Body Gears PT: Live Without Fear: Heal Your Hip Pain

DR. ELIZABETH RACIOPPI, PT, DPT, WOMEN'S HEALTH SPECIALIST, CROSSFIT LEVEL 1 TRAINER NEWSLETTER The Newsletter About Your Health And Caring For Your Body Getting To Know The Body Gears Physical Therapy Team

developed her passion for sports medicine and orthopedic physical therapy. Although she has vast experience with recreational and collegiate athletes, Elizabeth’s favorite rotation in PT school was at the Los Angeles VA hospital where she performed vestibular and orthopedic rehabilitation with veterans who had returned fromAfghanistan with blast injuries, concussions and traumatic brain injuries. Elizabeth believes that the pursuit of maximum human performance is for everyone, not just elite athletes. Since moving to Chicago in 2012, Elizabeth has worked in a variety of outpatient orthopedic and sports medicine settings, and has gradually learned to appreciate the snow! Elizabeth started her Body Gears journey as a patient at the Downtown clinic. After a number of injuries after the Chicago Triathlon sidelined her, she recovered with the help of Body Gears and the IPA philosophy which inspired her to join the team! In her free time, Elizabeth does CrossFit, travels the world, and volunteers for PAWS Chicago. When she is home, she likes to watch USC and Arizona Cardinals football, cook, and spend time with her rescue mutt Nova. Find Elizabeth at our Lincoln Park clinic.

Born and raised in Tucson, Arizona, Elizabeth has always been a fan of sports and outdoor activities. As a competitive show-jumper in equestrian, Elizabeth was also always prone to injuries and ended up in physical therapy in high school, spurring her interest in the profession. While earning her bachelor’s degree in Kinesiology at the University of Southern California, Elizabeth worked with the USC football and volleyball teams in the training room, and gained valuable experience as a volunteer at the USC Physical Therapy Faculty Practice. Elizabeth went on to attend Physical Therapy school at USC and

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NEWSLETTER The Newsletter About Your Health And Caring For Your Body HEAL YOUR HIP PAIN Live Your Life Without Fear

Quick, point to your hip joint! Many people will point to the top of their pelvis where you would put your hands if someone said 'put your hands on your hips.' Your hip joint is actually a few inches lower where your thigh bone meets your pelvis. As major load bearing joints, your hips have to withstand 3 times your body weight when you climb stairs and as much as 10 times your body weight when you run! Your hips are ball and socket joints, the most mobile type of joint in the body, but with more motion comes more potential for dysfunction. If you have hip pain, you're not alone. In the clinic, we often see people of every age and gender with pain on all different sides of their hips. Hip pain can be the result of a traumatic injury, a structural abnormality, bad movement habits, or dysfunction elsewhere in the body. Pain on the Side of the Hip Common diagnoses you'll hear for pain on the side of the hip are bursitis and IT band syndrome. Bursitis means inflammation of a small fluid-filled bursa sac that is meant to prevent excessive friction between layers of tissue. If your bursa sac is inflamed, that means there was too much friction for your bursa sac to handle and a larger biomechanical problem is likely afoot. The same is true of IT band syndrome. Contrary to popular belief, IT bands cannot be stretched and the pain is often due to tightness in the surrounding muscles, poor pelvic mobility, muscle weakness, and poorly coordinated muscular control. Pain in the Front of the Hip Usually referred to as hip impingement, pain in the front of the hip

is often experienced while squatting and driving. Common causes of hip impingement are poor hip and pelvic mobility, a lack of core muscle activation and strength (this includes your abdominal and pelvic floor muscles!), and using the wrong muscles at the wrong time (especially the adductors). A comprehensive exam can determine not just which structure is causing your hip pain, but how those structures became irritated in the first place. If you are suffering from hip pain, call us today to learn how we can put the spring back in your step!

INSIDE:

• Does Arthritis Pain Grind You Down? • Healthy Recipe

• Exercise of the Month • Patient Success Spotlight

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DOES ARTHRITIS PAINGRIND YOU DOWN?

