January 21, 2018

No Pain, No Gain

She strained her shoulder with that workoutShould I hurt after exercise?

Why do I have soreness in my muscles?

What does No Pain No Gain really mean?


We’ve all heard the saying, “No pain No gain”. The question is: myth or fact?

To know the true answer, let’s take a look at what is happening from the inside!

Post-exercise muscle soreness is referred to as “DOMS”, delayed onset muscle soreness. DOMS is a feeling of increased stiffness and/or pain following physical activities. So why does this happen and is this benefiting me?

During physical activity, your muscles contract concentrically (shortening) and eccentrically (lengthening). Imagine performing a bicep curl. When you eccentrically stress your bicep with elbow extension, what is allowing your arm to stop this motion against gravity? Your muscles are made up little muscle fibers that glide in and out of each other during muscle contractions. An eccentric muscle contraction requires “braking” in order to stop your arm movement against gravity. This in turn, causes small micro trauma to the muscle. During the healing process, nutrients are used in your body to repair the damaged tissue which results in muscle gains.

What’s important is knowing when to rest! A safe rule to follow is, allow each muscle group 4-5 days to recover before training it again. This gives your body enough time to repair the damage. You will soon notice that over time, your body will start to adapt to your workouts and the DOMS will become less severe (if felt at all). That’s why it is important to progressively overload your muscles without pushing them too hard. A nice consistent challenge will allow muscle growth without injury.

So yes, pain is a common side-effect of exercise. From athletes to weekend warriors to a patient initiating physical therapy, you will all experience this. What’s important is listening to your body and knowing when rest is appropriate. Nobody knows your body better than YOU!

~Lindsey Bolen, BS, PTA


Pass Thumbs UpCongratulations to Dr. Heather Tipsord, PT, DPT for passing her Indiana State Board Physical Therapy Exam.  Dr. Tipsord has been with Peak Performance since 2010 advancing her education and professional career to become a physical therapist.






Happy Halloween

Candy Corn Happy Halloween with decorHow can I make Halloween healthier?

What are some tips for Halloween safety?

As we head into fall, Halloween is quickly approaching. It’s a tempting time with so many sweet treats being thrown at us from all directions. Before you eat all that candy and slip into a sugar coma, consider keeping the holiday a bit healthier with these tips.
1. Fill up with a healthy dinner before you take the kids trick-or-treating to help avoid over-indulging on the sweet stuff.

2. Get active with some fun party games before trick-or-treating. Bob for apples, carve pumpkins, play witch’s ring toss, or have a monster mash dance party. Who has the best mummy, zombie or Frankenstein moves???
3. Walk the neighborhood with your kids while they’re trick-or-treating. Minimize driving, and if you must drive, accompany the kids up to each house for a little exercise.

4. If you’ll be passing out candy instead of collecting it, offer healthier snacks such as apples, dark chocolate, real fruit chews, pretzels, or sugar-free gum.

5. Keep your favorite treats and share the rest. Take them to work, or at least stash them away so you and the kids aren’t tempted to grab a piece every time you walk by the candy dish.
6. Don’t forget about staying safe. Remember to walk in well-lit areas, wear light or reflective clothing, use sidewalks, inspect treats for tampering, drive cautiously, and avoid open flames while dressed in costume.

Have a safe, healthy, and happy Halloween!





Happy New Year

Prueba1679Wishing all of you a safe and happy New Year’s.   May 2016 be healthy and prosperous for everyone!

What is the best position to sleep for back pain?

iStock_000025796411Small (640x426)Why does my back hurt in the morning?
Why is sleeping posture important?

Most of us have heard either mothers or grandmothers scold to “sit up straight.” Posture has always been a focus since we were little (despite few of us heeding this advice). We are exposed to ways to correct posture daily at work and home with the various ergonomic tools made to improve work place stations, but how often do we consider sleeping posture?
Mild stiffness in the mornings is a normal occurrence. When we sleep, gravity is no longer compressing the discs in our spine, allowing them to absorb the fluid around them, much like a sponge. Therefore, when we awake, these discs are a bit more swollen than they are the rest of the day, creating a bit of stiffness initially. As we begin to move around, gravity starts to compress these discs again, squeezing out all the excess fluid, giving us more mobility and less stiffness. Generally this resolves within 30-45 min of waking. However, if you are experiencing any stiffness lingering longer through the morning, or with a bit of discomfort associated with it, you may consider what positions you’re sleeping in.
Many people first admonish their mattresses; however this is generally a pretty expensive “fix” that does not make any guarantees. Ergonomic fixes at your work stations are designed to help keep your spine in a neutral position, why should sleeping be different?

