How I Lost the Most Valuable Ligament

Name: Erin Lemberger, Class of 2020

Undergrad: University of Northern Colorado

Hometown: Littleton, CO

Fun Fact: A one humped camel is called a Dromedary and a two humped camel is called a Bactrian.

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Let me just tell you about my first semester of PT school. I’ll start off by saying that PT school is a lot of work, so of course, the first semester was stressful. But regardless, there are 80 of your closest friends that make studying, adventuring, and everything that happens in between a whole lot easier. I started the semester by buying a season pass to ski all winter long and to use as a major de-stressor when school became difficult. I have been skiing since I was a little tike, so what could go wrong? I had never been hurt skiing nor seriously injured so it couldn’t possibly happen now. Here’s my advice, kids. When the mountain does not have enough snow to open up more than one run, there’s not enough snow. Just trust me.

 

So here’s how it went. I go to Arapahoe Basin (lovingly known as A Basin) with my now boyfriend, Preston, and we’re having a great time just enjoying the weather and the snow. We ski about three runs before the resort is flooded with people also trying to ski the one run that is open. We spend about 20 minutes waiting to get on the lift that will take us to the top, so the decision to get to the top, ski all the way down, and head on home is smart. I’m happily skiing along trying to keep up with Preston, but when I get to about 50 feet from the bottom, realize I’m going a little too fast. Preston is down at the bottom and I go to stop and my ski catches a patch of ice (remember the not enough snow comment?) that takes me out. I flip over backwards and roll hard, and although the details of that fall are fuzzy, I’m sure now it was a classic plant and twist. My skis don’t pop off and my right knee is screaming in pain; I can’t stand on it, so I get my first toboggan ride down the mountain to meet Preston.

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About 20 minutes before I fell. The view is pretty right?

I’m going to start this part of the story with the advice that I would not recommend getting hurt in PT school, but I want to brag about our professors for a little bit. I think I was in denial that I ruptured my ACL, so I went to Dr. Tom McPoil and asked him to check out the knee. Tom tapes me every morning for about 2 weeks while we are trying to get MRIs and doctors appointments scheduled; he was a saint. After a few days of taping, he decides Dr. Mark Reinking should check out my knee too, thus getting two amazing faculty giving me advice. You probably know what happens next: I have surgery to reconstruct my ACL with a semitendinosus/gracilis autograft (they took my hamstrings to make a new ACL). I was thankful I could do surgery over winter break. Over the month that we had off, I got time to recover and relax instead of worrying about school. I started PT off campus and then switched to seeing a PT in our faculty once the new semester got closer. Our faculty are incredible, understanding, kind, teaching, inspiring humans who are the reason I am fairly active for 5 months post-op. My PT, Nancy, is one of the many reasons I am certain that I want to go into this profession because she makes me laugh when PT for an ACL reconstruction is painful. Although I would not recommend tearing your ACL, I have gotten more perspective than I could have imagined from the process.

 

Okay, now go back. I tore my ACL. It was an absolute pain (in the knee) 90% of the time. It was hard watching my friends all ski while I was stuck at the lodge, it’s terrible that I still have pain running even though it’s normal, and I have a huge mental block doing most physical activity now, which is hard. Here’s my advice: Take care of yourself. Have fun, but within healthy limits for yourself. I recommend you also know that life simply happen. Having a positive outlook has made a huge difference for me. Sometimes you just have to see the brighter side. That all being said, I am here, I am passing, and I am chugging along just fine in PT school. So, if you do injure yourself while in school, remember that it is all doable. That’s a promise!

Here’s some other friends that are going through injuries in PT school and some advice they have for dealing with it:

Ryan Pineda, Class of 2020: Lisfranc fracture, surgery completed, in PT currently

“Find a good Netflix show to break up the studying and try not to think about

how much fun your friends are having. Also make sure to buy pass insurance for

your ski pass.”

 

Gabe Lawrence, Class of 2020: meniscal tear, surgery happening this week!

“Make sure to stay active and find something to take your mind off the injury

while you’re rehabbing. It’s easy to be lazy when you have an excuse. Just

because you‘re down a limb doesn’t mean you can’t use the other three.”

 

Jake Berndl, Class of 2020: bilateral inguinal hernia, surgery completed, progressing back to normal physical activity

“Don’t sustain a more serious injury like the above three. Put a positive spin

on your down time – catch up on studying while your classmates are out

having fun instead of studying. This way, when tests or finals roll up, you’re

prepared. Also, don’t forget to ask your surgeon the important questions…”

 

Managing Your Posture in PT School

Name: Joshua Holland

Undergrad: Idaho State University

Hometown: Centennial, Colorado

Fun fact: Before PT school, I worked at a BBQ restaurant in Missoula, MT called Notorious P.I.G.

