Category: Exercises

The Importance of a Neutral Spine and Deep Core Engagement with Weightlifting

October 18, 2022

Do you experience low back pain when weightlifting or while performing ordinary household/outdoor activities? If so, you may be struggling to engage your deep core musculature as well as maintaining a neutral spine while performing these tasks. Your deep consists of several muscles including your pelvic floor, transverse abdominis, and multifidus musculature. With overactive or underactive activation of these muscles, dysfunction may result leading to discomfort. If you combined decreased core activation along with increased lumbar flexion, increased stresses are placed on your low back. This is not to say that you will be injured if you lift something in this manner because our spine is very rigid and strong, however, it can place you at increased risk for an injury.

Weightlifting stands as one of the safest sports there is when performed correctly. It is also important to factor in outside stresses such academics, work, social life, poor sleep, and other hardships that one may experience. Injuries are multifactorial and happen for a variety of reasons. This to not say poor form alone places you at increased risk, however, if exercising at heavier loads with a combination of other outside stresses, your risk of injuring yourself increase, so this is when it becomes important to be cognizant of your form and core activation. Increased core activation leads to an increase in intraabdominal pressure which will help you lift heavier loads.

In the attached image, you can see a patient performing a posterior pelvic tilt which helps engage your deep core musculature and flattening your low back. To perform, think of rolling your pelvis backwards as if trying to tuck your tailbone between your legs. Perform lightly as if attempting to stop the flow of urine. In performing this movement, you align your pelvis in a neutral alignment and decrease the lordosis of your low back resulting in a neutral spine which is optimal when lifting heavy loads. To further progress this exercise, attempt to perform a “bird dog” in a quadruped position. You will alternate lifting your opposite arm and leg while maintaining a posterior pelvic tilt as well as attempting to keep your pelvis level as you transition from one leg to the other.

https://www.rocktape.co.uk/therapy-considerations-for-the-flexion-intolerant-low-back/

https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3DFZpEkDRINxY&psig=AOvVaw2OFx5hMxGvqxsQ56FKI_AW&ust=1665673562637000&source=images&cd=vfe&ved=0CAsQjRxqFwoTCODYiOP72voCFQAAAAAdAAAAABAD

In a more advanced exercise such as a squat, perform with a simple hip hinge. With the use of dowel or broomstick, think of maintaining 3 points of contact with the dowel (head, mid back, and low back). You will need to perform a posterior pelvic tilt to get your low back to maintain constant contact with the dowel. Next, lightly bend your knees and think of bending over without further bending your knees and instead push your hips backwards as if trying to close the door with your hips. To progress, attempt the same series of movements without the use of the dowel and then with exercises such as squats, RDL’s, and deadlifts. With proper deep core activation and a neutral spine, you will optimize your bodies mechanics and be able to lift heavier weights.

https://bodycomplete.co.uk/mastering-the-hip-hinge/

https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3DgwN_nXKVXXI&psig=AOvVaw3qcJp1CgvgsXpTgNG51Jii&ust=1665673631713000&source=images&cd=vfe&ved=0CAsQjRxqFwoTCNC22Pv72voCFQAAAAAdAAAAABAZ

With Winter Comes Low Back Pain?

February 2, 2021 – Back pain continues to be among the top conditions physical therapists treat. Back pain knows no season, but it does seem that the snow and ice of winter bring on more back issues in our patients. On top of that the inactivity that winter provides also is not good for our backs. Often keeping our joints moving and our muscles active will help with some of our more basic back issues. 

Multiple studies have shown that physical therapy can help treat low back pain and recently some insurance companies are recommending physical therapy before any other medical treatment. In some cases they are covering physical therapy 100% so your costs are ZERO! 

Image: ppsapta.org

A recent study published in 2018 (https://doi.org/10.1111/1475-6773.12984), concluded “When LBP (low back pain) patients saw a PT first, there was lower utilization of high‐cost medical services as well as lower opioid use, and cost shifts reflecting the change in utilization.”  

Below is a list of 4 exercises to begin with to help improve your low back pain or to keep your back “healthy”. These exercises help to improve flexibility, range of motion, strength, and core function to decrease your low back pain symptoms or the likelihood of them becoming a bigger problem.

Lumbar Rotations

Lie with both feet placed flat on the supporting surface and knees bent. Keeping your shoulders flat on the surface, allow your knees to slowly fall together to the side, rotating at your lower back as you do so. Return to the starting position and then allow them to slowly fall to the opposite side. Repeat 20 times and perform twice a day.

