Marin Movement Center Physical Therapy Blog

Marion Kregeloh, PT, CFP provides health information for physical therapy, osteoporosis, chronic pain, physical therapy, orthopedic therapy, Feldenkrais, in the Marin Movement Center blog.

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Bone Deep Strength

Posted by Marion Kregeloh
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on Wednesday, 30 October 2013
in Aging

Are you aligned well when moving through the day? Do you even know what good alignment is? Do you believe that strong muscles are all what is needed to protect your body from injury? Would you be able to carry a 50 pound heavy basket filled with water or rocks on your head and not injure yourself? Do you see kids, teens, adults who slouch and shrink when using their iPhone, iPad or sitting at the computer? And maybe you too are part of that postural epidemic that our modern world is facing each day?

Please watch the following video:

It is hopefully making you more aware, again, of the importance to not get sucked into this deteriorating downward spiral of our body's surrender to modern day and age and it's technology. Please remember that we can all re-learn how to move like a child again and reverse some of those aging effects modern life has imposed on us.

To your healthy and smart body!

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Dr Lorimer Moseley on Chronic Pain - part 4 of 4

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on Friday, 06 September 2013
in Chronic Pain

Can men have labor pain? And what about phantom pain after amputation? Thanks to neuroscience we now have more answers to some of the complex and strange events in the world of pain...


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Dr Lorimer Moseley on Chronic Pain - part 3 of 4

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Did you know that a famous brand of pain medication is more effective than the exact same medication from a less famous brand? Does this mean the brain is in charge, again....?


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Dr Lorimer Moseley on Chronic Pain - part 2 of 4

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The most severe injuries in the ER are the least painful........what does the brain have to do with it?


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Dr Lorimer Moseley on Chronic Pain - part 1 of 4

Posted by Marion Kregeloh
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on Friday, 06 September 2013
in Chronic Pain

Did you know that the left little finger of a violinist tends to hurt more when triggered than the right?


Listen more about pain and it's distinctive qualities in this part 1 of 4 interview.

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How We Move Defines Us

Posted by Marion Kregeloh
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on Thursday, 27 June 2013
in Feldenkrais

Our everyday movements repeated continuously  create individual body patterns. Such repetitive movements may become the source of various imbalances from joint stiffness, muscle tension and weakness to pain and postural asymmetries.

Once our bodies move on “automatic pilot,” we don’t think nor are aware of how we move. It may seem very convenient, no extra time spent thinking while we fix the car, attend to patients in the hospital, play golf, walk our dogs, do laundry, etc. Convenient only until the first signals get our attention.

As long as we move automated and repeat the same action day in and day out throughout the years, the more likely our bodies will encounter some wear and tear symptoms.

How can we prevent such overuse symptoms that ultimately speed up the aging process?

The answer truly lies in the HOW. How does your habit create the pain, soreness and tension?

We must become aware of how we move in order to reprogram the brain and introduce change.

In order to improve individual performance and prevent injury, we must establish self-awareness and new patterns of moving and thinking. This process allows us to move with greater precision, efficiency, stay vital as we age and keep our bodies and minds fit.

Feldenkrais lessons, either taught in a group setting or one-on-one with a certified practitioner, teaches how to develop healthy movement habits and un-do the “bad” ones.

Sound good? Then don’t hesitate any longer and find out more how you can find a practitioner in your area. So that you can return to the tennis court refreshed and ready to hit the ball, baby-sit your grandchildren with greater flexibility and think and feel better. It works!

 

For more information about Feldenkrais you can visit www.feldenkrais.org or visit my website at www.marinmovement.com.  Marion Kregeloh, PT, CFP.

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Walk and Move Toward a Healthier Back

Posted by Marion Kregeloh
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on Monday, 22 April 2013
in [ Back ]

A recent study in the Sage Journal talks about walking and its possible benefits for back pain. The study included 52 sedentary patients with chronic lower back pain between the ages 18 and 65. Half of the group walked 20 minutes twice a week, gradually working up to 40 minutes. The other half was assigned to a strengthening program, two to three sessions per week; both groups participated for 6 weeks. According to the study, the walking intervention was almost as effective as the exercise group. (Link to the Sage article http://cre.sagepub.com/content/27/3/207.full)

As a physical therapist, I see that walking is a very important element of treating back pain; one that is often underused. Walking moves the spine, activates core and leg muscles and creates some sense of wellbeing. It is not an option for everyone when impact activities trigger the pain. Hands-on manual therapy in combination with movement education (learning how to move to be safe) is often the best approach to start with. Together with the patient, we set goals such as walking time or distance for the week. The important part is to be consistent.

Walking in water is a therapeutic solution for those of my clients who cannot do much land-based walking as long they don't dislike being in the pool. Walking in the pool builds core and leg strength while unloading the spine. For many the movement education is the most enjoyable part of the therapy since it improves spinal flexibility and allows movement with less guarding and fear.

Learning how to stand tall, stand up from the sitting position, shift weight, turn and walk with less effort is like "coming back into your body," to quote one of my patients. When we become more aware of what healthy movement is like again (as we used to move before injury or sedentary lifestyles took over), we have a stronger foundation to engage in exercise routines and move beyond. Some patients get a pedometer midway in their therapy program to track their number of steps; this can be a motivating tool that helps build stamina. It seems so simple but, surprisingly, this little gadget has helped many of my patients get out there and walk; often to their own surprise they walk further and feel better. After back injuries, walking begins with small steps and short distances, sometimes in the water. When guided by a movement expert/therapist, walking can become a regular part of life again.

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How the Feldenkrais Method Can Help With Chronic Pain

Posted by Marion Kregeloh
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on Monday, 25 March 2013
in Chronic Pain

Dr. Feldenkrais created an educational system that consists of movement lessons designed to improve our every day functions: lifting, turning, reaching, bending, sitting, walking and more.

Working with people who have chronic pain, I learned that the Feldenkrais Method is an ideal approach not only for the management of pain but living with more comfort over time.

As a Feldenkrais practitioner I evaluate movement patterns: I observe how movement is organized and where it is stuck or compensated. My goal then is to help restore well-organized movement. When living with pain, the body adapts to various compensation patterns. The result can be stiffness, overuse, forceful movement or hardly any movement at all. This can create endless patterns of dysfunction, creating further deterioration, tension and pain. When working with the client it is as if “peeling the onion”; we want to re-establish natural pathways in which movement can happen easily and without much effort.

A healthy body can feel all the distinctions of sensations when the body changes position, moves or is exposed to pressure. We are in “kinesthetic balance”. When we live in constant pain, the ability to feel subtle changes of sensation is disturbed. Since the Feldenkrais Method works with kinesthetic and proprioception, the individual can re-learn to feel and sense the broad spectrum of sensations that our bodies are exposed to and experience all the time. I find that experience so invaluable since it provides an opportunity to distract from the debilitating pain and focus on other experiences in the body; therefore expanding our awareness of oneself. We become aware again of what the body wants, needs and how it moves. And we realize that pain is not everywhere.

Chronic pain has a big impact on self-image. The individual’s identity is circled around pain. When my clients fill out a body chart to indicate the areas of pain at their first visit, at times there is hardly any area left that is pain-free. When such is the case, we start with very gentle and easy awareness exercises. This includes breathing, one powerful tool of the Feldenkrais Method. Becoming aware of our breathing helps to restore it; breathing fuller promotes relaxation and makes us feel better.

