Why Proper Bike Fit is Important

Mountain Biking
We see a lot of cyclists here at PRO Physical Therapy. Let’s face it – we live in Madison! The biking community here is incredible. The trail system is far better than a lot of American cities, and you can pop outside the city quickly and be in the beautiful hills of the Driftless region in no time. How lucky are we? If you’re an avid cyclist, then you’ve probably at least considered getting a professional bike fit. People swear by them. After all, how much time do you spend on your bike? If you’re commuting or road riding, it’s probably a significant amount of time. If your bike hasn’t been properly fitted to you, chances are you’ll want to bike less, and you’ll hurt more afterwards. A proper bike fit is the difference between loving your bike even more, or never using it.

How to Get a Proper Bike Fit

Basically, if you hurt while riding, something needs to change. A proper bike fit can make you so much more comfortable, and even faster on your bike! Bike fits are for everyone – avid cyclist or new riders. A proper fit will help prevent overuse injuries from improper position, and varies from person to person. Depending on your age, style of riding, and physical attributes (flexibility, etc), your bike fit will be different than the next persons fit. While we know a bit about bike fitting and proper position here at PRO Physical Therapy, we always recommend taking your bike to a bike fit professional. In Madison, Stacey Brickson is our go to gal. She’s a Physical Therapist and PhD in Exercise Physiology, and has tailored her work to encompass her passion for cycling. She has a private niche practice here in Madison in a bike shop where she specializes in therapeutic bike fit. We often send our patients to her when they come in with bike fit questions or concerns.

At Home Bike Fit

While we think that it’s important to get fitted by a professional, that’s not always necessary for everyone. We recommend that you make the following adjustments if you’d like to try an at home bike fit first:

  • Size: make sure you’ve chosen the right size frame to fit your height/leg/torso length. There’s only so much a bike fit can do if you’re riding an improperly sized bike.
  • Seat Height: this is an easy one to mess around with. If your seat is too low or too high, this can cause major discomfort. A seat that’s too low can put a lot of strain on the knees, while a seat that’s too high can add unwanted pressure points on the saddle.
  • Reach to the Handle Bars: if this is too far or too short, this can result in a lot of upper body pain. You should be able to sit comfortably on your saddle, and reach the bars/hoods. Your elbows shouldn’t be locked, and your core should be slightly engaged.

Riding shouldn’t be painful. If it is causing you pain, consider getting a bike fit! Any pain, numbness, or tingling are signs of an improper bike fit. Some of these at-home fixes are simple, but if they don’t seem to be working, we definitely recommend calling in the pros!

Woman sitting at desk

New Lifestyle

About a year ago, I had the typical desk job. I was working 40 hours a week at an office, and I couldn’t help but sit. My lifestyle had always been very active, and  I had previously not held office jobs. In college, I worked on multiple farms, was a server in a restaurant and, after college,  was a full time potter. Transitioning to an inactive job wasn’t easy. The toll it was taking on my body was noticeable almost immediately. My office didn’t even have one standing desk, so sitting was (at the time) my only option. My lifestyle was still active, but over time it really started to show. I biked to work, and would go for a run after work. However, I would still be tired and stiff during the day, and it was only getting worse.

I started to go on runs on my lunch break so I could break the day up from all that sitting. That spring, I was training for a half marathon, so it was a good way to log extra miles. Running over lunch became harder than I’d expected. It would take me at least 20 minutes to get warmed up. My legs and joints were stiff, and my hip flexors were tight. I was out of breath more than I was used to, and it really threw me off!

Standing desk diagramMaking the Transition

Finally I decided to get a standing desk. I’d been making faux standing desks at work for the past month or two by stacking boxes on my desk and raising my monitors, keyboard, and mouse. However, it didn’t always work well, and there was a tipping/falling hazard that my boss didn’t approve of…

I finally bit the bullet and bought a standing desk. I got a small Varidesk, but was still able to fit my 2 large monitors on it, along with the keyboard. The change was almost immediate. I wasn’t falling asleep after lunch, and my legs felt better! Before, my legs literally felt like they were dying. I told people I could “feel my muscles disintegrating” (which clearly wasn’t the truth, but some days it really felt like it.)