Image: https://www.pinterest.com/pin/673288213013518236/?autologin=true

Supine Hamstring Kicks

Begin by lying on your back with your knees bent and feet flat on the floor. Keeping your knee bent, place your hands behind one knee and pull your leg towards your chest. While holding your leg in this position, actively straighten your leg, feeling a stretch in the back of your thigh. Hold for 2 seconds. Repeat 20 times on each leg, twice a day.

Image: https://www.youtube.com/watch?v=SzT7j7lcu3w

Abdominal Bracing

Lie on your back with knees bent and feet flat on the floor. Keep a neutral spine (small space between low back and the floor). Place your hands on your stomach so that your finger tips are palpating just inside your hip bone. Activate your transverse abdominus by drawing in your abdomen without moving your spine upon exhale. Some cues to properly activate your deep core is to brace your stomach as if your about to be punched in the stomach. You do not want your central abdominal muscle to protrude upward. When contracted correctly, the contour of the abdominal wall should be a balanced, slightly rounded appearance which should be maintained throughout the exercise with normal respiration. Hold each contraction for approximately 5 seconds. Repeat 10 times, twice daily.

Image: https://brookbushinstitute.com/article/drawing-in-offers-greater-sacroiliac-joint-stability-than-abdominal-bracing

Pelvic Tilts

Begin by lying on your back with your knees bent and feet flat on the floor. Using your abdominals, gently roll your hips backwards, feeling your low back press downwards towards the floor. Next, roll your hips forward feeling your low back slightly arch away from the floor. Repeat 20 times, twice daily.

Image: https://www.youtube.com/watch?v=-AWtsAzHBp4

Of course there are times when you can do all you can to prevent pain. You can do these exercises, watch how you lift and move and you can still have some pain or something that does not feel normal. If that happens you can always contact Witte Physical Therapy for a free consultation to learn more about your pain and what your next steps need to be. Give us a call in Louisville at 402-234-3333, Plattsmouth at 402-298-4747.

Physical Therapy and Physical Fitness – Why They Need To Go Together!

November 10, 2020 – At Witte Physical Therapy we have a unique set up and advantage for our patients. We have the ability to help you reach your physical therapy and your fitness goals. At our Louisville location we can utilize our expert staff and spacious clinic to get you back to doing what you want to do, pain free with the help of our physical therapy services. We can then assist you in transitioning from the physical therapy clinic to our 24 hour wellness center, Witte 24/7 Wellness. Here we can show you how to maintain and increase your gains made in physical therapy.

At Witte 24/7 Wellness we are open 24 hours a day, 7 days a week for our members. We provide memberships to the public and to our patients to give them full access to our aerobic and weight equipment. From treadmills, ellipticals, bikes and rowers to cable weights, free weights, and other fitness equipment we have what you need to work out. “Get in. Get Fit. Get On With Life.”

The APTA and it’s Private Practice Section recently posted a great blog about how and why physical therapy and physical fitness should go hand in hand. Please read it below.

5 Reasons You Need a PT to Coordinate Your Fitness Regimen

Physical therapists aren’t just for people that are injured or have had surgery. Physical therapists can also help healthy people improve their fitness. Here are 5 reasons why you should consider seeing yours.

YOU WANT A BASELINE

When you see a physical therapist to improve your fitness, you’ll get an assessment of your strength, range of motion, posture and movement patterns. This not only helps your physical therapist design a customized program just for you, it gives them a baseline to compare things to in the future should you start having pain or suffer an injury.

YOU WANT EXPERT GUIDANCE

Sure, other professionals could help with your fitness routine, but the fitness industry is not well regulated. Some certifications just require an online course and paying a fee. There are no licenses or other requirements to use many titles. Becoming a physical therapist requires at least a bachelor’s degree and most PTs practicing today have a doctorate. Every PT has passed a national board exam and maintains a state license. That guarantees you that every physical therapist is a verified expert in human movement.

YOU WANT TO PREVENT INJURY

Physical therapists don’t just work to heal injuries, they are also experts in preventing them. After a thorough assessment, a PT can help you design a program that will not only help you reach your fitness goals, but that can address any issues that increase your risk for injury.

YOU WANT UNBIASED ADVICE

Yoga instructors will want you to do yoga. Personal trainers will want you to come to their gym. Pilates instructors will want you to do Pilates. Strength coaches will want you to strength train. A physical therapist doesn’t have a bias or vested interest as to what type of fitness regimen you choose. They are only interested in helping you reach your goals.

