Physical Therapy

Centrum Vitamins: The Good, The Bad, & The Ugly

Great, you’re taking a multi-vitamin. Which one? Ahhh, Centrum. Let’s have a discussion.
I’ve had this conversation too many time with my patients over 50. The answer is often “Centrum Silver” or “Centrum Women’s 50+.”  I’ve had the conversation too many times, so I’m writing about it here.
Centrum has some great marketing, I’ll give that to them (The Good). Marketing supplements as healthy when there is a bunch of junk in there, is genius, if not downright wrong.
And I get why people buy them. It’s advertised to be this ultimate multi-vitamin with everything you could possibly need.
And why would we trust Wyeth, the company that […]

Can Stress Lead to Osteoporosis?


I find what is missing in information on osteoporosis is the effect of stress on bone health.

People talk and write about nutrition and exercise (though not in much specifics). But even in some yoga books, the element of stress reduction is not addressed.
Maintaining strong and healthy bones is a complex process.
And there are many factors at play: genetics, nutritional deficiencies (Vitamin D, phosphorus, calcium), medications (glucocorticoids like cortisone and prednisone), positive or negative stresses on the bones, our immune system, and hormones that are in disarray (thyroid, human growth hormone (IGF-1), estrogen, testosterone, cortisol, insulin).

Osteoporosis, meaning, “porous bone,” is a skeletal disorder characterized by compromised bone […]

Is jumping or hopping ok with osteoporosis or osteopenia?

I really started to investigate this information because I was curious how much force/pressure on the spine is produced by certain exercises. In particular, by someone that may have a compromised spinal column and wanting to exude the least amount of compression to the spine as possible.
One article1 with a small sample size demonstrated spinal loads given cycling, walking, standing or lifting 10kg. The smallest force on the spine was with unweighted standing, then with cycling, then with standing and then with lifting 10kg (see image). Not surprising. But it was nice to see some evidence (again with a small sample) that provides some […]

Pre-hab: Prepare Yourself for Surgery

You’ve heard of rehab, but have you heard of “pre-hab?”




Prehab is preparing your mind, body and spirit for surgery.
Recently, I’ve seen many of my patients and friends heading into surgery. But often times what I hear is that their care provider did not educate them on preparing for surgery. Prehab has been shown to reduce hospital stays and reduce the post-surgical pain experience.
A study by researchers at New England Baptist Hospital, Beth Israel Deaconess Medical Center and Harvard Medical School, based in Boston, found that knee and hip replacement surgery patients who had participated in water and land-based strength training, and aerobic and flexibility […]

Shoulder Series: Pain relief and strength using mind, body, breath awareness

Shoulder Series

Find pain relief and strength with yoga, breath and posture for rotator cuff injury

I created these a couple years ago but realized I never really posted them here. So here they are! There are certainly other aspects I would address, such as lifestyle, nutrition, sleep, etc. However, the emphasis of this post is on the physical.
What you will find:

Introduction to this Shoulder Series

Caution about these exercises

Posture and shoulder pain

Dolphin Glides for shoulder strength

Alternate Leg Lift with Strap for shoulder strength

Side Planks for shoulder strength

Sleeper Stretch at the wall

Sleeper Stretch sidelying

Shoulder Opener with strap

Neck Stretches for Shoulder Pain

Triceps Stretch

Posterior (back of) Shoulder Stretch–Eagle Arms

I […]

Hic-Hic-Hic…..A Method to Relieve Hiccups

Definition of a Hiccup: “A quick, involuntary inhalation that follows a spasm of the diaphragm and is suddenly checked by closure of the glottis, producing a short,relatively sharp sound.” (

So if the hiccup is a result of a spasming diaphragm, then I would hypothesize that performing a bit of massage or soft tissue work on the diaphragm during the spasming episode should help it to ease. In fact, WebMD lists massage as a way to ease muscle spasms. And on a search for “massage and spasm” on APTA’s (American Physical Therapy Association) Move Forward page, 39 results come up.

I don’t know why I didn’t think of this earlier, […]

4 Ways to Get Your “Yoga On-the-Go”


I’ve heard before. You’ve heard it before. Shoot, I’ve said it before. “I don’t have time for yoga.”  NOW I know this is true. There is always time for yoga. Or perhaps you might have thought, “I don’t know how to do yoga.”  Well, you’re in for a treat. And it doesn’t cost anything….just a little well-spent time.