The Results

It probably took me 2-3 weeks to get used to standing more. Again, not moving is what causes problems. With a standing desk, I wasn’t sitting all day anymore, but I still wasn’t moving. A first, I switched between standing and sitting a lot. As I got more used to it, I would stand for longer and longer. I tried not to lock my knees, and I would “dance” around a lot to keep from getting stiff. Sometimes, I stood on something softer (a foam pad I brought in) and that helped my legs/feet not hurt too. It was definitely tiring, but that felt good. Much better than when my muscles were “disintegrating!”

The biggest thing I noticed was that running was easier. I could pop out for a quick run and be at my pace right away. It felt amazing. Hills or sprints weren’t a problem either, and I wasn’t dragging for the first 20-30 minutes anymore. All in all, it was a game changer. I recommend getting a standing desk to everybody who has a desk job!

Taking Action

Interested in your own Office Ergonomics assessment? We can help! We offer both in-clinic and in-the-office assessments, and can help get your in a better position for your body. Call us today to schedule your own assessment!

Dave Playing Pickleball

I know this isn’t a basketball image, but it’s a picture of me as a practicing “aging athlete” so I thought it’d do!

As an aging athlete, I know what it is like to have aches and pains. I exercise regularly so I’m used to some daily discomfort. But this time was different. Here’s what happens when the PT gets injured.

I was playing basketball with some friends and our kids recently while we were out of town. I saw a 7-foot tall hoop, and knew I had to try to dunk the ball. I took off on 2 feet, touched the rim, and then felt the worst thing I have ever felt in my life… my quad rip. After I landed, I knew exactly what I had done. Immediately, I felt for my quad tendon, because if it was torn I’d have to have surgery.

This scenario is a common thing that happens to us as we age. People get injured all the time. What I want to talk about is how I managed this. After an injury, getting into Physical Therapy RIGHT AWAY is one of the most important things you can do. I was out of town when this happened, but needed to be treated right away. Since this was a musculoskeletal injury, it was right up my alley to treat. I didn’t think there was any need to go a doctor. That being said, you may often feel the need to go to a doctor for an overexertion injury like this. That’s ok too! This hurt more than anything I’d ever done before. This time, however, I decided that I could manage it myself.

First, I used ice (right away) for 20 min on, 20 min off. I did this three different times that first night. Icing with my leg bent could keep it from scarring too much. The next thing I needed was some compression. I went to the pharmacy to find an ace bandage and crutches. They did not have an ace bandage so instead I bought some Coban Wrap. Compression can help keep the bleeding to a minimum. I used a sock and wrapped my leg with Coban Wrap.

Two days later, I returned home and started to work on it. I did a lot of soft tissue work, kept using ice, taped it, used pulsed ultrasound, and I even dry needled myself (please don’t try that at home)!

I’m about two weeks out and doing better. I’m not there yet. I can walk and bend my knee but still can’t go up or down steps very well. However, the daily treatment has helped immensely. I know that this injury may take 8 weeks to fully heal, but if not for early intervention I would be in trouble.

So, what is the morale of this story? Get in to see a Physical Therapist RIGHT AWAY after an injury. We have been through this, and we are here to help!

David NissenbaumStay well and happy healing,
Dave

We’re seeing more and more people itching to get back out on the trails as spring approaches. This can mean that we will start to see a lot of people coming in with hip pain or hip injuries…

If you’ve taken the winter off from running – be careful when jumping right back in. We recommend you prepare for running season again with some basic strength training exercises to keep yourself injury free!

In the video below, Jaime takes us through 3 exercises that we use to treat hip injuries. These exercises cover mobility, strength, and endurance.

First, you need good flexibility or range of motion. Exercise 1 above is called “the couch stretch.” Make sure your hips are square, your pelvis is tucked, and your glutes are engaged. Do this exercise morning and night.

Second, you need strength and control through that range of motion. The second move focuses on hip extensor strength and power. It also engages the core, and uses rotational control in the hip. Do these 3x a week while watching TV!

Third, you need endurance. This last exercise is a single-leg dead life variation. It focuses on hip control and endurance.  It integrates the whole limb – some people will feel it even more in the feet and ankles than in the hip! You can do these 3x a week – hold for 20 seconds and repeat 3-6 times on each side. If you’d like to wake up the hip a little before a run, you can also use this one as a warm up!

Each of these exercises starts with basic movement, but has variations that you can build to as you gain strength. Watch Jaime’s video above for a demonstration of each variation, and tips on how to get the most out of these exercises.

Shoveling SnowWinter is upon us and now our driveways and sidewalks are covered in snow. It’s a good time to consider how your snow shoveling routine may be impacting your physical health. The most common injuries associated with snow shoveling include sprains and strains, particularly to the back and shoulders.