YOU HAVE A HISTORY

If you have some kind of history that affects your ability to exercise, a PT is the best person to help you design a fitness regimen. It doesn’t matter if it’s an old injury from athletics or work, back pain that comes up from time to time, COPD, arthritis or heart disease, a PT can help you safely work around it and meet your fitness goals.

Witte Physical Therapy and Witte 24/7 wellness can provide a great partnership for you to be able to be as good as you can be. Witte PT can be used to get you back in the gym and to keep you in there as much as possible. Call us today at 402-234-3333 in Louisville or 402-298-4747 in Plattsmouth for more information or to set up a free consultation to discuss how you can get started!

Is No Pain, No Gain Correct?

September 29, 2020 – Today is the last installment of our September blog series about pain. There is a common saying we all have heard, “no pain, no gain”. Is this true? In therapy we often spend a lot of time educating our patients on what pain is and how to deal with it. Does there need to be pain to see results? The answer is yes and no.

Pain is often the body’s way of signaling to us that something is wrong. Pain can be an early warning sign that we need to adjust what we are doing to avoid a new injury or making an old injury worse. Pain does not always mean stop, but it should mean slow down and re-evaluate what we are doing. If no pain, no gain is not the right way to push our body then what do we do?

Soreness is a better way to look at the intensity at which we are doing things. This can be thought of the initial period of pain or the “hurts so good” pain. We can feel this with certain activities or stretches. You can also think of how your form affects soreness or pain. If you are squatting and you are starting to get tired, then your form will start to suffer. If you push through this too much, then that soreness can quickly turn into pain due to poor form.

In summary it is important to understand what pain is and how it can be affecting you. If you get a sharp pain during a workout you are probably doing too much or doing something wrong and you need to stop immediately. If you are not feeling any soreness after a workout you are probably not doing enough.

Give Witte PT a call at 402-234-3333 in Louisville or 402-298-4747 in Plattsmouth for a free consultation to discuss your current fitness, issues you are having with getting over pain or getting back in shape, or to discuss any other health issues you may have.

1. References
   1. https://athleticperformanceinc.com/blog-posts/post/24/busting-the-myth-no-pain-no-gain.html#:~:text=No%20pain%2C%20no%20gain.,hard%20enough%2C%20is%20not%20true.
   2. https://www.ucihealth.org/blog/2019/04/no-pain-no-gain

MOVEMENT, it can cure your pain!

September 15, 2020 – Our September blog series has focused on pain. We have learned about the different types of pain and the mistakes we make when we are in pain. Now let us get onto the good stuff! Let us learn how we can help with our pain. This week we are going to focus on how exercises and modalities can help alleviate your pain.

Often when we first start to feel pain, we go to the standard things to try first. We try ice, rest, and medication to help our pain go away. Often these items can help to lessen the pain but rarely due they treat the source of your pain. Physical therapy can help treat the source of you pain and keep you off the meds! Physical therapy cannot treat all types of pain, but we can help identify where your pain is coming from and then work with you to get you on the right track with therapy or, if needed, another medical provider to treat the source of your pain.

Sometimes pain is caused by a lack of movement. Our joints, muscles, ligaments, or tendons get stiff, damaged, or loose hydration causing pain when we move. Often the best medicine for this is to get moving again! Movement allows our body to rehydrate the joints, warm up the muscles, and improve blood flow. These items are paramount in getting moving and feeling better. Remember, we are made to move. Sitting and resting too much is bad for our health and bad for our bodies. Physical therapy can help to get you moving again. We can start in a way that is less painful and controls any pain and work you back into a normal movement pattern that can get you back to working out, gardening, playing with your grandchildren, back on the playing field, etc.

Sometimes we do need modalities to help take the edge off the pain. These modalities can make it easier to try to move and get back on track fighting the cause of the pain. Modalities could include ice, heat, TENS, ultrasound, electrical stimulation, compression, massage, and activity modifications. Ice, heat, compression, massage, and TENS can be completed at home if you have the right equipment. However, all of these can be done by your physical therapist. Remember, moist heat feels better and travels deeper into our bodies than dry heat, such as a heating pad. TENS units can be purchased without a physician’s script, but often you get what you pay for. Your physical therapist can help you identify what modalities may be best for your situation, get your pain under control faster, and then help you get moving to cure the cause of you pain.

