165 Lilly Rd NE, Suite B, Olympia • 360.455-8014

Ankle Sprain

A better to way to stretch you Achilles!

Achilles-tendonIf you have a tight Achilles do you the usual stretch, which is to lean against a wall, the foot you are stretching farther back. Here is a picture: calf stretch Another way to stretch the Achilles is the stand with your feet on a step and slowly lower your body weight while keeping your toes on the stair. toe book stretch Stretching the Achilles feels good, and can increase motion, but how does that translate into walking? Could the problem be weakness in the front of the ankle, instead of tightness in the Achilles? And if the front ankle muscles are weak, and they are needed to help lift the foot when you swing the leg through, and needed to support the arch as you put weight on the leg, could you accomplish both front ankle strength AND Achilles stretch at the same time? Yes, you can, and it is better for your feet! What to do? First, standing, practice lifting the toes from the tips of the toes. Then, lift the foot, keeping the heel down on the floor. Take 10 steps on each foot. Repeat this in sitting to stretch the soleus muscle, the muscle underneath the gastrocnemius. toes up ankle up

Physical Therapy in Olympia, Tumwater and Lacey, Where should I go?

There are many fine physical therapy clinics in the Olympia, Tumwater and Lacey area. How do you chose where to go?

You can choose based on location. A friend of mine told me today she chose to go to physical therapy at a clinic close to her house. What would prompt a close choice versus reputation? Maybe she needed to go 2 or 3 times per week. If someone needs to go to PT 2 or 3 times a week for a month or so, then going close to your house would be very convenient, HOWEVER, ask yourself the question: does your condition warrant 2 or 3 times per week?

Recently a former patient returned for a new session of physical therapy. She is a fairly frail 80 something year old, and was sent for BOTH headaches AND shoulder pain by her physician. Her prescription from the physician was directed to be 2 to 3 times per week for 4 to 6 weeks. She may have thought she needed to come that often, but…….when I evaluated her headache AND shoulder pain, I determined that both problems were mainly caused by the same anatomical structure.

I gave her an exercise program based on this one problem, and added customized and specific exercises for the shoulders and neck. As of Friday (January 30) 100% better in the headache and 75% better in the shoulders. She came for 6 visits at 1 x per week.

So the bottom line is, unless you actually NEED to have therapy 2 or 3 times per week consider going somewhere that uses less visits more effectively and you may save yourself some time and money.

The therapists at Comstock Physical Therapy, Joyce Mills, Lori Waterman and Linnea Comstock have extensively studied the body to make our exercise programs very effective and efficient. Give us a call if you would rather go to PT once per week instead of three times a week!

Do I REALLY need to go to physical therapy 2 or 3 times a week for 4-6 weeks?

Patients never really say it, but I can tell they don’t really want to commit to 2-3 times a week of physical therapy treatment.  I’m not sure I would want to commit to that much time, given my busy schedule.  So…..I often schedule patients 1-2 times  a week unless they hurt really badly or they have an injury, surgery or goal that demands they come in 3 times a week.

If you’ve had a fresh injury like an ankle sprain, knee sprain, etc, PT right away is important to keep you as mobile and strong as you can be without making your injury worse.  This idea applies to some surgeries (see the surgeries mentioned in this post http://comstockpt.com/2014/02/01/physical-therapy-hurt/).   You may wonder, what happens if I don’t go to PT early on?

Let me tell you, it is BAD news!  When you are in a lot of pain from an injury some  muscles shorten up and spasm to protect you and other ones get shut down.  As a matter of fact recent science has shown that the big  muscle on the front of your  thigh (the quadriceps) begins to get shut down by your central nervous system 12 hours after pain begins.

When your pain level is lower, and your condition not as fresh you can cut down to 1 to 2 times a week. Chances are you will do well at 1 x per week if you are consistent in doing the exercise program the therapist has given you for homework.

Talk to your PT, she or he will work it out with you.

The Movement System–The core of Muscles-In Sync (R)

Joyce Mills and I just finished attending a educational course instructed by Shirley Sahrmann PT PhD.  The course was titled Movement System Impairment Syndromes:  Lower Quarter Advanced Applicatiion.  Two other PTs from Olympia went too.  It was very refreshing and stimulating and gave us new information about treating such difficult problems such as hammer toe, hip pain and back pain

What are Movement Impairments and why should I care?  Movement Impairments mean you are moving with a bad habit… stretching out what is already too loose and keeping what is too tight still too tight.  For example, in previous blog posts such as the one below::  http://comstockpt.com/2011/10/19/chronic-ankle-sprain-weak-hip-making-recovery-difficult-lacey-wa/

the young man with the ankle sprain was a medial femoral rotation impairment.  That means his knee kept rotating in because his inner thigh muscles were too short and gluts were too long and weak. Which out extra weight down through his ankle and made his recovery poor.  

What is new? One of the things we learned is that it turns out hammer toes are sometimes caused by over using the muscles that lift the toes instead of the ankle muscle that is supposed to lift the foot when you clear your foot.  This is often caused stiffness in the movement of the foot up, like you are marching.  How to fix?  Walk with more push off and stretch your calf.  

Muscle of the Week: Peroneus Longus pain masking as plantarfasciitis

The peroneus muscles are on the outside of the lower leg and ankle and usually get strained when the ankle gets sprained.  This makes sense to most people because the tendons run so close to the outside of the ankle. 

 

But…..the peroneus longus tendon crosses UNDER the foot after running along side the ankle bone to help support the arch.  It attaches in the middle of the arch on the bottom side. 

Here is  a picture of the bottom of the foot:

When the peroneus longus tendon insertion starts to pull and get irritated, it can feel like plantarfasciitis and be confusing.  However, the fix is usually the same, stretch your Achilles and plantarfascia and strengthen the side to side  muscles as well as get manual therapy. Sometimes orthotics help too.  Your physical therapist is particularly well trained to fix this condition.