Rules of Stretching

As you exercise and play sports, do you take time to stretch? As most people are short on time, the first thing to get cut from a workout is the stretching component. As physical therapists, we recommend that you don’t cut the stretching out as this can lead to an injury. Check out the stretching rules below to learn what you should focus on when you stretch:

  1. Perform a dynamic stretch (no holds) prior to your workout that mimics the sport or exercise you are about to participate in.
  2. Perform a dynamic stretch for a minimum of 5 minutes prior to your workout.
  3. After your work out, perform static stretches (hold stretches).
  4. Perform static stretches in all the major muscles groups you just used during your workout.
  5. Hold static stretches for 15-60 seconds for 2 repetitions each.

In summary, you can complete dynamic and static stretching for your workout in approximately 10 minutes. That 10 minutes is crucial to not skip as this could save you from an injury that could last weeks or months.

Written by Dr. Amanda Macht- owner of Harbor Physical Therapy

3 Easy Stretches for Heel Pain

If you suffer from heel pain, it may be caused by a condition called plantar fasciitis. The plantar fascia is a thick band of tissue that runs along the sole of the foot from your heel to your toes. Repeated stress to the foot can cause inflammation to that band and cause sharp pain in your heel. This pain may feel worse first thing in the morning or when you are on your feet for long periods of time.

One part of treatment for plantar fasciitis includes stretching the tissue and muscles in the foot and calf to decrease tension around the heel. When performing these stretches, try to hold them for 30 seconds each, repeat 3 times, and perform them 2-3 times a day.

Seated Stretch- while sitting with your foot crossed over your other leg, pull your foot and toes back towards you.

Runner’s Stretch- while standing in front of a wall, place the foot that hurts back behind you and push your heel towards the ground.

Stair Stretch- while standing on the edge of a step, drop your heels down until a stretch is felt in the calves.

If you would like to learn more about how to get rid of your heel pain, contact Harbor Physical Therapy

How Do I Start Running for Exercise?

While the act of running itself is quite simple, finding and getting into a routine of it can seem daunting and difficult. But no fear, today we are going to discuss a few tips to get you ready to run!

  1. Invest in a good pair of running sneakers – This is the one piece of equipment you need to run, so do yourself (and your legs) a favor and buy a good pair of sneakers. Your best way of finding the right shoe for you is to go to a sporting goods store or a running store, there you will find people who can help guide you to your perfect shoe.
  2. Start small and slow – Start by just running a block or a lap around a track and see how you feel. A good way to build endurance is to split your workout into run-walk-run-walk, etc. Another way to build up to increased distances is to give yourself a target and then go a little further; example: aim for a tree in the distance, then once you get to the tree go for the next building/mailbox/driveway etc. As you build endurance you will be able to push yourself farther and farther.
  3. Set a goal- Give yourself something to work toward! Get some friends or family and sign up for a fun laid back 1miler, 5k, etc. Community held races can be a great way to learn to pace yourself and meet other runners in your area.
    If you would like to learn more information about how to start running consistently for exercise, contact Harbor Physical Therapy and one of our physical therapists can help create you a running program.

Tips for Staying Active this Summer

Summer is just around the corner and with COVID-19 restrictions continuing to be lifted and the weather getting nicer, more and more people are headed outside to get some fresh air and exercise. While summer comes with more consistent warmer and nicer weather, it can also pose some challenges to daily workout routines. Here are some tips to stay safe and stay active this summer!

  1. Stay Hydrated– As temperatures continue to rise, remember to keep drinking water before, during and after your workouts. If you are engaging in more vigorous workouts, be sure to not only drink water, but also sports drinks to help replenish your body’s essential electrolytes (however, be sure to buy sports drinks low in added sugars).
  2. Save Your Skin– While you are moving around and not just lying in the sun, you are still at increased risk of getting sunburnt. Be sure to apply sunscreen prior to participating in any outdoor activity and reapply as necessary. For additional sun protection you can also add in wearing a hat and/or sunglasses to help protect your body from the sun’s rays.
  3. Time is Key– If your schedule is flexible, try working out early in the morning or later on in the evening to avoid increased exposure to the sun and the heat. If you do end up exercising in the middle of the day, be sure to take the above steps as well as listen to your body if it needs a break. You could also opt to take your workout indoors and do a circuit or a workout video.
  4. Plan Ahead– If you know it’s going to be a hot one and you are still planning on adventuring into the outdoors, be sure to be prepared and plan ahead. If you are taking a hike or going on a picnic, be sure to bring extra water, food and sunscreen with you. If you are going on a walk or a run, try to plan a route that has a lot of shaded areas, access to water, or even bring water with you.

