Hello, Goodbye!

Or is that goodbye, hello again?

Emma to BendMy news is bittersweet; I am relocating to Bend, OR. I am so excited for this new adventure, but it is very hard to leave the community here. When I started Focus Bodywork thirteen years ago, my dream felt like a pie-in-the-sky fantasy. I am in awe today that Focus Bodywork has exceeded my vision and provided the medium for me to develop into the therapist I am proud to be. I cannot thank each of you enough for trusting me, it has been a privilege. I leave you in the best hands I know, Margaret. – Emma

Hi! I’m Margaret Madsen – perhaps we’ve met in passing when you’ve come in for a treatment with Emma or Shannon in the past year and a half? Or when we’ve worked together directly? Maybe it was getting that rotator cuff functioning so you could do downward dog, or keeping your elbows happy so you could keep sending those hard routes, or was it sleuthing out the crazy-cool rotation of your torso that was leading to back pain? Whatever soft tissue restrictions have been keeping you from fully doing the activities you love, I am still here to help!

Mentoring with Emma has been a truly amazing professional opportunity. Being a part of Focus Bodywork has fostered my innate skills and knowledge while providing countless examples of how to push the envelope in providing the best care possible. Thus it is a great honor to announce I am taking on the role of owner of Focus Bodywork. I am sorry to see Emma go (I haven’t finished picking her brain yet!) but I am comfortable and ready to carry on the same high level care and customer service for which the business is known.

Shannon will continue providing her excellent care on her new-Mom based schedule. A few changes you can expect to see in April are a new location (a smaller treatment space) and, to reflect my professional growth, my rate will be $70/hr. Scheduling will stay the same, with the same phone number and online service – only now I’ll be the one answering the phone and responding to emails!

Goodbye for now, looking forward to our next hello (again)!

Growing!

Focus Bodywork is again on the move.  Not far though, just across the parking lot into #2C starting Monday, March 31, 2014.  This is a larger suite where we will have more treatment rooms and an exercise/movement therapy area to accommodate our clients’ needs more fully.

We are also so excited to announce that Focus Bodywork now has a resident physical therapist, Esther Smith, DPT, Cert. MDT.  Esther is an amazing manual physical therapist who specializes in treating athletes.  The collaboration of massage and physical therapy will allow us to treat soft tissue injuries, address structural and joint limitations, and create comprehensive rehabilitation plans.  We will work together as a team of experts providing a seamless plan to get clients back to doing what they love.

A bit more about Esther:

Esther Smith

Esther Smith

Esther received her doctorate of physical therapy degree from the University of Utah.  Since graduation, she has worked in the orthopedic setting with a particular focus on the management of musculoskeletal problems and sport performance.

Her goal is to offer clients education and treatment that addresses the cause of their symptoms and aids in the prevention of future injury, so that clients can get back to living life faster and pain-free.

Time with Esther means one-on-one, hands-on sessions that focus on client self-treatment education, tailored exercise and manual therapy including spine and joint mobilization. Esther is also certified in the McKenzie Method of Mechanical Diagnosis and Therapy™ and is a Restorative Exercise Specialist™. This additional training provides her with an assessment process that allows her to reach a mechanical diagnosis and produce an appropriate treatment plan for complaints such as:

  • Spine pain and referred pain into the limbs
  • Spinal disc pathologies
  • Joint stiffness and pain
  • Muscle problems including spasms and tendonitis/tendonosis
  • Intermittent numbness in hands or feet

In her free time, Esther enjoys cooking up good food gathered from local producers, testing her movement theory rock climbing in Utah’s wild places and generally playing outside with friends and family.

And Focus Bodywork’s growth does not end there!

Shannon is pregnant with her first (a girl), and will be on maternity leave for the month of July.  We are already discussing how to continue support for Shannon’s clients while she is out of the office to ensure there are no gaps in care.

Thank you so much for fueling our growth.  It is a dream of ours to create a team of sports minded therapists working together to meet the needs of the athletic community along the Wasatch Front.  It is so exciting to see this dream move into reality!

