Happy Marathon Training Season! Preserve your Performance with Beyond Basics Physical Therapy!

Fiona's Marathon photo

Fiona McMahon, DPT

Marathon training season is just around the corner! If you are competing in the New York Marathon, it’s about time to lace up those sneakers and set off on your 18 or 20-week training plan. As an experienced marathon runner, I know personally the frustration and anxiety that can accompany being sidelined from the action. Prior to my days as a PT, I accumulated ankle injuries, knee injuries (both of my knees), and hip injuries while training for various races. These injuries were so upsetting, I had given up my weekends with my friends to wake up for 20 mile long runs on Sunday, I had gone through more sneakers than I care to think about, and coughed up $300 a race in entry fees. Total bummer.
At the time of my first marathon, I was not a physical therapist; rather I was working in a genetics lab in Maine. I was fortunate to have two physical therapists that worked for my company help me when my knee became so painful I could not stand to work at my lab bench, let alone run 26.2 miles. Through weeks of work, they returned me to my old self and I successfully completed my first marathon in Mount Desert Island, Maine. Since that time, I have run 4 marathons and sought the help of physical therapists to help stave off injuries and allow me to train at my top capacity as I push closer towards a Boston Marathon qualification time.
Physical therapy helped me gain a critical awareness of my deficits as a runner. I found out I had a weak butt, tight iliotibial bands, and hamstrings. Who knew?! There is a lot as runners that we tend to overlook in terms of physical fitness. Many of us believe that putting in the mileage alone will prepare our bodies to endure the stress of months of training on hard pavement. It won’t. We need a strong core and hip stabilizers to reduce the impact on our joints. We need long and strong muscles to help generate enough force to efficiently move your body the length of the race. If you are only thinking cardio with marathon training, chances are good you are missing something that could help your overall time and health.
If you are starting out on your first 26.2 mile journey (or any athletic journey), or completing your 30th, don’t ignore your body’s signals that there might be an injury that needs attention. Treating an injury early with good physical therapy treatment is often much easier than treating one later on. Early treatment also minimizes disruption to your original training plan.
At Beyond Basics Physical Therapy, we go beyond what is offered in many physical therapy clinics. Our clinicians are orthopedic experts and spend an hour with their patients in one-on-one treatments, creating specialized plans to keep you in tip-top shape and return you to training faster. We are trained to look at the athlete holistically to determine the specific cause of a patient’s injury/deficit rather than a cookbook “one size fits all approach).
As clinicians, our goal is not only to heal our patients but to empower them to know more about their own bodies and to be able to take control of preventing future injuries. We take pride in our specialized home exercise plans, which a runner or any athlete for that matter, can take with them for the rest of his or her athletic career. I encourage you as a runner, to check us out and learn more about your running needs.

Bring out the Laser! Cold laser (Low Level Laser) …that is!

services-cold-laser

Fiona McMahon, DPT

When you think laser you may think of lasers for hair removal, tattoo removal, as surgical instruments, or if you are a child of the late 80’s early 90’s like me, you may think of Dr. Evil from the Austin Powers movies. These lasers are all examples of thermal lasers, ( ok, I didn’t check on Dr. Evil’s laser), which use heat to treat tissues. These examples may be all you think of when you think of lasers, but did you know that a different type of laser, cold laser, is a new and effective tool that the therapists at Beyond Basics are using to help treat their patients who suffer from a broad range of conditions from orthopedics injuries, pelvic pain to post operative recovery?

 

What is Cold Laser and how is it thought to work?

Cold laser or low level laser light therapy (LLLT) differs from the conventional lasers mentioned above in that they have a much lower light density than that of the lasers used in hair removal or surgery. Cold lasers do not emit heat, thus the moniker, cold laser.

Lasers were invented in the 1960’s and they were quickly used for therapeutic purposes.  1967 lasers were applied to the backs of shaved mice and the hair of the mice treated with laser grew back quicker than the mice that did not receive the laser treatment. Shortly after that study was conducted, lasers began being used to stimulate wound healing in non-healing ulcers.

Even though initial research on lasers started in the early 60’s, the mechanism by which lasers do their work is still not fully understood. There is strong evidence to suggest that laser therapy aids in ATP production ( the energy of cells), collagen production, cell turnover, and release of endorphins. The use of laser for therapeutic purposes was deemed safe by the Food and Drug Administration in 2002.

 

What can the use of cold laser help with?

Cold laser can be a brilliant adjunct to standard physical therapy treatment; however it is a component of treatment and does not correct the underlying factors that caused the original injury, therefore traditional physical therapy treatment of strengthening weak muscles and stretching and lengthening tight ones, correcting alignment, and improving overall fitness is essential to provide patients with truly long lasting results.

 

The use of laser has been found in many studies to be effective in reducing pain. In a meta-analysis conducted by Huang and colleagues, laser was shown to have a significantly  greater effect at lowering pain scores over placebo in patients with chronic low back pain.

