Tuesday, 11 August 2015

Stretch Your Calves: Why This Is So Important for Everyone




Calves
I'm guessing you don't think much about your calves as you go about your day-to- day activities.  There they are at the back of your lower leg, not doing much… so it seems.  They have a crucial role in your ability to stay balanced, strong and injury free and so they are worth an introduction.
Your calves are made up primarily of the Gastrocnemius and the Soleus muscles which both attach at your heel via your Achilles tendon.  This lovely strong part of your lower leg has a few important jobs to do as you go about your day-to-day life.
Responsibilities of Your Calf Musculature:
1) The muscles of the posterior lower leg (calf) act as powerful plantar flexors of the ankle joint.  Plantar flexion describes the movement of pointing/pressing the ball (front part) of your foot downwards.  You perform plantar flexion when standing on your tippy-toes, pressing the gas pedal of a car, walking, and running. While plantar flexing, the calf muscles provide the main forward propulsive force in walking and running by using the foot as a lever and raising the heel off the ground.
2) The Gastrocnemius muscle helps the bigger muscles further up the leg to bend or flex the knee.
3) These muscles help to keep you balanced and upright. They play a vital role in separating humans who stand and walk on 2 legs from other mammals that stand and walk on 4 legs.  While standing, these muscles neurologically communicate with other systems in your body to recognize when you start to sway (in any direction) and they are triggered to fire to keep you balanced and standing tall.
So why am I introducing you to your calves?
Here's why:  
In my office, every day, I see patients that have foot pain, heel pain (plantar fasciitis), achilles tendon pain and dysfunction, shin splints, calf pain, knee pain and even hip and back pain.
The thing that they have in common:  Tight Calf Musculature
In fact, even without symptoms, many people have tight musculature in this part of their bodies.  
Why does everyone have such tight calf muscles? 
It’s because almost everyone does something almost every day, for potentially many hours per day that human beings are not designed to do:
They sit in a chair.
In ancient cultures, human beings didn’t sit in a chair, they would stand or lie down or sit on the ground with their legs crossed or in front of them or squat on their haunches. 
In our current modern day culture we are rewarded as a society for sitting in a chair.  Many of us sit to work, we sit to eat, we sit to drive, we sit for entertainment in front of a television or a computer. 
All of us sit waaaayyy too much and it’s causing problems for our health.
We talked in a previous post about how all this sitting keeps us from being active and how that wreaks havoc on our health.
So what does sitting too much have to do with my calf muscles?
When you are seated at your desk or in your car, or relaxing in front of the television, your knees are bent (flexed at 90 degrees) and your feet are plantar-flexed or in a relaxed forward position.  This is especially relevant for women who wear high heels to work as their feet are automatically pointed downward in a plantar-flexed position because of the shape of their shoes.
The posture of your knees and your feet while you are seated bring your calf muscles to a shortened position making them tighter.
Therefore, since everyone sits too much, that is why pretty much every person has calf muscles that are too tight.
Ok, so how does that make me more susceptible to injury?
Well, your body is a wonderful compensator. If you have lost flexibility or strength in one area, it will find it somewhere else along the anatomy train. 
If your calves are tight and inflexible and can’t do their jobs (that we talked about above) which are all vital to the normal biomechanics of walking and running, then muscles and joints above or below your calves will have to work harder for you to do the same motions.  This can lead to all of the aches and pains that I mentioned above that can be anywhere from your toes to your low back.
Also, as you get older and you lose strength and flexibility in the musculature of your calves, your balance will get worse and you will be more likely to fall.
Do you want to know if your calves are tight and if you are susceptible to injury or are you looking for the potential cause of your back, hip or leg pain?
First:  How much do you sit?  This is a relevant question even if you exercise one or 2 hours (or even more) per day.  If you are sitting for many hours a day, you likely have tight calves.
Second: Try these 2 things:  (Disclaimer…please be careful and go slowly so as to not injure yourself and if anything feels uncomfortable or painful, stop)
1) While seated, lift your leg straight out in front of you and point your toes up towards the ceiling and pull them back toward your knee.  This action is called dorsi-flexion and you will feel a stretch in your calf muscles when you dorsi-flex.  As you pull the foot and toes back toward you, you should be able to bend your ankle 10-20 degrees past 90 degrees.  If you can't, then your calf muscles are too tight.
2) Stand with your feet hip distance apart and squat down.  As you squat down if your heels pop up off the floor, you have tight calves.  In order to have full range of motion, you should be able to bring your rear thighs in contact with your calves while your heels stay flat on the ground.  
Keep in mind, that you need good flexibility in your hips and your knees as well to do this posture.  Also keep in mind that most people are not ready to get to this level of flexibility so if you can’t do it, don’t beat yourself up, but make it a goal because it is a normal human range of motion.
So I have tight calves…what can I do about it?
1) Sit less, move more.
2) Stretch your calves at least once per day but preferably more often than that.  Once per hour is not too much, so take a break every hour and do a little stretch.
Here’s how:
Calf Stretch on the Stairs
Place your toes on the edge of a stair and drop your heel toward the floor. You’ll feel a stretch in your calf and the bottom of your foot. Hold for 10-15 seconds.
Lower Calf Stretch
As you drop your heel, bend your knee and push your knee down toward your toes.  You’ll feel this stretch lower on the calf and on the inside of the lower leg. Hold for 10-15 seconds.
You can also do each of these stretches with your heel angled in or out to get a bit more stretch on the inside or the outside of your lower leg depending on where you feel tightness. 
Who knew that those muscles back there at your lower leg could play such an important role in so many aspects of your musculoskeletal health.
Sit less, move more and stretch your calves.  It really is important for everyone.
Dr. Peggy Malone

