Category Archives: Megan Conklin Archives

My question is about menisci. I’ve read that damage often occurs when you go from squatting to standing and the menisci don’t move back into place, resulting in being crushed. But why didn’t they get back to their proper places? Is there something inherently wrong with the knee joint that didn’t allow them to get back to place quickly enough? Or is it just a freak thing?

Meniscal tears are among the most common knee injuries. In the younger population, a tear usually occurs from a forceful, twisting motion. As we age, the meniscus weakens and becomes more brittle which puts it at greater risk to injury, even with a very simple move such as a squat. Most often, these types of tears, referred to as degenerative tears, are precipitated by degenerative changes including fraying of the meniscus and osteoarthritis of the knee. Osteoarthritis leads to mechanical changes within the knee, which then places extra stress on the meniscus. The best preventative care is to keep your leg muscles strong and balanced, therefore maintaining the most normal joint mechanics possible.

About 6 months ago, I overstretched my mid back while working out. While I’ve rested it and tried going to a chiropractor, it still hurts when I stretch and limits certain movements. Should I be working on strengthening this area, and if so, what exercises strengthens the mid back? Thanks!

Pain in the mid or upper back is usually a result of muscular irritation or joint dysfunction. A joint dysfunction usually responds positively to osteopathic manipulation but usually requires those treatments to be followed up with appropriate stretches and exercises at home. Muscular irritation usually responds well to rest but then needs appropriate strengthening exercises to regain full strength. I’m attaching a link to a website that explains the various muscles in this part of the body. On the right side of this website you will also find links to videos of exercises.
http://exercisesforupperback.com/
If you can’t seem to shake your symptoms with stretches and exercises on your own, a physical therapist can evaluate you and design an individualized exercise program for your specific impairments.

My husband woke up one morning with significant tightness in his neck. Is there a particular way he should sleep or is there a special pillow he can use to avoid and relieve any further pain? Is there any exercises or stretches you recommend if it were to happen again?

We’ve all had those mornings where you wake up and just can’t move your neck. There are numerous causes to neck pain, but without any other precipitating factors this sounds to be a classic case of joint dysfunction, where the neck actually seems to “lock” up. In general, it is less stressful on our necks to sleep on our back or sides. Although comfortable for many, lying on your belly places your neck in an extreme position of rotation which may lead to the “locking”. It is best to have our spine in a neutral position while sleeping, which usually means using a single, thin pillow. From the side, you should look at your husband lying on his back or side and see a fairly straight spine (meaning his head is not lifted up or dropping down from his shoulders). If he does, though, wake with similar symptoms in the future, his motion can usually be restored with gentle neck stretches. Start with bending and rotating the neck to the non-painful side, then progress toward the painful side. If motion is not restored within a day, a physical therapist or chiropractor should be able to help with joint mobilizations/manipulations. If this becomes a recurring issue, he should have it evaluated for an underlying cause.

I would like to begin working out for 30 minutes in my home before work each morning. What suggestions do you have for making the most out of such a short period of time? My goal is to lose 10 pounds.

This is a fantastic goal!!! Studies have shown that 30 minutes a day is all you need to achieve the health benefits of exercise. If you have any prior health concerns, you should of course contact your doctor before starting an exercise routine. If you have any previous injuries, you may also want to contact a physical therapist to help guide your routine. Otherwise, the options are endless. Remember to start slowly and add gradually… especially if you have been away from exercise for a while. If you want to stay at home for your routine, there are countless options for home DVD exercise videos. You want to find something that is interesting and fun for you. For example, some women enjoy kick-boxing while others enjoy dance workouts like zumba. Recent literature shows that varying your intensity levels within your workout session is the most beneficial for weight loss. The nice thing about exercise videos is that they do this for you! If your goal is weight loss, you also want to add in resistance training at least 3 times per week. Since you have limited time, you want to focus on strengthening exercises that target multiple muscles in one move. Examples would be squats, lunges, bridges, push-ups, etc. Remember, every bit counts. So, even if you don’t have a full 30 minutes on a particular day, 10 or 15 minutes of movement is better than nothing!!! GOOD LUCK!

Hi,
I had a baby several months ago and have had nagging pains in my neck and lower back areas. Are there excercises that you recommend to help releive the pain and strengthen those areas to prevent further discomfort?
Thank you,
Chrissy

First and foremost, check your posture and body mechanics with your daily activities such as lifting your child, nursing/feeding and carrying him/her. Secondly, initiate a general exercise program to start restoring those muscles that were overstretched by pregnancy. Here is a link to a website that offers a great list of “tips for new moms”: http://orthoinfo.aaos.org/topic.cfm?topic=a00264 As far as specific exercises, you want to focus on the muscles that support your shoulder blades in order to stabilize that region while you are lifting/carrying your baby as well as general core exercises. For the shoulder blade region, exercises such as rows, push-ups/planks, chair press-ups (small tricep dips), and prone arm lifts are good. For core exercises, please see my answer to the question “I have had 2 c-sections and now my abdominal region feels non-existent”. My answer to that question probably applies to you as well. If you are following these tips and are still having nagging pain, I would recommend having it evaluated. A physical therapist will be able to provide you with the specific exercises that will help you overcome your symptoms.

