Dr. Rachel Tavel, PT, DPT, CSCS

Whether youve been in complete lockdown mode in your home and barely moving during quarantine (besides the occasional trip to the fridge), or youve simply just fallen out of your usual exercise routine, many might be feeling the urge to get back into their fitness groove. But after several weeks or even months of not hitting the gym or your usual training regimen, youre going to need to return to working out gradually and safely if you want to avoid hurting yourself.

One of the easiest ways to injure oneself is to rush the process of returning to exercise, going too hard, too fast. This can often lead to overuse syndromes or injuries such as tendinopathies or <a href="https://www.menshealth.com/fitness/a19537729/running-shin-splint-injury/" id="5f85264b-11cc-3864-a189-fc3bce271660"> shin splints </a> . In fact, it takes only two to three weeks for you to lose that muscle strength you worked so hard to build for and just two weeks to lose some cardio fitness. But even a little exercise can keep this detraining effect at bay.

The good news? Your body is amazing, and as long as your general health hasnt dramatically changed, implementing the right training regimen even after a period of inactivity can allow you to rebuild that strength and endurance you may have lost. But listen to your body as you go: Youll want to push it so that you're gradually challenged, but not stressed. That can be a fine line, so pay attention to warning signals such as pain, tightness, or discomfort.

Portrait of male boxer standing by heavy bag in boxing gym

Gradually Increase Workout Duration and Intensity

According to the , you should begin with 20-60 minutes of continuous aerobic activity three to five days per week, with 20 to 30 minutes of moderate intensity exercise.

Whats considered moderate? That can be slightly different for everyone. You should feel your heart rate increase, your breathing quicken without getting completely out of breath (you can speak without getting winded, but maybe not sing your favorite song), and you should break a light sweat after 10 minutes. This could be a quick walk, a light jog or a flat bike ride depending on your general health and fitness level.

After two to five weeks at this level of intensity, you can increase both the duration and intensity of your workout. Push yourself towards including bouts of vigorous intensity levelexercise that causes faster and deeper breaths (without hyperventilation or lightheadedness), earlier sweat development, and its harder to hold a conversation while exerting yourself.

Gradually Increase Your Resistance

Begin with light or bodyweight exercises before progressing to larger resistance. Before you start challenging your body by loading more weight onto it, it needs to be able to handle the built-in loads you put on it. To build strength, youll want to start with 1 to 2 sets of 12 to 15 reps of exercises such as squats, push ups, or lunges. Eventually, you can add resistance that is enough that you feel fatigued after 12 to 15 reps, like you might not be able to do any more. Add these into your routine for three to five days per week, gradually increasing the resistance as your body gets comfortable with the loads you give it.

Incorporate Diverse Activities to Complement Running

If you are returning to running, youll want to make sure youve done some good stretching and strengthening exercises before pounding the pavement. Find a good glute strengthening routine, get some new kicks that provide the support you need, and begin a gentle stretching routine to make sure youve got the joint mobility you need for healthy movement and body mechanics. As you ramp up exercise, youll want to consider your nutrition and sleeping habits. Recovery is a big part of health, so make sure you are putting time aside to rest.

How to Safely Return to Working Out After a Hiatus

Your Personal PT , Rachel Tavel, is a Doctor of Physical Therapy (DPT) and Certified Strength and Conditioning Specialist (CSCS) at Shift Wellness in NYC , so she knows how to get your body back on track when it's out of line. In this weekly series, she gives you tips on how to feel better, get ...

If you think youre too manly for a downward dog, think again. While some men might think yoga is strictly for the ladies, the very first yogis were actually exclusively men. In fact, you may be one of the only guys who hasnt tried these positions yetand in other news, <a href="https://www.menshealth.com/fitness/a26066307/mens-leggings-tights/" id="a0b0380b-402d-345e-a2f1-aa368e9c31d7"> you can wear leggings, too </a> .

Yoga, which has been around for over 5,000 years, is one of the most popular forms of exercise for men and women alike. According to of , yoga began as a male-only practice that included asana (postures), pranayama (breathing techniques), and meditation. It was seen as a way to improve both flexibility and strength while calming the mind. The feminine stereotype associated with yoga only began when it was westernizedso just like , many American dudes scoff only because they don't understand.

Part of the reason yoga has become so popular in western society is for its physical and mental health benefits. Dr. Blum states, There is a lot of new research coming out to support the benefits of yoga on overall wellbeing, happiness, and health and she reminds us that the benefits are not gender specific.

Yoga is perfect especially in the current moment, for men working from home and missing the gym. Youd be surprised how much hitting the mat can invigorate your body and mind. While there are many varieties of yoga to choose from (Bikram, restorative, vinyasa, to name a few), the research is clear: they can all do good.

<h1> Major Health Benefits of Yoga for Men </h1>

According to Dr. Blum, men can expect a few specific benefits from adding yoga to their workout routines.

Increased Mobility and Flexibility

Men typically focus their fitness on strength training and/or endurance training, such as running, weight lifting, or biking. While these workouts are great for muscle, bone, and heart health, the repetitive movements can lead to muscle, fascial, and nerve tightness. Yoga can be a great way to incorporate mobility work and flexibility into your fitness routine so that you are able to access your full range of motion at the gym.

Increased Body Awareness

Klutzy? Improving body awareness can go a long way in helping prevent injuries. Yoga classes emphasize the importance of correct form when practicing different poses. This attention to movement builds your proprioception, or knowing where your body is in space. By sharpening your proprioceptive skills, you improve your weight lifting form and balance, which decreases the likelihood of injury to your body.

Strengthens Deep Stabilizing Muscles

A big part of the typical gym routine includes using exercise machines and dumbbells to focus on building strength in the bigger, more visible muscle groups. Unfortunately, this often leaves out the deeper stabilizing muscles. This muscle imbalance can put your body at risk for injury. Yoga poses include a lot of core and trunk stabilizing movements that can strengthen the deeper muscles that are not addressed by many exercise machines.

Improves Heart Health

While you might think you have a good heart (we believe you), The breathwork and meditation practices found in yoga have been shown to decrease heart rate, blood pressure, and cortisol levels in your body which all contribute to a healthy heart.

