Healthy Tips for Better feeling and Better Movement
Table of Contents for this Page:
Strengthening a knee, the safe way
Sinus
Care by Dr. Makani Lew, DC, DACRB (Nov
18, 2019)
- Strengthening a knee, the safe way
- Natural Sinus Care (added 11/18. 2019)
- Plantar Fasciitis self care (added 4/24/2020)
Strengthening a knee, the safe way
So, the best thing for any knee problem is to keep the muscles around the knee strong and to keep them feeling good.
If you have pain on going down a hill, it's usually a problem with less strength in your quads (front of thigh) and maybe hamstrings (back of thigh) not pulling back enough when you are going down. When a muscle contracts and shortens, it's called a concentric contraction- eg your biceps muscle in your arm concentrically contracts when you bring a cup of coffee to your lips. When a muscle contracts and lengthens, it's called an eccentric contraction- eg. when you lower that coffee cup back down to the table. If a person has pain going down hill or down stairs, the thigh muscles need more eccentric strengthening. Furthermore, the safest way is to strengthen hip and knee muscles with a straight knee. So here are some exercises you can do daily that meet one or both of these goals.
Straight knee thigh strengthening and how to focus on eccentric training:
Stand and keep your knee straight- bending only at the hip- kick forward, backward, outward and inward. Do each of these movements slowly (count 2 sec kick away and 2 sec to return to neutral) 10x. The slower you do the return to neutral movement - eg 2 sec to kick away and 4 sec to return, the more you do eccentric strengthening. You can make it harder by adding a weight around your ankle or putting a band around your ankle attached to a table leg (or something solid and heavy).
Slight bent knee thigh eccentric strengthening:
Stand on a step or curb- 2-4 inches (2 is easier). Keep hips level and have one foot on the curb and one off the side. Make sure to pull your toes to your nose (extend your ankle) on the leg in the air. Bend your knee on the leg on the curb and lower down the leg in the air to tap the heel on the floor. Do this slowly (2-4 sec down, 2 sec up) 10x
Here's a good video of how to do this. Started video at 2m25s
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One of the easiest ways to find safe rehabilitative leg exercises is to search "exercises hip replacement". Here's a link of some good exercises (recommended post hip replacement) https://orthoinfo.aaos.org/en/recovery/total-hip-replacement-exercise-guide/
Note- if you know someone who is going to get hip or knee replacement, if they do these "post-op" exercises before the surgery, their recovery will go much smoother!
Self Massage to the thigh and leg muscles
The muscles of the knee are like the guide wires holding up the San Francisco Golden Gate Bridge. If any of them are too tight or weak due to overuse, inactivity, or injury, the whole knee can suffer. Eg. the back of the knee hurts but the problem is with a sore muscle on the front. An overused, inactive, or injured muscle will develop little scar tissue adhesions between the fibers of the muscles and between different muscle groups. Rubbing or stimulating the muscles until the "give in" is a way to get the guide wires to start to be more normalized overall in tension.
Here are some ideas on how to loosen those muscles:
Use a Percussive massager (Thumper, Hypervolt, Homedic Massager) or some strong hands to all the points of all the muscles surrounding the knee. You should feel slight discomfort and after 30 seconds or so, it should begin to dissipate. When using your hands on the sore parts, pushing into the muscle is one way to massage but you might try rolling across the bands of the muscle. Here's a quick video on how to do that on a biceps using your fingers. https://www.youtube.com/watch?v=Ft64kasMz5M
Here is a pretty cool tool- a hand roller massager? I just tried it on my quads and it felt pretty good!
I found one on Amazon Prime for $9.99 https://amzn.to/2Ru8UJ4
Here's a quick video of a guy using something similar called a Moji Pro
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Humidify!
Simply Saline- for everyday congestion
This is an aerosolized mist that is salty like your tears
that has no preservatives (preservatives tend to sting). It is very gentle and doesn’t
drown the sinuses like a Neti Pot can.
(Note- do NOT get the one for allergies- it is too salty and can sting) (Made
by Arm & Hammer or get the generic brand). Cost ~ $6.50 for 4.25 oz (Costco
has 3 pack).
Or order it on Amazon https://amzn.to/3vaWvgb
Steam up
the room- boils
a pot of water- add some herbs: oregano, thyme, mint
Sinus
Drainage
INSTRUCTIONS:
A) First, drain the “septic tank” - subclavicular-
left (though do both)
B) Next, clear the “pipes”- sweep lightly 5x down the
SCM, left then right
C) Then open the “drains”- rub little circles in
the “divots” at the eyebrow point, eye corner point, maxillary point, under the
jaw. Be gentle. Ask for input: pain?
D) Repeat A + C
Other natural tips:
- Essential oils- put a dot on your pillow or shirt (may sting on skin on some folks): Thyme (anti-microbial), Oregano (anti-microbial), Mint (opens sinuses), Eucalyptus (opens sinuses)
- Chinese herbs (pills)- Pe min kan wan (sinus), Chuan Xin Lian (sore throat), Pinellia Tea Root (cough)
- Get acupuncture treatments
- Get Chiropractic neck adjustments
- Get Chiropractic ear adjustments (grab “shelf” near “ear hole” and traction down and out. It may pop. It may cause drainage (gross stuff comes out)).
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Plantar Fasciitis Protocol- how to fix those aching feet!