Take a Dip– Planning on hitting the pool this summer? If you do, try doing a pool workout! Almost all exercises you can do on land you can also do in the pool. Advantages of pool workouts include increased buoyancy and availability of graded resistance. Be careful not to overdo it. Exercises in the pool can feel easier than on land so you may be tempted to do more, so be sure to progress yourself as tolerated.

Written by: Dr. Taylor Ryan

Eat Well, Feel Well

As we age proper nutrition becomes essential, however, getting older also can come with barriers to healthy eating habits. These barriers can include lack of appetite, decreased thirst and decreased sense of smell and taste. These barriers can be caused by a wide variety of factors, including medications and a sense of social isolation. Overcoming these barriers can be difficult, but with an open mind, positive attitude, and possibly a little bit of help, healthy eating habits can be achieved. Below you will find some tips on how to make some healthy changes to your diet. Please be sure to contact a health care provider before making any serious changes to your diet

  • Choose nutrients over calories- While those chips and candy bars may seem more appealing, they have what are considered “empty calories”, meaning they contain calories but very little nutritional value and will only sustain your hunger for a small period of time. If you’re craving something salty, try grabbing a handful of nuts or seeds instead of the bag of chips. If you have a sweet tooth, instead of going for the candy bar, try going for a piece of fresh fruit or a handful of dried fruit. These alternatives will still satisfy your cravings, while also fueling your body
  • Go for the H20- Remembering to drink water can be hard, especially if you have a decreased sense of thirst. A good way to help increase your water intake is to get a water bottle or a tumbler and always have it near you; that way you don’t have to get up and go to the kitchen, you can just reach over and take a swig or two. Another trick is to make it like a game- keep a tally in a notebook or on a whiteboard for how many cups/bottles of water you drink a day. Having that visual can help not only remember to drink water, but actually make it more enjoyable.
  • Stimulate the senses- If you have a lack of appetite due to decreased sense of smell or taste, this tip is the one for you. One way to boost your appetite is to have your food appeal to your other senses, like sight. Studies show that using bright colored vegetables and fruits in your meals can help increase your appetite and subsequently also make your meal healthier. You can also spice things up with different flavors and seasonings to enhance your taste buds. This does include salt-while salt may make your food taste better, too much of can cause/worsen certain heart issues. Instead, try grabbing spices like cinnamon, paprika, and curry, or herbs like cilantro, oregano and basil. 
  • Small and steady- You may not have the appetite for three large meals a day, and that is okay! Smaller and more frequent meals and snacks can still provide you with a sufficient amount of nutrients. When doing this, you want to be sure you are getting enough calories to meet your body’s needs, but also meeting your nutritional needs. Some examples are having a small breakfast of yogurt or oatmeal with some fruit, nuts or granola on top, or a lunch of a salad with dark leafy greens, veggies and seeds. 
  • Get moving – If you find yourself not having much of an appetite, get up and get moving! Along with its many other benefits, physical activity can help increase your metabolism and make you hungrier. Regular physical activity is also beneficial helping with proper food digestion and preventing constipation.

Written by: Dr. Taylor Ryan

Which Should Come First: Weightlifting or Cardiovascular Exercise?

As most people know, a combination of weight lifting and aerobic/cardiovascular exercise is recommended by medical professionals to enhance health and longevity. Because most of us don’t have the time nor energy to space out workouts into multiple gym sessions per day, a common question arises: should weights or cardio come first?

The answer, like most things health and fitness, is not entirely straightforward and depends largely on your individual goals. If you’re an endurance athlete or someone who just prefers to prioritize aerobic exercise, it’s recommended that you do your cardio prior to weight training in order to optimize aerobic performance and cardiovascular fitness. Performing exercise in this order is also shown to increase post-exercise energy expenditure (i.e., more calories continue to be burned even after you finish working out).