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Last week, I was editing my Biomechanics skills video when I noticed a curly-haired DPT student in my video with fairly poor posture. I was far from excited when I realized that student was me. I knew my posture wasn’t the greatest after years of asymmetrical shoulder position from college pole vaulting and poor lifting mechanics, but I had no idea it was THAT bad! My shoulders were protracted with my head in a significantly forward position. My initial thought was, “man, I am about to be a PT soon…how am I going to teach posture when my own posture is so poor?!”

An average day for PT students involves a heavy dose of lectures, studying, and an even heavier dose of sitting. Often a PT student may be seated in lectures for 8 hours a day. By the end of the day, professors may start to notice students performing many combinations of wiggling, shifting, and slouching, with many students standing up in the back of the class.

The field of physical therapy involves movement for rehabilitation and we often hear, “exercise is good!” However, within school, sometimes we neglect our own movement in order to remain studious. The intention of this blog post is to initiate the thought of posture and provide some quick exercises that DPT students can use throughout their day. As future clinicians, we are role models to many of our patients, so it is important that we recognize our own posture and work to preserve good body mechanics within ourselves in order to have long-lasting careers and fully help our patients.

I couldn’t sleep after seeing my poor posture! So, I set out the next day to find ways to correct and maintain posture and decided to share them with you all. In this blog post, I interviewed Dr. Alice Davis, an expert on the spine, and fellow first year DPT student, Sarah Spivey, a certified pilates instructor since 2007, to provide some tricks on improving posture!

 

Question and Answer Interview with Dr. Alice Davis

Q: Often our posture is poor in class, we tend to slump over to write down our notes, what are some cues we can use in class to correct this?

A: Make sure your feet are flat on the floor and use the back of the chair to support you. You are becoming kinesthetically aware of your body in space as PT students, so try to be aware of the weight on your ischial tuberosities as you sit. Try to make each ischial tuberosity level. The overuse of repetitive poor posture is what creates problems over time, so start to realize your body position while you sit in class.

Q: While we sit in class it feels like we roll our shoulders forward and lean forward to pay closer attention or write on our devices, what are some cues to get those shoulders back with a neutral head?

A: Because you are sitting at computers for most of the days, you tend to have some upper cervical extension and increased flexion in the lower cervical spine. Imagine there is a rope going straight through your head and down to your seat, try to make that rope as straight as possible. A quick exercise you can do in class is move your shoulders up an inch, back an inch, and down an inch, then hold this for ten seconds, and relax. Try to do 10 reps for 10 seconds of this exercise.

Q: For the anatomy nerds out there, what are some of the muscles that are affected by this forward leaning posture/slumped position?

A: The upper cervical spine is extended in this forward posture position. Suboccipitals are a major component in this and often called the headache muscles because it can result in cervicogenic headache. A cervicogenic headache is when the pain begins in the back of the neck first before it goes up to the skull. This can be posture and stress related. Other muscles that play into extensor moment of the upper-cervical spine are the splenius and semispinalis muscles.

Q: Is there any other tips and tricks we can use in the classroom and out of the classroom to help with posture?

A:  

  • Foam rollers are great! You can put the foam roller vertically along your spine with the head and sacrum supported. Using your arms, do some snow angels for pectoralis major and minor.
  • If you are feeling uncomfortable and wiggly, your body is telling you to move – get up and move around.
  • Do something during lunch time. Eating is important, but try not to study if you don’t have to. Give 30 minutes during lunch for your body and mind.
  • Breathing is important. Moving the body and getting the diaphragm to move through breathing helps those muscles that support the thorax. Watch your breathing pattern, especially when you are stressed. Try to do some slow inhales and exhales.
  • Try a simple nodding of your head, as if you’re saying yes. This lengthens the longus colli and capitis muscles that can help with postural support. You can even do this when you’re driving! Rest your occiput on the headrest and perform a little nod. Try to hold the nod for 10 seconds with 10 repetitions.

 

Here are some techniques and exercises for managing posture in graduate school (or any career environment!) brought to you by our very own DPT first year, Sarah Spivey!

 

Sit on deflated Gertie ball.

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This will allow you to sit up on your ischial tuberosities (IT) to encourage a more natural lordotic curve while also eliminating the pressure on the ITs. By sitting on a relatively unstable surface you will also increase the use of your postural stabilizers. Try to incorporate five minutes per hour of sitting.