So where should you begin? According to Dr. Blum, these 4 simple yoga exercises are a great way to get going. Knowing how to say the Sanskrit word for them, however, is optional.

Cat/Cow (chakravakasana)

Senior bald yogi men practices yoga asana marjariasana or cat-cow pose

How to do it: Begin on hands and knees in a quadruped position, with knees under hips and shoulders in line with wrists. Inhale as you drop your stomach towards the ground and arch your lower back, looking upwards. Pause. Exhale as you round your back up towards the ceiling, allowing your neck to drop down. Repeat 5 to 10 times allowing breath to lead the movement.

Benefits: By mobilizing the spine and surrounding tissues, this move promotes blood flow which can aid in healing. Focusing on segmental movement of the spine (moving each vertebra individually as you go between cat and cow poses) can help free up or loosen stiff areas of the spine.

Downward-Facing Dog (adho mukha svanasana)

Young strong shirtless man practices yoga at the yoga studio

How to do it: Begin in quadruped. Walk your hands about a hands distance forward. Lift so you are supporting yourself by your hands and feet, knees off the ground. Push your hips back and upwards towards the ceiling, straightening the knees and allowing your heels to come off the mat if you feel tightness in your calves. Allow your spine to be long here and avoid rounding your back. If your hamstrings are tight and you have trouble keeping your back from rounding, slightly bend your knees to release some of the pull from the hamstrings. Hold for 3 to 5 breaths, then release.

Benefits: This pose allows you to actively stretch your hamstrings and calves, which are notoriously tight in men. It strengthens your shoulders in a weight bearing position, which has been shown to increase bone density. Lastly, it teaches you how to dissociate movements between your hips and your spine, which is extremely important in overall spine health.

Upward-Facing Dog (urdhva mukha svanasana)

Young man working out, yoga, pilates, fitness training, exercises for spine

How to do it: Begin on your stomach. Place your hands on the ground in line with your chest. Draw your elbows close to your trunk. Point your toes away from you, allowing your weight to be on the tops of your feet. Lift your body up by straightening your elbows. Your weight should be on the tops of your feet and your hands. Your thighs should not be touching the floor. Draw your shoulder blades down and back, allowing your chest to stretch. Hold for 3 to 5 breaths, then slowly return back to your stomach.

Benefits: This pose actively strengthens the shoulders and upper back muscles while stretching the chest muscles. This combination of strengthening and stretching is needed to combat the slouched position most of us take on during our 8-hour work days. In addition to improving posture, this post is also great for stretching the abdominals and improving core strength and stability.

Boat (navasana)

Group of young sporty people in Paripurna Navasana pose

How to do it: Start sitting upright on the floor with knees bent. Make sure your spine is lengthened here and not slouching, especially at your lower spine. Begin to lift your legs off the ground with legs straight, feet extended away from you and balance. If you have tight hamstrings, you will need to keep your knees slightly bent in order to prevent your lower back from rounding. As you stay in this pose, allow your spine to continuously lengthen, as the tendency is to round the back as you fatigue. Hold for 3 to 5 breaths and then slowly release.

Benefits: This pose is great for strengthening your core while actively stretching your hamstrings. In addition, it teaches you body awareness and how to dissociate the hips from the spine, which is important for spine health.

Want to expand your practice even further? Check out <a href="https://www.menshealth.com/fitness/g22739495/yoga-poses-for-men/" id="a2a6ff9f-b3b9-3ab0-aba4-724d2c1145c6"> these other movements </a> , and consider giving a yoga class a try.

How to Get Started With Yoga

Yoga is perfect especially in the current moment, for men working from home and missing the gym. Youd be surprised how much hitting the mat can invigorate your body and mind. While there are many varieties of yoga to choose from (Bikram, restorative, vinyasa, to name a few), the research is clear: they can all do good.

So where should you begin? According to Dr. Blum, these 4 simple yoga exercises are a great way to get going. Knowing how to say the Sanskrit word for them, however, is optional.

Benefits: This pose actively strengthens the shoulders and upper back muscles while stretching the chest muscles. This combination of strengthening and stretching is needed to combat the slouched position most of us take on during our 8-hour work days. In addition to improving posture, this post is also great for stretching the abdominals and improving core strength and stability.

Don't just scoff. Despite what you might envision when you think of Pilates, this form of exercise is great for men. In fact, it was started by a man named Joseph Pilates, and he was no sissy (he started developing the method while being held in an internment camp, for starters). You can read more about Joseph Pilates and the fascinating history behind this workout practice but if you are still not convinced that Pilates might be what your body needs, take it from an expert.

Dr. Heather Mims, PT, DPT, OCS, PMA-CPT and Pilates Method Alliance Certified Pilates Teacher at , says that the balance the practice can bring is essential for men. Many men need to include a better balance of work on flexibility and strength in their exercise programs, she says. Dr. Mims explains that traditional workouts targeted towards men disproportionately concentrate on resisted strengthening programs that forcibly contract and shorten muscles. But this constant process of contracting muscles can lead to chronic tightness and decreased range of motion.

If you dont diversify your workout routine, Dr. Mims warns, a reduction in mobility at the joints can play a role in the development of common conditions such as low back pain, tendinopathies, muscle strains/tears, and plantar fasciitis. One of the many benefits of Pilates is that it includes a better balance of stretching and strengthening and often works the muscles in an elongated position, offering a long lever arm for the core muscles to work against.

Dr. Mims explains that eccentrically loading the muscles (resistance while lengthening rather than shortening them) in a slow, controlled "putting on the brakes" manner can offer really valuable functional strength training and stability work that can help men (and everyone else, for that matter) attain and maintain better posture and more efficient technique in their chosen sport, all while preventing injuries.

Not sure where to begin? Dr. Mims breaks down five of her favorite Pilates moves you can do at home, specifically for your man-bod.

