At San Ramon Valley Physical Therapy, we often see patients who are excited to begin (or return to) a strength training program. Building muscle, improving bone density, and enhancing overall function are all fantastic goals. However, one key element is often overlooked before loading up the barbell or dumbbells: having full range of motion (ROM) at your joints.
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What is Range of Motion?

Range of motion refers to how far a joint can move in each direction. For example, your shoulder should be able to comfortably reach overhead, your hips should allow you to squat down, and your ankles should bend enough to support proper walking and running mechanics.

Why is Full ROM Important Before Weight Training?

When we lift weights, we place additional stress on our joints, muscles, and connective tissues. If a joint is restricted and can’t move through its natural motion, the body often compensates with poor movement patterns. Over time, this can lead to pain, muscle imbalances, or injury.

Let’s look at a common example:

• Overhead Press: If you can’t raise your arm fully overhead while lying flat on your back (a quick test for shoulder mobility), pressing weight overhead may force your lower back to arch or your shoulder to move improperly. This creates unnecessary stress and increases the risk of injury.

By first restoring full motion, you’ll not only protect your body but also make your workouts more effective.

Benefits of Ensuring Full ROM Before Training

• Injury Prevention: Healthy joints distribute force evenly, reducing strain.
• Better Strength Gains: Muscles work best when trained through their full length.
• Improved Technique: Proper movement patterns lead to more efficient and safer lifting.
• Longevity in Training: Maintaining joint health helps you stay consistent for years to come.

How to Get There

Before beginning a progressive weight training program, consider:

• Mobility Screening: A physical therapist can assess whether you have adequate range of motion in key joints like shoulders, hips, and ankles.
• Corrective Exercises: Gentle stretching, mobility drills, and targeted strengthening can restore balance.
• Progressive Approach: Once full ROM is achieved, gradually increase weight and intensity with proper form.

​Takeaway

Strength training is one of the best investments you can make for your long-term health—but only if your body is ready for it. Ensuring full range of motion at your joints before starting prevents injuries, improves performance, and sets you up for sustainable progress.

At San Ramon Valley Physical Therapy, we help patients move better, restore joint mobility, and safely transition into fitness programs. If you’re unsure about your range of motion or want guidance before starting weight training, our team is here to help.

Lateral elbow pain, often referred to as tennis elbow or lateral epicondylitis, is commonly associated with repetitive wrist extension or gripping activities. While the pain centers at the outer elbow, research increasingly points to a surprising contributing factor: shoulder weakness, particularly in the rotator cuff and scapular stabilizing muscles. By addressing these upstream issues, you may find meaningful relief in your elbow.

The Shoulder-Elbow Connection
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Your arm functions as part of a kinetic chain—from the shoulder blade down to your fingertips. Weakness in the rotator cuff or scapular stabilizers can lead to poor mechanics and increased load on the forearm extensors, which attach at the lateral elbow. Over time, this overload can lead to microtears and inflammation at the tendon insertion point, causing pain and dysfunction.
A growing body of evidence supports this shoulder-to-elbow relationship:

• Cools et al. (2014) emphasized that shoulder strengthening, especially of the rotator cuff and scapular muscles, improves upper limb mechanics and reduces distal overload.
• Lucado et al. (2012) found that a comprehensive rehab program for lateral epicondylalgia that included proximal strengthening (shoulder girdle and rotator cuff) led to superior outcomes compared to forearm strengthening alone.
• Vicenzino et al. (2003) demonstrated that scapular-focused rehab helped reduce symptoms of lateral elbow pain more effectively than isolated elbow interventions.

At-Home Shoulder Exercises to Reduce Lateral Elbow Pain

Here are three simple, evidence-informed exercises to strengthen your shoulders and support elbow health. Each targets different muscles in the kinetic chain and can be done at home:

NOTE: DO NOT OVERGRIP THE BAND OR WEIGHT! Relax your wrist....this will take pressure OFF your elbow

1. Side-Lying External Rotation (Light Dumbbell)Targets: Infraspinatus and teres minor (rotator cuff)
How to do it:

• Lie on your side with your elbow bent to 90 degrees and a light dumbbell (1–5 lbs) in your top hand, resting across your abdomen.
• Keeping your elbow tucked to your side, slowly rotate your arm outward, lifting the dumbbell toward the ceiling.
• Lower slowly.
• Reps: 2–3 sets of 10–15 per side

Why it helps: Research shows that this isolated movement recruits the external rotators, which play a key role in stabilizing the shoulder during arm movements.

