Strengthening Your Weak Link!

Kinesiology is the study of movement. It is what physical therapists are experts at. In kinesiology, a leg or an arm is often referred to as a "chain." The reason being is that a leg or an arm is comprised of parts with links, those links being joints. Muscles originate on a bone, cross a joint and anchor on another bone so it can stabilize and move a joint. So when we hear the expression, "a chain is only as strong as its weakest link," we could easily apply that idea to a human chain. That's a very important concept especially if you are an athlete. 

Aside from being a Physical Therapist, I have been an avid martial artist for a good 20 years. In that time I have suffered a nice bouquet of injuries; everything from a broken bone, to torn muscles in my mid back. After a four year hiatus, I recently joined a new martial arts school. I wanted to see how well prepared I was physically to go back into this very demanding activity so I had myself evaluated by Renuka Pinto (the supervising PT here at D and B) using the Functional Movement System (FMS). The FMS system, is a movement screen that is often used to assess an athletes' quality of movement by studying each kinetic chain. It can also be used on a non-athlete to evaluate how well they are functioning in their body in terms of movement. The individual scores are added together to create an overall final score. The FMS helps to identify not only the athletes limitations or weakness but also the compensations that cover up those weaknesses. The test takes about 20-30 minutes. It is broken up into subsections that look at very specific movement patterns. What's great about the FMS, is that not only does it identify these weaknesses, with each section, it will also give specific exercises to help improve the areas the athlete is weak in making it a very clear systematic approach.

By the end of the test, I had a good idea of where my weak links were. Renuka and her student (Karen), gave me exercises to improve my weakness and  enlightened me on my compensations. So not only will the FMS help refine whatever game you compete in, but more importantly, will help identify what injuries you are predisposed to. Whether you are a golfer that wants to improve that vital finite control in your swing, or you are an Ironman competitor that is looking to improve your endurance, the FMS will help you improve your practice and prevent injury so you can keep doing the game you love to do... So for all of you athletes out there that are preparing for an event or want to maximize your chances of preventing injuries I would highly recommend the FMS here at Duffy and Bracken. It is one of the many programs we offer to try to maximize how we can help you. If you are interested, ask anyone of us and we'd be happy to answer any questions. 

 

Happy Training!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Johann Howard, DPT, LMT

DIARY OF A PREGNANT THERAPIST!

For my last blog before going on maternity leave for the first time, I felt inspired to share some reflections related to my experience during pregnancy which has enhanced my insight as a physical therapist. This may peak the curiosity of others interested in the topic of pregnancy or even on the topic of creating new physical experiences.

As I have undergone childbirth preparation classes and read material on natural childbirth in hope of promoting a birth experience as normal/natural and, believe it or not, enjoyable as possible, it has been repeatedly pointed out that the prevalent portrayal of childbirth as a painful and dangerous experience has created a fear of this experience and belief that this description is inherently true. Thankfully, there is a widespread body of resources that helps to transform these beliefs into confidence in a woman's innate ability to birth. This makes a very simple point that fear of the birth process creates resistance to and intolerance of the physical experience of labor, and that by both understanding the physiology of normal uncomplicated labor and trusting the natural ability of mother and baby to safely complete the process, this fear can be eliminated, allowing an entirely different birth experience to unfold.

So though one of the hottest topics during pregnancy is the birth itself, there is a lot of "story" about what "happens to" a woman's body during pregnancy as well. A conversation develops about the potential dangers of childbirth as well as the potential for injury due to pregnancy. This includes not only impact on the mother's body during birth but during pregnancy and in life after pregnancy. What I found novel is that while it is well established that these unfortunate perceptions of childbirth are prevalent in modern civilized societies, so might our perceptions of the experience of carrying a child before and after birth be influenced by cultural expectations. What became tangible for me was that much like I wanted to undo my learned cultural beliefs about childbirth, I could change my perception of what my body was experiencing as pregnancy progressed. Though I felt that I possessed helpful knowledge that would enable me to care for myself and "prevent injury", I still needed to believe in nature's design just a little more.

To build upon this conversation, I would like to also point out that so far the conversation is talking about the mother as a pregnant individual, not a mother and child living, moving, birthing, and continuing to live together with ease, harmony and comfort, and actually establishing a relationship (though perhaps not with a lack of new sensation and experience for both parties).

