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4 Pain Preventing Exercises to Do at Your Desk

The Problem With The "Desk-Job"

It seems like everybody is spending most of their time locked in front of a computer. Hours at a time, day after day, frequently coupled with job stress. And this is tough on your body! Certain muscle groups are tensed-up for long periods of time, circulation is restricted, and joints remain in a static position. All of this leads to varying degrees of discomfort. To help you get through the day, I recommend the following exercises. Try to do them every couple of hours or as needed. These exercises are supposed to be gentle, forget “no pain, no gain”. If you feel pain stop immediately!

4 Helpful Exersizes

1) Get up off your butt (frequently): The easiest exercise of the bunch. Stand up and move around.

2) Chest Stretch: And while you’re up, clasp hands behind your back and as you breath, reach your hands down. You should feel a pleasant stretch across your chest. Repeat 3 times and count to 10.

3) Shoulder Shrugs: And if you’re feeling ambitious, inhale and lift your shoulders up towards your ears, exhale and let them drop. This exercise should reduce shoulder and neck tension. Repeat 5 times slowly.

4) Head Retraction: And while you’re up, let’s not forget your neck (which has probably been straining in what we call a “head forward posture”). Place an index finger on your chin (helps you keep your head level). Pull your head back over your shoulders as far as you can comfortably go. This should help reposition the cervical vertebrae in your neck and redistribute pressure on the discs. Repeat 5x and hold position for count of 5.

I hope you find these exercises helpful and stay comfortable!

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Published on by Gary Barton.

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How to Stay Young and Vital - A Layman's Guide

The Big Secret to Aging Well

If you have looked around the website you won t see my name anywhere. I am the administrator for the practice, and as such, remain firmly in the background. I am not a physical therapist nor do I pretend to be one. I have too much respect for their level of education and dedication to their profession. But I have watched almost 6,000 patients walk through our doors over the last 22 years. The vast majority have benefitted from the experience and those we couldn't help we referred them to a healthcare professional that might be able to help them. Bottom line, we always try our best with every single patient. During these years we have treated young and old people, soloists with ballet companies, business people, professional athletes, you name it. And guess what, every one of them gets older! So in my layman terms let me tell the secret of aging well... You ready? A lot of people don't know this so I'm giving up a lot by revealing the following:

Here it Comes!

You age well if you keep your weight down, maintain some strength, flexibility, and challenge your balance.  The other big secret? It doesn't take that much work! Moderate your eating, participate in a physical activity that you enjoy, stretch before and after your activity, and do some challenging walking around the neighborhood. Of course this requires time. It is not free, but it is worth every moment you invest in your future.

Gary Barton

Pivotal Physical Therapy 
41 West 57 Street, 4th Floor
New York, N.Y. 10019
T: 212.317.9798 F: 212.245.5935

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Published on by Gary Barton.

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“Why don’t you participate in my Managed-Care Plan?”

My typical answer is, “because each patient is a unique case and we can’t treat them according to some pre-determined protocol”. In other words, Managed-Care is based on a “volume” model for patient treatment and at Pivotal we are dedicated to rendering individualized care. And, there is no getting around this, you need highly skilled professionals who spend one-on-one time with each patient. In our case, each visit is 45 minutes with the same PT throughout the course of treatment.

As a practice, we made a decision that we valued “quality” physical therapy over the “run-them-through-the-mill” model. So what is the difference? Well, with Pivotal you see the same therapist throughout the course of treatment, each visit is 45 minutes, and we never use assistants. As opposed to the “managed-care” model where you see the PT for 10-15 minutes and are turned over to an assistant who will then follow the PT’s instructions and hope for the best.

Here's why we disagree with the “managed-care” model: We believe that it takes a professional eye to chart, modify, and achieve the Long Term Goals we set out for the patient at the Initial Evaluation. Underlying this philosophy is, “no two patients are alike”, therefore we need to adjust the treatment techniques to suit those differences. And those adjustments are constantly being made from the first until the last visit. So, we check each patients insurance policy, inform them of the costs and, if they choose to attend Pivotal, do our very best to achieve optimal results.