By Dr. Makani Lew, DC, DACRB
April 24, 2020
Plantar Fasciitis is when the arch of the foot or the
insertion points of the fascia that is on the arch of the foot becomes painful.
One of the most common symptoms is pain after sitting or sleeping. The theory
is that the fascia or the insertion points become inflamed. After being off the
feet for some time there is some fluid retention from lack of movement. Then
when the person takes a step, the now more swollen area feels worse. Another
theory as to why the foot feels worse in the morning on those first few steps
is that when we sleep, we tend to put our feet into plantarflexion (toes
pointed away). Even the weight of blankets can do this.
Things that seem to bring it on include walking barefoot
after a time of not. Wearing inappropriate shoes. Overexerting the feet in a
new activity. For the chronic cases, it’s often a combination of all of these.
On x-ray, there is often evidence of a chronically tight
plantar fascia by showing a heel spur. This bony protrusion has developed
overtime by the constant pull on the insertion point. This is due to a
phenomenon called Wolff’s Law- bone is laid down when there is a demand on it
and reabsorbed when there is no load on it.
Caring for plantar fasciitis takes patience and an approach
that uses many different techniques. Here is the protocol I found works best.
You can’t skip any of these.
1) Wear a rigid dorsiflexor brace at night.
Dorsiflexion is the position of pulling the toes toward the nose. There are two
types- one that goes under the foot and one that goes over the foot. The under
the foot is far better because the over the top brace allows the foot to sneak
passively into some degree of plantar flexion. If the brace is too big, it will
not do the dorsiflexion hold as well. Both styles are available on Amazon for
$20-40. A podiatrist can also make a half cast to hold the foot into
dorsiflexion. It is held onto the leg with an Ace Bandage (tensor wrap).
2) Rub the feet for 30-60 seconds before taking a
first step in the morning. This appears to help move the swelling that occurred
overnight.
3) At
the end of the day, if there are no contraindications, immerse the foot in a
bucket of ice water. The easiest way to do this is to put cold water in a
bucket, put the foot in there (put a rolled up sock on the toes to spare them
the discomfort) and then add the ice. The maximum time to be in an ice bath is
until numb. For some people it is as high as 10 minutes. It’s recommended to
not go beyond the 10 minutes.
4) Throughout or at the end of the day is to roll
the bottom of the foot on a frozen water or soda bottle. After drinking the
beverage, rinse the bottle, fill it with water, and keep in your freezer to be
ready to go. It is okay to combine this with the ice bath- put the frozen
bottle in the bath. It also will be a good distraction.
5) Change the shoes! This can often be the hidden
issue. Too loose and soft, not enough support. Too rigid, not enough normal
movement during gait. Old and no longer providing good shock absorption, like
walking barefoot on cement. There are some sports orthotics that can be
inserted into shoes. Many drug stores have the Dr. Scholl’s scanners to pick
out the best inserts.
6) Use anti-inflammatory creams. Medical choices.
Over the counter- Aspercreme (aka Aspirin-cream or arthritis cream if buying a
generic brand) and by prescription (in the US)- Voltarin gel (aka Diclofenac
Sodium Topical Gel). Aspercreme also has creams that have lidocaine for pain or
Capsaicin (hot pepper) as a counter-irritant pain reliever as well as adhesive
patches
7) Use anti-inflammatory creams. Natural choices. These
mostly rely on the power of mint. Cooling ones: Biofreeze (very cooling), RockSauce
Ice (very, very cooling). Warming ones: Prossage Heat- warming massage oil
(lavender, mint, oil- very soothing. Light smell) and RockSauce Fire (very,
very warming- has Capsaicin and methyl salicylate- aspirin in it). There are
others, but these are pretty great.
8) Loosen up the calf muscles- Massage: roll the
muscles on a foam roller or tennis ball, use a percussive massager. Note, if
there is a clot in the calf, deep massage needs to be avoided. Stretch: Hands
on the wall, foot back as far as possible with heel still on the ground-
straight leg (gastrocnemius muscle) and bent knee (soleus muscle).
9) Last, but certainly not least, strengthen the
feet. This takes months! And these need to be done daily or multiple times a
day.
a.
Spell the ABCs with your foot- seated or
standing.
b.
Towel pulls- (Most pictures online show this
done wrong.) The heel has to be off the towel and don’t crunch or flex the
toes, but instead swipe the towel from left and right. Do this on a slick floor
surface like the kitchen.
c.
Calf raises- on toes, go up on tippy toes- goal
is 200-300 a day.
d.
Toe ups- on heels, lift the toes up- alternate
feet- try to go for 1 minute (start with about 20 seconds)
e.
Ice or Biofreeze the bottom of the foot after a
heavy workout
f.
Thera-band Academy (free to sign up) offers some
exercises
g. etc!
Links to products mentioned:
Dorsiflexor brace- bottom of foot ~
$30 https://amzn.to/2VR3fga
Dorsiflexor brace- top of foot ~$25
https://amzn.to/2Y0PMVO
Links (Opens in a new browser window)
- Home page
- About Dr. Lew, DC, DACRB (articles, curriculum vitae, seminars attended)
- Resources (books, equipment, movement seminars- for docs and inquisitive patients)
- Thoughts (on pain, ice, etc)
- Healthy Tips (knee, sinus care, plantar fasciitis)
- Favorite Products (best heating pad, trigger point ball, etc)
Note: If you click on the Amazon links on this page and purchase items, I may receive a financial compensation for the referral.
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