What to expect and not to expect from physical therapy

Are you wondering what you should expect from physical therapy? Or maybe what you should not expect? As a physical therapist for the past 12 years and as a movement specialist for the past 24 years, I can confidently share what you deserve in physical therapy.

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What you should expect from physical therapy

1. Thorough evaluation

You deserve a thorough evaluation, no matter what you are reaching out to physical therapists for, whether that’s movement issues, chronic pain, acute pain, vestibular, balance issues, post surgery, pre surgery, or any other reason.

That means not only a physical therapist should be looking at your current symptom (s), but they are looking to figure out why they happened in the first place, even during post-surgical cases. A thorough evaluation includes looking at a detailed movement assessment, where your compensation patterns lie, what might be driving some of the issues you’ve had, and all of your modifiable lifestyle factors. How is your sleep? How is your nutrition? How are your relationships? How is your stress management? If your therapist is missing these details, they are missing a huge element of helping you heal.

2.  Practicing what they preach

You deserve a physical therapist who practices what they preach, whether that’s movement, balance, or exercise. They should be a health leader, educator, and movement specialist, and because of that, they have an obligation to be able to do the things that they are recommending that you should do.

3. 1-on-1 care

It is hard to find 1-on-1 care in today’s healthcare environment. I worked in the outpatient practice for eight years, so I understand a busy outpatient setting, and unfortunately, the demands of insurance companies are dictating this. However, you deserve to be able to be the only person in the room, to be listened to, and to have your therapist understand your diagnosis, prognosis, underlying causes, current concerns, goals, and plan of care without being pulled in a million directions. One-on-one care is extremely important, whether that’s 30-minute sessions or 60-minute sessions.

4. Someone who will look at you as a whole person

You should expect someone who listens to your story and understands that you are not a “shoulder problem,” you are not a “hip injury,” and that you are a person; you are human with a story and emotions and thoughts and all the things that make you wonderful. So, make sure that someone is looking at you as a human with a beautiful story, not just an injury.

5. Mindful and intentional movement

You should expect a therapist to help you perform mindful, intentional movement to help guide you to move with interoception, internal awareness of self, to be able to understand movement quality, as opposed to high-volume exercises with poor form.  As movement educators, one of the greatest gifts we can share with you is to help you move your body the way it was intended to so that you can continue to do the things you love.

What you shouldn’t expect from physical therapy

What are some of the things that you should not expect from physical therapy? This is equally as important.

1. You should not be on things that will not help you get well

You should not be on hot packs, cold packs, electrical stimulation, ultrasounds, or other modalities that aren’t helping you get well. They are sometimes time-savers for the therapist, but they are not actually creating better movement in your body. They’re not getting to the root of your issue. They are not moving you forward, and you want to be able to maximize your time spent in physical therapy.

2. You shouldn’t be warming up on machines

You don’t want to get to physical therapy and go on the treadmill or bike to warm up for 10 or 15 minutes. You want to learn how to move your body. Every minute counts!

3. You shouldn’t be on tons of band exercises

You should not be going through tons and tons of band exercises with poor form without guidance. Especially when you feel like you are going through the motions and you could do this at home.

If you feel like you could do that at home, that’s your first sign that this is not a good fit.

I want everyone to believe in physical therapy. We have an amazing opportunity to share with you the gift of movement.

In summary, when you think physical therapy is a waste of time, you’re put on machines and lots of modalities, and you feel like you are competing for your PT’s attention, you deserve better.

Please make sure to find a great physical therapist in your area who does one-on-one care, that looks at you as the whole person, that addresses potential root causes of your injury or your pain or any other issue that you might be experiencing.

If you need help, please reach out to us, we do virtual and in-person care, and we perform holistic physical therapy. Schedule your evaluation here: https://p.bttr.to/3qHXz8i

If it was helpful, give it a like, share it, and subscribe to our YouTube channel, The Movement Paradigm, for weekly tips on mindset, nutrition, and movement.

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4 ways to improve your shoulder stability and symmetry

Are you struggling with a strength deficit or you keep getting injured? Well, it’s really important to address your shoulder stability and symmetry to be able to optimize your overall strength, performance, and movement longevity.

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What is stability?

Stability is defined as sequencing, timing, and coordination, also referred to as “motor control.” It is different from strength which is defined as how much force we can generate. The best way to improve stability is through isometric contractions that create fascial tensioning— tension around the joint. Think of our stabilizers as muscles that are close to the joint. If we’re referring to the shoulder specifically, the rotator cuff close to the joint.

