Maggie Duggan, PT, DPT, FDN-1, CF-OL1
We know that using BFR promotes muscle hypertrophy and strength as well as neuromuscular gains. Increasingly studies are now demonstrating improved bone health with BFR use. Who doesn't want improved muscle, nervous system, and bone health?
"First evidence indicates that low load BFR exercise is effective in promoting an osteogenic response in bone, although this has previously been postulated to adapt primarily during high-impact weight-bearing exercise....first long-term trials demonstrate beneficial adaptations in bone in both healthy and clinical populations."
We are proud to offer BFR to our healthy wellness populations to provide an edge in their strengthening, performance, and osteogenesis (bone growth) as well as our physical therapy patients who need it for strength, neuromuscular, and bone returns after injury or surgery.
One participant group performed low-intensity home resistance training (sit-to-stands, modified push-ups, and TheraBand leg exercises). The other group performed high intensity exercises in a facility with machines (same leg exercises but with machines, lat pull-downs, seated shoulder press machines). Participants had their muscle strength, muscle mass, and function measured at baseline, 6 months of training, 12 months of training, and 6 months post-study. Both groups used the same progression protocol, but neither demonstrated superior effects to the other group in terms of strength and muscle mass.
What does that mean for us?
It is ok to not have to go to the gym for every workout or at all to exercise. Going to the gym has other benefits such as accountability, exposure to new exercises, encouragement from peers, and more, but to maintain strength and muscle mass, you can keep going with your TheraBand and calisthenics exercises at home. Lack of access to a gym does not mean that you cannot work out after therapy ends.
Maggie Duggan, PT, DPT, FDN-1, CF-OL1
Committing to getting healthy, working out more, finally seeing results is a...journey
And one that can come to a grinding halt in on morning with tight, stabbing pain in the heel.
While it's easy to walk it off at first, hit the box, and continue on with the day, it becomes more difficult to ignore as the nagging pain in the heel grows stronger.
And walking becomes nearly unbearable, never mind box jumps and deadlifts.
Did this description sound familiar?
These are all common signs and symptoms of plantar fasciitis.
WHAT IS IT?
"Plantar Fasciitis (PF) is an overuse injury that occurs due to excessive loading of the plantar fascia, possibly related to pronation and low arch height, which flattens the medial arch and increases stress on the fascia"
TRANSLATED: The plantar fascia is a thick band of connective tissue at the bottom of the foot responsible for absorbing load and creating tension to enable walking, running, and jumping. When the origin of the plantar fascia becomes irritated, it becomes painful.
WHAT DOES IT FEEL LIKE? "PF is characterized by pain concentrated at the medial calcaneal tubercle that increases with weight-bearing following periods of non-weightbearing."
TRANSLATED: Usually plantar fasciitis is experienced as a sharp pain at the direct center of the heel, off to the inside of it, or all around it. Typically, it hurts most at the beginning walking after sitting/resting for an extended period of time. The pain can also improve as with continued walking, mobility, general movement, etc.
WHAT CAUSES IT?
SIGNS AN ATHLETE SHOULD NOT CONTINUE TO EXERCISE AND RUN THROUGH PLANTAR FASCIITIS:
While it is possible to continue with an exercise regime despite pain, strong indicators that it’s time to see a physical therapist include:
Consequences could include:
"Continuing to run (and exercise) through pain with plantar fasciitis could result in altered gait. Compared to healthy runners, individuals with PF have been shown to have [altered foot mechanics such as]…greater rearfoot eversion, forefoot sagittal range of motion, and first metatarsal phalangeal joint range of motion.
Further, individuals with PF have lesser vertical ground reaction forces during propulsion, reduced rearfoot center of pressure (COP), reduced impulse, and reduced peak vertical ground reaction force at loading response as compared to healthy individuals "
Translation: When an athlete is struggling through a rough case of plantar fasciitis, foot mechanics will be changed and altered. This can lead to general compensations resulting in further injury, especially during high impact activities such as box jumps, running, etc.
HOW TO FIX PLANTAR FASCIITIS
A well rounded approach including both manual treatment by a physical therapist and exercise is the best rehab routine!
Manual, or hands on, intervention, may include mobilizations of the heel bone to restore calcaneal mobility and soft tissues. This can including blading, dry needling, and more to improve tolerance to symptoms.
Exercises your physical therapist may use during your treatment session include:
If you’re wondering whether it’s time to seek out professional care, it’s time.
Cheung, R. et al. (2015) “Intrinsic foot muscle volume in runners with and without chronic bilateral plantar fasciitis,” Physiotherapy, 101. Available at: https://doi.org/10.1016/j.physio.2015.03.414.
Kelly, D.K., Wiegand, K. and Freedman Silvernail, J. (2022) “Dynamic Stability in runners with and without plantar fasciitis,” Gait & Posture, 96, pp. 301–305. Available at:
Osborne, J.W.A. et al. (2019) “Muscle function and muscle size differences in people with and without plantar heel pain: A systematic review,” Journal of Orthopaedic & Sports Physical Therapy, 49(12), pp. 925–933. Available at: https://doi.org/10.2519/jospt.2019.8588.
