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Dear Friends,
Greetings to you all on this balmy December day! I want you all to know, if you do not have or have never had a low back or hip problem, feel free to stop reading!
There is an exercise that many people are doing and it should NOT be performed by most people dealing with back and hip pain! It is an exercise that I am seeing being done by many of my patients that have back and hip pain. They perform this exercise regularly and it is actually INCREASING their risk of back and hip pain.
Evidence based studies are educating us more than ever on the importance of having strong hip abductors (exercises to strengthen the outside of your hips). There is little need to strengthen your adductors (muscles inside your groin area). As we age, gravity will win, if we don't exercise our anti-gravity (hip abductors are part of this group) muscles. What does that mean? We begin to hunch over and our knees begin to get closer together. We have all seen people walking this way as they age. Most patients beg me to educate them on how to avoid this from happening as they age. Reading the next few paragraphs will help decrease the chance of it happening to you.
We can all take a step toward a more healthy posture and less risk of back and hip pain by strengthening the outside muscles of our hips. A simple way to do this is to lie on your side and lift your top leg just parallel to the floor and hold for 5-10 seconds. It does not have to be raised higher to be more effective! Higher is not better and actually does not work the muscle we are targeting as well. This is one simple way to strengthen a very important muscle group that gets neglected in most workout programs and workout classes. 
An exercise that SHOULD NOT be done as frequently, is squeezing a ball between your knees. This will strengthen the anti-gravity muscle group and increase your risk of developing a bent over posture, while increasing your risk of a back and hip injury. I see this in my patients regularly and it must be stopped!
I am glad to get this frustration out to the community. I have had to visit too many exercise classes and alter too many workout programs of patients who are stressing the wrong muscle groups. If you have any concerns or would like any clarification on this article, please feel free to call or come visit us at our clinic. We can give you studies to read on this exercise issue. 
We wish everyone a wonderful Merry Christmas and Happy Holidays!
Health Information



Soreness vs Pain: What's the Difference? 
There are many benefits to exercise, including the potential for improved physical and mental wellbeing. However, there may also be some physical discomfort associated with these activities due to the stresses placed on the body.

When experiencing discomfort, it is important to understand the difference between exercise-related muscular soreness and pain. Muscular soreness is a healthy and expected result of exercise. Pain is an unhealthy and abnormal response. Experiencing pain may be indicative of injury.

Individual Activity Threshold
In order to make physical improvements, your body needs to be pushed to an appropriate level where gains can occur.

Each person's body has a different activity threshold dependent upon many factors, including age, baseline strength, and participation level. Remaining on the safe side of your threshold will result in muscular soreness. Exceeding your threshold will result in pain.

One of the expected outcomes of exercise, when done appropriately, is that this threshold will progressively increase. For example, when an individual begins running, their safe threshold may be 5 minutes of running. After several weeks of progressive increases in duration, this runner's threshold may increase to 20-30 minutes.

To maximize your exercise gains and minimize injury risk, it is important to be realistic about your activity threshold and to be able to differentiate between moderate muscle soreness and pain.

Soreness vs. Pain: How To Tell the Difference
The chart below highlights key differences between muscle soreness and pain.
  Muscle Soreness Pain
Type of discomfort:
Tender when touching muscles, tired or burning feeling while exercising, minimal dull, tight and achy feeling at rest
Ache, sharp pain at rest or when exercising
During exercise or 24-72 hours after activity
During exercise or within 24 hours of activity
2-3 days
May linger if not addressed
Muscles or joints
Improves with:
Stretching, following movement
Ice, rest
Worsens with:
Sitting still
Continued activity
Appropriate action:
Resume offending activity once soreness subsides
Consult with medical professional if pain is extreme or lasts >1-2 weeks
Muscle Soreness
After activity, muscular soreness typically peaks 24-72 hours after activity. This is the result of small, safe damage to muscle fibers and is called Delayed Onset Muscular Soreness (DOMS). During this time, your muscles may be tender to touch and feel tight and achy. Movement may initially be uncomfortable but moving and gently stretching your muscles will help to decrease soreness. During the few day period that you experiencing muscular soreness, you might consider performing alternate exercise activities in order to give your sore muscles an opportunity to recover while strengthening other muscles.

In contrast to muscular soreness, you may experience pain during or after performing exercise. This may feel sharp and be located in your muscles or joints. This pain may linger without fully going away, perhaps even after a period of rest. This may be indicative of an injury. Pushing through pain can result in injury. If you feel that your pain is extreme or is not resolving after 7-10 days you should consult with a medical professional. This person will diagnose your injury and direct you to the appropriate pathway of care.

How a Physical Therapist Can Help
A physical therapist can be a valuable resource to you throughout your exercise journey. Before beginning an exercise routine, your physical therapist can perform a variety of pre-activity assessments to determine your readiness for exercise. Based on this, your physical therapist may also recommend specific exercises that will best prepare you for your desired activities. They will also discuss the best strategies for introducing and progressing exercise activities while minimizing your chance of becoming injured.

In the unfortunate situation when exercise leads to an injury, your physical therapist will assist in your recovery in many ways. They will help with initial pain management, identify and address all factors that may have contributed to your injury to prevent further problems and provide specific recommendations regarding reintegration into exercise as appropriate.
If you have any questions or concerns, please call us at (574)233-5754!
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 Merry Christmas and Happy Holidays
from the MPT Family!!!
Fran's Favorite Quotes
 "You are the hero of your own story"



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McDonald Physical Therapy


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