What is the Rotator Cuff and What Does It Do?

 By Nick Mazzone, PT, DPT, CSCS

What is the rotator cuff?

The rotator cuff is the name given to the group of 4 muscles that originate from different positions on the shoulder blade and connect to the humerus (upper arm). These muscles all work together to ensure stability of the shoulder joint during movement (dynamic stability). When isolated, each of these muscles acts on the humerus and moves the shoulder joint in different directions. These muscles are named supraspinatus, infraspinatus, teres minor, and subscapularis.

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Why do we need this dynamic stability?

As we move the arm, these rotator cuff muscles will contract together to help keep the humerus centered nicely inside the cup of the shoulder joint (think ball and socket). If there is an asymmetry in strength among these muscles, the positioning of the shoulder inside the socket may be altered while you move your arm. Over time, this can cause irritation of other tendons, ligaments, and bone in the shoulder region. Some of the common diagnoses associated with rotator cuff muscle weakness are shoulder impingement syndrome and non-traumatic rotator cuff tears.

What happens if the rotator cuff is torn?

The most commonly torn rotator cuff muscle is the supraspinatus. People with supraspinatus tears typically have trouble elevating the arm and may exhibit a compensatory shrugging of the shoulder in order to assist in raising the arm.

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If a partial tear is present, the muscle and tendon have the ability to heal without surgical intervention. In order for proper healing to occur, we must provide an ideal environment for the muscle and tendon to recover. This would include intervention aimed at decompressing the region where the muscle attaches to the humerus, which would be achieved through range of motion exercise and strengthening of all 4 rotator cuff muscles to help produce more efficient movement of the shoulder (to put it briefly).

If a complete tear is present, there are two options that one may follow. The non-surgical route would include strengthening other muscles around the shoulder joint that will help to compensate and act as a substitute for the torn rotator cuff muscle. Fortunately, the shoulder joint was designed to be able to withstand this type of injury and with the right rehab protocol, may return to normal functioning. In cases where this method does not help, surgical intervention is typically indicated. After surgery, patients will be sent to a physical therapist in order to help them return to their prior level of functioning.

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What does physical therapy typically consist of for rotator cuff injuries?

The plan of care will consist of manual stretching and soft tissue mobilization of tense muscles, specific strength and stability exercise to improve the function of the shoulder, range of motion exercises to help normalize joint movement, and movement re-education to ensure pain-free use of the arm.

Check out this brief video for 3 exercises that will strengthen the rotator cuff muscles:

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Nick Mazzone received his Doctorate in Physical Therapy from Stony Brook University. He has a strong background in strength and conditioning and aims to bridge the gap between strength training and physical therapy. Nick believes that a lifestyle centered around physical fitness and mental well-being are vital to one’s successes and happiness. For this reason, he educates his patients on pain science and helps empower them and motivate them to reach their goals every day. You can find him at Evolve Physical Therapy in Mill Basin, Brooklyn. To view some of his other content, visit drnickmazzonedpt.wordpress.com.

Resources

Photo depicting widespread shoulder pain (top photo) retrieved from https://www.myanthemhealth.com/blog/shoulder-paincould-it-be-my-rotator-cuff

Photo depicting different muscles of the rotator cuff retrieved from https://www.slideshare.net/prkhuman/shoulder-impingement-syndrome-24685952

Photo depicting a rotator cuff tear retrieved from https://www.vivehealth.com/blogs/resources/rotator-cuff-tear

Photo depicting the compensatory shoulder shrug during shoulder elevation retrieved from https://healtheappointments.com/chapter-16-the-musculoskeletal-system-essays/5/

How Can PT Help My Carpal Tunnel Syndrome?

By Nick Mazzone PT, DPT, CSCS

What is carpal tunnel syndrome?

The carpal tunnel is the space formed by the bones of the wrist and hand that allows passage of the median nerve along with tendons of muscles that move the joints of the hand. This space is typically about an inch wide, however it can be made narrower in the presence of irritation and swelling of any of these structures. Narrowing of this passageway can lead to pressure on the median nerve, which may lead to symptoms such as tingling, burning, weakness, and pain in the hand and fingers.