By Emma Maaranen

Sherlock Holmes and the Painful Low Back

Sherlock Holmes Cartoon

By Emma Maaranen

We see many athletes each week with back pain. Some of these clients have disk, joint or nerve injuries that cause their pain, but more times than not, back pain does not come from a diagnosed injury or pathology. However, just because there isn’t a diagnosed problem does not mean that this pain is not real, debilitating or needing to be solved. Although we feel for your pain, we love these cases! It allows us to practice our detective work and help to solve the mystery of back pain!

It is a rare person who gets through life without experiencing a bout of back pain at some point. You may experience constant soreness, a biting pain that prevents you from standing, or momentary stabbing pain when you twist. The pain may last for a period of a few weeks to a few months, and it may be a one-time ordeal or a recurring theme. After serious injury has been ruled out as the cause of pain, we at Focus Bodywork put on our detective hats and get to work.

I hate to break it to you, but your lower back is not perfect. Each low back has a slight deviation from anatomical perfection: a small tilt in the pelvis, too much (or too little) curve, micro-scoliosis, tiny bone spurs, thin discs, extra-fat nerve sheath, etc. These deviations may not cause any grief and, if “fixed”, may actually cause a lot of new pain! In fact, when MRI’s are taken on people with no back pain and no history of back pain, the MRI’s often reveal bulged discs, arthritis or degeneration. (Click here for a nice NPR story about this.) Currently the spinal orthopedic world is revisiting commonplace spinal surgeries, such as fusions and micro-discectomies, and finding that for some patients these surgeries are not alleviating their pain and may in fact be making it worse. It could be that for these individuals, the pathology seen on an MRI was not the cause of the pain. Back pain is frustrating!

We love to search for clues to back pain. We start by watching you move (sitting down, standing up, walking, squatting, lunging, twisting, balancing on one foot, etc.) to spot odd patterns of motion. For example, we may notice that one hip does not rock back when you sit down. Or perhaps your low back is very stiff, and we notice it causing your mid-back to overcompensate by doing too much of the motion. Or maybe your gluteus muscles are too weak to stabilize your hip when you balance on one leg, which forces excess load onto your spine.

Clues to back pain can also be found in your story. An athlete’s training plan, if too strenuous, may not to allow tissue to heal. For others, a new diet plan to get to race weight may not provide sufficient nutrients to support tissue repair. Often insufficient (or absent) warm-up and cool-down procedures are suspect.

In addition to our eyes and ears, our hands are our top-secret tool for solving these mysteries! Through palpation (feeling your low back and surrounding tissues) we often detect adhesive scar tissue, taut fascia bands and trigger points in muscles that are contributing to low back pain. Now we know enough to set a trap to catch the culprit!

Focus Bodywork therapists are able to address problems in soft tissue that are contributing to low back pain, but often we need to call in experts from other fields to put away the problem for good. Depending on what we have uncovered in movement patterns, your story and palpation, we may recommend a manual physical therapist to manipulate joints, a movement practitioner to retrain faulty posture, a sports nutritionist ensure you meet your diet goals without compromising your health, or an acupuncturist to reduce nerve pain.

Just as Sherlock Holmes leaves no stone unturned, we are determined to guide you in solving the mystery of your low back pain.

Smart Supplementation

Dr. Shannon O'Grady

Dr. Shannon O’Grady

By Emma Maaranen

As we are making our New Year’s resolutions, many of us make some type of commitment to better our health.  These commitments usually include dietary changes such as reducing sugar intake, eating more dark leafy greens  or making sure we are getting the minerals we need.  Often these choices about diet supplementation are based on assumptions about what is good for us and what may be lacking.  Recently I had the opportunity to chat with Dr. Shannon O’Grady, an expert on human physiology and nutrition, who shared/debunked a few myths about supplements.

“I’ve heard nutritional supplements are not regulated by the FDA.  Therefore, how do I know if the amount of a nutrient on a label is really what I am getting?”