I know what you are thinking: isn't it more expensive? The quick answer is yes, but not always and sometimes the difference in pricing is not that significant; but most importantly, it's well worth it. As a practice we survive because our patients have experienced the results first hand and are strong believers in our approach to PT. As a result, many of our patients return to us when they have another issue or think of us when they need to refer their friends and relatives for PT. As someone who works at Pivotal, we have a side-benefit. I know we have always done our very best for each patient we have treated. That gives all of us here at Pivotal a deep sense of satisfaction.

Gary Barton
Pivotal PT
41 West 57 Street, 4th Floor
New York, N.Y. 10019
T: 212.317.9798 F: 212.245.5935

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Published on by Gary Barton.

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Walk With Your Stomach - Engage Your Core

In my treatment, a new development has arrived; when did things get so complicated? Radhika must watch me walk at least 5 times during any physical therapy session. And why does she watch me stride around? Because physical therapy is an iterative process. As I have stated before, I am 63 and that means I have a whole host of secondary conditions that contribute to my limp. Let’s see there’s stenosis, the Big Toe joint on my right foot that is arthritic and barely flexible, muscle wasting in the R leg due to nerve damage, and, oh yeah, I’m now 63! So, utilizing observation and the scientific method, Radhika comes up with a theory as to why I limp. She then tests that theory by getting me to activate certain muscle groups and observing the impact on my gait.

First we have the theory, then she tests the theory, and finally analyze the results. And here’s the interesting part. When we do certain exercises (i.e., get certain muscles working) my limp reduces or my gait smooth’s out, or my gait gets worse. And over a couple of sessions it becomes apparent that the answer to eliminating my limp has many different components. All of them contribute to the problem. One of the primary contributors to my problem (a very common issue) is a lack of core activation. And guess what, activating your core muscles is a lot more subtle than you might imagine. It is a lot more than just tensing your stomach muscles. Next blog will be talking about the mysterious core and trying to answer the question, “What in the world am I doing wrong?”.

Stop by and have Radhika assess you as well, I highly recommend it.

Thanks for reading.
Gnb

Pivotal Physical Therapy 
41 West 57 Street, 4th Floor
New York, N.Y. 10019
T: 212.317.9798 F: 212.245.5935

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Published on by Gary Barton.

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The Radhika Method to Correct Bad Physical Habits

Hip_Pain_NYC

I have the great fortune to work with Radhika, a very smart, former San Francisco native who relocated to New York City. Many years ago Radhika started out as a massage therapist, subsequently went back to school and got a Masters of Science in physical therapy. As if that wasn’t enough, she is a certified Pilates and Yoga Instructor.

Clearly Radhika brings a lot to the table. So, how does the “Limp begone” process begin? As it turns out, the process starts simply. Radhika suggests let’s talk and then observe how I walk. The talking phase is about my personal history (i.e., Pre-Medical, Pre-Surgical, medications, lifestyle questions), and a description of my current issue. My usual response to these kind of conversations is to minimize my complaints (that is probably the result of a mid-West based upbringing) and just stick-to-the-facts (i.e., surgeries, significant injuries, weight-gain, etc.). However, this time, I made a real effort to include more subtle information like how I had been trying to fix things, how the symptoms could vary from day-to-day, or how my leg cramped consistently in one area.

Radhika listened closely to my description and then sent me walking through the rehabilitation gym. I did my best to walk naturally and not suddenly turn into a cheap imitation of Frankenstein’s monster’s walk. I think I was successful, at least Radhika did not burst into laughter. After limping around for a bit she asked me to stop and started manually testing various body parts, specifically related to my “core” (e.g., the “core” encompasses a big area but basically from the bottom of my ribs to middle of my thighs). The tests were designed to look at various muscles in isolation. After all, the “core” is a very big area and if you’re going to improve things, you need to know the exact “why” something is happening. 

Assigning me 100 sit-ups and going for a coffee-break was not going to eliminate my limp. Hint, pay attention when they say, “Hmmmm, that’s interesting”. Thanks for reading.

Gnb

To book an appointment with us or Radhika - give us a call and we will get you set up.

t: 212.317.9798

 

 

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Published on by Gary Barton.

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Limp begone!