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How do I know it is carpal tunnel syndrome?

Symptoms from carpal tunnel syndrome such as numbness and tingling typically present themselves at the thumb, index finger, middle finger, and half of the ring finger. This is because sensation to these areas is supplied by the median nerve. If the median nerve is being compressed, these areas may become numb or painful. You may also find weakness of the muscles that move the thumb, first two fingers, and wrist. The picture below shows what the hand may look like when a person with long-standing carpal tunnel syndrome attempts to make a fist. It is known as the “Hand of Benediction Sign”.

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What is the traditional treatment for carpal tunnel?

Typically, people suffering with the symptoms of carpal tunnel syndrome receive anti-inflammatory medications or are suggested to have surgery. This surgery involves a “release” of the transverse carpal ligament, meaning that the surgeon cuts this ligament to help decrease pressure on the tunnel and, therefore, the median nerve. The issue is that this does not always solve the problem. If the tendons are still inflamed and swollen, we may still be feeling these symptoms after the post-surgical healing process is complete. For this reason, physical therapy should be a patient’s first option. Many people find that PT alone helps them return to normal, pain-free functioning during daily tasks.

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How do we improve these symptoms in PT?

The symptoms from carpal tunnel syndrome can be resolved by decreasing pressure on the median nerve at the level of the wrist and hand. This can be accomplished by improving flexibility of the muscles and connective tissues at the wrist and hand, especially those on the front of the forearm. Your physical therapist will perform mobilization and stretching techniques, postural training and education, nerve gliding techniques, and soft tissue mobilization. Once the tissues are of proper flexibility, we must ensure that the muscles surrounding the hand and wrist are strong to help stabilize the joints. A home exercise program with specific exercises to help your condition will also be prescribed.

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Check out the video below for a demonstration on how to perform median nerve gliding to help alleviate symptoms of carpal tunnel syndrome:

Resources:

Our knowledge of orthopedics. Your best health. (n.d.). Retrieved April 05, 2018, from https://orthoinfo.aaos.org/en/diseases--conditions/carpal-tunnel-syndrome/

“Hand of Benediction” photo retrieved from http://slideplayer.com/slide/9418409/

Photo depicting carpal tunnel release surgery retrieved from http://www.korshjafarniamd.com/treatment/minimally-invasive/endoscopic-carpal-tunnel-release.php

Photo depicting median nerve compression retrieved from http://nursinglink.monster.com/training/articles/814-carpal-tunnel-syndrome

Photo used at top of page depicting painful wrist retrieved from http://www.pipmchealth.com/conditions/carpal-tunnel-syndrome/

“Tips for preventing and treating carpal tunnel syndrome”photo retrieved from https://www.mispinerelief.com/blog/carpal-tunnel-treatment-and-preventing-for-carpal-tunnel-syndrome/

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Nick Mazzone received his Doctorate in Physical Therapy from Stony Brook University. He has a strong background in strength and conditioning and aims to bridge the gap between strength training and physical therapy. Nick believes that a lifestyle centered around physical fitness and mental well-being are vital to one’s successes and happiness. For this reason, he educates his patients on pain science and helps empower them and motivate them to reach their goals every day. You can find him at Evolve Physical Therapy in Mill Basin, Brooklyn. To view some of his other content, visit drnickmazzonedpt.wordpress.com.

How Can PT Help My Spinal Stenosis?

By Nick Mazzone, PT, DPT, CSCS

Spinal stenosis is one of the most commonly diagnosed conditions that affects the lumbar spine (lower back). It is common for people with stenosis to feel tightness and pain that radiates from the low back and buttocks down into both legs.

It is estimated that only about 5% of people with spinal disorders actually require surgery (Eidelson, 2018). So, what are the other 95% of people expected to do? This is where physical therapy comes into play. There are many methods your PT will use in order to help address the issue causing your pain and discomfort. This includes but is not limited to therapeutic exercise, soft tissue mobilization, manual stretching of the hips and spine, and postural re-education.

What is spinal stenosis of the lumbar region?