Shifting the focus and finding parts in the body that don’t hurt, including the breath, is often an introduction to the rehabilitation process. One other important part of pain management is to re-learn staying focused, other than on the pain. The brain seems stuck with pain signals and is challenged to think of anything other than pain. The Feldenkrais exercises help to improve thinking and concentration allowing all neuronal connections in the brain to function more smoothly, providing us with greater spontaneity in our thinking and attention.

What makes the Feldenkrais method successful when working with people with chronic pain is its focus on creating a safe environment, making each lesson safe and successful, its emphasis on having choices, inclusion of the mental and emotional being and work in a non-rushed pace. My clients typically leave the session feeling better, surprised that they are not in more pain and that they can move in ways they did not know they can.

Working with people with chronic pain teaches me patience but more importantly, it teaches me that there is no quick fix but rather an endless array of opportunities that help restore the body (and person), one small increment at a time. This is when we have to detach from our cultural background that taught us that “faster, bigger and more forceful is better”.

The message here is “small is powerful”. May be we all need this reminder at times to keep our bodies safe and healthy.

Please contact Marion Kregeloh at 415.479.1765 for further information.

 

Marin Movement Center Physical Therapy in San Rafael and Larkspur

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Robots for Injury Recovery?

Posted by Marion Kregeloh
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on Friday, 22 March 2013
in Physical Therapy

 

Robots for Injury Recovery?

 

Scientists are exploring the use of robots for treatment of loss of movement due to stroke. Intense rehabilitation and repetition are essential for recovery. Exoskeleton robots are used to mimic movement that is identical to the human limb. For example, in order to retrain lost arm movement, the robot is moving the paralyzed arm through its degrees of authentic movement. While the patient is witnessing the movement of the arm over a screen (worn like large goggles), the brain is receiving messages indicating actual left arm movement. It can also provide virtual tasks such as reaching for an object with the affected hand. Furthermore, the healthy arm can be used to activate movement in the left arm, via the robotic set-up. It is found that symmetrical, bilateral movements through visualization as well as virtual and actual movements enhance neuroplastic changes in the brain. Repetition, intention and consistency are important in order to re-establish the pathways in the brain that then allow for initiation of active movement. The brain is trained to rewire itself.

 

Another robotic model is used for home use. People who recover from stroke can take advantage of the McManus (newest model InMotion2) models that are being used in some case studies. It assists the individual with exercises and especially when insurance coverage for physical and occupational therapy runs out, the robotic model can further support the rehabilitation. Case studies have shown that weekly use of such robot assisted exercise for at least four weeks improve limb function. Long-term goals are to also support hand and wrist function and refine the robots for such function.


While the use of robots for movement recovery is still in its early stages, it already shows promising results. Thanks to the amazing capabilities of the brain to learn, change, and rewire itself, prognosis for movement dysfunction due to various pathologies is excellent and I am very optimistic that we are only in the very beginning of its vast capacity.

 

To see a video about robotic use in the recovery of stroke, please visit http://www.smartplanet.com/video/robots-to-aid-stroke-victims-with-physical-therapy/460398.

 

For further information, please call Marion Kregeloh, PT, CFP at 479.1765.

 

 

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Chronic Pain May Depend on Emotional Reaction to Injury

Posted by Marion Kregeloh
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on Thursday, 19 July 2012
in Chronic Pain

Chronic pain is one of the most expensive health care conditions in the U.S. An estimated 30 million to 40 million U.S. adults suffer from chronic pain.

Researchers found that the state of the brain at the time of the injury determines if someone will suffer from chronic pain; they could prognose the likelyhood of developing chronic pain with an 85% accuracy. These outcomes will have profound impacts on treatment. You can find out more at this site....................http://health.usnews.com/health-news/news/articles/2012/07/02/chronic-pain-may-depend-on-emotional-reaction-to-injury

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Back Pain and the Brain

Posted by Marion Kregeloh
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on Sunday, 08 April 2012
in Chronic Pain

50 million Americans suffer from chronic pain. Many of them experience depression, anxiety and memory problems. New studies have shown that the brain loses its grey matter when suffering from chronic pain. The longer the pain lasts, the more likely the brain will suffer. While some people give up hope and adjust somehow to a life with pain, others are actively involved to find the treatment that will finally bring relief from disabling pain.

The good news is that the brain can reverse its losses and rebuild the cortical layer of the brain. Once the effective treatment reduces or eliminates the constant pain, the changes in the brain reverse themselves. I highly recommend to anyone with chronic pain to not give up but keep searching for the treatment that will work best. Chronic pain is never a quick fix and as a physical therapist working with chronic pain, I have to be creative and reinvent my own professional experience over and over again. Body awareness and sensing, proprioception, breathing, relaxation and gradual progressive movement exercises are helpful to allow the body to learn and tolerate movement again. Some people require surgery or invasive procedures or pain stimulators for pain management.

When comparing the brains from patients with chronic pain to a peer group without pain, the studies have shown that six regions in the brain are thinner and less densely packed in the brains of those with pain. Three of these areas are part of the frontal cortex and are responsible for attention, judgment and reasoning. Other areas affected help process mood and pain signals. Six months after getting spinal surgery or injections, subjects who underwent challenging cognitive tests showed no difference anymore compared to their healthy peers.

With the loss of density in brain areas such as the prefrontal cortex, mood, memory, higher-order thinking and social judgment are affected and explain why people with chronic pain experience problems with some or all of the above.

Treating chronic pain successfully needs to be the top priority for the medical team of each patient. Once the pain is gone or reduced significantly, patients not only experience physical comfort but cognitive, mental and emotional wellbeing.

For more information contact Marion Kregeloh at Ext. 36 or at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

 

Marion Kregeloh, PT, CFP

 

If you have any questions regarding exercise routines or want more information, please contact Marion Kregeloh, PT,  at 415.479.1765.

Marin Movement Center - Helping Your Body Thrive

Your source for physical therapy in Marin

Locations in San Rafael and Larkspur

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Degenerative Changes in the Back: Lumbar stenosis

Posted by Marion Kregeloh
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on Monday, 02 April 2012
in [ Back ]

Lumbar stenosis is a narrowing of the lumbar spinal canal. It mostly occurs in adults older than 50 and is the most common cause for spinal surgery in people older than 65 of age. Stenosis can be congenital but the most common cause is degeneration with age. Conditions such as osteoarthritis, loss of height of the intervertebral discs or thickened ligaments are aging related sources. Other conditions that can lead to stenosis are tumors, injuries to the spine or Paget's disease, to mention some.

Depending on which nerves are compressed, lumbar stenosis can cause pain or cramps in the legs, especially when standing and walking. The pain typically eases with sitting and bending forward.

Complications of lumbar stenosis can lead to incontinence, muscle weakness and cauda equina syndrome. The latter causes compression of the lower nerve roots which may lead to paralysis and requires immediate medical attention.

Many patients with lumbar stenosis that we see in my physical therapy practice can improve their symptoms through a targeted exercise approach. The focus needs to be on core/abdominal strengthening and teaching the patient unloading positions and good body mechanics. It is important to avoid twisting movements and any jerky movements of the spine. Lumbar traction of the lumbar spine can also be helpful and some of our patients like a home traction unit. It supports the unloading effect and can give pain relief. Modalities such as ultrasound, heat and/or ice packs and TENS (transcutaneous electrical stimulation) are pain management tools that impact each patient differently and can be used as needed. At times we recommend a back support belt if worn only for short periods during the day to further allow the spine to be unloaded while actively strengthen abdominal muscles as part of a daily exercise routine. Some of our patients find good pain relief while strengthening their core with aquatic therapy, especially with water walking in 3.5 - 4' deep water. The traction effect of the water is reducing pressure in the spine while the water also provides resistance and supports abdominal strengthening. We offer aquatic therapy right here at the Mt Tam Racquet club. All our patients have a floor (or bed) exercise routine that is custom-taylored to their condition and fitness level.