Friday, 31 July 2015

How to Buy a Mobility Scooter

by Andy Rentschler, BS


Scooters are a popular way for people with some mobility problems to get around in their homes.
Mobility scooters are a popular way for people with some mobility problems to get around in their homes, the grocery store, the shopping mall and other important areas in their neighborhood. If you are fatigued after walking to another part of your house or to your mailbox, you can still maintain your independence with the use of a fun and comfortable scooter.





Another name for a scooter is PMV or personal mobility vehicle.
People who benefit from having a scooter for mobility include people with multiple sclerosis, mild cerebral palsy, severe forms of arthritis. The elderly and stroke survivors also find that scooters help get from here to there without using a product that looks like medical equipment!
With more than 40 scooter models to choose from, how do you choose the right scooter for your needs? It's kind of like shopping for a car. You know what you need to use the car for, so that helps you to choose which car to buy. The same is true for a scooter.
Here is an easy checklist to help you decide which is the right scooter for you!
Your weight. How much you weigh is the first consideration. When making a purchase, you'll be asked whether you weight 250 pounds or less, or if you weight more than 250 pounds. The second choice is a more durable scooter to be able to carry that difference in weight. Consider whether you are close to that weight limit, and if you will be carrying heavy objects on your scooter or in your scooter basket! It all adds up!
Scooter dimensions. The size of the scooter is going to be important based on your environment. If you use your scooter indoors where the hallways are narrow and the corners are tight, then a smaller scooter with a small turning radius will be your better choice. You can find those measurements in the specifications section when review the details of any scooter.
Scooter durability. Eighty percent of scooter buyers purchase a 3 wheel scooter. Scooters come in three general sizes: compact, midsize and rugged outdoor. If you will use your scooter on rough terrain, hilly grass or a rural area like a farm, you probably will want a 4 wheel outdoor scooter. Four wheels adds more stability over rough terrain. A 3 wheel scooter allows better maneuverability in tight spaces.
Transportation. Will you be transporting your scooter in the trunk of a car? If so, you need to consider a scooter that disassembles. You also need to consider the size of those individual pieces and the weight of the largest piece. Many scooters do disassemble into three pieces, not including the batteries. The heaviest piece can be as much as 30 pounds. So, you might need to consider how much weight your spouse, friends or caregivers can lift in order to get that into the trunk of your car. Also check the sizes of the pieces to be sure you or a friend can get them into the trunk of the car being used! Alternatively, you could look at scooter lifts.
The seat. If you are in and out of your scooter seat all day, then you would probably be fine with the seat that comes standard with your scooter. If you remain in the seat most of the day, you'll want to consider upgrading to a more comfortable seat that has extra foam padding. Also consider leg room; if you are tall, you will want a seat that can be moved higher. Some seats also swivel for easy access, then lock in place when you are facing forward. More expensive, and thus more comfortable seats, are oftentimes called Captain chairs because they look like the chair/seat used by a captain on a boat.
The arms. If you are in and out of your seat, you'll probably want arms that rotate back out of the way for easy transfer. Some scooters come with arms that can be adjusted wider to allow more room for you and a heavy coat on chilly days, or to help adjust the chair to the most comfortable position for your needs.
Accessories. There are many options from pouches to baskets to headlines, and many of these options have an additional charge to them, just like when you bought your car. Take your time when scrolling through the Accessories list when comparing scooters and their value to your needs.
