In the New Year, I, along with many others, partake in the tradition of resolutions; I try to push myself to be better with my health, personal, family, and career goals. I recently started reading The Impact Body Plan by Todd Durkin, M.A., C.S.C.S. This book explores many fitness myths that are often used as excuses to not reach certain fitness goal. Our main goal at Foothills Sports Medicine is to get our patients healthy enough to return to the activities they love, but we often find excuses to avoid caring for ourselves. Let’s tackle some of these myths or excuses and make 2017 the year we all focus on our goals. 

MYTH 1: “Aches and pains are expected with exercise.”

This is absolutely not the case. Muscle soreness is often expected after workouts, but pain or discomfort in your back, knees, or ankles is never normal. It is important to understand the difference between muscle soreness and pain in the muscles and joints. Muscle soreness can often feel dull, tight, or you may feel fatigued, whereas pain can be sharp and often lingering with no relief. Aches and pains often arise when you are not taking care of your body properly. Exercise should not be a negative experience for you, it should be a time you enjoy and are focused on yourself and reaching your goals.

MYTH 2: “The longer my workout, the more beneficial it is.”

Time is often one of the biggest excuses people use to not be active. Working out does not have to consume your entire day, or even a whole hour. The American Heart Association suggests only 30 minutes a day for five days a week. Let’s put that into perspective: studies have recently shown that the average person spends about 90 minutes on their phone a day, leading up to about 23 days a year and about 3.9 years of an average person’s life. You can incorporate this activity into your daily routine by going for a walk at lunch, parking farther away from your office, or even taking the stairs multiple times throughout the day. Be smart with your activity, work hard while you are training, and always put your best effort into your workouts and you will not have to spend hours at the gym.

MYTH 3: “I’ll never be flexible—my muscles have been tight all my life.”

Muscles can be trained. Being inflexible stems from not training your muscles in the correct way. Whether you don’t exercise consistently or exercise incorrectly, both can cause imbalances in the muscles. Our body is a machine that needs every single part to work together properly to function at its fullest potential. When we have imbalances in our body, it will find ways to compensate creating restrictions. Incorporate a foam roll session into your daily routine to promote the tissues’ ability to return to a relaxed state.

MYTH 4: “If I’m not sore or in pain, I’m not working out hard enough.”

Do not make soreness your priority. There are many factors that contribute to being sore including, but not limited to, type of exercise, amount of reps, and the weights being used. Try to use other tangible measures to verify for yourself that you are working hard, i.e. your progress from session to session. Are you able to complete more this time? What is your fatigue level in comparison? Use your feelings after a workout. How is your stress level? Are you feeling happy?

If you have any questions about what you may be feeling during your workouts or other activities, schedule a visit to one of our many locations for a Rapid Recovery Injury Assessment.

 

When I treated my first patient who had been diagnosed with Complex Regional Pain Syndrome (CRPS), the condition was foreign to me. To say I was overwhelmed would be an understatement. My mind began to race: How am I going to help this person if I can’t even touch their foot? What difference am I going to make? Will she be able to dance again? In the face of these challenges, I sat down, did some research, and gained a better understanding CRPS – then I was able to use my creativity to find a solution.

So how is this condition treated? First, let’s break it down. Complex regional pain syndrome is considered to be a chronic pain condition that usually affects the limbs following an injury or trauma. There are two types of CRPS; CRPS-I and CRPS-II. CRPS-I is found in patients who do not have a nerve injury, whereas patients with CRPS-II do have a nerve injury. However, both of these types usually present with the same symptoms and can be treated in the same way.

Next, a therapist needs to consider what their patient is feeling. CRPS can cause a variety of symptoms, but all patients with the condition are in constant pain. This pain can feel like ‘pins and needles’, or it can be a burning sensation. Your patient’s pain can also feel worse when even minimal touch is applied due to increased sensitivity. Additionally, pain can travel to larger portions of the limb, and even to the limb on the opposite side of the body.

My patient’s sensitivity was extremely heightened, and even the lightest of touches caused pain. She was losing range of motion, had increased swelling, and increased pain. She was only able to walk with crutches on both sides, and could not put any weight on her lower limb. This would be difficult for any patient to deal with, but this was particularly hard on my patient because she was a competitive dancer who needed to be flexible and constantly on her feet. She did not have any nerve damage and was diagnosed with CRPS-I following a simple sprained ankle.

This caused my initial concern – how can I treat her ankle if I can’t even touch her foot? That’s when I came across mirror therapy (MT). Mirror therapy is often associated with patients that have has amputations and are experiencing phantom limb pain, or pain and sensation in an area where the limb was removed and is no longer there. Some research on mirror therapy provided evidence that MT could be beneficial for patients with CRPS. Using a mirror box, you place the affected (painful/injured) limb into the box, and the unaffected limb facing the mirror. The therapy session begins by initiating movement in the unaffected limb, and the patient can see its reflection in the mirror as it moves, which gives the appearance that the affected limb is also moving. The patient receives visual feedback telling them they can move the affected limb without feeling pain. Essentially we are tricking our brain into reorganizing itself and forming new connections. The brain’s amazing ability to adapt and create new pathways is called neuroplasticity.

After reading the research that showed patients had positive responses patients to this treatment, I decided to give mirror therapy a try. I went out to get the supplies, picked up a mirror box, watched several videos on how to make them, and came up with a design. Now it was time to implement the treatment. My patient and I began with small movements of the unaffected limb in the mirror and eventually worked into full range of motion. We combined this treatment with sensory integration and gait training. With these techniques, she was able to gain more range of motion, decrease the hypersensitivity, and increase weight bearing. The MT techniques increased as well – we were able to incorporate active range of motion and greater movement of the affected limb while in the mirror box. Within a couple of weeks, my patient was making progress towards her prior level of function, and it was a very exciting time for her. Soon she was able to get off her crutches and walk normally. Our next step was getting her back to dancing. We implemented sport-specific exercises and she continued to make major advancements toward her goals. Although mirror therapy was not the only technique we used in returning her to competitive dance, I do believe it made a difference in the process. The patient was able to return to what she loved, and I was able to learn a valuable technique which I have since used multiple times.

If you have more questions about complex regional pain syndrome and/or mirror therapy, please contact your nearest Foothills Sports Medicine physical therapy clinic today. We would be happy to help you get back to your favorite activities!

 

References:

Cacchio, A., Blasis, E. D., Blasis, V. D., Santilli, V., & Spacca, G. (2009). Mirror Therapy in Complex Regional Pain Syndrome Type 1 of the Upper Limb in Stroke Patients. Neurorehabilitation and Neural Repair, 23(8), 792-799. doi:10.1177/1545968309335977

“Complex Regional Pain SyndromeFact Sheet”, NINDS, Publication date June 2013.

NIH Publication No. 13-4173

Definition of Neuroplasticity. (2012, June 14). Retrieved August 06, 2016, from http://www.medicinenet.com/script/main/art.asp?articlekey=40362

Lowe, R. (2015, March 7). Mirror Therapy. Retrieved August 06, 2016, from http://www.physio-pedia.com/Mirror_Therapy