When the Weather Gets Cold, Don’t Forget to Warm Up!

The man in sportswear is jogging through the winter country roadColder weather means some changes to how we exercise. Of course, it’s harder to motivate yourself to get outside for a run or bike ride when the temperature drops, and the shorter days compress our schedules, but there are changes in your body that affect your ability to exercise too. For many people with arthritis or other joint problems, cold weather brings more complaints of pain. To stay warm, our bodies narrow blood vessels to reduce blood flow to the skin, and more superficial muscles. That means that there is an increased risk of muscle strains in the cold. There is also an increased strain on the heart because of the narrowed blood vessels. This isn’t to say that you shouldn’t be active outdoors in the cold, it just means you may have to make a few changes to your routine. Here are a few to consider:

Warm up right

A good warm up is always important, but because of the tendency for joints to be stiffer, and blood flow to muscles to be reduced in the cold, it’s even more important that you do it right this time of year. To start, do something to get your heart rate up a bit, maybe a brisk walk or light jog. Follow that up with a dynamic warm up rather than static stretches. This could include walking or jogging while pulling your knees up high to your chest. Maybe some high kicks in front of you with straight knees to get your hamstrings loosened. A walking lunge with an upper body twist can get your whole body moving. Cater your warm up to what you have planned in your workout. If you’re not sure how it should look, ask your physical therapist!

Dress right

Dressing in layers allows you to adjust your insulation to your activity level. After you warm up, you might want to take off a layer to avoid getting too hot during your main activity. You’ll have it there later to put back on when your activity level drops and you start getting too cold.


Don’t forget about the sun either – just because it’s cold doesn’t mean the UV rays are gone. Sunscreen and sunglasses aren’t just for the summer. A lip balm with SPF can protect you not only from the sun but from the wind too.

Stay hydrated

Drink water before, during, and after your workout. The temperature may be down, but you’ll still sweat and you’ll still lose water vapor in your breath. The drier air in winter lets your sweat evaporate more quickly, so it’s easy to underestimate how much fluid you’ve lost.

Cool down

When you’re done, don’t rush to get inside and crawl under a blanket. Cool down properly. Keep moving with a walk or another form of active recovery to let your heart rate come down. After exercise is the right place for static stretching. You can also head inside for some foam rolling or self-massage.

The days being shorter and the temperatures being lower don’t mean you’re stuck inside for all of your exercise. If you follow these tips, you can safely keep moving outside. If you’d like a customized warm up or cool down, or have questions about your exercise routine, your physical therapist is a great person to ask!

Does your Growing Athlete have Knee Pain?

Patellar Femoral Pain Syndrome, otherwise known as PFPS, is common in adolescent athletes especially those who participate in sports year-round. This diagnosis presents itself with generic soreness in and around the front of the knee and/or kneecap. Since most athletes in their teens have growth spurts, their bones grow faster than their muscles. This causes an imbalance with the forces around the knee causing abnormal motion of the kneecap. Typically, this will cause pain with prolonged standing, negotiating stairs and athletic activity in general.

Physical therapy is one of the few avenues available to reduce the pain and accelerate a return to sports with full function. The typical plan of care is as follows:

  1. REDUCE SWELLING: Modalities, such as ice, heat or electric stim can help
  2. INCREASE FLEXIBILITY:  Chances are good that the ligaments surrounding the knee (IT Band, lateral retinaculum) haven’t kept up with the bone growth and are therefore very tight.  As a result, the patella moves laterally (to the outside) when running or walking, creating extra friction, and often pain.  Stretching the tight ligaments allows the knee cap to return to its normal tracking pattern and will reduce pain.
  3. STRENGTHEN WEAK MUSCLES:  As the therapist works to stretch tight ligaments, the patient must also strengthen key muscle groups, such as quadriceps, hamstrings, gluteus medius, gluteus maximus. These muscles help to stabilize the joint which provide increased endurance with sport-related activities and also help to keep the patella moving smoothly.
  4. ADD PLYOMETRICS:  As pain and swelling is alleviated, it is time to introduce a plyometric program, such as agility or sport-specific training.  This is the final step with therapy to help the athlete ease their transition back to his/her sport. This last step challenges the athlete with higher functional tasks in order to simulate game or field conditions. Quick steps, lateral jumps, and ladder drills are just a few of the techniques that a therapist may use to help move a young adult toward reentry to their sport or activity.

Don’t wait and deal with pain! Come in and see a physical therapist today.

Plogging: Jogging with a Dual Purpose

Yes, I know what you’re thinking, I am blogging about plogging. Well if that rhyme doesn’t convince you of the merits of this new trend, keep reading.

Plogging is a new spin on exercise that allows us to make the world a healthier place while making sure we stay healthy too. Originating in Sweden in 2016, this trend has generated increased attention over the past 2 years, and it’s easy to see why!

