TMJ Dysfunction -- East Greenwich, RI

The temporomandibular joint (TMJ) is the hinge joint of the jaw. We each have 2 of them located just in front your ears. Those who have dysfunction or pain in the jaw know exactly where it is located. 

When this joint becomes problematic it becomes difficult to open your mouth, bite and chew. The jaw often will click and pop. You may also have headaches. These symptoms can be due to many issues including muscle spasms, inflammation, or problems with the disc in the joint. 

One of the underlying problems associated with TMJd is loss of mobility in the upper part of the neck (suboccipital region) and associated postural changes in the spine. These issues cause the jaw to change the way it opens and closes. 

Physical therapists should be your go to person to address these problems with the jaw. Treatments include hands on techniques to relax the jaw muscles and correct the mobility issues in the jaw. They also address the underlying neck and posture issues with hands on mobilization techniques. PTs will teach self mobilization and postural exercises so that you can manage the TMJ dysfunction on your own. 

4 self treatment activities that may help if your jaw has not been problematic for too long would be:

• 1. Self massage:  to relax the clenching muscles. Laying on your back with a small pillow supporting your head place your tongue on the top of your mouth allowing your mouth to slightly open. Using your finger tips work in a circular motion at the junction of your jaw just in front of your ear. Move your fingers in forward and backward directions using light pressure. Then stroke down from your temple and cheek bone to the bottom of your your jaw bone gliding over the TMJ. 

• 2. Shoulder blade pinches: to help correct your posture. Sitting with your back away from the chair, pinch your shoulder blades back and down. Hold for 5 seconds. Repeat 10 -20 time

• 3. Chin tucks: to help correct your posture and improve neck mobility. Sitting with your back away from the chair, pull your head straight back keeping your chin tucked in.  Think of pulling your nose away from something that smells foul. 

• 4. Resisted jaw opening: to help relax the clenching muscles. Sitting or standing try to assume corrected posture by lightly pinching shoulder blades and tucking chin as described above. Place your fist under your chin. Gently open your mouth, resisting the movement with your fist. Hold for 5 sec. Repeat 5-10 times. This should help with reducing the tone of the clenching muscles around your jaw. 

If you need more advanced help in resolving TMJ issues please contact us at Tru-Care PT or call 401-884-9541.  If you are not in the East Greenwich area contact your local PT for further guidance. 

More Gardening Tips -- Erin Harrop, MSPT

April and May showers bring...

Spring flower beds to be cleaned and mulched, and vegetable and herb gardens to be prepared and planted.  With the weather finally starting to warm up consistently, for anyone who likes gardening (or doesn't like gardening), there is always plenty of work to be done in the yard as everything begins to grow.  With final clean-ups from winter and early spring, and preparations for the spring and summer seasons, there are many common yard tasks that can lead to stress and strain on muscles and joints and cause pain, such as digging, weeding, planting, lifting, raking and mulching. 

If you have been sedentary for most of the winter, have been dealing with previous injuries, are pregnant or have recently given birth, or are a senior, you may be more prone to injuring yourself.  Shoulders, neck, back, and knees are common areas of concern with gardening and yard tasks.  Taking consideration of some of the following tips can help to minimize your risk of injury.

• * If you have not been active in awhile, sometimes it can be helpful to start with a warm-up before beginning yard work.  You can start with a brisk 5-10 minute walk around the yard or down the street and then complete some simple stretches in your shoulders, neck and back.  Gentle shoulder shrugs and circles, gentle side to side neck stretches, and clasping your hands in front and behind your body to stretch can be helpful.

• *Don't over do it!  Be mindful of the sensations in your body and keep your tasks slow and controlled.  If you are feeling discomfort in any region of your body, stop and stretch, or switch to another task.

• *Take breaks and change position frequently.  Being in a static position or moving in the same pattern can cause increased stress and tension in a focused area of your body; overstretching some muscles or causing spasm in others.

• *Use appropriate body mechanics: bending your knees and using your legs with your core muscles engaged for any pulling, pushing, lifting or bending activities.  This will help to avoid straining your back.  Attempt to only kneel on one side, keeping the opposite foot on the ground to keep a flat back and provide your back with more stability, and switch kneeling leg as able.

• *Use tools if you have them:  a wheel barrow or garden cart to move tools, planting materials, yard waste; kneeling pads or pillows, et cetera.

• Taking a short walk or light stretching after completing your tasks for the day may help you cool the body down and stretch worked muscles in the body.  A warm shower or bath can also be helpful with easing muscles.