What is symmetry?

The first thing to recognize is that we are asymmetrical beings because of all the placements of our organs. However, asymmetry in movement can be a predictor of injury. For example, if we can move our right shoulder in a certain range of motion and we are very limited on the left, that could be a huge predictor of injury. As you are working through a proper training program, you want to try to create symmetry. The exception to that rule is high level athletes, like golfers, who whose asymmetry can contribute to their peak performance. To do that, it’s great to do unilateral exercises to see how the right shoulder compares to the left shoulder and vice versa, for example.

4 ways to improve your shoulder stability and symmetry

Although there are many exercises that you could do as well as assessments, I would suggest these few exercises that I think can be very valuable in assessing as well as treating your shoulder symmetry and stability. Now, if any of these progressions are too hard for you, please do what feels appropriate.

Here are four ways to improve your shoulder stability and symmetry:

1. Kettlebell screwdriver

Start with a kettlebell hold. You want to think about packing the shoulder, bringing the shoulder blade down towards the ground and down towards your hips, maintaining that tension in the shoulder while you slowly rotate it in and out. From there, you can move towards a kettlebell arm bar.

Link to Video

2. Kettlebell arm bar

For this, drive from the hips, while keeping the shoulder stable the whole time, moving into your arm bar position where you’re gazing up at the bell. Hold that position for 30 seconds to 1 minute and then come back to your start position while initiating the movement from the thoracic spine.

Link to video

3. Side kick through and crab

Based on animal flow, start from a beast position and drive the ground away and you reach one leg through. Then you can also move into a crab, maintaining strong shoulder integrity.

Link to Video

4. Halo

Lastly is the halo to bring it all together, integrating your core. From a tall kneeling or half kneeling position, while using a kettlebell, bringing it around the head while maintaining a strong foundation.

Link to Video

If these exercises were helpful, please make sure you give it a like, share it with a friend or family member who might need this, and of course, subscribe to our YouTube channel, The Movement Paradigm, for weekly tips on mindset, nutrition, and movement.

If you need help with your shoulder, please make sure you reach out. We can see you virtually or in person and would love the opportunity to help you on your journey.

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A neck exercise that really works

Optimize all 3 brains

A neck exercise that really works

Are you performing aggressive chin tucks due to your neck stiffness or neck pain with no results? Well, instead, try out this very simple and effective technique that works wonders.

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As a physical therapist for the past 12 years and being in the movement industry for my entire career, I’ve realized that chin tucks are prescribed so often, aggressively. As always, it is important to address root causes of why forward head posture is happening in the first place.  

In our previous videos and blogs, I’ve gone into more depth about forward head posture, and we have to think beyond just the mechanics of it. Is there an airway restriction? Is there emotional and nervous system dysregulation that’s contributing to poor posture? Aside from that, we want to also think about what forward head posture is doing to our nervous system.

What forward head posture does to the nervous system

Poor forward head posture can affect our vagus nerve (and other cranial nerves) and create more dysregulation in our nervous system. It can compress some of our spinal nerves as well as our cranial nerves, which have very important functions.

With that said, we have to think beyond just chin tucks and respect the nervous system.

One of my favorite basic techniques, which is a myofascial technique, stimulates the vagus nerve. It can ultimately help bring us into a better mechanical position and begin to reinforce optimal mobility in the spine.

How to perform

To perform this exercise, think about where the vagus nerve exits right behind the ear. Take both hands and place them right behind the earlobe. Traction that tissue up in the direction of the ear.

Place your hand on the tissue, move the tissue over, tractioning it up very gently, and you will almost immediately or shortly thereafter feel a sense of relaxation that could come in the form of a sigh, a swallow, or a yawn — it could just feel like a simple sense of relaxation.

You should feel like you’re actually placing the neck in a more neutral position, creating a natural lengthening of the spine.

Once you assume that position, from there, move through a gentle range of motion — forward bending, backward bending, rotation, and even side bending. What that will do is give good feedback to the nervous system because you’re actually stimulating the receptors in the joints and signaling to the brain that this is a good position. This feels safe. This feels pain-free.

Begin to incorporate this exercise frequently throughout the day. It’s easy, only about a minute, and can be very effective. 

Are you interested in seeing how we can help you with your neck pain, shoulder mobility, etc.? Schedule your 15-minute discovery session here: https://p.bttr.to/3qHXz8i

If you are ready to take action now, schedule here. https://p.bttr.to/3Qu7wRd

I hope this is helpful. If it was, please give it a like, share it, and subscribe to our Youtube Channel — The Movement Paradigm — for weekly tips on mindset, nutrition, and movement.