Millions of Americans suffer from arthritis pain every day, taking ibuprofen and even stronger medications to numb the pain and address the ongoing inflammation. The word arthritis literally means joint inflammation and the cause of osteoarthritis is usually attributed to 'wear and tear' while rheumatoid arthritis is an autoimmune disease. Three very common joints where people experience osteoarthritis are the hips, knees, and lower back (L4-L5 and L5-S1 joints). While the pain from osteoarthritis can sometimes occur suddenly, the degenerative process began long ago. Think of how laptop charging cables inevitably wear down from being tossed in bags and folded and unfolded hundreds of times. Then one day you plug in your charger and the power is suddenly cut off (that would be the onset of pain in this analogy), but then you manage to find juuuust the right cable position and it still works! (hint hint, efficient movement mechanics). Now that you know you can find a cable position that makes your charger work, you'll hunt for it every time and extend the life of your charger for as long as possible before replacing it because either you believe in the conspiracy of purposely weak cables designed to get your money or you know it's only a matter of time before the next cable breaks down too. (For anyone who needs duct tape to fix their charging cables, that would be the equivalent of strengthening muscles in this analogy!) Physical therapists are movement specialists, the health professionals whose job it is to help you find those efficient postures and motor patterns so that you can keep moving without pain. Preventing Joint Pain Studies show that the difference between people with painful and non-painful

osteoarthritis is movement mechanics. People with painful knee arthritis load the inner part of their knee more, whereas people with non-painful knee arthritis walk like people without arthritis 1 . Also, getting a hip replacement won't fix the walking pattern that led to the hip arthritis in the first place and will actually put the hip and knee of the opposite leg at a greater risk for also developing painful arthritis 2 . The best thing you can do to prevent arthritis is to exercise regularly with good form, using a mirror to make sure you can step up, squat, and lunge with a level pelvis and knees in line with hips. Remember it's never too late to re-train efficient movement! If you have questions or want your movement mechanics scrutinized by well-trained eyes, call us today and discover what physical therapy can do for you. 1. Thorp, L. E., Sumner, D. R., Wimmer, M. A., & Block, J. A. (2007). Relationship between pain andmedialknee joint loading inmild radiographickneeosteoarthritis.Arthritiscare& research, 57(7), 1254-1260. 2. Foucher, K. C., & Wimmer, M. A. (2012). Contralateral hip and knee gait biomechanics are unchangedby totalhip replacement forunilateralhiposteoarthritis.Gait&posture,35(1),61-65.

Exercise of theMonth Try this movement if you are experiencing hip pain.

Honey Garlic Shrimp

INGREDIENTS • 1/3 cup honey • 1/4 cup soy sauce

HipHikes

Glute Activation and Strength 3 x 10 + 10 sec x 3. Stand with one foot on the edge of a step and the other foot in the air next to the step. Make sure you have a railing or wall nearby if you lose your balance but keep your weight in your heel. Always keep your

• 1 Tablespoon minced garlic • 1 teaspoon minced ginger • 1 lb medium uncooked shrimp, peeled & deveined • 2 teaspoons olive oil • Chopped green onion garnish

INSTRUCTIONS 1. Whisk the honey, soy sauce, garlic, and ginger (if using) together in a medium bowl. 2. Place shrimp in a large zipped-top bag or tupperware. Pour 1/2 of the marinade mixture on top, give it all a shake or stir, then allow shrimp to marinate in the refrigerator for 15 minutes or for up to 8-12 hours. Cover and refrigerate the rest of the marinade for step 3. (Time-saving tip: while the shrimp is marinating, I steamed broccoli and microwaved some quick brown rice). 3. Heat olive oil in a skillet over medium-high heat. Place shrimp in the skillet. Discard used marinade. Cook shrimp on one side until pink-- about 45 seconds-- then flip shrimp over. Pour in remaining marinade and cook it all until shrimp is cooked through, about 1 minute more. 4. Serve shrimp with cooked marinade sauce and a garnish of green onion.The sauce is excellent on brown rice and steamed veggies on the side.

knees straight while doing this exercise. Slowly let the foot in the air move towards the ground. Use your glute muscles to bring your pelvis back to level and your feet next to each other. Perform a set of 10 followed by a 10-second hold.

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Patient Success Spotlight

Body Gears News

Congratulations Mom-to-be Kathleen Darley! Kathleen, PT and clinic manager of our Lincoln Park location,willbeonmaternity leavestarting in May to welcome her first child. Kathleen is

an accomplished ballet dancer and a Women's Health Specialist, so doubtless she is well prepared to

bring new life into the world. Everyone at Body Gears can't wait to meet her little one and we wish Kathleen's entire family health and happiness during this incredibly special time.