 

In another study conducted in 2003, low level laser therapy was found to be more effective than placebo in reducing pain in patients with myofascial pain syndrome. In this study, both groups were given stretching exercises, but one group was also given  LLLT.  Immediately following the experiment and at the 3 week follow up pain levels were found to be significantly lower in the group that received LLLT.

 

Another study conducted by Foley et al, examined the “return-to-play” times for college athletes who were treated with laser versus their projected “return-to-play” times based off of historical data for the players’ given injuries. The study found that laser treatment shortened the “return-to-play” times by 9.6 days, which was statistically significant. The athletes required 4.3 laser treatments on average before they could return to their sports.

 

Laser is a great adjunct to traditional physical therapy and is a great help to patients where nothing nothing else has been effective. At Beyond Basics PT, LLLT complements our expert manual and orthopedic skills to treat pelvic pain, incontinence, post-surgical injuries, and orthopedic conditions. If you think LLLT may be right for you, make an appointment at Beyond Basics Physical Therapy today!

 

Foley J, Vasily D, Brandie J, et al. 830 nm light-emitting diode (led) phototherapy significantly reduced return-to-play in injured university athletes. Laser Ther. 2016; 25(1):35-42

 

Chung H, Dai T, Sharma S. The nuts and bolts of low level laser (light) therapy. Ann Biomed Eng. 2012; 40(2) 516-33

 

Hakgüder A, Birtane M, Gürcan S, et Al. Efficacy of low level therapy in myofascial pain syndrome: an algometric and thermographic evaluation. Lasers Surg Med. 2003;33(5): 339-43
Huang Z, Ma J, Shen Bin, et al. The effectiveness of low-level laser therapy for low-level laser therapy for nonspecific chronic low back pain: a systematic review and meta-analysis. Arthritis Res Ther. 2015; 17: 360.

 

Why Do I Still Look Pregnant: Part II

Fiona McMahon, DPT

Diastasis-Recti-Repair

Diastasis recti (DR) can be the bane of many women who are trying to decrease the size of their stomach following pregnancy. DR occurs when the two six pack muscles (rectus abdominus) separate from one another, leaving the appearance of visible gapping and bulging of the stomach, creating the look of a belly or paunch. We most commonly see DR following pregnancy; however, it can be seen in men and women with abdominal obesity, children with bowel issues, and people who have undergone abdominal surgery. Aside from its cosmetic effects, DR can also cause problems with the low back, bowel, and bladder.

Most physical therapists are trained to recognize and treat the musculoskeletal components of DR. We know to release the tight structures that are preventing the full closure of the abs, we correct alignment to reduce pull, we use sports tape to encourage the abs to activate, and we strengthen our patients’ core. It usually works wonderfully, but what if it could work better?

Staff physical therapist and resident “thinker outside of the box”, Melissa Stendahl, PT lead an inservice earlier this May to instruct the crew at BBPT on how to incorporate visceral mobilization to improve the results of traditional DR treatment.

 

If DR is a dysfunction of the musculoskeletal system, why treat the viscera?

In pregnancy the uterus grows and as it enlarges and becomes an abdominal organ. The intestines don’t have much say when this happens and get pushed behind the uterus in order to accommodate their new neighbor. After pregnancy the uterus returns to her old home, however the intestines may remain “sticky” from the trauma of being squashed by the uterus, leading to pull on the abdominals from the inside, which prevents the full closure of the abdomen. By treating the organs (AKA the viscera) we can help reduce one more factor impeding the full closure of the abdominal muscles.

How do I know if my organs are playing a role in the failure of my diastasis to close?

Some of the signs of visceral involvement with DR include low back pain, left sided sciatica, lower extremity joint pain, distention or bulging of the lower abdomen, difficulty digesting raw vegetables, and weakness in the lower extremity following workouts, secondary to reduced bloodflow.

What type of results can I expect from visceral mobilization?

According to Brandi Kirk, pioneer of this approach for DR, resolution of DR using visceral techniques can take from 12 visits to 1 visit depending on the severity of the separation.  She was able to demonstrate in her visceral mobilization class the following closures:

 

Class 1

Patient Diastasis Width Before Diastasis Width After
A 2 finger widths 0.5 finger widths
B 3 finger widths 0.5 finger widths
C 1 finger widths 0 finger widths

 

Class 2

 

Patient Diastasis Width Before Diastasis Width After
A 2 finger widths 1 finger widths
B 3 finger widths 1.5 finger widths
C 2 finger widths 0.5 finger widths

 

If you have struggled in closing your diastasis independently or are experiencing some of the symptoms mentioned above, it is time for a little extra help. Come see the physical therapists at Beyond Basics, who are trained to give you the most complete treatment for your DR. You deserve it!