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Jaw-Emotion Link

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Jaw-Emotion Link

If you experience jaw pain, you should know about its link to emotions. Poor vagal tone is linked to things like clenching and grinding.

When we have overstimulation of the trigeminal nerve from the masseter muscle, one of our main jaw muscles, we are in sympathetic nervous system (flight/flight) overdrive. Clenching or grinding your teeth at night or during a stressful situation is very common.

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Other Factors that Affect Jaw Pain

Poor tongue posture can also contribute to jaw pain. The tongue should be on the roof of the mouth and gently touches the back of the teeth in our resting tongue posture.

If we have dysfunctional breathing or breathing from the neck and shoulders, that creates a stress response. That can further drive dysfunction in the trigeminal nerve.

The trigeminal nerve innervates the muscles of the face, sinuses, and nasal cavity. It is one of the biggest nerves that we want to associate with our sympathetic nervous system, our fight or flight system. It is also deeply connected to the vagus nerve.

Our vagus nerve is 80% of our parasympathetic nervous system. These two nerves are bringing information to the brain and affect transmitters such as serotonin and noradrenaline, which are linked to neuropsychiatric disorders such as depression and anxiety.

Ultimately, when we have dysfunction or miscommunication in these nerves, whether the sympathetic nervous system is increased or the parasympathetic nervous system is decreased,  then this can contribute to jaw pain. 

Most often, you’ll see clenching and grinding at night. Our reticular activating system is part of our brainstem and when we’re sleeping, our cerebrum is at rest and our reticular activating system is that alert system that is going to tell us if our child is crying.  Think of it as our survival mechanism. So during sleep is often where we’ll start to see the sympathetic overdrive kick in. 

Takehome Message

The take-home message is that there is truly a jaw-emotion link. If you’re suffering from TMJ, have your airway evaluated. It is important to make sure that there are no structural abnormalities that are contributing to it. However, you also want to dive into the emotional aspect of it. Explore your emotions, learn how to regulate your nervous system, try many of my vagus nerve hacks, speak to a professional. Find what works for you. 

I hope this was helpful if it was please give it a share with your friends and family. Make sure to subscribe to our YouTube channel The Movement Paradigm for weekly tips on mindset, nutrition, and movement.

Reach out for a 15-minute FREE discovery session to see how we can help you on your journey.

For more content, make sure to subscribe to our YouTube channel here.

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Stop Stretching Your Hamstrings

Have you been stretching the heck out of your hamstrings for years with no improvement?

Most people think that when we are stretching, we are lengthening the muscle. Unfortunately, that is not true. What we are doing is creating the neurophysiological response to convince our nervous system that we are safe in a new range.

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What is actually happening when you stretch?

When we are stretching too far, especially in the case of hamstrings, you have proprioceptors in the muscle fibers that signal to the brain to tell it, “Hey, this is a vulnerable position.”

We also have a stretch reflex that functions as a protective mechanism that you’re going too far. So when you begin to have this pain, irritation, or a sense of discomfort when you’re stretching, that means that you are not making a change. We have to think about changing our nervous system, so let’s get into how to do that.

Let’s use the classic toe touch test as our example. When we are touching our toes and reaching down, what ideally happens is that the pelvis shifts backward which allows for a uniform curve in our spine.

Most people that can’t touch their toes will see all of their motion is coming from their spine and there is no motion coming from the pelvis. That means that they’re not getting a natural sequencing in flexion, or forward bending, pattern. To change that pattern, we have to think about how is the pelvis and trunk sequencing with the rest of the body.

One of the most basic things from a biomechanical standpoint is to look at the position of the pelvis. Ideally, in a neutral position, we have our rib cage stacked over top of our pelvis. If our pelvis is tilted forward, an anterior pelvic tilt, or it’s tilted backward a posterior tilt, this changes the length of our hamstrings.

Our hamstrings, just like any other muscles, contract, relax and lengthen. When they are in the lengthened position, it might present as a tightness but doesn’t mean they are tight, and in fact, might need to be strengthened.

Essentially when we have one of these pelvic positions, then that means that our deep intrinsic stabilizing system, our pelvic floor, diaphragm, and our deep stabilizers of our core are not sequencing well.

If they’re not doing their job, including the deep stabilizers of the hip, then our glutes can never really produce the appropriate amount of force. We have to have enough stability to be able to generate force through our glutes.

