Stretching for the Active Adult Woman

Stretching for the Active Adult Woman

By Ryann Roberts, DPT and Brooke Smith, DPT

It is hard enough to squeeze a daily exercise routine into your busy schedule.  You may think adding extra time with a before or after workout stretch is something you should just fit in when time permits.  The focus is on the exercise, not the stretch, right?  Wrong.

Stretching is just as important in your workout routine as the actual exercise.  Stretching increases flexibility, which in turn will help to increase your athletic performance and decrease your risk of injury.  For the active adult woman, the emphasis is on decreasing the risk of injury.  Understanding why stretching helps, and what stretches the active adult woman should perform, can help reduce and/or eliminate these injuries.

Stretching can help improve flexibility.  Flexibility may decrease your risk of injury by allowing your joints to move through their full range of motion.  For example, let’s say you are a 60 year old woman with tightness in her hips and ankles.  This tightness prevents your body from going through its full range of motion, which eventually can develop into tendonitis in your knee or lower back pain.  Properly stretching can increase the range of motion in your hips thereby reducing the risk of these micro traumas to your tendon that may lead to overload or injury.

Stretching also increases blood flow to the muscles, sending oxygen to the tendons and ligaments, essentially waking them up and preparing them for your workout.  

There are two types of stretching routines to perform – dynamic and static.  Dynamic stretching is stretching with movement, designed to propel the muscle into an extended range of motion.  This form of stretching prepares the body for physical exertion and performance.  Static stretching is used to stretch muscles while the body is at rest.  It is composed of various techniques that gradually lengthen a muscle to an elongated position (to the point of discomfort) and hold that position for 30 seconds to two minutes, two or three times per stretch. 30 seconds is the minimum duration to get the benefits of stretching, whereas two minutes is the maximum.

Always take the time to make sure you are stretching safely and effectively using proper technique.  Stretching incorrectly can actually do more harm than good.  Stretching cold muscles may cause injury, so we recommend warming up with some low intensity cardio for five minutes before beginning any stretching.  When stretching, do not bounce.  Bouncing can cause small tears in a muscle.  These tears cause scar tissue in the muscle that as it heals tightens the muscle even more, making you less flexible and more prone to increasing pain and causing injury.

To help, we have prepared a stretching routine to perform before and after you exercise.  

The following dynamic stretches are performed prior to exercise:

• Walking Lunge with Overhead Rotation
• Lateral Lunge
• Squats
• Walking Russian Kicks
• Arm Circles
• Posterior Deltoids Stretch
• Triceps Stretch

For a detailed description of these stretches, click here.

The following static stretches are performed after exercise:

• Standing Calf Stretch
• Hamstring Stretch
• Ilio-Tibial Band Stretching
• Standing Abductor Stretch
• Posterior Hip Stretch
• Low Lunge with Twist and Hip Flexor Stretch
• Standing Extensions
• Corner Stretch

For a detailed description of these stretches, click here.

It’s very easy to bypass stretching due to time constraints, but keep up with it.  The benefits of stretching are best when stretching is regular.  In some cases, you may need to approach stretching with caution. If you have a chronic condition or an injury, you may need to adjust your stretching techniques. For example, if you already have a strained muscle, stretching it may cause further harm.  

Lastly, stretching does not mean you cannot get injured.   Overuse injuries may still occur.  If you are feeling pain or are injured, please contact AZOPT for your FREE injury and/or performance screen with a licensed physical therapist.

A Newborn Baby's First Year - The Sound Development Parents Can Anticipate

Early Speech Sound Development

By Lanni Reisinger,SLP-CFY

Kids Place Pediatric Speech Therapist

Often times, parents of a newborn will wonder which sounds will first be heard by their baby and how to help produce these sounds.  From the time a newborn baby reaches three months and starts making their first sounds to when a baby is 12 months and forms their first word, parents can expect to hear a wide variety of noises and sounds. 

In this blog, I will address these milestones as well as the activities parents can perform to help their newborn progress.  Please note, these milestones are meant to be generalized.  There is no reason to be alarmed if your baby is slower at hitting certain milestones.  At the end of this article, I will list certain “red flag” milestones that may indicate your newborn needs to be evaluated.