2. Band Pull-Aparts (Elastic Band)Targets: Rhomboids, middle trapezius, and posterior deltoid
How to do it:

• Hold a resistance band with both hands at shoulder width, arms straight in front of you.
• Pull the band apart by squeezing your shoulder blades together, keeping arms at shoulder height.
• Pause briefly, then return slowly to the start.
• Reps: 2–3 sets of 12–15

Why it helps: Strengthening the scapular retractors improves posture and reduces strain down the arm, which may alleviate elbow stress.

3. Wall Angels (Bodyweight Only)Targets: Serratus anterior, lower trapezius, and thoracic mobility
How to do it:

• Stand with your back against a wall, arms bent in a goalpost shape with your elbows and wrists against the wall.
• Slowly raise your arms upward along the wall, then return to the starting position.
• Keep your back and arms as flush to the wall as possible.
• Reps: 2–3 sets of 10

Why it helps: This exercise promotes scapular control and thoracic extension, both essential for healthy shoulder mechanics.

When it comes to shoulder health, mobility is everything. Whether you're recovering from an injury, dealing with stiffness, or simply trying to stay loose and strong, stretching the shoulder through its various ranges of motion is key to maintaining flexibility, preventing pain, and improving performance. In this post, we’ll go over four essential stretches that target different directions of shoulder movement: flexion, extension, internal rotation, and external rotation.

1. Wall Climb (Shoulder Flexion Stretch)Target: Shoulder flexion (lifting your arm in front and overhead)
How to do it:

• Stand facing a wall, about a foot away.
  
• Place your fingertips on the wall at about waist height.
  
• Slowly “walk” your fingers up the wall until you feel a comfortable stretch in the front of your shoulder.
  
• Hold the top position for 15–30 seconds, then walk your hand back down.
  
• Repeat 3 times on each side.
  

Tip: Keep your shoulder blade down and avoid shrugging during the stretch.

2. Towel Stretch (Internal Rotation Stretch)Target: Shoulder internal rotation (rotating your arm toward your spine)
How to do it:

• Grab a towel and drape it over your shoulder so one end hangs down your back.
  
• Reach behind your back with the affected arm and grab the lower end of the towel.
  
• Use your other hand (holding the top end of the towel) to gently pull upward until you feel a stretch in your shoulder and the front of your chest.
  
• Hold for 20–30 seconds and repeat 3 times.
  

Tip: Keep your posture upright and avoid arching your lower back.

3. Sleeper Stretch (Internal Rotation in Side-Lying)Target: Posterior capsule and internal rotation
How to do it:

• Lie on your side with the involved shoulder down and your arm bent at 90 degrees in front of you.
  
• Use your top hand to gently press your lower forearm down toward the floor.
  
• Stop when you feel a stretch in the back of your shoulder.
  
• Hold for 20–30 seconds and repeat 2–3 times.
  

Tip: Keep your shoulder blade stabilized by slightly rolling your torso forward into the stretch.

4. Doorway Stretch (External Rotation and Chest Opener)Target: Shoulder external rotation and pectoral muscles
How to do it:

• Stand in a doorway with your elbow bent at 90 degrees and your forearm resting on the door frame.
  
• Gently step forward with one foot until you feel a stretch across the front of your shoulder and chest.
  
• Hold for 20–30 seconds and repeat 3 times on each side.
  

Tip: Keep your core tight and avoid leaning too far forward.

Ankle sprains are one of the most common injuries, affecting athletes, weekend warriors, and even those who simply take a misstep on uneven ground. Though often dismissed as minor, a sprained ankle—when not properly treated—can lead to chronic instability, recurring injuries, and long-term limitations. The good news? With proper physical therapy, you can recover fully and regain confidence in your stride.

What Is an Ankle Sprain?

An ankle sprain occurs when the ligaments supporting the ankle stretch beyond their limit or tear. Most sprains happen on the lateral (outside) part of the ankle and can range from mild (Grade I) to severe (Grade III).