Shannon has been spending the past year working with a major supplement manufacturer ensuring they would meet the requirements of a scheduled FDA audit.  Per FDA regulation, all dietary supplement must meet any listed label claim for ingredient source and potency at the time of manufacture as well as through the listed expiration date (beware of supplements that do not list an expiration date). These label claims must be accurate after normal shipping and storage by the manufacturer and retailer. It is true that supplements are not as rigorously tested as pharmaceuticals.  This is because supplements “may help digestive health,” not “prevent acid reflux of the stomach.” Both supplements and pharmaceuticals may cause side effects and may even interact, and it’s extremely important to consult a healthcare professional if you have any major health issues and you’re thinking of starting a supplement program.

“Probiotics are in the news a lot lately, touting better immunity from communicable diseases to reducing belly fat.  I want to take this super supplement!  Is eating yogurt every day enough?”

vitamin picResearch on the exact benefits of probiotic and how they work is still being worked out, but all evidence suggests that a diverse and thriving flora in our guts enhances health in many facets.  However, when you take a probiotic, most of the bacterium are killed in the stomach before they are able to have a beneficial effect. The higher the per strain dose (measured in colony forming units of CFUs) you take the more likely it is that some of those microbes will get to their destination and have a beneficial impact on gut health.  In a nutshell, it’s better to take a probiotic containing 2 strain than a supplement with the same dose, but spread among 10 strains.  Also – stick with a higher CFUs count, at least twenty billion.   Unfortunately your yogurt has too few CFUs to be a therapeutic dose.

“I’ve heard you should take probiotics when you are on antibiotics; why is this important?”

Taking antibiotics as prescribed by your physician is very important.  However, the antibiotics will kill much of your beneficial bacteria as well.  If you are taking a probiotic while taking an antibiotic, the organisms your are ingesting will be killed off as well.  Most people will have their guts repopulated with flora a few days after the course of antibiotics is complete, but taking a probiotic concurrent with your course of antibiotics will help the process out.  There is probiotic yeast, sacchromyces boulardii, that has been found to aid in digestive function and is not venerable to antibiotics (antibiotics target bacterium, not yeast).  A significant body of scientific literature has shown that taking this yeast while on your antibiotic regimen will reduce antibiotic caused diarrhea and reduce the likelihood of developing a C. difficile infection (a life threatening bacterial infection of the digestive tract that can occur after antibiotic treatment). This can be taken while on antibiotics and may be compounded with antibiotics in the future!

“Vitamin D was the darling of the health industry last year, and I have added it to my regime of supplements.  Is it still believed to be important?”

Yes, vitamin D is important.  It is needed for our bodies to absorb calcium to strengthen bones, regulates the immune system and reduces the severity of asthma (including exercise-induced asthma).  We get vitamin D from the sun, but wearing sunscreen and living with air pollution reduces what we get naturally, so supplementation may be useful.  However, we don’t absorb those 600 IU/day we are taking unless we are pairing it with magnesium.  You could eat a spinach salad with avocados and pumpkin seeds to get a hefty dose of magnesium with your vitamin D!

These are some on the insights Dr. Shannon O’Grady shared with me that I thought were especially useful for athletes.  As you turn your New Year’s Resolutions into lifelong healthy habits, I hope these tid-bits about nutrition supplements help you navigate the confusing world of nutrition.

And Then There Were Three!

Margaret2We are excited to announce that Focus Bodywork has added another amazing therapist to its team!  Welcome Margaret Madsen.

Margarets childhood fascination of the natural world led her to earn a graduate degree in vertebrate paleontology.  After ten plus years working with fossils, Margaret looked to work with bones in motion and eagerly completed her national certification as a massage therapist in 2011.

Applying her unique understanding of anatomy to the quirks of the human body is one of Margaret’s strengths.  She incorporates orthopedic massage and deep tissue techniques to her sports massage therapy session, and recommends exercises based on her experience as a yoga instructor.  She also practices cranial sacral therapy, and when appropriate, incorporates this light tough modality into her work.

Margaret loves to hike in the Wasatch Mountains and keeping up with the real athlete of the family – her dog.  She can talk for hours about all aspects of food and freely admits her favorite hobby is puttering about the house and yard.