  • Headlights. If you drive your scooter at night outdoors, you probably will want headlights. That won't be just for the benefit of others to see you, but also for you to see cracks in you path. We do not recommend that you drive your scooter in the street. Some scooters come with directionals so you can alert others to the fact that you are turning.
  • Crutch, oxygen tank holders. If you walk with a crutch, you can order a crutch holder for your scooter. The same for your oxygen tank. If you don't need a particular accessory right now, consider what our needs might be next year and plan ahead.
  • Throttle. The throttle is near your feet, similar to the gas pedal for a car, and can be moved with your hands. But if you don't have good gripping with your hands, you might consider throttle extensions.
  • Left- or right-handed. If you are left-handed, or have had a stroke that left you weaker on your right side, you might want to ask for a left-hand drive scooter.
Colors. One of the most popular colors is red, followed by green, then blue. What was the favorite color of your favorite car?!
Tires. Most scooters now come with foam-filled tires. These eliminate the problem of flat tires.
The Tiller. If you have limited ability to grip, be sure you don't get a scooter that has knobs for release mechanisms. The tiller is like the handlebars of a bicycle, and it can be moved forward for easy access to sit down, the moved back in place for when you are ready to drive on. Some scooters are made with a lever that allows you to just move it with the push of your hand to release the Tiller.
Here is another important checklist of you are not sure if you are ready to buy a scooter. If you agree with the following questions, a scooter may be right for you:
1. My needs cannot be met with lesser equipment (e.g., manual wheelchair).
2. I have sufficient vision and judgment to guide a scooter safely.
3. Availability of power mobility will increase my access to different environments.
4. I can transport a scooter to and from intended environments.
5. I have sufficient strength, range of motion, and endurance in my hands and arms to guide a device with a tiller. (Scooters are guided by tillers, which are mechanically similar to the handlebars of a bicycle).
6. I have adequate trunk stability. (Seating options are limited on scooters so the user must be able to hold him or herself erect.)

Monday, 8 June 2015

When to Use Hot and Cold Therapy

Heat and cold are the two most common types of noninvasive and nonaddictive pain-relief therapies for muscle and joint pain. Which one you use depends on whether the pain is new or recurring.


In general, a new injury will cause inflammation and possibly swelling. Ice will decrease the blood flow to the injury, thereby decreasing inflammation and swelling. Pain that recurs can be treated with heat, which will bring blood to the area and promote healing.

The following information can help you learn when and how to use temperature-related therapies.

Heat therapy

What does heat therapy do?

Heat opens up blood vessels, which increases blood flow and supplies oxygen and nutrients to reduce pain in joints and relax sore muscles, ligaments, and tendons. The warmth also decreases muscle spasms and can increase range of motion. Applying superficial heat to your body can improve the flexibility of tendons and ligaments, reduce muscle spasms, and alleviate pain.

How is it applied?

Sources of heat can supply either dry or moist warmth. Dry heat sources may dry the skin. Moist heat may penetrate better. Heat can be applied by an electric or microwavable heating pad, hot water bottle, gel packs, or hot water baths. The heat should be warm, not too hot, and should be maintained at a consistent temperature, if possible. Ask your doctor or physical therapist which heat source would be best for you.

When do you use it?

Apply heat if you have stiff joints or chronic muscle and joint pain.

How can I use it safely?

Don’t apply it directly to skin. Instead, wrap the hot device in a thin towel.

