Physical Therapy

What are some simple activities I can do to release my psoas?

Physical therapist shares easy psoas release technique

My name is Emily, I'm a physical therapist. I'm going to show you one way that you can release your psoas, but there are a couple other different ways that you can do this. This is just the easiest to film. You're going to need a lacrosse ball or a tennis ball, a racquetball sometimes works, but a bigger ball that you can use, and a weight, a kettlebell or a dumbbell. You're going to lay down on your back and find the area between your belly button and like the pointy part of your hip bone and draw a line between those and you're going to put your ball in that space. Now you want to try to relax as much as possible so that you're not activating your abdominal muscles and then you're going to take that weight and put it on top of it. Now I will tell you you'll have to add a little extra pressure. I only have a 10 pound weight, I do have to add a little extra pressure. If it's pulsating, you need to move it over, that means you're on the wrong area, so move it over to the side a little bit. It shouldn't feel like it's pulsing, okay, that's the wrong spot. And then what you're going to do with your leg, I'm going to move up so you can see it, is the leg on the same side that you have the ball is going to fall out to the side and back in. Okay, you can also do little tiny marches. I'd say the hardest part here is you have to keep your abdominals relaxed so that that ball can sink underneath your abdominal muscles to get to your psoas, which your psoas lies right on the front part of your lumbar spine.

I'm demonstrating how to use a lacrosse ball, weight, and your leg to relax your abdominal muscles and work on the psoas muscle. This exercise helps you see yourself in a better way.

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To release your psoas, there are several simple activities you can try. One method involves using a lacrosse ball, tennis ball, or a larger ball like a racquetball, along with a weight such as a kettlebell or dumbbell.

Start by lying on your back and locate the area between your belly button and the pointy part of your hip bone. Place the ball in that space and try to relax your abdominal muscles. Then, place the weight on top of the ball. You may need to apply some extra pressure, especially if using a lighter weight.

Make sure the ball is not positioned on a pulsating area, as that indicates you're on the wrong spot. Adjust it slightly if needed. Next, move your leg on the same side as the ball out to the side and then back in. You can also try doing small marches with that leg.

The key challenge here is keeping your abdominal muscles relaxed so that the ball can sink beneath them and target your psoas, which lies on the front part of your lumbar spine.

Remember, this is just one method, and there are other ways to release your psoas. Consulting with a physical therapist or healthcare professional can provide additional guidance tailored to your specific needs.

What do you think are the biggest challenges facing the field of physical therapy today?

The Biggest Challenge in Physical Therapy: Medicare Cuts Threaten Patient Access

My name is Emily. I'm a physical therapist. One of the biggest challenges facing the field of physical therapy, specifically where I'm working in an outpatient clinic, but I'm specifically located at outpatient clinic in a hospital setting, is the cuts from Medicare and Medicaid in reimbursement, which is going to play a role in our ability to upgrade our technology or what we provide for patients and also what's accessible to patients. Where I work specifically, we see a lot of Medicare and Medicaid patients. We serve homeless population, and so it's just going to decrease their accessibility to care. And we know from research that early access, especially to physical therapy, can save on imaging, can save on medication, and can help people's pain that much faster. So we've been having to work extra hard to advocate for ourselves as a profession to our local government and to maintain the amount of reimbursement as much as possible. So that's, you know, specifically for a company that heavily serves those populations. I don't think that private practices are going to see as much of that because they can go to a cash model, but unfortunately that's not accessible to patients that are already struggling financially or within a low socioeconomic status.

One of the biggest challenges facing physical therapists specifically in an outpatient clinic setting is the cuts from Medicare and Medicaid in reimbursement which will affect the care given to patients, especially those of a low socioeconomic status. Therapists have been working hard to advocate for themselves and their patients in order to maintain the amount of reimbursement as much as possible.

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As a physical therapist working in an outpatient clinic within a hospital setting, one of the biggest challenges we face is the cuts in reimbursement from Medicare and Medicaid. These cuts impact our ability to upgrade technology and provide necessary services to patients. In our clinic, we serve a significant number of Medicare and Medicaid patients, including those from homeless populations. These cuts in reimbursement decrease their accessibility to care.

Research shows that early access to physical therapy can lead to cost savings in imaging and medication, as well as faster pain relief. To address this challenge, we have been advocating for our profession to local government officials, emphasizing the importance of maintaining adequate reimbursement rates. While private practices may have more flexibility to transition to a cash model, this option is not accessible to patients who are already facing financial struggles or belong to a low socioeconomic status.

Overall, the challenge of reduced reimbursement impacts our ability to provide quality care and limits accessibility for vulnerable patient populations.

How do you help patients stay motivated and engaged during their rehabilitation process?

