Modern society and the reliance on technology has led many of us to spend increasing amounts of time at the computer or staring down at our cell phones. Whether it is for your occupation or for a hobby, the majority of us spend many hours of the day sitting. Prolonged sitting can have detrimental effects on our neck, back, shoulders, and wrists. In the long term, there are stretches and exercises to do at home and at the office to reduce the negative effects.

Effects of Prolonged Sitting

The human spine has natural curves or arches. The lumbar spine (the lower back) has a natural backward arch which is reversed in the sitting position if there is not proper lumbar support. Knees being constantly bent also contributes to hamstring tightness. The reversal of the lumbar curve also puts stress on the thoracic spine to increase its natural forward curve (known as a kyphosis). An increased thoracic kyphosis also causes the shoulders to round forward, which can lead to tightness in the chest.

Exercises to Reverse Effects of Sitting

Even with a proper sitting position, prolonged sitting can still lead to tightness of the muscles described earlier. To reverse the effects of prolonged sitting, you need to begin with correcting the lumbar spine positioning.

Hamstring Stretch

The first stretch is for the hamstrings which are shortened due to the knee bent position and it can be performed while still sitting in your chair. Just scoot to the edge of the chair and extend one leg out in front. While maintaining an upright chest position (do not round your back), lean forward until a stretch is felt in the back of the leg and/or behind the knee. The stretch should be comfortable.

Hip Flexors Stretch

The next stretch is for the hip flexors. These muscles begin in the low back and come all the way forward to the front of your hips. Start by standing next to your chair. Place one foot on the seat with your other leg straight and slightly behind you. Much like the hamstring stretch, keep an upright chest position and then lean forward leading with your pelvis until you feel a stretch in the front of your hip.

       Corner Pectoral Stretch

Let’s move to the thoracic region to address the chest. Find an unoccupied corner and place your forearms on each side of the wall about a foot and a half from the wall. Keeping your feet together and arms at shoulder height, lean forward until you feel a comfortable stretch across your chest. If you are extremely tight you may scoot closer to the wall. It is common to feel some numbness in your hands which should dissipate as soon as you back away from the wall.

Scapular Retraction Exercise

In order to keep your shoulders from rounding forward, it is important to train and activate the muscles between your shoulder blades. You can simply do this by sitting in your chair and pinching your shoulder blades down and back.

Chin Tuck Exercise

Lastly, we must address the dreaded forward head posture. This exercise can be difficult to learn. Do the exercise in front of a mirror to check your form. Keep your head upright and tuck your chin in like you are trying to make a double chin. Your gaze should not shift down to the floor with this movement, your eyes should stay level.

These five exercises you can do at home or work and are a good start to maintain proper spine position and ward off low back, upper back, and cervical discomfort associated with prolonged sitting. If any of these stretches or exercises cause pain do not push through it. These exercises do not work for everyone. You may need an assessment from a physical therapist to determine if you are performing them correctly or need a modified version of the exercise.

‘Tis the season for not only the holidays but also to break out those running shoes, get out on the roads, and log some miles to prep for the busy running season here in Arizona. Whether you’re prepping for a local 5k or Phoenix Marathon, it is important to stay healthy. It is tough enough to find time to get in those runs, so who has time for stretching? You would be surprised how far a 10-15 minute stretching routine can go to help keep you on the road and off the treatment table. I am going to lay out some simple and easy stretches that can help to keep you in one piece this holiday season.

When is the best time to stretch?

Research has shown that static stretching (holding stretches for long periods of time) is best performed after running. The stretches should feel comfortable and you should be able to relax while doing them, not gritting your teeth. I am a big advocate of stretching straps — which can be purchased at running and sporting goods stores or, of course, online. If you do not want to invest in straps, you can use a large beach towel, rope, or a belt. Now that we have that out of the way, let’s get stretching!

Hamstrings

Everyone knows this classic stretch and there are many ways to do it. My favorite is with a stretch-out strap and is pictured below. To get the most out of the stretch, hold it for 30 seconds and keep the leg as straight as possible. Hold once you feel a comfortable stretch behind the knee and posterior aspect of the thigh.