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Another technique is to use the Gertie ball between your lumbar spine and your chair. Find your ideal posture by allowing yourself to slump in your chair. Now, move into a full anterior tilt of your pelvis until you feel pressure in your lower back. Now, ease off until you feel the pressure disappear. Scoot back toward the back of your chair and place the ball at the level of the lumbar spine. The ball will help you maintain your neutral posture during sitting.

Head nods/nose circles on Gertie ball.

Lie in supine on a firm surface. Bend your knees and place your feet at the distance of your ASIS. Allow your sacrum to feel heavy and equally distributed on the floor/mat. Take a few breaths and notice if you have excessive space between your thoracic spine and the floor. If so, on an exhale, allow your t-spine to sink toward the floor. This should limit any rib flare. Place a 1/3 – ½ inflated Gertie ball (or folded towel) under your head. You should feel pressure evenly distributed near your occipital protuberance – this will insure you are lengthening your cervical extensors (especially for those of use with a forward head!). Take a few breaths and allow your head to feel heavy on the ball. Imagine a one-inch line on the ceiling and slowly trace this line down with your nose. Return to your starting position making sure to avoid moving into extension. Repeat this 8-10 times. Now draw slow circles with your nose around your one-inch line. Keep your circles small and controlled. Perform 6-8 in each direction.

Wall sit pelvic curls.

While sitting in class, if you start to feel your low back tighten up, try this stretch! Stand against a wall with your feet about 12 inches in front of the wall and hip distance apart. Try to feel contact of your sacrum, rib cage and the back of your head on the wall. You should have a very small space between your lumbar spine and the wall. As you exhale, draw your abdominals in and curl your pubic bone up toward your nose. You should feel your lumbar spine flatter against the wall. As you inhale, slowly allow your ischial tuberosities to widen until you are back in a neutral position. Repeat 10-12 times.

 Seated neck stretch – sitting on hand.

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Feeling tension in your neck during class? Scoot forward so your back is away from the chair and sit tall on your ischial tuberosities. Imagine lengthening your cervical spine and then gently tuck your chin toward your chest. Try not to flex your cervical spine! Now allow one ear to fall toward your shoulder. You should feel a stretch on the opposite side. If you would like to increase your stretch, you can sit on the hand of the side you are stretching. For example, if you are feeling the stretch on the right side, sit on your right hand. This will bring your shoulder down and away from your ear.

 

Overall, I hope  this post helped you become more aware of how important it is that we practice good posture while in school, or with any lifestyle! Do you have favorite exercises or tips to remind you to practice posture? Feel free to share with us in a comment below!

Finals Week: A Beautiful Struggle

It’s that time of the year again…

No, we’re not talking about the holidays.

It’s Finals Week, the crescendo of each physical therapy (PT) school semester.

If you haven’t experienced a finals week in PT school, then here are a few ideas of what Regis students encounter during this time each semester.

  1. …but first, Practicals Week

Gone are the days of “dead weeks” leading up to final exams. Practical Exam Week is usually the week prior to all of the written final exams. This is where the skills you have acquired over the entire semester are put to the test to see how you are able to apply them in a real-life situation. During the days leading up to these exams, you will often see students crowding into room PCH 409 to practice their skills and drill each other on the specific times to use them. Study sessions can extend late into the night for some students (Pssst…PT school secret: often these practicals require knowing information that will also be on the written final, so it’s like studying for two exams at once…now that’s a deal!)

  1. Review Sessions

It is not uncommon for faculty members to hold review sessions discussing what to expect on the final written exam. These are often a great help in refining study strategies (PT school pearl of wisdom: take advantage of these sessions!)

  1. Finals Week Schedules

Each class takes 4-5 exams the entire week, with one exam per day and each one for 2 hours. You can find last minute study sessions dispersed across Claver Hall in the hours leading up to the exams to review any lingering questions or fill any remaining knowledge gaps. And hey, after one exam is over, students have 22 hours to study for the next test…what an ample amount of time!

  1. Work-Life Balance

In the words of The Great Tom McPoil, “take a day for yourself every week.” This may be hard to remember during these challenging weeks, but still very relevant. Students usually make modifications to Tom’s “day” suggestion during finals week, and instead take a few hours to relax and meditate with various types of exercise (or naps) – whatever takes the mind off studying for a few moments.

  1. The Triumph of Completing a Semester of PT School

At the end of each finals week, you will find students celebrating another semester down and another job well done! It’s a time to look back at the terrific accomplishments with pride and relish in the fact that your hard work got you here

– Courtney Backward

Check out this video of first and second year students studying (and relaxing) for their finals!

