Make Your Training Rope Last

 

Make Your Training Rope Last Longer

 



 

If you have purchased 1", 1.5", or 2" Manila Rope to train with, you may have noticed that some of the ropes come with heat shrink rubber ends while others do not (depending on where you purchased them).  I have purchased ropes with the rubber heat shrink rubber ends, which have actually fallen off after long term use.   

 

With nothing holding the rope's braided ends together, the rope begins to separate into individual strands.  You can do what I used to do and use electrical tape or duct tape, but the glue from the tape sticks to your hands and gets annoying. 

 

I suggest buying a can of Plasti-Dip from any hardware store.  To prevent the rope from coming apart, dip the ends of the rope into the Plasti-Dip a few times (the more times you dip the rope, the thicker the covering).  Then keep the dipped rope ends off the ground and allow them to dry overnight.  I would do this as soon as possible

The next day, you will have something like this...  And it lasts!

This is a 1.5" thick rope. 

How to use the incentive spirometer

How to use the incentive spirometer

 

As a Home Care Physical Therapist, I see many patients who have just returned home following a surgery.  Many of them have received an Incentive Spirometer from the hospital but do not know how to use it properly, or do not make the effort to use it consistently because they are unaware of its importance.  Here is a quick step-by-step explanation provided by the Cleveland Clinic website on how to properly use an Incentive Spirometer.

 



Using the Incentive Spirometer will keep your lungs clear and will help keep your lungs active throughout the recovery process, as if you were performing your daily activities

1. Sit on the edge of your bed if possible, or sit up as far as you can in bed.
2. Hold the incentive spirometer in an upright position.
3. Place the mouthpiece in your mouth and seal your lips tightly around it.
4. Breathe in slowly and as deeply as possible. Notice the yellow piston rising toward the top of the column. The yellow indicator should reach the blue outlined area.
5. Hold your breath as long as possible. Then exhale slowly and allow the piston to fall to the bottom of the column.
6. Rest for a few seconds and repeat steps one to five at least 10 times every hour.
7. Position the yellow indicator on the left side of the spirometer to show your best effort. Use the indicator as a goal to work toward during each slow deep breath.
8. After each set of 10 deep breaths, cough to be sure your lungs are clear. If you have an incision, support your incision when coughing by placing a pillow firmly against it.
9. Once you are able to get out of bed safely, take frequent walks and practice the cough.

References

• Agency for Healthcare Research and Quality. National Guideline Clearinghouse: Incentive Spirometry, 2011 Accessed 8/29/2013.
• Merck Manual for Home Health Care. Chest Physical Therapy Accessed 8/29/2013.
• Cleveland Clinic Website 

Why Again Should I Avoid Bending and Twisting?

Why Again Should I Avoid Bending and Twisting?

 

 

Unless you live under a rock, everyone has heard not to bend and twist, especially when attempting to lift something off the ground.  But why?  What really happens to our backs that makes this such a "no-no?"  Here is a quick explanation. 

 

Below is a picture of our intervertebral disc...

If you look carefully at the annulus fibrosis, you can see that the fibers run in oblique angles, alternating directions with each layer.  Half of the fibers resist rotation to the right, while the other half resist rotation left.  All of the fibers resist flexion and extension.  But when you combine flexion with rotation to one side or the other side, only half of the annulus fibers provide protection of the nucleus, while the other half does not.  Doing this motion enough times will very likely cause a bulge or herniation of the nucleus pulposus.  

