Home / Archive by category "Blog"
Biophilia and Emotional Connection

Biophilia and Emotional Connection

Close your eyes and imagine yourself in the middle of downtown traffic. The sound of the loud motorcycle engine next to you. The car horn of a hurried gentlemen two cars behind you. The “tick, tick, tick” of the crosswalk meter counting down from 10. Put yourself in this busy place for 5 minutes. How do you feel at the end of 5 minutes? Anxious, worried, annoyed, or stressed? Don’t fret you are not alone. This is a totally normal response subconsciously ingrained     in our brains. Even a doctor’s office with naked white walls can stir up these same emotions.

Believe it or not, the environment we are surrounded by can have a large impact on our emotional state, physical well being, healing, and even our immune system. I’m sure we have all experienced a time in our life when what we saw or heard considerably changed our mood or emotion. At that moment, our minds and bodies experience much more than just a “mood swing.” Our nervous, endocrine and immune systems were all compromised in that 5 second experience.

When feeling stressed, bogged down, injured, or angry, what types of coping strategies do you incorporate in your life to help subside these effects? Are they positive or negative? Like most humans we tend to lean more toward the negative influences without even realizing the choice we decided upon until our symptoms continue to arise.

Today I want to discuss one positive coping strategy that is available to every individual, free of cost. No I am not here to promote that next “fad pill” to help your aches and pains go away, or a sedative that will help take your mind off the stress of everyday life. I would like to introduce the word “Biophilia” into

your life today. What does the word Biophilia mean? An innate and genetically determined affinity of human beings with the natural world. Wait, what? It basically means you are influenced by the surrounding environment more than you actually think. For example, if an experiment were to be performed on employees that face a plain white wall packed with cubicles from one end to the other, compared to employees that face a window that engulfs a healing garden, it is suggested the individuals that face the window would have a higher productivity rate and positive emotional state. Ding ding ding! Perfect strategy for business employers to raise their employees productivity rate. Even adding a plant in the room if the option for a window is not possible would have this same effect.

There have been studies performed, such as the one mentioned above, involving how nature can actually promote healing. One such experiment involved patients who had recently undergone gallbladder surgery, in which half of them had a view of trees and the other half had a view of a wall. According to the physician who conducted the study, Robert Ulrich, the patients with the view of trees tolerated pain better, appeared to nurses to have fewer negative side effects, and spent less time in the hospital. Even studies taken as far as measuring brain activity through an fMRI have been performed. When participants viewed images of urban scenes, researchers found increased activity in the anterior temporal pole, the part of the brain that is associated with negative emotions and feelings such as anger and depression. But, when these same individuals viewed nature scenes, the parts of the brain such as the basal ganglia, associated with emotional stability, empathy, love, and pleasure, lit up.

Being a practicing Physical Therapist Assistant, I encounter patients on a regular basis that are experiencing the same emotions as you did when you first began reading this article. Their blood pressure and heart rate are elevated, stress and anxiety levels are bursting at the seams, and depression has likely set in due to the extreme pain they are experiencing. It is incredibly important to me to make sure my patients feel comfortable while being treated. Walking into a therapy clinic that has white walls, a cold atmosphere, and uncomfortable chairs is likely to add to the extreme negative emotions these patients are already experiencing. Adding some soothing paint on the white walls and adding pictures that immerse the patients in nature, placing plants in empty corners and bare counter tops can easily change negative emotions to feelings of euphoria.

Imagine the positive effects you feel when the brisk breeze caresses your skin, the sun warming your body, the smell of a wooded area, or the taste of grilled Nebraska beef on your lips. Did your body begin to relax and mind feel at ease? During that very moment your blood pressure, heart rate, anxiety and stress levels have all dropped. Here, at Complete Physical Therapy, we strive to create an inviting atmosphere that will make you feel as you did in the previous dialogue. The warm tan walls are lined with pictures of warm beaches, wooded streams, sunsets, waterfalls, and mountain ranges. Not only do the pictures create a relaxing domain but the bountiful plants and wooded greenery seen through wide open windows promote the proper balance for a speedy recovery.

The next time you are feeling bitterness, resentment, apprehensiveness, or uptight get away from the negativity of the downtown atmosphere described in the beginning and surround yourself with the serenity of nature. I have attached a website that will provide you pictures of nature and animals to reduce the stress you are feeling about the next project that is due by the end of the day or the extra hours needed to put into work this week. Take a break from whatever you are currently doing, put on some soothing music, and check out these fascinating images of tranquility.

Sources utilized during this blog to gain relevant information:

Solving the Mystery of Shoulder Pain

Solving the Mystery of Shoulder Pain

Whether you’re an overhead athlete taking swings at a volleyball, throwing a baseball, or someone who works an office desk job 40 hours a week, shoulder pain is a very common ailment that most of us will probably experience at one point in our lives. At Complete Physical Therapy we work with a variety of shoulder dysfunctions including impingement syndrome, rotator cuff repairs, labrum repairs, dislocations, adhesive capsulitis (frozen shoulder), total replacements, and the list goes on…


Although the shoulder may be one of the most complex joints in the body, I’m here to help break down the facts for you! Two of the most important structures of the shoulder include the glenohumeral joint, referred to as the ball and socket joint; and the scapula, also commonly called the shoulder blade. Two important muscle groups are attached to both of these structures – the rotator cuff muscles and scapular muscles.

