Chronic Pain Differs in Women and Men

male female pain grass valley nevada city physical therapy

We know that men and women are different. There are the obvious way, and not so obvious ways.  A recent  study  published in Nature Neuroscience suggests a different  brain pathway for pain between male mice and female mice. The explains why so many more women suffer from chronic pain syndromes than me, and why some pain medication may only help 50% of the population.

Males are from BDNF, Women are from ???


Walking Reduces Fracture Risk

hiking men

Did you know that a simple activity like walking can reap huge benefits? The medical community has long known that walking is a great bone building activity. The pull of muscles against gravity  stresses the bones to build new tissue.  Other bone building exercises include hiking, jogging, stair climbing, weight lifting, dancing, and tennis.  Walking creates rotation in your major joints; the spine, shoulders, hips, ankles, and knees. Motion is Lotion for your joints; lubricating and nurishing our connective tissue.

A recently published study confirms that yes, walking reduces fracture risk. This study published in the American Journal of Public Health looked at over 36,000 men aged 50-75 for 24 years.  The men  who walked 4 hours per week reduced their hip fracture risk by 44-62%.  Leisurely walking protected 44%, “Brisk” walking provided even more protection, with a 62% reduction of fracture risk.  4 hours a week of walking is well above the CDC recommendations for adult exercise.   This study looks just at men, but we know that walking improves women’s fracture risk too.

Not only does walking help your bones, it helps your brain, heart, lung, and mood too.  And it’s free! Get out there and move!

If you need more guidance on building strong bone to reduce your fracture or fall risk, see your local physical therapist for an osteoporosis fighting program.

Its Earth Week at Alive Physical Therapy.  We are celebrating  human powered transportation.  Do it for you, do it for the planet!


9 Healthy Hiking Essentials for Summer

Mags at the American River
Mags at the American River

Walking in nature is one of the most healing habits for the mind and body.  Japanese doctors even prescribe time in nature; they call it “forest bathing.” Living in a natural paradise such as we do, we all want to get out and experience nature. Especially in the heat of summer, with long days, we want to go to the river and go hiking. It is always important to put safety first when enjoying the outdoors. Whether you are in the desert, forest, beach, or mountains , safety becomes even more important in dealing with the roasting heat and blazing sun of summer.   Here are nine essentials for your hikes short and long:


Make sure you find a sunscreen that works for you before you rely on it during a long day of being outside. Some sunscreens go on too thick. All sunscreens should be reapplied often, at least every two hours. Make sure you get a sunscreen that meets your need, such as a water resistant sunscreen if you will be swimming.


A good sun hat will keep the sun off of your face, neck, and top of your head. These are areas that often get the most sun exposure.


Make sure your pack enough water. From experience, I’d say to bring one liter of water per person for every two hours of the hike. So if you are going with two people for a four hour hike (round trip), bring four liters of water, or about one gallon. You can even leave some extra in the car in case you are all out at the end.

Experience will tell you how to adjust how much water to pack. It is better to pack too much rather than too little if you are not sure. For emergencies, it can be good to bring water purification tablets in case you need to drink from a water source. Any water source you use should be flowing and should always be purified.


Do some stretching in the middle and end of your hike. You always want your muscles to be warm before you stretch. Stretching increases blood flow and flexibility.


Pace yourself and take breaks! After all, you’re out there to enjoy yourself. Your break is a great time to enjoy a snack and the view. Make sure your snack has some salt in it to replace the electrolytes.

Early and Shady

Hike early in the day if you can, so you can avoid the worst heat of the day. Research your hike and pick one with shade. A shady hike in the heat is definitely more pleasant than a hike in the full sun!


Know your limits. If you are not in peak physical shape, it would be best to work up to that 10-mile hike rather than doing it this weekend! If you start to feel weak or light headed from the heat, take a break in the shade, drink some water, and plan your way out of there.

Tell Someone

Tell someone where you are planning to go, and when you will be back, before you leave. If you get lost, rescue personnel will have a much easier time of finding you if they have an idea of where to look.

First Aid

Accidents do happen, even for the most cautious. Buy a hiker first aid kit. They are light and have the essentials. You can get them at outdoor stores or online. You may even consider taking a first aid class! Also, bring a cell phone with you in case you need to call out for help.

Next time we will cover how to treat and prevent the most common hiking injury: the ankle sprain.

4 Reasons New Moms Need Physical Therapy








When new moms and dads come home with baby the focus is all on their new bundle of joy.  What many parents don’t realize is that the post-partum period is the perfect time to check in with their own bodies to heal properly and develop new habits to strengthen your body.  After all the loads you carry will only get heavier and baby grows.   Pick up your baby and all her stuff  to strengthening your back. Learn how to brace and protect your pelvic floor to prevent incontinence and prolapse.  Prevent scar tissue adhesions, pelvic pain, and return to sex with ease.

We want to share this great article on  Read it, then call your physical therapist.