Common Symptoms Include:

• Pain, especially when bearing weight
• Swelling and bruising
• Reduced range of motion
• Instability in the ankle

The Phases of Recovery

1. Acute Phase (First 1–3 Days)Goal: Reduce pain and swelling.

• Rest: Avoid putting weight on the injured ankle.
• Ice: Apply for 15–20 minutes every 2–3 hours.
• Compression: Use a wrap or brace to reduce swelling.
• Elevation: Keep the ankle above heart level whenever possible.

Tip: This phase is crucial. Pushing through the pain can delay healing or worsen the injury.

2. Subacute Phase (Days 4–14)Goal: Restore mobility and begin gentle strengthening.

• Range of Motion Exercises: Ankle circles, alphabet movements with your toes.
• Gentle Weight Bearing: Progress from using crutches to walking with support.
• Manual Therapy: A physical therapist may use hands-on techniques to reduce stiffness.

Caution: Avoid high-impact activity or uneven surfaces during this phase.

3. Rehabilitation Phase (Weeks 2–6)Goal: Improve strength, balance, and function.

• Strengthening Exercises: Resistance band work for ankle muscles, calf raises, SIGLE LEG STRENGTH IS HUGE (single leg step ups and RDLs).
• Proprioception Training: Balance boards, single-leg stands to retrain the body's awareness of joint position.
• Functional Movements: Gradual return to activities like jogging or sports drills.

4. Return to Activity Phase (Week 6 and Beyond)Goal: Prepare the ankle for full function and prevent re-injury.

• Sport-Specific Drills: Cutting, jumping, or pivoting, depending on your activity.
• Preventive Strategies: Proper footwear, ongoing strengthening, and warm-ups.

Why Physical Therapy Matters

Many people try to “walk off” a sprain, but skipping rehabilitation can lead to chronic ankle instability or even future sprains. A licensed physical therapist can:

• Design a personalized rehab plan
• Monitor your healing progress
• Teach safe movement techniques
• Address muscle imbalances and flexibility issues

Final Thoughts

Recovering from an ankle sprain isn’t just about healing—it’s about rebuilding strength, balance, and confidence. With the right care and commitment to rehab, most people can return to their normal activities stronger than before.

If you've recently sprained your ankle or are dealing with lingering discomfort from a past injury, don’t wait. A personalized physical therapy program can get you back on your feet—and keep you there.

1. Set Up an Ergonomic WorkspaceEven if you don’t have a fancy home office, you can still make your space posture-friendly.

• Chair: Use a chair that supports your lower back. If your chair doesn't offer lumbar support, try rolling up a small towel and placing it at your lower back.
• Screen height: Your monitor should be at eye level so you’re not constantly looking down. Use books or a laptop stand to lift your screen if needed.
• Keyboard and mouse: Keep them close enough that your elbows stay bent at about 90 degrees and your wrists stay straight.

Pro Tip: Your feet should be flat on the floor. If they don't reach, use a footrest (or a sturdy box).

2. Move Frequently (Seriously!) Even with the perfect setup, staying in one position too long isn’t good for you. Our bodies are meant to move.

• Stand up every 30–60 minutes.
• Stretch your arms, neck, and back.
• Try a quick walk around the room, or some light mobility exercises.

Set a reminder or use a timer app if you tend to get lost in your work.

3. Strengthen Your Core and Postural MusclesYour posture isn’t just about sitting up straight—it’s about having the strength to maintain that position.
Here are a few PT-approved exercises to try at home:

• Wall Angels: Stand with your back against a wall and move your arms up and down like snow angels. Great for shoulder posture!
• Chin Tucks: Gently draw your head back to align your ears with your shoulders. This helps combat “tech neck.”
• Bird Dogs: On all fours, extend one arm and the opposite leg. Great for core and lower back strength.

4. Be Mindful of "Tech Neck"Looking down at your phone or laptop for hours at a time puts stress on your neck. This leads to forward head posture and tension headaches.

• Hold your phone at eye level.
• Take frequent breaks from screens.
• Practice chin tucks throughout the day.

5. Consider a Standing Desk or Desk ConverterAlternating between sitting and standing throughout your day can reduce the load on your spine and encourage better posture.

• Start by standing for short intervals (15–30 minutes).
• Use an anti-fatigue mat or shift your weight between legs.
• Avoid locking your knees or leaning on one hip.

When to See a Physical TherapistIf you’re experiencing ongoing pain or discomfort—especially in your neck, shoulders, or lower back—it might be time to consult a physical therapist. We can assess your posture, identify imbalances, and develop a personalized plan to get you moving and feeling better.

