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Knee Pain with Lunges and Squats

August 16th, 2010

Recently, I had a patient who was certain she was doing squats and lunges incorrectly with her trainer as she was experiencing knee pain.  She asked me to check her body mechanics and form with the squats and lunges so she could correct the problem.  Her form was perfect and she was surprise to hear that it wasn’t her execution of the exercises – it was the exercises themselves.  Here is the Squat Paradox:  Strengthening the gluts, quads and hamstrings is important to protect your knees from knee pain, but the most common exercises of choice to achieve the strengthening (squats and lunges) often irritate the knee joints.

Yes.  There is a good and a bad way to perform a squat, but sometimes these exercises are irritating to the knee joints regardless of form.  There are many other alternative exercises to strengthen the butt, quads and hips that can be used until the legs are strong enough to handle squats. The Strong Knees DVD has many good options for knee strengthening exercises that don’t irritate the joints.   My website also has some good mat exercises that will help the knees without over challenging the knee joints.

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Knee Pain on an Airplane

July 21st, 2010

I recently returned from 10 glorious days of sailing in the Greek Islands.  Unfortunately, the long flight home was a grueling 16 hours in coach.  Let’s face it – airplane flying is not good for the body.  We just aren’t designed to sit in those cramped spaces like that for so long.  During the 11 hour leg from Athens to Newark, NJ, I saw a lot of uncomfortable people – rubbing sore knees, stretching legs and moving around the cabin in a desperate attempt to relieve the discomfort of sitting for such a long period of time.  In the physical therapy world, we have a very technical term for knee pain from prolonged sitting – The “Movie Goers Sign”.  Really.  I am not making this up. A “positive” Movie Goers Sign means that you have knee pain from sitting for too long – essentially from having your knees in a bent position.  The medical community could have easily called this phenomenon the  “Airplane Fliers Sign”.  Same thing.  It is an indication of Patellofemoral Syndrome.

I would love to tell you that I have a magical stretch that you can do on an airplane that will make all the knee discomfort go away immediately. Unfortunately, it isn’t that easy. Stretching your legs while on an airplane does help, but to really get to the root of the problem, you need to strengthen your knees and improve the flexibility of your leg muscles BEFORE you take off on your wonderful vacation. In particular, you need to strengthen and stretch your quadriceps and your hamstring muscles. There are a couple of good quad exercises and hamstring stretches on my website.  Avoid squats and lunges as they can aggravate knee pain with sitting.  My STRONG KNEES DVD is also a good way to prepare yourself for traveling without pain. I recommend doing the DVD at least 2 weeks prior to getting on an airplane.

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Check out the May Issue of Pilates Style Magazine

May 23rd, 2009

My dear friend Tannis Kobrinsky is featured in this month’s issue of Pilates Style Magazine. If you are interested in some great Pilates mat exercises (and who isn’t?), check it out.

Pilates Style article

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Check out the January Issue of Woman’s Day

December 19th, 2008

Ready, Set, Walk! is the name of the article written by Karen Asp. I wrote the actual walking routines (one for AM, one for mid-day, and one for PM) and Karen wrote the article. In the January Issue of Woman’s Day – page 70.

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Knee Exercises – Not Surgery

October 2nd, 2008

A new study just released by the New England Journal of Medicine found that surgery for arthritis of the knees is ineffective. In the study, all subjects received traditional physical therapy, a home program and glucosamine. The subjects who also underwent surgery were initially better than the control group, but after six months, there were no differences between the groups.
Interestingly, the physical therapy treatment that subjects received was based on a 1999 systemic review of knee therapies. Had the study used more recent exercise protocols based on the current knee rehabilitation literature, the results may have been even more in favor of non-surgical treatments for knee pain.
The bottom line – exercising helps with knee pain. The Strong Knees DVD, which has a comprehensive knee exercise routine, is available for pre-order on Amazon and will be released as of early December.

