​​Recently, I just completed a certification course looking into the most recent and evidence based ways to treat low back and neck pain! In doing this, I earned my certification in Orthopedic excellence of the spine. During the course we discussed ways to group patients into different categories based on their pain so we can best treat them with specific techniques and exercises! 

If you are someone that falls into one of the four categories listed below, I believe we can help you reduce your pain and get you back to doing the things you love to do! 

1) Low back pain or neck pain with mobility deficits: 
This category is for people who are suffering from either low back or neck pain that are also experiencing trouble with turning your head, bending forward to touch your toes, or twisting to reach for objects. Typically, the pain is localized to either your low back or neck region and does not radiate or linger into other areas of your body such as your legs or arms. 

2) Low back pain or neck pain with coordination deficits: 
This category is for people who have a difficult time contracting certain muscles in either the low back or neck that are responsible for stabilizing the spine. Typically we see this in patients who have just experienced a car accident. In the neck region, this is associated with whiplash that many would get from an impact collision. If you are someone who has recently been through an accident and has since been experiencing low back or neck pain then this category is something you may fall into! 

3) Low back or neck pain with radicular symptoms: 
This category is for people who experience low back pain or neck pain that is radiating into your arms or legs. Typically, the feeling is described as "numbness or tingling" and can be very debilitating. Some people may only experience these symptoms in the arms or legs and may not even report low back pain or neck pain. If you think this is something you are experiencing then this is likely resulting from a compressed nerve. But don't worry, we can help you with this! 

4) Neck pain with headaches: 
Many times, headaches can result from increased tension in the muscles located in the neck and/or shoulder region. Headaches can also be associated with increased stress levels and prolonged postures during the day. If you are someone who experiences headaches throughout the day, it could be a result of something going on in your neck. 

If back pain prevents you from doing the stuff you love text BACKSCREEN TO 845-225-2000 and claim one of our 10 free back screens! ​

​Tony talks about his 5 Running Essentials.  In this episode he talks about 5 items he uses everyday for running.  Here are 5 quick running essentials that you should be using!

1. Shoes are definitely essential when it comes to running, you want to make sure you have comfortable shoes!  Tony uses Hoka Arahi and Nike Vomero running shoes.  These are 2 shoes he is rotating with for training.  
2. A running watch is great to have to track the time, heart rate and pace!  Tony likes to use a garmin forerunner watch that tracks a whole lot of data, heart rate,and his pace.  Another option is just an old school casio watch that just records the time! (www.garmin.com)
3. A good pair of shorts is needed for running!  Tony likes to wear the Tracksmith session shorts.  They are comfortable, sweat doesn’t stay on them, no chaffing and you can wear them around all day if you wanted! https://www.tracksmith.com 
4. Sunglasses are great to have when you are on a run so that you can see if it's a sunny day!  Tony uses a $25 pair from a company called Goodr.  They are nice because if they break it was only a $25 pair of sunglasses compared to $150 ones!  They have polarized options, different lens/frame colors and styles!  https://goodr.com 
5. Lastly, you want to make sure you have a good comfortable pair of socks on while running!  On amazon there is a really great 12 pack of socks for under $15!  They are made by a company called Bering. https://www.amazon.com/BERING-Athletic-Quarter-Running-Training/dp/B076FRJTY9/ref=sr_1_4_sspa?keywords=bering+socks+men&qid=1660833560&sprefix=bering%2Caps%2C71&sr=8-4-spons&psc=1 

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Tony gets a lot of questions whether he does strength, resistance or weight training as a runner and triathlete.  In this episode he talks about strength, resistance and endurance training for athletes.  Here are 5 quick benefits of why you should be doing that if you are a runner or triathlete!

• The biggest reason you should do this is because it can prevent injury and give you proper form.  It will prevent any muscle imbalances and or discrepancies whenever you step with your right, left foot or swing one of your arms-stuff like that!

