As athletes, it is always important to be able to self-assess our body's ability to perform at high intensity levels. Just as our cars feature alert systems such as "check engine", "low tire pressure", etc. our body's need to be able to do the same to assure that we are safe, and most efficient through our activity. Take football for instance, an athlete competing in this capacity not only requires great power and drive through their lower quarter, but also adequate joint mobility and muscle length. I'll explain, as a lineman gets into their stance he is shortening the hip flexor and hamstring muscles. It is in this shortened position that muscle energy is stored. As the ball is snapped the lineman must explode out of that muscle shortened position and now lengthen those very same muscle to generate utmost power. Now, consider if one of those mobility systems was compromised. If the hip flexor or hamstring muscles were too tight, or the hip joint was restricted in its range of motion, that athlete would not be able to explode off the line with the same degree of power. It is an unlikely scenario in this case that they are going to do a good job getting to, or protecting the quarterback. This is just one scenario. Take any position on the field however and you can make the very same argument.

So, what can we do to self-assess? How can we find these problems before they lead to inefficiencies on the field, or worse, injury? This article will go over a few quick assessments that will give you a good idea as to whether you are firing on all cylinders.

The overhead deep squat is a great self-assessment tool because it is easy to perform and assesses limitations of the upper quarter, lower quarter, and trunk. The goal of this test is to squat low with your butt below your knees while maintaining your arms behind the line of your toes. If you find that you are unable to do this, try these 3 modifications to find out what the limiting factor is.

1. Hands clasped behind your neck helps to take a tight latissimus (lat) muscle out of the equation. If you are better able to perform your deep squat in this position, the most likely limiting factor is tightness of your lats.
2. Heels elevated with a lift will help to shorten the calf muscles and give more room for the ankle joints to work. If you are better able to perform this test, the most likely limiting factor is restrictions at the ankle joint.
3. rms crossed is the final modification to this test. If still unable to complete a full squat here, well we have a lot to work on. This test will note limitations of the hips and trunk.

The hip swing test is another self-assessment that we can use to look more closely into our hips and pelvis. Stand with one hand touching onto a support surface. Proceed to swing a straight leg forward and backward like a pendulum. During this test you are encouraged to explore your full range of motion. Indications that your Range of motion is limited are:

1. Asymmetric movements on one side compared to the other.
2. Slumping of your pelvis when kicking forward may be indicative of tight hamstrings.
3. otation of the pelvis when kicking backward may be indicative of hip flexor muscle tightness and joint capsule limitations.

Identifying such limitations early on can be pivotal in improving performance and reducing the risk of injury. It is very important for every athlete to be surrounded by a good team. This is not only the case on the field, but off the field, and in the training room as well. In addressing the self-assessments that we looked at through this article, an athlete may find a physical therapist to be most helpful in improving an athlete's mobility and strength. Following up with a speed and agility coach would be recommended to now apply your bodies now efficient movement patterns into functional, sport specific training.

For any questions or comments regarding the information discussed in this article please feel free to email me at Robert@northislandpt.com. North Island Physical Therapy is located in Stony Brook, NY and uses the methods discussed above to benefit patients of all abilities. For more information about our patient focused clinic go to our website at www.northislandpt.com.

Stretching our bodies is not something new, and while there are many different types of stretching the idea is the same. Our muscles tend to shorten over time and with constant use. Stretching is important to help elongate our muscles and decrease any movement restrictions these tight muscles may have on our bodies.

While we may not be stretching as often as we would like, we have all experienced that gentle pulling sensation and that feeling of sinking into a new range we previously couldn’t get into. But even though people have been stretching for ages, we have continued to question and debate the best ways to improve our flexibility. Is it better to stretch before physical activity or after? How long should I stretch for? Is one stretch better than another?

Like many things in life, the answer is not as clear-cut as we would like. While researchers don’t always agree on the exact details of stretching there are a few principles worth mentioning to help you get the most out of your stretching routine.

Dynamic Stretching

Dynamic stretching is an active stretching technique that involves performing movements that are specific to the activity you are interested in. For example, a runner can perform walking knee lifts, which involve flexing the hips and bringing the knee to the chest while walking, before beginning a run. This motion is similar to the movements associated with running and help to stretch the hamstrings and gluteus maximus. Dynamic stretching has the added benefit of increasing the temperature of the muscles and allows you to practice movement patterns in a controlled range of motion that can have a carry over effect into the activity.

Tips for Dynamic Stretching

• Perform 5 – 10 minutes before activity or sport. Add dynamic stretching to your warm up routine.
• Progressively increase range of motion (and speed as appropriate) with repetitions.
• Control movement throughout range and avoid bouncing. Do not sacrifice proper technique for additional range of motion.

Static Stretching

A static stretch is a prolonged stretch typically held for 30 seconds. The idea is to elongate a muscle to allow for better mobility around a joint. Tight hamstrings for example can restrict you from touching your toes when your knees are straight. But it is important to remember that stretching occasionally isn’t going to help you get your palms to the floor; research shows that consistency is key. A stretching program consisting of stretching twice a week for five weeks has been shown to produce significant improvements in flexibility.