But before I learned what yoga could be, I probably would have felt the same way. “If I can’t get to yoga class or get on my mat, then it’s not yoga.”  Again, not true. The yoga asana (postures) are just one way to “do” your yoga. […]

Non-grippers only!….4+1 Poses/Exercises for Awareness + Strengthening of the Pelvic Floor

Now that you’ve learned a bit more about where that pelvic floor is and most importantly, how to relax it, it’s time to venture into strengthening that baby up!—but not too much….then we’d back to square one. There should be balance. Just like the song (or the Book of Ecclesiastes, depending on your version), “To every thing there is a season, and a time to every purpose.” There is a time to contract, like when you’re doing something requiring more force, like lifting your child or kicking that soccer ball. And there is a time to relax, like when you’re going to the bathroom.

Think of […]

Ahhhh…..3 Simple Poses/Practices for Awareness and Relaxation of the Pelvic Floor

So you’ve been told to do Kegel’s. Why? Possibly because you’ve been told you have incontinence or overactive bladder syndrome. But what if there is more to the story? What if you have pain “down there?” Or what if you have low back pain (LBP) or sacroiliac joint (SIJ) pain? Kegel’s, or contracting and strengthening the pelvic floor may not be appropriate for you. Sometimes the muscles of the pelvic floor are overworked, or tense or hyperactive (you choose). And this imbalance between short/tight muscles may be at the source of your issue (pain, incontinence, etc).

Let’s put it this way: if you have a […]

Back Pain and Pelvic Pain and Stress?—Oh My!


Ever wanted to follow the yellow brick road to Oz—make a wish that your pelvic pain would go away? Or perhaps just click your heels three times and you’d be home, comfortable in Kansas without any pelvic issues to speak of? Ok, perhaps not. But I can bet you’re wondering “if I could just find the source of this pain, I could change it.”  Not so easy…..

Before I started studying more about the pelvic floor, I would have not really considered checking the pelvic floor with patients that had back pain, abdominal pain or even stress. But you know how they say, “if you […]

Peeing Too Often?: Overactive Bladder Syndrome


Do you pee a lot? I mean do you pee more frequently than you think is normal? Or do you pee and then literally feel like you could pee again 10 minutes later? I used to pee about 4-5 times in the morning before I leave for work—this is in the span of four hours or so (I know, TMI). But, I was thinking, “I know this can’t be right.” Or maybe it is and it’s just because I drink of a lot fluids.   But it isn’t, “normal.” So, I’ve changed it. Find out how below.

 Overactive bladder syndrome could include any of the following:

Increased […]

Chronic Inflammation: Let Food Be Your Pharmacy (Part III)


Hopefully you didn’t skip the first two parts, because the foundations are there. In Part I, we looked at what inflammation is and how it becomes chronic. In Part II, we discovered that you can change your genes by changing your lifestyle and how certain lifestyle choices are better than others in reducing overall inflammation.

One of those lifestyle changes involves what you put in your mouth.  Yes, your diet… surprise there, I hope. Though I am quite alarmed and still surprised on my morning commute, every time I see a line of cars waiting to get through the McDonald’s drive-through on their way to work (adults, […]

Chronic Inflammation: Change your Lifestyle, Change your Genes. (Part II)

Let’s just start Part II by saying that the body is one amazing creation!  You do something, eat something, think something and there is an entire cascade of events that happen inside your body. The result is good/bad, necessary/unnecessary. Whether you like it or not, it’s happening.  But there are ways to alter the cascade. Part II will be looking more into empowering you–you just have to make a choice.

So last time (Part I) we looked a bit at the inflammatory process and where your medicines (NSAIDS, corticosteroids) come into play.  And how dietary nutrients can also alter the inflammatory process by halting the very enzymatic […]

Chronic Inflammation: Are you at risk? Where do NSAIDS fit in? (Part I)

We ultimately take medicine to get a result, right?–decreased pain, decreased inflammation, improve digestion because we’re taking medicine to decrease our pain and inflammation….you get the idea.  Over medicated and under nourished–it’s the world we live in. Don’t get me wrong, some medicines have stepped in and stopped epidemics and if I was faced with Ebola, I would definitely take the meds.