Steroid injections are common procedures that are performed by doctors as part of pain and inflammation management. One study (Johnsson et al.) followed 32 patients with moderate stenosis symptoms for 4 years without surgery. Results showed 16% with worsening of their pain and 30% with declined walking ability.

If symptoms persist despite a targeted conservative approach, surgery needs to be considered in patients with certain findings. Decompression laminectomies are common surgeries for stenosis while fusions may also be indicated. Several other surgery technologies are already available, as well as tested and developed. I encourage my patients to do their own research and discuss all their questions with the prospective surgeon.

If you have any questions regarding exercise routines or want more information, please contact Marion Kregeloh, PT, CFP at 415.479.1765.

 

Marin Movement Center - Helping Your Body Thrive

Your source for physical therapy in Marin

Locations in San Rafael and Larkspur

 

 

 

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Computers are a pain in the neck......!

Posted by Marion Kregeloh
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on Monday, 27 February 2012
in Neck

In a recent article from the Times of India, studies have shown that 50% of employees studied working in the IT sector, have back and neck pain and at least 20% complained of stress and headaches. Dr. Shah, director of Mission Health, says that it is "alarming that some employees exhibit severe spine problems at a young age which affects their quality of life".

 

Another study from Denmark uses resistance bands with office workers. Only one exercise was performed for 10 weeks and divided into three groups: a non-exercising group, a 2-minute exercise group and a 12-minute exercise group. The exercise performed is abduction to 90 degrees in the scapular plane.The 2 minute group performed one set of the same exercise while the 12 minute group performed 8-12 repetitions, 5-6 sets. Both exercise groups progressed to a stronger resistance band at the end of the 10 weeks (color blue).

 

The results showed a significant reduction of neck and shoulder pain and increased strength compared to the non-exercise control group. There was no significant difference between the two exercise groups.The researchers concluded that as little as 2 minutes of a one set exercise with resistance band can significantly reduce  neck and back pain and tenderness in office workers.

 

I very much encourage all my clients to add regular exercise into the day to counterbalance the  unnatural environments so many of us are exposed to during our work. Resistance bands are a very easy and convenient exercise tool that fits into any bag and can be taken to work. There are many exercises that target key postural muscles and prevent back and neck pain, especially when working at the computer.

 

Please check out my website for a set of easy resistance band exercises that are designed to strengthen your shoulder and back and protect you from overuse injuires.

 

While computers can be a pain in the neck for many reasons, we can conquer the physical pain and keep our bodies in charge.......hopefully your boss will support you when taking your mini exercise breaks.

 

Please contact Marion Kregeloh, PT, CFP 415-479-1765 or visit www.marinmovement.com.

 

 

 

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WEEKEND WARRIORS OR WHAT WE CAN LEARN FROM THE TORTOISE AND THE HARE

Posted by Marion Kregeloh
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on Saturday, 31 December 2011
in Exercise

 

Statistics show that most weekend warrior injuries happen to people over age 30; especially to those who used to be very active and whose work and family committments prevent regular, weekly exercise. The second most common reason for such injuries is an inactive period, such as after injury, with a sudden resuming of intense workouts.

 

Each day, 10,000 Americans visit the emergency rooms for sports or exercise-related injuries. Most common injuries are muscle strains as well as tendon ruptures such as the achilles tendon or chronic tendonitis.

 

Harvard studies from 2004 show that healthy male weekend warriors (who exercised 45 to 135 minutes once or twice a week) live longer than those who didn't exercise at all. Conversely, males who had healh problems including high blood pressure or cholesterol or who smoked, did not live longer.

While they theorized that for healthy men, some exercise is better than none, they also pointed out that men with health problems require regular exercise interventions since positive impacts such as lowering blood pressure are only shortlived.

 

For anyone who wants to stay fit and maintain or improve their overall health problems, the steadiness of exercise is a crucial factor. Here are two reasons why exercising on the weekend only does not promote enough health nor prevent injuries:

1. Our bodies need time to rest. After weight-training, our muscles need up to 48 hours to recover and after a cardio-vascular workout we need 24 hours between sessions.

2. Sprains and strains are most likely to occur when we overexert ourselves.

 

If you want to prevent injuries, here are a few healthy steps to follow:

1. Spread your workouts over several days throughout the week.

2. Warm-up such as walking or biking at a moderate pace.

3. Cool down gradually after a work-out, then stretch.

4. Avoid any pain during exericse. If you experience sharp or stabbing pain, stop immidiately and apply ice. Visit a doctor should the pain not subside within two days.

5. Think "Form" when you exercise. You always want to be in your best alignment in order to prevent overuse.

6. Other important considerations are weight management, hydration, cross training, diet and stress management.

 

Consider beginning the new year with a healthier exercise regime. Maybe the tortoise is right after all: "Slow but steady progress wins the race".

 

For more information,contact Marion Kregeloh, PT, CFP at 415.924.6226, Ext. 36.

 

 

Marion Kregeloh, PT, CFP

 

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Phone: 415-479-1765

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Sitting and Back Pain

Posted by Marion Kregeloh
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on Monday, 21 November 2011
in [ Back ]

 

 

Back Pain is the most common source for patient referrals to my physical therapy practice. Research shows that 80% of the population in the US has to deal with back pain on at least one occasion in their life time. Back pain is the second most common reason people visit their primary care physician and it ranks second behind

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FAQ About Feldenkrais

Posted by Marion Kregeloh
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on Wednesday, 28 September 2011
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1. Felden....What?

Feldenkrais! The Feldenkrais Method is named after Dr. Moshe Feldenkrais, scientist and Martial Arts teacher in the 1950's. Feldenkrais is a system designed to tap into the power of the human brain to improve functioning. Through gentle but powerful movement lessons, we improve physical performance on many levels as well as mental awareness. Feldenkrais has helped many people world-wide to overcome injuries and limitations. The Feldenkrais method is practiced both in a class setting ("Awareness through Movement" classses) as well as one-on-one with a practitioner.

2. Is Feldenkrais like Yoga?

Not at all! Yoga is an ancient form of practice with the goal to attain spiritual insight and tranquility; many forms of yoga practices exist in our western world today. Feldenkrais is a scientifically based movement method that uses the human neuro-developmental milestones as it's source. The way humans develop movement, from infant to mature adult, is the foundation for thousands of different movement lessons that facilitate movements that are more efficient, release unnecessary muscle tension, improve our posture and breathing, re-align the skeleton and allow us to reach our fullest potential as a physical, mental and emotional being.

3. Is Feldenkrais for people with injuries only?

Everyone can benefit from this method: all ages and all fitness levels;people who recover from injuries learn how to move again and healthy people learn how to prevent injuries through better skeletal alignment, improved self-awareness, greater flexibility and more efficient core power.

4. Is Feldenkrais better than yoga, Pilates or Stretching classes?

Feldenkrais is different: it is not a substitute for other forms of exercise. It is a foundation for healthy movement. By learning to move without overusing our bodies, we become more efficient in all other disciplines and tasks of life: when practicing Feldenkrais movements, the body integrates biologically inate healthy ways of moving again. This makes us more efficient with everything else we do in life: from yoga, to gardening. to sitting at our desks, to carrying our grandchildren to playing an instrument or playing basketball.