• *If you experience any lasting or severe pain, contact your physician or physical therapist.  If you have any further questions about how you should be modifying your yard work or gardening, contact us at Tru-Care Physical Therapy, 401-884-9541.  Erin Harrop, MSPT

Gardening without Pain

It's April 7th and I think I may be seeing signs of spring! The daffodils at my back door have bloomed. The birds are nosing around the bird houses for a new nesting spot. The neighbors are out raking, trimming, pruning.



Gardening is hard work, especially after a long cold winter. Our bodies are just never prepared for the bending, twisting and lift that comes with getting our yards ready to explode with green grass and vibrant colored flowers. So be sure to plan ahead and pace yourself, especially if you know that your (fill in the blank-- back, knee, shoulder....) has not been feeling so well in the past. Try not to push to get it all done in a single weekend.

TRX Suspension Training

Have you lately heard the terms TRX or suspension training and wondered what they meant? TRX stands for total resistance exercise and suspension training is a system of exercise that utilizes your body weight leveraged against gravity to create resistance. TRX suspension training was born out of necessity by navy seals to stay in peak physical condition while on missions where training space and equipment was at a premium. Because of its versatility, TRX suspension training is now utilized in a wide range of settings from training professional athletes to senior citizen wellness programs, and injury rehabilitation at Tru-Care PT.

How does TRX suspension training work?

Sprain or Strain?

Some of the most common injuries treated by PTs are sprains and strains. Although treated similarly they are injuries to different parts of the body.

Sprain: This is an over stretching of a ligament or a joint. Ligaments hold 2 bones together forming a joint.  The joint capsule and ligaments that are the support system of a joint.  If the joint is over stretched these structures become weakened and lax.These injuries occur when a joint is taken beyond its normal range of motion like rolling an ankle or over reaching with your arm. 

Deductibles in 2014

It is the beginning of 2014 and it is time to address the cost of being well -- The burdensome DEDUCTIBLES AND CO-PAYMENTS. 

This is a great post by Dr. Eric Christensen, PT, DPT. He lays out a great argument for why you should invest your healthcare dollars of your deductibles with physical therapy treatments. 

He makes the case based on:

• Average costs compared to other medical intervention. (ours is ~$75)

• Value received for those dollars invested

• PT's training as the musculo-skeletal and movement professionals of choice

• The diverse skill sets that PTs have allowing them to treat many issues.

So take a look at what he has to share and see if you don't agree. Check it out here.If we can be of assistance please let us know. Contact us at www.trucarept.com or call 401-884-9541.

Shoulder Bursitis

What is bursitis and how did you get it?

Lets start with what a bursa is.  The bursa is a fluid filled pouch that acts as a cushion between the bones of your shoulder and arm and the tendons and soft tissues that attach to them. Bursitis is an inflammation or irritation of this pouch. Bursitis is also often associated with tendonitis.

Balance and Falls

As we age, it becomes increasingly important to have good balance to assist in fall prevention. The CDC reports that 1 in every 3 people over the age of 65 years old will fall one time each year. This statistic increases to ½  population over the age of 80 years old. Those are some pretty staggering numbers! These falls can result in minor bruises or bumps but also often result in fractures or head injuries.  To prevent injury, we suggest assessing yourself to determine if you are likely to be one of those who might be at risk of a fall. 

Yoga For Back Pain-- Part 2

Part II         Improving mobility of the lower body is also important in controlling back pain.

            Tightness in large muscles in the lower body are also very frequent causes of in low back pain. The most common culprits are the hamstrings (back of your thigh) and the hip flexor, a deep muscle in the front of your hip that attaches to the low back . The hip flexor can causes increased curve in the low back  and pulls your pelvis forward if it is tight. The hamstrings often cause a flattening of the curve in the low back and tilt the pelvis backwards when it is tight. This creates abnormal stresses upon the spine.

Yoga for Back Pain-- Part I

Low back pain is one of the most common reasons people seek out physical therapy care, and clients often ask if yoga can improve their low back symptoms. Therefore, as part of National Yoga Month this September, Tru-Care Physical Therapy would like to share some insight why yoga is often considered effective in the treatment of back pain.

Yoga has many benefits that assist in the management of low back pain that include improving posture, increasing flexibility, and stabilizing the spine by increasing core strength.

Weight lifter's Elbow??

Weight lifter's elbow? Never heard of it!  