In the interests of full disclosure, I am a 63 year old male who sits at my desk all day long! However, it wasn't always like this. Through the age of 50 I have always been physically active. And those activities directly or indirectly have led to 3 back operations (perhaps my choice of activities have not always been physically the kindest). Now, and this is so annoying, I seem to walk with a permanent limp. The limp began very quietly 3 years ago and could be the result of many different physical problems. It could be due to nerve damage (remember those back operations), it could be habituated muscle patterns due to pain or nerve impingement (remember those back operations), or perhaps it’s because of joint pain (yep, I’m 63, I celebrate any joint that doesn't hurt). So after my last back operation (4 months ago) my back surgeon recommended that I get some physical therapy to sort out my limp. But first, some history. As I mentioned above I have been limping for the past 3 years, and during that time, I have been obsessing about this limp. It drives me crazy! So for 3 years I have tried fixing it myself by adjusting my gait, changing my heel strike, pushing off harder, etc. So there I am constantly switching it up! One day change things this way and the next day, another. Unfortunately, it has been to no avail, the limp has remained. So with the prodding of my surgeon and co-workers, I have begun physical therapy. Forthcoming blogs will track my progress and thoughts about the process.  I will try to be as straight-forward as possible. So wish me luck and thanks for reading. Gnb

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Published on by Gary Barton.

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Why Prenatal Physical Therapy is a Great Idea

This is an often overlooked concept in the PT landscape - which is curious, because it is very important!

Pregnancy results in many changes to the body. These changes are hormonal, physiological and structural. This “temporary body” brings with it many uncomfortable and often challenging demands. Especially with all the hustle and motion in New York City, physical therapy can help adjust to those demands, but it requires a practitioner with specialized knowledge and training. We have that training and can help you through this experience!

We take the whole body under consideration when addressing your needs during pregnancy and, above all, safety is first! We are concerned that this “temporary body” has added significant weight and moved your center of gravity at a time when hormones are telling your ligaments to relax and lengthen. We help you address those changes without unduly stressing your muscles, joints, and ligaments.

We focus on executing basic functional movements and minimize your risk of injury. Initially we need to assess your newly acquired sitting and standing posture. This will help prevent structural damage to delicate tissues. Beyond the basics our ultimate goal is to decrease pain in the later trimesters, strengthen your core and pelvic floor in preparation for labor. In addition, good core integrity will speed up delivery, the rate of post-natal healing and avoid incontinence issues. And, let’s not under-estimate its’ importance, we to optimize your sleep position so you cam recharge for the next day’s responsibility.

A good night’s sleep is integral to how enjoyable your experience is with pregnancy and how optimistically you approach the new challenges of being a parent. At Pivotal, we help make the experience of being pregnant safer and more pleasant. Working with pregnant women is particularly rewarding because it is a life changing event and we get to help! It doesn’t get much better than that!

Schedule a physical therapy appointment today and let us help you find more comfort in this exciting stage of your life!

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Published on by shawn platzker.

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Great Physical Therapy is Like Teaching Ballet

The professional eye!

Here in New York City we have some of the best ballet dancers in the world! They come from a variety of countries and backgrounds. For years, a group of very famous ballet dancers religiously attended ballet classes taught by the worlds’ worst ballet dancer. Okay, so maybe the teacher wasn't the worlds’ worst but she was not an imposing, technically-gifted virtuoso or former prima ballerina. And, she had never been onstage in any real capacity. Yet, here they were taking class from this lousy dancer.

So why did they take classes from this teacher with limited turnout and ugly feet (if you have had any exposure to ballet, you know all ballet dancers are obsessed with turn-out and feet)? The reason is quite straight-forward: she had an eye that could pick out and correct flaws in any dancers’ technique. She could watch a dancer take a ballet class, analyze which muscles were or were not working, where the center of gravity was located, and most importantly, help that dancer understand how to improve.

But, wouldn't you think that any professional dancer with all of that skill could do this by themselves? After all, every ballet studio is filled with mirrors just for that reason. So why would a professional, highly respected dancer have someone else pass judgment on their technique (and pay for the privilege)?