Mature men using pilates reformer while exercising during class in fitness studio

1. Hamstring Stretch with Pilates Magic Circle :

Lie on your back and hook one handle of the Pilates Magic Circle (or Ring) on the ball of your right foot. Straighten your right knee as much as you can, feeling a stretch in the back of your right thigh, knee, and calf. For 6 slow counts, push your right leg away from you but hang onto the Circle so that any actual motion is prevented (this is an isometric contraction of your right hamstrings). Relex, taking up the slack until feeling a stretch behind the leg. Hold 30 seconds. Repeat this cycle two more times.

Dr. Mims explains: This way of opening up the hamstrings makes use of an evidence-based stretching method known as Contract-Relax technique, which is part of PNF (Proprioceptive Neuromuscular Facilitation) techniques often utilized by physical therapists. By pairing the technique with the Pilates Magic Circle, you can stretch by yourself and achieve the same dramatic improvements in flexibility that we often see only when working with a trainer or PT.

2. Double Leg Lower/Lift :

Lie on your back and extend both legs straight toward the ceiling. If you cannot achieve completely straight knees, that's okaybut extend as much as possible. Tuck your chin and float your head and shoulders off the floor, looking toward your abdominals. You can support the back of your head with one or both hands if you wish. As you slowly exhale, lower both straight legs until feeling a little shaking in your abdominal muscles. Do not go any lower if you begin to feel pain or strain in the lower back. This should be an abdominal experience, not a back experience. Inhale, raising both straight legs up to vertical again. Perform 6 to 8 reps total.

Besides being a great way to work on core strength, this is a particularly good exercise to do right after stretching the hamstrings, as it strengthens into the available range of motion and thus helps make new gains in hamstring flexibility into longer-lasting changes in the muscles and connective tissue.

3. Bridge with Single Leg Lower/Lift

Lie on your back and bend both knees with feet hip-width apart on the mat. Exhale, raising the pelvis up into a bridge. Extend the right leg straight toward the ceiling, maintaining the height of the pelvic bridge. Inhale, lowering the straight right leg toward the mat and stopping when it is just slightly lower than the L knee. Exhale, raise the straight right leg again to vertical. Repeat for a total of 5 down/up motions of the right leg, then replace the right foot to bridge position and lower pelvis down to the mat. Repeat 5 times on the left side.

This bridge variation has the winning combination of strengthening and stretching the hamstrings in a dynamic and balanced way throughout the activity while also offering core strengthening and dynamic hip flexor stretching.

4. Leg Pull Front Support

Set up a plank position. Make sure that you can feel your abdominals supporting the weight of the pelvis in the plank and that you are actively standing tall on your arms (not sinking between your shoulder blades). Inhale to prepare. Exhale as you kick twice toward the ceiling with a straight right leg, taking care to make the kicks small enough that the knee does not bend, the rest of the body does not reverberate or shift in any way, and the pelvis does not creep upward out of its plank alignment. Replace right foot, then perform 2 kicks on the next exhale with the left leg. Continue alternating sides for a total of 5 to 6 kicks on each side. This exercise offers core and upper body strengthening in an elongated position of the body, as well as a balance challenge due to the perturbations created with the kicking motions.

5. Side Kick on Forearm

Set up a side plank with feet stacked one on top of the other and top arm extended toward the ceiling. Lift top leg off bottom leg so that it is slightly higher than the top hip. Exhale and kick the top leg forward twice without disturbing the position of the rest of the body (no collapse on supporting arm, no swaying or wavering of top arm, no twisting of shoulders/chest/pelvis). Then, on your inhale, sweep the top leg back behind you staying above hip height. Repeat for a total of 5 to 6 on the first side, then flip over to the other side and perform 5 to 6 on the second side.

This exercise offers coordinated shoulder girdle, core, and pelvic girdle strengthening, dynamic hamstring stretching, and is particularly good for strengthening obliques and gluteus medius muscles (hip abductors).

Before you grab your weights, you might want to consider another way to get your health and fitness on track. Maybe youre feeling strongbut are you feeling stiff? Too much sitting at your work-from-home station? Pilates might be just what you need to balance your body and optimize your strength.

You Should Start Adding Pilates to Your Home Workouts. Here's How.

Pain can come in many forms and affect any part of your body. That truly means any part of your bodyeven some areas you might not want to discuss. But know that if you are having pain in your most manly regionsparticularly during your most intimate momentsyou are not alone. Good news: there is a way to address your problem. The first step is understanding what's wrong.

This pain in or around your junk is called pelvic pain. That refers to pain in the pelvis, lower abdomen, groin, genitals, perineum, rectum, buttocks, and even lower back area. Depending on what exactly is going on in your body, this type of pain can be felt during numerous daily activities, including during sex, urination, ejaculation, sitting, and exercise. Unfortunately, the global pandemic has created circumstances that may be contributing to an increase in symptoms, especially if you're spending more time than ever sitting down indoors. Ive called in some other experts to help you out.

, a physician with a specialty in pelvic rehabilitation medicine, and , pelvic floor specialized doctor of physical therapy and founder of , have focused their careers on treating all different types of pelvic floor dysfunction and pain. They want you to know that you are not alone if you have pelvic painand there are things you can do right in your own home to address your symptoms.

<h1> What Is Pelvic Floor Dysfunction? </h1>

Pelvic floor dysfunction is often associated with womens health and postpartum recovery, but it is also quite prevalent in men. Common pelvic pain conditions include: , prostatitis, urinary incontinence, levator ani syndrome, pudendal neuralgia, and chronic pelvic pain syndrome (among many others). While it sounds scary (and maybe not so sexy), dont let it get you down. It doesnt mean you're damaged. You just need the right course of action.

According to Dr. Reutter, the pelvic floor consists of a network of muscles that act as a sling to support the pelvic floor organs (the prostate, bladder, rectum and seminal vesicles), stabilize the connecting joints and assist in bladder, bowel and sexual function. Unlike the muscles you see when you hit the gym, these muscles are mostly internal and (hopefully) not visible to the general public. But they are critical to your everyday function and easily affected by stress, sleep, and other lifestyle factors.