With the addition of Margaret, we will be better able to meet the needs of our clients.  We will have:

* Last minute sessions available weekly for those unforeseen massage emergencies such as the inevitable hamstring tension that develops the week before a big race

*Friday appointments

*Referral networks between several sports medicine doctors and physical therapists

*Community classes on self-massage, sports injury physiology and “anatomy for athletes”

We invite you to experience the excellent clinical work Margaret has to share.  As she grows her clientele we are offering a $55 introductory rate for a sixty minute massage therapy session with Margaret.  Call or text us to set up your appointment (801) 359-5149

By Emma Maaranen

Photo Diary of Injury Care

My dirt face after my bike crash

Post bike wreck grimace

By Emma Maaranen

Often I’m asked by clients, “What do you do when you get hurt?”  Unfortunately I did get hurt a few weeks ago, so I have a fresh example of what professional care I seek and what home care I perform to treat my injuries.

My Accident/Injury About a quarter mile from the finish of a mountain bike race, I took a high speed crash onto my right leg.  On impact I experienced sharp pain in my lower leg/ankle region, heard a snap and had a wave of nausea wash over me.  I rolled out of the way of chasing bikers to avoid further injury and quickly assessed my leg before the adrenaline wore off and pain set in.  Visually I was okay; there was no serious bleeding or visible

Care from the medic tent

Care from the medic tent

deformity to the injury area.  I was tender to the touch on the lateral maleoleus (the bony bump on the outside of the ankle) and along the bottom third of the fibula (outside lower leg bone).  I could put weight on my leg, but it was painful.  I performed a few orthopedic assessments to rule out ankle ligament ruptures or Achilles tendon tears (I know most readers won’t know how to do this, but if you have some special skills, you should use em’).  I knew I did not need immediate medical attention because of the lack of bleeding, or deformity, and because of my ability to move my leg and bear some weight.  I carefully got back on my bike, rolled through the finish line and into the medical tent.  The medical team repeated my assessment, decided I was just banged up, and sent me on my way with an ace bandage, ice and ibuprofen.

Icing my ankle

Icing my ankle

Immediate Self Care for my Trauma Injury I strictly follow the RICE (Rest, Ice, Compress and Elevate) protocol after any trauma.  Once home from my race I applied arnica, an herbal preparation that aids in inflammation reduction, and continued the RICE-ing through the evening.  I was confident that the injury I sustained could wait until the morning for medical attention.  It was possible that is was just really sore from impact, but I suspected that I had fractured my fibula.

Day 2 Before I got out of bed I assessed my ankle and leg again.  The swelling had increased, and bruising was apparent around my ankle and through my toes.  My ankle was stiff, but I could almost move it through a full range of motion.  Weight-bearing elicited the same level of pain as the day before.  I begin RICE-ing again and called a sports medicine clinic to schedule some x-rays this morning.

Walking boot

Walking boot

Diagnosis I had a stable distal right spiral fibula fracture.  This means: I broke the bottom third of my right lower leg. It is stable, meaning that only one structure (bone or ligament) in the ankle complex is severed, and the other structures will maintain ankle alignment so that surgical stabilization (pins and plates) are not needed to allow the bones to heal.  Because the fibula only bears about 20% of the body’s weight,  a walking boot was all I needed for added stability.  We decide to x-ray my injury again in two weeks to make sure the fracture is healing well and the ankle is still stable.

Throwing Everything Into Healing I am a believer that to heal an injury best, you need to provide it all the nutrients and support it could possibly need.  Now that I know what I’m dealing with for an injury, I can be active in my healing.

Some of my nutrition products to aid bone healing

Some of my nutrition products to aid bone healing

Nutrition Healing takes a lot of energy (calories!), this is the worst time ever to think about losing a few pounds.  I often struggle to keep weight on when I am injured because so much fuel is needed to repair tissue.

