Cheryl Alden, PT

To work on the vastus medialis muscle when your knees are hurting, use a strap or a loop band to target the inner thigh and then do exercises like squats, back lunges, and step-ups while keeping the inner thigh active. This will help balance the inner and outer quadriceps and reduce knee pain.
 
Transcript: "What's a good way to work the vastus medialis when your knees are hurting? Well I think it's to recruit more muscle especially the adductor. So I'm over here I've got a strap of just above my knee joint so I'm at a spring wall but you could use a flex band, a loop band, anything that you can to try to get into that inner thigh and feel it kind of kicking on because sometimes that knee pain is caused because of an imbalance between that inner quadricep muscle and the outer quadricep muscle. So recruiting the inner thigh helps to up regulate that inner quadricep muscle, that vastus medialis a little bit more. So once you've got that inner thigh kicked on a little bit then try to do your strength training exercises. So trying to do some squats, you could do some back lunges, you could do some step ups, various different exercises but trying to keep that inner thigh turned on a little bit to see if that will help to start balancing out the inner quadricep and the outer quadricep. I hope it helps, thanks!"

Mobility Exercises: Rotating on your hands and knees, Lifting the arm up on your side, Foam rolling Latissimus Dorsi. Strength Exercises: Side rotator cuff, External rotation balancing out internal rotation, Wise and Tease on a ball for scapular stabilization.
 
Transcript: "What are the five to ten top exercises to avoid swimmers shoulder? Not necessarily to rehab but for prevention. So I'd like to break it up between mobility exercises and strength exercises. For mobility we want to make sure that thoracic spine can move because that's where that shoulder attaches. So on your hands and knees putting one hand behind your head you can rotate toward that arm that's on the ground and then you're gonna lift that elbow towards the ceiling. So getting into some good rotation through that upper back. Also to open up through the chest and to continue with that thoracic mobility onto your side lifting the arm up and then thinking about opening through the chest and shoulder getting that nice length through the chest but again trying to keep those hips relatively stacked. You could do that a few times and then we also have to think about that latissimus dorsi length. So taking a foam roller you can roll on it this is a soft foam roller just kind of putting around your shoulder area and then just rolling back and forth keeping that arm long as you roll back and forth and if you feel that you have any particular areas that are tight you can kind of roll back and forth as well as up and down. We also have to think about strength obviously so rotator cuff is a huge thing you get you can do it by your side but we also have to think about all these other planes of motion because swimming is an overhead activity so working that external rotation to balance all that forward movement but we do want to balance out that internal rotation and again you can think about a lot of different planes of motion. Going on to your stomach going to the classic Y's and T's. I do it on a ball reaching your arms out to the side reaching them overhead to get into that good scapular stabilization strength as well."

It is important to find an expert that can evaluate the source of the low back pain and then design a rehab program specific to one's individual needs.
 
Transcript: "Hi, if someone has low back pain how should he be taking care of it? Well the short answer is it depends right? It depends upon what the source of the problem is. So back rehab is not a one-size-fits-all thing. What I would suggest is going to somebody that can evaluate the source of the problem right? It could be muscular tightness and you'd need to stretch it. It could be muscular weakness and you need to strengthen it. It could be compensatory patterns and you need to figure out how you can move differently in order to prevent the back from hurting you. And sometimes unfortunately the back is just where the body broke down because other parts of your body may not be working as well as they could be. So it really is important that you find that expert that can evaluate you, figure out the source of the dysfunction and then train you appropriately by designing a rehab program specific to you and your needs. Thanks!"

Not judging people's physical ability based solely on their age has been the most beneficial contrarian opinion I have held in my career as a physical therapist.
 
Transcript: "What contrarian opinion you've held has benefited you the most in your life? I think professionally as a physical therapist, not judging people's physical ability based solely on their age. And that translates also into the Pilates studio that I'm now working in. Early on in my career I learned this, which was great. I met a lovely 80 year old woman whose biggest complaint was that she couldn't walk the nine holes of golf she played every day because of back pain. So she just wanted some stretching and strengthening exercises and I assumed that it was going to be a hard case just based solely on her age. But then opposite of that I saw a woman who was in her 50s with a total knee replacement and I thought it was going to be an easy recovery, but unfortunately she seemed much older and not living as healthy a lifestyle. So not judging anybody's physical ability based on their age, but also not allowing people to think that they can't do something based just on their age as well. Like, well I can't do balance work anymore because I'm too old or my balance is not as good because I'm too old. Saying that I don't think is reality. I think it's just sometimes a mindset. So not judging people's physical ability based just solely on their age, but actually how they're actually moving."

To stretch the Soleus, try to keep your thigh perpendicular while tucking your tush under and posteriorly tilting your pelvis. Lunge forward a bit while engaging the abdominals and glutes. Raise your arm up side-side and bend away from that side as well as rotating towards it to open up through the psoas. Extend a little but not getting extension in the low back and rotate and reach the rib cage away to open the psoas further.
 
Transcript: "Best way to release and stretch the psoas. So I've got a way that I'm going to show you now. How to stretch the psoas. Well one way to do it is in a half kneel position. That psoas attaches to the spine and then also into the lesser trochanter of the femur so it helps to flex the hip but we want to make sure that the spine doesn't extend as we're trying to stretch the hip. So if I'm trying to stretch this psoas I'm going to try to keep my thigh perpendicular right now and I want to think about tucking my tuck my tush under. Think about posteriorly tilting your pelvis so that's going to open up through the front of the hip. From there you can then lunge forward a little bit getting that thigh bone into extension but making sure that the spine doesn't extend. So you really want to think about drawing up on the abdominals kind of engaging the glutes a little bit as you hinge forward as you move forward opening up through the hip. From there you can raise the arm up side bend away from that side but then you can also rotate towards it to really try to open up through here and if you can extend a little bit but again not getting the extension through that low back. Think about just rotating and reaching that rib cage away to really open up through the psoas. Hope it helped. Thanks!"

A good stretch to prevent Achilles tendonitis include using a foam roller, foot mobility exercises, and toe extension stretches.
 
Transcript: "What are good stretches to prevent Achilles tendonitis? Well, I like to use the foam roller in order to maintain the Achilles length versus just stretching. So, in addition to stretching, using the foam roller. This is a Rollga. It has little indentations, which I like, so you can put the muscle in it and roll back and forth. It kind of gets into little different nooks and crannies than a standard foam roller doesn't, but it is still extremely good. So in order to do it, I put the heel area around it, so right on that Achilles area, and then you can just roll back and forth. So putting it in the little indents and making sure you kind of roll the leg outward. You can roll the leg inward to get to both muscle bellies and also get into that soleus behind the gastrocnemius. Then going into foot mobility. We can't think about Achilles tendonitis and calf issues without addressing the foot. So I have a little trigger ball here, standing, and I start with the ball on the heel, and then I just think about going back and forth from the heel to the big toe area. Then think about going from the heel to the second and the third toe, and then the heel to the fourth and fifth toes, just to keep that foot nice and mobile. Going into a little bit more standard stretching, I put the toes in a position of extension just to get a little bit more length through the toe extensors as well in doing those classic stretches. You're going to put the toes up on something. I have a couple mats here, but you could also use a rolled up towel. So the toes are extended and to stretch the soleus, you're just going to bend that knee. And then in order to stretch that gastroc, you're just going to kind of reach that heel on the ground, but try to keep those toes lifted just to get that little bit more elongated stretch."