With quarantine and a terrifying global pandemic in full-swing, many men are experiencing heightened symptoms. Dr. Weber believes this may be due to the current circumstances. Quarantine and a global pandemic might just be the perfect storm for pelvic floor dysfunction. Dr. Reutter adds that working from home, stress, uncertainty, sitting, lack of exercise, and lack of social connection contribute to any of these symptoms. According to Dr. Weber, the pelvic floor muscles often respond to our emotional state, acting as our human tail. During times of stress, fear and anxiety, we tend to tuck our tails and contract our pelvic floors. Sitting on a couch or make-shift home office doesn't help the situation.

<h1> How You Can Handle Pelvic Floor Dysfunction </h1>

To avoid this perfect storm of tension, Dr. Weber advises that you try to connect with your breath to help reduce any unwanted tension. Taking deep belly breaths can reduce any pelvic floor gripping that might unconsciously happen in response to our current situation, she advises.

Also, adjust how you're sitting. Make sure you are sitting with your feet grounded, maintaining the neutral arch in your lower back. Try to "sit on your junk," avoiding rolling back onto the SITS bones and slouching. Now take a big inhale and imagine that space relaxing. As you exhale, think of drawing that space together, lifting the scrotum. You should feel a contraction and subsequent relaxation of your pelvic floor muscles.

In addition to breath work, Dr. Reutter suggests you take warm baths, increase aerobic activity (which increases endorphin levels, the bodys natural painkiller) and avoid prolonged sitting on hard surfaces to help relax the pelvic floor and mitigate symptoms. If you dont respond to conservative treatment, injections could be administered to help break up the tension in the contracted pelvic floor muscles, reduce nerve inflammation, and improve blood flow to the affected region. But as tempting as injections might sound (ouch!), youll want to try conservative options such as physical therapy first.

<h1> Common Pelvic Floor Conditions </h1>

man wearing shorts holding genitals. Men's health, venereologist, sexual disease

Dr. Reutter and Dr. Weber go deep on a few common conditions below. If you are experiencing the symptoms described here, reach out to one of these experts to help determine the true cause of your symptoms and whether or not there is more you can do. If not addressed, your pelvic pain could have a large range of effects, from reducing your ability to produce power during your workout to impacting you emotionally and socially.

The prostate is a small gland located directly below the bladder that enlarges over time. According to Dr. Reutter, prostatitis consists of swelling and inflammation of the prostate gland. This gland secretes a fluid that helps constitute semen or seminal fluid. Prostatitis can be bacterial or non-bacterial. Non-bacterial prostatitis is more common form and can be due to nerve irritation, chemical irritation, stress, and often a weak or spastic pelvic floor. Symptoms normally include painful urination, pain w ejaculation, and pain in the groin, genitals, and pelvic floor.

Levator Ani Syndrome

The levator ani is one of the muscles of your pelvic floor. It is primarily responsible for preventing urinary incontinence and supporting the pelvic organs. Dr. Reutter explains that this syndrome can be due to chronically contracted pelvic floor muscles.

Symptoms often present as pain in the rectum resulting in an achy feeling during and after intercourse, pain with bowel movements, constipation, and/or a feeling of rectal fullness or pain. Dr. Reutter notes: Patients often describe a feeling of a golf ball or similar in the rectum. He adds that stress, anxiety, chronic constipation, a history of hemorrhoids, anal fissure, and prior colorectal surgery are all causes of levator ani syndrome.

Pudendal Neuralgia

Pudendal neuralgia is a condition that involves pain of the pudendal nerve, which runs from the anal region to the genitals. This condition is commonly associated with pinching or compression of the nerve. Symptoms include aching, burning, or stabbing pain in the penis or scrotum. This pain can increase with sitting and ejaculation.

Common causes are nerve entrapment, straining from bowel movements, trauma, and prolonged pressure on the pudendal nerve due to prolonged sitting on a hard surface, biking, and similar activities.

Chronic Pelvic Pain Syndrome (CPPS)

Anything chronic means youve been experiencing the pain for quite a while. Dr. Weber describes this syndrome as pain over a longer duration of time, often causing discomfort with urination and ejaculation. As a physical therapist, she usually finds patients have pain throughout the lower back/sacrum and lower abdomen/hip flexor/adductor muscle groups.

Men with CPPS undergo testing that rule out a bacterial infection, or are often given antibiotics as a trial for pain relief without success. We find that the root of the pain is the overactive pelvic floor muscles. To treat this type of overactivity, Dr. Weber creates a physical therapy plan consisting of reducing the muscle tension using manual therapy techniques applied to both the pelvic floor muscles and surrounding muscles/fascia throughout the pelvis (abdominals, hip flexors, adductors and deep hip rotators). Another important part of the intervention includes activity and exercise modification, along with postural education.

What To Do About Your Pelvic Pain

You dont want to mess with your back. If it hurts, youre not going to want to wait too long before finding a solution. Upper, middle, or lower back pain can get in the way of productivity, sleep and general quality of life. Who wants to mess with those things right now?

Back pain can have many causes, from poor posture, muscle weakness, joint stiffness and even more serious problems in the spine. But chances areif there was no traumatic injury or incident that led to your paina few adjustments to your body positioning and some key exercises (including stretches) can help.

Back pain can affect any portion of your spine from the cervical or neck region to upper or thoracic section and most commonly the lumbar or lower back area. Different stretches can help target different areas, but one thing is usually a safe bet: Moving is better than not moving.

Strengthening the right muscles is important. But for some immediate relief, stretching can help. By stretching the muscles that surround the spine, you can help promote mobility and reduce stiffness and pain. While stretching can help ease symptoms, knowing the true cause of your painwhether its body positioning, weakness, or a more serious injuryis important.

But in the meantime, give these stretches a try to find some immediate relief.

<h1> 8 Stretches to Help Your Back Feel Better </h1>

Hamstring Stretch

Calm relaxed handsome young man with beard lying on back and lifting leg while stretching it with yoga strap at home

The hamstrings attach directly to your pelvis and can lead to stiffness and pain in the lower back if they are particularly tight. There are multiple ways to stretch the hamstrings. Try lying on your back with both legs straight. Loop a yoga strap or towel around one foot and slowly draw that leg up towards the ceiling until a stretch is felt behind the thigh. Make sure you arent rounding your back and your other leg stays flat on the floor. Hold at least 30 seconds.

