Physical therapy is a conservative form of treatment for multiple pelvic health issues

December 6, 2017 in News by Horizon Physical Therapy  |  Comments Off

Did you know that physical therapy is a conservative form of treatment for multiple pelvic health issues that lead to symptoms involving urinary incontinence, pelvic organ prolapse, and sexual dysfunction? Urinary incontinence is reported in up to 45% of women (Hay-Smith 2012) and affects over 200 million people worldwide (Knorst 2013). Approximately 41% of women between the ages of 50-79 experience some degree of pelvic organ prolapse (Hendrix 2002). Pelvic floor muscles have multiple functions including continence control, support to pelvic organs, core stability/postural control, and sexual function.

Pelvic floor muscle disorders are classified in two general categories: underactive pelvic floor and overactive pelvic floor. Underactive pelvic floor is typically caused by childbirth, advanced age, obesity, and heavy lifting or straining. Underactivity of the pelvic floor results in weakness of the pelvic floor muscles and contributes to symptoms of urinary incontinence and pelvic organ prolapse. Overactive pelvic floor is often multifactorial and caused by childbirth/surgical trauma, anxiety/stress disorders, bowel and bladder disorders, and orthopedic joint malalignments. Overactivity of the pelvic floor results in tightness of pelvic floor muscles and may contribute to a variety of pelvic pain disorders.

Physical therapy interventions can be utilized to address weakness and/or tightness of pelvic floor muscles to reduce symptoms of incontinence, pelvic organ prolapse, and pelvic pain disorders. We are pleased to offer services at Horizon Physical Therapy to assist you in reducing symptoms associated with pelvic floor muscle dysfunction and to help you return to a functional and active lifestyle. Examinations include internal and external pelvic assessment as well as musculoskeletal assessment to determine dysfunction of the pelvic floor. Interventions for pelvic floor muscle dysfunction often involves pelvic floor strength, endurance, and coordination training; behavioral training, including urge control/suppression techniques; musculoskeletal intervention; and diaphragmatic breathing techniques. For a comprehensive assessment and individualized treatment interventions to address your pelvic health issues, call today! ☺

Your Leg Raises Aren’t Doing Squat

October 30, 2017 in News by Horizon Physical Therapy  |  Comments Off

The underbelly of many lower extremity injuries

Pick up a copy of any popular running magazine. Page after page, your eyes gravitate toward gear you don’t need at prices you can’t afford. Your eyes scan over a cross-training regimen that promises to prevent injury and propel performance. The most common muscle groups addressed in these articles are, and always will be, core and hip exercises.

From our clinical experience and well-published research, these types of exercise regimens have a significant positive impact on performance and injury prevention. A strong core and strong hips are essential to a healthy and well- balanced exercise regimen.

Then why are you thinking, “I’ve done those clamshells and leg raises every day, but my runner’s knee still pops up every year during AthHalf training”? You’re right; you’re doing your homework, and you’re still getting hurt. So how can you correctly train your hips?

The misconception we see most often isn’t in which muscles our patients choose to cross train, but how. And this is true for more than just runners. In fact, sports which require any amount of rotation or agility (tennis, baseball, football, soccer, basketball, golf, gymnastics, etc…) each have a high demand for hip strength in order to diminish stress to the knees and ankles.

The problem is that the hip and core muscles are most often trained concentrically in an open-chain environment. However, these muscles typically function eccentrically in a closed-chain environment, which is when the hips work to control the legs and torso while your foot is in contact with the ground. The hips are highly adaptable muscles, which means they are very easy to train correctly, or incorrectly.

The commonly prescribed straight leg raise creates an open chain environment because your feet are not touching the ground. This type of exercise trains the hips but not in a functional pattern.

