Sunday, January 24, 2010

Walking Backwards Up the Stairs (and other PT moves)

I still have a sore achilles and so only mananged 20 miles of slow treadmill running this week. That is 8 more than last week, but I had to miss a few days after tweaking the achilles just by making a short dash to my car through a parking lot to beat my daughter.

Maybe it is good I am not running so much as I continue the Postural Restoration exercises and twice weekly visits to the physical therapist. My hip is getting stronger and as I do my exercises and strengthening moves there are many little shifts going on in my body. I am accomplishing many new movements and notice great improvements in my balance. When running on the treadmill I feel so much better, but not perfect yet. It is going to take the muscles a couple months to catch up with what my brain wants them to do. As I feel shifts in my feet, hips, or torso they send signals to other parts to re-balance and it is hard to recognize which is the proper movement and which is an old pattern trying to hold on. It is fascinating stuff.

I do about 4 Postural Restoration exercises and then many traditional strengthening and balancing exercises: like full squats on a Bosu Ball (round side down) or one legged squats (round side up). I am doing a move that starts off like a turkish getup and ends like a side plank (for my obliques), and lunges (the secret I learned to clean up my wobbly lunges was to engage the hamstrings. Now I am doing medicine ball rotation lunges (hands out straight holding the ball and move the arms side to side as you lunge over the extended knee. I started off doing all of these real poorly but have learned the balance and stability needed to execute them correctly. Here is a variation of the lunge with a medicine ball twist. It took me a while to get my hip, knee, and ankle in alignment and then all of a sudden my body "got it".

One of the four Postural Restoration exercises that I do first is called the "Retro Stairs". This is one that is supposed to "reset" my hips as well as strengthen my gluteus medius. I have been doing this daily for a few weeks. At first I started on only my left leg and hip. I push my left hip back and to the side, bend forward, and lift my right leg slowly off the ground before stepping back up to the next step. In the beginning I had zero strength to pull off this move. When I lifted my right leg up, my left leg and torso would sink together and it was hard to step back without feeling like a million pounds was on my back. When I did this on the opposite side, I could easily float right up the stairs without any problems. I complete the maneuver now with much more ease on the left side than previously, but it is still not as strong as my right side. You can see a version of the retro stairs here. It is a great hip strengthener and rebalancer. While I have done some of the other exercises in that document and moved beyond them, the second PRI exercise in my list of four that I do daily is also in the document. It is the "Single Leg Wall Left AFIR with Right Glute Max". The third PRI exercise I do is on this document. It is called the Figure 6: "Sidelying Resisted Right Serratus Punch with Right
Trunk Rotation" (OK so the rest of these names are not that catchy!). This is for my hips and twisted torso. The fourth of the exercises I am currently doing is the "Seated Alternating Reciprocal Quad Sets with IR" (found here). Of course I am doing these based on the feedback the physical therapist sees as I progress through different exercises. So far, I give my therapist and Postural Restoration the highest praise. These are exercises that I have seen no where else and they are perfectly suited and geared towards my imbalances. Now I just can't wait until my achilles feels better so that I can get back to running full-time again.

If you are in the southern New Hampshire (Nashua) area and are looking for an excellent physical therapist, Jackie is definitely the person you want to get referred to by your doctor. If you are interested in the Postural Restoration therapy, I think she is the only person doing this in the area. Here is her business card:

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