Perform Better by Relaxing More!

While the title of this blog is absolutely true, I chuckle as I suspect that the benefits of relaxation it promises might appeal to New Yorkers living a fast-paced lifestyle. My colleagues agree that while many of our clients report having difficulty relaxing, many also confess great relief taking a break to focus on their body.

According to the Mind/Body Institute at Harvard University, 60-90% of medical visits per year in the US are for stress-related disorders. Many conditions we treat clients for have a stress-related component. So how can you get those tense muscles in your neck, back or pelvis to relax?

Often in physical therapy treatment, we recommend a course of progressive relaxation on a daily basis for a minimum of 8 weeks, which is the length of time studies have shown to have long-term effects. It makes sense to treat the nervous system which may be out of balance due to chronic pain or stress, both of which trigger the autonomic nervous system’s sympathetic fight or flight response. The body responds in predictable ways under these conditions. To name a few: breathing becomes shallow and more rapid, heart rate and blood pressure increases, digestion slows and becomes more acidic, and concentration and memory are decreased. Plus, prolonged stress inhibits the immune system from fully functioning.

The good news is that the autonomic nervous system also has what is called a relaxation response (controlled by the parasympathetic division). This is not just the absence of the flight or flight response but an actual process that the system “does”.

After regular daily practice of progressive relaxation or other techniques such as meditation, yoga or breathing exercises, one can expect to experience a more natural calm, increased ability to concentrate and solve problems and increased resilience to stressful conditions. Studies show that a long list of medical conditions can be improved with these practices. While other interventions may be important or beneficial to address sources of stress, progressive relaxation can be a helpful adjunct to any of those interventions.

I usually recommend using a recording (the one our practice uses is 25 minutes long) as one falls asleep at night since it may be the only time you lie down to relax without doing anything else, and also to improve sleep quality, since during deeper stages of sleep we replenish neurotransmitters needed for coping with stress or pain. I’ve also found it enjoyable to listen to the recording while commuting on the subway or even walking -- why not learn to relax while you are in motion?

If at times during practice of progressive relaxation you experience challenges in your ability to maintain focus, letting go of tension or discover tension that results in you feeling less relaxed, realize that with intention and practice you will improve these skills.  Also the nervous system takes time to adapt so results may take minutes or repeated practice, and “more relaxation” versus “perfect relaxation” constitutes success.

Overall this healthful practice is fairly simple to implement and has a wide range of health benefits. Once you’ve discovered whether it works for you, it’s a practice you can return to throughout your life. 

Sara Chan, PT, CFMT

Duffy & Bracken Physical Therapy

Is Your Home Exercise Program Really Necessary?

 I asked my Dentist years ago if I really had to floss my teeth regularly. His reply simply was, “only the ones you want to keep.” Ever since I’m a flosser! When a physical therapist gives you an exercise, activity or stretch it’s a lot like flossing… It’s in your best interest to do them and to do them every day unless your PT states otherwise. Your home exercise program (HEP) and your postural corrections are as important to the success of your therapy as is the massage, ultrasound or joint mobilization. The HEP is not only designed to correct muscle imbalances but in the long run, and sometimes short-run, helps reduce your pain and keep it from coming back. 

     I used to be a massage therapist and I would get a lot of  “PT drop-outs.”  My clients/patients would say things like, “PT didn’t help me at all. I still have pain, that’s why I’m here to see you.”  I would ask if they did their HEP. Often I would hear, “No, was that really so important? It was so boring and I didn’t have time.” I think from the patients’ point of view it’s easy to feel that way. Your PT gives you these exercises and some of them may indeed feel really boring and inconvenient to do. However, what is more inconvenient, the pain that can keep you up at night or the exercises?

     It is important to remember that a therapy program is usually not an overnight process. Typically patients come to us with groups of muscles that are weak or dysfunctional (Even athletes! Especially athletes!), and in order to help stop the pain, we need to improve the strength/performance of those muscles. Improving strength typically takes 4-6 weeks when the exercises are done regularly. So, we ask you to please hang in there and be patient with your exercises. The results are not over-night.  This is true particularly when we are trying to break poor postural habits and inspire new ones.