Long story short, your straight leg raises aren’t as productive as a squat for injury prevention and increasing performance. A squat, in comparison to a straight leg raise, requires additional core and hip control with your feet in contact with the ground. Below are videos demonstrating four closed-chain exercises intended to help with injury prevention and increasing performance. For those who are looking for a more technical explanation, I encourage you to watch Michael Griffith’s lecture from the 2016 NCSA National Conference.


  1. Single Leg Deadlift Reach
  2. Squat and Chop
  3. Monster Walks
  4. Alternating Lunges With a Twist

Common injuries linked to inadequately trained hips

Low back pain
Hip impingement
Piriformis syndrome
Hamstring strain
Runner’s knee
ACL Tears
Shin splints
Achilles tendonitis

Runners, listen to your feet

October 11, 2017 in News by Horizon Physical Therapy  |  Comments Off

Having worked with runners of all ages, shapes, sizes, and ability levels through the years, we are always looking for ways to improve our approach to diagnosing and treating running injuries. We’ve done this long enough to realize that the prescription commonly given in most health care facilities that sounds something like “if it hurts when you run, just stop running” simply doesn’t work. Rest simply doesn’t change mechanics, and runners who are told that stopping running is their only option normally are going to terminate their care with you ASAP.

Most running injuries are based, to some degree, on a biomechanical flaw that must be diagnosed and corrected in order for the pain to go away. One common biomechanical flaw, and one of the first things that we commonly assess in our runners, is their cadence. Cadence is the average number of times your feet strike the ground in a minute and ideally should be ~180 strikes/minute for shorter-statured runners and ~170 strikes/minute for taller runners. The idea is that most runners have a cadence that is too low, and they cover too much ground with every stride. This increases the load of each stride on their lower body. When a runner is diagnosed with a low cadence, our first intervention is to equip them with a metronome to help their body keep the rhythm of their newer, faster turnover. Many of you have entered our facility to the rhythmic, sometimes maddening tune of incessant beeping of the metronome with a runner trying to keep pace on the treadmill. A 2008 presentation by Willy et al revealed that cadence re-training lowered peak impact in runners by ~18-19%. This reduction often makes a significant improvement in the runner’s pain with running.

I give you all that information as a backdrop to say that I was very interested to read a research article in the August 2017 edition of The Journal of Orthopaedic and Sports Physical Therapy (JOSPT) entitled “Sound-Intensity Feedback During Running Reduces Loading Rates and Impact Peak”. Now I won’t bore you with all the specifics here, and I encourage those of you who are interested to find the article online and give it a read, but I found the results of the study to be very compelling. Basically runners were given a decibel meter (a free app that had been downloaded on an iPad) and told to try to decrease the sound intensity of their foot striking the treadmill using the decibel meter as instantaneous feedback. After 15 minutes of sound intensity feedback training with running, most runners (~80%) showed a 20% reduction in the peak impact on their lower body. This is a greater reduction than we would expect with cadence re-training.

Based on this research, we now have another, possibly improved, tool to reduce impact forces on a runner’s lower body and may eventually be able to step away from the incessant beeping of the metronome as our go-to tool for one of the most common mechanical flaws in our ailing runners.

Personalized Physical Therapy

November 28, 2016 in News by Horizon Physical Therapy  |  Comments Off

We were recently featured in an article, Personalized Physical Therapy on the Horizon for Athens Area.

If you’re interested in Georgia State Homes, check out what they have to offer for Watkinsville, GA Real Estate.

Fibryomyalgia: Learning to Live Again with Horizon Physical Therapy

October 21, 2016 in News by Horizon Physical Therapy  |  Comments Off

A year ago I was celebrating turning 50 by training for the AthHalf Marathon. Thrilled to be back home in Athens after 3 years abroad, the team from Horizon Physical Therapy was hosting weekly runs. I was always the last to finish the training runs, as an older, heavier runner, but I was still having a great time knowing I could do it. This would be the fourth half marathon I’d run and having the supportive Horizon team on my side while running the streets of Athens made me feel like a kid again.