Here are some tips to help improve sleeping posture, to set yourself up for a more limber, pain free day:

1. Try to avoid any twisted positioning, i.e. half stomach, half side
2. Consider the firmness of the mattress, is it very firm? Or very soft allowing some sag in your spine?
3. Consider “lumbar support” in laying: roll a towel into a 3-4 inch roll and wrap it around your natural waist; this will either fill in the gaps your waist creates on a more firm surface or helps prevent any additional “sag” on a softer surface.
4. If you notice the towel roll is helpful, more permanent solutions can be made, much like the lumbar pillows you can buy for sitting during the day.

K. Schultz

Patient of the Month

Patient of the month JuneEach month, the staff at Peak Performance select and recognize a current patient who stands apart for his or her exceptional attitude, compliance and progress over the course of physical therapy. The patient of the month for June, 2015 is Scott. If you see Scott in the clinic please join us in congratulating him on this distinction.

What to expect after a knee joint replacement

iStock_TKAWhat should I expect after my knee replacement?

How should I prepare for my knee replacement?

Total knee replacements are becoming an increasingly common surgery. Knee replacements are often performed on patients with severe osteoarthritis, which causes pain and/or buckling of the knee resulting in loss of function, such as difficulty walking, squatting or climbing stairs. (Osteoarthritis is caused by the loss of joint cartilage resulting in bone spurring, commonly known as “bone on bone”). During a knee replacement the ends of the thigh and shin bones are replaced with hardware in order to alleviate the pain produced at the arthritic knee joint.
So, what should you expect following your knee replacement? You can be certain that you will have physical therapy. You will likely start your therapy in the hospital, then transition to an outpatient facility after you return home. Your surgeon might even have you perform exercises before surgery in order to maximize your flexibility and strength, thereby making your post-operative recovery faster. Pre-operative exercises are often prescribed either at the physician’s office, or you may be sent to a physical therapy facility for a one-time visit that will include exercise instruction.
You can expect to have a substantial amount of knee pain immediately after surgery and for several weeks thereafter due to the trauma of the surgery itself. However, your pain can be managed with the use of prescription pain medication, a walker or cane when walking, and management of swelling with ice, compression stockings and leg elevation. It is extremely important to keep up with your prescribed regimen of pain medication, icing and elevating for the first several weeks after surgery in order to minimize your knee pain and better tolerate your rehab experience.

After a total knee replacement your physical therapy rehab is equally important to having the surgery itself. You cannot expect to have good outcomes with your new knee if you do not put in the time and effort rehabilitating it post-op. Your physical therapist will instruct you in a variety of exercises that will work on improving your knee range of motion, flexibility, strength, swelling and scarring that will ultimately allow you to return to routine daily activities like walking, squatting and stair climbing without pain or the use of an assistive device.
You will likely attend physical therapy for 6-8 weeks after surgery; this varies on an individual basis. Full recovery often takes 6-9 months, and you may still notice swelling for up to 1 year. Your new knee is meant to enable you to perform everyday activities, but not necessarily aggressive or high impact sports such as running, tennis or skiing. Most knee replacements will last upward of 20 years, and you can help prolong the life of your new knee by managing your weight and staying active without over-stressing the new joint with high impact activities, such as those mentioned above.

K. Collins

Happy Valentine’s Day: A Key to a Healthy Heart

iStock_Heart (640x480)As Valentine’s Day is quickly approaching, we at Peak Performance would like to remind you how important it is to take care of your heart.  Unfortunately, obesity and over-weight levels continue to rise in our country.  The good news is that you can take control of your health today with the helpful tips listed below.

 1. Start moving!

The key to heart health is physical activity.  The American Heart Association recommends 150 minutes of moderate exercise or 75 minutes of vigorous exercise per week.  A good place to start is by taking a brief, 10-15 minute walk, 2 to 3 times per day. If you’re concerned the winter weather will make it tough to get outdoors, then try taking a few laps around your local mall or supermarket.  Bicycling, swimming, and jogging and are also great cardiovascular workouts.

