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.

Join our email list to get our special report on the 3 Keys to a Fantastic Ski Season.  Just leave your name and email address in the space on the right side of this page.

Physical Therapy Hows & Whys

Is Physical Therapy a good way to get started on an exercise program if you have been inactive for a long period of time or is a personal trainer a better option?

It is always best to consult with your doctor before beginning an exercise after prolonged inactivity. Your doctor will perform a complete physical and determine if you will be at risk or if you are safe to begin an exercise program. If the MD gives you the “Go Ahead”, physical therapy is your best option for proceeding.

The PT will evaluate your body before developing an exercise program. Tests may include an assessment of muscle strength in your arms, legs and core. He or she will assess your flexibility, your ligamentous stability, your range of motion in your joints, your endurance level, and your current fitness level. The PT will measure our blood pressure and your heart rate at rest and determine an appropriate activity level for your exercise program. He or she can tailor the program towards your specific fitness goals, for example, weight loss, improved endurance, strength gains, toning or others you may have in mind. If you wish, the PT can also measure your body fat level and develop a plan to reduce that level.

One benefit of beginning a fitness program with a PT is that you are being medically monitored. As you proceed with your fitness program, the PT will assess your heart rate and blood pressure before, during and after activity. Your exercises will be adjusted accordingly. If you have any previous injuries, alert the PT so that area can be protected in your program to prevent a flare up. Additionally, the PT can add exercise to your program to rehabilitate the injured area.

One last advantage of a fitness program which is performed under the direction of a Physical Therapist is the price. A medically guided program may be covered under your health insurance. This means that you may only need to pay for your copayment or coinsurance. If, however, you do not have insurance, many Physical Therapists provide personal training to their clients. The cost may be slightly higher than the fee a personal trainer may charge (about $10-$20 on average). But, the Physical Therapist is a medical professional who has either a Masters or a Doctor of Physical Therapy degree and is trained in the biomechanics of the body, muscle structure and function, injuries and rehab, anatomy and physiology, orthopedics, and strengthening and conditioning.
North Tahoe Physical Therapy works with many clients for reconditioning programs both through insurance and on a cash payment basis. We also offer personal training and Pilates exercise programs.

-Jane O’Brien, MSPT

Rotator Cuff Surgery and Repair

How long does it take a rotator cuff tendon to heal after a surgical repair?

A surgical rotator cuff repair requires a tendon reattachment into a bony anchor in the shoulder. The bone site of tendon reinsertion requires eight weeks to heal. Physical therapy, although specifics depend on the surgeon’s rehab protocol, usually begins three-five days after the surgery and continues for up to twelve weeks in three distinct phases until all prior shoulder function returns.

During phase one, the first eight weeks of physical therapy, while the bone is still healing, rehab is focused on symptom control and the return of symmetrical range of motion (ROM). Educating the patient to ice, encouraging the use of an arm support to rest the irritated tendons, and introducing the Codman pendulum exercises are all common strategies for controlling shoulder symptoms. ROM activities are limited in phase one to passive stretching (the patient must keep the muscles relaxed while the therapist stretches the rotator cuff muscles).

After the surgical repair site has healed and the patient has full ROM, emphasis shifts in phase two to shoulder strengthening. Strength work focuses on both rotator cuff muscles and the interscapular muscles to promote the return of normal shoulder biomechanics. Rotator cuff strengthening begins with isometric contractions and progresses to eventual strengthening with weight or Theraband resistance.

Phase three involves proprioceptive training for the upper extremity to ensure proper reaction time and future injury prevention. During week twelve of physical therapy the patient performs final assessment to determine if they can safely return to all activities of daily living before formal discharge from physical therapy. Once discharged, the patient is encouraged to maintain shoulder flexibility and strength with an independent exercise program.

-Rebecca L. Deal, MSPT