Tips for Static Stretching

• Ease into the stretch of the muscle until you feel a slight pulling sensation. Stretching should never be painful and you should not feel any numbness or tingling.
• Hold for 30 seconds. Holding for less may not be enough to promote lasting changes and holding for too long may not provide any additional benefit.
• Perform static stretches after activity while muscles are warmed up for a more effective stretch. The elastic properties of collagen in the muscle and tendons increase with an increase in body temperature allowing for a greater stretch.

Therapists at North Island Physical Therapy can teach you specific stretches to improve your flexibility, as well as provide more advanced stretching techniques called Proprioceptive Neuromuscular Facilitation (PNF) that use your body’s own muscle receptors and inhibition systems to help improve your range of motion.

Dynamic Stretches

• Walking Knee Lift is a great way to actively stretch the glutes and hamstrings before going for a run. Use your hands to assist your knee up as you walk forward.
• Heel-to-Toe Walk involves bending the ankle all the way up when stepping forward and then pressing down so your heel lifts off the surface as you step with your other leg. This helps to stretch out your calves and also helps warm them up for activity.
• Arm Swings is a nice way to warm up and stretch some of your back and shoulder muscles before activities that involve movement in your arms like tennis. Bring your arms across your body from side to side in a controlled manner. Arm Swings can also be done while walking to further help your entire body to warm up.

This blog is inspired by the many questions that the therapists at our facility get pertaining to nutrition plans and inflammation. Nutrition is a growing trend today. People are more aware of what they are eating and the effect it may have on their body. You have likely heard of many different types of foods that are known to promote inflammation in the body. Our goal in this blog will be to identify some of those common treats and help you establish a plan to not completely subtract, but to substitute. The reality is that if there is a guilty pleasure in your nutrition plan and it has been part of your daily routine for years, it is likely hard to omit. But perhaps what we can start to think of is addition and eventually substitution. For example, if you are someone who must have a small bag of potato chips and diet soda with lunch each day, try also adding a portioned snack of walnuts or almonds and seltzer water with a squeeze of lemon. The nuts will give your body that crunch that it often seeks out and the seltzer water will provide that little bit of carbonation without the overload of sugar. Eventually you may find that “hey I can do without the chips and soda”. The most important thing to remember when it comes to changing your nutrition plan is that you must make it realistic for yourself. Establishing a realistic goal is the first step to changing your lifestyle. Focusing on nutrition is just that, a lifestyle change. Many people use the term “diet”. The problem with diets is that they are temporary. People go on diets for a week or a few days. In regard to changing your approach to nutrition, you should look at it as a change in lifestyle.

Inflammation is your body’s way to protect itself from infection, illness or injury. As part of the inflammatory response, your body increases production of white blood cells, immune cells and substances called cytokines that help fight infection. While this process occurs naturally in the body and is mostly beneficial, our body’s ability to shut off this process can sometimes become inhibited causing a chronic buildup of inflammation. Chronic inflammation can lead to tissue damage, swelling, joint degeneration and ultimately pain. Research shows that the foods we eat can directly contribute to the cyclical nature of the inflammatory process. For individuals experiencing chronic pain and inflammation a simple change in nutrition strategies along with proper exercise and regulated sleep regimen may be the solution to achieving wellness.

What should we limit

Dairy products- 60% of our population do not have the gene required to break down dairy. As a result this causes a reaction that promotes inflammation. Consider substituting nondairy alternative such as coconut and almond milk.

Red meat and processed meat in excess- Commercially produced meats are fed with grains like soy beans and corn, a diet that is high in inflammatory omega-6 fatty acids but low in anti-inflammatory omega-3 fats. Consider limiting red meat serving to 6 oz portions. This is a case where buying organic truly is beneficial. Organic, free-range animals that are fed a natural diet such as grasses instead of grains and hormones contain more omega-3 fats. Having more room to roam freely, they are also leaner and contain less saturated fat.

Refined grains- Includes white rice, white flour, white bread, cereal, pasta. These grains have a higher glycemic index than unprocessed grains and when they are consistently consumed, can hasten the onset of degenerative diseases. Consider 100% whole grain, but be careful that the product truly is whole grain as packaging can be misleading.

Processed foods- Quick and easy, but contain a high level of Trans fats. Look out for hydrogenated oil, margarine and/or vegetable shortening. Quite simply, AVOID!

What should we add?

Hydrate, hydrate, hydrate- Drink water and drink enough of it. This simple adjustment helps to flush our body of waste product that can be damaging to our tissue.

Anti-oxidants- Including beans, some berries, and leafy greens into our diets can help promote anti-oxidants which are known to combat the inflammatory response.

It is most important to remember that even with all of these ideas considered; the inflammatory process is most responsive to a sedentary lifestyle. Consult a physician, physical therapist, or nutritionist regarding an appropriate exercise regimen in conjunction to your new nutrition plan.