So what happens if we’re not using our glute and we’re not using our core properly? Then, the hamstrings present as tight because we’re having a global tightness or facilitation from our nervous system. Our nervous system is saying “Hey, I have to tighten up something to create some stiffness somewhere.”

So what can you do?

Reestablish your breathing and pelvic position. Using a diaphragmatic breath, breathing into the base of the abdomen, all the way into the pelvic floor, and getting that ribcage stacked over the pelvis. It is important to do this in a variety of different movements and patterns. Everything from standing, sitting, quadruped, and lying on the ground; establishing this and integrating it into all of your movements and activities.

Here are a few things that you could do, most importantly reestablishing new movement patterns, especially a posterior weight shift of the pelvis. Allowing for proper sequencing in the pelvis reinforces that your nervous system isn’t in protective mode all the time, using hamstring stiffness as a way to protect your body.

3 Exercises To Establish New Movement Pattern

Here are some exercises you can perform to help you establish this new movement pattern.

1. Rock on Forearms

To perform this exercise, place your elbows and knees wide on the ground. Inhale as you rock back, only bending from the hips and keeping the spine straight. Exhale as you return slightly over your shoulders.

2. Hip Hinge

For the hip hinge, place a dowel behind your back touching your pelvis, middle of your shoulder blades, and your head. Inhale as you go down, hinging in your hips backward and allowing the knees to bend softly. Exhale as you come up.

3. Toe Touch Progression

For the toe touch progression place a block between your thighs and start with your toes elevated. Inhale as you reach up, and exhale as you reach down to touch your toes. Then you’ll reverse the direction by putting your heels up on the board and toes down, and performing the same thing. This creates a natural posterior weight shift in the pelvis and activates the deep core.

Reach out for a 15-minute FREE discovery session to see how we can help you on your journey.

For more content, make sure to subscribe to our YouTube channel here.

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Vagus Nerve Hack | Pelvic Floor Relaxation

Another great vagus nerve hack that you can do is pelvic floor release and relaxation.

The vagus nerve is integrated with a sympathetic nervous system (fight/flight) almost everywhere in the body, but especially the gut and the pelvis. What’s interesting about the pelvic floor is that we tend to hold so much tension here. This is where we tend to hold our emotions, too.

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Let’s dive into the anatomy. The posterior vagus nerve actually integrates with a network of sympathetic plexus with a network of nerves:

  1. celiac plexus
  2. superior and inferior mesenteric plexi
  3. superior and inferior hypogastric plexi

This plexi actually forms an integrated circuit that moves blood flow in and out of the pelvis, and this is exactly what the autonomic nervous system is all about—moving blood. This network of nerves is where the vagus nerve brings blood to the heart and brain. Lastly, urination, defecation, sexual orgasm all require this complex integration of all of these nerves and blood flow from the pelvis to the rest of the body. In order to do all of those things, we have to feel safe in the bedroom as well as in the bathroom. Safety is the cornerstone of our state of social engagement of the ventral vagal nerve. Check out the video HERE to see how to perform:

1.   Pelvic Floor Release

Sitting on a ball and addressing the pelvic floor musculature is a great way to create this efficient relaxation response. The placement of the ball is behind the pubic bone to address the front of the pelvic floor and then right inside of the buttocks to address the back of the pelvic floor. Sit on the ball and breathe diaphragmatically until you feel a release or relaxation response.

2.   Happy Baby

This is a great relaxation exercise where there are lots of variations. However, you just need to get to a position where you feel very comfortable, and you’re able to inhale into the pelvic floor. When you are inhaling, that’s when the pelvic floor is relaxing and you are opening the pelvic outlet.

3.   Rock on Forearms

Resting on the forearms and knees wide, inhale as you rock back and exhale as you rock slightly forward. Once again, you’re opening up the pelvic outlet, inhaling into the base of the pelvic floor to create that relaxation response.

The pelvic floor is one of the most fascinating connections with the vagus nerve, so it’s a really great way to address this from a chakra standpoint. It tends to be an area for clenching and guarding, and especially for holding emotions.

You can see this intimate relationship with your nervous system and how it could affect you.

Reach out for a 15-minute FREE discovery session to see how we can help you on your journey.

For more content, make sure to subscribe to our YouTube channel here.

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8 causes of LOW BACK PAIN that isn’t a weak core

Do you have low back pain, and you’ve been told that it’s from a weak core? Here are eight reasons why it may not be coming from your core.

