JohnstonPT: Herniated Discs



NOTES FROM ANDREW I don’t know how many of you read our newsletter eachmonth, or are aware that we host free workshops eachmonth typically at each of our clinic locations.

Being underprepared might be more appropriate to describe what is happening when normal loads or conditions seem result in injury. Sometimes people call these “overuse” injuries. Really what is happening is the level of training is not adequate for doing a desired task or activity. ln this thought process, we are responsible for improving our tolerances by actually doing something ahead of time of exposure to the desired activity. If I expose myself to something I am not prepared for, I am at amuch greater risk of injury. Not that the activity itself is necessarily dangerous. Asweage,wetendtothinkthatthe levelsof loadorstress that the body can handle gets lower and lower. Maybe there is some truth to that. Our joints, ligaments, tendons andmusclesdon’tseemtogetmoreandmoreresilientas we get older. There is a general belief that these tissues naturally breakdown or wear out over time. I don’t believe that this is necessarily true. It makes us almost a victim to age. Maybe we should change our thoughts on this. Approach it from the idea of keeping our body as healthy as needed to be to withstand the things “we used to be able to do”. This will definitely take more preparation as we age- but it is not impossible. We don’t want to stop doing the things we love or feel worse as we age and this iswhyweencouragebeingasconsistentaspossiblewith taking care of your personal health. From exercise, diet, rest/recoveryandevensleep.Changethethoughtprocess from “its easy to overload specific tissues of the body as weage”toweneedto improveour“preparedness”.IfIwant to ski, play a specific sport, carry my kids/grandchildren (whatever is a priority for you), I have to do the work to keepmy body ready for these tasks.The heavier or more intense the activity, the more preparation it will take. If there is any task or activity you are struggling with, give us a call. We can see if we can help you PREPARE better for your success!

WE DO!!! – and these are great classes for anybody who would be experiencing symptoms in the region or just want to learn more about the topics we are teaching about. There is always great information and plenty of time to get your personal questions answered. We have mostrecentlytaughtaboutneckpain, lowbackpain,knee pain and shoulder pain. April’s workshops are running workshops-hopefullyatimelyspringtopic.Youcanalways find and register for our latest workshop on our website ( - look under HEALTH TIPS). Last month when Grant was teaching about common causes of knee pain and strategies for management to decrease needformedications, injectionsorevensurgeryweended up discussing OVERLOADED and UNDER PREPARED . It wasaconversationonhowwe lookatthesourceof injury and how we rehab individuals. I think we tend to understand what “overloaded” is when it relates to our schedules (I was complaining about it last month in my newsletter notes). Overloading our bodies occurs when the stress or load we put ourselves through (intentionally or unintentionally) exceeds the tissues capacity of some component of our body. It seems like a good explanation for so many of our easily identified traumatic injuries. For instance, when we are in a car accident or something we are carrying is heavier than expected or shifts on us unexpectedly. Typically, we see overload injuries occurring when unexpected or atypical loads are experienced. Rarely would someone think of overloading as something good- but we often do it intentionally to tissue to improve its capacity over time.


• Physical Therapy • Work Injury Rehab • Sports Injury Rehab

• Trigger Point Dry Needling • Education



UNDERSTANDING HERNIATED DISCS INSIDE: • How Does A Herniated Disc Happen? • Relieve Back Pain In Minutes

• Patient Success Spotlight • Tell Us How We’re Doing By Leaving A Google Review

Whether you have back pain or have been suffering for a long time, seeing a physical therapist at one of our clinics can help you return to a more active and pain-free life. Give us a call today! When a disc becomes herniated, the cushioning in between the vertebrae decreases, essentially deflating the cushioning in between the vertebrae and can result in spinal facet joints beginning to rub against one another. This is painful enough as it is, but can become even more painful if the herniated disc actually begins to press on the adjacent spinal nerves, causing the pain to spread even further up the spine, or down the legs. The most common location for a herniated disc is at the lumbar vertebrae in the lower back. While it is not the only reason that pain can become severe in the lower back, it is definitely one of the most severe forms of back pain. If you suspect that you may have experienced a herniated disc it is important that you seek medical attention, such as from your physical therapist. A herniated disc may not heal on its own, but working with a physical therapist is one of the best ways to experience relief from the pain associated with this common concern.