Muscle is mostly protein so I increase my protein intake to provide my body the building blocks needed to repair soft tissue.  My nutritionist recommended I increase my protein intake from 40g/day to 100g/day.  This is a lot, so I incorporate a protein shake in my daily diet to fill this need. (My favorite protein smoothie is a scoop of Vega vanilla chai protein powder blended with 1c. almond milk, 1T peanut butter, 1T cocoa powder, 1t. vanilla extract, a pinch of salt and a frozen banana.)

Bone requires minerals to rebuild.  I take a bone-specific formula that has calcium, magnesium and potassium along with other minerals needed for bone remodeling.  I also take vitamin D, which is necessary for the body to actually process calcium.  Otherwise most of the minerals you are taking pass right through you!  Just in case I’m missing some nutrient, I also take a multivitamin and fish oil.  Fish oil is high in omega fatty acids, which work as an anti-inflammatory.  In addition I take a homeopathic remedy for bone fractures (available at any holistic grocer).

Spiral compression wrap

Spiral compression wrap

Swelling When you first injure yourself, swelling runs rampant to act as a cast and stabilize the injury site.  Swelling is great at protecting the injury from movement, but the swelling actually impedes healing.  Wanting to heal fast, I put myself to the task of reducing the swelling.  RICE is the first step to swelling management.  (A  note on compression: you do not want to wrap an injury so tight that you restrict circulation.  For acute swelling I apply an ace bandage starting at my toes and spiraling the bandage up to my knee.) I also performed MLD (manual lymphatic

Kinesiotape application for swelling

Kinesiotape application for swelling

draining) therapy to my leg twice daily.  MLD is a gentle massage technique that assists the lymphatic system to vacuum up the inflammation (bits of torn cells, blood leaked from capillaries, fluid, etc.).  I applied kinesiotape in a web fashion to aid the lymphatic system and continue using arnica.

Exercise No, I wasn’t about to get a cleat fitted for my boot so I could get back on my bike, but I did need to get my heart rate up!  Yes, I was antsy to be active, but getting circulation cruising through an injury also helps push out inflammation and deliver the nutrients to where they are needed.  I headed to the pool and put a buoy between my legs so I could swim with my arms and went to my favorite Pilates class where I modified any activity that might have compromised my injury.  I also took my ankle through all its pain-free ranges of motion before I iced (which I did as often as I could).

Acupuncture to aid healing

Acupuncture to aid healing

Day 4 At this point I was out of the acute injury phase, so I could start doing some real massage therapy on it.  Daily I spent 30 minutes self-massaging all the soft tissue in my foot, ankle and lower leg.  I was able to move inflammation out, gently move the joints my foot, treat sprained ankle ligaments, address trigger points in the muscles, and drive more circulation to the healing area.  I also set up an appointment with my acupuncturist to help in pain management and aid in healing.

Day 11 I had another visit with my sports medicine doctor to make sure we did not miss any serious soft tissue injuries (torn ligaments, tendons or muscles), to x-ray my leg again to make sure the fracture is healing in alignment and to check that the ankle is in fact stable.  My doctor found that everything is looking great!  Over the next two weeks I can start adding in some stationary biking, and two weeks after that I can start weaning off my boot.  I should be back on my mountain bike in four more weeks, and my fracture will continue healing for 6 months before it is completely healed.  I will keep up my regiment of home therapy and have scheduled physical therapy and massage therapy appointments to begin in two weeks.

Every injury is different and has specific needs to heal.  I hope this “diary” entry gives you a few ideas of what you can do to heal proactively rather than just waiting for your injury to heal.  Being active in your healing process will improve your recovery and help you stay sane while you are side-lined!

Just Run Through It?

Holly's beautiful running form at the end of the Mid-Mountain Marathon

Holly’s beautiful running form at the end of the Mid-Mountain Marathon

By Emma Maaranen

It is prime time running season with runners all over the Wasatch Front training for the Wasatch 100, Mid-Mountain Trail Marathon and St. George Marathon.  At Focus Bodywork we are often asked how to decide if a pain experienced during a run is okay to run through or not.  First, pain is your body’s way of letting you know that something is not okay and needs to be investigated.  Listen to your body!  I lump running pain into two categories: pain that develops while running and pain that develops after or continues several hours after a workout.

