The Inside Press

Magazines serving the communities of Northern Westchester

Physical Therapy

The Experience of Being a Single Mom and Going it Solo during COVID-19

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The following was written on April 13, 2020, as an FYI, and edited here for publishing clarity. Three plus weeks later, the feelings are pretty much status quo, although I’ve settled into more of a routine, which helps. Like many, I imagine I’d be in a state of acute despair without Governor Cuomo’s daily briefings or summaries.

 

 

 

 

 

 

I simply wish to bear witness to my personal experience as a Single American, Empty Nest mom staying home solo and doing my best to follow the new COVID-19 rules. 

My 23-year-old son lived with me for Month 1 of ‘all this.’ Renewed bonds, his humor, mine too, all helped ease the transition to this ‘new way.’  I loved having him here, in fact, after two plus years since starting empty nest in earnest (that is, post his graduation from college when he moved into the city permanently). 

It may appear at first glance that I rescued him bringing him home to the burbs after he developed mild symptoms, got diagnosed as positive with COVID-19, and recovered here, but I know the truth now.

A certain household structure of cooking and meal preparation is comforting and calming. Permission to and the ability to take care of a loved one are absolute gifts, too.

Please never take any of that for granted, ever, not for a minute.

So…

This one is for all the single people living in what boils down to, what is amounting to, a stretch of house arrest.

But ok, without the ankle bracelet.

Yes, social media and FaceTime calls with kids, family and special friends help. It has been especially heartening to keep up with my daughter almost daily as I had been feeling we had grown apart. She has taught herself new skills, and I’m planning on blaring about them soon too, if she’ll let me.

Yes, absolutely, a Zoom meeting or the sometimes seemingly infinite number of fitness or meditation classes and musicians and entertainers and political/educational forums online breaks things up and absolutely does help with motivation or to keep spirits up.

I’d have been lost for a stretch without private stretching/exercise sessions with a therapist from New Castle Physical Therapy for a back-related issue.

Laughter has been key to so many getting through this, so trust me that all the funny online posts in goofy Facebook groups or from all the self styled comedians out there are amazing lifelines for me, too.

I marvel at all the ingenuity and entrepreneurship and ponder the transforming future of where we will all land in the realm of real time versus virtual time. 

Still.. I spend a lot of time online for my work, so I look forward to getting off line… so there’s that. Ultimately, online communication is not like having humans in proximity in your home-whether it’s hearing the sound of a voice or seeing the gleam in someone’s eye. If you are a people person, which I am, by and large, the absence of  ‘actual’ time together is felt deeply.

If you don’t own a pet, which I don’t anymore (a long story for another day, perhaps), yes, it’s far worse than that.

I hear a lot: “I can’t imagine not having my dog through this (or dogs, or cat, or cats).”

Well, imagine it. Many single people do not have pets for a variety of reasons. At this juncture, I don’t have a pet. Not even a fish. And that is that, too. I am not looking for leads on getting a pet, so please, dear reader, do not go there. It actually hurts for you to. I’m fully aware of the options, and let’s just say, it’s complicated.

For me, all I know is that today is Day 10 of alone during COVID-19. For many, it’s well into the 20s, 30s or even 40 plus days. I contemplate the continued impact of long-term isolation. 

Whether it’s your kid’s groan when you tell him to get back to his homework, or your spouse or significant other yelling out, “What’s for dinner?”, please don’t underestimate the value and comfort of a voice that’s in proximity to you. I wonder: Will I settle into isolation? Will it get easier? Harder? Impossible to bear?

I am a person who considers my mental health as intact, stable as she goes. But anxiety is taking hold now, and I’m keeping a variety of toll-free numbers handy. 

The days are much easier than the nights. I am intensely grateful to live where there are many neighbors in proximity, at least. I take my near daily walk for the people and pet visuals, for the dose of Vitamin D, too. The sun sustains me like nothing else. I appreciate even a wave from six feet away at the occasional neighbor, or even someone’s puppy or dog wagging its tail. 

Neighbors’ eyes sparkle and even the wrinkles surrounding them ‘speak’ to me from above the bridge of a nose and circumference of a mask. If they are not wearing masks, I keep my distance, wave anyway, and pray they simply stay safe, too. 

I like getting into my car for the reminder of the old normal as I set about to perform only the most necessary errands. I gratefully take in the ‘hum’ and ‘sounds’ of the market, or at the pharmacy, too. Those fill the soul some, too.

When night falls, a certain fear takes hold, a sense of vulnerability that’s hard to explain. Maybe it’s when all these feelings of aloneness peak. Watching TV, binge watching especially, helps a good deal. I mourn the end of any good series! When I turn the net and TV off, though, it’s me again, and… the pockets of dark space. I’ll slog through some darkness, contemplate the dishes in the sink, but usually choose to leave them for the morning. I try to reduce the night hours by going to sleep as early as possible. Sleep is a bit of a messy affair, too, also the subject of a future post. 