“Body Gears literally transformed my life. When I started therapy in February, I could not take a step without pain. Walking my dog had become the most dreaded act in my entire life. Sharp pangs in my right hip led to other compensations and my rib cage had migrated unusually far to the left. Prior to starting therapy, I was stuck in that position. Some doctors were talking about hip orthoscopy, while other folks said I needed disc surgery. Neither was true! Six months later, I am walking straight and am totally pain-free. All the therapists I saw were amazing, releasing restrictions, teaching me how to confront pain in a healing way, and helping me regain proper use of my muscle chains. I learned an incredible amount along the way.They are totally committed, super resourceful, and an outstanding motivator. They went out of their way to make my journey a success. As far as I am concerned, these guys are among the very best on the planet.” - Ryan L. (Body Gears Graduate!) I am walking straight and am totally pain-free!

Pilates Around the World: Body Gears Founder April Oury and Body Balancing Pilates Founder Sondra Karman join together to discuss the

many benefits of Pilates and how it compliments physical therapy. Sondra was diagnosed with hip arthritis when she was 19 years old and has been doing Pilates to help manager her symptoms ever since. Check out our podcast to hear Sondra's success story and how it has shaped her Pilates instruction philosophy. Find us on Sound Cloud @BodyGearsPT

Request AComplimentary Screening

Schedule Your Discovery Session www.BodyGears.com | 877-709-1090 VISITOURWEBSITEORGIVEUS ACALL:

Whether you’re recovering from an injury, training for a competition, or you’re striving for health, wellness and freedom of movement, Body Gears can help improve your physical health.

This 20-minute appointment will allow you to meet a physical therapist, share your story, and complete a mini-assessment. The purpose of this screening is to answer two questions: 1. Which techniques will help you change your story? 2. How can Body Gears help you achieve your functional goals? Our physical therapists will be able to quickly provide you the information you need to take the next step. We hope it's with us!

AOneDayCelebration! IN HONOR OF NATIONAL WOMEN’S HEALTHWEEK

The Discovery Session consists of a 30-minute one- on-one appointment with a Physical Therapist to: ü Talk with you about the history of your problem. ü Take measurements to test things like strength and how well you are moving.

Afterwards, you will receive a written copy of:

ü The cause of your pain or problem ü A plan for successful treatment

The Discovery Session is ideal for people suffering with:

THIS EVENT IS OPENTOALL! Tuesday, May 15th 8:30am - 6:30pm Lincoln Park (last appointment starts at 6pm) May marks National Women’s Health Week and we are celebrating! Women’s health issues like leaking and pain during intercourse are kept secret due to stigma or because women don’t realize there’s a solution. Come get answers to questions about the “down there” area. These issues are common but not normal. To celebrate, we set up one day of FREE Discovery Sessions with our Doctors of Physical Therapy. Explore answers to your questions, find out if you are “normal,” or if you’ve been living with something that you don’t have to put up with anymore.

• Lower Back Pain • Pregnancy pains • Sciatica • Painful sex (during or afterwards) • Painful periods • Diastasis recti (separated abs)

• Leaking urine • Tailbone area pain • Neck Pain • Headaches • Shoulder Pain • Knee Pain

Don’t delay, register today by calling 877-709-1090 now!

BONUS! All people attending our National Women’s Health Week Event will receive our report: “Answers to the 4 Questions Men & Women are Afraid to Ask Out Loud About Their Pelvic Health.”

We Want To Help You Get Better Once And For All!

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WHAT TO EXPECT ON YOUR FIRST WOMEN’S HEALTH INITIAL EVALUATION AT BODY GEARS PHYSICAL THERAPY