     On the other hand, we need to know if the HEP is increasing your pain as you perform it and if so how much. It should not increase your pain significantly so if the next day you wake-up after your exercises and the pain has shot up a lot, you need to tell us. As it relates to your HEP and your symptoms, it’s good to ask yourself: “When does the pain come on? …… When I’m sitting, laying down, running, washing my hair or right after my HEP.” Being clear about what aggravates your symptoms really helps us identify the culprit. 

     Lastly, look at the exercises this way, you will not only be proud of yourself when you stick to it, but you’ll look better and feel stronger. Also some of you ask if you’ll have to do these exercises for the rest of your life. The answer is not necessarily, but you should want to keep strong for the rest of your life anyway; look at the exercises like a tool that’s helping you keep healthy and away from pain. It’s a win, win situation!

John Howard (Johann), DPT, LMT

john@duffyandbracken.com

Duffy & Bracken Physical Therapy

Make Sitting at Your Desk a Great Core Exercise!

We all have to sit too much these days and we are seeing the effects on our bodies. Poor posture and prolonged sitting can cause neck, back, shoulder, wrist & hand, hip & knee problems. Strengthening the core - the muscles that support the spine - helps to prevent these muscular-skeletal problems and the poor posture that accelerates them.

Here are some tips on how to make sitting a dynamic exercise:

1. Practice sitting up tall, like you are being pulled by a string from the center of the top of your head and hold that position for as long as possible each hour you have to sit.

2. Set up your work station so that it promotes tall sitting, placing your computer screen at the height you would look at it when you are sitting tall.

3. Keep a ‘Swiss Ball’ -also known as a 'Theraball'- in your office to sit on for periods of the day. Use it during lunch to stretch & do a few exercises. (see pics below)

4. Drop a leg down as if in a lunge intermittently throughout the day. (see pics below)

5. Sit on your feet for short periods of time if you can tolerate this. You will know when to stop, as your feet will go numb.

6. Turn your chair around & straddle it. Every kid knows this is more comfortable!

7. Get up 2-3 times an hour, as you sit better when you first sit down.

Sitting doesn't have to ruin your body especially if you follow these tips. Don't forget to get 30 minutes of exercise 5 days a week, eat right, get 7-8 hours of sleep & laugh a lot!

Here at Duffy & Bracken Physical Therapy we help our patients to stand tall & beautiful. We recommend the Theraball to our patients who are returning to work after spinal fusion, acute disc and lumbar surgery. We see a 95% success rate with patients who commit to our step-by-step back care program. Additionally, we have a Posture Training program available to all our patients. This program teaches you how to correct your posture and make the changes necessary to maintain good posture throughout your lifetime. Check out the program at www.duffyandbracken.com.

Ann Duffy, MA, PT

Owner of Duffy & Bracken Physical Therapy & Wellness

Olympic Dreams - My Snapshot Memoir!

The Olympics have always fascinated me…the glory, the prestige and most of all, the honor! I was fortunate enough to be able to live my Olympic dream four years ago during the games at Beijing.

August 2008 – I will never forget stepping out of the plane as a Physical Therapist and following the color-coded lines through immigration and customs at the airport. When you came through the doors there were people to greet you and whisk you away to the Village— YES the ‘OLYMPIC VILLAGE’ was to be home for the next 2 weeks.

I lived in a 3-bedroom apartment, which I shared with the Indian team. Across the street was the recreation area with video game arcade, soda machines and an Internet café. The courtyards were magnificent with its stone and water features, murals, flowers, trees etc. Everywhere and anywhere you looked embodied the spirit of the Olympics—higher, stronger, faster. A 5-minute walk down the street was the cafeteria…the size of 3 football fields if not bigger. Here you we were all equals; standing in line at a food cuisine of your choice. There were stations for fruit and yogurt, desserts, fusion, Asian, Mexican, Middle Eastern, Grills, BBQ and good old McDonalds.

