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

Thurston County

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

Get your glut muscle workout with every day activity!

Gluteus Maximus

Gluteus maximus muscle-get your workout with everyday activity

Do you want to strengthen your gluteus maximus during day to day activities? Why is it even important? The gluteus maximus is important in preventing hip, knee and foot pain. It supports the thigh, knee and foot when you shift your weight onto your leg when you walk or run. It is absolutely essential for good balance. The gluteus maximus also supports the hip by keeping the ball and socket of the hip held closely tight, instead of allowing larger, longer muscles such as the hamstrings to pull ball towards the edge of the socket. At the image below, from “Diagnosis and Treatment of Movement Impairment Syndromes” by Shirley Sahrmann PT PhD FAPTA, it can be see on the top image, that the

Glut max versus hamstring

Gluteus maximus versus hamstring

that the gluteus maximus, the muscle on the top of the thigh, hugs the ball into the socket. In the lower image the hamstring can be seen pushing the ball forward in the socket, which can cause groin pain in the short run and hip arthritis in the long run.

To strengthening the glut with day to day activity do the following:
1) get in to a sitting position in a chair (or even on a toilet) and tuck your feet under you
2) reach around behind you to your buttocks
3) activate (tighten) your gluts
4) use your gluts to push you into standing
5) when moving from standing to sitting reverse this procedure

If you have in leg or back problems, be sure to check with your health care provider before attempting this exercise.

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!

Physical Therapy…May I have a private room please!

When you go to a physical therapist have you been offered a private room or are you treated in an open gym, no curtains to provide privacy, with many other people in the gym?

As a patient YOU can choose what you want. When you go to your first PT appointment, make sure to let the scheduler know that you would like a private room, if you wish.

Many clinics have one or two private rooms and a large gym. It is less expensive to have an large open gym with a few private rooms than to have many private rooms and a smaller gym. Why? It is much more expensive to frame in, sheet rock, putty and paint walls then leave spaces open. Unfortunately you, if you are the patient, may be more likely to gently be guided to an open gym space due to the lest costly nature of this arrangement.

Recently my husband went with his buddies to go get coffee. He came home telling me they watched a lady receiving physical therapy in an open gym with lots of windows. They watched her on her hands and knees stretching her buttocks towards the window. Unfortunately they got quite a show.

What are the positives to private rooms?
1) you can have a candid conversation with your therapist about YOUR needs and wants.
2) You can move in physically awkward positions in privacy with your therapist. This is an advantage to you as you have more privacy; also your therapist may be more comfortable asking you to get into awkward positions (which may be helpful for your therapist to understand your problem) to assess your problem knowing she/he is not putting you in potentially embarrassing positions.

At Comstock Physical Therapy we have 3 private rooms and 2 other rooms in our gym which have full curtain coverage. Here is a video of our clinic on the inside. Take a look, you’ll see our private rooms.

Inside of Comstock Physical Therapy

Please feel free to request a private room as we are ready and able to accommodate your request and keep your needs in mind.

You’re kidding right?! Hip muscle strength helps bladder prolapse AND knee pain

Who knew?  The obtruator internus, a hip and pelvic floor muscle both, supports the bladder from below.  

When the bladder begins to slip down into the vagina that is called prolapse, and the obtruator internus, a HIP muscles can help support the bladder.

Ideally the pelvic floor muscles will lift the bladder…but another muscle supports the bladder, too. It is the obtruator internus which is a supporting pelvic floor muscles as well as a hip stability muscle. Look at the picture of a bladder to the right and below.

obtruator internus muscle next to bone

obtruator internus muscle next to bone

The bladder is the balloon looking object in the middle of the picture, and you can see the hip joints. The OI wings are the obtruator internus muscle underneath the bladder, helping to lift it. This particular picture is of a man, but the obtruator internus muscle lays the same way in a women. Look down and to the left to see the obtruator internus (in green) in the pelvis:
obtruator internus connection to pelvic floor

obtruator internus connection to pelvic floor

Interestingly, the obtruator internus muscle is very important for preventing knee pain as well as preventing plantarfascia. “Why?” See how the obtruator muscle wraps around the sit bone and attaches to the hip? It turns the hip and thigh out, which helps prevent the knee from rolling in (which causes kneecap pain).

obtruator internus posterior view attachment to hip

obtruator internus posterior view attachment to hip

The picture to the right is of the hip and thigh rolling in…the obtruator internus stops that movement AND helps the bladder.
knee cap pain due to hip weakness

knee cap pain due to hip weakness

If you have bladder prolapse, knee pain, or hip pain, or all 3, come to Comstock Physical Therapy to be evaluated by a therapist to get the help you need.

Comstock
Physical Therapy

165 Lilly Rd. NE, Suite B
Olympia, Washington 98506

360.455.8014

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