Final ThoughtsGood posture isn’t about perfection—it’s about being aware of your habits and making small, sustainable changes. By improving your home setup and staying active throughout the day, you can help prevent pain and improve your overall well-being.
Need help getting started? Contact us today for a personalized posture assessment and home exercise program. We’re here to help you feel your best—wherever you work.

1. Runner’s Knee (Patellofemoral Pain Syndrome)

• Symptoms: Pain around the kneecap, especially when running downhill or sitting for long periods.
• How PT Helps: Strengthening the quadriceps, glutes, and hip muscles to stabilize the knee and improve alignment.

2. Plantar Fasciitis

• Symptoms: Heel pain, especially in the morning or after long runs.
• How PT Helps: Stretching the calf muscles, strengthening the foot muscles, and using custom orthotics if needed.

3. Shin Splints (Medial Tibial Stress Syndrome)

• Symptoms: Pain along the shinbone, often due to overuse or improper footwear.
• How PT Helps: Adjusting running mechanics, improving flexibility, and strengthening the lower leg muscles.

4. Achilles Tendinitis

• Symptoms: Pain and stiffness in the Achilles tendon, often after intense training.
• How PT Helps: Eccentric strengthening exercises, soft tissue mobilization, and gait analysis.

5. IT Band Syndrome

• Symptoms: Pain on the outer knee, typically aggravated by running downhill.
• How PT Helps: Strengthening the hip abductors, improving flexibility, and using foam rolling techniques.

Injury Prevention Tips for Runners

1. Warm Up Properly
   • Incorporate dynamic stretches like leg swings, high knees, and lunges before running.
   • Avoid static stretching before a run—save it for post-run recovery.
2. Strength Training for Stability
   • Strong muscles absorb impact better, reducing stress on joints.
   • Focus on core, glute, and hip strength to improve running form.
3. Gradual Progression
   • Follow the 10% rule: Increase weekly mileage by no more than 10% to avoid overuse injuries.
4. Footwear Matters
   • Get fitted for running shoes based on your gait and foot type.
   • Replace shoes every 300–500 miles to maintain proper support.
5. Listen to Your Body
   • Pain is a warning sign—don’t push through it.
   • Rest and seek professional help if discomfort persists.

How Physical Therapy Can Improve Running Performance

• Gait Analysis: A PT can assess your running mechanics and suggest changes to improve efficiency and reduce strain.
• Flexibility & Mobility Work: Improved joint mobility leads to a longer stride and better running economy.
• Recovery Techniques: Manual therapy, dry needling, and therapeutic exercises can speed up recovery and keep you running pain-free.

Final Thoughts
Whether you're a seasoned marathoner or a beginner, incorporating physical therapy into your routine can help you run smarter, stay injury-free, and reach your full potential. If you're experiencing pain or want to improve your performance, consider visiting a physical therapist who specializes in working with runners.
Need help with your running mechanics or injury prevention? Contact SRVPT today!

Step Up Your Strength: Why Calf Raises Deserve a Spot in Your Routine
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If there’s one exercise that deserves more love, it’s the mighty calf raise! Whether you’re a seasoned athlete, weekend warrior, or someone just looking to improve mobility, adding calf raises to your routine can do wonders. And no, we’re not just talking about getting sculpted legs (though that’s a nice bonus!).

Why Should You Care About Your Calves?

Your calf muscles—specifically the gastrocnemius and soleus—play a major role in walking, running, jumping, and even standing for long periods. Weak calves can lead to issues like shin splints, knee pain, and even balance problems. But here’s the good news: strengthening them is as simple as rising up on your toes!

Benefits of Calf Raises

1. Stronger, More Stable AnklesEver taken a misstep and felt your ankle wobble? Strengthening your calves helps support your ankles, reducing the risk of sprains and improving overall stability. This is especially important for runners and athletes who make quick directional changes.
2. Better Balance & CoordinationThink of your calves as your body's shock absorbers. They help with balance and coordination by controlling movement and absorbing impact. Strong calves mean a lower chance of trips, slips, and falls—something we all want to avoid!
3. Reduced Risk of InjuryTight or weak calves can contribute to injuries like plantar fasciitis, Achilles tendonitis, and even knee pain. Regular calf raises keep these muscles strong and flexible, helping to prevent common lower-leg issues.
4. Boosted Athletic PerformanceWant to run faster, jump higher, or just move more efficiently? Strengthening your calves gives you the explosive power you need for sprinting, jumping, and quick movements.
5. Improved CirculationCalf raises act as a mini pump for your veins, encouraging blood flow from your lower legs back up to your heart. This is especially helpful for those who sit or stand for long periods during the day.

