Getting in Shape for Skiing

What are the most important elements to getting in shape for ski season?

The first thing that comes to mind for getting in “ski shape” is strengthening. I believe everyone would agree that strengthening of the lower extremity or leg muscles is top on the list. The legs are doing most of the work during a ski or snowboard run, so, focus strength training here. The muscles to emphasize are the quads (front of the thighs) the hamstrings (back of the thighs), the calf muscles, and the glutes. It is very important for one to gain strength of the proximal leg muscles, those closest to the trunk, typically called the hips. The stronger one is in the hip region, the less strain will occur across the knee joint.
A great exercise for the whole lower extremity is the squat. This uses the buttocks, the quads, the calves and the hamstrings. Also great are lunges and leg presses. These exercises directly correlate to the motions used in telemark skiing and downhill skiing. Bicycling is a wonderful outdoor activity for lower extremities. Lastly, calf raises (going up and down on tip toes) is great for balance and calf strength.

Besides strength, flexibility is highly important for all activities. A tight muscle is more likely to tear or be strained because there is no slack in the system. Stretches create length in the muscle and allow for freedom of motion.

While everyone agrees that training the lower extremity muscles is highly important, I also want to emphasize the importance of training the trunk or core muscles. The trunk is the “power center” of the body. These muscles include, among others, the abdominals, the iliopsoas, the glutes, hamstrings, and the spinal extensors. A strong core helps with speed, balance, strength, and power, quickly changing directions, improvement of skill level and prevention of injury. A training program needs to consist of trunk flexibility and strength conditioning. Having a strong and flexible core allows one to twist, turn and stabilize the body during the downhill journey. According to Douglas Brooks, MS, who wrote Effective Strength Training, the trunk is the base or foundation of the body. A body is only as strong as its weakest link. A body needs a strong base from which to direct its energy. If the core is weak, it leads to poor performance or worse, injury.

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Massage and Chronic Pain

Can massage help me with chronic pain that I have had for years?

Therapeutic and deep tissue massage and bodywork can not only relieve acute symptoms but can also affect a change in chronic pain that you may have been experiencing on and off for years. In some cases, massage is the most beneficial tool used to deal with these ongoing discomforts.As with anything, it may take several sessions to relieve symptoms of chronic pain. You didn’t develop these pains overnight, so they may take more than one session to relieve. As you begin to treat your condition, it may be important to be treated several times before you can transition to a less frequent schedule for health maintenance.

Please be sure to share specifics with your massage therapist to develop the best plan for you.Massage therapy is particularly effective in treating the chronic pains experienced as a result of exercise, fibromyalgia, and job related discomforts (i.e. working at a computer, sitting or standing for long periods of time). I have the experience and training to facilitate your bodies healing process and look forward to ridding your body of the pain and discomfort that keep you from enjoying a healthy lifestyle in Lake Tahoe. Massage should not only be looked upon as a commodity, but as preventative maintenance on your body’s tissues and subsequent organs which is one of the best ways to stay out of your doctors’ waiting rooms.

-By: Brian Hrindo, LMT

10 Steps to an Ergonomic Office

Where do you spend the majority of the time during your typical work day? If your answer is sitting in an office chair staring at a computer, it is time to evaluate your work station with regards to your health. Setting up a desk that minimizes prolonged postural stresses can prevent work-related episodes of low back pain. To set up your own ergonomically designed work station, follow these 10 simple steps:

Sitting Posture- When sitting in your chair, it is important to maintain three spinal curves: an inward curve in your low back, an outward curve in the mid-back, and another inward curve in the neck. Shoulder should remain relaxed but kept back in a retracted position. Your head should be kept level with the chin tucked in for the ideal desk posture.

Seat Settings- Adjust your office chair for optimal posture and comfort. For computer work slightly recline the back of the chair. Although some office chairs have lumbar settings, a separate lumbar support pillow is best. A small towel rolled and put in the small of your back works great to maintain the inward lumbar curve. When sitting against the back of the chair, there should be approximately two inches between the edge of the seat and the back of the knees.

Bending in the Chair- To bend over to reach an object out of a low drawer or pick up an object from the floor it is imperative to maintain the inward curve in your low back. Scoot to the edge of the seat and extend one leg out in front of you. Place one hand on the desk surface to assist with balance and bend from the hips. Using your hips as the hinge for this bending motion helps protect the low back.