The rotator cuff is a collection of muscles that connect to the ball and socket joint to stabilize and help rotate the arm. There are exactly four different muscles (supraspinatus, subscapularis, infraspinatus, and teres minor) that allow you lift your arm to the side and rotate your arm in different directions (i.e. putting on a jacket, reaching for the seatbelt, tucking in the back of your shirt, or fastening your bra).

Fun Fact: You cannot fully raise your arm overhead without using your shoulder blade. One of the most common shoulder injuries we see in the clinic is shoulder impingement and it is often caused by poor posture and muscle imbalances that disturb proper movement, which we like to call scapulohumeral rhythm. The arm and shoulder blade coordinate movement together, so for full 180 degrees of overhead movement, there should be about 60 degrees of upward rotation in the shoulder blade. If the shoulder blade gets stuck or moves incorrectly it can cause pain and immobility. There are three important muscles in the shoulder blade that have to work together for the arm to properly move upward.

  • Upper trapezius – pulls the shoulder blade up
  • Serratus anterior – keeps the shoulder blade snug to the rib cage and slides the shoulder blade sideways
  • Lower trapezius – pulls the shoulder blade down

Importance of Good Posture and Scapular Balance

Imagine these three muscles as a team. Each muscle has an important responsibility and they depend on each other to achieve proper arm movement. If one teammate is too weak or too strong, it can disturb proper rhythm, leading to pain and dysfunction. Poor posture is almost always to blame and one key player involved in particular is the upper trapezius. In the case of shoulder impingement, the upper trapezius is often overworked, causing the shoulder blade to hike up, pulling the shoulder into a bad position. This overactive upper trapezius also makes it difficult for the lower trapezius and serratus anterior to perform their duties, turning them into lazy team slackers. A skilled physical therapist can assist you to help improve scapular strength and identify areas of weakness or overuse. They can also use hands-on techniques to reposition and mobilize the scapula so it glides smoothly with appropriate muscle recruitment.

If you work or sit for long periods of time, listen up! Sitting hunched over with your shoulders scrunched up and your head forward places the shoulder in a very vulnerable position. When the shoulders are rounded forward, the space where the rotator cuff muscles slide and glide becomes cramped, reducing the space needed for movement. This results in pain and can create micro tears in the rotator cuff muscles. If this continues for long periods of time with repetitive movements, the muscles can lose integrity and partially or completely tear!

Fun Fact: Another key muscle group that can cause disturbances to proper shoulder placement is the anterior chest muscles along the front of the chest. Tight chest muscles will round the shoulders even more forward, further reducing the space for the rotator cuff muscles.

It is Time to Make a Change!

Although you may not be experiencing pain now, poor posture over time can really wreak havoc on your shoulders, neck, and back. When seated for prolonged periods of time, consider the following tips:

  • Sit with a neutral spine – hips are not rounded back or arched too far forward
  • Implement a lumbar support to prevent a slouched low back
  • Keep ears in line with your shoulders
  • Computer monitor should be at eye level with feet flat on the floor
  • Get up and move every 20 to 30 minutes

The great thing is that there are simple exercises you can do throughout the day to not only help strengthen your postural muscles, but help you become more mindful of your movement and posture. At Complete Physical Therapy we advise our patients to perform postural exercises at least once an hour to effectively enhance posture. Click the PDF below for pictures and descriptions of these exercises so you can start improving your posture today! Stay tuned for another blog post with progressions of advanced strengthening exercises you can perform to improve rotator cuff and scapular strength.

Postural Home Exercises

The Importance of Good Sleep

The Importance of Good Sleep

Our lives are so bound by time, by order. We are subconsciously measured by time, living minute by minute, working hour by hour. It may seem like we don’t have enough time in the day to be the perfect mom, finish the last load of laundry, start the dishes, or work on the next promotion; ultimately ending the phrase “I’ll sleep when I’m dead.” This causes a vicious cycle allowing an individual only 4-5 hours of sleep a night. Dr. William Dement quoted, “You’re not healthy, unless your sleep is healthy.” If you are an individual living the life that was explained above you will begin to realize being the perfect mom is becoming exhausting, resulting in an extra cup of coffee added to the day or requiring the use of medication to help your brain focus on the new promotion. In reality all that is needed to fix these problems is more sleep.  Being a healthcare professional I rehab patients who have recently undergone surgery or an injury that is limiting them from performing at 100%, exactly what happens to our function when we don’t get the adequate amount of sleep per night.

First let’s discuss the cycles we progress through as we sleep. There are two cycles Rapid Eye Movement and Non-Rapid Eye Movement, I’m sure you have heard these phrases during your lifetime but weren’t quite sure what they meant. NREM has four different stages involved in the process, for the sake of this article I am going to focus on stage 3 and 4 or otherwise considered “deep sleep”. In this stage of the NREM cycle our blood pressure drops and our breathing becomes deeper and slower allowing our brain to experience little activity; ultimately resulting in an increased blood supply to the muscles. This phase is essential for restoring the body, hence why our muscles feel weak or fatigue sets in sooner when the proper amount of sleep is not accomplished.