How to Do a Proper Calf Raise

1. Stand tall on the edge of a step, knees straight with feet hip-width apart
2. Slowly rise onto the balls of your feet, squeezing your calves at the top.
3. Lower back down with control, letting your heel drop below the step.  Feel a stretch in the calves at the bottom.
4. Repeat for 10-15 reps, 2-3 sets.

​For an extra challenge, try single-leg calf raises or add weights!

Ready to Step Up?

Whether you’re looking to improve athletic performance, prevent injuries, or simply walk more comfortably, calf raises are a simple yet powerful tool. So next time you hit the gym (or even while brushing your teeth), give your calves some love—you’ll be surprised at the difference it makes!

Need help with a strengthening routine? Our expert physical therapists are here to guide you toward stronger, healthier movement. Book a session with us today!

Here is a nice, low impact, shoulder exercise that compliments a typical gym routine with weights and machines.  Write out the entire alphabet while holding a band that comes across your body.  Pretty easy and very effective!!

The Breztel 2.0 (yes, there is a Bretzel 1.0, which is a little more difficult for everyone to get there) is a great stretch that hit many different components that need moving.  I use this as a warm up and cool down and it is even great during the day to break up long hours on the computer.

Make sure to work both sides and it will also let you know if one side is more restricted that the other.

It is great for hip and spine mobility...Now, it is not a catch ALL, but it's a good one!  Check it out!

​Let us know if you have any feedback :)

Undergoing surgery can be a daunting experience, especially for older adults. However, one of the most effective ways to enhance surgical outcomes and facilitate recovery is through pre-operative physical therapy. At San Ramon Valley Physical Therapy, we understand the unique challenges faced by our patients, and we’re here to provide guidance on how physical therapy can play a vital role in your surgical journey.

The Benefits of Pre-Operative Physical Therapy

1. Improved Strength and Flexibility
Engaging in targeted physical therapy sessions before surgery can help improve muscle strength and joint flexibility. This is particularly important for older adults, as maintaining strength can lead to better surgical outcomes. Stronger muscles support the surgical site, reducing the risk of complications during and after the procedure.

2. Enhanced Recovery Time
Patients who undergo pre-operative physical therapy often experience shorter recovery times. By preparing the body for surgery, patients can bounce back more quickly, allowing them to return to their daily activities and enjoy a better quality of life sooner.

3. Pain Management
Pre-operative physical therapy can also help manage pain levels before surgery. Techniques such as manual therapy, stretching, and specific exercises can reduce discomfort and increase mobility, making the transition into post-operative care smoother.

Common Surgical Procedures That Benefit from Physical Therapy

Several surgical procedures particularly benefit from pre-operative physical therapy, including:

- Knee Replacement Surgery: Strengthening the muscles around the knee and improving range of motion can lead to a more successful surgery and quicker recovery.

- Hip Replacement Surgery: Pre-operative therapy can enhance hip strength and stability, making it easier for patients to regain mobility after surgery.

- Spinal Surgery: For those undergoing spinal procedures, pre-operative physical therapy can help improve core strength and flexibility, which is crucial for post-operative recovery.

What to Expect from Pre-Operative Physical Therapy

When you begin your pre-operative physical therapy program, a licensed physical therapist will conduct a comprehensive evaluation. This assessment will identify areas requiring improvement and help tailor a program to meet your specific needs. Sessions may include:

- Strength Training: Focused exercises to enhance the muscles supporting the surgical site.
- Flexibility Exercises: Stretching techniques to promote range of motion.
- Education: Learning about post-operative care, including exercises and movements to avoid during recovery.

​Conclusion

Preparing for surgery doesn’t have to be overwhelming. By incorporating pre-operative physical therapy into your surgical plan, you can significantly enhance your recovery experience and improve surgical outcomes. At San Ramon Valley Physical Therapy, our dedicated team is here to support you every step of the way. If you have a surgical procedure on the horizon, reach out to us to learn more about how we can help you prepare.