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As you can see from the picture above, stenosis of the spine involves a narrowing of the canal in which the spinal cord sits. This leads to increased pressure on the spinal cord as well as the nerves that branch from it. This is the reason why people feel pain in the buttocks and legs; the region of pain stems from a specific section of the spinal cord that is under pressure. For this reason, two people with the same condition will present with different symptoms.

How can physical therapy help with this problem?

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The treatment plan will be specifically tailored to each patient with stenosis. The main objective is to help decompress the spinal cord and its nerve branches by using techniques that create more space in the spinal canal. Bending backward, also known as extension of the lumbar spine, will decrease the space in the spinal canal due to the way the joints of the spine are oriented. This may increase pain and symptoms in a person with spinal stenosis. For this reason, the treatment plan will be focused on utilizing and improving spinal flexion, more commonly known as bending forward. This will help to widen the canal and decompress the inflamed structures, effectively providing relief of symptoms.

A comprehensive treatment plan will help you find positions of maximal comfort and give you more drug-free and surgery-free options for taking care of your lumbar spine and preventing pain in the future.

Please check out this brief video that provides 3 simple exercises to help decrease symptoms due to lumbar spinal stenosis.

Resources

Eidelson, S. G., & An, H. S. (February 2018). Spinal Stenosis Center | Lumbar, Cervical, Symptoms, Exercise, Surgery. Retrieved March 18, 2018, from https://www.spineuniverse.com/conditions/spinal-stenosis

Picture of person with low back pain retrieved from http://www.omegapainclinic.com/spinal-stenosis-pain-treatment-utah

Pictures of stenosis in lumbar region retrieved from https://www.spineuniverse.com/conditions/spinal-stenosis

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Nick Mazzone received his doctorate in Physical Therapy from Stony Brook University. He has a strong background in strength and conditioning and aims to bridge the gap between strength training and physical therapy. Nick believes that a lifestyle centered around physical fitness and mental well-being are vital to one’s successes and happiness. For this reason, he educates his patients on pain science and helps empower them and motivate them to reach their goals every day. You can find him at Evolve Physical Therapy in Mill Basin, Brooklyn.

What Does Foam Rolling Do for Me?

By Nick Mazzone, PT, DPT, CSCS

 Foam Rolling has become one of the more popular health and fitness topics over the past few years or so. These tools can be found in many different shapes, sizes, and colors with varying textures and firmness to fit everybody’s apparent need. If you google this, you will find claims that foam rolling can help you improve range of motion, muscle strength and performance, and decrease pain. It is also often used as part of a warm-up and cool-down within an exercise program.

Who do I believe?

Well, unfortunately there are very few studies on foam rolling and its effects on our muscles and connective tissues. The following bullet points can be used as a summary of the current body of research on this topic:

Positive Effects of Using a Foam Roller

·      Increased blood flow

·      Increased tissue temperature

·      Better short-term improvements in range of motion versus static or dynamic stretching

·      Decreased sensation of pain

What Foam Rolling Will NOT do for You

·      Increase strength or power output

·      Give lasting improvements in range of motion when used as a stand-alone treatment

·      Lead to complete resolution of pain/symptoms when used as a stand-alone treatment

Let’s Discuss these findings…

As you can see, there are some benefits to using a foam roller, however I feel it is important that we clear up some of the common misconceptions on the topic…

Many people who use a foam roller use it in isolation as a method of improving their mobility. I understand why people want this to be true; foam rolling is much easier and less strenuous than stretching. Unfortunately, you will not receive lasting effects from foam rolling alone. While foam rolling will only provide temporary improvements in range of motion, we can take advantage of this temporary improvement by proceeding to perform static or dynamic stretching. With consistency, this can help to improve range of motion on a more permanent basis (although more studies are needed on this topic).

There is also no evidence that foam rolling increases strength or explosiveness during your workout, however one may argue that by utilizing a foam roller you are increasing blood flow to the area, and therefore, helping to facilitate contraction of specific muscles during exercise.

Foam Rolling may also help decrease pain by working to desensitize the area through repetitive stimulation and can help promote tissue healing by improving local blood flow.

How do you suggest I use the foam roller in my daily life?