5. I heard Feldenkrais is very gentle. How can this help me? I usually like fast and intense power workouts.

Like every method or fitness style, people either resonate with the approach or they don't. Some people don't like the idea of moving rather slowly and gently. Yet, this is the only way to re-learn movement and become aware of our own patterns. Moving fast and forceful in a stereotypical, repetitive fashion does not give our nervous system new information. In listening to our movements and observing how we move, awareness sets in and the brain can actually create new neuronal pathways. This is the beginning of learning and manifesting new movement configurations. Once the new information is processed and repeated through a variation of paces, orientations and challenges, the brain creates new "maps". This means movement becomes more easy, effortless, efficient, powerful. And this is the amazing thing: through all these rather gentle movement progressions, our movements become more powerful.

6. How can Feldenkrais support athletes?

The Feldenkrais method bridges the worlds of the mind and the body. As an athlete, our self image is around our goals, our motivations and why we try to stay fit (mind). Then we have our physical condition and the fitness techniques we use to improve it (body). The Feldenkrais Method focuses on exactly that relationship between movement and thought. It teaches us a deeper understanding of what it means to be fit, how to integrate movement lessons into warm-up and full workouts, learning why often, less is more and provides a strong foundation for keeping our bodies and minds active and sound through our life time. This is especially important because our bodies mature and have different needs as we age: and this makes it more so important for high performance bodies to learn new ways of moving in order to improve and keep the performance level at it's fullest.

For further questions or information contact Marion Kregeloh, PT, CFP at 924.6226, Ext. 36 or at 479.1765.

 

Marion Kregeloh, PT, CFP

 

If you have any questions regarding exercise routines or want more information, please contact Marion Kregeloh, PT, r at 415.479.1765.

Marin Movement Center - Helping Your Body Thrive

Your source for physical therapy in Marin

Locations in San Rafael and Larkspur

 

 

 

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How to Retrain an Orchestra

Posted by Marion Kregeloh
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on Tuesday, 30 August 2011
in Chronic Pain

 

Chronic Back and Neck Pain---------or How to Retrain an Orchestra


Chronic pain is about making changes: the way we think, feel, move and breathe. Healing from chronic pain is about transferring control back to the individual who is in pain as opposed to pain being in control of the patient. 

Pain occurs when the body’s alarm system signals to the brain that there is tissue damage. In chronic pain, we can use the metaphor of an orchestra:  it is as if the orchestra in the brain plays the same pain tune over and over again. It lost the ability to find its entire repertoire of tunes. And this is the source for more dysfunction and more pain and so on.

Movement is essential for the health of all body systems and processes. When dealing with pain, movement is the key function that is affected. While movement is always therapeutic for the tissues and aids healing, many people with chronic pain feel “trapped” by pain. Movement can even make their pain worse.

The approach to getting out of the “pain trap” includes following key steps:
1.    Understanding pain and its physiology and source: Once pain is understood, it is given less power and the individual can engage more efficiently in her/his recovery.
2.    Understanding the fact that hurt does not always equal harm. This is a very important piece of information for anyone who is recovering from pain and/or enrolled in physical therapy as part of a chronic pain management program.
3.    Understand the principles of pacing and gradual exposure: a) choose one activity that you want to do more. b) determine your baseline of that activity, such as how long you can walk without flaring the pain. c)  plan how to progress: if your baseline walking is 10 minutes, plan to add ½ minute each day, to 10.5, 11, 11.5 etc d) stick to your plan. Know that flare-ups are part of the natural response of the nervous system. e) include pleasurable activities into your daily life since they have positive effects on the brain-pain cycle.
4.    Here are some of the fundamental criteria that are needed for restoring healthy and pain-free movement:
•    Imagine movements.
•    Introduce different orientations for the same movements.
•    Include balance tools such as gym ball or roller for the same movements.
•    Include exercise in the water.
•    Play with different speeds, qualities, or break the movement into different components.
•    Include distraction such as music, art or visualization; let your mind create new ways.
•    Allow movements in different emotional states. Just because you feel down one day, does not mean you need to put your movement routine on hold.

This list for movement restoration retrains the orchestra so it can play its full range of tunes, harmonious notes, revive old tunes and prepare new masterpieces, eventually.

After all, who wants to hear the same tunes over and over again....and remember: “You own your body, medicine doesn’t”.

To find out more about chronic pain, please contact Marion Kregeloh, Physical Therapist and Feldenkrais Practitioner, at 479.1765 or at 924.6226, Ext. 36.

Marion is part of a renowned chronic pain management program in Marin County, California.

 

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Patello-Femoral-Pain: Pain in the front of the knee

Posted by Marion Kregeloh
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on Wednesday, 06 July 2011
in Knee


Patello-femoral pain (PFP) is pain that occurs in the front of the knee. It refers to a number of different conditions such as patella tendinitis, plica syndrome, bursitis, chondromalacia patellae, ilio-tibial-band syndrome, lumbar spine or sacrum dysfunction or referred hip pain. It is also referred to as "runner's knee".  

The kneecap, or patella, sits over the front of the knee and is attached to the bones and muscles by strong tendons: the patella tendon connects to the shin bone and the quadriceps tendon attaches to the top and sides of the knee cap from above. 

Problems begin when the kneecap does not move properly and rubs against the lower part of the thigh bone.  The most common causes of runner's knee are lack of balanced alignment between the knee cap, femur and tibia bone, muscle tightness or weakness, overuse such as running, jumping, playing soccer or skiing, flat feet and overweight. 

When walking, half the body weight acts on the knee; when walking on stairs, it is 3-4 times the body weight and when squatting, 7-8 times the body weight. Now imagine some of the above mentioned causes combined with excessive impact!  

If no surgery is required, the patient  with runner's knee will need to commit to a strict, regular exercise routine with the goal to restore muscular balance. An orthopedic doctor typically refers the patient to a physical therapist for rehab. In my own practice ,  I know of the importance to correct any imbalances in the pelvis, back or feet first. Patella mobilization and friction massage are important to assist with normal patella movement as are strengthening of the gluteal muscles including the hip rotator muscles.  Also, hamstrings and the muscles in the front of the hip need to be stretched.  

Most people with pain in the front of the knee heal well from their injury if they are committed to a regular exercise regimen, usually daily for at least 6-8 weeks.  After that, once your physical therapist has helped you establish your individual exercise program to maintain knee health, you can go back to running, skiing or other athletic activities.


Feel free to contact Marion Kregeloh, PT, CFP for more information on rehabilitation of anterior knee pain and exercise specifics. You can reach Marion 415-479-1765.

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Don't Let Your Back Pain Become Chronic!

Posted by Marion Kregeloh
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on Friday, 22 April 2011
in [ Back ]

Researchers at the University of Utah have recently found a genetic link for back pain. While researchers typically had more difficulties ruling out environmental factors such as life styles, professions, exercise and smoking, they now found a clear connection between back pain occurrences in families. They studied more than one million Utah residents with herniated or degenerated discs. Results show that the risk of such back injuries increases when a second and third-degree relative has that condition. In case of an immediate family member with such back injury, risks are more than four times as high.Other studies point to a gene that is linked to sciatica and disc herniation.

 

While we now know that for some of us genetics can be the source for back pain, it is nevertheless most important to not let back pain become chronic. Acute back pain is a common condition and needs attention in order to prevent it from becoming chronic. When resting, applying ice packs, and anti-inflammatory drugs do not bring relief after 2-3 days, it is recommended to seek a health professional who is familiar with treating back injuries. Based on evaluation, each individual needs to have a custom-taylored exercise program that assists in the recovery as well as prevents the back pain from reoccurring.