Hamstring Stretch for Marathon Runners

Adductors

This is a group of several muscles that travel along the inside of the thigh. This area is often left out of stretching programs, but it is important to have balanced flexibility on either side of the knee. We will bring back the stretching strap for this one. Lay on your back with your legs straight. Loop the strap around one of your feet and lift your leg up and out to the side until you feel a stretch in your groin muscle. Make sure this stretch is comfortable so you do not strain the groin.

Adductor Stretch for Marathon Runners

Iliotibial Band

These muscles form a long, thick band that runs along the lateral — outside — part of the thigh. Excessive tightness here can cause a lot of pain and irritation to the outside of the knee. Place the leg you are stretching behind the other one. Keep your foot on the floor and push your hips out to the side of your front leg until you feel a stretch in the outer hip. This stretch should be felt along the outside thigh and possibly the buttocks as well.

Quadriceps

This is another stretch that everybody knows but is often performed wrong. The key to this one is making sure that you do not bend forward at the waist. Keep an upright posture with your chest and upper back.

Hip Flexors

Responsible for raising the knee towards the chest, if these muscles are tight they will limit your leg extension and prevent you from elongating your stride. Like the quadriceps stretch, keep your chest upright and do not bend forward at the waist. You should feel the stretch in the front of your hip.

Hip Flexor Stretches for Runners

Calves

Located in the back of your lower leg, these muscles span from your heel to the back of your knee. Lean against a wall, and while keeping your knee straight and your heel on the ground, lean forward and maintain a comfortable pull. You will feel this anywhere between the heel and the knee.

Calf stretches for Marathon Runners

If you’re a runner, it’s important to stretch before you peel off your running shoes and hit the shower. Unfortunately, injuries can still happen. If you do find yourself with some pain that won’t quit, schedule an appointment and we’ll help you to get back into tip-top shape!

What is it?

Lateral epicondylitis, also known as tennis elbow, is the general term for lateral pain in the elbow caused by overuse of the muscles and tendons. The name is deceiving because very few people actually get this injury from playing tennis. Some of the more common causes include yard work, prolonged use of a computer mouse or keyboard, construction work, or any other activity that involves repetitive gripping, lifting, and twisting. Pain is typically located in the meaty part of the lateral forearm or over the bony prominence at the elbow.

Once this pain is recognized, it is important to act quickly and seek physical therapy. This condition is notorious for becoming a chronic issue, which can last up to six months to a year if left unaddressed and untreated.

What can I do about it?

The first step in recovery is to cut back on the aggravating factor; in other words, back off of the activity that caused your pain in the first place. If swelling is present, ice and anti-inflammatories can help to ease the initial pain. You should always check with your physician to make sure anti-inflammatories will not interfere with any other medications you may be taking. Light stretching of the forearm extensors can be performed to decrease the tension of the muscles and tendons at the elbow. Seeking the attention of a physician or a physical therapist can help guide you the rest of the way.

What can physical therapy do?

Your physical therapist will perform range of motion, strength, and special tests to determine the precise muscles and tendons that are affected, and then they can prescribe the appropriate exercises for the stage of injury that you are in. Modalities such as ultrasound (to help improve blood flow to the injured tendons and muscles), electrical stimulation (for pain relief), and/or laser therapy (used to help increase intracellular metabolism to speed healing) can help speed along the healing process.

Your therapist will also perform soft tissue mobilization (massage) and possibly trigger point dry needling, which can be extremely effective for relieving muscle tension and improving pain and activity tolerance in a short amount of time. There can be multiple muscles involved, such as your extensor carpi radialis brevis and longus, extensor carpi ulnaris, extensor digitorum, and extensor digiti minimi. They all attach to the same bony prominence in the lateral elbow, which a skilled therapist can identify and treat.