3 Easy Tips for Riding Your Bike to Work

Mags rides to work
Alive Physical Therapy celebrates Earth Day by riding our bikes to work all this week!

Biking or walking to work is a great way to exercise without having to go to the gym. You can show up at work with a smile on your face after getting your blood flowing.

Especially with beautiful spring weather and longer days, there is really no reason to get in your car for short trips. Two miles are an energizing ten minutes to refresh yourself on the way to or from work.  Besides being great for your own health, replacing a car trip with a bike trip is great for our planet’s health, too, not to mention the health of your neighbors.

I have found Nevada City and Grass Valley to be great places to ride. While there is always room for improvement, in general the low amount of traffic and polite drivers makes this area quite enjoyable to ride in. Do you notice how many cars are on the road in the picture above? And how about that bike lane? So get on out there, and chances are we’ll see each other on the road with smiles on our faces! Check out the tips below to make your ride even better.

  1. A little bit of equipment can go a long way. A backpack is an easy way to start. But, with a bike rack and bag, it’s more comfortable to bring a computer, extra clothing, lunch, lock and whatever else you need. You’ll like this a lot better than wearing a bag on your back. Especially when the weather is a little bit warmer, you’ll appreciate letting your back breathe by letting the rack hold your gear. Beyond that, you should have some basic safety equipment. A helmet is a must, as are lights if you are riding in the dark. A new $30 helmet is just as safe as a $100 helmet. Check out Tour of Nevada City Bike Shop for your accessory needs.
  2. Practice some basic maintenance. First, keep your tires inflated to their recommended pressure. The pressure will be listed on the side wall of the tire. Bike tires sometimes need to have air added once a week. Also, keep your bike dry, in a garage or shed, so it doesn’t rust and wear. If your bike has been sitting untouched for a couple of years, bring it in to Tour of Nevada City for a tune up. You don’t need to be a gear head to take care of the most basic bike care tasks.
  3. Your bike ride is a meditation, not a race. Racing to your destination will only make your ride dangerous and make you sweaty when you arrive. So, calm down, put it into low gear on the hills, and enjoy the ride. Signal your intentions clearly to other road users, and be patient. A slow and steady bike ride will get you to your destination feeling refreshed, like a walk through the woods.

Once you start riding your bike to work, you’ll wonder why you even own that second car! Happy Earth Day!

To Kegel or not to Kegel? 5 Myths of Kegels debunked!

Your Pelvic Floor muscles are like a hammock or sling to support your back and pelvic organs
Your Pelvic Floor muscles are like a hammock or sling to support your back and pelvic organs. Don’t let things fall through!

You may or may not have heard of Kegels, the pelvic floor muscle exercise made famous by gynecologist Dr. Arnold Kegel to reduce leaking, pelvic organ prolapse, and assist in pregnancy.  Your pelvic floor muscles act during orgasm, hold in your pelvic organs, stabilize your pelvis and back, relax during toileting, sex, and childbirth, and keep you from leaking at all other times.  There is some controversy over whether people should perform Kegels.  Today, we will clear up some misconceptions!

Myth #1 — Kegels are a squeeze of the vagina

Kegels engage more than just the vagina. To understand the Kegel we first must understand the pelvic floor muscles.  This group of muscles acts like a sling or hammock running from your pubic bone to your tailbone and to each side of your sitting bones (those two bony knobs under your butt when you sit down).  The pelvic floor muscles run under and around the vagina or penis, urethra, and anus making figure 8’s.  A good Kegel should squeeze and lift the whole hammock of muscles.  Then relax, let the hammock hang down and open for at least as long as you squeeze.  The relaxation is just as important at the squeeze. Women can feel the contraction at the opening of the vagina and near the anus. Men can do Kegels as well, they may notice a lift and pulling in of the penis.

wikimedia commons
From L to R: Pubic bone, bladder, uterus, rectum, and spine.  Squeeze and lift! Then relax.

Myth #2 Kegels can make you constipated

Kegels will not make you constipated.  If you are squeezing to avoid a bowel movement then yes, constipation can occur.  Don’t hold it in. To avoid constipation go as soon as you feel an urge. The longer the rectum sits full, the longer your body ignores the call to use the toilet, the drier and harder your poop becomes.  If constipation is an issue for you, properly performed Kegels will not make things worse. In fact, as you increase the range of motion for your pelvic muscles, you may find it easier to have a bowel movement.  During a bowel movement you should perform a reverse Kegel, completely relaxing the pelvic floor muscles.  I describe some techniques in Myth #4 below. For those  struggling with constipation, consider increasing your warm fluids, fiber, and fun exercise to get things moving.  Also do not squeeze to push poop out. You are likely tightening and making it harder for yourself.  Instead, lean forward or squat, breathe deep and easy into your belly, and let your gut do the work.