Lower Trunk Rotation

Promote some mobility in your lumbar spine with this nice, gentle exercise. Begin lying on your back with both knees bent and feet flat on the floor. Keep your shoulders connected with the floor and your knees glued together as you slowly and gently drift both knees from left to right. Allow knees to fall all the way to one side and hold for a moment so you feel a little twist and stretch happening in your lower back. Repeat about 10 times to each side.

Knee to Chest Stretch

While lying on your back with both knees straight, bend one knee and hug that knee towards your chest (so one leg is compressed in towards you, the other is straight, extended away from you). Hold 30 seconds. Repeat on opposite side. Also, try hugging both knees to your chest at the same time so that you make a small ball. While doing this, allow your lower back to relax by taking several slow breaths.

Fit fitness man doing fitness exercises outdoors at city

Low back pain and hip tightness often go hand-in-hand. Stretch out the piriformis muscle with this therapeutic stretch. Begin lying on your back. Bend both knees. Cross the ankle of one leg over the top of the opposite knee, allowing the hip of the crossed leg to open up. Clasp your hands behind the uncrossed leg and draw that knee in towards your chest as far as you can comfortably go. Hold this stretch (stretch should be felt in the crossed leg) for at least 30 seconds.

The upper back (or thoracic spine) can become quite stiff and tight when working at a desk or computer for too long. Free up some restrictions by adding some very necessary rotation to your day. Begin lying on your side with knees bent, head supported and hands outstretched in front of you with palms facing each other. While keeping the hips pointed forward, lift the top arm straight up and over like you are a book opening until your top hand rests (or almost rests, depending how tight you are) on the other side of your body. Allow your head and eyes to follow the hand that is moving while the other hand stays outstretched in the starting position. Repeat 8 times on each side and hold the end range stretch for a few seconds before folding back up.

This popular yoga pose can feel wonderful on an achy back. Begin on hands and knees, then sit your hips back until you are sitting on your feet (or put a pillow between your hips and your feet if its too hard on the knees). Sink your hips back and reach your arms straight out in front of you as you keep your head down and hold this pose. For an added stretch, crawl hands to the right side so that you elongate the left side of your body and hold. Repeat to the left side. Maintain each position for at least 30 seconds.

Sometimes a little segmental movement can free up tension and restrictions in the spine. Begin on hands and knees. Slowly exhale as you round out your spine pushing each vertebra up towards the ceiling to make a C-shape from the crown of your head to your tailbone. Inhale as you reverse that shape so that your belly moves towards the floor and your head looks up. Alternate between these two positions on your own time, pairing breathing with movement. Stay in a pain-free range, but allow your spine to move into restrictions.

This stretch is nor for everyone, but if you have a history of disc herniation or bulges this one may help you. Lie flat on your stomach and gently push your upper body up using your hands until you have extended as far as youre comfortable. Let your belly relax and your lower back tense as you prop yourself up on your hands (or forearms if you cant make it to a straight arm position). Hold, relax, and breathe for at least 30 seconds.

Back pain can make spending your time stuck indoors even more uncomfortable. Whether that discomfort stems from spending too many hours sitting on your couch or at your makeshift WFH desk, or overdoing it during an overly-ambitious home workout, it's no less fun. In the good ol days, you could just head right to your physical therapist when things in your body got weird. But now, many people are being left to take matters into their own hands at home.

8 Stretches to Relieve Your Back Pain

Walking in circles around your home during quarantine? With nowhere to go, nobody to see, and no room to move, these strange times have created prime toe-stubbing conditions.

A stubbed toe happens to everyone at some point (and for some of us, more than wed like to admit). The injury usually happens out of nowhere, and once it does it can make even the toughest man scream.

A stubbed toe usually occurs when you are not paying attention, you're rushing, or you make a spacial miscalculation in a crowded room. If you find yourself trying to transform one part of your home into a work-from-home-office or gym, then you might be setting yourself up for a toe disaster. We get used to our surroundings and have a general sense of where things are, but once we move everything around (which is happening a lot these days, given the circumstances), one wrong move and this little body part you rarely think about will cause you a shocking, sudden jolt of pain that makes you blurt out expletives youve never used before.

But what really happens when you stub a toe?

Low Section Of Man Touching Leg In Pain On Road

Technically, a stubbed toe usually occurs to the big toe (or hallux), which protrudes further out than the other toes. When this toe collides head-on with another object (usually a firm or fixed object like a piece of furniture or a wall), a compressive force is sent through the joints of the toe that light up your pain center and make you reflexively and rapidly pull away. The result: pain, possibly swelling and/or difficulty walking, and soreness that might last several days.

Depending on specifics of the injury, it could be a minor sprain or even as bad as a fracture. Youll want to monitor your symptoms to determine whether or not to seek out medical care. If you notice the toe is bent to the side or deformed in some way with the added element of pain and swelling, you may have fractured it. If you are unable to move the toe, it could indicate a fracture, damage to the joint capsule or a ligament tear. In most cases, the toe will become temporarily inflamed but will heal on its own.

That said, no matter what the specific injury is, begin with these go-to moves. If your pain doesnt improve within a day or two, then you might want to see an MD for possible imaging.

Rest . It might seem obvious, but if you have pain with walking and you keep putting pressure through that toe, youre not helping. Walking requires extension of the big toe and hinging at the metatarsophalangeal joint (where that big toe knuckle is), which can often be painful after a toe stubbing incident. Repeatedly moving through that motion with the added pressure of your body weight over it can irritate the inflamed tissue. While you want to maintain mobility through this joint, listen to your body if it's painful and cut back on your 10,000 steps until pain and inflammation have reduced.

Ice . If you have swelling in the big toe area, wrap an ice pack around it and elevate your foot above heart level for about 15 minutes 3 times per day.

Move (gently) . Give your toes a wiggle (scrunching and moving up and down) and make sure you pump your foot (point and flex the foot) while lying down and elevating the foot. This can help reduce swelling while also promoting mobility in the painful joint.

Adjust footwear . Try wearing comfortable sneakers instead of work shoes to avoid pain with walking. If you're at home, ditch your slippers or any other footwear to go barefoot.