Summer Time is Perfect to Learn Core Engagement

Summer Time is Perfect to Learn Core Engagement

 

 

 

Just this past weekend I was visiting family in Rhode Island.  My 4 year old wanted to go swimming and so I began to blow up the many pool toys my father-in-law had purchased for the kids.  We did not have an air compressor available so I had to do it the old fashioned way.  After blowing up the third toy, I realized that as I pursed my lips tightly around the air nozzle in order to open the safety valve, and began to blow into the tube, my core engaged quickly and firmly.  It was not a "drawing in" or "hollowing," nor was it flexing of my abs.  It felt like my entire core stabilized my spine 360 degrees.  If you are having a difficult time teaching your clients (or youself) what true core recruitment and engagement should feel like, go to the dollar store and pick up an inflatable pool toy.  Try it for yourself.  Upon inflating the toy, keep one hand on your abs/obliques and you will feel it immediately.  Then try to incorporate this recruitment with your lifts.

Negotiating With Your Patients

Negotiating With Your Patients

 

 

You would think that a patient would do anything in their power to return to their prior functional level.  Unfortunately, this is not always true.  For patients who were in the hospital for an extended period of time, they usually return home extremely deconditioned, with low self-confidence, feeling hopeless.  They may receive Home Care Physical Therapy 2-3 times a week with the therapist establishing a Home Exercise Program to be performed on the days the therapist is not there.  However, in my experience, when discussing rehabilitation with these patients, they want to get better but are non-compliant with their exercise program.  I admit, some of the exercises become monotonous after a while.  I have come to the realization that I must choose my battles, and negotiate in order to "win the war."  If a patient is not performing the exercises on his 'non-PT days,' then I try to find something that they will do...something less complex than a list of exercises.  For these deconditioned patients, I found that walking is a an all-around conditioning exercise that they are not so resistant to.  Because many of them are deconditioned, I usually recommend short frequent walks in their home.  Many of them spend a great deal of time on the couch watching TV.  Because of this, I recommend getting up and walking a lap around the house whenever a commercial comes on.  When their show returns, they can go back to their seat to watch it.  They will repeat these short frequent walks every time a series of commercials comes on.  You would be amazed at how much exercise this is.  This is one way to get your patient to increase the volume of activity without being so resistant to it.

Common Physical Therapy Questions

Common Physical Therapy Questions

 

As a Physical Therapist, I have heard certain questions frequently over the years.  This past week, I have been treating numerous patients following a Total Hip or Total Knee Replacement Surgery.  Many of these patients have trouble lifting their operative leg into bed when transferring from the sitting to the supine position.  My previous post explains how using the S.O.D. Stretch Strap can assist the patient with maintaining independence while performing this technique.  However, most patients do not have a strap so soon following their return home from the hospital.  They accept the fact that they can't lift their leg and rely on a family member to lift it into bed for them.  Even weeks after surgery, they may rely on someone else's help for this.  When the family asks me if this is normal, I tell them that the weakness is normal.  However, it is not only muscle weakness that is the cause.  The patient must begin to redevelop the motor pattern to lift their leg into bed by practicing it over and over.  Many times, if I perform the leg raise while cueing the patient to assist, after a few times, the patient is amazed at how quickly the movement returns.  It is as if they must re-establish the brain-leg connection in order to perform the task again.  I advise family members to assist only after the patient has made an effort first.  This will help the patient recover quicker and will prevent the family member from injuring themselves in the process of helping.

 

I have also been working with many Worker's Compensation patients who have injured their backs.  Most of them tell me that they bent over to pick something up and felt it "go out" at that moment.  After weeks of successful therapy, including core stabilization activities, body mechanics and lifting education,  I usually get the same question:  "When can I go back to lifting like I used to, without having to think about it?" 

 

And I answer them with: "Never.  You should have never lifted like that to begin with.  That's why I have been teaching you body mechanics and lifting techniques.  It is your goal to establish new posture and body mechanics so that you don't have to think about it the next time you are required to bend to lift something."

 



 



So although most of us have rarely thought about how we are to lift something off the floor, if we are taught the correct way to do it, and practice it repetitively, our new habit will minimize the risk of lower back injury in the future.  Just because we have been lifting a certain way all of our lives, does'nt mean that we have been doing it correctly.  The older we get, the higher the chance that poor lifting techniques will catch up with us.