·      In conjunction with a stretching program for improving range of motion

·      As part of a warmup routine, especially for activities that have high mobility requirements

·      As an alternative to pain killers for temporary pain relief

·      As a method of soothing sore, painful muscles after a physically demanding workout

 

Check out this video for a brief introduction on how to use a foam roller:

For more information or any questions, give us a call at 718-258-3300 or contact us today!

Resources:

Su, H., Chang, N., Wu, W., Guo, L., & Chu, I. (2017). Acute Effects of Foam Rolling, Static Stretching, and Dynamic Stretching During Warm-ups on Muscular Flexibility and Strength in Young Adults. Journal of Sport Rehabilitation,26(6), 469-477. doi:10.1123/jsr.2016-0102

Cartoon depicting man foam rolling retrieved from https://www.gq.com/story/foam-roller-tips

 

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Nick Mazzone received his doctorate in Physical Therapy from Stony Brook University. He has a strong background in strength and conditioning and aims to bridge the gap between strength training and physical therapy. Nick believes that a lifestyle centered around physical fitness and mental well-being are vital to one’s successes and happiness. For this reason, he educates his patients on pain science and helps empower them and motivate them to reach their goals every day. You can find him at Evolve Physical Therapy in Mill Basin, Brooklyn.

 

How Do I Warmup Prior to Lifting Weights?

By Nick Mazzone, PT, DPT, CSCS

The warmup phase is easily one of the most forgotten components of an exercise program these days. Would you intentionally leave it out if I told you that it could lead to increased performance and results during your workout?

Traditionally, people have used static stretching (long holds in a position that lengthens a muscle) before workouts to help decrease their risk of injury, however there is no evidence that this is the case. Static stretching before exercise has actually been shown to decrease maximal force production, jump height, and sprint speed while increasing reaction time and impairing balance (Perrier et. al).

Rather than static, long holds in the lengthened position of a muscle, dynamic movement involves actively moving through a joint’s range of motion without holding at the end point. A study by Perrier et. al found that dynamic movement including skipping, shuffling, and calisthenics of increasing intensity that were chosen based on the movements that would be performed during training led to improved athletic performance versus static stretching and no stretching at all.

Dynamic movements that mimic the exercises you will be performing help to prepare the central nervous system for physical activity. By activating specific muscles prior to exercising, we are facilitating proper muscle activation patterns and therefore, “priming” the nervous system.

Suggestions for a proper warmup routine

·      15-20 minutes of dynamic movement

·      Must make an effort to mimic the activities that will be performed in the exercise  program

·      Must include enough intensity to elevate heart rate

·      Should not approach more than 30% of your maximal effort to prevent muscle fatigue

Example of warmup routine prior to squatting or deadlifting

·      Bridging with a resistance band 3 sets of 15-20 reps

·      Marching with a resistance band 3 sets of 15-20 reps

·      Body weight squatting with a resistance band 3 sets of 15-20 reps

·      Lateral Band Stepping with resistance band 3 sets of 10 steps in each direction

Example of warmup routine prior to overhead pressing or bench pressing

·      Banded shoulder external rotation with retraction 3 sets of 12-15 reps

·      Wall Angels 3 sets of 10-15 reps

·      Overhead Arm Raise at Wall 3 sets of 10-15 reps

·      Banded Wall Climbs 3 sets of 8-12 reps

 

For a preview of upper and lower body warmup routines, check out these videos:

For more information or any questions, give us a call at 718-258-3300 or contact us today!

Resources

Perrier, E. T., Pavol, M. J., & Hoffman, M. A. (2011). The Acute Effects of a Warm-Up Including Static or Dynamic Stretching on Countermovement Jump Height, Reaction Time, and Flexibility. Journal of Strength and Conditioning Research,25(7), 1925-1931. doi:10.1519/jsc.0b013e3181e73959

Warmup picture retrieved from https://www.hosmerchiropractic.com/blog/7-ultimate-dynamic-stretching-exercises/

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Nick Mazzone received his doctorate in Physical Therapy from Stony Brook University. He has a strong background in strength and conditioning and aims to bridge the gap between strength training and physical therapy. Nick believes that a lifestyle centered around physical fitness and mental well-being are vital to one’s successes and happiness. For this reason, he educates his patients on pain science and helps empower them and motivate them to reach their goals every day. You can find him at Evolve Physical Therapy in Mill Basin, Brooklyn.