Strengthen it . Once pain and swelling are down you can begin with some gentle strengthening such as active big toe flexion, extension, and foot doming to maintain and build strength in the intrinsic foot musculature.

How to Recover From a Bad Stubbed Toe

Lets be honest: Youre probably used to flexing your biceps, not stretching them. But with all that loading and lifting (and checking yourself out in the mirror, perhaps?), the right stretch might be just what you need.

After all, we use our biceps for more than just lifting heavy weights at the gym. Whether youre hoisting up a small child, grabbing a bag of groceries, or lifting up some furniture, these attention grabbing muscles get worked pretty hard during the day. They also tend to perk up pretty quickly when loaded with resistance, making them a popular target of most guys workouts.

The biceps brachii, as its name suggests, is really two muscle bellies that join together in the upper arm (bi = two, brachii = arm). With tendons crossing the elbow and the shoulder (the long head and short head, as they are called, originate from different parts of the scapula and attach to the top of the forearm), this two-joint muscle (technically 3-joint if you count the radio-ulnar joint) flexes the elbow and supinates (rotates) the forearm while also helping to elevate the shoulder making it a prime mover of the upper extremity.

With all that flexing and contracting, your biceps could use a break. Mixing in some stretches that help lengthen the biceps will allow you to move the upper extremity through its full range of motion. Static and dynamic stretching is a great way to promote mobility at a joint and protect against possible overuse syndromes. So give the flexing a rest, and try these feel-good biceps stretches to give the gun show a little break.

<ol><li> Standing arms-behind-the-back biceps stretch . Interlace your hands behind your waist and slowly raise them up behind you as you tilt your upper body forward. Keep your arms straight and your palms face down. Hold 30 to 60 seconds. </li><li> Seated biceps stretch . Sit on the floor with knees bent, feet flat, and palms down on the ground behind you. Scoot your hips forward keeping your hands where they are until you feel a gentle stretch in your arms and shoulders. Hold 30 to 60 seconds. </li><li> Wall biceps stretch . Press one hand against the edge of a wall at about shoulder height. Slowly turn your body away from the wall, creating a stretch throughout your upper arm and shoulder. Hold 30 to 60 seconds. </li><li> Doorway stretch . Line up forearms on either side of a doorway with elbows just below shoulder height. Gently lean forward through doorway until a stretch is felt in the chest and shouldersmake sure you don't go any further to avoid potential injury. Hold 30 to 60 seconds. </li><li> Wrist-rotation stretch : This one is more subtle than the others, but give it a try. Stand with your arms out to the side and palms facing forward, like youre making a cross or T. Slowly rotate forearms with thumbs pointed up then backwards so that palms face behind you (as far as youre comfortable). Hold 30 seconds. </li></ol>

Dynamic Biceps Stretches

If youre about to do an intense workout, dynamic stretches are a great way to start.

Arm circles: Begin with arms out to the sides and make small circles keeping the arms straight. Gradually increase the circle radius. Try about 30 forward, then 30 backwards.

Arm swings: Begin by swinging arms forward and up and then back and down behind you. Swing arms using momentum up and back, up and back, then back behind you, opening up the chest and shoulders and swinging through the front crossing arms in front of your chest. Repeat 10 to 20 forward and back swings followed by 10 to 20 open-close swings.

7 Biceps Stretches to Give Your Arms a Break

7 Biceps Stretches to Help Prime Your Guns for Action

If youve heard of the term scapular winging its probably because a physical therapist or medical doctor has told you something is off with your shoulders. No, this type of winging is not a bar special or something your buddy does to help you out when youre trying to make a move on someone. Its a sign of weakness in the muscles of the shoulder blades (or scapulae)and if its true winging, it can be more serious than you think.

The scapula is one of the bones that forms the shoulder girdle together with the clavicle and humerus bones. Muscles work together to move all three bones in such a way that the arm can move in the way it's meant to in every direction. The scapula is a floating bone that is held in place on the upper back by a set of 17 different muscles, and relies on solid muscle activation to be both mobile and stable.

Winging of the scapula is a term that describes when the muscles surrounding the scapula are either too weak or unable to function properly, leading to a lack of connection between the shoulder blade and the back of the thorax or upper rib area. When the muscles are weak, the border of the scapula lifts away from the body resembling a wing (hence the term).

Causes of scapular winging can be musculoskeletal (a weak serratus anterior muscle, for example) or due to neurological damage such as trauma to the neck, shoulder, or ribs leading to injury of the long thoracic nerve, a nerve that is responsible for activating this muscle. Scapular winging can be due to weakness in any one of the muscles, but the serratus anterior is one of the larger and more commonly affected ones. A neurological problem generally indicates a more serious condition that requires a more specific, hands-on treatment approach.

Knowing what to do about scapular winging begins with understanding why its occurring. If youve been cleared neurologically, then strengthening the muscles of the scapula and retraining the brain to connect with and control those muscles is your best bet to healthier, more stable shoulders and injury prevention down the line. A physical therapist can help guide youbut in the meantime, try these moves.

Strengthen the Serratus Anterior

The serratus anterior (SA) is responsible for protraction and aiding the shoulder blade in upward rotation so that you can bring your arm overhead. To strengthen the SA, there are many options. Start with these two methods.

Wall slides with protraction - Begin with a resistance band around your forearms. Stand in front of a wall and bring forearms up to just below shoulder height so that elbows are bent and forearms are parallel to each other. Create slight tension in the band by separating forearms away from each other. Then, with your forearms against the wall or against a foam roller that is against the wall, slowly push forearms toward the wall (protraction) and slide your arms up and down wall 10 times. Be sure not to use your bodyweight to push into the wallmake sure effort comes from the scapulae. Repeat for 2 to 3 sets of 10 reps.

Planks with protraction - Begin in a plank position, either resting on your hands or on your forearms. While in this position, protract your shoulders by pushing your shoulder blades away from each other like you're pushing the floor away from you while maintaining a neutral spine. Slowly return to starting plank, then repeat this protraction motion 10 times.