 

Video Credit: Janki Patel

 

5 Ways to Make Your Summer Last Longer

Name: Evan Piché, Class of 2018
Undergrad:
 Colorado State University
Graduate: 
Masters in Public Policy
Fun Fact: 
I’m an ordained minister (thanks, Universal Life Church).
Hometown:
Holyoke, MA

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The air is starting to get crisper, your neighbors are raking the first leaves into huge piles that just beg to be jumped into, Instagram posts contain things like #pumpkinspice, and–of course–decorative gourds are beginning to make their annual appearance on countertops everywhere. Soon we will perform the yearly ritual of enjoying one extra hour of sleep in exchange for enduring six months of perpetual darkness.

Lamentably, summer is drawing to a close. Skiers and snowboarders are understandably stoked. But even football fans and snow-sport enthusiasts must acknowledge the bittersweet mood that accompanies the changing of seasons as we collectively bid farewell to flip-flops, sundresses, grilling, swimming, drinking margaritas on the porch, and falling asleep in a hammock. If you are like me—still wearing sandals and denying the inevitability of winter—or you just want to make the most of these final few precious days of summer-like weather (while also avoiding adult responsibility), you will find the following tips useful:

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#pumpkinspice

1. Watch the Sunset with a Beverage

This is self-explanatory. The sun typically sets in the west (if you’re directionally challenged, and reside in the Front Range, look towards the mountains) sometime between 7:00 o’clock and it’s-way-too-early-for-it-to-be-dark-already o’clock. Sunsets pair well with beer. The type/brand of beer doesn’t matter so much; just about any beer will taste good when enjoyed outdoors. Can or bottle? Doesn’t matter. Actually, the beer isn’t even the important part; this will work with Coke, or tea, or V8 juice, or whatever. The important part is the sunset.

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Sunset-beers with anatomy lab group

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Enjoying sunset-beers in Zion

2. “Food Poisoning”

Autumn is a great time to stay home sick with “that gnarly stomach bug that’s been going around” and go do something fun outside (*Editor’s note: for the responsible student, skip to #3). It’s starting to get dark earlier and earlier with each passing day; you can’t realistically be expected to go mountain biking after class when the sun sets at 4pm. I can’t condone faking sick, but if you do decide to head up to the mountains for a hike instead of going to class, make sure your fabricated illness is embarrassing/gross enough that no one will dare question you. Food poisoning is a personal favorite—it’s extremely common, utterly plausible, and no one likes to ask probing questions about that kind of stuff.

Bonus Tip: The phrase “it’s coming out both ends” and adjectives like “explosive” and “violent” should be sprinkled in liberally as they will lend credibility to your story. This is important to ensure that the legitimacy of your “illness” will not be questioned. Fall is a great time to hike to Bierstadt Lake in Rocky Mountain National Park while recovering from your unfortunate gastrointestinal distress.

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Sky Pond, Rocky Mountain National Park

 

3. Ride Your Bike to Nowhere in Particular…But Make Sure to Get Ice Cream While You Do It

Perhaps you can’t justify skipping class (*responsible students, continue reading here). Fair enough. Maybe an afternoon of avoiding studying and reconnecting with your childhood is more your level of procrastination. Have you ever ridden your bike to Sweet Cow at 2:00 pm to “study?” No?! Try it sometime! After stuffing your face, spend an hour or so just cruising around the block on your bike and embrace that feeling of being twelve again.

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High Lonesome Trail in Nederland, CO

4. Camp

Myth: camping season runs from Memorial Day Weekend to Labor Day Weekend.

Fact: those are actually the starting and ending dates of white-pants-wearing season for people who own white pants.

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Camping in Zion

5. Drive Around with Your Windows Rolled Down While Doing That Airplane Thing with Your Hand

How many hours did you spend driving around this summer with the windows down, blasting 90’s Hip-Hop/Dixie Chicks and pretending your hand is an airplane? Quite clearly, you did not spend an adequate amount of time engaging in this activity. Today, after class, hop in your car, crank up the stereo to that obnoxiously loud volume that makes things in your car vibrate and take a drive to absolutely nowhere.

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Cruising around (and climbing) in Crested Butte, CO

Since the author is approaching 30, and therefore not “hip” to what the “kids” are grooving to these days, I will suggest a few classic summer anthems that are sure to enhance the stoke level:

-I Believe I Can Fly – R. Kelly (pre-weirdness)
-Wide Open Spaces – The Dixie Chicks
-Born to Run – Bruce Springsteen
-Boys of Summer – Eagles
-Milkshake – Kelis
-Pretty much anything by Prince, David Bowie, or Snoop-Dog/Lion

These are only suggestions. I encourage you to be imaginative and creative in your recreational procrastination.