Injury prevention is another area that your therapist can aid in. They can help examine and correct your form and mechanics during your sport or activity to alleviate the strain on your elbow. In the event of a computer-based mechanism of injury, an ergonomic assessment can be done to improve your workspace, remove the stress from your forearms, and correct overall posture. A timeline of return to sport or activity will be reviewed and established to make sure you do not re-aggravate the injury by ramping up too quickly. Weakness in the shoulder and back and wrist joint tightness or instability are other predisposing factors that can be addressed to decrease the amount of stress placed on the elbow.

Summary

Lateral epicondylitis is a very common and difficult injury to beat. No injury or person is the same, and attention needs to be placed on the specific causes and structures involved in each case. Physical therapy can be an effective way to speed healing time to get you back to the activities that you love, or back on the job as quickly as possible. Please contact your local Foothills Sports Medicine Physical Therapy location for any questions or to set up an appointment.

Foothills Sports Medicine Physical Therapy has a reputation for providing quality, hands-on care to patients across the Valley. We believe that every person is different, so everyone should have their own personalized physical therapy plan. To find out what’s right for you, go online today and schedule a free assessment with us. To learn more about physical therapy and our services, follow our blog.

Scottsdale physical therapy expert, Michael Heidt, has a doctorate degree and specializes in manual therapy, including spinal mobilization. He is here today to explain what spinal stenosis is, and how a physical therapist can treat it.

What is spinal stenosis?

Lumbar spinal stenosis, also called degenerative joint disease and degenerative disc disease, is a condition that affects millions of Americans. It is defined as a narrowing of the spinal canal or intervertebral foramina— the space where the spinal cord passes through the back, and the areas in the side of the spine where nerve roots exit to supply nerves to the lower parts of the body. This means that the spaces for the spinal cord and nerve roots to travel through becomes smaller, which can cause nerve impingement (pinching) and pain. Spinal stenosis is a degenerative condition usually seen in people who are 50 years of age and older. The onset of symptoms is gradual and worsens over time, but there is usually no specific incident causing pain to begin.

How do I tell if I have spinal stenosis?

Individuals with spinal stenosis generally complain of pain in the buttocks, thigh, and/or lower extremities. Pain can even radiate all the way down to the foot if severe nerve root impingement is present. Pain could be felt in only one of the legs or buttocks, or both. Symptoms are worsened by activities such as prolonged standing and walking, and getting up from a sitting position. Morning stiffness and pain is also common. Symptoms are often relieved by sitting down or by leaning forward at the waist, such as leaning forward onto a shopping cart while walking at the store. Spinal stenosis can usually be diagnosed by X-rays that show the decreased space between the lumbar vertebrae.

It is important to have these symptoms checked by your physician and/or physical therapist, because other, potentially more serious conditions can cause similar symptoms. It is especially important to see your physician if you are also experiencing any of the following symptoms: fever or infection, significant weight loss, constant severe pain not relieved by positional changes, and changes in bowel and bladder function.

How do Physical Therapists treat this condition?

After performing a thorough subjective and objective evaluation, your therapist will determine an individualized exercise program. Avoiding certain positions and postures will be important in reducing initial pain. Your therapist will also educate you on how to perform different activities of daily living in order to reduce pain. If core musculature weakness is found, basic core strengthening exercises will be taught, such as abdominal bracing and posterior pelvic tilts, to begin strengthening the muscles surrounding the spine and low back to provide support. Strengthening of the abdominals and gluteal (buttocks) muscles are other common treatments for this condition. Stretching exercises for the hip flexors, hamstrings, and piriformis can also be helpful tools in improving posture and alleviating pain. Proper form while performing these exercises are very important and should be taught in person by a certified professional physical therapist.

Manual therapy can also be performed by your therapist. Manual therapy consists of hands-on treatment involving massage, trigger point release, passive stretching, and mobilizing the vertebrae in your lumbar spine to improve your range of motion and take pressure off of the pinched spinal nerve roots. Therapy modalities such as heat, ice, electrical stimulation, and ultrasound are other tools that can be utilized by your therapist to help improve muscle extensibility and reduce pain.

Although spinal stenosis is a degenerative disease, it can be treated with the help of a physical therapist. If you’re feeling pain and are in need of treatment, visit any one of our clinics across the valley, or stop by our website for more information.