There are a couple things to keep in mind as the winter season finally hits us:

  1. What snow shovel is best for me?

    • When purchasing a snow shovel a few things to look for include; the height of the shovel, the overall weight of the shovel, the width of the blade, and the shape of the handle.
      • Not too short and not too long: use a shovel that allows you to keep your back straight
      • A lighter shovel (plastic vs metal blades or fiberglass vs wood shafts) will also decrease the amount of stress placed on your back, as the snow can be plenty heavy on its own
      • A smaller blade will decrease the amount of snow removed at one time, but will lessen the load and the amount of strain on your back
      • Bent-shaft vs straight-shaft handle: a bent-shaft snow shovel can likely reduce lower back stress as it decreases the amount of motion required by the back
  2. How should I shovel?

    • When going outside to shovel, there are a few things to remember:
      • Warm-up before going out
        • A warm body/muscles work better. Your warm-up should include 5-10 minutes of light aerobic activity to get your blood moving, followed by gentle stretching.
      • Maintain good stable posture
        • Pay attention to your posture. Stand with your feet hip width apart and staggered. Hold your shovel close to your body.
        • Space hands apart to increase leverage. Bend from your knees and hips, not your back.
        • Make sure you tighten your stomach muscles and avoid twisting while lifting (push snow rather than lift if possible).
        • Preferably walk to dump snow, but if throwing, throw forward and step in the direction that you are throwing.
      • Pace yourself
        • Shovel for 5-7 minutes and rest 2-3 minutes. Start slow and continue at a slow pace. When snow is deep, shovel small amounts 1-2 inches at a time. New snow is lighter than packed/partially melted snow, so it’s better to get out early and more often.

Ultimately, TRY before you BUY. Make sure the shovel fits you and your body. And always warm up before going out! Try to avoid excessive motion to your low back by using your legs and hips more. And don’t forget to take rest breaks!


Sources

https://www.moveforwardpt.com/Resources/Detail/snow-shoveling

https://www.toronto.ca/community-people/public-safety-alerts/safety-tips-prevention/home-high-rise-school-workplace-safety/snow-shovelling/

https://www.ncbi.nlm.nih.gov/pubmed/23845725

My Knees HurtWe get this question all the time. “I’m in my 40’s and want to exercise but the next day I am miserable” or “I played tennis and basketball and now my knees are really sore” or “I can’t go upstairs easily, and I’m really sore when I’m sitting for any length of time.” You may think you need knee surgery or to have a knee replacement to get this pain to go away. But this is not necessarily true. Let’s take a look at your options.

Why do my knees hurt?

Before we talk about why we hurt, we need to talk about normal anatomy first. Our knee joint contains 2 parts: the tibial/femoral joint and patellofemoral joint. The tibial/femoral joint connects the femur and the tibia together and the patellofemoral joint is the kneecap in front. We have different ligaments that connect the bones together, and a meniscus that sits between the tibia and the femur. These can get injured with trauma. The biggest thing that we have on each part of the bone is called articular cartilage. Articular cartilage is usually what wears away with age and intense physical activity. It acts as a coating for our joints just like coating on our pots and pans when we cook to protect food from sticking. As we age the articular cartilage wears down and can start to cause pain. (Ahh=articular cartilage – that’s the reason why I hurt!) So, here is the question I always get: should I stop exercising? The answer is NO – that will do the opposite of help in this situation. Instead, there are things we can do to hopefully keep you from needing surgery. Staying active with Physical Therapy is very important. With the right treatment plan and exercises, we can help you get back on track.

What can PT do to help?

There are a number of things that Physical Therapy can do to help those achy knees. Here are a few:

  • Manual Therapy – our focus is on unloading the knee and taking pressure off your joints
  • Exercises that won’t aggravate the knee
    • these include hip drills: clams, clam lifts, band walks, RDLs, planks, etc (we give examples of these on social media and in our monthly recommended exercises)
    • try to avoid exercises that will aggravate the knee (deep squatting, stepping down from something, etc)
  • Wearing a Knee Sleeve – this can be helpful during activity to keep your knee warm and calm down your symptoms
  • Taping – this is a great way to help your symptoms as well
    • we can be specific to just your kneecap, or your tibial/femoral joint too, depending on the areas affected

If you have knee pain and have been avoiding getting treatment/diagnosis, come see us. Our job is to get you back to where you belong – as quickly as possible! Schedule an appointment here.

