Aquatic Physical Therapy

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We are excited to announce that we are now offering Aquatic Physical Therapy at our Mercer Islappostcard Aquaticnd location!!

We have access to a pool at our Mercer Island facility and there are many benefits to using the water for physical therapy.  The bouyancy of water decreases the amount of weight one puts through joints and applies compression from the outside.  With just these two properties of water, one can begin to bear weight through injured joints, and decrease inflamation.

Aquatic Therapy has been used for arthritic conditions, joint replacement and other orthopedic rehabilitation, sports injury rehabilitation, and low back pain.  All of these, and more, can benefit from physical therapy in the water by decreasing the amount of stress through the joint.

Treatment in the water can include, but is not limited too:

  • Range of motion exercises
  • Core strengthening and stability
  • Strength training
  • Endurance training
  • Gait training

There are so many benefits to being in the water for therapy:

  • Increased temperature in therapy pools can help to decrease inflamation and increase circulation inside the body.
  • The resistance applied by the water can change depeding on the depth of the water, so a treatment can be constantly varied to meet individuals needs
  • Studies show that the copmbination of warm water and bouyancy can decrease sensitivity to pain

To experience the benefits of Aquatic Physical Therapy, please contact Advantage Physical Therapy at 425-883-9631.


Maintaining your balance

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English: Vrksasana, the tree position, a Yoga ...

English: Vrksasana, the tree position, a Yoga posture. (Photo credit: Wikipedia)

Is balance an issue for you? You are not alone!

I see many patients with balance problems, and not all of them are using canes, walkers, wheelchairs, crutches, or other aides to keep them upright.  Some of them feel they are moving and balance just fine on their own.  And maybe that’s true.  But I find it much more common that someone creates a way to balance so there is no need to realize that balance is poor.

The leading reasons for poor balance are; hip weakness, poor core stability, ankle instability, and joint hyper/hypomobility.

By keeping the muscles and joints of the low back and lower extremities in good condition with exercise and movement, we can prevent developing balance problems later in life.

Did you know that by moving, you innately need some balance?  Walking and running are basically just alternating balancing on one foot as well as moving forward at the same time.

In order to keep your balance long into life, you can try these exercises to keep you upright.

Here is an exercise to practice your balance:

You can make this harder by adding a pillow under your foot or closing your eyes, or both!!!

This second exercise will strengthen your hips to help your balance:

Knee Pain

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Upon returning to exercise, it is common to feel pain in the front of the knee just below the knee cap (patella).  This is a very common complaint among my friends and in my practice.  In physical therapy and orthopedics, this type of pain is generally referred to as patellofemoral pain.  It is related to the way the patella tracks in the femoral groove.  There are many reasons for this to occur:

English: Right knee.

English: Right knee. (Photo credit: Wikipedia)

  • Weakness of the hip abductors
  • Tightness of the illiotibial band (IT Band)
  • Poor foot control
  • Tightness of the lower extremity musculature (hamstring, quadriceps, and gastroc-soleus complex)
  • Poor form in exercise

Because there are many causes for this anterior knee pain, it is important to get a proper and correct diagnosis from a physical therapist.  If you have pain in the front of your knee, your physical therapist can design a program to help you beat the pain and return to your exercise program.

This month’s Sports Health: A Multidisciplinary Approach has an article that talks about how exercise (done properly) is the best intervention for patellofemoral pain. (Read the Abstract here)

In my practice, I find that a majority of patients require training of the gluteus medius, which is the major hip abductor muscle.  This muscle can become weak due to positioning of the leg during exercise.  If you look at your feet when they move, are they turned outward?  If so, this is the body’s way of compensating for a weak gluteus medius, and forces the tensor fascia latae (TFL) and ITB to do a lot of the work, thus changing the position and angle of the knee bending during gait and squatting/lunging movements.

Here are a few exercises that can be performed to target and strengthen the gluteus medius:


Sidelying Hip Abduction:


Bridging with Band:


Single Leg Balance:


Wall Slides/Squats:


It is important to remember that, although these exercises may help your knee symptoms, a physical therapist can help treat the cause and individualize a program for you.  Please contact Advantage Physical Therapy to set up an appointment!!!


The Importance of Good Posture


Advantage Physical Therapy has two clinics; Mercer Island, WA and Redmond, WA.  Also in these communities are Amazon, Google, Microsoft, AT&T, and T-Mobile.  In this area, a lot of people work in the tech industry and are therefore sitting at a computer for most of the day.  Add to this today’s instant news cycle and we can expect a lot of problems.  Almost everyone I know has a cell phone, tablets are becoming more common, and a majority of people communicate with email at work.

This means a lot of people spend a lot of time with poor posture staring at misaligned screens that might be too small for what they are doing.  They may be squinting to read small writing on the latest iPhone or Android device.  All of this can result in postural deficits.  Anyone with a posture issue may have some of the following issues:

  • Low Back Pain
  • Neck Pain
  • Temporomandibular Dysfunction (Jaw)
  • Tension Headaches
  • Carpal Tunnel Syndrome
  • Illiotibial Band Syndrome
  • Piriformis Syndrome


    POSITION OF SKELETON IN GOOD AND POOR POSTURE - NARA - 515194 (Photo credit: Wikipedia)

With the rising use of mobile devices and computers, it is important to maintain good posture.  As a species, we are not meant to be hunched over a desk.  Follow these tips to help maintain your posture and prevent posture related injuries.