How Can Physical Therapy Help My Arthritis?

By Nick Mazzone, PT, DPT, CSCS

What is Osteoarthritis?

Osteoarthritis is a major cause of chronic pain and disability in our society today. People with arthritis typically report deep, aching pain in the joints affected as well as stiffness and inability to get up and get right out of bed in the morning. The most common treatments for this painful condition include cortisone injections aimed at decreasing inflammation, over-the-counter NSAIDs (non-steroidal anti-inflammatory drugs), and knee replacement surgery once the condition significantly worsens.

What is going on in my joints that causes this pain?

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Osteoarthritis is a degenerative condition that leads to wearing away of the outer layers of cartilage and bone as you can see in the image above. This causes an inflammatory process to be induced by the body which leads to swelling, increased sensitivity to touch and pressure, and pain. On an X-ray, you will see decreased space between the bones and potentially bone spurs, which the body lays down in response to excess pressure in the area. This inflammatory condition typically leads to inactivity, which then leads to decreased range of motion along with muscle weakness.

What will physical therapy accomplish?

The hallmarks of arthritis include joint stiffness, swelling, muscular weakness, and pain. In physical therapy, your therapist will prescribe specific exercises that will help improve range of motion, and therefore, stiffness, as well as exercises for strengthening the surrounding muscle groups. These exercises will also act to help decrease the central nervous system’s hypersensitivity to pressure and touch, which will allow you to perform your daily tasks with much greater ease. Your therapist will also work on improving your patterns of movement in order to ensure that you are decreasing the pressure on your arthritic joints and using the most efficient pattern available to your body. There are also modalities and other methods used that will help to decrease the amount of swelling in the joint, which then leads to decreased pain.

Great. Stronger muscles, improved range of motion. How exactly is this helping my condition?

Good question. I would like to start by saying that there is currently no way to reverse the arthritic condition. That being said, I would like you to consider this example. Think about a stiff and swollen knee joint. When a person bends their knee, the stiffness in the muscles and fibers of the joint force the bones to glide along a smaller surface area. This will eventually lead to more breakdown of the cartilage and outer layers of bone, which means progression of the osteoarthritis. Now imagine we have a knee joint that has been sufficiently stretched and has less swelling. These bones glide in a smoother manner across a larger surface area (due to less range of motion restrictions). Now that the force can be spread evenly across the bony surfaces, there is a much less chance of increasing breakdown of the cartilage and bone.

Strengthening the muscles helps to ensure that while walking or performing other functional daily tasks, the joint is kept in a position that ensures proper alignment and efficiency of muscle function. This formula along with a prescribed home exercise program will prevent progression of the condition and assist in avoiding knee replacement surgery.

 

Check out this brief video which shows how to utilize a “hip-first pattern” to help offset pressure on the knee joint when bending down and squatting.

For more information or any questions, give us a call at 718-258-3300 or contact us today!

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Nick Mazzone received his doctorate in Physical Therapy from Stony Brook University. He has a strong background in strength and conditioning and aims to bridge the gap between strength training and physical therapy. Nick believes that a lifestyle centered around physical fitness and mental well-being are vital to one’s successes and happiness. For this reason, he educates his patients on pain science and helps empower them and motivate them to reach their goals every day. You can find him at Evolve Physical Therapy in Mill Basin, Brooklyn.

What is Shoulder Impingement Syndrome and how can i treat it?

About the Shoulder

The shoulder is one of biggest and most complex joints in the entire body. It's the most mobile joint in the body which allows the upper body tremendous range of motion. This evidently causes the joint to be extremely unstable which makes it easy to injure. The shoulder joint consists of the scapula (shoulder blade) and humerus (upper arm bone) which connect like a ball and socket. Some other bones and structures that make up the shoulder are the acromion, clavicle, coracoid process, rotator cuff and bursa. 