Return to SportPRO Physical Therapy is hosting its second Return to Sport/Athlete Development Program. This athlete development program is meant to bridge the gap between rehabilitation and sport. Additionally, it will prepare athletes for a step up in competition, because we are focusing on risk of injury.

The program will be coached by a former Oklahoma City Thunder and Golden State Warriors strength and conditioning coach, and our very own Jeff Schleusner, Physical Therapist.

The class is limited to nine athletes. We are directing this towards female athletes who make up a higher risk category for injury. However, everyone is encouraged to participate if interested. The program will consist of 10 sessions that run from February 18th – March 15th. There will be two sessions per week on Mondays from 6-7:30pm, and Fridays from 4:30-6pm. The cost is $350 for all 10 sessions.

If you’re interested in learning more about our athlete development programs or registering for this course, please contact PRO Physical Therapy (608) 841-1290 to reserve your spot today!

Return To Sport

In-Season Training

Boys and Girls high school basketball seasons have kicked off and teams are into their conference schedules. Questions often arise concerning how often and how intense in-season training should be for teams. This is a topic that is worth hours of discussion.

Here are a few key things to consider:

  1. BasketballHopefully the players trained hard in the off season to build up strength, speed, and reactiveness. This will better prepare them for the season. Athletes need to be stressed in the off-season so they can adapt to handle the new workload once the season starts. It’s almost like building up a strength ‘reserve’. Players that stress themselves to the point of adapting in the off-season will likely have a larger reserve to draw from as the season begins. However, the qualities built during off-season training need to be trained in-season as well. In order to maintain qualities in-season, players need to train their bigger strength lifts every ten days. That means finding a time within the game schedule to program intense strength sessions. The players will need to lift > 90% of their maximum lifts.
  2. Recovery and response to injury drives everything. For the players getting lots of game time, overall volume needs to be lower. For players not getting as much playing time, coaches need to be careful not to let them become deconditioned. The individualization of workouts within the team will really spread out as the season progresses. There will be players who can continue to progress strengthening during the season, and others that need to be dialed down.
  3. Sleep, diet, academic stress, and mood should all be monitored for each player during the season. The best strength training plan in the world will fall apart if these four areas are draining a player’s reserve.
  4. Track RSI (4 hop test), maximum vertical jump, and even how players are handing some of their bigger lifts (squat, dead-lift). This will give a coach a decent measurement of where the team stands in terms of neuromuscular readiness. If these numbers start diving, workload needs to be adjusted.

Overall, teams that enter the season having been properly stressed to handle demands will be the strongest. Those that are given managed stress during the season to help maintain important athletic qualities are the ones who are most fresh in late February and March. They’ll likely be less injured and closer to their peak physical ability as tourney time begins.

Many clients come to us with back pain – and if you’re like 80% of Americans, you’ll experience some sort of back pain in your life time. A weak core is often the reason for this – and includes a fairly simple fix. Below we share our top 3 core strengthen exercises. Do these 3 times a week for a strong, healthy core and back!

Front Plank

Front PlankEveryone knows this move – and loves it right? Ok, front planks might not be your core strength favorite, but they are one of the all time best core exercises because they engage multiple muscle groups simultaneously. They will tighten your tummy, improved your posture, help your balance, and even lessen back pain. For a strong front plank, make sure your hips and shoulders are in line with your ankles. Your shoulders should be pulled together and down your back, and your butt should be tucked. Neutral spine alignment is key! Hold for 10-30 seconds a set, and repeat as able.

Side Plank

A sister to the front plank, side planks are equally as important. When you shift from a front plank to a side plank, you are reducing your contact with the floor. This creates a more challenging balance. The extra effort required teaches you to use stabilizing muscles around your spine, hips, and shoulders. Make sure there’s a straight line between ankles, hips, and shoulders. Then, pull against the floor toward your feet with your elbow. You might begin to shake, but that just means it’s working! Hold for 10-30 seconds a set, and repeat as able.

Paloff Press

A lesser-known core strength workout, the Paloff Press is one we should all be talking about. Many people believe that great abs result from movement-based exercises, like crunches, leg raises, etc. Instead, the core muscles are actual stabilizing muscles. Rather than just being the 6-pack we often think about, your abs extend from just below your chest all the way down and around to your glutes. Known as a “corset of muscle”, it not only gives people a defined, tight core, but also stabilizes the spine and disks, and protects them from unnatural bending or twisting. The Paloff Press works your entire core, not just the front section we often focus on.