Whoever imagined that the day would come when "text neck" would become an actual medical diagnosis. Well, it is here. It is quite evident that the use and misuse of smart phones and tablets is becoming an ever growing trend. And despite what my mother may say, it is not just "these young kids". Smart phone and tablet use has been accepted by individuals of all ages and life styles.

In our last blog we discuss, at length, strategies to use to efficiently engage your "core muscles". We learned that focus on this muscle will help to provide direct stability to your trunk/spine. If you have not yet read our previous blog you can find the content on our website at norhislandpt.com/blog. I mention this because the neck and trunk are no different. Both use "core muscles" to stabilize against excessive mobility and compression.

As is the case in the lower spine, segmental muscles attach from vertebrae to vertebrae of the cervical spine to decrease forces that cause compression of the discs in the neck. Research shows that forward head positions associated with use of smart phones and tablets contribute to a tremendous increase in compression at the lower segments of the cervical spine. The diagram associated with this blog gives a great representation of the relative increase in the weight of the head, and increased force through each disc with forward tilt of the head as you look down toward your device. At 60 degrees of neck flexion, we are exerting 60 pounds of force on our discs! That's a heavy head!

As technology evolves, we have to evolve with it. Our smart phones and tablets are our connections to the social world, easy access to work emails, our source of news and entertainment, etc. No matter how you look at it, they are part of our lives. Lets learn to use them more appropriately.

1. Maintain neutral alignment. Consider using a chin nod pattern when looking downward as opposed to hinging from the base of the neck. With this, your ears should always remain in line with your shoulders. As an exercise, think about performing a chin nod and rolling your neck into a slight bend.
2. Elevate your device. Whether you are working with a desk top monitor or a tablet it is always best to raise your screen toward eye level. With this, I recommend using support to elevate your arms to remove your focus from your lap to slightly more in front of you. This will help to take stress away from neck and shoulder muscles as you no longer have to worry about holding your shoulders up. Your support will do that for you. When possible, let your body rest. We abuse and overuse it every day
3. Stabilize your shoulder girdles. The shoulder bone is connected to the neck bone. It may be a children's song, but it is still very accurate! The shoulder and the neck are very closely related. We can not be stable through the neck without support from the shoulders. Now that your arms are supported with a pillow, or your briefcase (if commuting home on the train), focus on drawing back and down your shoulder blades. Ever so slightly tucking your shoulder blades toward your back pockets helps to maintain proper alignment of the upper trunk

Following these 3 simple principles can make an enormous difference in managing acute to chronic neck and shoulder pain. For any questions regarding this content please feel free to reach out to me via email at Robert@northislanpt.com. Also remember, North Island Physical Therapy offers free functional screens which gives you an opportunity to sit down with a therapist and discuss wellness related issues that you may be dealing with.

Our bodies take a beating day after day, week by week, year by year. Symptoms associated with back and neck discomforts are incredibly common. In my career I have seen all too often that people approach pain by saying "well, this is how it is and how it will always be". Nothing is more painful to your physical therapist's ears than this!

There are solutions! There are ways! There is hope for you! It seems the most popular trend in managing back pain based on recent research is "USE YOUR CORE". What is your core? How do you turn on your core? Your core is made up of four groups of muscles that form a drum, or cylinder around your trunk. The "core" is compromised of segmental muscles that attach from one vertebra to the next. Its base is known as your pelvic floor, and its ceiling is your diaphragm. The focus of this grouping of muscles is to decrease force through the spine. Because of the segmental nature of these muscles, the core can assist in spreading force outward as opposed to allowing compression. Now that we have some base of knowledge on these muscles we and their function, how do we make them work?

These muscles are not easily isolated. Bummer. However, if we focus on some basics of mechanics and positioning they will fire automatically without focusing on contractions. These are some basic strategies to focus on:

1. Base of support: Your core first response begins from your base. Whether you are standing or sitting, your trunk is best supported by a hips width base with appropriate weight through your feet
2. Alignment: Focus on a neutral spine alignment. Everybody's neutral spine is different. This should be a position of comfort that is neither flexed (slump) or extended (overly arched). Your core muscles do not function outside of neutral! This is a very important principle. To assure you are maintaining neutral, focus on mobility through the axis of your hips. A strategy we call hip hinging.
3. Weight shift: Combining the above mentioned principles, weight shifting allows for efficient movement within your base of support without changing your spinal alignment. For example, In the case of shoveling 30 inches of snow, allow your weight to transfer from rear foot to front foot as you work toward removing snow. This will eliminate the need to bend from your back.

Following these 3 simple principles can make an enormous difference in managing acute to chronic back and neck pain. For any questions regarding this content please feel free to reach out to me via email at Robert@northislanpt.com. Also remember, North Island Physical Therapy offers free functional screens which gives you an opportunity to sit down with a therapist and discuss wellness related issues that you may be dealing with.