By:  Physical Therapy Contributor Jessie Carter, PT

Low back pain has been a common theme around the clinic lately. Every year around this time, there seems to be an increase in patients complaining of back pain – aches and pains from shoveling snow, back strain from carrying shopping bags and packing gifts, and chronic pain patients want to address before the holidays.

I was out with the best of them on Black Friday braving the crowds. What started as a quick trip to snag some deals, however, turned into an all-night, exhausting event.

Consider these tips to keep your body from wearing down before you do:

• Wear comfortable shoes such as walking or running shoes when shopping. When it comes to walking the mall, comfort should win out over your cutest pair of heels to prevent stress to your ankles and feet.
• Lighten your load when you can. If you are shopping for a lot of items or for a long period of time, consider making frequent trips to your car to drop off packages. This provides extra exercise while reducing the stress on your back muscles.
• Distribute the weight of packages and shopping bags evenly on both sides of your body.  This means that you have to avoid holding all your bags in one hand to sip your favorite drink or fumble for your keys. This also means avoiding what I call “attitude standing” – propping all your weight through one hip (often times to hold a child propped on that same hip). Standing in this position can create undesirable forces through the hip joints, pelvis and spine.
• Women, keep your suitcase (I mean purse) weight to a minimum to avoid undue stress and fatigue. Only carry necessary items such as your wallet and keys. When carrying your purse, consider strapping that makes your body work the least or requires large joints over smaller joints to carry. For example, use a bag that has a shoulder strap or can be worn as a backpack instead of a purse with smaller handles.
• Plan ahead if possible. Whether you are going to campout to get the best deals or do a marathon shopping spree, you can ease physical and mental stress by making a list and avoiding prime shopping times. Remember that long lines and busy parking lots increase your time standing and walking.

While most back pain is mild and resolves on its own, some pain persists or comes back repeatedly over time. A lot of my patients, who have experienced low back pain for years, tell me they have tried multiple treatment options without success. They also report that each time the pain returns, it seems to get worse.

When you experience low back pain, one of the best things to do is to stay active and continue with your normal routine as much as possible, without the risk of further injury. This seems to contradict the old approach of “putting someone to bed” when they are down on their back. Bed rest for more than a day has been shown to actually slow recovery.

If your pain worsens or lasts more than a few days, then it is time to see a medical professional.  Immediate medical attention should be sought if you experience loss of bowel or bladder control, numbness in the groin or inner thigh and/or pain that does not change with rest.

Continue your Total Gym routine over the holidays to maintain optimal strength and tone. Try these “Cable Core Work” exercises to target your snow shoveling and shopping muscles: the shoulders, back, arms and chest in conjunction with the core.

Arm Cable Exercises; Recruiting the Core

The mad rush of the holidays is here…following these simple tips and taking care of your body will allow you to enjoy the season and shop without the drop.

Happy rehabbing!

Jessie Carter is the owner of High Pointe Rehab in Clarksville, TN, where she utilizes Total Gym for physical therapy and fitness training to offer the full continuum of patient care. Jessie is a 2001 graduate of the University of Evansville (UE) in Evansville, IN, where she earned both her BS and Master’s degrees in physical therapy. Contact Jessie at jessie@highpointetn.com with your questions or ideas for future topics.

I’ve had a total knee replacement, is it safe for me to work out on my Total Gym?

A:  This is a common question we receive at my clinic High Pointe Rehab. In a nutshell, the answer is absolutely! The Total Gym is a great equipment choice following both total knee and hip replacements. While it is important to adhere to certain restrictions, Total Gym is an integral part of our rehabilitation program for clients who have had either or both knee and hip surgeries.

The main goal after total joint replacement is to restore functional movement. This includes walking, squatting, and performing transitional movements, such as rolling over in bed and going from sit to stand and vice versa. To achieve this, exercises must focus on improving range of motion, strength, balance, and endurance. While there are different approaches used in therapy settings to focus on these goals, I prefer to perform the specific activities we are trying to restore.  I find that exercises with the feet planted (closed kinetic chain) are particularly effective. This includes squatting and heel/toe raises on the Total Gym. Beyond allowing us to strengthen the lower extremities and core musculature, these partial to full weight bearing exercises help to properly seat the implanted artificial joint components. For some patients, aquatic therapy unweights the joint too much while full weight bearing can be quite painful. The Total Gym offers the perfect medium.

An important thing to remember when returning to exercise following a total joint replacement is to follow the guidelines provided by the surgeon and physical therapist. With total knee replacements, our referring physicians discourage bending of the knee past 120 degrees therefore limiting squat depth. We also recommend avoiding knee compression or kneeling. Unfortunately, kneeling exercises on Total Gym might be out after a knee replacement!

Hip precautions are typically more involved but again this depends on the specific surgical technique. Our patients must avoid hip motion past midline, such as when crossing one leg over another or side lying and letting the top leg fall in front of the bottom leg. As with knee replacement, there are range of motion limitations with hip replacements. When squatting, patients must avoid going deeper than a 90 degree bend at the hip. This can be controlled when using exercise equipment but very difficult when getting up from a plush couch or low surface.