To perform this exercise, attach a band to a door handle or table leg. Clasp both hands, palms together, on the end of the band. Place your feet hip-width apart, and make sure your knees are slightly bent. Bring the band up to the center of your chest, and keep it taught. Extend your arms slowly and fully. Your body will want to lean toward the band – don’t let it. Return your hands to your chest, and repeat for 8-12 reps on each side.

There’s a few things to keep in mind with the Paloff Press. Make sure you aren’t locking your knees. Aim to fully extend your arms, and move slowly in both directions. And brace your entire core to resist the pull from the band. Don’t forget to do both sides!

FamilyDinnerToast

The holidays can be a stressful time for everyone. Not only do all your work projects seem to suddenly need to be wrapped up before you leave, but then there’s travel plans, meal plans, gift shopping, and of course – family plans. Finding balance during the holidays can come in many forms, and is different for every person. Below are our favorite things we recommend you keep in mind as you enter the holiday season.

Vacation PlanningTake Vacation

This is very important, and often overlooked. Even from the time you start planning a vacation, your mood lifts. Studies show that adults who haven’t taken a vacation in several years have a 30% higher risk of heart issues than those who have taken a vacation from work. Get as much work done as you can before the holidays, and then take a break!

Stay Active

This is a big one. The holidays can involve a TON of sitting. Here are some fun ideas for you and your family – instead of watching TV all day!

  • Go for walks with family. You can take breaks between movies or shows on the TV and take a lap around the block. Even better, find a place nearby to hike for an hour – getting outside brightens your mood, and fresh air is refreshing! Plus, the endorphins released in physical activity will definitely come in handy later when your great uncle so-and-so inevitably tries to bring up politics over dinner…
  • Sign up for a charity run/walk as a group! Again, this will get you outside, and provides a fun social activity to do as a group. And these charity walks generally support a good cause.
  • Volunteer for a local charity. Food pantries often need help packaging holiday food baskets for local families in need. Some stores look for gift wrappers, or help with food/toy drives. Or, you can set up a caroling group and visit a nursing home! Any way you slice it, helping others while spending time with your loved ones will only make you feel better. We should all try to brighten others’ holidays.
  • Attend a donation-based yoga class. Or, if you can’t find one near you, get everyone in the living room in stretchy pants and put on a YouTube yoga video. Getting everyone up on their feet and moving will feel good, and you might even find it giggle-worthy. Light stretching and twists are helpful for those tight muscles after all the travel you might have done, and it’s also great for digestion!

Maintain Your Sleep Schedule

AlarmClockIt can be very tempting to stay up till all hours of the night catching up with family and friends that you haven’t seen in a while. However, maintaining your sleep schedule is important. Our bodies crave consistency. With regular daily activities, our various body systems are able to prepare for and anticipate events. We naturally become more alert closer to our wake-up time. Our digestive systems become activated in advance of regular meal times in order to more efficiently process food. We start to relax and become sleepy prior to bedtimes. It turns out that these regular daily events serve to anchor our underlying daily rhythms. Maintaining a normal sleep schedule will help all of your body’s system run at peak efficiency.

Say No

It’s as simple as that. Whether said to your coworkers or to your friends and family, saying “no” is an important act to practice. Only you know what’s too much for you during the holidays. Don’t be afraid to decline more work, turn down responsibility, or move meetings that will push you over the edge. You’ll actually have more to give if you’re taking the time to care for yourself and your family! Set your limits and say no as needed,

Cook Together

ThanksgivingDinnerThis one may not be for everyone, but it can still be a fun activity that doesn’t involve sitting, the TV, or being distracted by cell phones. It’s a great way to save money, and you’ll probably feel better than when you go out to eat. If you have nephews or nieces, this can be a fun way to bond and involve them. Google some recipe ideas and get started!

Take Breaks

If you’re around too many family members that you aren’t used to, this can stress anyone out, especially those with heightened anxiety. Take a walk by yourself or go to the gym if you know that might help. You’d be surprised what getting a few endorphins and some exercise can do for your patience. If you know that 2 days with your in-laws is all you can handle, plan to stay only 2 nights. Setting rules that you know fall within your limits isn’t just beneficial to you – it’s also respectful of everyone else. You’ll be more pleasant in your time together, and they’ll enjoy you more because of this.

More important than all these warning signs, have FUN! The holidays are a wonderful time for families, especially those with children. Enjoy every moment!