Let me illustrate what these changes in perception boil down to for me. There were times I was distressed because of pain while walking. However, as the baby grew it dawned on me that I was already the mother of this baby.Then a bigger picture emerged illustrating that just walking down the street pregnant was at this stage already an activity in our parent-child relationship. I began to realize that it made sense that I could move in a natural way (though perhaps slower) with her (yes, it's a girl!), and not only feel less pain but feel happy in my new relationship. Sensations that I felt as physical stresses (abdominal muscle strain, pubic bone pressure when I walked or sacroiliac pressure with changing positions) began to be perceived differently- as evidence that my baby was resting on certain body parts of mine or guides for me to move with more mindfulness. Feeling “out of breath” and extra work in my legs going up stairs changed into “taking in more air” for the two of us.

Now am I saying that pain is all in the mind? No. Have I enjoyed the benefits of physical therapy to prevent, prepare and manage? Absolutely! Though attention to physical wellness continues to play an important role, what has also contributed to me feeling better and better while walking and moving are perceiving things in the following ways:

1. RELAXING and trusting that my body can "carry" my baby without additional effort or injury if I let it. In the early stages I noticed that as I walked there were times I tensed muscles around my waistline and in my hips, exerting effort to “carry the baby”.  When I realized I could relax all those muscles and move in a way that was harmonious with her, I soon saw that my body did not feel added stress. 

2. Building on the point about relaxing, being sure to BREATHE PROPERLY. Though the growing uterus takes up space near the diaphragm and ribcage, the diaphragm can still do its job. A breathing pattern which primarily originates in the diaphragm and is not restricted by tension in the shoulders, ribcage, abdomen or pelvis is an essential component of efficient posture. Being able to maintain efficient breathing is a good sign that you are feeling good!

3. TAKING TIME to move, whether it’s getting up, moving in bed, walking or squatting, not just because of being heavier or that it’s “harder”, but because “moving for two” may take that extra bit of mindfulness to negotiate how to move in a way that is kind to my body. I’m not saying that you couldn’t still run in the Olympics if you wanted to, but as for me, no more running for the bus!

As a PT, I have learned important lessons from experiences as the caretaker of my own human body which enhance how I help others help themselves. Whether you are carrying a baby in your womb, a child in your arms or even bags of things in a city schlep, I invite you to create a new language for what it is you are doing. Is there some way you could create more ease for your body, create more harmony between you and the person or things you are carrying, or learn to trust your body more? Time and time again it is a relief to find out that breathing easier and relaxing more creates more efficiency, comfort and pleasure in the body. If you are unsure of how to create ease in your body - pregnant or not - schedule an appointment with a physical therapist...we can help!

Sara Chan, PT, CFMT

Sugar Uncovered: Don't Make These Mistakes!

In the last few weeks there has been a lot of buzz around sugar because of the law that Mayor Bloomberg is trying to pass limiting the sale of large sized sugary drinks. As a health coach, I have had many people ask me about sugar and its effect on the body. The short answer is frequent consumption of sugar leads to weight gain, lethargy, and mood swings. Prolonged overconsumption can lead to obesity, diabetes and heart disease! How could such delicious treats cause so much harm?

The challenging part is that sugar has become part of our cultural DNA, which makes it almost impossible to avoid completely. Every holiday has its special sweet. When we mark significant life milestones - birthdays, graduations, weddings - cake takes center stage. Children do well on a test; we reward them with ice cream. When I walk around the streets of NYC, there are frozen yogurt shops and cupcake cafes popping up on every corner. We are surrounded by it!

But aforementioned sweets are not the only sugar culprits. The obvious treats are easy to spot and we can try to avoid them. But what happens when we THINK we are making a healthy decision BUT we are actually ingesting large amounts of sugar and don't even know it!

Don't be duped by these seemingly healthy but sugary favorites:

• Sauces/Glazes - Many times to get that perfect complement to your savory dish, chefs will add a sauce or a glaze. But beware, many glazes have added sugars. So that soy glazed salmon dish you love may look like the healthier choice but could have over20g of sugar...more than 1 chocolate glazed doughnut!
• Yogurt - This delicious snack can be very healthy but beware of yogurt with added fruit. Yoplait strawberry yogurt has 26g of sugar...as much as a Snicker's bar! If you are going to eat yogurt, eat the plain and add your own fruit for the touch of sweetness.
• Granola - Eaten by hippies for years...it must be healthy right? As it turns out, Kellogg's Original Granola has 17g of sugar...as much as 3 chocolate chip cookies!! If you are going to have granola, either make your own or be sure to check the labels for lower sugar options.
• Coffee/Iced Tea -I was floored when looking into coffee drinks and iced teas. I never thought twice about these, as they were obviously the healthier choice to the dreaded soda. Wrong!  A Starbucks Grande Cafe Mocha has 33g of sugar, which doesn't include any flavor shots, or sugar people add after they get it. If you are going to drink coffee or iced tea it's best to have it black/unsweetened.