 2. Eat smart!

Make good decisions when it comes to what you eat.  Minimize processed foods, and incorporate lots of fruits and vegetables into your daily diet.  Do your best to lay off the holiday sweets.  If you must indulge, remember to do so in moderation (That means just one piece of chocolate from that heart-shaped box)!  Dark chocolate is believed to be a better choice than milk chocolate, because it contains flavanols, which help lower blood pressure, improve blood flow, and reduce the risk of blood clot formations.

 3. Stop smoking!

This one goes without saying.  Most everyone has heard about the health risks of smoking, including increased blood pressure and hardening of the arteries.  But don’t forget about the negative effects of second hand smoke.  Encourage those close to you to kick the bad habit, and choose to dine in the non-smoking sections of restaurants when you go out.

Remember, one of the sweetest gifts you can give your Valentine is the gift of good health.  Instead of snacking on candies at the movie theater this year, try cooking a healthy meal together along with a romantic walk.  The choices you make today impact your future health and happiness for years to come.

K. Collins

Do arthritis supplements really work?

How do arthritis supplements work?Hands of an elderly lady with medication.

What is Glucosamine?

Does Glucosamine help relieve arthritic pain?

What is Chondroitin Sulfate?

Does Chrondroitin Sulfate relieve arthritic pain?

Osteoarthritis (OA) is the most common type of arthritis and is a degenerative disease process that targets the hyaline articular cartilage of several joints throughout the body, most frequently affected are the hands, knees and hips (Madry et al., 2011; Sawitzke, et al., 2008; Yang et al., 2013). OA is characterized by reduced articular function, impaired mobility, joint swelling, and pain (Madry et al., 2011; Yang et al., 2013). OA was once thought to be an inevitable result of the aging process, although current literature recognizes multiple predisposing factors such as genetics, age, sex, obesity, previous joint injury, muscle weakness, and joint hypermobility (2nd Arthritis Study, 2009; Ciccone, 2007; Sawitzke et al., 2008). OA affects more than 20 million Americans and is expected to double over the next decade (Sawitzke et al., 2008, p. 3184). One in three older adults within the U.S. has clinical OA; ambulatory deficits are the most frequent reported functional limitation as a result of OA, more so than any other disease process (Yang, Dube, Eaton, McAlindon, & Lapane, 2013, p. 1691).
There are many pharmacological and non-pharmacological treatment interventions available to individuals suffering from the symptoms of OA. Some of these options may include over-the-counter (OTC) drugs (Tylenol or NSAID’s), prescription medications (NSAID’s- Cox-1, Cox-2; glucocorticoids; DMOAD’s), dietary supplements, nutritional therapy, exercise, weight loss, acupuncture, and physical therapy. Surgical options should be a last resort. Glucosamine and Chondroitin Sulfate are two popular dietary supplements used to help manage the symptoms of OA. An estimated 2.3 billion dollars are spent each year on these supplements worldwide (Glucosamine, 2014; Wandel et al., 2010). Glucosamine is an amino sugar that is the essential building block for glycoaminoglycans, which bind to water and help cushion, protect, and lubricate joint cartilage (Schardt, 2009; Wandel et al., 2010). Chondroitin is a highly hydrophilic, gel-forming polysaccharide that has protective properties to resist compressive forces of joint cartilage (Schardt, 2009; Wandel et al., 2010). Both glucosamine and chondroitin are naturally produced in the body; ingested versions of these sugar macromolecules may be partially absorbed in the intestine. It is highly debatable if any of the absorbed amounts reach the joints.
Wandel et al. (2010) performed a systemic review of 10 quality large scale patient blinded randomized controlled trials showing no statistical significant difference or clinical relevant effect from using chondroitin, glucosamine, or in combination on perceived pain (p.6). Sawitzke et al. (2008) performed a 24 month double-blinded, placebo-controlled study conducted as part of the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT) which revealed no statistical significant difference between treatment interventions (Glucosamine, Chondroitin, Celecoxib) and joint pain or joint space width (JSW) compared to placebo. (p. 3188). There is recent evidence supporting that regular exercise, including walking, can improve symptoms and functional mobility in people with knee OA compared to supplement users or control group (Joint support, 2014, p. 3). There is little evidence that suggest taking glucosamine and/or chondroitin are harmful for our bodies. Most experts agree if a person suffering from symptoms of OA has less pain and improved mobility from taking these supplements, and they can afford them, there is little harm (Glucosamine, 2014, p.3). Yang et al. (2013) recommend future studies to assess the extent to which these supplements interact with medications and/or assess the potential cause of unintended adverse effects such as hepatotoxicity (p. 1699).
~Sean White, PT, MPT, OCS, CMDT


2nd arthritis study finds glucosamine and chondroitin no better than placebo. (2009). Tufts University Health & Nutrition Letter, 26(11), 1-2.