The REM phase is the stage where we are able to remember our dreams; this is the most important phase of sleeping, as well as the shortest phase. During REM the body is able to restore organs, bones, and tissue as well as replenish our immune cells and circulate the human growth hormone. A lack of the REM cycle is particularly problematic for recovery as well as our physical well-being. If the human growth hormone is unable to be secreted due to difficulty progressing through the REM cycle we are more likely to catch a cold or wake up feeling groggy and ill. For example, secretion of the human growth hormone is critical to my patients’ rehabilitation process when recovering from post surgical work or even a minor strain to their hamstring muscle. It is during NREM “deep sleep” that the brain is resting with very little activity resulting in increased blood supply available to our muscles; which in response will deliver extra amounts of oxygen and nutrients assisting in healing and growth. Muscles and tissues are then rejuvenated and new cells are regenerated during this phase of sleep.

Not only is the proper amount of sleep necessary for muscle and tissue recovery, but also for fundamental brain health. There was a recent study done on high school students that compared standardized test scores of students who began their school day at 8:00 a.m. and those students who began at 9:00 a.m. The results revealed those students who got one extra hour of sleep scored higher on the standardized tests compared to those students who began at 8:00 a.m. How is this? Getting longer hours of sleep allows for an individual to spend more time in the REM phase where memory consolidation takes place. In other words the brain is constantly making memories from our day whether it was a new task learned in school or even the emotional response to the way an individual treated you.

We are always making memories. In order to make the memories stick in the brain there are three stages that need to take place. The first is acquisition. This is where we learn or experience something new. Next, is consolidation. Here, the memory becomes stable in the brain. Lastly is recall. This is the ability to access the memory in the future. Both acquisition and recall occur during our awakened hours, where consolidation occurs during the REM cycle of sleep. This should be clear as to why the students who got an extra hour of sleep received higher test scores. Without adequate sleep the brain has a harder time absorbing and recalling new information or a learned task.

Not only is the suggested eight to ten hours of sleep crucial for muscle, tissue and brain health but also for weight control. Researchers have found that sleep and metabolism are controlled by the same sector in the brain. The hormone Leptin plays a key role in making us feel full; when we don’t get enough sleep our Leptin levels will drop, resulting in a hunger spike or an increased level of the hormone Ghrelin. The Ghrelin hormone has a main purpose to make us feel hungry. This can be a vicious cycle inevitably ending in weight gain. This would explain why crispy fries, a greasy cheeseburger, or a large pizza sounds indulging after a long night of finishing paperwork for the new job or a shortened night of sleep due to a crying baby. I just want to throw this major hint out there, if you are having trouble focusing, constantly experiencing fatigue and have difficulty controlling your weight; set an alarm on your phone to go to bed an hour earlier. Make it a goal to get eight to ten hours of sleep a night. I promise you will be functioning better at work, school, soccer game, and even through parenting.

Of course like anything in life there are a few components that can influence the cycles of sleep I had described above. No I am not talking about the crying baby or the dog that needs to go outside every hour. Every 21 year old has probably experienced this once or twice; alcohol is actually one of the biggest contributors to lack of sleep. Have you ever had a few drinks and felt like it was your cure to insomnia? Alcohol can actually help an individual fall asleep, but once asleep the REM cycle is interrupted or completely skipped when alcohol is in the blood stream. It’s no wonder why we wake up and feel groggy, have difficulty focusing, and feel like greasy food is the answer to feeling human again after a night of drinking. Not only does alcohol affect sleeping, but in obvious manners so do caffeine or stimulants such as nicotine, cocaine, and amphetamines. These  cause hyperactivity in the brain not allowing for a full “deep sleep” in stage 3 and 4 of the NREM cycle. Like caffeine having our eyes stimulated by our smart phones right before bed can also be detrimental to dozing off into a deep sleep.

Want a sneak Peek of the rest?

Join our mailing list to read the rest of the article and receive wellness tips and information in your inbox!

Simple Ways to Improve Sleep Hygiene:

  • Try to go to sleep at the same time every night and wake up at the same time every morning.
  • Choose a bed time when you typically feel tired and a time where you naturally wake up without the use of an alarm. If you still feel groggy when awaking you should consider going to sleep earlier an hour or two earlier.
  • Control your exposure to light. Melatonin is a naturally occurring hormone controlled by light exposure in order to regulate the sleep-wake cycle. Our brain will secrete more melatonin when it’s dark (making you more sleepy) and less when it is light (making you more alert).
  • Regular exercise will help reduce anxiety and symptoms of insomnia as well as increase the amount our bodies spend in the deep (restorative) phase of sleep.
  • Avoid drinking alcohol, caffeine, or inhaling nicotine prior to bed time. All of these substances will interrupt the REM phase of sleep or even completely skip the phase, resulting in symptoms such as difficulty focusing and increased hunger throughout the day.
  • Try to perform deep breathing along with visualizing a peaceful and restful place to help reduce late night stress and over thinking.
  • Lastly, keep your room cool, dark, and quiet.

The Pelvic Floor — We all have them, so why do we ignore them?