Back pain can develop for all sorts of reasons. From a car accident to bad posture, to an uncomfortable seat for a prolonged period of time, back pain can come out of nowhere and cause no small amount of discomfort once it arrives. There are some back injuries, however, that are even more painful than your run-of-the-mill back pain. A herniated disc is one of the most painful back injuries that you can experience, and it is far more common than you may be initially aware. What is a Herniated Disc? Your spine is made up of a series of interlocking bones with small cushions in-between each vertebrae. The structure of your spine is what allows you to move freely from side to side. Every time you crunch your abdomen by bending forward, or lean to one side or another for a deep stretch, those little vertebral bodies move with you, keeping you comfortable and your back strong. Without cushioning in between each of those sockets, the bones would rub against one another with every movement, and this would be incredibly painful.

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The vertebrae in the spine are stacked closely together, with only a small amount of space for the discs in between each bone. A disc can become herniated as a result of injury, car accident, or even simply from overuse. One of the most common causes of a herniated disc is heavy lifting that your body is not prepared for. Weight lifters have to be cautious not to suddenly lift something too heavy, to decrease the rate of a disc injury. But experienced gym-goers are not the only ones at risk. Every time you attempt to move a piece of furniture, a heavy box, or even a big bag of books you need to be wary to lift correctly, otherwise face the risk of potentially herniating a disc in your back. Treatment for Herniated Discs. Pain associated with a herniated disc often develops in the sciatica nerve, and doesn’t subside with simple rest and relaxation. While hot and cold therapy may alleviate the pain associated with many different back issues, it won’t make the pain of a herniated disc go away.The pain is often frequently associated with numbness, weakness, and tingling in the legs. In many situations, the pain will feel more severe after initial movement, such as standing up or laying down. Many people mistakenly refer to having a herniated disc as having “pinched a nerve,” but that is not the case. Physical therapy is a great resource for attempting to overcome the pain associated with a herniated disc. A combination of passive and active techniques is typically employed, including deep tissue massage, electrical stimulation, and hydrotherapy, as well as deep stretching and specific strength building. Welcome Bryan Sumner, PT, DPT Bryan is the newest member of our team and he is excited to be back in the Des Moines metro area! Bryan is a Des Moines area native, growing up and graduating from Ankeny High School. Basketball was his passion, which led him toDordtCollege topursuehisdreamofplayingbasketballat thecollegiate level. However, following his junior year, Bryan underwent two hip surgeries. After a year of rehabilitation, this experience solidified his desire to pursue the profession of physical therapy. Bryan understands first-hand the adversities associated with the rehabilitation process. He states, “If there is anything I have learned throughmyownrehabilitation journey, it’s toneverunderestimate thepowerofa fun/encouragingatmosphere,positiveattitude,andhardwork”. Bryan uses these lessons to provide the best possible care to every patient he encounters, with the ultimate goal of helping each patient return to the activities they love. Bryan graduated from Dordt College with his Bachelor of Arts in Exercise Science. He continued his education at the University of Iowa CarverCollegeofMedicinewhereheearnedhisDoctorateofPhysicalTherapy. Bryan, and his wife, Claire, were married this past August.Together they enjoy walking their Golden-doodle (Theo), volunteering/coaching Special Olympics STAFF SPOTLIGHT

If you suspect that you may have a herniated disc, contact a physical therapist right away. Attempting to engage in therapy at home could lead to further injury. It is best to have an experienced therapist assess your injury before attempting any treatment options.

Call us today to schedule an appointment!

sporting events, and exploring the Des Moines area. Bryan’s instinct is to be a teammate, and he is thrilled to be a part of a team that values intentional and meaningful practice. “The Des Moines area has been my home for as long as I can remember and I look forward to serving this community. I couldn’t be more excited to join the Johnston/Elevate Physical Therapy family!” We are grateful to have him here and look forward to doing great things together.

Patient Success Spotlight



Johnston Clinic

“I was treated with the upmost respect!” “JPT has the most genuine, caring, and knowledgeable staff. During both pre- and post- op care for work comp and athletic injuries, I was treated with the upmost respect and concern. From the time I walked in the door for a consultation to the time I walked out after my “graduation” I felt heard and valued.” - Andrea J.


1. Open your smart phone to the camera app 2. Center the QR code above in the frame (this will take you directly to our Google Review page) 3. Tell us how we’ve done! Elevate Clinic

Relieve Back Pain In Minutes Try this movement if you are experiencing back pain.

SINGLE KNEE TO CHEST STRETCH While lying on your back, hold your knee and gently pull it up towards your chest.

If this exercise does not provide you relief/help, please consider an evaluation to see if we can identify the source of your pain and provide a plan to get you back to normal.


On Tuesday, April 28th • 6pm At Johnston Clinic Location

On Saturday, April 4th • 10am At Ankeny Clinic Location

• Do you need strategies to improve your running performance? • Do you want to decrease your chance of injury? • Do you suffer from a past injury? • Do you have pain while running? • Are you afraid your pain will get worse if you don’t do anything about it?