Pain That Develops While Running

Discomfort while running is part of the game; if you run you will experience pain now and then.  There are times, however, when you need to listen to your body and call it quits. When running pain causes you to alter your gait, it is time to call it a day.  Your compensated gait is a sign that there is a problem, and to run through it in this odd gait will most likely cause more problems and/or usher the painful site into full-blown injury status.  If the pain is not altering your gait, slow down for five minutes and focus on good running technique.  At the end of five minutes check in to see how the pain has changed.  If is the pain has reduced, pick up the pace and see what happens.  If is the pain has stayed the same, try another 5-minute technique period.  If at the end of this second test period the pain has increased or your gait has altered, it is time to walk home.

Pain That Develops or Persists Several Hours Post-Workout

You need a rest day! If the pain has subsided after a day of recovery try an easy run and see how it goes.  If you do not have pain while running and it does not return a few hours after rest, you can resume training.  If not, start with some good home therapy.

Home therapy:

1.)    Day 1 – Take a rest day- a real rest day!  Don’t even go to that yoga class.  RICE (rest, ice, compress, elevate) as often as you can.  Sit in a hammock (with your legs up and iced) and catch up on some reading (If you NEED to call this day a training day I recommend reading “The New Toughness Training for Sports: Mental, Emotional and Physical Conditioning from one of the World’s Premier Sports Psychologists” by James Leohr.)

2.)    Day 2 – If your pain is still hampering you, try a regiment of OTC anti-inflammatory, such as Ibuprofen.  Initially this will mask pain symptoms, but if taken as prescribed for 5 days you will reap the anti-inflammatory benefits of the medication.  RICE.  I know you are panicking about your fitness diminishing already (it is not, this takes two weeks), so try some cross-training, such as swimming or biking.  If your cross-training sport increases any of your pain symptoms, you need to try something else.

3.)    Day 5 – If your pain has not resolved, it is time to see a professional.  A sports massage therapist (like the ones at Focus Bodywork), a physical therapist or sports medicine doctor can help you develop a plan to get back to running pain free.

Endurance sports regularly require athletes to push through discomfort.  Should you “just run through it?”  It is important to evaluate your pain keeping in mind that cutting a training day short may save you several weeks of being side-lined.

Now That Summer Has Arrived, It’s Time for Ribs!

BBQ ribs

By Emma Maaranen

Ribs – not the barbequed ones, yours!  At Focus Bodywork we have seen many rib injuries lately, and I have my own handlebar-induced one as well.  Rib injuries come in many flavors: bruised, separated, cracked, broken, and even collapsed.  These injuries are common in athletes participating in sports where contact or crashing occurs.  You may have heard a friend talking about one of these (hopefully you have not had one of these injuries yourself), but few people actually know what these terms mean and what a rib injury really is.  Let’s clarify.

Your ribs surround your torso, protecting vital organs.  With the assistance of several muscles, ribs help our lungs expand and contract so we can breathe; two very important jobs!  Each of your twelve thorasic vertebrae (the part of your spine between your neck and low back) has a pair of ribs attached to it that wrap around your torso, and all but the bottom two attach to your sternum (also called your breast-bone) on the front of your body.  When your ribs experience a serious blow, they can be injured.  They are designed to displace or crack to absorb a serious force so your organs below are not damaged.  They are not invincible, and sometimes lungs can be punctured,  or other organs experience trauma despite the ribs’ aid.  Here are the common rib injuries:

Bruised Ribs – The muscles and connective tissue around the rib were injured, but the rib bone is ok.  The area will be sensitive to touch, and moving the torso (looking over your shoulder, bending forward) will be painful.  Discomfort from sneezing and laughing are common.  Rest, avoiding jostling activities, and icing the painful area should resolve bruised ribs in a few weeks.

rib-fractureSeparated Ribs – The rib has sprung free from its attachment on the sternum.  The site of impact will feel deeply bruised, any torso movement will be uncomfortable and it will be very touch sensitive at the sternum where the rib attaches.  A separation is a joint injury where the ligaments that hold the rib in place are injured, similar to a sprain.  This will take about six weeks of rest to heal.  Many athletes get frustrated with the healing time of this injury and return to play too soon. Separated ribs can progress to a chronic inflammatory condition that is very painful and will require ongoing medical care, do it’s best to see the rest period through.