The Pelvic Floor — We all have them, so why do we ignore them?

How many of us can relate to a little leakage following a sneeze or a cough, while jumping on the trampoline, or running after our littles?  We joke about it with our mom friends.  Somewhere along the line I’m sure you’ve heard it’s just a “normal” part of having children.  Like the sleepless nights, overwhelming fatigue, and just overall chaos that is now your life after children, a little urinary leakage may seem normal.  I am here today to tell you that while it is common following pregnancy and childbirth, it is by no means normal and there may be help out there for you in the form of physical therapy.  If you are experiencing any leakage of urine, stool or gas with exercise, laughing, coughing, etc. please read on to see how physical therapy may be able to help you change your life for the better.

At this point you are probably thinking: “How can a Physical Therapist help?”  Pelvic floor physical therapy addresses the issues listed above, commonly referred to as pelvic floor dysfunction.  There are many reasons pelvic floor dysfunction may exist.  The two most common sources of dysfunction include weakness of the pelvic floor muscles, resulting in incontinence; or tension/spasms of the pelvic floor muscles, which may lead to pain and incontinence.  Millions of women and men suffer from pelvic floor dysfunction.  Pregnancy, childbirth, chronic constipation, chronic coughing, surgery, trauma and aging can cause pelvic floor muscle tension, incoordination and weakness.

I keep talking about the pelvic floor, but what is the pelvic floor?  The pelvic floor consists of three layers of muscles.  It acts like a hammock extending from the tailbone to the pubic bone and it is responsible for housing the reproductive organs, bladder, and colon, as well as preventing leakage of urine and stool.

The most important thing to note about the pelvic floor muscles is that they are under voluntary control.  Just as it is possible to improve the strength of the muscles of the arms or legs, it is also possible to strengthen the muscles of the pelvic floor.  The most common way to strengthen the pelvic floor is by performing a contraction of the pelvic floor muscles, more commonly known as a Kegel.  The only problem with this is that most people do not know how to properly perform a contraction of the pelvic floor musculature.  This is where a specially-trained Physical Therapist can help.

Because the pelvic floor is a group of muscles that are under voluntary control, a Physical Therapist who has special training in treating the pelvic floor, is the perfect person to aid in the functional strengthening of this group of muscles.  In addition to incontinence being related to muscles with too little tone, there are also different types of incontinence including stress, urge and frequency.  There are different techniques to treat each type of incontinence.  A Physical Therapist is able to identify the different types of incontinence the patient is suffering with, teach a patient how to manage their symptoms, teach a patient how to properly perform a contraction of the pelvic floor muscles, and progress those exercises at the appropriate time.

It is important to remember that the problem is not always weakness of the pelvic floor.  The second group of patients suffering with pelvic floor dysfunction may have musculature that has too much tone or scarring secondary to child birth.  These patients need therapy to prepare the muscles and surrounding tissues for the ability to properly contract.  These treatments may also include work to enable musculature that has too much tone to work at its best.

Now that you’ve made it this far, is physical therapy something you think you could benefit from?  As I mentioned at the beginning, these things can be difficult to talk about, but I want to reiterate that at Complete Physical Therapy, you are in the hands of professionals who have been specially trained to perform these techniques.  You will have a safe place to talk about these tough topics.  After meeting with a Physical Therapist, we will come up with a plan that best suits you and your life.  These techniques will be explained to you after being evaluated by our specially-trained Physical Therapists.  Each patient will be evaluated on an individual case-by-case basis and a treatment plan will be developed for each patient.

If you’re ready to tackle this pesky problem or have questions regarding the process, please don’t hesitate to contact our specially-trained therapists, Stefanie Urbom, PT, DPT, CLT-LANA, ACSM-CCET or Renee Dominy, PT, DPT, ACSM-CCET, at Complete Physical Therapy 402.483.0006.  We take such good care of our kiddos, now is the time to take care of ourselves.  What are you waiting for?

Exercise and Prevention

Exercise and Prevention

Have you ever heard the phrase, “Treat your body like a temple for you are only blessed with one?” What does this phrase actually mean? It wasn’t until I became a healthcare professional that I truly understood the meaning. In my profession I am privileged enough to treat patients of all ages, due to which has given me great insight on many unknown possibilities one may not consider in his or her early 20s. For example, the stress I put on my body in my 20’s will ultimately determine my abilities when I reach my late 80’s. This has changed my mindset when exercising, eating, and overall appreciating my youth. In order to maintain a healthy, well-rounded body in my late 80’s there were a few areas that needed to be improved in my training regimen. This is when I discovered preventative training.

Preventative training is like rowing a boat. In order to get from point A to point B without travelling in a circle, one must evenly distribute the oars from left to right. The same concept can be thought of when exercising. If an unbalanced training regimen is implemented, our body will play the same role as the uneven rowing of the boat. Goals will not be accomplished and the body will remain the same, or worse, injury may occur. Too often at the gym I see individuals working past their limitations. Not only that, but often I don’t even see these individuals perform a simple hamstring stretch. From personal experience, I know this will eventually hinder goals; as well as mentally and physically set them back. Last summer, when attending boot camp after boot camp I began to see change in my body and my exercise regimen was at its peak performance, but I forgot one major piece of the puzzle; stretching. It wasn’t long before sleeping became an issue, standing for long periods of time became painful, and bending over was nearly impossible. Due to such pain, I was no longer able to attend boot camps let alone even make an appearance at my daily “therapy session”, the gym. For months I struggled with this set back, until one day in late November I decided it was time for change.