Right after surgery, patients are typically in pain and guard how much weight they put through the involved joint. The Total Gym allows me to decrease the weight through the painful joint to a tolerable level. With the patient’s back supported on the glideboard, I find that stability is improved and there is less tendency to “cheat” with the uninvolved side.  As strength increases, the glideboard is moved up to allow more weight bearing until the patient eventually resumes normal function.

Happy rehabbing!

Jessie Carter is the owner of High Pointe Rehab in Clarksville, TN, where she utilizes Total Gym for physical therapy and fitness training to offer the full continuum of patient care. Jessie is a 2001 graduate of the University of Evansville (UE) in Evansville, IN, where she earned both her BS and Master’s degrees in physical therapy. Contact Jessie at jessie@highpointetn.com with your questions or ideas for future topics.

Question:  I tore the meniscus in my knee and I’m hoping to forgo surgery. I’ve continued doing upper body exercises but was wondering if there are any rehab exercises I can do on my Total Gym at home?

Answer:  Meniscal tears come in all shapes and sizes and these factors greatly impact how your injury will heal. Some meniscal tears are managed very effectively through conservative methods, while others may require surgical intervention. I always recommend seeking the advice of an orthopedist you trust, who can talk to you about the advantages and disadvantages of surgery as they pertain to your specific injury. Depending on the location of the tear and the pattern of the tearing, exercise may be the treatment of choice.

Yes, there are specific exercises you can do on your Total Gym to help strengthen your knee.  Because the details of your injury are unknown, it would benefit you to work with a physical therapist who uses a Total Gym in a rehab setting. This will allow you to learn the exercises and techniques under a trained eye and transition this to your home machine. Your therapist will be able to watch your mechanics and provide feedback to prevent abnormal stress on your knee.

Squats, heel raises, and inner/outer thigh work are all appropriate when nursing a knee injury.  While you may have to modify the level of resistance and repetitions, these exercises can be performed safely. Just remember to listen to your body – if an exercise is painful, you should not continue.

Avoid these technique blunders that I see in the clinic:

• Don’t allow the knees to go over the toes when performing squat work. Make sure you position your feet appropriately to direct weight down through the ankle and to prevent the knees from going over the toes when bending down. Start out with a partial squat at a low level and progress as your knee allows.
• Another key area to focus on is your core muscles. Rehab professionals have started to recognize the importance of the hip girdle and abdominal musculature in rehabilitating knee injuries.
• I also encourage patients to contract their pelvic floor muscles (similar to Kegel exercises) with all Total Gym exercises. You’ll be surprised how this intensifies your workout. The glideboard itself helps recruit core muscles and the added Kegel will kick in key pelvic and abdominal muscles.

Hip muscles are also considered part of your core. Try using accessories such as resistance bands around the knees or lower thighs with squat work. Pushing out slightly on the band while squatting helps recruit hip muscles that are vital to overall lower extremity strength. Alternately, you can place a volleyball between the knees with squat work. Squeezing lightly against the ball during the squat sequence will again recruit hip and leg muscles that might otherwise go along for the ride.

Happy rehabbing!

Consult a doctor or physical therapist prior to starting/continuing an exercise program after injury or surgery.

Jessie Carter is the owner of High Pointe Rehab in Clarksville, TN, where she utilizes Total Gym for physical therapy and fitness training to offer the full continuum of patient care. Jessie is a 2001 graduate of the University of Evansville (UE) in Evansville, IN, where she earned both her BS and Master’s degrees in physical therapy. Contact Jessie at jessie@highpointetn.com with your questions or ideas for future topics.

Jessie Carter, PT, owner of High Pointe Rehab

Are You a Donald Duck or a Pink Panther?

Posture affects most everything we do from performing our jobs without pain to exercising efficiently. But most Americans fall short of the optimal posture mom always wanted us to have. We more closely resemble cartoon characters than the upright model with a book on her head.

Pink Panthers are those individuals whose shoulders and heads are forward, upper backs are rounded, low backs are flat and rear ends are non-existent. Donald Ducks have other issues. Their heads may still be forward but the low back has too much curve inward. Pinks are always pulling their pants up while Ducks have ample tail feathers.

The problem with both of these postures is that they fall short of what is considered normal. Everyone’s normal is a little different but some general guidelines follow:

• When looking at the body from the side, the ear, shoulder and hip should all line up in a straight line when sitting or standing.
• The shoulders should be level and pulled back slightly, not slumped or rounded forward.
• The low back should have a slight curve inward at all times. If you sit as tall as possible with your chest up, this posture should happen automatically.

To correct your posture, start by trying to sit up straight as often as possible. Sit on your “sit bones” with your feet flat on the floor and your bottom as far back in the seat as possible. Pull your shoulders back and lift your chest up slightly to develop the curve in your low back, mentioned above.