In October 2015 I completed the 13.1 miles and was much more worn out than usual, but I was determined to keep going. By late January, it became obvious that something was wrong. I was unusually fatigued, my joints and muscles ached, and my brain felt foggy. Nothing seemed to make alleviate my symptoms.

My physician ran numerous tests, but nothing in the results explained my symptoms. I was referred to a rheumatologist. I was suddenly aware that I may be headed for something very frightening. Given the pain, the exhaustion, and foggy-headedness, I was already mourning the plans I had to be an energetic old lady. Instead I felt crumpled, defeated, and depressed. The rheumatologist diagnosed me with fibromyalgia. She shared that, in her experience, the patients who did the best were those who stayed active. I was elated I might be able to run again, one day, maybe.

I realized I wanted to be active but getting dressed and leaving the house felt overwhelming. I tried walking but would be too sore and exhausted to do it again the next day. I gained over 20 pounds on my downslide and lost the muscles I needed to support me at a slow walk. I needed to sleep 10 – 12 hours a night. More often than not, I wanted to cry with frustration. I needed to find solutions.

I learned how to cope with the exhaustion, but I also honed in on the importance of staying active – using moderate exercise as a way to reduce the symptoms. I felt trapped between what I wanted to do and my body’s ability to do it.

So I made an appointment with my friends at Horizon Physical Therapy. In the years before, Jimbo Wood, the owner of Horizon, helped me gain the confidence and ability to run long distances safely and comfortably. That confidence in my running ability allowed me to find balance through the most stressful of times. Now I needed his help again; I was at a loss and compared to how my health had been 9 months earlier, I was embarrassed by my condition.

My first appointment with Jimbo after the fibromyalgia diagnosis felt overwhelming, but his sympathy and compassion gave me hope. We agreed to look at this from all the angles we could. One of his first suggestions was using the Alter-G treadmill to help get me moving.

It was the first time I stepped into what I call “Jimbo’s Magic Treadmill”. The Alter-G treadmill would allow me to exercise at a percentage of my body weight. Jimbo was right there with me, and adjusted my body weight to 50% to allow me to walk half a mile at 2.7 mph. He calmly reassured me as I started taking steps. I thought half a mile would be too much – it was when I tried on my own-, but I trusted Jimbo, and I wanted to get better. So I did it, and I did feel a little better. I had moved my body and gotten the blood flowing, but I didn’t feel beat up for once. I felt tired but in a good way.

And then Jimbo dropped the bomb- he wanted me to use the Alter-G daily for the next two weeks. My initial reaction was that I would be too tired, but I also wanted to feel better. So I began.

While I was there, Jimbo and the whole team at Horizon were so encouraging. They asked how I was feeling, cheered me on, and laughed at my bad jokes! There was such genuine care.

Jimbo had been closely monitoring my progress, and after my first two weeks, we agreed to extend my time on the Alter-G. I was able to go longer and further than I had imagined. Within 6 weeks, I was able to walk three miles at 50% body weight. More importantly, I was sleeping more soundly than I had in months, and my brain was clearer. Seven week after I first crawled into Horizon, I was ready to run again. I was so nervous about it, fearing a relapse but also excited to try.

In the weeks since that time, I’m on the Alter-G five times a week. I am running harder every day, and slowly building up to full body weight. The weight I gained is coming off, and my fibromyalgia symptoms have become much more manageable The team at Horizon is constantly encouraging and supporting me. Even on days I’d be happy to stay in bed, they make it worthwhile to go workout.

Soon I’ll be running on dry land without “Jimbo’s Magic Treadmill”. It has not been a quick and easy fix – I had to commit to doing it, day in and day out, but I never would have gotten to this point without help. When you see me running through town in the rain, jumping in the puddles, you will know the reason for my pure joy. I’ve actually been given my life back by the care and compassion of my friends at Horizon Physical Therapy!

Fibromyalgia: Learning to live again (PDF)

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