Wiegand, K., Tandy, R. and Freedman Silvernail, J. (2022) “Plantar fasciitis injury status influences foot mechanics during running,” Clinical Biomechanics, 97, p. 105712. Available at: https://doi.org/10.1016/j.clinbiomech.2022.105712.
“How do I fix my weak glutes?”
"My glutes won't turn on."
“What are the best glute exercises I should be doing?”
Ever had ANY of these injuries before?
general difficulty "turning the glute muscle on"
But there's a twist.
There's a difference between glutes "being on" and activated vs. glutes being strong.
Case in point:
"Electromyography research has shown that the single-leg squat and clam shells activate the gluteal musculature. A variety of hip extensibility exercises have been proven in the literature to increase hip range of motion in runners. No research measured the effects of a combined hip strengthening protocol with a hip stretching protocol on the presence of lower crossed syndrome in high school runners and the effect on running economy and performance."
While fancy EMG studies say single leg squats and clam shell exercises are some of the best when it comes to activating glute muscles…
Some exercises work better than others.
Meaning, these exercises may be a great place to start, but for an athlete who is routinely working out multiple times a week at an intense level (crossfit, running, baseball, soccer, etc)...
Clam shells just don’t cut it.
So while it remains true that to build strong glutes, FIRST the glutes need to be "on" or activated, each athlete’s glute activation exercises will be slightly different.
HOW DO I TURN ON MY GLUTES?
The most common self-treat method:
While the “do it yourself” method is possible, it:
Or…steal exercises directly from physical therapy clinicians, especially the ones used in the clinic on a regular basis.
After finding the correct glutes exercises (with the help of physical therapy clinician), it becomes easier to feel glutes firing and activating,
Benefits of strong glutes:
BEST GLUTE ACTIVATING EXERCISES: 3 rounds using a medium to heavy weight
While this circuit can help relieve pain and address lingering glute weakness, if pain persists during or after these exercises, it’s best to consult with a physical therapy clinician to determine root causes and appropriate individualized treatment.
Have questions about whether it’s time to schedule an appointment? Fill out any contact form on our website.
We can’t wait to see you!
Marie Whitt, PT, DPT
Elbow pain in lifters is a common and an especially frustrating occurrence, which can derail your goals, cause lost gym time, and create a great deal of misery.
Elbow pain in weightlifters is generally attributed to an overuse or inflammatory issue of the tendons, muscles, and other soft tissues around the elbow. Pain and symptoms can be at the inside of elbow (sometimes called golfer’s elbow), the outside of the elbow (tennis elbow), or on the back side of the elbow (triceps tendonitis). Additionally, peripheral nerves running through this area can also be over tensioned or compressed and create symptoms. If too much stress is locally placed on these areas, the tissues can become irritated and inflamed. Often the onset of symptoms happens with:
What are the most common complaints of lifter’s elbow?
What causes it?
The standard explanation is an overuse or over stress of tissues around the elbow as explained above. This can be the result, but not necessarily a good explanation of the cause. Predominantly, complaints of elbow pain and irritation are the symptoms of an issue that is happening upstream or downstream from the elbow. Similarly to the knee, the elbow is stuck between two other major joint areas. If the hip or ankle/foot cannot do their jobs due to mobility or strength deficits, the knee joint and tissues around it will have to “pick up the slack” and take on extra stress.
The elbow will act in a similar fashion if the shoulder and wrist/hand cannot meet the demands of the task imposed upon them. Examples of this include increased inside elbow stress if one lacks mobility in the shoulder, trunk, or wrist while in a front rack or catching a clean. Any activity involving a barbell or pull up bar will put the hands in a fixed position, The body must find a way to get into a shape to successfully perform the lift or task. If mobility is lacking in the wrist, shoulder, or even the spine, the elbow is prime candidate to bear the brunt of extra stress. This is an underappreciated component and many times why rehab programs that only address the local area without looking at the whole body are not successful
local structures of the elbow, but globally treating whole system and how to integrate the body together, allowing more efficient movement and improved distribution of forces.
If you are experiencing lifter’s elbow, don’t wait and hope it will go away. Contact ProFormance Therapy and Wellness today!
Kevin Steen, PTA
May 15th at 12 pm.
Be sure to sign up for this year's Wayne C. Gardener Memorial Golf Classic at the Huntsville Country Club sponsored by T&W Operations! We will be there helping golfers before and after the event. Proceeds go to Helping a Hero. Do not miss out on a fun day of golf!
Who is Helping a Hero? What has Helping a Hero done locally?