Simply put, and every professional athlete knows this, you cannot step outside your body. You cannot critically examine yourself in action. Without a highly-skilled observer to provide you with feedback, bad habits sneak in, and your previously beautiful technique becomes sloppy. How does this apply to the average human being? Well, that professional, independent perspective is exactly what you want from a good PT.

You go to a PT because a problem (also known as a “diagnosis”) has developed. Perhaps suddenly through an accident, or more slowly through disease, aging or repetitive movement patterns. A good Physical Therapist will take a holistic approach and critically examine your unique circumstances. They will analyze your habits, lifestyle, physical strength, flexibility and movement patterns. Then provide you with clear, useful guidance. With good advice you should understand where to make changes, why, and how to implement them. Be forewarned, change does not happen overnight and requires real work. However, for a lot of people it means returning to a pain-free life with an increased ability to function and enjoy every day. It takes time, but a good PT will help you make it happen.

Give us a call and let us show you what great PT in NYC is like.

Permalink Funny Physical Therapy NYC, Ballet, Critical Assesment, One on ONe

Published on by shawn platzker.

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Schroth Method for addressing Scoliosis

In 1921 Katherine Schroth developed an exercise method for addressing scoliosis based upon corrective movement principles. When applied, these principles would change spinal loading, incorporate dynamic postural re-education, and change postural balance. It was a non-invasive, non-surgical approach that would retrain the body’s musculature to help the alignment to a more neutral stance. Ms. Schroth’s technique was to address positioning, corrective breathing, trunk elongation, stabilization, and mobilization. The ultimate goal of her technique was to avoid asymmetric loading of the spine, improve dynamic alignment, change habitual movement patterns, and incorporate spinal relaxation.

 

Anyone can benefit from the Schroth method. A juvenile can reduce the rate of curve progression and improve their functional alignment. An adult with a stable scoliosis but concurrent lumbar, cervical or pelvic pathology can maximize symmetry. And adults with degenerative scoliosis or post-lumbar spine surgery can benefit from improved functional movement and body mechanics with activities of daily living.

 

Each patient who comes to our practice is unique and requires a program tailored to their diagnosis. So the number of treatments and frequency is dependent upon many factors including age, severity of the scoliosis, and adherence to our recommendations. However, in general, the therapy is expected to be 2 times per week for 6-8 weeks to see significant results.

 

At Pivotal we have great respect for the Schroth method and through therapeutic techniques obtain maximum benefit for our patients.

 

 

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Published on by Nicole.

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Bathroom Booby Traps

If everything in the bathroom were at chest height, I wouldn’t be writing this article. Unfortunately this is not the case. With a quick look around most bathrooms, you will realize the fixtures (e.g., sink, toilet, bathtub) all require a certain amount of maneuvering to be useful. Let me give you a quick example of what I often hear from my patients: “Well, I got up this morning, walked into the bathroom, and bent over to brush my teeth. Next thing I know, I’m laying on the floor with my back locked up in spasm. Since it is still in spasm please make me feel better or put me out of my misery.” So the question is what happened, and how do we prevent it?

This particular person made the classic mistake of rounding their back while brushing their teeth. This required their back muscles to stretch eccentrically (i.e., the muscle has to contract while simultaneously lengthening) after not moving for several hours while sleeping. Eccentrically stretching muscles that haven’t moved for several hours can be anywhere from uncomfortable to extremely painful. If that isn’t bad enough, bending at the waist creates a significant amount of pressure on the discs in your back.

So here is the Master Rule for the bathroom: Don’t bend at the waist. Instead, bend your knees, keep your back straight and try to stay vertical. So how do we put this principle into practice? A couple of examples follow:
• When you lean over the sink to wash your face or brush your teeth, use your arm to support the weight of your torso. Use a footstool to rest one foot, as this will change the position of the pelvis and decrease the strain on the back. Finally, rather than bending farther forward, make sure you lift the cup of water, toothbrush or wash cloth to your face.
• When you shave or put on make-up in the morning, bring the mirror closer to your face. Don’t lean closer to the mirror.
• While washing your hair, do not lean your torso back or allow your head to drop backward. Included in this is any wild behavior while blow-drying your hair, such as dropping the head and torso forward while ventilating all those follicles.

So remember, for the health of your back try to stay vertical.

 

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Published on by Eveline Erni.

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