 

Here are some examples on how to keep your back healthy:

1) Maintain a healthy weight

2) Give up smoking

3) Avoid heavy lifting

4) Walk at least three times a week for 20-30 minutes each

5) Find an exercise routine that you enjoy and that strengthens your core and legs: gym training, dancing, swimming

6) Keep improving your posture with programs like Feldenkrais or therapeutic yoga

7) Avoid hours of sitting when at work; change your position frequently

8) Manage your stress and learn how to worry less

 

If you would like more information on treating back pain from the physical therapy and Feldenkrais perspective, please contact Marion Kregeloh, CFP, PT at 415.479.1765.

Marin Movement Center - Helping Your Body Thrive

Your source for physical therapy in Marin.

Locations in San Rafael and Larkspur.

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Are you more acid or alkaline?

Posted by Marion Kregeloh
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on Monday, 28 February 2011
in Nutrition

When it comes to health, our acid-alkaline balance is extremely important. As a specialist for osteoporosis, I am constantly reading about the newest research regarding bone health. And this is true for our overall health.

What is the acid-alkaline balance? It is the acting ph level in our body. The ph level is measured on a scale of 0 to 14. 0 is the most acid and 14 is the most alkaline. 7 is the neutral ph level. For optimum health, our body must be in a specific blood ph of 7.35 to 7.45. This is a minimally alkaline level. What is interesting is that even a very small deviation from that level causes health problems. You may have a shift towards acidity by 0.1 ph unit and the cells lose their ability to function properly. Even though our body has the amazing ability to counterbalance and neutralize high acid ph levels, acid can accumulate in the body. This is the cause for so many of our modern world health problems.

While exercising, getting restorative sleep, and living a balanced life are all essential to maintain a balanced ph level, our diet is extremely important. While our ancestors ate plenty of the "whole" foods that our modern society is lacking as well as many different vegetables, seeds and roots, they also ate meat and fish. Of course, their meats were all from grass eating animals. All the acid-forming high proteins from meat, fish and poultry was counterbalanced by a high alkaline vegetable, fruit and seeds diet.

Today our diet has lost it's balance due to acid forming foods such as processed foods, saturated fats, sugar, and other carbohydrates. Our acid-alkaline balance is out of order, and therefore, so are our ph levels. The result is chronic low-grade metabolic acidosis: too much acid in our body. This chronic acidity causes inflammatory conditions such as arthritis, gastrointestinal conditions, chronic fatigue, autoimmune and heart disease, urinary tract infections, osteoporosis, sagging skin............and the list goes on.

The good news is that we can change our ph level in changing our diet! First of all, give up the bad habits as mentioned above and replace your diet with approximately 70% fresh vegetables or alkaline producing foods (some of that can be fruit) while making the rest of your diet a combination of protein and carbohydrates (acid producing foods). I highly recommend detoxifying regularly. One simple daily detox approach is to drink plenty of water (64 oz) mixed with some lemon juice. It gives your body a nice alkaline rush and helps to remove toxins. To find out more about how to balance your diet, talk to your nutritionist or detox specialist.

How do you know what your ph level is? Get a "ph test kit" (most drug stores have one) and find out. It's super easy.

Enjoy getting back into balance! From a ph level point of view.

 

For more questions, please contact Marion Kregeloh, CFP, PT at 415.479.1765.

 

Marin Movement Center - Helping Your Body Thrive

Your source for physical therapy in Marin

Locations in San Rafael and Larkspur

 

 

 

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Modern Life, Busy Bodies

Posted by Marion Kregeloh
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on Monday, 24 January 2011
in Repetitive Strain Injury (RSI)

Our bodies are challenged daily with the hectic lives we live. The normal 24 hour "circadian" rhythm is out of sync for most of us modern folks. The result is a lack of sleep and concentration and chronic fatigue. Bodies are more vulnerable to injury, hurt and are chronically tense. On top of all that, many professionals spend 8 hours a day under flourescent light, in air conditioned rooms and cramped work areas that lack space to stretch or even lie down in order to unload the back and neck. Sitting all day long at the computer is one key contributing factor for chronic muscle tension, eye strain, headaches, back and neck pain, insomnia and repetitive sprain injuries.

Here are some statistics that relate to computer use:

The growing number of laptop computers has increased the rate of injuries because the keyboard and screen are very close together. This will either cause too much neck tension or shoulder-arm tension.

Using the computer for three hours at a time can cause repetitive sprain/strain injuries, headaches and back pain.

10 years ago back injuries were caused primarily by heavy lifting. Today they are caused primarily by people sitting at the computer for long work days.

In the early 1990's, the average age of workers with carpal tunnel injury was late 30's to early 40's. Today it has dropped to mid 20's and younger.

The US bureau of Labor Statistics says computer related injuries accounted for 66% of work-related injuries in the US in 1999. We can assume most certainly that this has increased today.

One study conducted in India on 650 people in computer-dependent careers shows 55% developed overuse symptoms within one year of beginning their careers; 60% of those with severe symptoms reported neck, back and shoulder stiffness and pain; 6 software engineers had to give up their careers.

As a physical therapist and Feldenkrais practitioner, I am passionate about helping people improve their physical wellbeing. One part of my physical therapy practice is Back and Neck health. Because I have worked with many people who suffer from CRI, I am more so interested to develop programs for that population. I recently started putting together short video clips of Feldenkrais movements to help my patients have convenience in accessing exercise tools at home. You can find a video of several exercises at this link:http://marinmovement.com/educational-information/feldenkrais-videos.html.

I would encourage you to visit this site and begin your practice...............just a few movements as part of your daily life would change the statistics drastically. I believe that we all can be free of most overuse symptoms if we'd begin to change our pace and include some healty movement stretches. You don't have to become a workout freak to return to more balance.

Let's move towards modern life, clever bodies....

Best to your health,

 

Marion Kregeloh, PT, CFP

If you have any questions regarding exercise routines or want more information, please contact Marion Kregeloh, PT,  at 415.479.1765.

Marin Movement Center - Helping Your Body Thrive

Your source for physical therapy in Marin

Locations in San Rafael and Larkspur

 

 

 

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Health Advice - Keep It Simple

Posted by Marion Kregeloh
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on Thursday, 30 December 2010
in Nutrition

We are exposed to so many health suggestions these days that it becomes somewhat challenging to stay on top of it all. If I had to give just one piece of advice, I would say: Keep it simple!

This can relate to all areas of well-being: exercise, nutrition, supplements, life style.....We all experience stress or overwhelm or schedule changes due to work, family or the holiday season. If we run out of time for our usual wellness routines, then simplicity can be the best friend.  Instead of going to the gym 7 days a week, pick your favorite workout and do it when you can.

Food: keep meals simple but whole. A big salad or bowl of veggies, some chicken or fish and brown rice: ready is the meal! Supplements: find out if you can cut back on some. At times my patients seem overwhelmed with the amount of supplements they read about and believe they should take. Discuss with your health practitioner which ones are your most important. It is different for each of us, after all. Lifestyle: Hurry less, take one breath at a time, eat while you sit down at the table. Chew and taste your food. Smile more.................Sounds familar? Well, you are in pretty good shape then. But experts say we all need these reminders over and over again: so that we don't get stuck in the "got- to-do-world" but live more in the "pleasure world". And to avoid burnout. I still need these reminders myself.....over and over again. One Chinese proverb says: "Don't forget: Inhale. Exhale."