Knowing a few of these sugary pitfalls will hopefully help you to make healthier, informed decisions. At 1 Healthy Life we know that it's easy to get off the healthy track and sometimes difficult to find your way back. That is why we work with people to help them take small steps(like cutting out sugary drinks) now that lead to BIG changes in your health later.

Working with a health coach will:

• Help you to truly identify realistic, attainable health goals
• Develop a customized plan that will step you toward your goal over a series of sessions
• Hold you accountable (in a loving way) to those goals week after week
• Identify if there are certain steps that are not working for you and help you to modify the plan so it works specifically for you. Not everyone is the same...therefore, no plan is going to be exactly the same

1 Healthy Life has partnered with Duffy & Bracken Physical Therapy to develop a program that is the one...two health punch combining wellness & exercise. In only 3 months you will have a Total Health Transformation! We will dive deep into eating right, reducing stress and improving your energy while Duffy & Bracken trainers will kick your butt on their Gravity Training System to improve your muscle tone, flexibility and overall physique.

You only get 1 life; why not make it your best life possible? And you can...with small steps and support along the way.

Schedule your 1 on 1 complimentary health breakthrough session today. What do you have to lose?

Mina Penna, Holistic Health Coach

Mina Penna is a Holistic Coach who works with clients to help them reduce stress, improve their energy, find more balance and lose weight. Mina was certified at the Institute of Integrative Nutrition and is a member of the American Association of Drugless Practitioners. Additionally, Mina is the Corporate Nutritionist for Sabra Dipping Co., LLC.

Cliffs Notes: Your Guide to Physical Therapy!

About a month ago, Duffy & Bracken owner, Ann Duffy wrote a passionate blog detailing both the role and the ability of physical therapists in providing preventative services and helping to curb ever-growing healthcare costs. A few weeks later, D & B director, Renuka Pinto, wrote an equally fervent blog highlighting how physical therapists can help individuals invest in their health with the same proactive, calculating approach they take to investing in their financial well-being. As luck would have it, these blogs were posted around the same time that a very poorly-informed segment aired on Dr. Oz, grossly misrepresenting what we as physical therapists actually know and do. (Disclaimer: if you are currently attending PT and receiving the type of care depicted in Dr. OZ's segment, please find a new physical therapist ASAP) To this end, I felt it only appropriate that I complete the D & B blog trifecta and devote this entry to summarizing the many skills that we as physical therapists possess, and reiterating how we can help you, the health care system, and the country as a whole .

Despite what Dr. Oz would have you believe, physical therapists are not merely the keepers of the machines, wielding ultrasound and electrical stimulation units against the dark forces of persistent low back pain, reinforced by our trusty sidekicks, the hot and cold packs; quite the contrary. Currently, to become a physical therapist, one must attend 3 years of graduate schooling, in addition to their undergraduate or post-baccalaureate. Pre-requisites for PT school are the same as those required for med school, generally with the addition of courses like exercise physiology and kinesiology in place of organic chemistry. Physical therapy graduate course work includes biomechanics, physiology, kinesiology, pharmacology, and radiology. PT students study pathology of not just the musculoskeletal system, but also pathologies of the neurological, cardiopulmonary, genitourinary, gastrointestinal, and integumentary systems. Following roughly 7 years of schooling, physical therapists currently graduate with their doctorate, and then enter the health care industry with an identity that is often time misunderstood, and a role that is severely underutilized by the general public.

Here are the cliffs notes as to what a physical therapist is, and what we actually do:

Physical Therapists are musculoskeletal specialists. With extensive coursework in anatomy and physiology, physical therapists possess the knowledge to both diagnose and treat nearly all musculoskeletal pathologies or refer patients to the appropriate practitioners if needed.

Physical Therapists are movement experts. With a strong foundation in biomechanics and kinesiology, physical therapists are trained to analyze everything from your gait to your golf swing. We can determine why your knee hurts when you go down the stairs, help you decrease your half marathon time, and tell you which shoes are best for your needs.