Ciccone, C.D. (2007). Pharmacology in Rehabilitation (4th ed.). Philadelphia, PA: FA Davis

Glucosamine fails to help arthritic knees. (2014). Tufts University Health & Nutrition Letter, 32(4), 3.
“Joint support” supplements for arthritis. (2014). Harvard Men’s Health Watch, 19(2), 3.

Madry, H., Grün, U. W., & Knutsen, G. (2011). Cartilage repair and joint preservation. Deutsches Aerzteblatt International, 108(40), 669-677. doi:10.3238/arztebl.2011.0669

Sawitzke, A.D., Shi, H., Finco, M.F., Dunlop, D.D., Bingham, C.O., Harris, C.L., & … Clegg, D.O. (2008). The effect of glucosamine and/or chondroitin sulfate on the progression of knee osteoarthritis. Arthritis & Rheumatism, 58(10), 3183-3191. doi:10.1002/art.23973

Schardt, D. (2009). Do arthritis supplements work? Don’t bet your joints on it. Nutrition Action Health Letter, 36(8), 10-11.

Shibing, Y., Dubé, C. E., Eaton, C. B., McAlindon, T. E., & Lapane, K. L. (2013). Longitudinal use of complementary and alternative medicine among older adults with radiographic knee osteoarthritis. Clinical Therapeutics, 35(11), 1690-1702. doi:10.1016/j.clinthera.2013.09.022

Wandel, S., Jüni, P., Tendal, B., Nüesch, E., Villiger, P. M., Welton, N. J., & … Trelle, S. (2010). Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis. British Medical Journal, 341(c4675), 1-9. doi:10.1136/bmj.c4675

What is frozen shoulder?

Senior womanWhat is frozen shoulder?
What is adhesive capsulitis?
What causes adhesive capsulitis?

Frozen shoulder (also referred to as adhesive capsulitis) is a condition characterized by stiffness, pain, and limited range of motion in the shoulder joint. It occurs most often in postmenopausal women, after surgery or an injury, and in people 40-70 years of age. There are two classifications of adhesive capsulitis, primary or secondary. Primary adhesive capsulitis occurs when there is no significant cause for the pain or stiffness. Secondary adhesive capsulitis follows as a result of an injury. It is not known what causes this condition, but it is thought to be a tightening or inflammation of the joint capsule that surrounds the shoulder joint. Due to this tightening, adhesions are formed, limiting the range of motion and function in the patient.
Frozen shoulder typically has a gradual onset, and progresses through three phases. The first phase is referred to as the freezing (or painful) stage. This phase is characterized by a gradual onset of aching in the shoulder that is often widespread, and can be worse at night, making it difficult to lie on the shoulder. The range of motion begins to become limited in the shoulder. This phase can last 2-9 months. The second phase is referred to as the frozen (or stiffening) stage. It is characterized by continued stiffening of the shoulder joint, reduction of pain, continued decrease in range of motion, and difficulty with daily tasks such as dressing. The patient may also notice decreased strength and muscle wasting. This phase can last 4-12 months. The third phase is referred to as the thawing stage. It is characterized by continued reduction in pain as well as increased range of motion and function of the shoulder.
Treatment of this condition often times includes over the counter medication such as ibuprofen for inflammation reduction. Your physician may prescribe anti-inflammatories, pain killers, or steroids to help as well. Physical therapy will focus on range of motion restoration, pain reduction, strength training, and returning the patient to their prior level of function. Majority of individuals respond well to physical therapy and resume normal pain-free activities. Anesthetic manipulation or surgery is a last resort.

H. Tipsord
Visit Us On FacebookVisit Us On TwitterVisit Us On LinkedinCheck Our Feed