That said, I wish you a peaceful and mindful end of the old year and a healthy, vital and exciting new one. Happy holidays.

To your health,

 

Marion Kregeloh

 

For more questions, please contact Marion Kregeloh, CFP, PT at 415.479.1765.

 

Marin Movement Center - Helping Your Body Thrive

Your source for physical therapy in Marin

Locations in San Rafael and Larkspur

 

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Five Essential Exercises For Your Back

Posted by Marion Kregeloh
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on Tuesday, 22 June 2010
in [ Back ]

It's summer, finally. And for that reason I decided to keep my monthly article light and easy. It actually is not much of an article but rather a list of exercises.Here are five essential back exercises that help your back to stay flexible and healthy. I am doing them on a regular basis myself, besides a variation of Feldenkrais exercises . When I injured my lumbar spine during pregnancy 17 years ago, I received manual therapy treatment from another physical therapist. After the birth of my son, my lumbar spine got injured again. After completing physical therapy treatment, I have been committed to including regular stretches and Feldenkrais movements into my exercise regime. If you experience recurrent low grade back pain or tension and fatigue in your back, you can try these exercises. Please keep in mind that this is not a substitute for an examination by a health care provider. If you have serious pain or your spine is locked up, please see your practitioner first.

The first four exercises are done lying down on the floor, both knees bent. Support your neck as needed. Always start from a comfortable starting position.

1. Pelvis clock: Bend both knees, arms at your side. Gently tilt your pelvis up and down (imagine a clock dial under your back with the 12 pointing up towards your head and the 6 pointing down towards the feet). Tilting up towards 12 will flatten your back and gently tilts the head back; tilting pelvis down towards 6 creates a gentle arch while chin moves towards the chest. Repeat at least 5 times, moving in a comfortable pace. This exercise is a basic spinal alignment exercise.

2. Knee to chest stretch: Bend both knees with arms at your side. Lift one knee at a time towards you, holding leg behind the knee with both hands. Keep the stretch at least 10 seconds or as desired. Repeat 3 to 5 times with each leg. Now lift both legs up, one at a time. Each hand holds knee from behind. You can do some gentle pelvis circles, small to larger, as tolerated. Change direction. Slowly lower one leg at time. This exercise takes pressure of the lumbar spine and releases muscle tension.

3. Bridging: Bend both knees, arms at your side. Gently tilt pelvis towards 12 and begin to lift hips off floor, gradually moving one vertebra at a time, until you are on your shoulder blades. Now begin to gradually lower your hips, one vertebra at a time. I like to coordinate this movement with breathing: exhale, lift, inhale while up on shoulder blades, exhale and lower hips. Repeat at least 3-5 times. This exercise is excellent for realigning the thoracic spine, since you move one section at a time.

You can modify arm position with arms stretched out at your side. This adds more stretch in the front shoulder-chest section.

4. Knees side to side: Bend both knees, arms at your side. Place arms at your side, shoulder-high. Inhale and lower knees to the left, exhale and return knees to the middle. Use your abdominal muscles! Inhale and tilt knees to the right, exhale and return knees to the middle. Begin with small tilting movements and gradually lower your knees further down to the side. Stay within your comfort range! Repeat at least 3-5 times to each side.

Progression: You can do the same exercise with both knees and hips bent 90 degrees towards you. You will feel more stretch in your torso, ribs and shoulders while you lower the knees. Your abs will work harder. Repeat at least 3- 5 times. Note: do not do such twisting movements if you suspect an acute disc injury!

5. Cat and Camel stretch: Get on your knees and hands. Find the "neutral" position in your spine. When exhaling, gently round your back, allowing abdominals to engage and pull naval up, head looking towards belly. Inhale and gradually unfold and extend your spine, allowing belly to protrude towards floor. Make sure your neck stays aligned with the spine.

Continue for at least 5 times, allowing breath to determine the pace of the movement. Make it your intention to move all segments of the spine, including the upper and middle back.

Please contact Marion if you have any questions, Ext. 36. Or visit one of the weekly Back classes on Wednesdays at 12 noon. You will learn more about how to keep your back in balance.

 

For more questions, please contact Marion Kregeloh, CFP, PT at 415.479.1765.

 

Marin Movement Center - Helping Your Body Thrive

Your source for physical therapy in Marin

Locations in San Rafael and Larkspur

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Got Healthy Bones?

Posted by Marion Kregeloh
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on Monday, 06 July 2009
in Osteoporosis

Osteoporosis is loss of bone density and strength leading to a higher tendency for bones to break. The genetic makeup, aging and menopause are some of the key causes for osteoporosis. Other factors are conditions such as anorexia, depression, hyper and hyperparathyroidism, myeloma, rheumatoid arthritis, organ transplants, genetic disorders as well conditions of the lungs, kidneys and digestive system.

High consumption of caffeine, alcohol and nicotine can also cause bone density loss.

What is bone? Bone is a hardened mass of living tissues that supports the body and protects internal organs from injury. The outer bone is called the cortical bone, the internal and more spongy part is the trabecular bone (or cancellous). Small amounts of bone are broken down (bone resorption) continuously while it is replaced with new bone (bone formation). Large numbers of blood cells are produced within the bone marrow.

Bones are an important reservoir for minerals: Calcium phosphate and carbonate, fluorides and chlorides are constantly shifted from other parts of the body to the bone and back. This is happening through hormonal regulation as well as bone cells and the stresses of weight-bearing activities and muscle "strains". The amount of minerals in the bone determines hardness. Collagens contribute to mechanical strength.

How do we keep our bones healthy? Bones need strains and impact. Strains are produced through muscle contractions while impact are weight-bearing activities. The #1 form of bone building exercise is resistance training. Followed by impact exercise. Plus other stimulations such as stretching, posture building and awareness of healthy movement patterns. Alignment is an essential form of maintaining compression of the spinal joints needed for bone building. Research has shown that certain forms of exercises from the Feldenkrais Method (Bones for Life), Tai Chi and yoga contribute to healthy bone stimulation.

Nutrition is the next most important factor in bone strength. It is recommended to get as much calcium and other minerals and vitamins from your diet versus supplements. Eat green leafy vegetables, legumes and seeds. Avoid a high protein diet since this can leach calcium from the bones.

Keep a healthy life style. Walk whenever you can instead of taking the car. Don't become a couch potato. Be as active as you can. Plus: get good professional advice. If diagnosed with osteoporosis, discuss treatment options with your doctor including if medications are right for you or not. Whatever your choice: Do what you can control: exercise, nutrition, and life style.

This will lead you to healthier bones!

 

If you have any questions, please contact Marion Kregeloh, CFP, PT at 415.479.1765.

 

Marin Movement Center - Helping Your Body Thrive

Your source for physical therapy in Marin

Locations in San Rafael and Larkspur

 

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Brain Plasticity

Posted by Marion Kregeloh
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on Wednesday, 20 May 2009
in Aging

 

Brain plasticity.................can our brain change throughout life?

Have you ever heard comments like "you will have to live with this pain for the rest of your life" or "sorry, you will never walk again".........and on and on it goes.

May be you were never told any of those gloomy predictions but you may know someone who was. In my own practice as a physical therapist I have met countless people with stories like that and many of them have proven the world otherwise. Their belief, determination and will power has created change with a healing capacity much beyond their told prognosis.