How about Mommy's elbow? Carpenter's elbow? Typer's elbow? Salesman elbow? ..... No?

Perhaps Tennis or Golfer's elbow?   Yes I am sure that most of you have heard of these 2 issues.  But all the others are the same problem.  Any of the options above create similar stress on the elbow as does tennis or golf. Mom tries to do all her tasks one handed while keeping hold of a crying child; Joe swings a hammer or holds a drill overhead for hours at a time; Jean decides that doing 3 sets of lateral raises with increased weight should be OK; and Fred sits at his computer programming all day long with fingers flying across the keys.

All of these tasks stress the forearm muscles.  These muscles actually are responsible for motions and movements at the wrist. The common extensors are the muscles that pull your wrist up and they attach to the outside condyle (bony area) of your elbow and the common flexors attach to the inside condyle and they pull our wrist down.  They also control the movements of the fingers for opening and closing the hand. 

Why am I Taller in the Morning?

Ever notice that when you get into your car at the end of the day you need to readjust the mirrors? Somehow you are not sitting as tall as you did when you got into the car in the morning. Are you shrinking?

Well, yes, in a way you are. The discs in your back are cushions of sorts and they react to pressure. After a good nights sleep lying stretched out without compression on your spine the discs are full and plump. This makes your spine a little longer and taller. Once you are up sitting, walking and vertical all day gravity takes its effect and slowly compresses those discs. As they compress they loss a bit of fluid and and become a bit narrower bringing your vertebrae closer together. Essentially you are shorter than when you started your day!  

Over time our discs become "dehydrated" and are less plump and flexible. This is part of the reason that over our lifetime we may lose up to 2 inches or so. On average we begin shrinking at about age 40 and lose about a 1/4 inch per decade. If you are losing more height than that some other issues may be involved. You could be losing muscle bulk and decreased strength allowing for poor posture that can result in decreased height. Osteoporosis could also be a culprit as the bones lose density they can also compress. 

So don't be surprised when you need to adjust your mirrors. It's part of standing upright all day. If you feel you are losing more than the average be sure to check in with your physician or physical therapist to be sure there are no other factors involved. Try to keep yourself active, maintain your muscle tone and strength. These will keep you standing tall.

Visit Tru-Care for more information or call 401-884-9541

Take a hike, fly a kite

As we are wrapping up the final weeks of Summer , the heat wave has been keeping most of us indoors by the air conditioner or fan, or seeking respite in pools or beaches.  Although it may have been too hot to pursue many of the following this past month, the State of RI has many beautiful beaches, park lands, and bike paths great for walking, biking, swimming, hiking, canoeing or kayaking, and many outdoor endeavors to keep ourselves and families active and healthy.  The month of July has been National Recreation and Parks month which leads us into Family Fun Month in August!  Here are a few tips and opportunities to get out and enjoy the summer!!

Link to Recreation and Parks in RI:
http://www.riparks.com/
http://www.visitrhodeisland.com/what-to-do/
http://www.ri.gov/links/?tags=outdoor+recreation


Family Fun
http://www.rifamilyguide.com/index.html
http://www.southcountyri.com/what-to-do/family-fun

If you have not been able to get out and enjoy the activities available due to being limited in your general activity level due to pain or injury, please do not hesitate to contact us at www.trucarept.com

Vertigo -- The Room is Spinning, Make it Stop

Vertigo can be caused by many things including head trauma, stroke, neurological issues or tumors.  This post will focus on a very easily treated form of vertigo-- BPPV (Benign paroxysmal positional vertigo).  This type of vertigo is related to changes in position of the crystals that are a component of the inner ear. 

Symptoms include brief bursts of dizziness, spinning sensations, nausea and or lightheadedness. Some complain of a vague sense of not being "grounded" and being off balance.  Symptoms are often intermittent being present for a few days or weeks, stopping and recurring again. 

Self Assessment Yoga Style

Thanks for checking out our second post on Posture in the month of May.  Last week we told you what "optimal posture" would look like.  Today's article incorporates some self mobility, assessment and awareness to work on correcting your posture by sensing were you are in space.  Let us know how it feels when you get your self "stacked up right" (or is it "upright"!!!)