 

• It will improve your running economy and help make you an efficient runner.  

 

• If you lift weights you will get faster.  So by lifting weights you will increase your power output.  This will make you able to generate more force while you are running.  This will make you faster!

 

• You will maintain fitness longer as you age!  That means you will detrain faster by being stronger as you get older.  

 

• Strength training will make you stay leaner.  The calories you are going to burn and more muscle mass you will have.  Overall you will be leaner from lifting as opposed to endurance training like swimming or running all the time.

 

•  Along with that the type of lifts you do if you do multi joint lifts such as, a deadlift, a power clean.  Those will benefit you more so rather than doing an isolated movement like a one body part movement!

Graston technique is a unique, evidence-based form of instrument-assisted soft tissue mobilization that enables clinicians to effectively address soft tissue lesions and fascial restrictions, resulting in improved patient outcomes.

When you combine Graston technique with some of the exercises we give you in the clinic it’s going to help you improve your motion and function. This tool kind of looks like a butter knife, some are in an s shape and are different in thickness and size.

• Is Graston something that is new?

It is not something that is new, it was originally founded years ago.  The results you'll get are 75-90% of conditions it is used on in restoring function to acute and chronic injuries, pre and post surgical.  If you come into the clinic we likely will use it if you have an ACL tear or some kind of incision.  We would use it around those scars to make sure you don't develop anymore scar tissue around those incisions.

• What conditions can be treated?

It can be used around scars, very common with Achilles tendinitis, lateral epicondylitis in the elbow and patellofemoral disorder.  We like to use it a lot on the tendons because it helps loosen them up.  Tony likes to use Graston!  It is a great form of instrument assisted therapy.  Sometimes he likes it better than massaging in the quad area on a client.  He feels like it works better and gets deeper!

With this stainless steel tool It works in a way that your hands or other tools cannot.   This helps Set Graston apart because the whole patten is inside the edge and curvature. You can purchase a tool like it on amazon, but you won’t get the same results. Tony feels like when using it on himself and on patients it works great!

Kinesio Taping is a stretchy, moveable tape.  It comes in different colors and stabilizes the injured area lightly by adhering to the skin and applying pressure to the tissues the tape is wrapped around.  This is very popular with Olympic athletes who use this tape to alleviate pain and improve blood flow!

• A patient asked which tape is the best one to use?

There are a couple different kinds of tapes.  You want elasticity and want it to stretch up to 140% normal length, be light, hypoallergenic, latex free, air permeable and durable. Kinesio Taping can last anywhere from 3-5 days per application depending on what you use it for. For our patients we like to use Rock tape. 

• Is there a difference between the colors?

There is no physical or chemical difference between the colors!  Tony prefers the black tape because he thinks it is stronger.  The lighter color tapes are good to use if you want minimal visibility.  Other colors you can match with your uniforms if you want! Color choice is a matter of individual preference.

• Is it the tape or the technique?

 It is all about the technique and how the tape is applied.  This will help alleviate pain and facilitate lymphatic drainage by lifting the skin.  This lifting technique forms convolutions in the skin increasing space and allowing for decreased inflammation in affected areas!

• How is the tape applied?

It is applied over the affected area, the muscles will be in a stretch position and then when the tape is applied.  You will stretch the tape and then apply it down to the skin.  It will be constricting a little or stretching out, but this all depends on how you apply it.  

​They sell Kinesio tape at stores like CVS that you can purchase and use at home.  It is important to make sure skin is dry, oil free, no lotion, and sweat free.  You should try to not get the tape wet for an hour after it is applied.  They say it's heat activated so you'll have a better adhesion if it is gently warmed up with a hairdryer- don't hold too close!  Natural movement of the body will generate enough heat to give it a good stick as well!  Mostly all tapes are water resistant.  Just read the back of the box to make sure yours is!  I believe they all offer water resistant tapes such as Kinesio, Kt and rock tape.