Most individuals feel that stretching is a waste of time because they don’t get that “exercise high” or they’re not “burning calories” or “gaining strength” from stretching. Unbeknownst to most people, stretching can actually promote fat loss in the body when done on a regular basis. How, you may ask? With proper breathing techniques, stretching encourages relaxation which lowers cortisol levels in the body. Cortisol is a “stress hormone” which spikes with any physical, mental, or emotional stress, which ultimately allows for fat to build up in unwanted areas of the body. After reading this unknown fact, and realizing stretching took away the pain that was limiting my ability to make it to the gym; I decided it was time to stop rowing my boat in a circle and focus on getting from point A to point B. Not only did I notice this similar trend in myself, but as well as the patients I was treating. I’m sure I’m not the first to tell you that everything needs to be done in moderation. This includes exercising. You could work out seven days a week and ultimately end up in the same place as someone who has never stepped foot into a gym. For example, I have treated patients who had the ideal lean, toned, fit body everyone sees in the fitness magazines on the outside, but on the inside there was a different story. All the hard training, no rest days, and neglected stretching led to tonic musculature restricting everyday tasks. Stretching is an activity that can be performed by everyone, from top athletes to senior citizens, meaning any person at any activity level can stretch and notice benefits. A top athlete will be able to perform a deeper squat due to improved range of motion in their lower extremities. Where senior citizens can improve their mobility as well as functional independence when performing regular stretches due to less restrictions in joints.

In order for it to be effective, stretching needs to be done with a purpose. This doesn’t mean flipping through Facebook or posting on social media. Tune out every day stresses and focus, focus, focus. Take slow deep breaths to allow oxygen back into the muscles that were just stressed. Each stretch should be performed twice for at least thirty seconds, with mild to moderate tension on the elongated muscle. During the second set you should be able to stretch the muscle farther than the first. Soon, this will become a standard to your exercise routine. Results will show and you will be able to start making strides toward your fitness and health goals while preserving your “temple” with preventative training. It is now my goal to shift my patients’ perspective on exercising for the rest of their lives, rather than just appreciating their ability in their early 20’s. If you are unsure of how to integrate preventative training into your exercise regimen contact Complete Physical Therapy at 402-483-0006 and a licensed professional can assist in making your life easier in your late 80’s.

Allison’s Top 10 Tips to Avoid Burnout and Enjoy Your Sport

Allison’s Top 10 Tips to Avoid Burnout and Enjoy Your Sport

  1. Always remember the reason why you’re playing—for the love of the game. For example, I loved a good fist pump after a stuff block. Remember those moments of joy and build off the experiences that remind you of why you love the sport.
  2. Consider cross training and play multiple sports throughout high school. Although I decided to specialize and pursue volleyball, there are benefits to playing multiple sports at different times of the year. Starting a new sport can be refreshing and help keep you re-energized throughout the year.
  3. Train hard in the off-season with proper recovery to prepare your body for in-season competition. Decrease the frequency of lifting weights while in-season and focus more time on the sport. When lifting during the competition season, decrease repetitions and increase weight.
  4. Maintain a positive, respectful relationship with your coaches. Having an open line of communication is healthy and will benefit the both of you. Their job is to win and your job is to play well. Don’t be afraid ask your coach what you can work on to be better.
  5. Learn to take criticism. Use it as motivation to get better. It isn’t an attack on you as a person, so take it constructively. Athletics can develop other life skills needed to be a successful adult in other parts of life. In the long run, it is going to make you a stronger person
  6. Making realistic short and long-term goals is important. Something has simple as getting 8 hours a sleep every night may play a big role in your success. Having something to work toward will keep you on the straight and arrow and keep you motivated throughout the long season. It also promotes self-improvement and is an objective way to monitor personal and team growth. Thrive on the feeling of getting better!
  7. Don’t push through injuries. More is not better. Be sure to properly warm up and cool down. Post practice stretching and icing can help decrease muscle soreness and help you recover faster. Be aware of your body mechanics and consider implementing exercises to activate muscles along the kinetic chain. Always land on two feet! Young, females are more likely to tear their ACLs due to biomechanical factors that can be addressed!
  8. Confide in your teammates and build a support system. Don’t look at your teammates like they are the enemy. Sure, you are both vying for playing time, but use that as motivation to push each other and make each other better. Lead by example! They are experiencing what you are experiencing. Providing positive gestures such as a high fives and other compliments can go a long way, especially if you or they are having a rough day at practice. Also, please do not create cliques. That’s never cool.
  9. Be patient with your body. Recognize your own limits and how much you are willing to sacrifice. Don’t let your past experiences dictate what kind of high school or collegiate athlete you can be. You are still growing and maturing—let your first memories of athletics be happy, pleasant ones. Later you can hone in on your potential, and with hard work it will pay off. Always dream big! Also, recognize that every not practice is going to be awesome. Acknowledge your weaknesses (and strengths) and come to the next practice, ready to do better and fix those mistakes. Before setting foot on the court, field, track, etc. leave all your personal drama outside the door. Practices should be a distraction free zone.
  10. Always have a day of the week where you can relax and not think about your sport. Try to plan other activities you enjoy and can look forward to. Sundays were always my days for physical and mental rest. By the time Monday rolled around I felt recharged and ready for a new week. Also, set aside time for visualization. Before practice, games, or during any moment of self-doubt, close your eyes and see yourself make a great play. Play it out in your mind, and coordinate the triumphal moment with a sense of calm and confidence.
Avoiding Burnout in Young Athletes

