Thursday, February 26, 2015

Oh my aching back!

Tis the season for shoveling snow.  One of the dreads of winter is the aftermath of all the serene white flakey stuff gracefully falling to a peaceful landscape of calm; you are left with cleaning up mother nature’s mess so as to resume some sense of normalcy in the days after.
Shoveling snow as we have all been warned is not something to be taken lightly.  Even for us “fit” folks, we get sore after moving and clearing the white stuff off our driveways, cars, front walks and steps.  It’s not an activity that ANY of us are accustomed to doing unless you actually perform manual labor for a living.  As much as I try to perform the correct maneuvers to shovel, I inevitably end up with a sore back for a couple of days afterwards.  I see my neighbors out shoveling and the bad form makes me cringe with each scoop of the shovel. 

With all that said, what are some ways to help minimize injuring ourselves while we dig out from Mother Nature’s fury?

·         Lift with your legs.  Time and time again this has been repeated.  Think of a squat, brace your abdominals to protect your back, bend the knees to scoop and then face the direction you will be placing the snow. 

·         NEVER twist and fling the snow.  This will almost guarantee you will probably hurt yourself in the long term.  This is how people ultimately herniate or bulge discs in their low back.  Bend over, twist and fling.  BIG NO-NO.

·         If the snow is heavy, scoop smaller loads.  Let’s face it, snow can get heavy if it’s wet and packed down.  Add that to the bend and twist; it’s a recipe for disaster.

·         If the forecast calls for A LOT of snow, try and go out more frequently.  2-3” of snow at a time is a lot easier to move than 6-8” in one go. 

·         In the aftermath, don’t wait too long to let the snow melt off.  It just gets heavier.  The sooner you get to it, the sooner your cleared areas melt off and dry with the sun shining (we hope).  If the forecast calls for continued sub-freezing temps, even more of an excuse to clear off the snow.  If it refreezes, now you’re dealing with ice, which is harder to clear out.

·         OR avoid it all together:

o   Put your kids to work or hire the neighbor’s kid.  Although, I would clear your own car first.  DO NOT take your shovel or a broom to the roof of your car if you at all care about damaging your vehicles paint.

o   Invest in a snow blower.

o   Move some place where it doesn’t snow (Hawaii sounds nice about now).

Shoveling snow can certainly be a chore and a nuisance if it does it a lot.  For those who already have preexisting low back issues (80% of the population has suffered from low back pain at some point or another), be extra cautious.  Shoveling is a strenuous and repetitive activity.  Most of us are unaccustomed to this type of activity and will most likely be sore to a certain degree.  If that soreness, lingers past 3-4 days after, you may have over done it.  If at 7 days, the pain persists and has not managed to go away, it may be best to seek out your friendly PT or orthopedic to get things checked out.  For more serious issues (and you’ll know), shooting pain into the legs or sharp pains to the low back which leaves you unable to move for days, get into the doctor ASAP.  They can prescribe medications that will help subside some of the symptoms, then get into see your PT for further management and resolution of symptoms.  Stay safe and keep warm…spring can’t come soon enough!

Friday, February 13, 2015

"Magic Tape"

We’ve all watched the Olympics on TV and I’m sure many of us saw a good number of those world class athletes with some elaborate tape job on their body. So, what’s the deal?

For those in the PT field or in athletic training rooms, we know this tape as “kinesiology tape.”  I have used this tape on myself for many issues I have developed over the years.  I have also used it on clients if it was deemed appropriate for the client and the condition.  What is it and what does it do?
Kinesiology tape is a non compressive, non restrictive taping method used by physical therapists and athletic trainers to compliment ongoing treatment of an injury.  Depending on the goal of its use on the body, it can be used to modify muscle tone or movement, provide feedback to the brain from the body, and /or improve blood/lymphatic flow while decreasing pain in order to facilitate healing.  It acts as a sort of second skin layer.  The elastic properties of the tape and its application provide the “magic.” 
There are also several brands of kinesiology tape out on the market.  They all have similar characteristics of the original kinesiology tape, but not all tapes are created equal.  I have tried many of the tapes out on the market.  The elastic properties are similar (but the weaves are different), the adhesives used are different, the quality of the materials are different and subsequently, their effectiveness will be different.   I tend to gravitate towards the higher end original tape.  The feel, the elasticity, the materials and adhesives are well made and not overly done.  It truly feels like second skin.  For my clients with possible adhesive allergies or sensitive skin, I would only use the original.  I would be weary that the adhesives of the other brands would be a little too aggressive in terms of “stickiness.”
As far as what the evidence says: recent studies have shown that the use of kinesiology taping methods used in conjunction with manual therapy techniques (the very same techniques we use for our clients) are beneficial in reducing pain and returning clients to their activities sooner than exercise alone.  There are a number of studies that have shown the benefits of manual therapy techniques and exercise over exercise alone.  However, as with many things, there are limitations to these studies such as the limited number of subjects utilized and the intertester consistency (the PT).  These studies at least provide a basis for adding “tools to the toolbox” when it comes to treating a client/patient effectively.  There is no “cook book” recipe for how to treat any one person.  Each person will respond in their own way to treatment.  It is up to the PT to determine whether one tool or method is better than another to yield the desired results.  Be aware that not everyone is necessarily a candidate for kinesiology tape.
We have utilized an array of hands on techniques to help our clients.  We also have used kinesiology taping, athletic taping and lesser known to consumers, McConnell Taping techniques to assist not only us as PTs but to help clients return to activity.  Anecdotally, a good number of clients respond well to kinesiology taping.  Technique and knowledge of the body, as with most things, is key in determining its effectiveness.  I personally have used the tape on myself for a few minor soft tissue “injuries”.  Whether it was placebo, or physiological or both, the tape did the trick to allow me to continue training/racing.