Delicate Body Parts: Ankle Sprains

How many times have you experienced or heard of “rolled or sprained ankles” that happen on a regular basis? There seems to be a stigma around ankles and their susceptibility to sprains. Many believe it is a normal occurrence and will carry on their entire life dealing with constant “rolled ankles” and never be treated for one. However, did you know that people who experiences multiple ankle sprains throughout their life actually lack a key aspect of awareness that can be addressed by a physical therapist and prevent ongoing sprains?

When someone sprains their ankle for the first time, initial swelling and pain occur with pain intensity being dependent on the severity of the sprain. The body attempts to heal itself and goes through its normal inflammatory healing process. Although this initial phase is good, it has secondary effects that cause ongoing ankle sprains if they go untreated. With inflammation, there is excess fluid in the ankle, this causes the nerve endings responsible for detecting spatial awareness to turn off. When this happens our proprioception and kinesthetic awareness – medical terms that mean knowing where you are in space- no longer function correctly. Because of this, our brain is unable to safely detect where our ankles and feet are in space without looking down. This causes a problem as we shouldn’t walk around looking down at our feet to make sure they’re stepping on flat ground! This not only makes us heavily reliant on our vision for stability which isn’t normal, but also makes us susceptible to accidents because we’re not looking up at our surroundings!

If you or anyone you know suffers from constant ankle sprains, let them know physical therapy can help them out!

Jennifer Santamaria PT, DPT
Performance Plus Physical Therapy
P: (619) 482-3000
F: (619) 482-3001

Have you received scary MRI results or been told you have degenerative disease/degeneration in your spine?

Have you received scary MRI results or been told you have degenerative disease/degeneration in your spine?

Imaging (MRI) results showing degeneration in the low back are common in asymptomatic individuals (people without pain). Examples of degenerative findings include disc degeneration, disc bulging or protrusion, and facet degeneration. These findings are normal age-related changes (usually unrelated to pain) and are likely an incidentally finding.

Normal MRI findings in the low backs of “pain-free” individuals:

45% of 20-40 year olds
75% of 40-60 year olds
Over 90% of 60-80 year olds
…have disc degeneration

30% of 20-40 year olds
55% of 40-60 year olds
Over 75% of 60-80 year olds
…have disc bulging

25% of 40-60 year olds
Over 65% of 60-80 year olds
…have facet degeneration

Have questions about your MRI findings or what’s causing your low back pain?
A physical therapist can help answer those questions and get you moving again!

Reference: Brinjikji, W. et al. Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Propulations. Am J Neuroradiol. 2015 April; 36(4): 811-816.

Is Stretching Effective?

Is stretching effective? The short answer is yes! Stretching is practiced frequently here at Performance Plus. However, to completely answer that question we first need to be more precise. What does it accomplish, and how or when should we stretch? Some sources may suggest that stretching is a cure all for muscle soreness, an important step in your pre-workout routine, or aides in increasing ROM (range of motion). These benefits, however, need to be taken with a grain of salt. We will discuss or debunk each of these theories.

Let’s begin with the idea that stretching cures muscle soreness. We all have those days: a couple days after a hard workout, during which we targeted a muscle group that we had ignored for a while. We are sore and seeking relief, when someone suggests a stretch. While it may feel good to stretch a sore muscle, stretching will not actually aide in relieving the soreness. You may develop a tolerance for the pain, but the real reason for muscle soreness is from minute tears in your muscle fibers, which ultimately just need time to heal. Avoid stretching aggressively at this time, as it could do more harm than good by further tearing the muscle fibers.

Next we have the idea that stretching is beneficial –necessary, even – for your pre-workout routine. Do you find yourself doing static stretches, where you hold position for just around 30 seconds? If you do, consider instead warming up in a more dynamic way (if you are physically capable of doing so), such as jumping on a stationary bike for a few minutes. Something light, but enough to get your heart rate up. Stretches will serve you much more effectively after your workout and when done consistently. For the same reason that aggressive stretching should be avoided while very sore, stretching over time will strengthen muscles. As in a dynamic workout (albeit on a smaller scale), stretching contributes to hypertrophy or muscle growth via the minute tears it creates in muscle fibers. Therefore, recovery time is so important for gaining strength.

Lastly, we will tackle whether stretching helps increase ROM. ROM is described as the full movement potential of a joint. Very often after an injury ROM is decreased. While stretching has been long known to increase flexibility, as mentioned earlier, more dynamic stretching will serve you better. It is important to know, especially within a sports setting, that static stretching may temporarily weaken the muscles you are stretching. They will get stronger in the long run, but a quick fix is not found in static stretching. Dynamic stretching, on the other hand, such as squats or lunges, is better backed by science to help increase flexibility, range of motion, and strength.

Remember that stretching is beneficial and effective when done appropriately AND at the appropriate times. Consistency is key. Happy safe stretching!

Is It Normal To Be Sore After Exercise

You have just gotten back from a 6-hour hike, complete with some grueling escalation. “It was a great workout!” You think to yourself, “so why am I not sore?” Many of us look forward to being sore, as a telltale sign of our hard work.

Do not worry, the soreness is likely to come. This is called delayed onset muscle soreness (DOMS) and it is common to feel the height of the soreness 24-48 hours after a workout! This is a completely normal process that is necessary for the muscles to rebuild themselves. Before anyone is too discouraged by the pain and stiffness to keep up with their workouts, here’s what you need to know:

DOMS is the result of tiny, microscopic tears in your muscle fibers and the connective tissue that surrounds it. These tears occur during eccentric exercise, where muscle fibers are being lengthened. Eccentric movement is performed daily, whether by lowering a barbell in a biceps curl or lowering your baby down for bed. The severity of DOMS will decrease once the body adapts to the intensity. Your body will strengthen to accommodate the certain number of sets/reps you’ve been doing at a consistent resistance. Just one exercise can help prime your body for the next exercise and you will find yourself much less sore the next time. To get stronger, however, the intensity must be increased and DOMS will likely occur again.

Learn to listen to your body. Soreness does not equate to ALL pain. Though a great workout will yield soreness – a sign that your muscles are getting stronger- rest days are just as important. While overloading your muscles is necessary for improvement, there is such thing as a tipping point. If a dull pain becomes sharp, shooting pain – you have already gone too far. It may be tempting to push through the pain, but eventually more harm than good will be done and you will be wishing you gave your body that extra day to recover.