If you have answered YES to any of the above questions (or have a stubborn spouse who is in denial) the Running Workshop is the event for you!

ü Learn the latest tips, training strategies and research to improve running ü Find out what simple exercises can keep you running consistently ü Learn keys to training that apply to beginning runners and seasoned, competitive runners alike Here’s some of what you’ll learn:



1810 SW White Birch Circle, Suite 107 Ankeny, IA 50023 P: 515-964-8885

5627 NW 86th Suite 200 Johnston, IA 50131 P: 515-270-0303 |


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WHY IS WARMING UP BEFORE EXERCISE SO IMPORTANT? Wealwayshearabout thecrucialaspectofproperwarm-ups,butwhyexactlyare they so crucial? Well, the truth is that while it may not seem like it at the time, warming up thebodybeforeengaging inexerciseofanysortcanposeseveralbenefits. Ifyou are a fitness enthusiast who is looking to enhance their warm-up routine, contact Johnston & Elevate Physical Therapy today. 9 5 2 1 9 6 5 1

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The importance of proper warm-ups. Stretching and proper warm-ups before exercise are arguably most important in helping your body avoid injury. As an athlete, we understand that one of your primary goals is staying healthy so you can participate inyoursportorexerciseofchoice.Ourphysical therapistsatJohnston& Elevate Physical Therapy can teach you warm up routines that utilize light weights, resistance bands, or targeted stretches to get your body ready for physical activity. Some light cardio can also be beneficial in your warm-up routine, as the goal is to have your muscles warm and loosened up. When this happens, your muscle cells become oxygenated and ready to work. Maintainingproper formduringyourwarm-ups is justas importantasmaintaining it duringyourmainexercise,and isoneof themainkeys toavoiding injury.Yourphysical therapist will analyze your form to make sure you’re doing everything correctly in order to maximize results during your workout and help you get the most out of it. Warming up can make all the difference for those who are aging and active. As we age, our bodies simply aren’t as limber as they used to be – putting us at risk for exercise-related injuries.Properwarm-upsareagreatresourcefor thosewhostillwant to remainactivebutmaybeprone to injuriesoratahigher riskofdeveloping injuries. Additional benefits of warming up before exercise. While injury prevention is the mainbenefit, therearemanyways thatwarminguphelpsyourbody.Someadditional benefits include:


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• Reducing muscle tension. Tense and tight muscles have restricted blood flow and may not activate as effectively. Stretching and light exercises before a workout helps toalleviate this tensionandhelpmusclesexpandandcontractmoreefficiently. • Increasing range of motion in your joints. Warming up helps your joints move fluidlyand throughout their full rangeofmotion.This improvesmovementefficiency and function, which means better performance. • Improving circulation. In addition to improving muscle mechanics, the enhanced circulation that warm-ups bring can also accelerate the recovery of painful areas, reduce post-workout soreness, and increase your energy levels. •Helpingwithstressrelief. Byalleviatingphysical tensionwithaconsistentwarm-up routine,youcaneasepsychologicalstress, too.Plus,evidenceshows thatstretching and/orparticipating in lightexercisesbeforeaworkout improvesyour “psychological readiness” and helps you get your head in the game. Ready togetstarted?Contactus today! All inall,adoptingaproperwarm-up routine before participating in strenuous physical activity is a small-time investment for a long-term benefit. If you have any questions about how to warm up properly and how we can help, contact Johnston & Elevate Physical Therapy today. 6 4 7 7 9 3 8 5 9 4 3 5 1 2 2 8 4 9

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INGREDIENTS • 1 head leaf lettuce, torn into bite- size pieces • 3 pears • 5 ounces Roquefort cheese • 1 avocado • 1/2 cup thinly sliced green onions • 1/4 cup white sugar • 3 tablespoons red wine vinegar • 1 1/2 teaspoons white sugar • 1 1/2 teaspoons prepared mus- tard • 1/2 cup pecans • 1/3 cup olive oil

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• 1 clove garlic, chopped • 1/2 teaspoon salt • Fresh ground black pepper to taste

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DIRECTIONS In a skillet over medium heat, stir 1/4 cup of sugar together with the pecans. Continue stirring gently until sugar has melted and caramelized the pecans. Carefully transfer nuts onto waxed paper. Allow to cool, and break into pieces. For the dressing, blend oil, vinegar, 1 1/2 teaspoons sugar, mustard, chopped garlic, salt, and pepper. In a large serving bowl, layer lettuce, pears, blue cheese, avocado, and green onions. Pour dressing over salad, sprinkle with pecans, and serve.

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Play on your mobile these puzzles and find their solutions by flashing n° 315825 n° 329837 n° 3996 |

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