Avoiding Burnout in Young Athletes

For as long as I can remember athletics have always been a huge part of my live. Growing up in Texas with a father who coached high school football, I learned very early the importance of a strong work ethic. Over the years, I had a front row seat to the highs and lows of competition, but what I remember the most was learning to appreciate and respect the time and commitment required for athletic achievement.

In today’s society, kids are encouraged to start competitive sports at a young age. Professional sports are glamorized, inspiring young athletes to be the best on their team in order to receive attention and fame. The pressure to be the best can often lead to unrealistic expectations, overtraining, injuries, and— burnout. Athlete burnout is defined as “physical and emotional exhaustion, sport devaluation, and reduced athletic accomplishment.” Each case of athletic burnout is different and can be triggered by:

  • Pressure
  • Unrealistic expectations
  • Increased demands resulting in low gratification
  • Entrapment due to circumstances out of the athlete’s control
  • Inadequate mental and physical recovery

An athlete’s motivation may be intrinsic, induced by peers/parents, or derived from other extrinsic rewards. I believe it’s important to recognize the source. Competition as we know it revolves around bragging rights and material accolades, but the biggest piece of advice I can give parents of children starting organized sports is to facilitate the love of the game. A true internal desire will promote steady growth leading to greater satisfaction and sense of achievement in the long run.

Instead of focusing on the number of points scored or how well your child played compared to others, focus on what they enjoyed and encourage them to keep trying their best. Children who are feeling the pressure or feel consumed by sports early on may develop resentment and drop out before they even hit their full potential.

  • Being a little league MVP is trivial in terms of long-term athletic success.
  • Lay down a foundation of support and be patient. Don’t rush it.
  • Instill values of strong work ethic, coachability, discipline, and good sportsmanship.
  • Introduce your children to variety of sports and other extra-curricular activities and let them decide what they enjoy and where they want to spend their time.


I did not start playing competitive sports until the age of 15 when I decided to try out for a local club volleyball team. I was more mature, focused, and prepared to commit my time to playing. This was also the time where my love of the game started to grow. After the regular high school season, I continued to play elite volleyball through the winter – spring – and summer months. I spent several nights a week practicing, as well as, numerous weekends competing in national-qualifying tournaments.  In addition to volleyball, I was a high jumper during the track season. I qualified to compete in multiple state championships, earning two silver medals, and a gold in 2007.

I got into a great routine of juggling the demands of sports for a long period of time but towards the peak of my high school career, I started showing signs of perfectionism and low self-esteem despite my achievements. On paper, I was successful. I was ranked the 4th best senior volleyball player in the entire country. I had boxes of recruiting letters arrive at my doorstep each week, but deep down something was missing. I was getting tired and I was starting to feel the pressure. I didn’t recognize it then but I was starting to show the early signs of burnout.

According to the National Athletic Trainers’ Association (NATA), “Burnout is a response to chronic stress of continued demands in a sport or activity without the opportunity for physical and mental rest and recovery. Burnout is a syndrome of continual training and sport attention stress, resulting in staleness, overtraining and eventually burnout.” Are you showing the signs of burnout syndrome? Check out the NATA’s list of physical and mental signs below.

Physical Signs Mental Signs
·         Diminished performance or conditioning

·         Loss of strength and stamina leading to chronic fatigue or illness

·         Higher resting heart rate and blood pressure

·         Changes in energy levels, sleeping, and appetite

·         Difficulty concentrating, forgetfulness

·         Disinterest, moodiness, irritability

·         Low self-esteem, increased anxiety, and depression

·         Feeling withdrawn or disconnected from others

·         Feeling sad, empty, hopeless, or worthless


In the summer of 2008 I became a Nebraska Cornhusker. I entered a new level of competition and became exposed to a new paradigm of training. Very quickly I learned that with hard work comes recovery. I was introduced to a nutritionist, met one-on-one with a strength coach, and became very familiar with the training room ice bath. We met with physical therapists who evaluated our stature and biomechanics, in addition to athletic trainers who helped perfect our jumping, squatting, and running form. Proper hydration, sleep, and the supplementation of vitamins was mandatory. Instead of abusing my body, I started respecting it.

For the first time in my life I saw a difference between a competition period and a training period. At Nebraska, the goal was to be the best during the peak of competition season. To avoid overtraining, the frequency/intensity of practices and strength/conditioning sessions changed throughout the year using the concept of “periodization”. This continuum of training varies the levels of training intensity throughout four different phases of the athletic year.