How to Handle Scapular Winging

You might not want to admit it, but it's not uncommon to feel some pain between your legs. Maybe you over-lunged, sprinted too hard, made a quick kick or turn, or even got a little overzealous in the bedroom (it happens!). Now youre in a world of discomfort, left with a sore groin and a sore ego.

A sore groin is never sexy, but it can happen to anyone. While the injury is most common in hockey and soccer players who put an extra eccentric strain on the inner thigh muscles, just one wrong move can cause this type of pain. If youre experiencing pain in the muscles close to your pubic bone, or anywhere along the inner thigh, you may have pulled or strained one of the groin muscles, also known as the adductors.

Muscles of the groin include the adductor brevis, adductor longus, adductor magnus, obturator externus, pectineus, and gracilis. These muscles spread across the groin line and help stabilize the hip and lower extremity by keeping the leg in towards your midline.

A muscle strain can be caused by excessive use (taking on too high of a load) or over-stretching of the muscle. There can be sharp pain along the muscle or at its attachment points at the pubic bone or along the inner thigh. Weakness often follows pain leading to stiffness, range of motion limitations and dysfunctional movement patterns.

While rest, ice and exercise modification can be the first line of defense after an injury, youll want to make sure you do some gentle stretching and strengthening to maintain mobility and restore strength to the injured tissue. But, like all injuries, if pain is limiting your function during the day or stopping you from doing what you love, see a physical therapist for a complete assessment and individualized plan.

Move: While the injured muscle is healing, youll want to maintain range of motion at the hip and leg. Performing gentle active movement in the directions the hip allows (flexion, extension, abduction, adduction, external and internal rotation) will keep the joint from getting stiff and promote mobility in the joint.

Stretch: Youll want to gently stretch the affected musculature within a pain-free range. Think lengthening and stretching but do not recreate any sharp pain while stretching. To stretch the groin muscles, try standing side lunges, a sitting straddle stretch or the butterfly stretch. Hold your stretch of choice for at least 30 seconds, and dont forget to breathe.

Strengthen: Begin with isometrics (adductor ball squeeze in supine with knees bent, ball between knees for 10 by 10-second holds) before moving on to eccentric and concentric loading of the tissue. If its not painful, try concentric hip adduction against gravity by lying on the affected side, bring the opposite leg in front of your affected sides knee (flat on table) and raising affected sides leg up and down for 2 to 3 sets of 10.

Eventually you can progress to regular squats, sumo squats, lateral lunges, and sliders (stabilize the unaffected leg and slide the affected side out away from you on a reduced friction surface before bringing it back). To maintain cardio conditioning while recovering from this type of injury, trying biking instead of running.

How to Work Through a Sore Groin

Chances are youve heard about the IT band. But Is it a muscle? Is it a band? Is it a computer programming department in your body? What does IT stand for, anyway? Mystery surrounds this common instigator of knee painso its time you finally get some answers.

The IT band (iliotibial band) is a thick band of fibrous connective tissue called fascia that extends from the muscles of the hipmore specifically: the tensor fascia latae and gluteus maximusdown to the knee. It spans the length of the lateral thigh, initiating at the iliac crest of the pelvis and extending towards the tibia of the lower leg, hence the name. It crosses the knee joint along the way, overlapping with large muscles of the thigh.

Contrary to popular belief, the IT band itself is not a muscle and it does not actually stretch, at least not with human levels of strength. But that wont stop you from hearing the terms tight IT band or IT band stretches.

So whats really going on with when the IT band leads to pain? IT Band syndrome can develop from repeated flexion and extension of the knee during sports such as running or cycling. Due to its attachment point along the side of the knee (the lateral tibial plateau or Gerdys Tubercle if you want to get specific), this repeated bending and straightening with a possible valgus (inward) angle can lead to the band of fascia moving across this bony projection. Repetitive sliding of the band at the joint can cause friction, inflammation and pain at the outer knee. Glute tightness or weakness, single leg instability, poor body mechanics, and soft tissue restrictions may be to blame.

If youre experiencing pain at the outer knee or along the lateral thigh that is worse with activity, you might have IT Band Syndrome. To treat it, temporarily modify your activity to avoid repeatedly irritating the attachment point and stick to these three moves.

Strengthen the glutes : Try hip hikes, resisted lateral walking, resisted side lying or standing hip abduction, monster walks, single-leg bridges, single-leg deadlifts, and squats. Add resistance when 3 sets of 10 reps at bodyweight resistance is easy.

Stretch everything but the IT band : The IT band itself might not stretch much, but the muscles from which it extends and overlaps do. Stretch the hamstrings by lying on your back and extending the leg straight up as close to 90 degrees as your body allows. Using a yoga strap or towel, gently draw your leg across your body to lengthen the outer portion of the thigh. Also stretch the glutes by performing a figure 4 stretch. Stretch the quadriceps by doing a kneeling lunge stretch with overhead reach. Hold all stretches for at least 30 seconds and make sure you take deep slow breaths to fully allow the stretch to take place.

Foam roll : <a href="https://www.menshealth.com/fitness/a25936990/foam-roller-reduce-pain-soreness/" id="bc31d4aa-e807-3fd1-a61a-412e916aaba5"> Foam rolling, or self-myofascial release (SMR) </a> , can help reduce tone in the muscles, promote blood flow and help improve soft tissue extensibility. Roll out the quads, hamstrings, and glutes. Need a how-to? Check out for a solid demo.

Every Question About Your IT Band, Answered

For many runners, aches and pains are par for the course. But when nagging knee pain gets in the way of logging miles, youre going to want to do something about it.

Runners knee, also known as patellofemoral pain syndrome (PFPS), is one of the most common overuse injuries among runners (hence its name). This particular type of pain is an umbrella term, but typically presents as a dull and irritating unspecific ache in or around the kneecap (the patella). It is often worse with activity but it can also arise after sitting still for hours.

The knee joint is formed by the femur, tibia, and patella. The patella is a floating bone that sits on top of the joint, gliding within a groove in the femur called the femoral groove. When the patella doesnt glide smoothly in this groove, it can lead to increased friction in the joint. This friction often causes pain in the joint, especially with repeated unilateral loading or bending at the knee since knee flexion creates an increased compressive force at the patellofemoral joint.