Cracked Ribs – This is where the rib is cracked, but does not actually break.  It will be extremely sensitive to touch, and any torso movement (including breathing) is very painful.  Rest and minimal activity for 6-8 weeks is the typical protocol for healing a cracked rib.  Athletes that return to play too early risk the cracked rib progressing to a displaced fracture (where the bone breaks into two or more pieces).

Broken Ribs – This is a displaced fracture, the jagged edges of the broken rib may shred the muscles around it and can puncture the lung.  This is an extremely painful injury where moving or even breathe is excruciating.  It will be extremely sensitive to touch, may be visibly deformed and will likely bruise severely.  Six to eight weeks of rest are needed to heal, but athletes with broken ribs are typically in so much pain they won’t return to play too early!

Flail Chest – This is where several ribs are broken, and the rib cage is no longer able to assist the lungs to breathe.  This is a medical emergency.

Pneumothorax – This is where a broken rib punctures the lung.  This is a medical emergency! Fortunately there are two lungs, so breathing is sort of possible before a medical team can intervene.  Again, six to eight weeks of well-deserved rest are the norm.

Rib injuries are frustrating.  Your arms and legs work just fine, but you can’t bend, twist, lift, breath hard, laugh, sneeze and I hope you don’t get a cold with cough!  There is little you can do to speed  the healing ; it just takes rest.  Ice and anti-inflammatory drugs can help with the pain. Increasing your protein intake will ensure you have the building blocks needed for tissue repair and taking a calcium/magnesium/phosphorus supplement will aid in bone repair.  An acupuncturist can help with the pain and stimulate your body to put a lot of effort into healing the injury.  In the past, rib injuries were taped or supported with an ace bandage.  This is no longer recommended because the limited rib motion from the brace can lead to pneumonia.  The last thing you want is to have more problems breathing with a rib injury, and coughing may make you more miserable and lengthen healing time.  When the rib injury has healed to where it is not very touch sensitive and any broken bones have knit back together, massage therapy can help to restore normal rib motion.  When rib injuries heal, it is common for the intercostal muscles (the ones between ribs that pull two ribs together) to develop scar tissue and adhesions.  These muscle restrictions can limit  torso motion and the ability to breathe deeply.  Often the diaphragm (the muscle at the bottom of your lungs that helps the lungs expand and contract) has developed adhesions as well.  Using neuromuscular therapy and myofascial release, your massage therapist can resolve these tension sites, which helps you return to pain-free activity quickly.

I sincerely hope you do not have a rib injury this summer; but if you do at least it’s BBQ season.  While gnawing on some baby back’s and resting in a lounge chair, you can share some rib injury trivia with your friends.

Since your egg can be in only one basket, it might as well be a helmet!

Will this helmet make me faster?

Will this helmet make me faster?

By Emma Maaranen

It is spring, and after a cold and inverted winter along the Wasatch Front the bikers have taken to the streets again.  As I pedal around town running my errands, I cannot help but feel love for my fellow cyclists: the serious commuter bogged down in panniers, a hipster on a fixie, the matching-kit roadies headed up Emigration, and the mountain biker dusty from the just-dry bobsled trail.  But many of these cyclists are testing heart by not wearing helmets!  This appears to be a new trend, and it terrifies me.

I have heard all the excuses and arguments against wearing a brain-bucket. “It will flatten my hair”, “I’m just riding on the sidewalk to the corner market”, “I’m a careful rider.” I’ve even been in a debate with a guy who thinks buying and wearing helmets prevents more people form riding bikes and therefore a “critical mass” is not being reached.  A critical mass of cyclists, he believes, would change motorists driving habits thus alleviating auto/bike accidents.  I say that even a careful driver can be surprised by a cyclist from time to time, but fear of auto/bike accidents is not the only reason to don a brain bucket.