I have had 2 c-sections and now my abdominal region feels non-existant. What can I be doing to help strengthen that region besides crunches.

Great question and one I hear often, not only from post-pregnancy women but also from men and women recovering from low back pain. The traditional form of crunches primarily targets the Rectus Abdominis muscle. This is the most superficial abdominal muscle which displays the ‘six pack’ if you’re lucky enough to achieve that! The problem is, this muscle is not very influential in the true stability of the spine. The deeper abdominal muscle that protect the spine is the Transverse Abdominis. In a healthy individual, meaning no history of surgery or significant back/pelvic pain, these muscles should all work together. As a therapist, I often see people who have diligently developed their Rectus Abdominis muscle but have neglected the Transverse Abdominis and with your history of 2 c-sections, I would guess that you may fall into this category. On the flip side, we also need stength in the low back muscles, with the most important muscle being the Multifidus. Moves that are taken from pilates and yoga are great ways to target these deeper muscles. These exercises include but are not limited to bridges, planks, bird-dog (on hands and knees, extend one arm and opposite leg out), and balance activities over a physio-ball. This happens to be a topic that I am passionate about and I could therefore talk about it for hours. If you would like to discuss this further or would like some guidance developing an exercise program, feel free to contact me!

I am a very active person and workout frequently. Lately I have been experiencing occassional knee pain with working out. What should be my key sign that I should stop? What should I do if the pain begins to occur a while after my workouts.

Knee pain can be a result of many things. Exercise is usually a part of the rehab process to recover from knee pain, however, it needs to be the right kind of exercise. If you are noticing sharp pains or if your discomfort seems to progressively get worse throughout a workout, you should stop. If your pain begins to persist even after workouts, then you should definitely give your knee a few days rest or find a workout that places less stress on your knees (ie. aquatics). If you can’t seem to get back to your typical workout routine without pain, I would suggest having it evaluated. Non-traumatic knee pain can usually be addressed by appropriate strengthening exercises designed to minimize any muscle imbalances that may be leading to poor knee mechanics. A physical therapist will be able to pinpoint the cause of your knee pain and provide a treatment plan that will get you back on your feet!

My daughter’s soccer coach has been encouraging our team to perform all their stretches with a “bouncing style” and feels strongly that this is more effective than static holds. I have always been told not to use this stretch but researching some articles they made it sound also like this is very effective. What is your opinion? Oh the girls are12 & under.

Also what is to young for strength training?

There are many different forms of stretching. The most common are static, ballistic, and dynamic. 1) Static stretching is the traditional form of stretching where you take the joint or muscle to its end-range and hold for 20-30 seconds. Recent studies have shown that static stretching prior to physical activity may actually deactivate muscles and lead to earlier fatigue during the activity. Static stretching, however, does increase overall flexibility which is why most medical and fitness professionals will instruct athletes to perform static stretching after sport.
2) Ballistic stretching uses the momentum of movement to force the muscle/joint beyond its normal range of motion. Some professional athletes use this technique to prepare for sports that require bursts of speed. There are some studies to show that this form of stretching increases muscle power during sport, however, there is a greater risk of injury with ballistic stretching when not performed properly and safely.

I have off and on problems with sciatic nerve pain. I often feel the pain after lifting one of my sons. Is there something I can do to prevent this and/or what can I do to help relieve the pain? Thank you.

Sciatica is a broad term often used to describe any pain radiating down the leg. Keep in mind, though, that sciatica is a symptom of another medical issue, not a medical condition on its own. This means that you need to have an idea of what is causing it in order to treat it. It can be caused by piriformis syndrome, sacroiliac dysfunction or by more serious problems such as herniated disc, degenerative disc or spinal stenosis. In your case, because you have small children, I would think it is most likely being caused by decreased stability in the lower lumbar and pelvic region. If your youngest is still an infant, this could be due to residual hormones in your system leading to increased laxity in your ligaments. If your youngest is a year or older, then it may just be that your body never regained the proper stability after pregnancy.

How soon after a natural delivery can I begin to work out? I am very worried about losing all of my baby weight and I want to begin to exercise while I am still on maternity leave. Thanks!

Physicians used to recommend that pregnant women avoid exercise during pregnancy. Fortunately, times have changed! The same goes for exercising after pregnancy. If you had no complications during a vaginal delivery and you were exercising throughout your pregnancy, then you are safe to start exercising whenever you feel comfortable with it… even within days of delivery. Of course, you should start off slow and listen to your body.

Some literature suggests avoiding vigorous exercise while you are breast-feeding. This is due to the lactic acid that builds up during intense workouts, which may produce a bitter taste in the breast milk for the baby. If you keep your workouts in the moderate zone, however, you should be fine.

If you are new to exercise or stopped exercising during pregnancy, I would recommend consulting your physician before starting a new program. If you happen to fall into this category, remember that daily walks are always a safe start to a new exercise program. Fall weather is around the corner, so grab the stoller and enjoy the sunshine!