Tips for Lifelong Shoulder Wellness Part II – The Treatment

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fitness, Longevity, physical therapist, physical therapy, prevention, scapular strength, shoulder health, Tom House

Tom House Shoulder Exercises. – check out the blog I wrote for CPMC’s Sports Wellness.    Everyone should do these regardless of age, occupation, or sport.  Here is a video of some of my favorite Tom House drills.

Brain Benefits of Exercise. Getting Back on My Soapbox.

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brain chemistry and exercise, chronic pain, depression, exercise, fitness, pain, physical therapy

Repost from my blog Brain Benefits of Exercise.  I have been seeing a higher percentage of patients that just need to start moving.  At least half of the people coming in with pain are depressed, sedentary and lack motivation to begin making changes.  So, I am reposting this blog…just to get back on my soapbox.

It is official – we are no longer hunters and gatherers.  We spend most of our day sitting in front of a screen.  Because of this 65% of the United States adults are overweight or obese.  It is well known by now that we are killing our bodies due to inactivity – creating heart disease, type 2 diabetes, and increased cancer risks.  But what many don’t realize is that lack of exercise significantly affects our mood, intelligence, and motivation.  Exercise has recently been proven to be more successful and long lasting than many drugs in treating depression, anxiety and the non-brain related diseases listed above.

Learning and Memory – According to John Ratey, MD in Spark, exercise is “miracle grow for the brain.”  Learning requires Long Term Potentiation (LTP) or a strong affinity between neurons.  When the brain is called to take in new information and a chemical called glutamate is present in the synapses, the link is more likely to bond.  Exercise increases levels of glutamate  and a protein called Brain Derived Neurotrophic Factor (BDNF) – both important for survival of and generation of new synaptic connections to learn new information and tasks.

Depression – In 2000 researches from Duke University made the New York Times with a study showing that exercise is better than Zoloft at treating depression.  In most psychiatric issues, stress causes the brain to get locked into a pattern of pessimism, fear, and retreat.  Stress is normal for people to feel and to recover from,  if the body is allowed to recover.  The problem with psychological stress is that because the brain is so good at creating synapses, the negative pattern is learned and repeated and we never get a chance to recover.  When we exercise, new patterns develop and new hormones are introduced  (serotonin and norepinephrine).  When we are done exercising, the body recovers.

Our brain does not distinguish between good and bad stress on the system, just the increased demand on our system.  How the brain reacts is purely based on how things are processed in the cortex.   Are there enough STRONG and ACTIVE connections and cortisol levels in our brain at the time of the stressor?  If there are too much cortisol levels for prolonged periods (no recovery) it becomes difficult to learn something new, but in short bursts (during exercise for example), our bodies can long term potentiate easier.  This is why it might be a good idea to have a good session of cardio exercise prior to cramming for a test.

The key point made above is that if we stress ourselves in short doses, physically, we can treat our depressive moods.  This is why you feel so euphoric after a High Intensity Interval Training (HIIT) session. What does this all mean?  We need to exercise OFTEN and HARD to help offset the chance of chronic stress that results from overconsumption of social media, high work demands, learned pessimism, or general lack of movement. So what are you waiting for?  Get out there and move.  Your brain and body depend on it.

http://serendip.brynmawr.edu/bb/neuro/neuro05/web2/mmcgovern.html

http://en.wikipedia.org/wiki/Brain-derived_neurotrophic_factor

http://www.biopsychiatry.com/bdnf.htm

 

 

Exercise your Vestibular System for Improved Balance

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aging, balance, exercise, playground, proprioception, stregth, vestibular system, vision

Balance is something that most people are born with and develop in the first few years of life.  At the same rate, as we age, we begin to lose it.  BUT, it is never too late to start working on your balance.  Below are some ideas but first it is important to understand what gives us balance.

The four primary components of good balance are:

1)  Proprioception (awareness in space) – coordination b/t sensation and orientation to upright

2)  Vestibular system in the ear  – controls equilibrium, balance, and orientation to up

3)  Vision

4)  Strength – trunk, hip, ankle

If you deficits in any of these the body has to compensate through the other three components to maintain balance.  This is similar to someone who is blind develops a good sense of smell and hearing to make up for inability to see.   Some people are born or work hard to develop some of the components  above to become excellent at balance.  Professional athletes have superior components of balance.  This is in part to exercising the proprioception, strength and, visual system to improve reaction times and precision of power required to excel at their sport.  Through vigorous training and repetition of activity, they become experts.   Not all people are born with superior components of balance.  When we age and become more sedentary proprioception, vision, strength, and the vestibular system begin to decline.  As balance declines in older adults, fear of falling promotes lack of movement and these systems become even weaker.  This can be delayed by exercising and maintaining each system.

The vestibular system is highly developed in the early years of life as toddlers and children are playing on merry-go-rounds, teeter totters, monkey bars and swings.   These toys can all be found in playgrounds.  Other games that we used to play are “upsy daisy”, “bucking bronco” on your dads knee,  and “rocket launcher” in the swimming pool.   Bounce Houses are one of the most popular events at birthday parties.  Kids become obsessed with these games and toys.  They focus on inversion, foot/hand precision, rapid change of direction, and strength to enhance our vestibular system.

Without even realizing it parents are helping developing their child’s vestibular system.  These children become fearless if balance is developed properly and early in life.  Before you know it, those kids are zooming down the mountain without ski poles and doing flips on the gymnastics floor.  The minute we stop exercising our balance, we begin to lose it.  Athletes will continue to enhance or maintain balance through their sport however most sports do not focus on inversion, heights, or rapid change of direction on an unstable surface.  Gymnastics is one of the most popular sports for young children and involves jumping, hanging, and flipping.  Unfortunately, many kids do not continue past age 8-10 with it.  Recess time and PE classes are cut exponentially until middle school.  The kids who do not participate in sports are left in the dust and vestibular systems begin to decline.

As we become adults, unless we practice inversions in yoga, take part in rock climbing, mountain biking and sports alike we become deficit in our tolerance to positions other than upright.  If one other component of balance is lost – strength, vision, or proprioception – risk of fall is exponentially increased.  The “use it or lose it rule” becomes vital to long-term maintenance of balance.  This is already common knowledge as many people are practicing their single leg balance (for proprioception), strengthening their core/hips with gym programs and getting their eyes checked for long-term optical health.   How do we exercise our vestibular system?  As physical Therapists we have people do balance exercises (such as single leg standing) with eyes closed. This takes away vision to force the vestibular system and proprioception to compensate.  Great exercise but…Boring.

It is never too late to start playing

Instead, I say we all resume childhood games.  Play at the playground:   go swinging  merry-go-round, order a Bounce House for your next bar-b-que at the park.  If you have kids, play the same games with them.  Start doing somersaults and hand stands on the wall like you did when you were 6 years old in gymnastics class.  This would be the fastest way to start exercising your vestibular system.  If you want a more organized form of exercise, take Yoga, go rock climbing, or enroll in a trapeze class.  It will be fun and will keep you on your feet longer with less chance of falling.  And, it is never too late to start.  There is no reason why your 80-year-old grandma can’t get on the swing set with the grand kids.

Use it or lose it for prolonged vestibular function and balance.