  1. Off-Season/Preparation Period: High volume strength and conditioning/minimal sport specific training
  1. Pre-Season/First Transition Period: Increase quality sport specific training/decrease quantity
  2. In-Season/Competition Period: High intensity/high technique. No more than 20 hours of training a week
  3. Post-Season/Active Rest Period: Decrease in all aspects of training/maintenance

During the competition season, my teammates and I took time to attend rehab between classes for aches and pains and participated in rehab exercises before practice, as a way to prevent injuries and athletic burnout. During my time at Nebraska, I was very lucky to have an arsenal of professionals help me through every aspect of collegiate sports. After a year I noticed changes in my physical and mental well-being:

  • Gain in muscle mass leading to quicker agility speeds and vertical touch
  • Improved energy levels and less fatigue during practices
  • Awareness of sports specific body mechanics helping me avoid injuries
  • Clearer mind and improved confidence
  • Better time management with school and sports

Since entering the “Club of Retired Athletes”, I still uphold the values of proper training and strive to share my knowledge with others as a physical therapist assistant so that others may also avoid athletic burnout.

Stay tuned for my next blog post where I break down my top 10 tips YOU can implement to avoid burnout and enjoy your sport!

Prehabilitation and Breast Cancer

Prehabilitation and Breast Cancer

What does the term prehabilitation mean and how does it fit within the scheme of PT?  Prehabilitation is therapy that is done prior to a surgical procedure or prior to beginning chemotherapy or radiation therapy.  To better explain this concept, let’s think of a prize fighter preparing for the biggest fight of her or his career.  A skilled fighter wouldn’t just show up for a fight unprepared.  The fighter spends hours, days, weeks and months preparing for that big fight.  Prehabilitation can be thought of as the training before the fight.  Once a patient is aware of an upcoming procedure it is of great benefit for that patient to prepare so their body is able to heal as quickly and efficiently as possible.  Let’s take a brief look at the benefits of prehabilitation for a patient preparing to undergo treatment for breast cancer including mastectomy with lymph node removal followed by chemotherapy and radiation therapy.

The patient is first educated about the surgical procedure including a discussion about limitations following surgery and strategies to successfully maintain those precautions.  Next, strength, posture, and range of motion are assessed and limb volume measurements are taken.  The patient is then educated on lymphedema risk reduction principles.  These measurements enable the physical therapist to better monitor the patient for shoulder dysfunction and the early stages of lymphedema.

The findings from the prehabilitation evaluation provide the physical therapist with valuable information needed to develop and prescribe a home exercise program that the patient is to begin working on prior to surgery.  The patient will return following surgery where the physical therapist will progress exercises, re-check limb volume to more closely monitor for lymphedema, and look for changes in strength and range of motion.

If chemotherapy or radiation therapy will be part of the treatment, the prehabilitation evaluation will include the assessment of the patient’s current level of fitness and goals for therapy while undergoing treatment.  The patient is also taught how to monitor blood values during chemotherapy and radiation therapy to assist the patient in how to determine a safe and effective exercise routine.  Treatment may be continued during cancer treatment to ensure strength needed for chemotherapy and to improve shoulder range of motion to allow proper positioning for radiation therapy.

Prehabilitation is an essential piece of the treatment for patients undergoing treatment for breast cancer that is slowly moving to the forefront.  Since implementing the cancer prehabilitation program at Complete Physical Therapy over a year ago I have seen firsthand the benefits this program offers my patients.  They are empowered with the knowledge they receive and feel more confident and in control on their road to recovery.  They understand the importance of early detection of lymphedema and I am able to earlier detect common issues, such as lymphatic cording, protective posturing, and swelling, before they become a bigger problem.

To learn how a physical therapist at Complete Physical Therapy can assist you in preparing for an upcoming fight, whether it be a surgical procedure or prior to beginning chemotherapy or radiation treatments, call Complete Physical Therapy at 402.483.0006.  Schedule a visit with us today to assist you in creating an individualized prehabilitation program.  Complete Physical Therapy, where no one fights alone.

10 Tips to a Healthier You

10 Tips to a Healthier You

1. Start Out Small – More than likely, in the past, you have tried to change everything all at once and very few of your intentions stuck for good. The answer to staying committed for life is to start small. Making a single change every week, instead of overwhelming yourself with a bunch of changes all at once, will create healthy habits that last a lifetime.

2. Find Your Motivation – Motivation is what keeps you on the path to success. Whether it is good social support, music, getting stronger, or just fitting into an old pair of jeans. Find out what fuels you, tap into it, and use it!

3. Do NOT Deprive Yourself – Eliminating foods entirely can end up making you want them more. It is better to find healthy alternatives to the foods you love. For example, instead of using regular sour cream substitute with plain greek yogurt.

4. Consistency Is Key – The key to losing weight and keeping it off is consistency! Planning your meals and exercise around your busy schedule will eliminate excuses and create deep-rooted healthy habits. You need to be 100% all in to be successful. Remember, this isn’t a quick fix- this is a lifestyle change.

5. Find Healthy Foods You Love – According to it can take up to a dozen times for people to accept new foods. Start out by eating the healthy foods you already enjoy and slowly introduce new ones. If you have been on a solid sugar and salt diet for years, it will take some getting used to. Sooner than you think, those cravings will decrease and nutritious foods will sound more appealing.