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What Causes Shoulder Impingement?

Shoulder Impingement Syndrome is a condition where the rotator cuff tendons become trapped and compressed when moving the shoulder. The bone impacts the rotator cuff tendons or bursa to cause this shoulder pain. As result, the tendons become swollen and inflamed which then leads to rotator cuff tendinitis. If its the bursa thats impacted, its called shoulder bursitis. Both of these could occur at the same time. These injuries aren't caused by one wrong fall or movement but continuous movements that build up over time to cause impingement.

How can I treat this?

Before taking steps to treat you pain, it is recommended to get an official diagnosis from your doctor. Medical history, physical exams and X-rays should be incorporated to rule out other injuries or conditions such as arthritis and bone spurs. If the doctor diagnoses you with Shoulder Impingement Syndrome, it is recommended to take anti-inflammatory medications such as aspirin or ibuprofen to help treat your pain. Along with the medication, stretching is key to healing your shoulder. Here are some great stretches to incorporate into your everyday life.

5 stretches to help relieve your shoulder pain

Cross Body Arm Stretch

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Take your right arm and cross it against your body. Using your left hand, gently pull the arm closer to your body until you feel a stretch. Hold for 5-10 seconds and repeat with the other arm.

Anterior Shoulder Stretch 

Grasp a doorframe or something above your head. Then move forwards while continuing to hold so that your arm is left behind to stretch the front shoulder and chest muscles. Hold the stretch for 20-30 seconds and repeat. 

Supraspinatus Stretch

Stand with a straight spine while putting your hands on your hips with your palms facing outwards and fingers pointing backwards. While pressing your hands onto your hips, slowly begin to move your elbows forward until you feel a light tension behind the shoulders. Hold this position for 20-30 seconds and repeat.

Shoulder Flexion Stretch

First begin by grasping a light bar or household item like a broom stick. Make sure that you stand straight with shoulder blades back and palms at shoulder width. With your arms being stretched perfectly straight, raise the bar over your head for 5 seconds then slowly return to the starting position. Repeat this stretch 10-20 times for multiple sets. 

Shoulder Internal Rotation

You will need a resistance band for this stretch. 

Tie the band to something sturdy such as a door or piece of furniture. Then grasp the band close to your side with your elbows bent 90 degrees. Put a towel or piece of clothing between you and your arm to make sure your arm stays steady as you perform the stretch. Hold the band and slowly move your forearms towards your stomach, across your body. Then slowly return back to the starting position and repeat. 

Working on your posture may also benefit your shoulder pain and you could read all about that here.

For more information or any questions, give us a call at 718-258-3300 or contact us today!

Why do you have bad posture and how can you treat it?

Why do I have bad posture?

There are many reasons as to why you may have bad posture.  They include: Injury and muscle guarding, disease, bad habits, weak muscle areas and genetics. When we injure a muscle, our brain automatically tries to prevent from adding insult to that injury by locking the muscles in the area that may cause spasms. Those spasms will reduce painful joint movements. This whole process causes other muscles to come together to support that weak area which results in bad posture. Habits such as slouching in a seat or hunching over while texting are examples of everyday habits that take a toll on our posture. All of these causes are preventable and curable with the correct treatment. 

What should I do to improve my posture?

Improving bad posture involves not only working on breaking bad life habits but incorporating the correct exercises to strengthen your core, back and shoulder muscles. Core and back muscle exercises move your torso by flexing and extending your spine while also stabilizing the spine so it aligns in its natural position. Shoulder exercises will strengthen the shoulder blades while also pulling back the shoulder blades to reduce slouching. Strengthening these areas will improve overall bodily fitness levels and posture.

What are some exercises to improve my posture?

Plank

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Go into modified push-up position with your elbows bent 90 degrees and both forearms resting on the floor. Position your elbows directly underneath your shoulders and look straight toward the floor. Your body should form a perfectly straight line from the head to your heels. Your feet are together with only the toes touching the floor. Hold for as long as possible while keeping the abdomen and lower back muscles tight

 Leg Lifts

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 Lay down flat on the ground with your legs fully extended and raised upwards. Point your toes and set your neutral spine. Then brace your core so your back doesn’t move while having your legs raised. As one leg lifts, lower the other. Do 10-12 reps on each side maintaining a strong, braced core while relaxing your shoulders and maintaining your breath.

