Physical Therapy

Mind Body

What are the top 5-10 exercises to avoid “swimmer’s shoulder”? Not necessarily to rehab it but for prevention?

Prevent swimmers shoulder with these top exercises

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.

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.

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To avoid swimmer's shoulder, here are some recommended exercises for prevention. Let's divide them into mobility and strength exercises. For mobility, it's important to focus on the thoracic spine, where the shoulder attaches. One exercise involves being on your hands and knees, placing one hand behind your head, rotating toward the arm on the ground, and lifting the elbow towards the ceiling to promote rotation in the upper back. Another exercise is lying on your side and lifting the arm up while opening through the chest and shoulder to improve thoracic mobility. Using a foam roller can help lengthen the latissimus dorsi by rolling it along the shoulder area, keeping the arm long and targeting any tight areas.

Moving on to strength exercises, it's crucial to work on the rotator cuff as well as other planes of motion since swimming involves overhead movements. External rotation exercises help balance out forward movement, while internal rotation exercises help maintain balance. Various planes of motion can be incorporated for this purpose.

Another exercise involves lying on your stomach and performing Y's and T's, either on a ball or flat surface. These exercises focus on reaching your arms out to the sides or overhead to strengthen scapular stabilization.

By incorporating these mobility and strength exercises into your routine, you can help prevent swimmer's shoulder and maintain healthy shoulders for swimming activities.

What is a good way to work the vastus medialis if your knees are hurting?

Unlocking the Key to Alleviating Knee Pain: Strengthen Your Vastus Medialis

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!

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.

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A good way to target the vastus medialis when experiencing knee pain is by recruiting more muscle, especially the adductor. Using a strap or a band just above the knee joint can help engage the inner thigh and activate the vastus medialis. This can address any imbalance between the inner and outer quadricep muscles that may be causing knee pain. Once you feel the inner thigh working, you can proceed with strength training exercises such as squats, back lunges, or step-ups while keeping the inner thigh activated. The goal is to balance out the inner and outer quadricep muscles. I hope these tips are helpful!

What contrarian opinion you've held has benefitted you the most in your life?

Defying Age: How Not Judging Physical Ability Pays Off

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.

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.

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The contrarian opinion that has benefited me the most in my life is not judging people's physical ability based solely on their age. This perspective has been particularly valuable in my professional role as a physical therapist and also in the Pilates studio where I currently work. Early on in my career, I had the opportunity to meet an 80-year-old woman who complained of back pain, preventing her from walking the nine holes of golf she played every day. Initially, I assumed it would be a challenging case due to her age alone. However, I quickly realized that age did not necessarily dictate physical ability. Conversely, I also encountered a woman in her 50s who had undergone a total knee replacement but seemed much older and less physically capable due to lifestyle factors. This experience taught me not to judge individuals' physical capabilities based solely on their age but rather on how they are actually moving and functioning. Moreover, it has been important for me to challenge the notion that someone can't do certain activities or exercises simply because of their age. The belief that balance work or other physical tasks are impossible due to age is often more of a mindset than reality. By avoiding age-based judgments and focusing on individuals' actual movement abilities, I have been able to better serve my patients and clients.

If someone has lower back pain, how should he be taking care of it?

Find the Right Expert for Your Lower Back Pain

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!

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.

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If someone is experiencing lower back pain, the approach to taking care of it depends on the individual's specific situation. Back rehab is not a one-size-fits-all solution. It's essential to seek out a professional who can evaluate the underlying cause of the pain. It could be due to muscular tightness, which would require stretching. Alternatively, it could result from muscular weakness, necessitating strength-building exercises. Compensatory movement patterns might be contributing, requiring adjustments in how one moves to prevent further back discomfort. In some cases, the back may be affected due to other parts of the body not functioning optimally. Therefore, it's important to consult with an expert who can assess and identify the source of dysfunction and develop a personalized rehab program tailored to individual needs.

Best way to release and stretch the psoas?

The Best Way to Release and Stretch the Psoas

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!

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.

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The best way to release and stretch the psoas is by performing a half kneel stretch. The psoas muscle connects the spine to the lesser trochanter of the femur and helps in hip flexion. However, we want to avoid extending the spine while stretching the hip. To stretch the psoas, start in a half kneel position with your thigh perpendicular to the floor. Tuck your tush under and posteriorly tilt your pelvis to open up the front of the hip. Engage your abdominals and glutes as you lunge forward slightly, ensuring that your spine remains neutral. This movement helps open up the hip. To further enhance the stretch, raise your arm and side bend away from the stretched side, then rotate towards it. Avoid arching your lower back and focus on rotating and reaching the rib cage away to target the psoas. Remember not to overextend but instead aim for a gentle opening of the muscle. I hope this explanation helps you!

What are good stretches to prevent Achilles tendonitis?

Prevent Achilles Tendonitis with These Stretching Techniques

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.

A good stretch to prevent Achilles tendonitis include using a foam roller, foot mobility exercises, and toe extension stretches.

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Good stretches to prevent Achilles tendonitis include using a foam roller, such as the Rollga, in addition to traditional stretching. The foam roller with indentations allows for targeting different areas of the Achilles and rolling back and forth. Foot mobility is also important, so using a trigger ball and rolling from the heel to different areas of the foot can help maintain flexibility. For standard stretching, placing the toes in extension and elevating them on a mat or rolled-up towel can stretch the toe extensors. To stretch the soleus, bending the knee while keeping the toes extended is effective. Stretching the gastroc involves reaching the heel to the ground while maintaining lifted toes for an elongated stretch. By incorporating these stretches, you can help prevent Achilles tendonitis and maintain flexibility in your lower leg.

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Cheryl Alden is a 1996 (cum laude) UVM grad with a bachelor degree in physical therapy. She specializes in outpatient orthopedics and is the lead instructor trainer for STOTT PILATES® in NH. Cheryl teaches certification courses, workshops and the STOTT PILATES® rehab program. She also travels the USA and abroad teaching the rehab program to medical professionals. Cheryl is an avid runner and triathlete and has completed various distance races and triathlons including IRONMAN Lake Placid and Coeur D’Alene. She enjoys educating and motivating others to reach their fitness goals.

Neither AnyQuestion nor its Experts provide medical advice, diagnosis or treatment or otherwise provide professional healthcare services.

Cheryl Alden, PT