One in four people experience low back pain in their lifetime, and it is also one of the number one causes of the opioid epidemic. Most people that are seeking pain medication are coming in initially for low back pain.

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One of the things that is important to recognize with acute low back pain is that it can be treated very easily. However, because of the nature of our medical system, we tend to go to our primary care, get a muscle relaxer and pain medication, and get referred potentially for an X-ray. The X-ray doesn’t show anything, but you still continue to have low back pain. Now you are referred for an MRI but still don’t show anything except for some degeneration, which everyone after the age of 35 is going to have. You still don’t have any answers, so you get an injection. Then three months after this acute low back pain episode, you’re still having pain. Now you are in a chronic pain state. 

Chronic pain is much different than acute pain. It is defined by having pain greater than three months and is referred to as central sensitization. Our nervous system becomes sensitized. We have no tissue damage, however, the brain is still interpreting that there is pain in, let’s say, for example, the low back.

Here are eight root causes of your low back pain, that isn’t simply a weak core. All these can also contribute to acute and/or chronic low back pain.

1) Poor Breathing

Our breath should be a diaphragmatic breath. We breathe 20 to 25,000 times a day. If we are not breathing from our diaphragm, then that means that the sequencing of our entire abdomen is affected. It also creates a stress response.  

2) Movement Compensations

When we think of how pain or injury ultimately happens, think it’s when anatomy meets opportunity. If you have an ankle sprain, let’s say three months ago, and although it’s getting better, there’s still some stiffness in the ankle. Now every time you are walking and striking the ground in dynamic movement, there is asymmetry. You have different forces that are being transferred up through your body.  That means that now you’re going to begin to compensate. You’ll change how my foot strikes the ground; how your pelvis is moving. This can be an example of how any movement-compensation, especially over a period of time, can ultimately lead to pain and or injury.

3) Stress

This can not be emphasized enough and how it’s one of the biggest factors in low back pain. Not only can we hold tension in our abdomen and our pelvic floor, but it also shifts our breathing to an upper chest breathing pattern. Additionally, stress is linked to inflammation. Without a doubt, I’ve seen in my clinical practice that this is one of the biggest driving factors of low back pain, especially chronic low back pain.

4) Poor Sleep

Inadequate or interrupted sleep is actually one of the biggest drivers of low back pain. Poor sleep also shuts down the release of our growth hormone, which is needed for repair and healing.

5) Chronic Inflammation

Ninety percent of all health conditions are linked to excessive or persistent inflammation; from eczema to anxiety, depression, and even Alzheimer’s. Now, when we think about inflammation as it relates to our musculoskeletal system or nervous system, inflammation will contribute to pain, joint stiffness, joint inflammation, osteoarthritis, and more. This can also consistent with chronic low back pain.

6) Sedentary Lifestyles

This can be one of the biggest drivers of recurring low back pain, per some of the research. We are meant to move; our bodies crave movement. We do not want to be in one position all day long. As you’re thinking about your day, think of it from a ‘movement mindset’. It doesn’t have to be exercising 30 to 60 minutes; you need to be moving all day long.

7) Poor Gut Health

Your gut is your second brain, and we have an entire nervous system located right there. If there are gut issues, that means there are inflammatory issues. Without a doubt, because we have 70 percent of our immune system in our gut, and we have this nervous system, when we are having visceral pain, this will influence the sequencing, timing, and coordination of all of our muscles and our abdomen and pelvis. It is definitely something that can contribute to low back pain, especially in the case of bloating and constipation. 

8) Lack of Movement Variability

As I mentioned earlier, our bodies crave movement. When we are in sustained postures all day long like sitting at a desk or crossing our legs in one direction, not changing positions consistently throughout the day, then our fascial tissue, our three-dimensional network, or ectoskeleton can get sticky. It is meant to be elastic, create tension, and transfer force efficiently. If we are sitting in sustained postures throughout the day and not changing positions, like getting down to the floor and getting back up, this can, unfortunately, contribute to low back pain.

There you have it; eight different root causes of why you might have low back pain. There are, of course, other things like pelvic pain and other medical conditions, but hopefully, you can appreciate that it is not necessarily because you have a weak core that you are having low back pain, and if you strengthen your core it’s going to get better. You want to look well beyond that. 

Reach out for a 15-minute FREE discovery session to see how we can help you on your journey.

For more content, make sure to subscribe to our YouTube channel here.

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WHAT SHOES TO WEAR FOR FOREFOOT PAIN

Do you have forefoot pain or pathology and you’re not really sure what shoe you should be wearing? There are numerous foot pathologies that you could have, however we are going just zero in on a few today, such as bunions, first metatarsal joint arthritis, neuromas, and plantar plate tears.