Tailoring Treatment with Personal Goals and Education for Effective Rehabilitation

My name is Emily. I'm a physical therapist. I'm going to answer this from a slightly different position because I do work with a lot of chronic pain, chronic illness, and our clinic particularly serves a large portion of our homeless community. So how do I keep them motivated and engaged, especially when they've had pain for many years? I take the time to get to know my patient and really tailor their treatment plan toward their personal goals and things that they find valuable. I also spend a large amount of time in between exercises explaining why they need to do their exercises in terms that I know they'll understand. I'm not going to use textbook terms because I do realize that not everybody goes to school for physical therapy or athletic training. They're not going to understand the anatomical terms or scientific terms. So creating an environment where I'm educating them on this activity is going to help you for this reason and for them in particular. Like for a specific activity that they want to get back to doing or that they want to have less pain while they're doing. And then I just spend extra time each session, especially at the beginning and the end, explaining to them why it's important that they continue their plan of care even after they discharge from physical therapy. You know, sometimes I'm really straightforward and say if you're not willing to work in physical therapy, physical therapy might not work for you because that is the physical aspect of it. You are required to do a certain amount, a certain amount of movement with your body for it to help you.

I take the time to get to know my patient and their goals, and explain why they need to do exercises in terms they can understand. I then create a positive environment where I'm educating them on why it's important to continue with their plan of care, even after they discharge from physical therapy.

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As a physical therapist, my approach to helping patients stay motivated and engaged during their rehabilitation process is slightly different. I often work with individuals dealing with chronic pain, chronic illness, and even those from the homeless community. Here's how I approach it:

Firstly, I take the time to truly understand my patients and their personal goals. I tailor their treatment plan to align with what they find valuable and important.

I also make an effort to explain the reasons behind each exercise or activity in a way that is easily understandable to them. I avoid using complex anatomical or scientific terms that may not resonate with everyone. Instead, I focus on educating them about how a specific activity will benefit them, especially in relation to something they want to get back to or reducing pain during certain activities.

Additionally, I dedicate extra time during each session, particularly at the beginning and end, to emphasize the importance of continuing their plan of care even after they complete their physical therapy. I'm honest with them, explaining that their active participation is crucial for the success of their therapy. I may even say that if they're not willing to put in the effort, physical therapy may not be effective for them, as it requires a certain level of commitment and movement from their side.

By personalizing the treatment plan, providing clear explanations, and emphasizing the importance of their active involvement, I strive to keep my patients motivated and engaged throughout their rehabilitation journey.

Musculoskeletal

How soon can I come back to working out postpartum? What signs should I look for to know I'm doing too much too soon?

Postpartum Workout: Signs You're Doing Too Much

Hi, I'm Emily. I'm a physical therapist. I do actually specialize in postpartum care, so this is a tough question to answer. Ultimately, it does come down to the conversation that you need to have with your OB-GYN right after you have your baby, and it depends on how you delivered your baby. If it was a cesarean section or a vaginal delivery, and how things went during that vaginal delivery, do you have any tears or stitches or anything like that? Assuming an uncomplicated delivery, vaginal delivery, you could start simple breathing exercises and light transverse abdominus activation exercises, not like sit-ups or crunches or crazy core work, and very light pelvic floor work as soon as up to day two postpartum. I personally also started walking very short distances, keeping in mind if I felt lightheaded or dizzy or anything like that, I didn't go any further the day after I delivered both of my kids. So that was a conversation that I very openly had with my OB-GYN the day after I delivered. I asked if it was okay if I went for a short walk. How do you know if you're doing too much? Number one, you're gonna watch for how are you managing your pressure. If you have midline doming, if you look up diastasis recti, it's very normal to have a separation of the abdominals in this region immediately postpartum because you just grew another human being. But if you are doming in the midline when you're doing any of the breathing or the exercises, it means you're not managing your pressure well and you need to avoid that because that's making that tissue have too much pressure. Also if you notice if you're going for walks that you're bleeding increases, it means you're doing too much because where the placenta is attached in the uterus and then it detaches when you deliver it, there is basically a wound inside of there that you need to allow to heal. So you have to listen to your body during this time. So you're going to watch for your pressure management, I don't want you breath holding, and for any increased bleeding.

Depending on how you delivered your baby, postpartum exercises can start as early as the day after delivery. These should be light breathing exercises and transverse abominus activation as well as light pelvic floor work. It is important to also watch for diastasis recti and midline doming, as this could mean that too much pressure is being put on the tissues. Additionally, if there is increased bleeding it could mean that you are doing too much and need to take a break.

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As a physical therapist specializing in postpartum care, I understand the importance of safely returning to exercise after giving birth. The timeline for resuming workouts depends on various factors, such as the type of delivery and any complications you may have experienced. It's crucial to have a conversation with your OB-GYN to determine the best approach for your specific situation.