At three months, your baby will begin to make sounds.  The first sounds you can expect to hear are vowel sounds when your baby is cooing and making pleasure sounds (“oo,” “ah,” “uh,” “oh,” “ee”).  At this time, your baby will also begin producing distinctive cries when they are hungry, wet, etc.  They will then begin producing strings of vowels with varying intonation.

When your baby begins babbling at four to six months, the first consonants they are likely to produce are “bilabial” sounds, produced with their lips (p, b, m).  These sounds are learned first because they are easily seen by your baby and fun to make.  This is also around the time you will first see your baby laugh.

At seven months, your baby will produce “reduplicated syllables” - repeating the same sounds over and over again (“babababa”).  Your baby will first produce these sounds in play, without any communicative intent.  You should then begin to notice your baby making sounds to gain attention.  Furthermore, around this time your baby will begin imitating more sounds and “talking” when others are talking.  You can prompt your baby to make sounds playing some basic games in which you take turns making sounds.

Here are some of my favorite games and songs for babies at this age:

• Peek-a-boo (hiding behind hands, blanket, napkin, etc.)
• Patty-cake
• This Little Piggy
• Head, Shoulders, Knees and Toes
• Row, Row, Row Your Boat
• Old MacDonald

It is also important to read with your baby.  It is not necessary to read every word in a book.  Simply talking about the pictures and pointing to things in the book will help.  You can prompt the production of sounds through making silly and nonsensical sounds while you play (“wee!” or “uh-oh!”).  You can also prompt your baby to imitate environmental sounds like animal sounds (“quack-quack!” and “moo!”) and transportation sounds (“vroom!” or “urch!”).

It is important to remember not only to prompt your baby to imitate your sounds, but imitate your baby’s productions as well.  Face-to-face time with your baby is important and using a “sing-song” tone with lots of rising and falling intonation will help your baby attend better to your sounds.  

By your baby’s first birthday, you can anticipate their first word, typically a word they use often (e.g., “mama,” or “hi”).

As a precaution, if your baby is not making any sounds by six months, or no consonant sounds (p, b, m) by ten months, an evaluation by a doctor is appropriate.  By 15 months, a baby should be saying their first word.  If this is not the case, an evaluation should be sought.

Why You Should See a Physical Therapist

Why You Should See a Physical Therapist

We thought it timely to remind readers about the importance of physical therapy. Here are 5 (of the many) reasons you should work with a physical therapist.

1. PTs are highly educated musculoskeletal specialists.

Physical therapists are required to complete extensive training — and to earn at least a master’s degree, if not a doctorate — before applying for state licensure. PT programs require coursework in anatomy, physiology and biomechanics, as well as multiple apprenticeships at physical therapy clinics. Even once a PT graduates and is licensed, the state requires continuing clinical education in order to maintain licensure.

2. PTs are able to treat the whole person, not just a single body part.

Because of their extensive musculoskeletal knowledge, PTs can evaluate your body as a whole. For example, knee pain could be related to weakness in your hip; back pain could be related to your general posture. This is why a physical therapist will do an evaluation of your entire body on your first visit, to assess not only where you feel pain, but the variety of factors that could cause it, and then create a specific treatment plan for your condition.

3. PTs not only do rehab after an injury, but also provide health and wellness programs.

As health care practitioners trained to help people recuperate from injury, physical therapists are uniquely prepared to help people live healthier lives. For example, many PTs offer nutrition and exercise programs through their clinics. The programs can be used to supplement the clinical treatment of a patient, like an arthritis sufferer who needs to lose weight to relieve joint pressure, or a client who is simply interested in living a healthier life. In the same vein, PT clinics offer such programs as wellness/fitness evaluations, strengthening and conditioning classes, and more.

4. PTs can design individualized programs to improve your health.

PTs have the knowledge to treat a variety of symptoms. The most common reason physical therapists are approached is pain relief, but they can also improve posture, body structure, circulation and function, as well as correct deformities and promote healing.

5. PTs often specialize in a variety of fields.

Chances are high that a physical therapist has specialized in a field of interest. While many work with specific types of athletes, others focus on general orthopedic concerns, or children, or seniors. Some PTs choose to do further study of particular health problems, work with cancer patients, help patients with Parkinson’s or multiple sclerosis maintain their strength or grow stronger, or rehabilitate back to independence.

As we continue to fight obesity and improve health throughout our country, it is clear that physical therapists are key partners in living healthier lives. Their training and clinical expertise are essential to maintaining strength and moving forward in all walks of life.