But the medicines that were designed in labs were created to step in at crucial pathways in the body to inhibit pain and inflammation. And they actually mimic natural dietary source, meaning they have an effect on the very same enzymatic pathways and genetic transcription.  So […]

Trust Your Gut, Heal Your Gut: A Personal Story


I just wanted to share my personal story of working through a case of systemic inflammation—because I didn’t think it could happen to me.  And perhaps you are feeling similar and it might help direct you towards some resources so you can start to feel better.

I consider myself to be healthy—a vegetarian since 1999, practice and teach yoga, a physical therapist, daily exercise and meditation.  I teach and talk about having an anti-inflammatory diet to my clients and suggest stress-relieving tools. Pretty healthy, right?

But then I started to not feel so good….just not like myself. And when you practice yoga and meditate, you can […]

Ouch, my jaw hurts!……must be my TMJ, or is it?

Jaw pain, you may have had it at some time, but that doesn’t necessarily mean it’s a larger problem. When it is ongoing and starts to interfere with eating or is causing headaches, then it’s time to seek help.

Several patients have come in, reporting, that they have a “TMJ.”  Well, that’s true, and its true for all people, we all have a TMJ. TMJ stands for temporomandibular joint—a long word for the joint of your jaw.  What they really meant to say was that they had “TMD,” which is temporomandibular disorder.  TMD is defined as disorders associated to the jaw, ie difficulty opening, pain […]

Find Resolve in Impermanence: A Look at Dancer’s Pose


Shiva Nataraja: Lord of the Dance
Inspired by a recent article in Yoga Journal with a combination of a grief relief workshop I took this past weekend—a look at this pose with a little more depth.

Shiva derives from the Sanskrit root, meaning “liberation.”  “He cannot stop the passage of time or the fire that surrounds him, but he can find bliss amid the chaos.”1 In one image, it combines Shiva’s roles as creator, preserver, and destroyer of the universe. It conveys the conception of the never-ending cycle of time.

Shiva’s dance is set within a flaming wheel. The god holds in his upper right hand the […]

Cup Therapy (Cupping) for Pain Relief & Rehabilitation

Cupping, Myofascial Release, Myofascial Decompression

Myofascial decompression or cup therapy is a form of myofascial release. To understand release of the fascia we must understand fascia and it’s role in the body.


We have extensive information about the myofascial tracks or trains (Anatomy Trains1) by the work of Thomas Myers.  His definition of fascia is “ all the collagenous-based soft tissues in the body, and the cells that create and maintain that network.” 1  This includes all the fascia that is in and around the muscles (endomysium, perimysium and epimysium), ligaments, and tendons. It also includes the fascia in and around the organs, the chest cavity and […]

Chronic Pain: Changing Your Brain

I was just looking through an old book I have on Repetitive Strain Injury (RSI). They go over the usual tips of relaxation, posture, and strengthening.  In 2006, I thought it to be a pretty comprehensive book to treat the RSI that I was dealing with at the time. But nothing in there approaches the science behind the pain and therefore, how we can make lasting changes.
The emerging science out there shows that with chronic and even acute […]

You are not your diagnosis to be “fixed”

Tat tvam asi, “I am that.” But your doctor wrote you that you were a bulging disc, or a torn rotator cuff, or a neck strain, or a ruptured achilles tendon, etc, etc.  Understand that you are more than your diagnosis.  There is more to you than is written on that prescription pad. You are more than the physical body; you are a mental body, an intellectual body, a spiritual body. And with that, you can not be fixed.  I see patients daily, often with a dozen or so co-morbidities and a half dozen or so medications to “treat” the co-morbidities. They come to […]

Learning to Breathe

Hmmm, a blog. I never thought I would have this.  But then again, I never thought I would be chanting and teaching yoga classes but here I am.  I started taking my yogic path more for exercise.  The first thing I noticed was that I didn’t know how to breath, or I did, but I just wasn’t doing it. Wondering why my mind felt better but my body was hurting, I didn’t quite realize what this yoga was all about.  I read BKS Iyengars, Light On Yoga and had no idea what I was reading at the time. Then, I found out about physical therapists getting […]

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