To all the women who are scheduled to come in for an initial evaluation with a Body Gears Women’s Health Specialist – congratulations! You have taken a big step towards restoring your quality of life regarding incontinence, prolapse, pelvic pain, painful sex, and any other symptoms you may be having. It’s absolutely normal to feel nervous, curious, scared, excited, or any other combination of emotions. You may also have countless questions floating in your mind: •How is thiskindofPTgoing tobedifferent thanwhen IhadPTformysprainedankle? • Are they going to look inside my vagina? • How is this different than a pelvic exam I get from my OBGYN? • I don’t know what to expect – is anything going to be really painful? • I really don’t want anyone looking at or touching my vagina. Can I tell them I don’t want that? To help you feel more relaxed when you come in for your initial evaluation, we want to share the framework of the initial evaluation process with you. Discussing Your History: Our first job is to listen, as we ask some questions along the way that can help us form a few hypotheses on what may be going on. Here are some of the rather “odd” questions we may ask you: Whatdoyoudo fora living? (Occupationcanhaveahuge impactonhowyourpelvic region is being stressed) Whatdoyoueatanddrink?(Typeoffoodandfluid intakecancausefrequenturination, constipation, and bladder irritation) Do you have pain with sex, and if yes, what kind of positions are more painful? (Regardless of your complaint, such as having to frequently go to the bathroom, your therapistmaystillask thisquestionas themuscles thatsupportbladder/bowel function also support sexual function) Are you able to use a tampon or does it seem to just slip out? (Gives us a clue on muscle tightness or looseness of your pelvic floor) Doyougetpainatyourvaginawhenyouwearyourskinny jeansor tightunderwear? (Even something like tight clothes can clue us in on the possibility of soft tissues, joints or nerves being compressed and causing your pain) Taking Measures: By the time you and your therapist are done chatting, she will have a good idea of what may be going on.The goal of the next part is simply a way for us to confirm or deny our hypotheses and determine a diagnosis.. This is where we actually put our hands on you and ask you to do certain movements. Posture: With your permission, your therapist will take photos of your posture from the back, side, and the front, as well as take a video of you walking. Your therapist willview these images tofigureouthowyourpostureaffectsyourcurrentsymptoms. When your rib cage and pelvis are not well-aligned on top of each other, it can put unnecessary tension or pressure into your pelvic floor muscle and organs. Core activation and postural alignment tests: Your therapist will do three tests to assess how well you stand and how well your core muscles kick in automatically. Since your pelvic floor muscles are core muscles, we can get a good sense of how strong they are with these tests too. Lumbar spine motion and hip strength: Your therapist will ask you to bend forward, bend side to side, and to rotate at your back while standing. Assessing your lumbar spine is important since sometimes you can feel pain around your groin or vaginal area but it’s actually caused by something going on in your lumbar spine. This is

called referred pain and it’s fairly common. The strength of your hip muscles can also provide a lot of clues, such as whether your pelvic floor muscles might be over- activating tocompensate forweakhipmuscles, leading to tightnessanddiscomfort in your pelvic floor region. Pelvic Floor Assessment Based on Necessity and Consent: The important thing toknow is thatby thisstage,your therapistwillhaveaverygood idea of whether an internal pelvic exam is needed today. She will ALWAYS ask for your consent. You can always say no at any time. Your therapist will prep a private room before beginning your pelvic floor exam. She will drape a sheet over the table, and have another sheet ready for you. Before your therapist leaves the room, she will ask you to undress everything your bottoms and underwear and to lie on the table with the second sheet draped over you. When you are ready, your therapist will come back into the room. Observation and external palpation: Your therapist will first perform an external observation while you perform pelvic floor muscle contractions (also known as Kegels), in order to assess how efficiently your muscles are working together. She will then feel your pelvic floor region externally, looking for any areas of tenderness or soft tissue tightness. Internal palpation and strength assessment: Your therapist will then proceed to feeling the three layersofyourpelvicfloormuscles from the inside.Shewillproceed from the superficial layer (layer 1) to the deep layer (layer 3) one at a time, as she asks you for feedback on pressure and how you are feeling. Even before she asks, you can ask your therapist to stop at any time if it is too uncomfortable or you are simply not feeling like it today! If you choose to continue, your therapist will ask you to perform different types and holds of Kegel contractions so she can feel for your muscle strength and endurance. Internal assessment for prolapse: Your therapist may assess for signs of prolapse, a condition where pelvic structures, such as the uterus or bladder, slip out of their usual position. While your therapist maintains her finger internally in the vaginal canal, she will ask you to perform a Kegel contraction followed by a ‘bearing down’ action. Your therapist is feeling for any organ positional changes. Plan of Care: Once the examination is over, your therapist will summarize the findings, explain the factors driving your symptoms, and explain what can be done to make it better! TheWomen’sHealthSpecialistsatBodyGearsPhysicalTherapyarehere toempower, educate and help you feel better about a variety of pelvic symptoms that you don’t have to put up with anymore.

By: Dr. Toshi Odaira, PT, DPT, Women’s Health Specialist, Oak Park Clinic

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