Do you have tightness, tension or pinching in the front of your hip? How about low back tension or pain? A limited ability to get the hip flexor muscles to relax and lengthen can be a contributor to these issues. Additionally, limited hip motion due to tension in the hip flexors will make it difficult to hit good positions with lifts such as snatches and overhead squats. Limited hip motion will also shorten stride length with running.
What are hip flexors?
Neck Pain and Whiplash
Shoulder, Elbow, and Hand Pain
Rotator Cuff Pain
Carpal Tunnel Syndrome
Repetitive Stress Injury
Tennis Elbow and Golfer's Elbow
Knee and Ankle Pain
Herniated and Bulging Discs
Heel Spurs / Plantar Fasciitis
Nerve Root Pain
Post Operative Pain
How does it work?!?
How ML830 cold laser therapy can help you rapidly reduce pain and inflammation
and/or quickly strengthen healed tissues to prevent re-injury. As the ML830 microlight increases the speed of healing through a complex augmentation of your body’s normal inflammatory process. The non-thermal laser penetrates deep into your tissue promoting photobiostimulation. In essence, the cellular metabolism increases which in turn accelerates cell repair increases blood flow and stimulates the immune and lymphatic systems.
The photobiostimulation energizes cells and accelerates your body’s normal healing process.
That’s not all; Low-Level Laser Therapy with the ML830 also improves collagen and muscle tissue
development and helps generate new healthy cells and tissue. Clinical studies to date have shown a
reduction in pain, inflammation, edema, and an overall faster healing time. Amazingly, the ML830
creates true healing instead of masking pain as in the case of ice, heat, medication, and electrical
What does treatment look like?
Treatment with the ML830 Laser is painless consisting of several brief sessions, lasting a couple of
minutes to about five minutes per whole body part on average. Each area is treated with the laser for about 1.5 minutes. Roughly 3 to 4 areas make up a whole body part. You should not feel anything during treatment other than the ML830 Laser’s tip coming into contact with your skin. There is no pain, electrical pulses, or feeling of heat during treatment as is common with other therapies. Only a very small number of patients have ever reported feeling anything during therapy (about 3%). Of those, they only report a feeling of slight warmth or slight stimulation of nerves, nothing discomforting at all.
You may be one of the 75 to 80% of patients who feel improvement immediately after (and sometimes
during) treatment. For chronic conditions, it might take a few treatments. This advanced technology is non-invasive, painless, and drug-free!
How the ML830 is unique
Up until now, other lasers were only able to penetrate half as deep into bodily tissues. The ML830,
with its patented 830nm wavelength, is the only device capable of a penetration capacity of
approximately 5cm with a 3cm lateral spread. This makes the ML830 the deepest penetrating
treatment modality currently available allowing it to reach many more of your tendons, ligaments,
and muscle tissues.
ML830 Cold Laser Therapy Is Safe, Painless and Noninvasive.
The MicroLight Corporation is the exclusive manufacturer of the patented ML830 Laser and the first company approved in the United States by the FDA to provide low-level laser therapy for the non-surgical treatment of Carpal Tunnel Syndrome.
The ML830 has been safely used around the world for over 30 years with great
success. In fact, General Motors was part of the original ML830 Laser clinical studies, testing all
employees at their Flint Michigan plant who suffered from Carpal Tunnel Syndrome (this was a large
group). “GM found it to be 70 to 80 percent effective – nearly 80 percent of the people in the study went back to work, while the other 20 percent experienced some improvement.” However, there’s more, the ML830 is the world’s first FDA-approved “3-B Laser” after passing guidelines that include years of clinical studies and tests. The FDA has some of the highest standards in the world. Surprisingly enough, the Laser doesn’t generate heat and is approved to be used over metal implants and fractures making it safer than Ultrasound. Laser therapy can be used when you want or need a drug-free procedure to control pain, when conventional therapies have been ineffective, or when you want to quickly heal from injuries.
For more information, please see the MicroLightCorp website.
Take advantage of this exclusive decrease way to decrease pain and promote tissue healing pain with the ML830 Cold Laser Therapy.
“Normally, patients undergoing Achilles surgery take a year to return to sport. We are hoping to cut that down by at least 30% and potentially make patients stronger as well,” said Dr. Drakos. “Blood flow restriction therapy is an accelerated rehabilitation protocol. The therapy essentially creates an environment in the muscle where it makes the muscle work as hard as if it is lifting heavy weights when it is lifting smaller weights. Cutting off the blood flow tricks the muscle into working harder than it actually would be doing…
Achilles rupture often presents a difficult recovery for patients, who commonly suffer a 10% to 30% strength reduction in the affected leg up to one year postoperatively… Blood flow restriction therapy allows us to work the muscle right away, so it doesn’t atrophy and shrink. It safely allows the muscle to see some loading and develop more muscle, so that it can actually start to recover while the tendon is not completely healed yet.”
This technique can be used for most muscle groups. We have the Smart Cuffs Pro here for your training and rehab needs. Get the most bang for your buck here at ProFormance.