Here you were just another Olympian --- it was here that I got to meet Kobe Bryant and the USA women’s volleyball team. One night I sat next to the Greek men’s basketball team, the next night I caught a glimpse of Usain Bolt getting dinner. I would try and guess an athletes sport based on their build as they walked by with food trays ;-))

The gym and fitness center was an absolute treat to me as I watched various sports train all under one roof, every athlete pushing themselves to their potential, reaching for the best they can be. In the evening I hung out at the players area where we played foos ball, shuffle and air hockey --- just being people

My most memorable moment would have to be the opening ceremony---walking around the birds nest stadium in my colors behind the flag, the flashing lights in the arena, the deafening sound of the crowd, the performances – the drummers ---I still feel the enthusiasm and the sheer pride of being a part of something so spectacular.

My most cherished moment would have to be the long-lived tradition of the pin exchange. You see the Olympics is about brotherhood and friendship – so one exchanges pins of one’s country with a person from another country. You got to share a story, you learnt where they were on the map, you said a greeting in a new language, whatever the exchange – a memory every single time. Some of the pins were more beautiful and ornate than others, some fun amd others were just special. I could go on and on --- what I have besides my memories – are my badge, my Olympian bag, my colors and my pins. 

 Since the 2008 Olympics I have joined a new team, here in New York at Duffy & Bracken Physical Therapy. Were I am proud to help our patients become pain free and assist them in becoming “Olympians” in their own right. If you would like to see any of my personal memorabilia and hear more tales…. head down to the clinic where they will be on display to celebrate London 2012.

Check out some pictures below of my Beijing 2008 Olympic experience:

Avoid Injury by Steering Clear of the Terrible Toos!

It is that time of the year again... The time when runners begin training for the abundance of Fall marathons all over the United States. It has been said that approximately 1/3 of all individuals training for a marathon will never cross the finish line, or for that matter, even make it to the starting line. The reason? Injury, most likely due to over training. 

Every research paper and expert agrees that —"training errors"—are the number one cause of self-inflicted running injuries. Runner and Sports Podiatrist, Stephen Pribut D.P.M., warns runners to beware the "terrible toos"—doing too much, too soon, too fast. The body needs time to adapt from training changes and jumps in mileage or intensity. Muscles and joints need recovery time so they can recover and handle more training demands. If you rush that process, you could break down rather than build up. 

Most marathon programs will build up your running mileage 10% per week for an average 16-week program. Yet, there may be times when even a modest 10% increase proves too much. Biomechanist Reed Ferber Ph.D., an assistant professor in the faculty of Kinesiology and head of the Running Injury Clinic at the University of Calgary, found that most 16-week Canadian programs push the mileage too hard. Meanwhile, his clinic's nine-month marathon training schedule for first-timers increases mileage by just 3% per week. "We have a 97 percent success rate getting people through the entire program and to the marathon finish line," Ferber says. 

Keep these few tips in mind and be injury free come race day.

Increase your weekly and monthly running totals gradually. Use the 10% rule as a general guideline, but realize that it might be too aggressive for you—especially if you are injury-prone. A 3-5% increase might be more appropriate. And remember that mileage isn't the only issue. Experts point out that an overly aggressive approach to hill running, intervals, trail running—or, any change in your training habits—can produce problems. Keeping a detailed training log can help you gauge your personal training threshold. Record your weekly mileage and how you feel after your runs. Look for patterns and listen to your body!  More is less when training for your first marathon.  

Greg Minnis, DPT

Ann Duffy Featured in Ladies' Home Journal

We are very excited to share the July 2012 issue of Ladies' Home Journal. In it Duffy & Bracken owner, Ann Duffy is featured in the article 'Keep Your Hips & Knees Happy'.

Click on the link below to check out the article. It is a great read on staying physically strong while avoiding injuries.

http://www.lhj.com/health/news/happy-hips-knees/

Team Duffy & Bracken at the 2012 Arthritis Walk

Thanks to everyone who helped us to support the Arthritis Foundation by walking with us or donating. It was a beautiful day! It's amazing how quickly you can walk three miles when you are doing it for a good cause and you have people with you to share the moment.

 

Kieffer Pearce

Director of PR & Marketing

Duffy & Bracken Physical Therapy