Here are other tips:
  • Don’t apply heat for longer than 20 minutes, unless your doctor or physical therapist recommends longer.
  • Don’t use heat if there’s swelling. Use cold first, then heat.
  • Don’t use heat if you have poor circulation or diabetes.
  • Don’t use heat on an open wound or stitches.
  • Don’t lie down on a heating pad; you could fall asleep and burn your skin.
Cold therapy

What does cold therapy do?

Cold slows down blood flow to an injury, thereby reducing pain and swelling. Cold therapy slows circulation, reducing inflammation, muscle spasm, and pain. It should be used if the area is swollen or bruised.

How is it applied?

Cold is applied by an ice or gel pack.

When do you use it?

Any cold treatment should be used for 24 to 48 hours after an injury. Cold therapy is good for sprains, strains, bumps, and bruises that may occur in sports or lifting. Apply cold packs or ice bags to injured areas for no more than 20 minutes at a time, removing the cold for 10 minutes and reapplying it again.

How can I use it safely?

Don’t apply it for longer than 20 minutes. Also, wrap ice or ice packs in a thin towel before applying.

If in doubt as to whether to apply heat or cold to an injury, call your health care provider’s office.
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How to Use an Exercise Ball As a Chair

An exercise ball is a useful workout tool that helps to increase balance and strengthen the core muscles in your back and stomach. These muscles support your spine and help to take the burden of weight off the spine. Strong core muscles are elementary in achieving good posture. Recently, the fitness ball has moved out of the gym and into the home and office. People are using the ball as a chair in order to strengthen core muscles. This is called "active sitting" because your muscles are engaged. Using the wrong techniques with an exercise ball may do you more harm than good. This article will tell you how to use an exercise ball as a chair.

 photo 629px-Use-Exercise-Ball-as-Chair-Step-1_zps8258848a.jpgSteps

*Choose the right fitness ball for your height and weight. Measure your current chair and aim to have the diameter of the ball be about 4 inches (10.2 cm) higher than your current chair.
*If you are of average weight and you are under 5'3" (160 cm), you should choose a 55 cm (21.7 inch) diameter exercise ball. If you are between 5'3" and 6' (160 and 182.9 cm) you should choose a 65 cm (25.6 inch) diameter exercise ball. If you are over 6 feet (182.9 cm) tall, you should probably use a 75 cm (29.5 inch) diameter exercise ball

*Buy a burst-resistant exercise ball. These balls have an extra strong layer between the inside cavity and the environment. Offices and homes often have sharp objects like scissors, staples, paper clips and other items that can cause an office exercise ball to pop.
*Purchase your ball at a store that allows returns if the ball is not the right size. You will not know for sure that the ball will fit your desk and chair until you try it out in your home or office.
*Pump up the ball, aiming to pump it up to maximum diameter so that you do not sink too far into the ball.
*Sit up straight on the ball with your legs out in front of you. They should be at a 90 degree angle to your thighs and parallel to the ball.
  • At first, you can place your calves in front of you so that they are touching the ball. This will give you added stability while learning to use the ball. Later, you will want to move your calves so they are not touching, which will provide more benefits for your core


*Bend your elbows and place your forearms at a 90 degree angle. Reaching forward slightly, you should be able to rest them on the top of the desk or table.
 photo 629px-Use-Exercise-Ball-as-Chair-Step-6_zps6215cdb7.jpg
*If you are using a computer, make sure it is at a 90 degree angle. If it is not, your neck will be out of alignment with the rest of your spine, and the ball will be less useful in helping your posture.
 photo 629px-Use-Exercise-Ball-as-Chair-Step-7_zps15b6785a.jpg 
*Practice active sitting. This is the state when your body reacts to the prospect of falling off the ball by tightening your core muscles in your stomach and back. Flex the muscles in your abdomen to add an extra element of exercise.
*Use the ball in 20 minute intervals. Do not get rid of your office chair. Just like exercise, it is important to give your muscles rest to prevent muscle fatigue and get the maximum benefit.
*Work up to 30 minute intervals as you get used to the chair. Doctors do not recommend that you sit for longer than 30 minutes at a time. If you need to get up to change chairs frequently, this will also benefit your spine.

Tips

  • Most exercise balls are sold in metric diameter measurements, so be sure to measure your office chair in cm as well as inches.

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