6. Explore New Forms Of Exercise – Experience different types of exercise until you find one that you enjoy. Finding physical activity that you enjoy will feel less like a chore and more like fun!

7. Beat Indulgence By Planning Ahead – An essential part of weight loss is occasionally enjoying your favorite snack or meal. When you know you’re going to splurge, take the stairs, ride your bike, or work out ten extra minutes to burn those extra calories that you will be consuming.

8. Have Compassion For Yourself – Sometimes, we give into temptations and eat foods we hadn’t planned on eating. That’s okay! It doesn’t pay to dwell on something that has already happened. Forgive yourself, and move on.

9. Continue to Set New Goals – As you progress, it is important to set new goals for yourself. This will keep you motivated and reduce the chances of hitting a plateau.

10. Envision A Healthier You – For some of you this may be hard to visualize, especially if you have struggled with your weight your entire life. A healthier you, isn’t feeling like you have to look like a movie star. It is about feeling better and being the best version of yourself, not anyone else.

Preparing For A Race

Preparing For A Race

Check below for tips on how to prepare for Race Day and download the full list with Race Day Checklist at the bottom!

Race Day Preparation

  • Visualize Your Race Day
    • 1-2 nights/week for a month or two leading up to race
    • Utilize all 5 senses in your visualization
    • Visualize different race day scenarios – good and bad
  • Trust in Your Taper
    • 2-3 week reduction in mileage and intensity
    • Necessary for maximal performance
    • Legs, body, and mind need this
    • Not an excuse to do nothing for 2-3 weeks
  • Nutrition Up to Race Day
    • 3 days before increase consumption of complex carbs
    • 2 days before begin decreasing high fiber foods (fruits and veggies)
    • Avoid high fat/high carb foods such as cookies/pastries, etc.
    • Don’t over eat
  • Sleep the Night Before the Night Before the RaceKevin_Kim_Family
    • Typically less stressed and will sleep better
    • Poor sleep the night before does little to you physiologically
  • Gather and Organize Race Day Items the Night Before
    • Set out all race essentials the night before
    • Make a check list
  • Race Day Clothing
    • Be aware of race day forecast
    • Dress as though it were 15 degrees warmer
    • Bring extra “throw away” clothing for start line
    • Trash bag – keeps you warm and dry
    • Avoid wearing cotton
  • Transportation and Logistics
    • Leave extra time for unforeseen incidents (traffic, can’t find parking, etc.)
    • Parking locations and proximity to start/finish
    • Carpooling – everyone ready and on time
    • Drop off – make sure ride is on time
    • Know where baggage check is located
    • Know when you need to be in starting area
    • Set a predetermined meeting place for friends and family after race
  • Race Day Warm-Up
    • Wake up at least 2.5-3 hours prior to race
    • Perform an easy shake out run for 10 minutes
    • 5 min brisk walk and/or light jog prior to race
    • Dynamic stretching routine in small space/starting area
    • Ease into first 1-2 miles as cardiorespiratory warm up
  • Pace Yourself
    • Race day adrenaline
    • Follow your race plan
    • Run with pace group or use pace chart
  • Use a Positive Mantra when Running
    • At some point the race will get tough and you will hurt
    • Don’t let negative thoughts enter your mind and derail all you have worked for, it will pass
    • Formulate 2-3 easy and positive mantras to gain confidence and help you persevere
    • REMEMBER: Everyone is hurting like you are.
  • Focus on Form when Things Get Tough
    • Takes your mind away from the pain
    • Allows you to examine your efficiency and make changes
  • Set Small Goals
    • Keeps you focused
    • Keeps the race manageable
  • Fix it Earlier Rather Than Later
    • Sock/shoe rubbing, shoe tied too tight, have to use the restroom, etc.
    • Stop early in race and deal with it, don’t wait
  • Race Day Nutrition
    • Critical to practice in order to avoid GI issues
    • Use same nutrition on training runs for practice and refinement of refueling plan
      • No two stomachs are the same. Experiment to find out what works for you
    • Drink early and at regular intervals of 15-20 minutes (20oz/hour:1 big gulp = 1oz)
    • Don’t over drink/hydrate – sloshing in stomach, urge to urinate, hyponatremia
    • 1-2.5 hours of activity: 30-60g of carbs per hour
    • Greater than 2.5 hours of activity: 80-90g of carbs per hour
    • Gels, salt pills and alternative fuels
    • Top off fuel stores 15 min prior to race – ex. Gatorade Prime, GU, Power Gel
    • Stop ingesting fluid 45-60 min prior to start – let bladder empty out
  • Managing the Aid Station
    • Avoid congested area of aid stations
    • Make eye contact with volunteer
    • Move into middle of road once you no longer need any more fluid
    • Be aware of other runners
    • Squeeze cup to form a spout
    • Tip head, lean, and drink out of side of mouth
    • Avoid spilling on shoes
  • Enjoy the Day
    • Payoff for all your hard work
    • Take in your surroundings and interact with crowd
      • Be within reason and don’t let it take away from your goal