This activity turns a boring old jog around your neighborhood into a unique type of scavenger hunt, all while improving your community, one piece of litter at a time! Not a runner?  No problem! You can still participate with a simple walk while cleaning up the street, also known as plalking.

While jogging and walking are both fantastic aerobic exercises, plogging increases your workout potential by incorporating several functional activities, such as squatting, lunging, stretching, and maintaining balance. However, to avoid injury, follow these recommendations:

  • Ensure you maintain proper form as you bend to pick up items from the ground. This includes bending at the knees, not at the waist.
  • Be sure to come to a full stop before bending over, which will help avoid over-extension of joints and muscles.
  • Perform squats or lunges in a slow and controlled manner to avoid putting unnecessary stress on your back, knees, and hips.
  • When squatting, make sure you can see your toes past your knees, if you look down. Imagine you are sitting in a chair placed behind you.
  • Avoid motions that cause pain to reduce the chances of inflammation following exercise.

If plogging sounds like it’s for you, here are a few tips which will help ensure a safe and healthy experience before you set out to clean up your neighborhood:

GERM PROTECTION: A good pair of gloves are a must to ensure protection from bacteria and germs.  Some of stuff you’ll find can be pretty dirty!
PLASTIC BAGS:  This one is a no-brainer, but it might be a good idea to pack an extra bag or two…you never know how many “treasures” you’ll find!
WARM-UP/COOL DOWN: No matter your age, a light warm-up before plogging and brief cool-down afterwards are always a good idea.  Dynamic stretches (stretching as you are moving) before and static stretches (long holds in a stretched position) afterwards will help your muscles stay limber and healthy.
HYDRATION: Drink plenty of water! Our bodies love water and making sure you stay hydrated is an easy way to keep you energized and healthy.

The bottom line is, if you’re looking for a spin to your daily workout and would like to do your part to help clean up your community, get out and get plogging!  Interest in plogging is growing and you are likely to find others who are passionate about it in your community.  Check out the Lancaster Plogging Facebook page where like-minded people often plan group plogging outings for the community.  Happy Plogging!

Shoulder Injuries in Swimmers

Around 70% of Americans will be treated for some type of shoulder injury in their lifetime.  If we narrow the focus to competitive swimmers, the percentage skyrockets.  Why, you ask?   Well, the repetitive motion inherent in the act of swimming combined with the complicated junction of muscles and tendons surrounding the shoulder joint can be a recipe for disaster in those swimmers who don’t yet have perfect technique.

A COMPLICATED JOINT: The shoulder joint is intertwined with many other muscles groups of the torso including the abdominals, upper and lower back, and pelvic muscles.  When one of these adjacent muscles is not working in harmony with the others, the instability causes increased wear and tear on the shoulder joint.  This can contribute to unnecessary fatigue and potentially cause injuries, like “Swimmers Shoulder”.   Beginners and those who swim with poor technique are especially susceptible to such injuries.

There are three distinct components of the shoulder on which we should focus when assessing strength for injury rehabilitation or prevention:

  1. Rotator cuff
  2. Muscles that stabilize the shoulder blades (upper back)
  3. Muscles of the lower back including the pelvic muscles and abdominals


Injury prevention techniques can be a good way to ensure you can continue to have fun in the water without pain, but the best advice is to slow down and use good form to avoid future injuries.

Strengthen Rotator Cuff: A great exercise to ensure rotator cuff strength is to place the arm at 90 degrees with the elbow at your hipbone and rotate to the outside.  This builds strength and muscle stamina

Joint Stabilization Exercise: For shoulder stabilization improvement, you can do a straight arm lift. Keep your arms out to your side as long as you can hold them.  This will strengthen the muscles behind and between the shoulders.

If you are a competitive swimmer or triathlete who is experiencing shoulder pain, we welcome you to stop in for a visit, even if only to get some tips on prevention and strengthening.  As a former Division 1 collegiate swimmer, Brian Hartz specializes in treating and preventing swimming injuries. HARTZ PT offers an endless pool in its Lititz office which is ideal for stroke analysis and modification.

Snap Krackle Pop…The Truth about Joint Cracking

It’s a long day. Tension is telling your spine that you need some relief so you decide to crack your back. Your mom’s voice echoes in the back of your head “Don’t do it! Cracking your joints is not good for you!” You ignore the voice and obtain a satisfying “pop” before returning to the workload, wondering if you did yourself a favor or contributed to future joint degeneration.

So what makes that sound anyway? And how can something that feels so good ever seem bad for you? One theory is that quick movements change joint pressures, moving nitrogen bubbles inside your joint fluid (synovial fluid) and resulting in that desired “pop”. Another mechanism that can cause noise is ligaments undergoing rapid tension. These sounds typically occur when a joint is in a position where it is running out of movement. This is why you may have to bend or twist your body in an unnatural position before you get a “crack”. These mechanisms are usually what are involved when joint cavitation (the medical term for pop) is discussed.