Neuroscientific research over the recent years has shown that our brain can change and adapt to trauma. The "old" belief, for over 400 years, was that the brain is fixed and no change through life possible. This meant that any injury to the brain could not be healed,ever!
Thanks to the revolutionary discovery we now know that the brain can change itself, not through surgery or medication, but through thought and activity. What does that mean for our lives? In short: we can learn, grow, change at any age and at any point of our life. Habits and patterns that most of us have developed and live by, reduce our capacity for a more full life experience: we can not only create new patterns of thought and emotion, we can also undo old ones, that are not suiting us any longer. Such as limiting self beliefs. We can train an injured person to use the body

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Knee Injuries and How to Prevent Them

Posted by Marion Kregeloh
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on Thursday, 19 March 2009
in Knee

 


Knee injuries
and how you can prevent or improve them


One out of every four sports injuries affects the knee. Knees are under a lot of stress when you are running, skiing, dancing or gardening. Climbing stairs may put pressure on the knee equal three to four times the body weight. Our knees are essential for walking, climbing and kicking. In order to be stable the knee depends almost entirely on soft tissue: ligaments, tendons and muscles. Multiple factors subject the knee to injuries: imbalance in thigh muscles (quadriceps and hamstrings), ankle- foot imbalances (pronation and supination), weight, posture and movement habits and angle of thigh bone (hip to knee). Women have a few disadvantages that are the reason for a higher injury rate among female athletes: smaller and weaker muscles that support the knee, wider pelvis with a sharper angle of the femur (thigh bone) to the knee, weaker hamstring muscles and hormonal changes (have an impact on ligaments and connective tissue). All these criteria make women’s knees more unstable. Women are likely to injure the ACL (anterior cruciate ligament) two to eight times more than men in the same sports. They are also more likely to developchondromalacia (“runner’s knee”).

 

Here are some important tips that can help reduce the risk of knee injury:

 

1. If you have pain in the anterior part of the knee, most often associated with patello-femoral pain or chondromalacia, it is absolutely important to avoid stairs and sitting with the knee flexed for prolonged periods of time. If the left knee is affected, avoid driving a car with clutch for longer periods of time. Avoid any pain in the knee with exercising.

To heal patellofemoral joint pain, the most important strategy is to unload the knee joint and avoid heavy impact activities. The combination of a careful exercise approach wiht anti-inflammatory medication, is best in most cases and often makes surgery unnecessary (D. Scott Dye: "pathophysiology causing patellofemoral pain")

 

2.Strengthening hamstrings and quadriceps (especially vastus medialis) muscles: you can perform the following exercises: straight leg raise while lying on your back and standing hamstring curl. Eccentric strengthening of the quadriceps is especially important for the anterior knee pain: it provides proper energy and shock absorption under functional load. (Wojtys EM). Example: partial lunges.

 

3. Stretching tight hamstring muscles.

 

4. Maintain balanced crouched position during sports (especially women who tend to be more upright due to quadriceps dominance) to build hamstrings and reduce risk of ACL injury.

 

5Plyometric training (when no knee pain is present) in order to prepare the muscles and ligaments to respond quickly to force (for example jumping activities). Consult your physical therapist or trainer.

 

6. Address ankle foot imbalances: such as flat foot, pronated foot, knock-knees. Get professional advice from your physical therapist or other expert.

 

7.Lose weight if you are overweight to avoid excess weight on the knee joint.

 

8.Wear proper foot wear that supports your foot and fits well.

 

9.Avoid: downhill running, deep lounges and full squatts, cycling with the seat low and in high gear, leg extensions with locked knees and heavy weights, exercising on hard surfaces, large steps on stairs and high heels.

 

10. If you have knee problems resulting from sports or other activities, get professional advice.

 

You can contact Marion Kregeloh, PT, CFP at 415-479-1765 for further advice.


 

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Female Athlete Triad - Causes and Cures

Posted by Marion Kregeloh
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on Sunday, 22 February 2009
in Exercise

Sports and exercise are part of a balanced, healthy life style. When sports is taken to an extreme, some girls are at risk for a condition called female athlete triad.

This is a combination of three conditions: eating disorder, amenorrhea and osteoporosis. A female athlete can have one, two or all three of this triad.

#1 Eating disorder: girls want to lose weight for better performance in their sport discipline. The eating disorder can range from leaving out certain foods such as fat to more serious disorders like anorexia nervosa or bulimia nervosa. Low self esteem and stress can cause disorderd eating.

#2 Amenorrhea: A girls's period may become irregular or stop altogether when exercising intensely while not taking in enough calories. Once the body weight falls too low, estrogen levels decrease affecting the menstrual cycle. ( it is normal for teen girls to miss periods occasionally and not every girl who experience this has athlete triad).

#3 Osteoporosis: Low estrogen levels and inadequate diet, especially lack of calcium, can lead to osteoporosis. This condition weakens the bones in reducing bone density and affecting healthy bone formation. Osteoporosis may lead to stress fracture and can ruin a girl's athletic career.

The teen years are crucial for bone formation and usually bones reach their peak bone mass in that time of life. Lack of calcium, low estrogen levels and underweight can have a lasting effect on the bone health later in life.

Who is at risk for female athlete triad? Competitive athletes, girls who participate in sports that classify them by weight such as rowing and marital arts, or sports that emphasize thin apperance such as figure skating, diving, ballet and ballet.

The truth is that girls who are fit and active enough to compete in sports, do not improve their performance when losing weight. Since those girls usually have more muscles than fat, what gets starved is the muscle when losing weight.  When body weight is normal in teen girls, yet weight loss occurs, the hormonal cycle and bone building processes are negatively affected.

What can be done? It is important to address the physical and emotional issues. A doctor will take a medical history, possibly order labwork and bone density testing. Once diagnosed with athlete triad, the girls will work with a nutrionalist, exercise specialist or physcial therapsit and psychologist.

 

Tips for female athletes:

Keep track of your periods. Dont's skip meals or snacks, consult with a nutritionist who works with teen athletes.

Remember: It is about your body and your life!  Not your coach, parents or team mates have to live with any damage to your body. Enjoy your sport and do not sacrify your health.

 

If you have any questions, please contact Marion Kregeloh, CFP, PT at 415.479.1765.

 

Marin Movement Center - Helping Your Body Thrive

Your source for physical therapy in Marin

Locations in San Rafael and Larkspur

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Plantar Fascitis: "A Pain in the Heel!"

Posted by Marion Kregeloh
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on Tuesday, 20 January 2009
in Feet

 

Have you ever experienced pain and swelling in the heel and/or bottom of your foot? Or intense pain with the first steps when getting out of bed or after getting up from a chair?

Plantar fascitis is an inflammation of the fascia of the foot. The fascia is a fibrous band which connects the heel with the back of the five toes. It acts as a shock absorber and supports the arch of the foot.

Certain factors can contribute to the onset and they usually work in combination:

1. Overload: Running, especially long distance, high impact aerobics, sudden triggers such as lifting or moving heavy objects.

2. Faulty alignment of the foot such as excessive arch or lack of arch, pronated or supinated foot and other foot conditions that cause imbalanced weight distribution with walking, sagging of arch common in middle age

3. Arthritis

4. Diabetes

5. Tight foot and calf muscles

6. Unhealthy training habits such as lack of warm-up, running or jumping too much or too soon

7. Weakness of the foot

8. Shoes that don't fit, such as lack of arch support and/or cushioning (thin sole), too high heels

9. Overweight

10. Pregnancy

11. Prolonged standing on hard floors

Plantar fascitis most often develops gradually but can come on suddenly and be severe, usually it affects one foot at a time.

What can you do? Most important is the beginning of treatment with first symptoms. As you begin to experience heel pain or pain in the bottom of your foot, find out if any of above mentioned risk factors apply to you. If left untreated, problems can become more severe and recovery time can take up to 18 months or longer; some people have chronic problems. I recommend to consult your physician and get a referral to a physical therapist.

