around your neighborhood (that’s right, where everyone can see you). This will help you gain confidence in going at different speeds, stopping appropriately, and restarting…without any other cyclists or cars to worry about.

 Tip #3: R.E.S.P.E.C.T.

find out what it means …for you…sing with me now!

No matter where you’re going or what kind of bike you’re riding, you should always always ALWAYS respect the road. Remember that it is a very hard surface and fairly unforgiving to your amazing flesh covered body. I could rant about wearing a helmet, but I will assume that if you’re smart enough to be reading this blog, you likely R.E.S.P.E.C.T your brain and the way it currently functions, so I will not address its importance specifically in this article.

Respecting the road also means adhering to the rules. Stop at signs and lights that involve the color red, use appropriate signals for turning and indicating a change in direction, and just say no to agro! Remember, you have nothing to prove out there and in a fight between you and a heavy metal box with wheels, you will always lose. Keep this in mind.

Some of these tips go back to visibility and communication. Just because you’re wearing that superstar helmet does not mean that cars or other cyclists can read your mind. Tell us what you’re going to do before you do it! Biking on the street is like having a relationship, the more open and forthright you are, the less likely that anyone will get hurt.

Riding a bike is one of the funnest, bestest, most awesomest ways to get around. Making every pedal a comfy cozy happy safe ride can only help! More power to the pedal!

 morgan's winter ride

Morgan’s commute to New Heights is 30 miles round trip.  This is the view from her bike during the February snow storm.  

Holiday Decorating

Both of our clinics are getting in to the holiday spirit! Alex, Amy, Mark, Dave, and Sue helped decorate the clinics this week.

Alex decorating the tree in Vancouver.
Alex decorating the tree in Vancouver.
Mark and Dave decorating the tree in Portland
Mark and Dave decorating the tree in Portland
Mark decorating the tree in Portland.
Mark decorating the tree in Portland.
Our Portland tree!
Our Portland tree!
Portland Clinic Entryway
Portland Clinic Entryway