At Witte Physical Therapy our number goal is to get you back to doing what you want and need to do. We do not worry about our goals, because our goals are your goals! Give us a call at 402-234-3333 in Louisville or 402-298-4747 in Plattsmouth to schedule your free, no obligation consultation and let’s begin to discuss your pain and what we can do to help you!

What to do between the bells?

August 25, 2020 – Children are no different than us. They get stressed and often have too much on their plate throughout the day. We can talk to them about getting off their devices and getting moving, but sometimes they do not have the time or energy either.

Here are a few examples of some exercises that can be done quickly in between classes:

1. 1. In standing run your hands down the front of your legs to the floor and then walk your hands out on the floor as far as you can and then walk them back to return to your starting position
   2. Lunges
   3. Sit on the edge of your chair with your hands behind you. Using your arms lower you butt down to the floor and then push up with your arms to return to a seated position (tricep dips)
   4. Walking butt kicks
   5. Sit on the edge of your chair with your hands behind you. Bring your knees up to your chest using your core muscles and then return your feet back to the floor. (seated crunches)
   6. Reach for the sky by standing as tall as you can and stretching your hands as high and back as your can

Doing these simple exercises for a few minutes in between classes can help keep the blood flowing, keep your muscles stretched and flexible, and improve strength to those muscles we don’t use while we are sitting and learning.

If you experience pain or issue with any of these exercises give us a call at 402-234-3333 in Louisville or 402-298-4747 in Plattsmouth for a free consultation.

References

https://www.theshorthorn.com/life_and_entertainment/6-quick-exercises-to-do-between-your-classes/article_a86e35f0-be36-11e5-b17f-27fcd9fa6500.html

https://www.healthline.com/health/exercise-fitness/walking-lunges

Stretching and Posture – 2 Big Ways to Help with Shoulder Pain!

July 21, 2020 – The month of July is flying by! So far we have learned about the different types of shoulder pain and what therapy’s role is in helping with that pain. This was all great information, but what can you do to stop shoulder pain from starting?

The issues in our shoulders come most from muscle weakness and imbalance. As long as we keep all of our muscles functionally strong and we don’t do things that we are not conditioned to do, our shoulder strength should be sufficient to complete the tasks we need to complete. However, through compensation and lifestyle we can develop muscle imbalance.

Muscle imbalance simply means we have muscles that are too tight or too weak when compared to their counterpart. This cause asymmetry within our shoulder joint and the muscles that supply it. This asymmetry can lead to bursitis or tendonitis, which if left untreated can cause more serious shoulder issues.

Most people spend a good part of their day on a computer, at a desk, on the phone, reading, etc. These postures have become integral to our every day lives. However, they often promote bad habits that can lead to big problems. It is important to stretch out the front of our shoulders that counteract this leaning over posture. A simple pectoralis stretch in the doorway can produce some big results.

This simple stretch can help us with our tight muscles in front. But normally we have a tight muscle on one side we have a weak muscle on another.

Adding in some simple scapular squeezes to actively engage our scapular muscles and work to open up our shoulders should be another daily change to your routine.

Making these simple changes can make a big difference in improving your shoulder positioning and health. If these aren’t enough give us a call at 402-234-3333 in Louisville or 402-298-4747 in Plattsmouth for a free consultation with a therapist to get a more in depth look at your shoulder pain and your situation.

The Role Of Physical Therapy in Your Shoulder Pain

July 14, 2020 – Last week we discussed the different types of shoulder pain that you may experience at some point in your life. These pains all have some connections but can affect you in many different ways. Once the source of the pain has been identified we need to move forward on helping to get that pain resolved.

First the therapist will do an evaluation to help you understand the underlying cause of your pain. This evaluation will also develop some baseline measurements on what your motion, strength, and function currently are versus what they would normally be.

Next, the therapist will work with you to build a plan to start to get you back on the right track. Initially this plan usually focuses on pain management, improving shoulder motion and flexibility. Postural assessments, sleep education, and developing pain free movement patterns are also often discussed.

As your pain decreases and your motion returns then strength and stability become the main focus. These are used to get you back to doing what you want to be doing. We can focus on getting you as strong as we can, but if you can’t get back to working or your hobbies then what does it matter? It is important that you and the therapist work together to develop a plan that is specific to what you need.

At Witte Physical Therapy we work for you. You and your goals are our number 1 priority. Not all shoulder pain is the same and not all patients have the same goals. Your plan will be set up specific to your needs to help you efficiently and effectively get back to doing what you need to do. Call us today at 402-234-3333 in Louisville or 402-298-4747 in Plattsmouth to schedule your free consultation.