On the other hand, if you’re a powerlifter or simply someone who prefers to lift weights, doing so prior to cardio is shown to maximize muscular strength and size gains. Weightlifting prior to cardio is also recommended in older individuals as age-related declines in muscle mass that hinder aerobic performance may be mitigated when workouts are structured in this fashion.

Here’s the main takeaway: choosing whether to do cardio or strength training first depends on your fitness goals, but either way is shown to confer great health benefits. So the choice is yours!

Written by: Dr Scott Newberry

How to Prevent Carpal Tunnel Syndrome

As more of us work from home, we are at a higher risk of developing overuse injuries including carpal tunnel syndrome. This is a common condition that is associated with pain, numbness, and tingling in the wrist and hand. This occurs when the median nerve, one of the major nerves that travels through the forearm and hand, becomes compressed as it travels through the carpal tunnel in the wrist. Common causes of this compression and irritation to the nerve include repetitive hand and finger use when typing and writing as well as poor wrist and hand positioning while performing these activities. Here are some suggestions to help prevent and treat this condition:

  1. Take breaks – If you find yourself doing a lot of typing throughout the day, make sure that you are taking a 10 minute break from typing every hour at the minimum.
  2. Keep your wrists neutral – Avoid excessive bending of the wrists in either direction to avoid increased compression on the nerve. As you type, try to keep your wrists in a neutral or slightly extended position
  3. Focus on posture – The positioning of the rest of your body, including your head, neck, and shoulders can contribute to symptoms all the way into the hands. As you sit at your desk, make sure that you maintain good posture by keeping your head upright, shoulders back, and avoiding a slouched posture.
  4. Stretch – Tightness in the muscles of the wrist and forearm can contribute to your symptoms. As you are taking a break every hour, stretch the muscles by pulling your hand and fingers back towards you and holding for 30 seconds at a time, as seen in the picture below.


Assistive Devices: One size does NOT fit all

Walkers, crutches and canes – oh my! Assistive devices are great tools to help those who need them increase both functional ability and safety. When someone is in need of a particular assistive device it is important to not only choose the right device for their needs, but to also make sure that it is adjusted appropriately in order to provide them with optimal function and safety. Often, people are either given or go out and buy an assistive device without any guidance on how to size it correctly. Using a device that isn’t appropriately fitted can cause safety hazards but also can put strain on other parts of your body. Below you will find general guidelines to adjusting common assistive devices.

– Use the buttons on the legs of the walker to make them shorter and longer.
– Make sure each leg leg of the walker is set to the same level.
– The handgrip of the walker should be at the level of the crease of your wrist with your arms down at your sides.
– If the walker is too high it will cause increased bending of the elbows and cause increased strain on the shoulders.
– If the walker is too low it will cause the person using it to slump forward, causing strain to the back.

– Similar to walkers, the height of a cane should be set to where the handle of the cane is at the level of the crease of your   wrist with your arms down at your sides.
– The potential consequences of setting a cane too high or too low are the same as with walkers with the addition of possible leaning of the trunk which can cause a higher risk for falls.

– When sizing crutches, the bottom tips should be a few inches in front and to the side of your feet.
– Similar to walkers and canes, the hand grips the crutches should be level with the crease of the wrist with your arms down at your sides.
– The top of your crutches should be about 2 inches below your armpit.
– If crutches are adjusted too high, it can cause the top of the crutch to put increased pressure on the armpit which can lead to possible nerve damage.
– If adjusted too low, it can cause the individual to slouch over which can put strain on the back but also have an impact on the person’s balance.

These are only the guidelines for a few of the most common assistive devices seen in the community. There are many other types of devices that each have their own sizing standards for optimal use. If you or someone you know needs assistance in sizing a device, please consult a physical therapist to assist you to ensure a proper fit.

Written by: Dr. Taylor Ryan

How does Movement Help Injuries Heal? I’ve got a bone to pick.

If you’ve ever been to a physical therapist, you know that exercise is usually prescribed as the primary treatment for a number of injuries and conditions. Clearly exercise has numerous benefits, but it can sometimes seem counterintuitive to place resistance or load through an injured area — doesn’t it need time to rest and heal? The short answer to that question is generally yes, especially immediately following the injury; however, the appropriate amount of movement and exercise can actually promote healing and recovery.