Myth #3 Kegels make it harder to give birth

baby-momWomen hear that strengthening their pelvic floor will make it harder for the baby to come out. Properly performed Kegels also tone the abdominal muscles which can make pushing easier, decrease back pain, and prevent leaking during pregnancy . Each squeeze and lift should completely relax.  Starting in the 3rd trimester, I suggest women begin to train relaxing their pelvic floor muscles with an abdominal contraction to simulate muscle activity during delivery.

 Myth #4 Kegels can lead to pelvic pain and nerve entrapment.

Some folks might get only half the message about Kegels, the squeeze. They might go around all day squeezing without relaxation because of habit, stress, or anxiety. Improperly performed exercise of any kind can unfortunately lead to pain.   Try it: Squeeze your hand into a fist, hold it as tight as you can for as long as is comfortable.  You end up on the verge of pain right? Notice your hand is pale when you open it.  A constant squeeze limits the blood and nerve flow to the area which can increase pain or dysfunction.  Some people may have a weak and tight pelvic floor and not know it.  These folks need to focus on the relaxation, not the squeeze. If you are having trouble relaxing your Kegel  try a flat foot squat, or child’s pose.  Visualize your pelvic hammock hanging down and open with deep belly breathing.   As your belly fills with air, imagine the air filling your pelvic hammock.

GNU free documentation photographer Daniel Case
Childs Pose- relax the forehead on the ground. Option: Add pillows under your butt to ease your back, hips, or knees

Myth #5 Kegels take too much time 

A Pelvic Floor Exercise program takes only a few minutes of your day.   The beauty of the Kegel is you can do it any time anywhere, and no one knows except for you!  Squeeze and lift every time you cough, sneeze, bend over, or stand up.  Squeeze in a few while waiting, brushing your teeth, or after using the toilet.  Never Kegel while peeing or pooping; it sends the wrong signal to your nervous system and increases urinary retention and UTIs.  I do not recommend Kegels while driving, as it is not safe to multitask while behind the wheel. For strengthening: perform 50-80 squeezes daily For maintenance: 30 squeezes should be enough.  Use both quick contractions, and longer holds.  A good goal is to work your way up to ten ten-second holds, and ten quick one-second holds. Be sure to relax between for at least as long as you squeeze.

Kegels are important to do every day. If you are old enough to vote, Kegels should be a daily part of your life, like flossing your teeth! Up to 40% of women do not do Kegels properly on their own. If you are at all unsure, have difficulty starting the stream of urine, or performing Kegels causes you discomfort, stop trying, then see your physician or local Pelvic Physical Therapist!

Direct Access? Californians do not need a doctor’s referral for PT!

On January 1, 2014, California Assembly Bill 1000 took effect, giving patients direct access to physical therapists. This means that you can now go directly to your physical therapist without a diagnosis from your doctor first, getting you the treatment you need more quickly.  If you sprain your ankle you can get treated the same day!  With any injury, aches, or pain, the more time passes, the more likely you will feel negative effects. For example with an ankle sprain, without treatment you are likely to limp for longer, and stress other joints such as the toes, knee, hips, and back. Even as the pain goes away compensation patterns can translate into other injuries and over use down the line.  Once an area is injured, that part of the body is more prone to injury, unless you are vigilant about rehabilitating the area.  Now there is no need to go down that path! If you have any acute injuries or falls, you can treat it now. If you are experiencing pelvic or back pain, leaking, or sexual dysfunction you can see a physical therapist and take care of it.

photo credit J.J. Verhoef
Hurt yourself while playing?  Don’t wait, Treat it now!                                    photo credit J.J. Verhoef

A physical therapist is able to treat a patient without diagnosis or referral from a doctor for 45 days or 12 visits, whichever comes first. Physical therapists are highly trained in their trade, enabling them to determine the nature of your problem and get right to treatment.

Call us at (530) 362-8181, and we can set up an appointment to treat what ails you.

New Class, Core Power!

Physical Therapist Mags Matthews is teaching a new class for the new year. Called Core Power, this class focuses on building strength in the center of the body.

Mags demonstrating an exercise.
Mags demonstrating an exercise.

When you think “core,” you may think that just means your abs. Not so! This means your whole torso. This class will strengthen your whole body  through your shoulders, back, abs, chest, and hips.

Mags takes input at the beginning of the class to see if there are areas of concern for any of the students, and adjusts the class accordingly.

Mags and student Aero do ab curls
Mags and student Aero do ab curls

The class has its challenging bits, but is more refreshing than challenging. Most of the exercises will feel pretty easy until the last couple of repetitions. And Mags can watch your form to make sure you are getting the most out of the exercise.

When: Every Tuesday at noon

Where: The NEST classroom, 208 Providence Mine Road, Suite 122, Nevada City

How Much: $15 drop-in, $50 4-pass, $80 8-pass. These passes are good for any AlivePT class.

Who: This class is appropriate for everyone, including new and expecting moms.