References:

https://www.webmd.com/pain-management/physical-therapy-rotator-cuff-tear#2

https://www.restoreorthopedics.com/blog/night-time-shoulder-pain-and-what-to-do-about-it

Can Witte 24/7 Wellness Help You?

June 30, 2020 – We have spent the majority of June talking about how to get back into working out as the COVID restrictions have started to be lifted. These items have been discussed in our blogs the last few weeks and have served as a good resource as you work to get back to moving. From the initial steps of working out at home, to getting out and getting going, to the final step of developing a plan that can be sustained.

For many people it is tough to maintain a consistent work out routine without outside help. This could include working out with others, using an online video class, doing in person classes, or going to a gym. Witte 24/7 Wellness offers all of these options!

Witte 24/7 Wellness opened in January of 2019 with the sole purpose of serving the communities that surrounds it with a safe and clean place to workout and get fit. It maintains the hours of being open to our members 24 hours a day, 7 days a week. The goal was to make it as usable as possible for everyone. This includes flexible hours and a variety of equipment to serve as many people as possible.

Our aerobic machines include incline/decline treadmills, adjustable stride ellipticals, various styles of bikes, a NuStep, and a rowing machine. For those who prefer weight lifting we offer cable machines, a Jones machine, dumbbells, barbells, and other free weight items. We also have pylometric equipment, swiss balls, TRX straps, and the space to work on body weighted exercises.

However, if after all of this reading you still are not quite sure where or how to start we have a personal trainer who can help.

Finally, we are launching a new wellness service. This will use the therapy staff of Witte Physical Therapy to provide exercise specific classes and training based on your needs. Multiple levels will be provided for people to find the right fit for them. These services are aimed at members and former PT patients who are interested in keeping their wellness journey moving forward by giving them access to Witte 24/7 Wellness and a professional that can break down their movements and help them reach their goals. More information on these services will be coming out soon.

For any of these services reach out to Dan at 402-234-3333 or email dan@wittephysicaltherapy.com for more information. Mention that you read this blog and receive a discount on your Witte 24/7 Wellness membership or on one of our new wellness services staffed by our therapists! At Witte 24/7 Wellness you can “Get In. Get Fit. Get On With Life.”

What does being active do for me?

June 23, 2020 – By now hopefully the theme of our blogs in June has made sense. We have moved through the stages of returning to exercise, starting a normal exercise routine, and given ideas of how to get around the excuses of time management to make sure we get our exercises completed. But why are we doing all of this? Usually by the time we start exercising and reach 3-5 weeks of trying to get a new routine we struggle to keep it up. If we can push through for a total of 6-8 weeks your chance of making a real and sustainable change to your routine is at an all time high.

So what are the benefits of staying healthy and getting in all those minutes of exercise?

1. 1. We are happier. Chemicals are released in our bodies which improve our mood and feeling of well being.
   2. We can lose weight. By increasing the amount of calories we burn throughout the day we can begin to drop those quarantine pounds.
   3. It is good for our muscles and bones. Exercise helps us to keep our muscles and bones strong. This ensures that they are being used appropriately and can delay any health issues for weakness in these areas.
   4. It can give you more energy. Most of us struggle with how much energy we have for all we have to do throughout the day. Instead of reaching for the sugar or caffeine which provide quick and inefficient energy boosts, try getting in your exercises for a pick up.
   5. It can help keep chronic disease away. We discussed this for your bones and muscles earlier, but what about your heart and lungs. These are no different. Exercise helps us to maintain a healthy balance in our body.
   6. It can help with your skin. By exercising we produce antioxidants which can help to improve how our skin looks and feels.
   7. It can help your brain health and improve your memory. Exercise increases blood flow to your brain and produces chemicals which aid brain cells.
   8. It can help you relax and improve your sleep. By increasing your body temperatures with exercise it can actually help your lower them for sleeping.
   9. It can help with your pain. Getting things going and moving can help to reduce joint stiffness and pain.
   10. It can promote a better sex life. By exercising and feeling better about ourselves we can be more into sex. It can lead to more frequent and better quality sexual encounters.

These are great reasons to start exercising. You can use these to fight off the excuses we create in our heads. If you want to start to experience these benefits sooner rather than later, please reach out to Witte Physical Therapy and Witte 24/7 Wellness for further resources and help for you to reach your fitness and wellness goals.

References

https://www.healthline.com/nutrition/10-benefits-of-exercise#section10