At first, your muscles will not be strong enough to keep your posture in perfect form all day, but as you begin using proper posture more frequently, it will become easier and easier. Your Total Gym will help you to strengthen key back and core muscles to maintain the posture mom wanted you to have. Total Gym uniquely requires you to maintain straight spinal alignment while also recruiting core muscles to balance on the sliding glideboard while performing upper body cable exercises. Here are a few Total Gym exercises to help improve your posture:

1)     Reverse Fly (sitting or kneeling) – Emphasis on pulling shoulder blades back and down as opposed to shrugging.

2)     Surfer Lat Pull – Emphasis on full upright back extended position at end of contraction, again pulling shoulder blades back and down and avoiding shrugging.

3)     Plank position on SCRUNCH with Shoulder Protraction/Retraction – While maintaining the forearm plank position on the SCRUNCH board, pull shoulder blades back and down (pause). Then push up on forearms moving shoulder blades away from each other (pause).  Repeat for duration of plank hold (e.g., 30-60 seconds).

If you find it painful to correct your posture or you continue to have difficulty after 6-8 weeks of self-correction, a physical therapist can assist in identifying your specific deficits and design an exercise program to address your issues.

Whether you are a Pink Panther, Donald Duck or something in between, you have the ability to improve your health and posture with stretching, strengthening and corrective body positioning.  Despite popular belief, you can teach an old duck new tricks.

Jessie Carter is the owner of High Pointe Rehab in Clarksville, TN. Jessie is a 2001 graduate of the University of Evansville (UE) in Evansville, IN, where she earned both her BS and Master’s degrees in physical therapy. Prior to transferring to UE, she attended Murray State University in Murray, KY, where she majored in biology. Contact Jessie at jessie@highpointetn.com with your questions or with ideas for future topics.

Those on the run love the Total Gym “GRAVITY Blast Series” offering 15-minute, muscle isolation exercises that work the agonist and antagonist muscle groups to feel the burn and see results!
Click here to learn more.

“Just bought the Total Gym XLS…I will be using it to help in my rehab from getting hit by a car riding my bicycle. They turned left into me. I need to get ready to teach skiing here in Utah and need to get the old legs back in shape. Have started riding my new seven bike and will be using the Total Gym for the rest of my workout. ~ LS Bike, Utah.

We wish you a speedy recovery “LS Bike.”

Here’s another story from Total Gym user Keith in Tennessee:

“Thank you for making a product I truly believe in! Great product! Been using [Total Gym] for 8 years. Absolutely makes you stronger! Wonderful and easy to use. Way to go! A+ rating for your product.” ~ Keith, Oak Ridge, TN.

I look forward to reading more of our customer’s stories in the future. Please send your stories to TotalGymBlog@totalgym.com. We want to hear from you.

Cheers!

Tom C

I wanted to briefly recap my rehab for my left ankle, which started with exercises on Total Gym, as you’ve seen, including lots of stretching of the ankle and calf for that ever-shrinking left calf. Today, I incorporated vibration training on Total Gym Zen Pro, one of the new Vibration Training Platforms. First thing I noticed was the added ankle flexibility while squating on the platform. It was a nice feeling doing calf raises while on the Zen Pro and I felt a nice loose sensation in my lower body. More to come on my vibration training…

Enjoy the video and your weekend!
Tom C

Always consult your doctor or rehabilitation specialist before performing Total Gym exercises if you are injured or recovering from an injury.

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One of the best upper body exercises is the pull -up, but not many people are able to do them using their full body weight.

Total Gym allows you to unload your body weight using the incline plane so you can do higher-repetitions of pull-ups that you can’t do on a static pull-up bar in the weight room.  Do these exercises with your Three-Grip Pull-Up Bar attachment for your Total Gym 14000 or 26000 (for Total Gym XLS accessories click here), or your Total Gym GTS or PowerTower model with folding LAT bars.

Check it out!

Total Gym has been a major part of the fantastic work Project Walk is doing for spinal cord injury patients. We are fortunate to have them right here in our own backyard. What a dedicated group!

Can you imagine one day you are whole and the next you are unable to walk? This is what happened to Kendell Hall from Dallas, TX. A bad car accident left her paralyzed from the neck down. During the last three months at Project Walk, Kendell has regained movement in her upper body and is now doing load bearing exercises to help her regain strength in her legs.

Check out Kendell as she goes along her very challenging life road. Here she is doing squats (unassisted) on Total Gym at Project Walk:

Project Walk does not accept insurance so clients must actively fundraise to pay for their rehabilitation. If you would like to donate to Kendell’s cause, visit www.help-a-fwend.com.

Here’s our latest Total Gym exercise sequence targeting the upper body. Maybe this will give you some motivation to get your butt on the board – or “B.O.B.” as we like to call it – and start burning off the hamburgers, hot dogs and desserts that come along with a long holiday weekend!

What do you think of this workout? Leave us a comment.

Always consult your doctor or rehabilitation specialist before performing Total Gym exercises if you are injured or recovering from an injury.