Before we get into details about each, let’s just go over some quick anatomy.  The forefoot includes the phalanges (toes), the five metatarsals, and the connective tissue.

Now, let’s jump right into our foot pathologies and what feature in the shoe you should be looking for to accommodate for your pain.

  1. 1st MPJ arthritis:

This 1st metatarsal phalangeal joint is also referred to as the great toe. This is caused by the joint jamming too early in the gait cycle or an inflammatory reaction.  If you have arthritis in this toe and it is either painful and or limited in mobility, then the most important feature for your shoe will be a more rigid midsole. Secondly, you’ll want a wide toe box so that you have room for your toes to splay properly.

midsole

2. Bunion:

A bunion occurs when we lose stability in the metatarsal cuneiform joint (first ray). The first metatarsal will swing out and create a valgus position on the great toe. With a bunion, you definitely want a wide toe box. Because a bunion is caused by a lack of stability in the 1st ray, this often indicates that the foot is likely an unstable, everted foot type. In this case, a stiff heel counter in the back of the shoe will help control the foot so that it does not overpronate.

heel counter

3. Neuroma:

A neuroma is a scarred or fibrotic nerve often between the third and the fourth metatarsal. The nerve rubs on the fascial tissue and then becomes fibrotic.  This typically occurs from a loss of stability in the foot and/or compression in footwear, among other things such as injury. What will be most important with acute symptoms of a neuroma will be a stiff midsole. If the midsole is flexible, and you have an active, painful neuroma, you will continually compress the nerves at toe-off in your gait. So when your foot is more irritated, a stiffer midsole with a wide toe box will be most beneficial. 

toe box

4. Plantar plate tear:

The plantar plate is an extension of the plantar fascia that runs horizontally across the joints. A plantar plate tear can be very painful, and you’ll want to immobilize the tissue for a period of time. In this case, once again, you’ll want something more rigid in the midsole. During an acute injury, you will want to immobilize the tissue for a period of time, therefore utilizing the rigid midsole.

In certain circumstances depending on the level of forefoot pain and pathology and how it’s affecting your quality of life, a forefoot rocker is frequently recommended. If someone has advanced great toe arthritis, whether it’s fused itself or a fusion surgery has been performed, a rocker bottom shoe can be very helpful.  It can be added to the shoe or there are actually shoes that you can purchase with this specific feature.

Now for your bonus! The more cushion you have in your shoe, the more impact force you will have through your body. Picture yourself walking outside barefoot. Imagine how you would walk–your pace, your intention, your impact.  Now picture yourself doing the same walk in high cushioned shoes. Think about the difference in how you would interact with the ground. You will strike the ground much harder because you do not have the same sensory input that you would have if you were walking barefoot. 

When you have pain that is affecting your quality of life, shoes can be part of the solution, rather than part of the problem.

If you’d like to schedule a free 15-minute virtual discovery session, please email drarianne@themovementparadigm.com or text 302-373-2394 to schedule. We’d love to help you get healthy again!

Make sure to subscribe to our YouTube channel for weekly tips on mindset, nutrition, and movement, and share with anyone you think may need this.

HOW TO TEST YOUR VAGUS NERVE | Polyvagal Theory

Did you know that you can test your vagal nerve function, and not only can you test it, but you can begin to tap into the healing power of the vagus nerve? Your vagus nerve is responsible for the regulation of internal organs such as digestion, heart rate, respiratory rate and impacts certain reflex actions like coughing, sneezing, and swallowing. It is critical to optimal health and you can tap into it-but first, find out what state you’re in.

The Polyvagal Theory

Before we jump into how you can assess the vagal nerve, let’s talk a little bit about the autonomic nervous system. We used to think of the autonomic nervous system as simply fight or flight or rest and digest. However, Dr. Steven Porges’s work shows us that there’s much more to it and there are actually three circuits of our autonomic nervous system. This is referred to as the polyvagal theory.

Essentially we have our fight or flight state, which is also considered our sympathetic spinal activation. We also have our dorsal vagal state, referring to the most primitive vagal nerve, and indicates we are in a freeze state. This means we are shut down and feel hopeless. We are disassociated from ourselves and other people.