My goal is to help you understand just how exercise helps restore normal functioning of injured body tissues. This article is part of a series that will discuss how various types of tissue depend on movement to recover. Today’s subject is bone.

In the case of fracture, bone is the exception to the rule of “get it moving ASAP.” Allowing a bone to fully heal is vital to maintaining its structural integrity throughout the rest of your life. However, once it is healed and in cases where the bone has begun to weaken such as osteoporosis or osteopenia, weight-bearing exercise is vital to maximizing its strength and reducing the risk of re-injury.

Exercise helps strengthen bone by increasing its density. Density is typically measured by something called a DEXA scan, which is used to diagnose osteoporosis/osteopenia. Over time, the density as measured by these scans is maintained or increased in response to exercise. However, these increases are site-specific, meaning that exercises involving your lower body will only increase the density of the bones in your lower body (and vice versa with your upper body). Of particular note is that in postmenopausal women — the demographic most affected by osteoporosis — exercise is shown to mitigate losses in bone mineral density. So, after speaking to your physician or physical therapist about which exercises are best for your condition, it’s time to get moving!

Now let’s get specific about the best types of exercise. Exercise that is in an upright position against gravity is considered most effective for improving bone health. Such exercises include walking, jumping, and resistance training with weights or bands. Bone thickens in response to these types of exercise because gravity and the physical pull of the muscle tendons on our bones elicits an adaptive response. Exercises such as swimming, while still very healthy for us, aren’t quite as effective for improving bone density.

Written by: Dr. Scott Newberry

How does Movement Help Injuries Heal? Tendons and ligaments.

If you’ve ever been to a physical therapist, you know that exercise is usually prescribed as the primary treatment for a number of injuries and conditions. Clearly exercise has numerous benefits, but it can sometimes seem counterintuitive to place resistance or load through an injured area — doesn’t it need time to rest and heal? The short answer to that question is generally yes, especially immediately following the injury; however, the right amount of movement and exercise can actually promote healing and recovery from injury. This is where PT comes in.

My goal is to help you understand just how exercise helps restore normal functioning of injured body tissues. This article is part of a series that will discuss how various types of tissue depend on movement to recover. Today’s subject is injured tendons and ligaments.

Tendon and ligament injuries range in terms of type and severity and are broadly categorized as tendinopathies or ruptures in the case of tendons and sprains in the case of ligaments. Examples of tendinopathy include tennis elbow, golfer’s elbow, and Achilles tendinopathy. You may have also heard the term “tendinitis” used with these conditions. Though complex and multifactorial in nature, tendinopathies often involve tissues that have become weakened and painful through repetitive usage. Ligament injuries are usually due to trauma — you’ve likely heard of athletes injuring their anterior cruciate ligament, or ACL.

Tendons connect muscle to bone, transferring the force produced by a muscle into a nearby bone to create movement. Tendinopathies often develop in situations where a person puts a repetitive load through a tendon over a sustained period of time. It is most likely to occur when the level of activity is increased relative to baseline (i.e., too much too soon), such as someone taking up tennis for the first time in a while or playing more matches than usual.

The sustained tendon stresses can cause areas in the tendon to become disarrayed and no longer align with the direction of applied force. In other words, the fibers aren’t able to convert muscle energy into movement as efficiently. The gold standard strategy to disrupt this process is to load the tendon through slow, heavy resistance training which stimulates the tendon to remodel itself and repair the injured areas. Eventually, the tendon becomes strong enough to handle loading without pain.

Ligaments connect one bone to another, protecting joints from moving in directions they shouldn’t. While ligaments are not exactly the same as tendons, the loading principles discussed with tendons allow them to handle higher loads through similar mechanisms — by increasing their thickness and the amount of force they can handle.

One very important thing to keep in mind is that immobilization is very detrimental to the strength and health of tendons and ligaments. Therefore, seeing a PT after injury may give you the best shot at retaining as much function as possible in the injured tissues.

Look out for the next article in the series about bones.

Written by: Dr. Scott Newberry