A tire puncture on a steep descent, a railroad track that grabbed a wheel, sand, ice, operator error… I have been victim to each of these, and once I walked off the sting of the ground I was able to ride home with only a rattle to my noggin and a renewed apprehension of gravity.  My ER doc friend has seen minor plops to the ground from bikes lead to concussions, traumatic brain injuries, strokes, comas and deaths that he believes a helmet would have prevented.

Some facts from the CDC (Center for Disease Control and Prevention):

* Head injury is the most common cause of death and serious disability in bicycle-related crashes; head injuries are involved in about 60 percent of the deaths.

* Many nonfatal head injuries from bike accidents produce lifelong disability from irreversible brain damage.

* Bicycle helmets are a proven intervention that reduces the risk of bicycle-related head injury by about 80 percent, yet bicycle helmets are not worn by most riders. Only 19 percent of adults and 15 percent of children use helmets all or most of the time while cycling.

Much research has been published in the past year about the long term effects of head trauma, and stories about athletes experiencing serious neurological and psychological diseases believed to be a result of repeated head trauma are surfacing.  Early onset Alzheimer disease, dementia and depression are believed to be directly related to a history of head trauma.  What’s frightening is that these diseases are turning up at high rates in athletes who experienced only a few hard head hits over their careers or who experienced many mild ones.  This is not a consequence of boxers and football players alone.  There is also evidence that brain deterioration is more profound if the individual is younger and if there are repeat injurys before the brain has completely healed.  For example, a mild (grade 1) concussion, which causes temporary amnesia but not loss of consciousness, will reduce motor control and the ability to focus while the brain is healing.  This may take up to as long as three months!  With these afflictions, the individual is at greater risk of another trauma.  Another head injury in this window is likely to have more severe symptoms and increased future consequences.

I think the new research into head injuries and especially repeat trauma may be enough to inspire any intelligent cyclist into the pro-helmet camp.  I’m going to invest in a few more helmets and see if I can start a fashion forward health trend!

Lift Without Lower Back Pain

Professional mover exhibiting bad lifting habits

Professional mover exhibiting bad lifting habits

By Emma Maaranen

I recently moved into a new home, and although I hired professional movers, I did a fair amount of lifting myself.  It is so easy to injury your lower back when lifting and moving heavy or odd shaped objects, but a few simple tips on lifting safely can go a long way to ensure your spine stays safe.

We put our lower back at risk when we lift heavy objects by bending at the waist.  This becomes exponentially more risky if the object is held away from the body and/or if the lifting motion involves twisting.

Here are some guidelines:

1.) To lift a heavy object like a moving box, squat as close to the box as you can.  Move your feel shoulder-width apart, and lift the box by straitening the knees and tightening your core.  Keep the box as close to your body as possible, keep your knees slightly bent while  you move and do not lean back as you walk forward!  If you need to move the box to one side, avoid twisting your body.  Instead, shuffle your feet around until they are directed at where you plan to set down the box.  Do not forget good body mechanics when you put the box down; reverse the lifting motion!

2.) If you are placing the box on a shelf or on something above waist height, move as close as possible to the shelf. To get more support, take a wide stance with one foot in front of the other, and do not lean forward or extend your arms while holding the box.  Lift the box chest high, keeping your elbows at your side, and push the box up onto the shelf.

3.) Lifting an object with a handle, such as a bag of groceries, to your side can put excessive stress on your lower back.  Stand alongside the bag, bend at your knees, grasp the handle and straighten up preventing the back from bending to the side or rotating.

4.) Finally, if the object to be moved is really heavy, odd shaped or the bulk of the weight of the object will be away from you when you move it, get a friend to help you!

Following these simple lifting principals will reduce the wear and tear on you back, make it easier to lift and carry heavy items, and keep you from needing to come into Focus Bodywork to have us work on your sore lower back. (Great for you, bad for us!)