Lastly, we have the ventral vagal circuit, which means we are in a state of social engagement-a state of safety. This means we are connected to the greater world. We’re connected to ourselves. We are joyful and mindful. All three of these are critical and during the day we go through all of these different circuits, but most often we don’t even recognize that we do because we go through them so quickly. However, we can get stuck in these. We can get stuck in a fight or flight stress response where we’re constantly worried, anxious, frustrated, or irritated. It’s also easy to remain in a shut-down mode. We of course could be mindful and joyful. We’re constantly fluctuating.

polyvygal chart
Adapted by Ruby Jo Walker

Check out our previous blog on “How to Map your Nervous System” here.

Breaking that down a little further, let’s speak about the ventral vagal nerve. This originates from the brainstem just as the dorsal vagal nerve does. This innervates most of the muscles of the throat, such as the larynx, pharynx, uvular muscles as well as the levator palatini muscles in the back of the throat. Whereas our dorsal vagal nerve, which is more subdiaphragmatic, innervates the muscles of the stomach, liver, and digestive system. It also does innervate the muscles of the heart and lungs. Just a reminder, the dorsal vagal nerve is impacting that freeze state, shutdown mode, whereas the ventral vagal is eliciting that sense of inner calm and relaxation and is associated with our state of safety or state of social engagement.

Testing Ventral Vagal Function

You may need a partner for this. This is a really powerful technique that can have a profound impact on how you address your body. Remembering where all the powerful neural innervations are, one of the innervations of the ventral vagus nerve is the throat.

  • Grab a partner and a flashlight.
  • Have your partner look at the inside of the mouth at the back of the throat at the uvula that drops down right in the center.
  • Now, perform an “ah, ah, ah” sound.
  • When you open your mouth, you can use a tongue depressor or your fingers to push down your tongue so the uvula and soft palate can be more visible.
  • The examiner is going to look at the uvula to see if there is a deviation to one side.  
three mouths anatomy
Adapted from Stanley Rosenberg’s Healing Power of the Vagus Nerve

What you’re looking for, specifically, is if there’s any deviation from one side to the other. If the uvula pulls over to one side, then that is indicative of ventral vagal nerve dysfunction. If it moves up symmetrically, then that means that you are in that state of social engagement. So, if you have the soft palate moving up on one side, let’s say it’s moving up on the left side, and not moving up on the right side, then that would be indicative of a dysfunction of the pharyngeal branch of the ventral vagal nerve.

Now, that you’ve tested let’s move into how to stimulate the vagus nerve.

Vagus Nerve stimulation: The basic exercise

If your test indicated that you had a ventral vagal nerve dysfunction, perform the basic exercise for vagus nerve stimulation.

  • Lie on your back on the ground.
  • Interlace your fingers and bring them behind your head- right at the base of the skull
  • Look with your eyes to the right until you sigh, swallow, or yawn, and then repeat on the other side.
  • You may blink during the exercise.

Now that you’ve stimulated it, retest your vagal nerve and see if there was a change.

This is just one way to measure your autonomic nervous system function. This is also just one way out of many to stimulate your vagus nerve. However, recognize there are so many ways to become more aware, more in tune, and map your nervous system. You are completely in control of what’s happening in your life.

I want to give a huge thank you to Dr. Steven Porges for all of his amazing work in this area, as well as Stanley Rosenberg, for their contributions to this area of life-changing research. Make sure to check out the book, Accessing the Healing Power of the Vagus Nerve, by Stanley Rosenberg.

If you’d like to schedule a free 15-minute virtual discovery session, please email drarianne@themovementparadigm.com or text 302-373-2394 to schedule. We’d love to help you get healthy again!

For more content, make sure to subscribe to our YouTube channel here.

Why you should stop “stretching” your hip | HIP PAIN

Do you have hip pain that you are continually trying to stretch, roll, or smash, and nothing seems to get better?  Before we get into the role of the psoas, one of your key hip flexors, let’s speak about the local stabilizers and global stabilizers of the body. This is important to understand how you are going to treat your hip flexors and hip pain.

Think of the local stabilizers as being muscles that are close to the joint. They create more of an isometric contraction versus concentric (shortening) or eccentric (lengthening) contraction. They control the joint centration which means keeping the joint centered in its axis. It’s also independent of the activity of motion so if you raise your arm overhead, the deep stabilizers in my spine are going to activate before your arm goes overhead. Essentially these local stabilizers are imperative for stabilization in the body so that we can have proper movement.

Our global stabilizers are equally as important. However, they have a different role, so they have more of an eccentric contraction. They decelerate the range of motion, are continuous with motion, and are farther away from the joint.