Assuming an uncomplicated vaginal delivery, you can start with gentle breathing exercises, light transverse abdominus activation exercises (avoiding sit-ups or intense core work), and light pelvic floor exercises as early as two days postpartum. Personally, I began with short walks, being mindful of any lightheadedness or dizziness. I openly discussed my plans with my OB-GYN and received their approval before starting any exercise routine.

To know if you're doing too much too soon, pay attention to how you manage pressure during exercises. If you notice midline doming (diastasis recti) while performing breathing or exercises, it means you're not managing pressure properly and should avoid that movement. Additionally, if you experience an increase in bleeding during or after walks, it may indicate that you're pushing yourself too hard. Remember, your body needs time to heal, especially the area where the placenta was attached in the uterus.

Listen to your body and watch for signs of poor pressure management or increased bleeding. Avoid breath-holding and be mindful of your body's signals during this postpartum period. It's essential to prioritize your recovery and gradually increase the intensity of your workouts as you heal.

What are three things you do to be productive?

Productivity hacks: Setting small goals, finding dopamine boosts, and planning ahead

I'm Emily and I'm a physical therapist and I also have ADHD. So three things I do to be productive. Number one, I give myself small goals. I write out a list. I enjoy crossing things off. Number two, I alternate things that I know give me dopamine such as vacuuming because it's very satisfying with something that I don't necessarily like like putting away laundry. That way I have moments in which I'm doing something maybe I don't enjoy and then I do something that does give me kind of that boost and feedback. And then the last thing is every night and especially at the beginning of the week, I write out my week so that I can look ahead at each day and make it feel a little bit more doable so that night after night, I'm only looking at one day at a time. So calendar lists and alternating those valuable tasks with less valuable tasks.

I use lists and calendar to set small goals and alternate between enjoyable, rewarding tasks and less enjoyable tasks in order to be productive.

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As a physical therapist with ADHD, there are three things I do to enhance my productivity. Firstly, I set small goals and create a list. I find satisfaction in crossing off tasks as I complete them. Secondly, I alternate between activities that give me a dopamine boost, like vacuuming, and tasks that I may not enjoy as much, such as putting away laundry. This way, I have moments of reward mixed with less preferred tasks. Lastly, I make it a habit to plan out my week, especially at the beginning of each week. This allows me to focus on one day at a time, making it feel more manageable. By utilizing calendars, lists, and alternating valuable and less valuable tasks, I optimize my productivity.

What stretches and tools would you suggest for someone experiencing arthritis in their fingers, especially with weight training?

Creative Weight Training Solutions for Arthritis in Fingers

What stresses and tools would you use for somebody with arthritis in their fingers for weight training? I'm a physical therapist and some would say I think with an OT or an occupational therapist mind the first thing I would tell you actually is to look at the way that you're loading your weights. So are you holding them in your hands and at your side? Are you loading them up high? Are you using different types of weights? Maybe bands, maybe cuff weights, maybe machines. So just getting creative with different types of weights that you use and also considering some lifting gloves that are going to add some grip to your fingers so you don't have to grip so hard. I would encourage you not to hold the weight quite as much down this way. That's going to put a lot of load on your forearm. Occasionally loading it up high kind of right in front of your shoulder or at your chest like a single heavier weight for leg exercises is going to save how much grip you're performing. And then for stretching it's going to be gentle because of the arthritis kind of opening up that hand getting in a more what we call supinated position to stretch that forearm. Stretching out your thumb maybe doing some thumb massage and then strengthening in between those fingers so maybe some putty exercises and work on strengthening opening not gripping. So no more gripping exercise but strengthen opening the hand.

To search for somebody with arthritis in their fingers for weight training, consider using different types of weights such as bands, cuff weights, and machines. Additionally, use lifting gloves to add some grip and provide support. For stretching, use gentle exercises to open up the hand and stretch the forearm and thumb. Strengthening exercises should focus on opening the hand and not gripping it. Putty exercises can be useful for this purpose.

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For weight training with arthritis in the fingers, there are a few stretches and tools that I would recommend. Firstly, consider the way you load your weights. Explore alternatives such as holding them at your side or using different types of weights like bands, cuff weights, or machines. Lifting gloves can also provide added grip and reduce the need for a tight grip. Avoid holding the weight with a downward grip as it puts excessive load on the forearm. Instead, try loading the weight higher, near your shoulder or chest, for certain leg exercises to minimize grip requirements.

When it comes to stretching, be gentle due to the arthritis. Open up your hand and try a supinated position to stretch the forearm. Additionally, focus on stretching your thumb and engaging in some thumb massage. Strengthening exercises should target the spaces between your fingers rather than gripping exercises. Consider using putty exercises to strengthen these areas and work on opening the hand rather than gripping.

Remember to consult with a physical therapist or occupational therapist for personalized guidance and recommendations tailored to your specific situation.

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Physical therapist specializing in sports medicine, women's health, orthopedics, Parkinson disease/Parkinsonism and multiple sclerosis.

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

Emily Hill, DPT