Standing Postural Assessment 2: You can also check your posture by bringing awareness to your body. Give it a try on your own, or come see Erin at our yoga classes Tuesday at 8 AM or Thursday at 7:30 PM. Stand with your feet slightly apart, placed directly under your sit bones. Shift your weight slightly forward and backward on your feet a few times. Then, settle with equal weight on the heel and ball of the foot. Next, shift your weight onto the inside and outside edges of your feet a few times. Then, settle with equal weight on the inside and outside points of the foot. Moving up, stack your knees directly over your ankles. Then hips over your knees. Check in!  Do you have equal weight on each leg?  Are you able keep muscles relaxed along the front and back of your legs? Now, bring your attention to your tailbone and pelvis. Your center of gravity is located here. Tip your pelvis forward and backward a few times. Then, settle so your tailbone is pointing down towards the floor directly between your feet and your belly is tightened slightly like you are zipping up a pair of pants. Continue by moving your attention up your spine stacking each vertebrae on top of one another. Now, turn your attention to your rib cage, gently rock forward and back a few times to feel gravity pull you in each direction.  Settle in the middle so your rib cage is stacked over your hips and you feel like your rib cage is floating effortlessly over your abdomen. Bring your attention to your shoulders. Shift your shoulder blades up and down, forward and back, then in circles. Settle with your palms facing forward, your shoulder blades gently pinching and your chest opening. Now move your attention up your neck, one segment at a time until you get to the base of your head. Gently tuck your chin so the crown of your head is reaching towards the ceiling and the base of your head is gently resting on the top of your neck.   Imagine yourself being pulled from the crown of the head along that "plumb line"  that we discussed in the previous post.  Lengthen out your body, reversing the effects of gravity. Stand tall and feel what it is like to draw awareness to your posture.

As always we hope the information is helpful in your daily pursuit of good health and improvements in mobility

Standing Posture

Most of you likely do not know that May is POSTURE MONTH.  Who would think that posture could hold your attention for a full month! Well being that posture has an effect on how we move, (or maybe don't move) breath and function there is a lot to know. Please read on for the first of this months four postings on posture.

Standing Postural Assessment  Standing posture is often assessed from the side of one's body with the use of a plumb line. The plumb line is used as a visual reference to look for muscular and skeletal balance in the body.  If you have "good posture" the line should pass through your ear lobe, the center of your shoulder, your center of gravity located at the base of your spine, the center of your hip joint, the front portion of your knee joint, and just in front of your outer ankle bone. This alignment maximizes the efficiency of our systems by minimizing the work required by our muscles and decreases stress on the joints.  You can take a look in a full length mirror and get general sense of how "aligned" you are.  If your head falls forward of your shoulders you will likely have or develop neck and upper back pain. If your shoulders are forward or your mid back is very rounded you may develop shoulder pain and tendinitis. If your back is excessively arched you will likely increase wear on the small joints of your lumbar vertebrae. That will lead to central back pain. What to do if you notice any of these problems when you look in the mirror: There are basic stretching and strengthening exercises that can help correct these issues.  Give us a call and we will send you a FREE stretching and strengthening program to help you address the tight and/or weak muscles.      For more information you can check out this web site.  http://www.posturereview.com/myPosture/myAssessment/mySideAssess.html

As always we hope the information is helpful in your daily pursuit of good health and improvements in mobility.

Golfer's Body

Preparing your Golfer’s Body

The greens are finally warming up and though many of you probably were able to play through the winter, we will soon be experiencing some awesome sunshining golf days.  Shouldn’t you tune up your best piece of sporting equipment?  No -- not getting new grips on your clubs or buffing your shoes!  I’m talking about the true piece of equipment that will provide the longer drive or more precise putt... your Golfer’s Body!

Considering that you must be fit enough to be on the course for several hours and bend, twist, rotate and squat,  what will you do before getting back on the course.  Some things to consider are flexibility, strength and balance.  

Since the distance you hit the ball depends on the rotation of your trunk and the ability to shift your weight from back to front as you swing it makes sense to work on flexibility of the legs, hips back and shoulders to allow more range in which to develop your swing speed.

But what good is all that motion if you have no control of it?  You need to work on core strength and balance too.  What does this mean?  You can do some basic exercises that target the muscles you use to swing your club with better rotation, control and speed.

Here is a great resource for golf related exercises:  http://www.mytpi.com . Take a look and see how easily you can get your Golfer’s Body back in great form.

On top of improving your swing, game and hopefully bragging rights you may well avoid back, hip and knee pain/injury, golfers elbow, rotator cuff issues and many other maladies.

So try a few exercises, get your mobility and strength working for you. Then go on out there and hit em straight and far. If you need more help head to www.trucarept.com and set up screening to get more help