Now getting back to the psoas, which is what everyone wants to stretch when they have hip pain.  The posterior or the back of the psoas is a local stabilizer. Think of it as one of our deep core muscles that is helping to stabilize the spine and also prevent the femur, our leg bone, from shifting forward in the hip joint. The anterior or front of the psoas serves as a global stabilizer. So, it is necessary to think of the psoas muscle as a stabilizer. Not only is it a stabilizer but it works in an integrated unit with all of the other muscles, including the pelvic floor, diaphragm, multifidus, the deep five rotators in the hip, and the transverse abdominus. All of these have to work together, and once again in this integrated fashion to be able to stabilize the low back and the pelvis during any kind of movement.

For example, if you performed a chest press with 30 pound in each hand on a bench and then transitioned into doing that on a stability ball, your weight would naturally go down. Why? Because you now have an unstable platform to work from and therefore can not generate as much force.

There are a lot of different hip pathologies that we won’t get into today, but when you have hip pain it typically happens from losing the deep stability of the hip. There are two common muscle imbalances that will exist. One is the TFL(tensor fascia latae) muscle, which is right in the front lateral side of the hip, can get tight, especially with increased sitting. Based on this attachment, it will pull the hip forward, and that will therefore inhibit or shut down the psoas. The other common muscle imbalance is the hamstring muscles, which can get tight for various reasons, inhibiting the glute muscles. The hamstrings can push the femur forward and that also leads us to lose that optimal position on the hip joint. Overtime if we have these muscle imbalances, instead of the hip being centered in the axis, it will start to shift forward and up. This will cause all types of pain issues and pathologies. Whether that’s a labral tear, hip impingement, tendinopathy, bursitis, and so on. So, it is important to get the hip stabilized and centered in the joint in order to decrease pain and ultimately improve function.

You can begin to do this through a four-step process. This is a great way to begin to address your pain, as well as any kind of movement compensation, and most importantly, integrate your foot with your core, in a very integrated manner. First is inhibiting the tissue, in this case we inhibited the TFL muscle that typically pulls the hip joint forward and creates that inhibition of the psoas as a deep stabilizer. Then, mobilize the hip joint to center the hip joint. Remember that when it is not in that center position it’s shifting forward enough so we’re shifting it back to the center position. Next, stabilize it by activating the deep stabilizers, such as our diaphragm, pelvic floor, etc. Then we’re integrating it with the ground. This is super important because the foot is part of the core and they work as an integrated unit. To get those deep stabilizers of the hip firing, short foot, i.e. foot to core sequencing, allows us to do that in a very integrated fashion.

4 Steps

1. Inhibition

For the TFL release, place the ball right on the outside of the hip. When you lie down, you’ll naturally rotate the hip in, which will expose the TFL muscle. With the other leg, anchor it up at a 90-degree angle and come down to your forearms. Holding that position your leg will be nice and long, naturally rotated in, and breathing throughout the exercise trying to relax into it.

2. Mobilization

For the hip mobilization with a band, you’ll place the band high up in the groin. You’ll have it back at a 45-degree angle away from you. You’ll start in a table position rocking forward 15 times, making sure your spine stays nice and long, and you’re breathing. Then rock away from the band, so to the opposite side, once again about 15 times, making sure you’re breathing throughout the exercise.

3. Activation

Now it’s time to activate the deep core, so you can do this by diaphragmatic breathing. Inhale, breathing into the abdomen and into the base of the pelvis allowing the abdomen to expand 360 degrees. Exhaling, letting the abdomen contract and the belly button in towards the spine. Once you feel like you have this established, then on your inhale allow the pelvic floor to relax, so you can exhale and gently lift the pelvic floor about 20% contraction to get a deeper integration. You want to think of this as a rhythmical balance, so nice and fluid. Inhaling to the base of the pelvis and exhaling gently lifting the pelvic floor.

4. Integration

Lastly, it’s time for integration. This is to be done with short foot. Standing on one leg, sitting the hips back, knees slightly bent, taking a breath in, while your foot relaxes then exhale and gently root the tips of the toes into the ground. That will naturally lift the arch and lift the metatarsal heads or ball of the foot.

So whether you have hip pain or hip tightness and are constantly stretching your hips, hopefully, this video will give you a little bit of insight to allow you to think about your hip differently and recognize that it is part of an integrated unit. It is really important to understand how that works as it relates to stabilization and movement

If you’d like to schedule a free 15 minute virtual discovery session, please email drarianne@themovementparadigm.com or text 302-373-2394 to schdule. We’d love to help you get healthy again!

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