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Back Pain with Pilates

August 15th, 2008

Pilates is often the prescription for reducing back pain, but occasionally, I will get a patient who complains about an increase in back pain with Pilates. If you are experiencing back pain or low back stiffness during or after a Pilates session be aware that you are probably overusing your hip flexors instead of properly engaging your deep abdominal muscles. During exercises such as The Hundreds or Single Leg Stretches your abdominals are fatiguing and your hip flexors are taking over.

To avoid the problem, choose less challenging abdominal exercises (a simple chest lift with your legs resting on an exercise ball is a good place to start)or take a break as soon as you feel the work happening in your low back instead of in the lower abdominal area (just above your pubic bone).

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Avoid Knee Pain at The Gym

August 5th, 2008

knee-extension-machine.jpg There is only one weight machine I warn my patients to stay away from at the gym. I cringe when I see people using the knee extension machine. This is the piece of equipment you sit on, hook your feet under a t shaped bar and straighten your knees. The problem with this machine is that your knee is most unstable and vulnerable when it is straight. Your knee is subjected to way too much pressure and stain when you add resistance to the equation. Strengthening your quadriceps with bent knees is a better way to go. Try the shuttle machine or the leg press machine instead.

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Back Pain and Depression

July 21st, 2008

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Is my back pain all in my head??? I have patients ask me that question all the time.

Pain signals are processed in the brain – so it has to be involved somehow. Research has, in fact, linked anxiety and depression to back pain. But what comes first, the depression or the back pain?

Certainly either scenario is possible. You are depressed; you walk around slouched with no energy; you stop exercising and taking care of yourself. That is a recipe and a precursor for a back problem. But pain is depressing and often the psychological component occurs because of the back problem. A recent study found that 42% of people with back pain where depressed PRIOR to the onset of pain, while 58% became depressed AFTER the onset of back pain.

Depression is a reaction to feelings of hopelessness. So whether your depression came on before or after back pain, you are feeling a lack of control over your life – your job, your body, your financial situation, your relationships. The key to improving your back symptoms and your emotional state lies in your ability to re-kindle your sense of control and personal power. This is why I think life coaching is such a wonderful tool for people with physical pain. I’ve personally worked with a couple of life coaches over the years and The Handel Group is a coaching company that I highly recommend. The coaches at The Handel Group can help you understand how your reaction to life events creates stress, not the events themselves. Therein lies the control. You can change your physical and emotional response to stress by changing how you think about stress. The Handel Group will guide you through that process.

So is back pain in your head? Can you improve back pain with your mind? Well, sort of… You can change the way you respond to stressors in your life thereby decreasing your back tension and flare-ups… and improving other aspects of your life while you are at it.

To find out more about The Handel Group and to contact them about private or group life coaching go to www.handelgroup.com. If you tell them Chantal sent you, they will give you a discount on your first trial session. There is even a free, group session on August 13th. Their website has more details.

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Age-Defying Fitness

June 15th, 2008

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If you are looking for a great injury prevention and physical wellness book, I have a recommendation for you. Age-Defying Fitness: Making the Most of Your Body for the Rest of Your Life is written by two well respected physical therapists – Marilyn Moffat and Carole B. Lewis. The book is divided into the “5 domains of fitness”; posture, strength, balance, flexibility and endurance. There are a series of self-tests for every domain followed by exercises and stretches to improve your self-test score. Some of the exercises involve using an therapeutic band, which comes with the book.

I like this book so much that both my mother and mother-in-law each got a copy from me as a gift. Kudos go out to my physical therapy colleagues, Moffat and Lewis, who have put together a media-savvy book that is comprehensive, effective and a great tool for anybody looking to improve their physical well being.

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Back Pain With Driving – Tip #2

June 10th, 2008

A lot of people experience back pain AFTER (not during) a stint of driving. Usually this has something to do with the way they are getting out of the car. When you turn and put your left leg on the ground and push off with your right leg to get out, there is a tremendous amount of torque and compressive stress at the knee, hip and sacrum on the right side.

To avoid this problem, try this…when getting out of a car, imagine that you are wearing a very short and tight mini-skirt (come on guys, it’s just pretend!). Swivel both feet out of the car before you get out of the seat. It is a lot easier on your back.

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