Instead of tracking smoothly along its groove, the patella is often pulled laterally, leading to discomfort. If the hips or quads are weak, the hamstrings are tight, the tibia doesnt properly rotate, or soft tissue restrictions limit mobility or muscle activation, this can all lead to poor biomechanics and an increased pattern of maltracking.

Runners knee often develops over time. Get ahead of the pain by addressing these areas early on.

<ul><li> Strengthen the quadriceps . </li></ul>

Try straight leg raises in flexion and with toes pointed up and slightly turned out to the side (slight external rotation) to target the quads (and specifically, the VMO portion of the muscle). To do this: Lie on your back the painful knee straight and the other bent. Draw in abdominals to stabilize core, tighten the front of the affected sides thigh by pressing the knee down towards the floor and straightening the leg as much as possible, then lift your leg straight up and down. Do 2 sets of 10 with the toes towards the ceiling and 2 sets of 10 with the toes slightly turned outwards. Maintain a totally straight knee throughout the movement.

<ul><li> Strengthen the glutes . </li></ul>

Youve heard this before, but here we go: Glutes glutes glutes! If youre a runner or any type of running/jumping/cutting athlete, you will need a strong set of glutes. Thankfully, there are a million ways to strengthen the muscles. Try straight leg raises in abduction lying on your side with a band around your ankles or in standing with band around both ankles. Also, try lateral walking with a band around the ankles and resisted clamshells to strengthen external rotators to prevent the knees from going inwards. Repeat for 2 to 3 sets of 10.

<ul><li> Stretch hamstrings . </li></ul>

You can do this lying down with a strap around the foot or in a long sitting position on the floor with legs (both or one at a time) straight out in front of you.

<ul><li> Foam roll lateral quadriceps and ITB . </li></ul>

Yes, the research is mixed on the true effectiveness of foam rolling the ITB (which doesnt actually stretch). But there does seem to be a neuromuscular component of foam rolling that helps relieve symptoms, and it feels pretty darn good (and by good I mean terrible, but runners like that sort of thing). Give it a try and see if it helps provide relief. Kinesio taping may also help.

Your Personal PT , Rachel Tavel, is a Doctor of Physical Therapy (DPT) and Certified Strength and Conditioning Specialist (CSCS), so she knows how to get your body back on track when it's out of line. In this weekly series, she gives you tips on how to feel better, get stronger, and train smarter.

How to Deal With Pain From Runner's Knee

Youve got a routine. You do the same exercises over and over again, or maybe your job requires you to repeat a movement all day. Whatever the reason, your body is repeatedly loading the same muscles and tendons, and this can lead to pain.

Tendonitis can occur just about anywhere in the body. Muscles attach to bone via tendons, and that tendinous junction between muscle and bone can become inflamed with repeated stress. It should be noted that tendonitis and tendinosis, or tendinopathy, are slightly different. Tendonitis is, by definition, an inflammation of the tendon due to microtears at the muscle-tendon junction. This usually occurs when the tendon is being overloaded by tensile forces that are too heavy or sudden. Tendinosis is a term that refers to degeneration of the collagen protein at the tendon, usually from repetitive straining of the tendon and lack of recovery time. Though slightly different, they both tend to present with similar symptoms.

Symptoms of tendonitis include pain and weakness or stiffness at a joint. Pain is usually worse with certain movementsparticularly the movements that load the specific tendon most. The cause of your tendonitis is often identifiable by your symptoms, and how they are exacerbated. If the outside of your elbow hurts every time you use a hammer, maybe thats what provoked it. If you feel pain in your heel or ankle during or after a run, you may have limitations in ankle mobility or stability that is affecting your foot strike pattern with each stride, repeatedly irritating the tendon. Pay attention to when you feel the pain and where, and that will be the best way to identify the cause of your symptoms.

Common sites of tendonitis include the ankle (peroneal, posterior tibialis or achilles tendonitis), shoulder (rotator cuff tendinitis), or elbow (lateral or medial epicondylitis). Often times these smaller joints at the extremities take on the brunt of larger forces when there is weakness in the bigger stabilizing muscles closer to your trunk that need the work.

The cause of tendonitis isnt always at the site of pain. It requires a complete movement assessment by a physical therapist to identify where your weakness is in your movement and what pattern you are repeating that is causing the stress.

Your Move : While treatment is different for every body part (and every person), the general protocol is to temporarily offload the painful tendon to reduce pain, ice the inflamed tendon, perform soft tissue mobilization such as cross friction massage to stimulate circulation and cellular activity, and maintain mobility of the joint with active range of motion exercises.

Next, youll want to begin with gentle stretching and eccentric strengthening of the affected muscle, followed by graded concentric loading. Keep in mind that it is extremely important to look for other places of weakness in the body. Simply strengthening the muscles with the tendonitis may not address why the tendonitis developed in the first place. It usually is the result of weakness or instability elsewhere, for example hip weakness if there is an achilles or peroneal tendonitis, or scapular weakness if there is rotator cuff tendonitis.

Your best move is to see a physical therapist to get the individual assessment of your strength, mobility and body mechanics that you really need to properly treat your symptoms and get you back to optimal health and movement.

Finally, dont forget sleep and nutrition! Getting enough Vitamin C and zinc are important for the synthesis of collagen, while sleep is often critical for proper healing.

How to Work Through Tendonitis

Whether youre a swimmer, a thrower, a CrossFit junkie, or just a guy trying to get through the workday, shoulder pain can pop up. Exercise can definitely help, but doing the wrong set of reps might lead you down a path of even more pain rather than reliefso youre going to want to be careful about your next move.

If youre experiencing pain with overhead or cross-body movements, or simply when sleeping on your side or putting on a coat, you might be experiencing symptoms associated with shoulder impingement.

The shoulder joint is one of the more complex joints in the human body. When the mechanics are off, pain can be a result. Formed by the humerus, scapula, and clavicle, multiple muscles help move these bones in a rhythm to allow for pain-free functional use of the arm. Unfortunately due to poor posture and muscle weakness, sometimes this sequence of movement is off and one or more important structures can become inflamed.

Dr. Rachel Tavel, PT, DPT, CSCS

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