STRENGTHENING

Building strength is one of the primary things a physical therapist works on.  I think it is very important to build and especially to maintain strength.  It is one of the main reasons people are able to live in their own homes and are not required to live in a skilled nursing facility (SNF) or nursing home.  

 

 

Many people end up in a SNF because they can no longer take care of their own needs.  They cannot get out of a chair, cannot make it to the bathroom, have difficulty walking, or lose their balance and fall frequently.  

 

I feel that strengthening should be addressed once the skeleton is in neutral alignment.  It has been interesting observing that in addition to pain reduction, strength can immediately improve in people who have their alignment restored to neutral.  I have tested this several times and my suspicion is that when the alignment of the skeleton is off, the muscle no longer has the best angle of pull and therefore tests weak.  Once the alignment is restored, the muscle function can also be restored.  This is common with what appears to be an overuse or tendinitis. 

 

Tendinitis has tenderness to palpation (pushing or poking) at the musculotendinous junction or the place where the muscle joins the tendon.  After performing the Releasing Joint Restriction (RJR) protocol listed under Pain Reduction page, the tenderness often reduces and the function of the body part can be restored.  It all depends on the amount of injury present. 

 

Once enough tearing has occurred in a muscle, the only options are to fix it surgically or live without that muscle function.  Several patients over the years have been told by their orthopedic surgeon that they are not a surgical candidate because their muscle turned to shreds and looked like chewed gum so the surgeon had nothing to attach to the bone.  

 

With reduced pain in the muscles and joints, I begin focusing on the inner core, or pelvic floor muscle group.  I find this is the most important muscle of the body to prevent the spine from going out of place and causing pain.  Learning to fire this muscle takes a little bit of practice but I find it to be the most important tool for anyone who wants to prevent pain from recurring and for people who want to improve their incontinence or ability to hold back urine.  Once alignment is restored, I work with people to improve their function or ability to move the body around and do everyday activities of self-care such as moving from sitting to standing and walking.   

 

While building any muscle it is very important to start slow and build very gradually.  With any strengthening activity, or moving a body part repeatedly, there is a risk of overusing the muscle.  There is a page on muscle overuse under the Information page on this website.  Every muscle has a certain number of energy tokens it can spend during each day.  Once you go over that number, if you continue to use the body part then you start popping or tearing the smallest fibers of the muscle.  When you rest, those fibers can repair.  But if you keep using it you can tear it completely and rupture the muscle.  The only thing that repairs a torn muscle is surgery.   

 

Pretend you are a marathon runner and start slowly and build gradually when you start any strengthening program. 

 

If you are weak, start with only a few repetitions of each activity or exercise and then every few days or at least one time a week add 1-2 repetitions.  Keep building gradually so you can stay strong enough to live in your own home ideally without needing a cane or a walker and you will be able to make it to the bathroom and ideally sleep through the night without having to wake to use the bathroom.