Joint pressure and ligament tension changes are the main causes we will discuss, however there are a few other sources of joint noise which may include tendon rolling, arthritis, or other conditions/mechanisms.

Let’s look at spontaneous popping first (the kind that happens with ordinary movements). Despite these sometimes ominous noises there are usually few reasons to be concerned. Most health professionals agree that cavitation is a very normal occurrence that doesn’t contribute to osteoarthritis or other degenerative joint conditions. So if things get noisy when you roll out of bed in the morning, stand up from a chair, or warm up for your next athletic event, don’t worry. It’s a normal occurrence that doesn’t necessarily point to a brewing joint problem.

Repetitive, intentional joint cracking (the kind your mom didn’t like) is a little different. This self-administered cracking is a little more controversial when applied to the spine. Why the concern? Looking back at the physiology, we see that joint cracking has the potential to apply stress to ligaments. This is due to those tight, end range movements. Concern arises when tight, irritated muscles and joint structures cause an individual to repetitively treat themselves with a crack multiple times per day. The problem is that muscle and other tissues get stretched (potentially) at the ligaments expense. This could create areas of instability in your spine if performed consistently and will not contribute to a long term solution for your stiff back.

So what’s the answer? Instead of twisting and manipulating your own spine, good posture, gentle stretching and strengthening can be beneficial in resolving your pain. See a physical therapist for treatment options on improving your painful neck, back, elbow, etc.

Cracking is only a concern when in conjunction with other problems. Medical examination may be warranted if joint cracking causes pain, results in restricted movement, or is accompanied by signs of inflammation such as redness or swelling. If any other abnormal joint functions occur (such as buckling) seek assistance from a doctor or physical therapist that is trained in joint care and can often see you without a prescription.

Bottom line: don’t worry if your body is determined to be noisy. If you constantly find relief from frequent cracking maneuvers you aren’t doomed to joint problems. However there are probably some other interventions that can fix the root of your problem like physical therapy. Finally, if you experience pain or concern involving a joint seek out a qualified medical professional.

Good Pain versus Bad Pain

For many reasons, I will never forget the first half marathon I ran.  In the spirit of full disclosure I will admit that I was never a runner (and by runner I mean slow jogger who could not hear the music through my ear buds over my own labored breathing). However I decided that with a little training and hard work, a half marathon would be a great challenge to undertake. After months of training, mostly pain-free, I completed a half marathon in Virginia with a time that I was only minimally embarrassed to disclose publically.

Along the 13.1 mile course, there were thousands of people cheering on the runners and holding up tons of signs that were a mix of motivation and humor. I remember one in particular that said in GIANT blue letters “Runners, enjoy your pain, you’ve earned it”. I laughed at the time and didn’t think more about it.

About a year or so later, while training for a full marathon, I often thought of that very sign when running became painful and I didn’t listen to my symptoms. I tried to continue running for a few weeks through foot pain by simply being, as my mother would put it, “a knucklehead”. As the pain got worse — which I would later learn was a stress fracture — I realized that some pain isn’t worth earning.

We’ve all heard the mantra “No pain, No gain”.  I’ve heard this phrase thrown around since my days of little league baseball, long before coaches monitored pitch counts and days’ rest for young growing arms. It’s popular in locker rooms, post-workout chats and even some physical therapy offices. The question we have to ask though is “Does this long held belief hold up when it comes to exercise? Sure it sounds great, heck it even rhymes, but does it still apply to individuals who are looking to get healthy and treat their bodies a little better in 2014? ”

Pain has a protective function in our bodies. Pain helps tip us off to tissue damage that is occurring and allows us the opportunity to change our activity so we may allow our bodies’ adequate time to heal. When exercising, it is normal to feel that deep burn in your muscles as lactic acid, a natural byproduct of muscle contraction, accumulates.

Pain is not a normal byproduct of exercise. Typically after an appropriate workout, you can expect to experience what is known as delayed onset muscle soreness. Most commonly experienced 24-48 hours after a good workout, this is simply soft tissue inflammation caused by asking your body to do more than it is accustomed to doing. If you experience no soreness, you can probably ramp it up a bit. If you’re sore for greater than 48 hours, you likely overdid it. When you experience pain sooner than 24 hours after your workout, it is an indicator that you are doing something incorrectly.

If you are having pain, consider getting it checked out by a physical therapist. Physical therapists are experts in how the body moves and can evaluate your pain to determine good vs bad and get you started on the path to exercise health.

Signs You May Have Injured Yourself

  • The pain you are feeling is sharp.
  • The pain you are feeling is shooting or accompanied by
    numbness, tingling, pins and needles
  • There is a sudden onset of pain.
  • The pain developed in association withpopping, clicking,
    snapping or giving way underneath you

~ Hayden McDevitt, DPT, OCS, CSCS, ART