Archive for 'exercise treatment'

Stepped Care Model

Stepped Care Model to Exercises

 

You may have heard of the term stepped care model. This often means that you are being treated in a conservative manner prior to doing anything more dramatic. With muscles, we use a stepped care exercise model. You don’t proceed to the next step without fulfilling the previous one. Our exercises are based on the following steps:

 

Relaxation –> Limbering –> Stretching –> Strengthening

 

First step is to relax the muscles to relieve tension caused by stress. This may sound easy, but without proper relaxation of the muscles, the muscles will not easily move.

Limbering is moving within your range of comfort, and stretching follows with gentle movement beyond the comfort range.

 

Strengthening is last because if you strengthen a tight muscle, you are only going to be making it tighter, which might make you feel worse.

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The Start of Baseball Season

The baseball season just opened and already players are calling off their first few games due to “tweaked knees” and “sore backs”. As the sun is starting to come out, and the snow is (FINALLY!) melting, many of us are anxious to get outside and start playing sports again. However, this is also a time where pain can start rearing its ugly head. Many people forget to limber and stretch properly before AND after playing sports, causing strains and sprains of muscles.baseball

So keep in mind these important tips to get moving again this spring:

  1. Do gentle limbering stretches every day to help maintain flexibility of your muscles.
  2. Stretch before and after any exercise.
  3. Start slowly – if you haven’t moved all winter, start with simple exercises, like walking, before starting anything more difficult.
  4. If you’re feeling extremely sore the following day, it means you may have done too much. Cut back on the difficulty and amount of time the next time you exercise. Slowly increase the difficulty and the length of the session. A safe rule of thumb is to start out after a long layoff at 50% of your prior routine and then increase 15-20% every 5-7 days as long as you feel okay at any level before going to the next.
  5. Drink lots of water!
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Stiffness is an important aspect of muscle pain

I recently saw George, a 48-year-old man, who suffered from pain, described as soreness in the thighs, neck, shoulders and arms, and tingling in his calves and shin. Sitting for more than two hours or sitting for more than 20 minutes would cause an increase in his pain.  Bending over also brought on his pain.

George had tried physical therapy on multiple occasions, and saw two neurologists, who could not find anything that would explain his pain.

When I examined him, I found him to be strong but very stiff. When he bent over, he was able to reach within 14 inches of the floor. When he lied on his back and lifted one leg up at a time, he was able to reach only 57 degrees (85 75 degrees is normal). Because he was so stiff, I decided to start a course of exercises that would help increase his range of motion.

Over the next few weeks, George learned all 21 of the Kraus-Marcus exercises, which he was advised to do every day. As he did the exercises, he noticed that his pain level was decreasing and wasn’t occurring as often as usual. When he was taught the last 7 exercises, he was able to bend over to within 9 inches of the floor, and could lift each leg to 80 degrees.

A month later, George reports a 90% decrease in his overall pain.  Sometimes we find that starting with the most conservative of treatments can prevent us from performing more costly and dangerous treatments. Very often, stiffness is an important aspect of one’s pain that can easily be found and treated!

 

 

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NORMAN MARCUS PAIN INSTITUTE
30 East 40th Street - New York, NY 10016
Tel 212-532-7999 Fax 212-532-5957
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