Today Tony talks electrolytes! Patients have been asking Tony what he uses to replenish and what they should be using.  

Each person has about 100 sweat glands that are about a quarter the size of your skin which makes you have about a total of 2.6 million sweat glands.   The amount of sweat you excrete will depend on gender, fitness level, weather conditions, and altitude.  The importance of sweating is to cool your body down.  When you work out your body temperature will increase and can rise anywhere up to 3 degrees and that will trigger your body to start sweating.  When that happens you'll lose water and electrolytes.

What are electrolytes?
Electrolytes are substances that have a natural positive or negative electrical charge when dissolved in water. They help your body regulate chemical reactions, maintain the balance between fluids inside and outside your cells! 
What do electrolytes do?
Magnesium, calcium, potassium and sodium are critical to body function.  They help balance the amount of water in your body and help maintain body PH levels.  

How much electrolytes do you need?
The amount of electrolytes you will need will vary by person.  Tony’s favorite electrolyte supplement is UCAN Hydrate Powder.   It comes with a scooper and you just add a little bit to your water!

What are the signs of electrolyte imbalance?
Signs of electrolyte imbalances can lead to decrease in performance, muscle spasms, weak, dizzy, tired, nauseous, constipated, dry mouth, dry skin,urine and pain.  A large majority of muscle cramping can also be due to lack of muscle fitness too.  So this could just mean you are overworking your muscles.

This is why electrolytes are so important!  They regulate and control the balance of fluids in the body.  Stay hydrated!!

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Running Shoe Basics

Tony wore a different pair of shoes to work this week and got lots of questions on what shoes are good to use for running.  So here are 5 tips on what you should consider when buying a pair of running shoes:
1. Shoe Size
Shoe size is important because it is very important to wear the correct size shoe.  Tony likes to buy his running shoes true to size, but the size you buy is up to your personal preference.  You want to make sure your toes have room to spread wide and they shouldn’t feel constricted where they touch the end of your shoe.  It is important for your heel to feel comfortably cupped in the back of the shoe too, this will make it so your foot doesn’t slip!  Try on different shoes until you find the ones that fit and feel the best!
2. Stack Height
​Stack height is the amount of shoe material between your foot and the ground.  This is expressed in the millimeter height of the heel and just below your toe.  A high stack usually is 40 millimeters and has more cushion. Low stack height shoes such as track shoes are about 20 millimeters.  Minimal and low stack height shoes are best for people who prefer feeling the ground over the cushioning of a shoe.  Highly cushioned shoes are good for someone that prefers feeling the cushioning of a shoe instead of the ground.  It depends on whatever you prefer!
3. Heel Toe Drop
This is the difference between the level of the heel and level of the toe from the ground. Take one and minus the other and that will give you your heel toe drop.  The greater the drop the steeper the angle from the ankle to the forefoot.  The lower the drop is considered by many to have a lower impact on the stride. The lower the drop the more the Achilles tendon is going to have to work.  The best amount of drop is a personal preference. Anything over 7 is considered a high drop and under that is going to be getting closer to that barefoot feel. Most shoes are at a drop of 6, but it’s up to you what you prefer.  
Tony sees it all the time when someone comes into the clinic and they just started running or bought a new pair of shoes.  They feel like they get a new ache or pain while running and they aren’t sure what happened.   This is because shoes have different stack heights so it creates different forces through the leg!
4. Stability or Motion Control
Stability running shoes are best for over pronators or if you have more of a flat foot.  These shoes are often more rigid and are made to support the arch of the foot, which will provide greater support through the midsole that can also extend into the heel.  Stability shoes are something to consider if you get aches and pains!  Motion control shoes can be a little stiffer and heavier than a stability shoe.  Sometimes motion control shoes have some additional heel cup support and other features in the shoe that stop the foot from rolling when running.  Stability and motion control shoes are both great options for runners and should be based on what works best for you!



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