  • Take a break:  Get up from your desk at least one time every hour, even if it is just to get up and get some water.
  • Position your monitor:  The top of your computer monitor should be at eye level when you are sitting up straight.
  • Lumbar support:  Prevent decreased lumbar curvature by adding support in your chair for your low back.
  • Standing work stations:  By standing, we can alleviate some pressure on the spine and increase our posture

It is good to know that your physical therapist can correct most of these problems with some manual therapy, stability and strengthening regimens, and an ergonomic evaluation.


Lateral Epicondylitis vs. Common Extensor Tendon Strain

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Flexor pollicis longus (left) and deep muscles...

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Christmas and Hanukkah are both over, as the new year approaches, it is time for resolutions!  I made mine at the beginning of December.  Over this last summer, I was getting really out of shape and was struggling to run the bases in my softball league.  I was up at almost 300 pounds.  In September I decided that I needed to lose some weight and get in better shape.  I should not struggle to run from home plate to second base.  I returned to some Master’s swimming, but because we were opening a new clinic, I was only able to do it for a month.  At the beginning of December, I decided to try out Crossfit as an early start to my New Year’s Resolution.  So far it is going great, but I did sustain a minor injury to my right forearm extensor tendon.

Let’s talk about a forearm extensor tendon injury:

The extenosr muscles of the forearm insert by a common tendon into the lateral epicondyle.  This injury is often confused with lateral epicondylitis (tennis elbow).  Lateral epicondylitis is called tennis elbow to the repetitive stress at the joint in performing a tennis backhand, so any activity that has a similar action can cause lateral epicondylitis. A muscle strain to the common extensor tendon may present very similar to lateral epicondylitis in that you have pain on the outer side of your elbow or just below the elbow.  In true lateral epicondylitis, the ligament that attaches to the lateral epicondylitis is stressed and pain will be elicited to touch of the lateral epicondyle. With an extensor tendon strain the epicondyle is not painful to touch.  In both injuries however there may be pain to touch of the common extensor tendon.  Both injuries can be classified as overuse injuries, but there are many more activities that can cause injury to the extensor tendon than the lateral epicondyle itself.

The approach in physical therapy to both of these is similar. Therapy will include manual therapy to loosen up the tissues in the area of the elbow, some posterior glide of the radial head, ultrasound to help calm down the inflammation, ice or ice massage, and some strengthening exercises to help increase the function of the wrist extensors.

When either injury first occurs, it is best to call your physical therapist.


Surviving the Holiday Season!

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English: Snow on the mountains of Southern Cal...
Image via Wikipedia

You know winter is upon us when college football gets to the Bowl season, the NFL is in its playoff run, college basketball is warming up, and the NBA is opening on Christmas day.  Football season is closing and basketball season is beginning.  The holidays are coming up, and New Year’s Resolutions are getting prepared.

Every year around this time I make a resolution to stay away from the horrible seasonable foods and get into better shape to start the new year off right!  From experience, I know it’s a difficult task.

If you haven’t been keeping up with your activity, it is recommended to ease into an exercise and weight loss program.  If you get going to fast, you can injure yourself.  Here are some helpful guidelines to get through unscaved:

  • Begin any weight routine with light weights and progress to heavier weights as tolerated
  • If you want to start a cardio routine start with 15 minutes and see how you feel.  You can add more time and intensity as it becomes easier
  • Try using interval training- after a warm up period of around 5 minutes, go hard for 1 minute and rest for a minute and repeat.
  • You can make an apointment with a personal trainer and they can asses your fitness level and design a program specifically for you
  • Give yourself plenty of rest between exercise bouts.  Try taking 24-48 hours between sessions to start.

Exercise not only helps you shed unwanted pounds, but it boosts your immune system.  We all know that this time of year sickness abound throughout the office.  Getting in better shape will help you fight off the flu and you will feel more energized for the lines at the mall for holiday shopping.

If you do find yourself returning to activity to fast and have an injury, a physical therapist can help you through the injury and guide you through recovery to full participation in your exercise program.

For more information check out our last two newsletters:

11.21.11 –  Tips to Avoid Injury During Fall and Winter Activities

12.5.11 – Stay Healthy and Lose Weight During the Holidays


Yoga for Chronic Back Pain

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Image by Kerala Tourism via Flickr

Most of us have had at least one episode of low back pain.  I remember, in PT school, our instructor would ask if anyone has ever had back pain and all but one person out of 60 would raise their hand up.  Now I have never had debilitating back pain before, usually I can fix any symptoms I have with a change in position or some stretching.

Friends and family often ask me “what should I do for my back pain?” I usually reply by asking what makes it worse and trying to get a fix on a cause. Last week, an interesting article grabbed my attention  from the PT in Motion website in regards to treating chronic back pain.

The article talked about a recent research study published on November 1st, 2011 in Annuals of Internal Medicine. This article talked about the study and how it showed that people who participated in a 3-month yoga program saw greater improvements in back function than usual care for patients who had/have chronic low back pain.  Now, it is important to note that in this study, all participants had, at a minimum, “usual care.” Everyone in the study showed improvements in the standardized tests that represent disability, pain, and general health, but by adding a yoga class approximately once a week, patients showed slightly more improvements.  You can click here to read the post on PT in Motion.