Physical Therapists take an active role in your recovery. Physical therapists use manual techniques such as joint and soft tissue mobilizations, taping in conjunction with therapeutic exercises to facilitate a return to full function. It is our hands, not the hot packs that will make you better.

Physical Therapists are easily accessible. Thanks to Direct Access, patients in New York can see a physical therapist (who has been practicing for at least 3 years) WITHOUT a referral from a physician. Patients are allowed to attend physical therapy for 10 sessions or 30 days before they are required to see their doctor and obtain a prescription.

Physical Therapists don't just cure pain, we can also prevent it. Physical therapists can predict your likelihood of injury by watching you perform simple functional movements. Additionally, patients are provided with home exercise programs and educational tools that allow them to prevent the reoccurrence of injuries and employ self-management strategies should symptoms return.

Physical Therapists help save you money. Although co-pays can be frustrating, attending physical therapy can help people get out of pain quicker, help people avoid invasive surgical procedures, and decrease the amount of medications that a patient needs to take. Six sessions with a $20-$35 co-pay and an adjustment to your workstation versus back surgery. I'll let you do the math.

If you're reading this blog, there's a good chance that you already know the benefits of attending physical therapy. However, I ask that you share this blog with your friends and family, and anyone who's complained to you about their stiff neck and their sore knee. For those of you who just had a mind-blowing experience, carry this knowledge with you and see a physical therapist the next time that ankle (or knee, shoulder, elbow, back, neck) starts acting up.

Carmen Shante Cofield, DPT, CSCS

Duffy & Bracken Physical Therapy

NO PAIN, NO GAIN!

My Duffy & Bracken Physical Therapy one year Anniversary is fast approaching. As the PR & Marketing Director, I wear multiple hats but one hat I didn't see coming was that of (wait for it) ....PATIENT. You see while finishing my Masters Degree, I worked from home for three years. As you can imagine, when I started commuting to Downtown NYC to work and began moving around more and more, I started feeling all sorts of aches and pains in my body. Even though I went to the gym when I could and got a work out in here or there....my mental activity certainly didn't make up for all my physical inactivity.

I figured how convenient for me....I work at a physical therapy clinic so I could just get a quick fix and be on my way. Boy was I wrong...TOTALLY wrong.

Many of you will want to argue with me that the 'No Pain, No Gain' philosophy is actually a myth and pain is not required to have a quality workout. Trust me I get! But I'm not here to argue that point....the truth is that Physical Therapy is unlike any other visit to your doctor's office. It most times will require more than just the quick fix even I expected. Like everyone else I was going to have to put in the work if I wanted to be pain free.

Here is what I learned while walking a mile in your shoes as a PT patient:

1. It may pain you to have manual therapy. Physical Therapy is not like getting a massage at your neighborhood spa. Manual therapy techniques are not as relaxing, it can even be uncomfortable, but trust your therapist to be your guide to long term freedom from pain.

2. It will pain you to do your exercises everyday. No one likes to do them but they are an integral part of your treatment plan....don't neglect them. And if you ever find yourself in pain again after being discharged, the first question you should ask yourself is ...have I been doing my home exercise program.... then make an appointment.

3. It will pain you to carve out a couple of hours a week for 4-6 weeks. Having been in your position, I definitely understand how difficult it can be to make time for treatment. We know your busy but don't be what I like to call a 'Repeat Offender'. Repeat offenders are patients who start feeling better in the middle of their treatment and decide that they don't need therapy anymore. They end up back in therapy because they didn't commit to the process. Would you tell your cardiologist that you don't need your heart medication anymore?

4. It may pain you to dip into your pockets for those co-pays at every visit. Yes, we know it adds up but we didn't make the rules we just enforce them. If you think about it...can we really place a price tag on being pain free and able to live your life to its fullest without physical limitations.

Anyone who has successfully completed their PT treatment plan will tell you that the benefits far out weigh the costs. When it comes to PT...No Pain, No Gain! So yes, it may be a pain in one way or another but most things worth doing are usually not easy. If you are currently in a PT treatment plan, commit to it and if your living in pain, you don't have to....make an appointment today!

Kieffer Pearce

PR & Marketing Director

What's Your 401 (k) Health Portfolio?

We are constantly being warned about SAVING....saving for retirement, saving for an emergency, saving for unknown medical expenses. Most individuals over 30 are warned to start saving TODAY  to ensure a nest egg at 65, as social security may be non-existent at their retirement.