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For further reading:

Richman, Meryle. October 2011 is National Physical Therapy Month. Yorktown Patch, October 2, 2011.
Richman, Meryle. Living a healthier lifestyle. Yorktown Patch, August 30, 2011.
Slayback, Carrie Luger. My turn: Friends shine after physical therapy. Los Angeles Times, July 25, 2011.
Rachlin, Natalia. War wounds and tutus. Wall Street Journal, July 6, 2011.
About physical therapists. APTA, 2011.
Physical therapy eases burden of lymphedema. PennLive.com, November 2, 2010.
Hilton, Lisette. Aging frames: Baby Boomers visit PTs with musculoskeletal complaints. Today in PT, September 6, 2010.
Weinper, Michael. Physical therapists have what it takes: Meeting the health and fitness needs of Americans in challenging times. Impact, May 2010.
Rodriguez, Diana. Physical therapy after a stroke. Everyday Health, March 25, 2009.
Wiggin, Sally. Direct access can save patients time, money for physical therapy. WTAE Pittsburgh, March 9, 2009.

What is Torticollis?

What is Torticollis?

By Nichole Hagerty, DPT

Bringing home your precious newborn is an exciting yet nerve wrecking experience.  Parents will lay awake staring at their little girl, conscious of all their movements.  Her baby pictures will fill your walls, office spaces, and phones.  You will spend endless amounts of time hoping and praying she is perfect.

But then something seems off.  She only looks to the left.  In all of the pictures, her ear is constantly on her shoulder.  When she is placed on her stomach, she will continue to look left, but never right.  As the sleepless nights continue, you begin to notice her head shape is changing.  She begins to have a small flat spot because she is consistently looking left while keeping her ear tilted toward the left shoulder.

You become concerned.  Others may tell you not to worry, that your baby will grow out of it.  But your gut instinct is telling you something is wrong.  A pediatric physical therapy evaluation will determine if your child is affected by torticollis.

Torticollis, derived from the Latin words tortus for twisted and collum for neck, is the tightening of the sternocleidomastoid (SCM).  The SCM is a muscle that goes from the mastoid process of skull to the sternum and clavicle.  You have a right and left side SCM.  When the muscles work together, they flex the head forward.  However, when one is working alone, you bend your head sideways to the right and rotate your head to the left.  This is what occurs when a child has torticollis.  One of the muscles is tight, possibly due to positioning in the womb, birth trauma, or positioning after birth.

The incidence of Torticollis has been steadily increasing since 1997 with the introduction of the “Back to Sleep” campaign.  Not only is your child sleeping on her back, she is often times spending a lot of time in her car seat, her swing, her bouncer, and all of this wonderful baby holding equipment.  However, she is not spending enough time on her stomach.  She is not learning how her body works.  She has difficulty with being on her stomach and has not developed the neck extensors to lift her head that will allow her to explore her world.  Once these are developed, she needs to learn to play on her tummy without as much support, but still being supervised.  She needs to be able to reach and play with both of her hands equal. She needs to discover her body. The best way to do this is to spend time on her stomach.

Torticollis is typically treated with changes in positioning at home, as well as specific strengthening and stretching exercises.   A physical therapist can teach you simple stretching exercises to perform daily at home with your baby.  As time continues, physical therapy will progress to more strengthening exercises.

The best way to decrease continued pressure on the back of the head is to increase the tummy time.  For more reading on tummy time, read our blog post from Kids Place’s Teri Roberts, DPT.

Torticollis is not preventable, but it is treatable with an early referral to a Pediatric Physical Therapist and committed parents who follow the home exercise program recommended by the therapist.  Ask your pediatrician for a physical therapy evaluation if you are concerned your newborn is suffering from torticollis.



Articles referenced:

• Boere-Boonekamp M, van der Linden-Kuiper L. Postional preference: prevelance in infants and follow-up after two years. Pediatrics. 2001 Feb; 107 (2):339-43
• deChalain T, Park S. Torticollis associated with positional plagiocephally: a growing epidemic, J. Craniofac Sugery. 2005 May; 16(3): 411-8
• Do T. Congenital Muscular Torticollis: Current concepts and review of treatment. Curr Opin Pediatr. 2006 Feb; 18(1):26-9.