Bird Dog

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Begin on all fours with your knees directly under your hips and hands under your shoulders. Pull in your abs and keep them tight while reaching out with your right arm and extending your left leg. Make sure to not let your ribs sag toward the floor while keeping your pelvis secure. Then return to the starting position and alternate your arm and leg. 

Wall Angels

Stand with your back against the wall with your arms out to your sides while bending your elbows. Rotate your arms so that the back of your hands are touching the wall directly above your elbows. Slowly move your arms up and over your head while focusing on maintaining contact between your elbows, hands, and the wall, and then lower your arms. Only go as high or as low as you can to ensure your hands and elbows are always making contact with the wall. 

Back Extensions

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Lie face down, extending arms straight above your head and extending your legs behind you. Keeping your head in line with your spine, gently lift your shoulders as far off the floor as possible, while also lifting your legs for a few seconds to cause a stretch in the back. Once completed, return to the starting position.
 

For more information or any questions, give us a call at 718-258-3300 or contact us today!

Anterior Hip Pain and How to Manage It

How does the hip work?

The hip is a ball-and-socket joint that comprises the top of the thigh. The femur, which is your thigh bone, sits into the acetabulum, which is the socket that allows it to remain both stable and mobile, and to allow for movement without dislocation.

What is Anterior Hip Pain and what are it's causes?

Anterior hip pain is most often caused by a strain in the hip flexor muscles which are located at the front of the hip. A strain, which is a injury to a muscle or tendon, causes a painful sensation to the hip which heavily contributes while walking, running or squatting. These strains are common with overtraining, strength imbalances, poor technique, inflexibility and forceful contractions such as kicking and sprinting. The most common and impactful of these is overtraining which includes insufficient rest and difficult training sessions. Consistent overtraining sessions will result in micro trauma which accumulate and result in a possible hip flexor strain or tendonitis. 

Myofascial Release of the Anterior Hip

In this video, Chris Desiderio, DPT will explain how to release some tension that may be in the front of the hip in order to help the hip flexors function optimally.

Posterior Mobilization

In this video, Chris will demonstrate a mobilization of the hip in a posterior direction to help release the front of the joint capsule.

Standing External Rotations

In this video, Chris will demonstrate a standing external rotation, which can help strengthen the gluteus medius to prevent anterior hip pain.

Physical Therapy and Your Insurance

Authorization

Though your insurance company may allow many physical therapy visit per year, they usually also reserve the right to do a pre-check to ensure that the treatment you’ll be receiving will be medically necessary or able to make a positive change.

A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary. Sometimes called prior authorization, prior approval or pre-certification. Your health insurance or plan may require preauthorization for certain services before you receive them, except in an emergency. Preauthorization isn’t a promise your health insurance or plan will cover the cost.
Healthcare.gov

In and Out of Network

Some insurance companies have in-network providers, which means that they have pre-negotiated rates with those doctors or physical therapists, but insurance companies may also restrict the patient to the in-network providers. Some insurance providers that have in-network providers will also have out-of-network providers, although they may cover less of the expense of the treatment and have the patient pay the remainder of the bill.

Knowing your rights when it comes to your insurance

  • First, you should know that your insurance company is there to help you, you are not subject to their demands

  • You have a right to go out of network if your provider doesn’t have any in-network providers

  • If you are denied for authorization, you have your right to have your voice heard and to request more visits. If you are entitled to more visits than you were authorized for, you can speak to your insurance along with you physical therapists and doctor to be granted more visits

  • You are never locked into a healthcare provider, whether it is a doctor or a physical therapist. If you are unhappy with the care you are receiving, you are entitled to finding a care provider that you feel is good for you

  • For some more detailed info concerning healthcare laws in New York, please visit: http://www.dfs.ny.gov/consumer/hrights.htm

If you have any questions, give us a call at 718-258-3300 or contact us today!