The size of your present investment will determine the quality of your retirement life!

Our previous blog talked about changes in healthcare and changes in the way we should look at health. This one is no different.

Lets look at health as an investment; the same way we look at stocks.

If you invest 30 minutes 3 times a week in exercise, research shows it's enough to ensure a healthy cardio vascular system. So let's name this investment "aerobic stock".

If you remove trans fats, fried foods, processed foods, fast foods from your diet and switch to home-cooked and healthy green meals; research shows it can reduce your risk of cholesterol, CVS disease, and high blood pressure. So let's name this investment "diet stock".

If you maintain a healthy lifestyle, don't smoke, don't consume excessive alcohol and get enough sleep, research shows you reduce your risk of liver, lung and heart disease. So let's name this investment "choice stock".

But have you ever thought about "MOVEMENT STOCK" ?

You may get to 65 with a strong heart, no cholesterol and no liver disease but they may seem quite useless if you cannot move!

No one is taking this "mobility stock" as a serious contender to their overall health portfolio.

Hence investment is low.

Here are some risk factors that are indicators of a poor mobility investment:

1. Can't cross legs to tie shoe laces (men) and (women) needing to sit down to strap shoes or put on stockings.

2. Neck and low back stiffness upon waking up or going to bed.

3. Headaches - not normal- even it triggered by stress.

4. Can't bend or stoop down to pick up things from floor or need help getting up from floor.

5. My favorite - POSTURE- your posture slouched, stiff or unaware is enough to breakdown the entire movement system.

While you may say I go to pilates, yoga, gym etc. therefore by default my investment is solid.Think Again! If you get a blood test every year even if you go the gym and eat healthy, why are you not assessing to see if your movement system is optimal or headed to breakdown?

Prior to private practice in NYC; I was a Physical Therapist to professional athletes world wide including tennis stars like Sharapova and the Williams sisters. The biggest reward was not having a million dollar athlete miss a match due to a movement breakdown. Preventing an injury is much better than rehab -- as it takes time away from life!

So I urge you big apple residents --- assess your movement stock by scheduling an appointment with a physical therapist- as living in the city is a professional sport!

Renuka Pinto, MPT, PGDR, CSCS, CES

Duffy & Bracken, Physical Therapy

-Serving Downtown NYC for over 24 Years!!

Physical Therapy for the 21st Century!

Physical Therapy never ceases to amaze me. I continue to be a huge advocate for the profession I fell in love with 34 years ago when I observed my first physical therapy session and the patient that was being treated told me that he had back pain for years and that PT cured him. I have heard that story so many times since then, from patients saying they thought they would be in pain the rest of their lives and that they should have come much sooner or that they were told that they would probably need surgery and now they no longer do. The pelvic work we do gives both men and women their life back, by strengthening the muscle to cure incontinence or stretching it to allow a normal sex life.

The future of Physical Therapy is not only to be able to get people out of pain or dysfunction sooner, reduce surgeries and medication use but also to prevent the ever growing need for joint replacements, assisted and nursing home living. This is not only the future of PT but it must be the future of the country. We cannot afford the ever-looming healthcare escalations.

We need to practice progressive and preventative medicine even if our archaic insurance companies and government haven't embraced it yet.

Physical Therapists have so much knowledge to share with you about your bodies and how to prevent future injuries and pain. It is crazy not to seek their help... I certainly do! I have been a physical therapist for 29 years and I know that when I have muscular skeletal pain or I'm having trouble with my sports performance and my instructor whether tennis, skiing, golf etc isn't completely solving the issue, I turn to our sports physical therapist to get the exercise or body correction needed to complete the task. An instructor can teach the correct technique but they don't change your body so you can perform the technique. That takes a physical therapist's knowledge.

This mindset of prevention and getting the help of physical therapists has and will keep me active. So far in my 50 years, I have climbed to Everest Base Camp, Kilimanjaro, the Inca Trail to Machu Picchu, the Milford Sound Trek, hiked many mountains, biked many hills and continue to jump on my wake board, surf board, snowboard or skis plus play competitive tennis and golf, all without incident, and my bucket list is still full. I plan on bucket listing into my 90's. What's on your bucket list and how can we help you continue to play the game of an active lifestyle.

I highly recommend it!

Ann Duffy, M.A., P.T.

Owner