PhysioDoctorYour Physical Therapy, Exercise & General Health Source

As a physical therapist, a great deal of my time is spent educating people on the importance of proper body alignment, symmetry and posture.  I would be willing to bet that most of us have been told since an early age that correct posture is important, but how many people can actually explain why this is true.

As I have mentioned in previous posts, most humans fall into a few typical movement or postural patterns and it is these patterns that are responsible for the majority of musculoskeletal complaints.  Now take a minute and think about what I am saying…imagine that on average you are awake 16 hours per day and that a large percentage of those hours are spent in a gravity dependent position such as standing or sitting, whether at school or at work.  Both school and work, in most cases, involve prolonged periods in which we are not moving a whole lot and even sitting for extended amounts of time.  I realize this does not count for everyone, but trust me this scenario is true for most.  While you are sitting or standing in place, your postural muscles are active in an effort to fight the effects of gravity and keep you upright.  This is where the problem occurs.  Most of us give in to the effects of gravity and begin to slouch either out of habit, muscle weakness or fatigue.

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I just wanted to send out a quick note to let everyone know that I will be in Aspen, Colorado and Billings, Montana over the next month visiting friends and family so my posts may be a little sporadic depending on whether or not I have internet access.  I apologize in advance, but will try to post anytime I get a chance.

It’s summer time again and that means people are heading off on vacation to catch up on a little rest and relaxation.  One would think that a week or two of relaxing would be the perfect prescription for nagging low back or neck pain, but in many cases the opposite may be true.   Most trips include sitting for extended hours in a car or plane to reach a particular destination, increased stress at the beginning and end of the trip, eating junk food, drinking alcohol and most likely exercising less.  All of these factors can lead to increased aches and pains and make your trip that much less pleasurable. 

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Many of us have suffered an injury and been diagnosed as having either a sprain or strain.  I often hear patients and individuals outside of physical therapy using these two terms interchangeably when really they refer to two very different injuries that affect two very different tissue types.

Sprains are injuries that affect ligaments, which are the passive stabilizers of our joints and cross from one bone to another bone.  They usually occur when a given joint is taumatically pushed beyond it’s normal range of motion and will often result in a “pop” type sound.  Sprains can be graded into three groupings (grade 1, 2 & 3) based on the pain and the amount of laxity found in a given joint upon clinical inspection. 

• Grade 1: pain and no joint laxity
• Grade 2: pain and some joint laxity
• Grade 3: no pain and complete ligament tear (very lax)

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I know we have all heard it a million times or more, but I would really like to reiterate how crucial correct posture is for optimal musculoskeletal health. This is even more important in jobs that require a great deal of time spent in static positions such as sitting. I would say that approximately 50% of the patients I see on a daily basis are having pain related to prolonged sitting while working at their computers! The question I always get is “I’ve been doing this job for a long time, so why would I have pain now?” My answer always relates to the “smart line” phenomenon, which basically states that each of us as unique individuals has a unique perception of how much and what kind of stimulus can be tolerated before the nervous system tells us that pain is occurring. For one person, sitting in a dysfunctional position for 4 hours my cause pain, whereas, another individual may be able to tolerate the same position for years before experiencing pain. Either way, most people will experience pain at some point and all will suffer from increased levels of tissue degeneration as compared to their more ergonomically correct counterparts if behavioral adjustments are not implemented.

I had a quite unusual evaluation today. A man who had developed strep throat earlier this year and ignored the symptoms thinking he would recover without any problems. Unfortunately, that was not the case! The infection ended up spreading to his bloodstream over the last couple of months, which resulted in him going into kidney failure and losing consciousness this last weekend. His wife immediately took him to the hospital where she was informed that he had developed necrotizing fasciitis or “flesh-eating bacteria”. Scary stuff! This poor guy developed a large abscess in his left armpit that was deep enough that the surgeon could fit his entire hand and part of his wrist into the cavity. After clearing the infected material, they sewed up the wound, gave him antibiotics and sent him home. He came in today to see me for restricted shoulder range of motion and weakness. Apparently, the infection may have spread to his shoulder joint resulting in scar tissue adhesions, which have caused the stiffness he is now experiencing.

I guess the moral of the story is make sure to see your health care provider if you are sick and things do not seem to be resolving within a normal time frame.

Have a great day!