Turning in the Chair- No Twisting!! When it is necessary to reach into the cabinet behind you or respond to a co-worker in the cubical next to you, it is important to avoid twisting motions that put excessive forces on the spine. Instead, move your body as a single unit in the direction you intend to go with the hips and feet pointed in the same direction.

Foot Rest- Optimal leg position is a 90° angle at the hips and knees. A 90° angle is best obtained using an appropriate height foot rest. Prevent “slouching” by sliding the office chair under the desk as far as possible while making sure to have adequate leg room.

Wrists over Keyboard- Chronic incorrect wrist positioning while typing can lead to the common office injury of carpal tunnel syndrome. To avoid carpal tunnel syndrome, use a wrist rest to position the wrists straight. Keep both of the elbows bent approximately 90° and supported by the desk surface. Adjusting the keyboard to maintain the straightened wrist position can help prevent the excessive wrist extension which leads to carpal tunnel injuries.

Monitor Position- The computer monitor should be angled to be level with the eyes in order to maintain proper head and neck posture. When attempting to type written material, use a document holder to position items at eye level.

Reaching across the Desk- Arrange the work area to eliminate tasks of repetitive reaching. Keep frequently used items close while storing rarely used supplies in a lower drawer. Repetitive lifting can irritate rotator cuff muscles and should be avoided without proper conditioning.

Talking on the Phone- When conducting business on the phone, do not support the receiver between your neck and shoulder. It is best to use a head-set or speaker-phone features to maintain proper neck alignment while talking on the phone for long business conversations.

Take Frequent Rest Breaks for Exercise- To take the strain off your back and prevent fatigue, change positions often. Alternate job tasks that require different postures when possible. The goal for all office workers is to take a break for one minute every hour to stretch and mobilize all the major joints of the body.

So if you’re up for the challenge of setting up your own ergonomically correct work station, print this list out, tape it to the bottom of your monitor and take the time to save your spine from the work-related aches and pains. For additional work station consultation advice or further questions, contact the physical therapy team at North Tahoe Physical Therapy.

-Rebecca L. Deal, MSPT

Position For a Good Night’s Sleep

For A Good Night’s sleep… According to one Physical Therapists perspective

Have you ever awoken from a long night of sleep feeling sore, stiff, or in pain? Sleep is supposed to be the body’s way of recovering, resting and rejuvenating the body. Many people find that the 6-8 hours they spend sleeping is anything but restful.

As a physical therapist, I inquire of my client’s sleep position. I find that they are often sleeping in the wrong position. I rarely advocate sleeping on one’s stomach due to the extreme neck rotation combined with extension required in order to achieve this position. This small change in sleep position from the stomach to the side or back can relieve a tremendous amount of neck pain. If you must rest on your stomach to fall asleep, put a pillow under the chest to lift the trunk and allow for the neck to drop into flexion and rotation. One should also remove the pillow from under the head.

Pillows can be used to support the spine during sleep. Side sleepers can place a pillow between the knees to keep the hips from rolling forward and to keep the pelvis level. Back sleepers can place a pillow under the knees. This will allow the back to rest flat against the bed. A rolled towel can be placed inside of the pillow case to support the neck arch just as a contoured pillow would do. Lastly, one can buy pillows designed for side sleepers or for back sleepers in bedding stores. The firmness of these pillows differs to provide the proper amount of support for the cervical spine.

The mattress is an important component of a proper nights sleep. Imagine if you had to stand for 6 hours on a pair of shoes such as flip flops which do not support your arches. Later that day, you may have foot, leg or low back pain. If you had to sit on a chair for work all day that was leaning to one side and too tall for you, your body would ache after the work day. Now, think of sleeping on an old bed that is sinking in the middle or perhaps it is too soft. This bed cannot support the curves of your spine. Your muscles must work all night to give you that support. If you have not replaced your mattress in 4 or 5 years, it may be time to consider a change. Also, remember to flip the mattress as directed by the manufacturer to promote proper wear of the mattress. Firmness of a mattress is dependent upon taste to a degree. A mattress that is too firm may cause a backache while one that is too soft will not provide support. It is up to the sleeper to determine the density that will both create comfort and support.

-Jane O’Brien, MSPT