Change your work-out regimes as needed. Talk to your trainer or physical therapist about how to reduce impact on your foot.

Apply ice after each work-out; either with an ice pack or ice bath for 15 minutes.

Gentle massaging of the bottom of the foot including the heel before getting out of bed.

Non-steroidal anti-inflammatory drugs such as ibuprofen or aspirin (consult with your doctor if you have not used any before).

Wear proper shoes or insoles.

Learn correct foot and leg stretches.

Emphasize warm-up and improve your work-out pace.

Watch your weight.

Avoid prolonged standing.

Consider Feldenkrais exercises to learn to move easier, effortless and more balanced with more even distributed weight.

Should symptoms be more severe you may be in need for a night splint to allow the fascia to relax over night and custom fit orthotics to help distribute pressure to the feet evenly.(different devices are available, your health practitioner can inform you about possible options).

 

Wishing you healthy feet!!

Marion

 

If you have any questions, please contact Marion Kregeloh, CFP, PT at 415.479.1765.

 

Marin Movement Center - Helping Your Body Thrive

Your source for physical therapy in Marin

Locations in San Rafael and Larkspur

 

 

 

 

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Loss of Bone Tissue

Posted by Marion Kregeloh
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on Monday, 28 May 2007
in Osteoporosis

Loss of bone tissue: An irreversible natural process of aging or a response to life conditions?

Loss of bone mass used to be perceived as a normal part of getting old. This belief lost credibility after astronauts, the representation of fitness in the Western world, returned from space with weak bones. NASA’s research has shown that the weakening of bones does not depend on age alone, but rather, is dependent on the reaction of the organism to the conditions in which it lives.

This is good news, since the studies have shown that it is possible to restore bone density. Bone re-generates when introduced to certain pressures. Our posture is a key factor. When the skeleton is organized into a firm and well-aligned axis, the pressure of the body weight is increased through the stepping foot while counter pressure from the earth pushes upward. This springy pressure transmission has the effect of renewing bones. Only a well aligned skeleton will be able to sustain safely the increased load of the pressure in dynamic movement that is needed for nourishing the bones.

Sluggish body movement and stagnant circulation are cause for the failure of the mature body to absorb the calcium and minerals from the blood into the bone. Besides hormonal, nutritional and chemical aspects of the problem, life style is one important factor. Our western world has become dependent on machines and our activities are limited. Not only do the joints become too stiff or too loose, but the rhythm of moving is fragmented from lack of coordination and our walking pattern is poorly synchronized. Our fast paced and tense bodies are not meeting our internal striving for well-being and vitality.

In order to recreate our natural springy, rhythmic and fluid body movements, we can learn the functional conditions that are capable of stimulating re-growth of bones. Weight lifting is important but better results are created with vibrations and pressure, as NASA studies have shown. While weightlifting is increasing bone mass, vibrational movements are also improving the thickness of the bone and its resilience.

“Bones for Life”, a complete program for stimulating bone strength through dynamic movement and weight bearing posture, is based on Dr. Moshe Feldenkrais’ approach to somatic learning. Marion’s Wednesday morning Feldenkrais class is integrating “Bones for Life” movement lessons.

Please contact Marion Kregeloh at 415-479-1765 for further information.

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Repetitive Strain Injury

Posted by Marion Kregeloh
Marion Kregeloh
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on Sunday, 29 April 2007
in Repetitive Strain Injury (RSI)

 

Repetitive strain injury and Carpal Tunnel Syndrome

Are you spending hours at a computer? Sit for hours at a time? Forget your body because you are immersed into your work?

And may be you are noticing some sensations in your body that you have not noticed before, e.g. fatigue, tingling, clumsiness, stiffness, difficulty carrying things or holding a coffee mug, cold hands, pain in neck, shoulders or forearms?

There are things you can do to improve your workstation as well as change the way you move and do your work. Here are just a few tips:

I recommend a trip to a computer store and check out their ergonomic options. You can also check different ergonomic companies on-line. “Back Designs” in Berkeley has a huge variety of products. Their staff is well trained. It is worth a trip to look for ergonomic products.

  1. Raise your computer monitor to eye level
  2. Make sure the monitor is directly in front of you and not to the side.
  3. Use a document holder at eye level; switch sides of its position
  4. Be aware of your posture. Keep head above shoulders
  5. Wrists need to be in “neutral”, this means in a comfortable position, not flexed or bent back; do not lean wrists against desk.
  6. Keep your arms approximately in a 90 degree angle to the body and parallel to the floor.
  7. Wrist rests are best when used as a reminder for neutral position; there are many models out there; try it first before you buy one. You can also try a small folded towel at the base of your keyboard.
  8. Ergonomic keyboards and mouse; you can check out different options and select what you like best.
  9. Keyboard platforms allow you to raise the keyboard to any height.
  10. Gliding pads attach to the keyboards
  11. “Wrist Reminder” is a wrist band that supports and limits wrist flexion; works well for some people
  12. Check in with your breathing periodically; notice how you are breathing and take a deep breath on a regular basis. There are many wonderful breathing exercises (Feldenkrais, Middendorf, yoga)
  13. Take your hands off the keyboard every 20 minutes for at least 5 minutes. Get up and walk around, stretch. It is important to get your body out of the work position and stretch for 3 to 5 minutes every hour. Feldenkrais exercises are ideal.
  14. Drink plenty of water…….64oz per day minimum.

In case of serious symptoms you need to see your physician. Most likely she/he will refer you to Physical Therapy. Some people have success with acupuncture, osteopathy, biofeedback, homeopathy and massage. Whatever approach you choose it is important to actively correct your posture and participate in regular cardio-vascular exercises and stretching.

 

Please contact Marion Kregeloh, PT, CFP at 415-479-1765 for further questions.

 

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Rotator Cuff Injuries

Posted by Marion Kregeloh
Marion Kregeloh
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on Tuesday, 27 March 2007
in Shoulder

Tip of the month - Rotator Cuff Injuries

Too often I see clients in my work as physical therapist who have injured their rotator cuff in doing their “normal” daily movements of habit. Athletic overuse is a common rotator cuff injury source but this article is not addressing that.

Two common causes for injury in the shoulder are reaching for the night light while lying on your back (shoulder lifts, rotates out and abducts) and reaching to the back of the car seat from the front.  Anatomically the shoulder is not a very stable joint. It relies on its muscles and ligaments for stability. That stability is challenged with postural weakness or imbalances and unhealthy movement habits that cause micro traumas and eventually a torn tendon. We need to become aware of our habits in order to change some of them or make them better.

The most important element in learning good body mechanics is the movement from the core: when lying on your back and wanting to turn off the light to your right, roll on to your right side and initiate that movement from the core: allow the left arm to be the extension of your torso while reaching. When you fixate your torso while lying on your back and reach with your arm to the side, you are putting unnecessary pressure into the shoulder and overstretch the anterior structures. When the rotator cuff is already inflamed or thickened the risk of tear is high. Same for the car scenario: shift weight onto the right side of your pelvis and turn your whole self to the right. This way your shoulder is not overstretched and most of the movement happens in the pelvis with even distribution of spinal twist movement.


Moving the way nature intended us to is for too many people beyond their reality. But it is never too late to learn and move beyond our limiting patterns. Move with ease and pleasure…….and join any of our weekly, ongoing Feldenkrais classes.  For further questions, call Marion Kregeloh at 415-479-1765

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