Yahara Therapy

June 2011 Newsletter:

  1. PT school update
  2. Internship: Nursing Facility and Walter Reed Army Medical Center
  3. Clinical highlight: What is "Tight", anyway?
  4. Appointments and Referrals
  5. Healthy backs in the news

1) PT school update
I am now in year two of the DPT (Doctor of Physical Therapy) program at UW-Madison! This summer I'm studying orthotics, health promotion and wellness, and the science of "physical agents": How to apply heat, ice, and traction as well as electrical stimulation and ultrasound. It's a good thing I actually enjoyed the physics classes I've had to take!

2) Internship: Nursing Facility and Walter Reed Army Medical Center
I recently ended my first year of school with a four week clinical internship which I chose to complete in the DC metro area (Rockville, MD). This allowed me to study while simultaneously making a trip back to visit friends and family. I had an extraordinary learning experience at a skilled nursing facility (SNF, or "nursing home") as well as at Walter Reed Army Medical Center.

I met and worked with wonderful people--patients and therapists--and was able to practice what I've learned so far. I also know better what I need to work on!

TIPS for YOU based on my experience at the SNF:

  1. Stay or get flexible and supple. I'm talking simply about keeping your ability to move. If you cannot flex your ankles enough to walk...walking is hard. You fall down.
  2. Stay or get stronger. Women - I beg you - strengthen your upper body. If you break a hip, and you cannot push up from your chair...you are stuck in a chair. Or a bed.
  3. Keep your friends and family close and apprised of your wishes. A network of people who support you is a wonderful healing tool. Invest now!
  4. Pain and disability are not a natural part of aging.
  5. Massage is a beautiful tool. Use it as often as you can! I was able to use my massage skills with many of the patients, which was rewarding and useful for us all.

I spent one day at Walter Reed Army Medical Center in their therapy department. This powerful experience will stay with me for a very long time. I was able to shadow therapists working with soldiers, mostly recent amputees.

I met a special operations soldier who planned to return to combat. I was introduced to him in the state-of-the-art biomechanic laboratory created and operated by physical therapist Barri Schall. Reflective markers were taped all over his body, measuring and recording him (via cameras) walking in each of his three prosthetic legs, and a force plate embedded in the floor recorded how he stepped. Each leg had features that made it best for a different job: Jumping off of cliffs with this one. Long marches for that one. View a video of the lab here.

I was fortunate to have a chance to witness the work at Walter Reed; they are closing their doors after over 100 years.

3) Clinical Highlight: What is "Tight", anyway?

I hear the word "tight" on a regular basis. "I'm tight in my low back." or "It feels tight where you are working. What is that?!"

What does that mean to me? To you?

Muscle and other soft tissue like fascia can become rigid, inflexible and less-than-optimally functional. This can occur because of imbalance (we don't live symmetrically) caused by underuse, overuse, trauma or other injury.

Tissue can be considered "tight" in one of two ways. My favorite definitions come from an approach to the body called "Anatomy Trains" developed by massage therapist Thomas W. Myers.

  1. "Locked Long" is "a tense muscle held in a state longer than its usual efficient length, a muscle under strain, known in physiotherapy as 'eccentrically loaded'."

    This one is like a rubber band stretched as far as it can be without breaking. Lots of tension! It is often asked to do so much more than it has the strength to endure.
    Example: The area between your shoulder blades gets locked long from typing all day on a computer.

  2. "Locked Short" is "a tense muscle held in a state shorter than its usual efficient length, a bunched or shortened muscle, known in physiotherapy as 'concentrically loaded'."

    This is like a very wound-up spring that is too tight to stretch. This might keep you from stretching easily without a cramp.
    Example: Your calves get locked short from walking all day in shoes with heels that shorten them.

You can see how these two "tight" feelings are quite different.

Therapists will address "tight" tissue in different ways depending upon if it is locked long or locked short. You might be encouraged or helped to stretch a "locked short" area of your body. For those areas "locked long", you may be encouraged to strengthen them. Often, for both locked long and short tissues, hands-on therapy like massage is helpful.

This can be performed by a professional (like me!), but it can also be performed by you! You might use a foam roller, tennis balls, a racquetball or other tool like a Theracane.

If you would like to discuss ways that you can learn how to balance your "tight" tissues, please don't hesitate to contact me. I may be able to schedule an appointment (see below), make time to discuss a plan for you, or refer you to another qualified professional in your area.

4) Appointments and Referrals
I have occasional appointments, still, throughout the summer. If you would like to schedule an appointment, my general policy is to contact me in the week you would like an appointment to check availability.

If you are unable to schedule with me, I will refer you to my recommendation list of amazing local therapists on my Web site. The page is here: www.yaharatherapy.com/recommendations.html

Do you have any recommendations?
I have heard that some of you have discovered good therapists! I'd love to know whom you are working with, so that I may meet them and refer other folks to them as needed. Please do send any information along!

5) Healthy backs in the news

  • "Along the Spine, Women Buckle at Breaking Points"
    By Jane E. Brody
    June 27, 2011
    The New York Times: Health
    From the article: "Vertebral fractures affect a quarter of postmenopausal women and account for half of the 1.5 million fractures due to bone loss each year in the United States."

  • "Forget About Crunches. Here's How to Protect Your Back."
    By Jane E. Brody
    June 27, 2011
    The New York Times: Health
    From the article: "Adopting an exercise routine that improves posture and strengthens back muscles can go a long way toward preventing pain."

Thank you, and I look forward to hearing from and seeing you, soon!