Hi, I'm Doctor Jo, a licensed Physical Therapist and Doctor of Physical Therapy. I hope you enjoy my video demos of stretches & exercises for common injuries and syndromes. If you have a question, just ask! Be safe. Have fun. And I hope you feel better soon.

How to Walk with a Cane Correctly

Using a cane or a crutch when you have an injury can be very confusing especially when characters on TV shows don't even use them right! So let me show you how to walk with a cane correctly. Once you get the hang of it, it becomes very easy and natural. When we walk normally, our opposite arm swings forward with our opposite leg. When using a cane, you want the same technique so you don't risk injuring something else while you are recovering.

The most important part to start with is to make sure your cane is the right height. Most canes have a pin you can push in to change the height. On your upper leg there is a bone that sticks out called your greater trochanter. It is just below your hip. This is where you want the top of the cane. You should have a slight bend in your elbow about 20 degrees.  If the cane is too high, you might irritate your shoulder, and if it is too low, you might lean over too much.

Now for the walking part. The cane should be in the opposite hand of the injured side.  Yes, House, MD did it wrong! The cane should always move with the injured side. If the injured side goes forward, the cane goes forward for support. Again, this is how our bodies naturally move; so don't think about it too much. Just move how you would normally move. The cane should be for balance and safety, and if you feel like you are pushing really hard on it, or if you can't walk smoothly, then you probably are not ready for a cane yet.

Neural Glides for Ulnar, Median & Radial Nerves

The nerves in your arms and legs can move and stretch. Nerves can become injured just like muscles and tendons. Scar tissue can build up and trap the nerves. This can lead to chronic inflammation and pain. To get the nerves moving again, you can do special stretches called neural glides (also called neural flossing or nerve stretching).  

For your arm, there are three main nerves that can get damaged or trapped at your neck, shoulder, wrist, or elbow. These three nerves are your ulnar nerve, median nerve, and radial nerve. Neural glides should be performed very gently and there should never be pain. Nerves are very fragile and too much stretching can injure them as well.

To stretch the ulnar nerve, take your index (pointer) finger and touch it to your thumb while holding your other three fingers in the air, like an okay sign. Bring your hand towards your face leading with your pinky finger like you are going to place it over your eye (like making a mask when we were children). At first you might not be able to place it completely over your eye, but remember not to push too hard, you just want a gentle stretch. Start off with ten times and do this two to three times a day.

The next stretch is for the median nerve. Take your arm out to the side of you at a ninety-degree angle with your palm facing up. Keeping your fingers straight, bend up and down at your wrist. You can add more of a stretch by side bending your head to the opposite side (touching your ear to your shoulder). If that is still not quite enough, then move your arm slightly behind you and repeat the process.

With the radial nerve, you want to perform the same stretch as the median nerve, but this time turn your palm down towards the ground.

For the legs, you want to sit down. Straighten out your leg (kick it forward). Pull your toes towards you and then point them out (doriflex and plantarflex). If that is not enough stretch, then slump your upper body down and bring your chin to your chest, and repeat the above movements.

Remember to be very gentle with these stretches and only do about ten at a time, two to three times a day.  

Reverse Core Exercises & Traction for Lower Back Pain

Do you have a weak core? Is your back still hurting when you are exercising? Here are some reverse core trunk stability exercises to help prevent and relieve lower back pain. I'll also show how to do some traction at home to take some pressure off your back with simple positions.

Many times with low back pain our trunk area becomes unstable. The core muscles become weak and this can cause increased pain. Working the core can irritate the back sometimes, so this video is going to show you some reverse core or trunk stability exercises, and then finish with traction to the back. When you do reverse core exercises, your back stays flat and supported by the ground and you are moving your legs to give the lower portion of your abdominals a workout. 

First, you are going to lie down on your back. Bring your leg straight out and then bend your knee up towards your chest. You can do them all on one side or alternate back and forth. If that is too easy, bring both legs up off the floor and do the same exercise without putting them down in between. Then, you can add in arm movements, which is called the dead bug. Use your opposite arm when you kick out your leg. You can also do a bicycle movement with your legs in the air. Finally, you can put both legs at a 45-degree angle and keep them straight while performing a scissor like movement. 

For the traction, you want to find a countertop or area with a corner like in a kitchen. If you have shoulder problems, you probably don't want to perform this because it puts a lot of pressure on your shoulders. The best place to do traction is on a traction machine in a PT clinic or in a pool, but this will help relieve some of the pressure in your low back. Slide down into the corner pushing your arms out to each side. You can hang your legs all the way out in front of you. If that is painful on your shoulders, you can pull your feet in and bend your knees like a squatting position. If that hurts your shoulders, you can lock out your elbows, and hang in the corner with your feet barely touching the ground as seen in the video.

 

TMJ Exercises & Stretches to Relieve Jaw Pain

The temporomandibular joint, TMJ, can cause severe jaw pain. The jaw joint and surrounding facial muscles that control chewing and moving the jaw are often involved. Clicking, popping, pain, and deviations in the movements of the joint are common symptoms. Stretching the TMJ and strengthening the muscles around the joint are just as important as any other part of your body.

First, take your palm and slowly push on one side of your jaw. The pressure is on your chin. Push back with your jaw, but make sure your teeth are aligned. Start off gently, and if there is no pain, push a little harder.  Do both sides; this will increase the strength and control of the joint.

Next, push down on your bottom teeth with your fingers, and push up with your jaw.  Try to keep your jaw in one place, and don't bite down.

Finally, hold your mouth slightly open and aligned. Then, with your palm, push your chin straight in towards you. You should feel a stretch on your TMJ. 

Hold these for about 5 seconds each, and build your time up to 30 seconds, doing 3-5 each.  

 

Yoga Poses for Physical Therapy

Even though I'm not a yoga instructor, yoga is a great way to stretch several muscles at one time while strengthening your core. Here are a few of my favorite poses that we use in rehab every day.

The first is the child’s pose. You want to start in a kneeling position and sit down onto your feet.  Bow down to the ground and stretch your arms as far forward as you can.  This is a great stretch for your mid back and shoulders. You can hold it for 30 seconds up to a minute.

The next pose is the downward dog. You can start from all fours on your hands and feet, in a quadruped position. Lift your knees off the ground, and try to keep your heels down with your feet flat. Push your buttocks back away from your arms while trying to keep your legs straight. This is a great hamstring, calf, and back stretch. This is more stressful so you might want to only start with 10 – 15 seconds and work your way up.

Now you can transition into the upward dog. Bring your buttocks forward and down to the ground.  Roll onto the top of your feet, dorsum area, and keep your arms straight with your head up looking forward. You can start with your thighs on the ground, but eventually you want to push them off the ground. This will stretch your hip flexor muscles, your anterior tibialis muscles, wrist flexor muscles, and your core muscles.

The last two poses you will do standing. Not only will these stretch your muscles, but they will also challenge your balance. You will now move into the chair pose. Bend your knees into a squat position, and make sure you stick your butt back so your knees do not go in front of your toes. Have your feet about shoulder width apart, and slowly raise your arms to an upward angle. Hold this pose for about 30 seconds to a minute. This strengthens your hamstrings, quads, gluts, and shoulder muscles.

Finally, you can end with the popular tree pose. This will stretch your inner thigh muscles (adductors) and challenge your balance. Take your foot and slide it slowly up the inner part of your opposite leg as high as you can go while keeping your balance. Then slowly raise your arms above your head and put your palms together. Hold this as long as you can up to a minute.

Make sure you control your breathing with all of these poses. You want to take deep slow breaths through your nose. Namaste!

 

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