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I am presently flying home from spending a July 4th long weekend with my daughter, son-in-law and grandchild. This month's story is about a young, 39-year-old personal trainer. She is also in the Air Force National Guard. You would think that this girl knows her way around exercise! I am sure she does, if she were not injured. Unfortunately, she tore cartilage in her hip and had surgery to repair it. Her goal was to get back to exercise, running and passing her National Guard Training Test.
Following the surgery, she was sent to her surgeon's physical therapy clinic and worked harder at her rehab than most of us would even think to work. She bypassed many of the basic exercises and even began running faster than she ever imagined. She was so excited to be working so hard. After 7 weeks, with 3x's a week of intense physical therapy, there was only one problem. She still felt the same pain she had before the surgery. She still could not run without pain. This was disappointing and depressing for her.
At 7 weeks, she saw her surgeon, who sent her to our clinic as a last chance effort to avoid having another surgery. We performed our back, hip and knee examination and found out that she did not pass our strength tests to begin running. Her strength in her hips and legs were approximately 50%. She needed to be at least 80% to safely run and execute the fun exercises she was performing that were causing her pain.
We backed her off all her exercises and showed her a few key hip strengthening exercises. They were not as exciting, but because of her work ethic and desire, we sent her away for a week to work on her own. After one week, she was stronger and thinking she might not need a second surgery. After one week of her hard work on 3 hip strengthening exercises, she was feeling very little discomfort.
It was because of the remarkable strength in her hip that we decided to put her in our Alter-G. (This is a special machine designed by NASA. It can assess a person's weight, enabling the machine to reduce the force of their weight- up to 80% and get the person back to exercise with little to no pain using gravity.) In the Alter-G, we slowly brought her up to a jog and found out that her hip was strong enough to jog pain-free at half her weight. Over a period of just 3 weeks of specific hip, leg and back strengthening exercises, she was able to jog in the Alter-G with 80% of her body weight and no pain.
This patient continued exercising her hip, back and legs until they were stronger than before the surgery. She passed her Air Force Test, is back to personal training and has a new appreciation for the importance of making sure all her clients have muscle groups strengthened to a certain point before having them perform more complicated activities.
If you have had any surgery to help you get back to your normal activities, please call us. We specialize in getting young and the older athletes back to their activities with little or no pain. Even if you do not consider yourself an athlete, we are excellent at helping you regain your strength and get you back to an activity level you may have never thought possible!

Health Information
Physical Therapist's Guide to Headaches 
Pain of any type that occurs in any part of the head is called a headache. There are many different types of headaches, with just as many causes. The International Headache Society describes several different categories of headache:
  • Tension-type
  • Migraine and cluster
  • Secondary headaches from an underlying condition, such as fever, infectious disease, sinus disorder, or in rare cases, a tumor or more serious illness
  • Cranial neuralgias, facial pain, and other headaches
Most headaches are harmless and resolve on their own, although severe headaches that recur frequently can affect your ability to do your daily activities and can reduce your quality of life.
There is effective treatment for almost every type of headache. The challenge lies in determining the type of headache, its cause, and in developing an appropriate treatment plan that will reduce both its frequency and intensity. Physical therapists can help determine the type of headache you have and are experts in managing pain from tension-type headaches.
What are Headaches?
Headaches, like back pain, are one of the most common of all physical complaints and can be one of the most frustrating to manage. Pain of any type that occurs in any part of the head is called a headache.
Tension-type headaches (also called muscle-spasm headaches) are the most common types of headaches in adults. They may be the result of a neck or jaw problem, poor posture, fatigue, or stress.
A problem in the neck, head, or jaw--such as an injury or arthritis--can lead to tension in the muscles at the back of the head and to increased pressure on the nerves to the face and head. Poor posture can cause these muscles to become overworked, which can trigger a headache.
How Does it Feel?
A tension-type headache typically begins at the back of the head and spreads to the top of the head and the eyes. You might feel an increase in facial pain along the cheeks near the jaw bone (temporomandibular joint dysfunction). People often describe a tightness, a sensation of someone tugging on their hair, or a feeling of wearing a tight cap. These headaches can worsen with specific positions--such as sitting at a desk--and may ease with rest.
How Can a Physical Therapist Help?
Your physical therapist will conduct a thorough examination that includes a review of your health history. Your therapist will ask you questions and will perform tests to determine the most likely cause of your headaches. For example, your therapist might a sk you:
    • to recall any previous injuries to your neck, head, or jaw
    • the location, nature, and behavior of your pain and other symptoms
    • to draw your areas of pain on a body diagram
    • Perform tests of muscle strength and sensation
    • Examine your posture when sitting, standing, and performing various activities
    • Measure the range of motion of your neck, shoulders, and other relevant parts of your body
    • Use manual therapy to evaluate the mobility of the joints and muscles in your neck
If it appears that you do have tension-type headaches, your physical therapist will work with you to design a plan of care to meet your goals. If the evaluation indicates that you may have a different type of headache--such as sinus, migraine, or cluster headache--your physical therapist likely will refer you to another health care professional for additional diagnostic tests and treatment.
Your physical therapist will work with you to correct the problems that are causing your pain and will help you learn to prevent headaches through simple changes in your posture and lifestyle:
Improve neck mobility. Physical therapists use a specialized technique called manual therapy to increase movement and relieve pain and to stretch the muscles of the back of the neck.
Improve your strength. Your physical therapist will teach you exercises to increase the strength of the muscles that help stabilize your upper back and neck to improve your posture and endurance and make it easier for you to sit or stand for longer periods of time without discomfort.
Improve your posture. Physical therapists will teach you to ways to improve your posture. Whether it is simply pushing your chest out or pulling your shoulder blades backward and together, slight modifications to everyday living can make a vast improvement in posture.
Modify your workstation or home office. Tips may include:
    • using a headset instead of a regular phone
    • adjusting your computer screen so that it is no lower than the level of your eyes
    • finding an appropriate desk chair
    • adjusting the position of your computer mouse
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