I won’t venture too much here into the lack of touch or intimacy and the total weirdness of virtual dating, or rather, foregoing virtual dating, for the most part.  For reasons also best left to another column, perhaps, I will say I don’t feel this is the time to embark on new romance, either. For personal reasons, I wasn’t necessarily ready for new romance before COVID-19, and I don’t believe that has changed. If anything, those feelings are exacerbated. Still, I’ve always been in the never say never school, too. 

I don’t want pity, but compassion and understanding are great. I don’t need advice or suggestions either. Or maybe I do. I don’t know.

I understand my feelings are unique too, and not universal.  An old friend, similarly alone, is not experiencing it this way at all, and even expressed a comfort level with the isolation, so go figure. She describes herself as perhaps always having been an introvert and that somehow ‘all this’ is suiting her.  I would describe myself as more of an extrovert (although a shy one, too, in a way, as contradictory as that may sound), so perhaps we are hit a bit harder. Then again, I always loved my alone time, too, but by design. And choice. So, again, I don’t know.

I am not writing this to compare pain and painful situations. The tragedy is devastating and on some days, beyond all comprehension. The disease has hit terribly hard taking tens of thousands of lives across the country, hundreds of thousands across the world, and threatening the health of family members, roommates, as it devastates nursing home residences, in particular. Prison populations have also been horribly impacted. And so on.  Solo in my otherwise comfortable suburban pad is certainly also better than any domestically violent situation in any socio-economic circumstance.

And yet, what I want to convey, is that pain is relative, and that the pain here is real for me, too.

Human beings are largely social creatures. Our souls are tested, and I believe shrink in any prolonged isolation. I want to erase the stigma too that anyone weathering this solo is similarly feeling. I know that I’m not alone with these feelings, and that they are widespread.

And yes, yes. I am still counting my blessings to be alive and healthy. I was never going to even share these words as I worry  they may sound somewhat self indulgent or morose. But then again, if a pandemic is not the time to feel those things too, then I don’t know what is. You are welcome to search elsewhere for inspiring and uplifting right now.  I have tried to keep busy sharing all the drama and news I possibly can through this press on a most limited budget. I have plenty of work to do to make sure my 17-year-old business survives COVID-19.  I’ll overshare too that it can feel like wading through molasses. I go through all the steps I’m advised to take as a small business and wait for those to bear fruit.  And wait.  I have rooms and a garage I promised myself I could declutter now, but somehow, paralyzed to, since that feels like the ultimate solo punishment.

I write this simply to self-express (that helps me, so forgive me if my oversharing causes you any discomfort). Finally, I share also to express that I do feel empathy for everyone weathering this storm. My heart goes out to all of you, to those single and to those in semi full or very full houses (maybe we can trade places for a day?) and all your own unique challenges.  And yes, I must believe that we too can get through this, #AloneTogether, and #NewYorkTough. Or when you’re not feeling so tough sometimes, too. 

 

Empowering Westchester Residents to Better Health at the Innovative Center for Healthy Living

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Northern Westchester Hospital (NWH) believes that health care is about getting involved in health rather than just sickness. The hospital is supporting, coaching, and empowering Westchester residents to become partners in their care. From physical therapy to weight management to the new and innovative Center for Healthy Living, the NWH services offered at Chappaqua Crossing are designed to keep the people of Westchester healthy and out of the hospital, enjoying the activities they love.

Through the Center for Healthy Living, NWH offers the community free Healthcare Navigation services. A Healthcare Navigator can work with you to understand your health and wellness needs and can connect you with experts and services that can support you best. Some people are seeking physician referrals, others are looking for specific counseling or support, and others are in search of wellness classes. The Healthcare Navigator is available to help you in these situations and many more. To learn more, contact Lauren Selsky, Healthcare Navigator at 914-666-1955 or lselsky@northwell.edu.

Rehab services at NWH’s Chappaqua Crossing site span several specialties from physical, occupational and speech therapy to cardiac and pulmonary rehab. The goal: to enhance and restore functional ability and quality of life to those with impairments, disabilities or those recovering from an accident, illness or surgery. NWH also offers a concussion management program at Chappaqua Crossing that uses a multidisciplinary approach to effectively treat adolescents and adults who have sustained concussions. Whether the goal is to speed recovery, decrease pain or return to activities –or a combination of these goals–NWH rehab services provide patients with the education, support and motivation that they need to succeed. For more information, visit nwhrehab.org

Just next door is home to NWH’s innovative new Center for Weight Management which takes a clinical, evidence-based approach to weight management and helps you identify the core reasons you’re struggling with weight loss. The Center will help you overcome these obstacles and empower you to adopt lifelong healthy behaviors.

Northwell Health Physician Partners Surgical Services can also be found at NWH’s Chappaqua Crossing Campus, offering the community access to top-notch specialty surgery including, surgical weight loss, plastic surgery and Medi-Spa services, and Vein Center.

NWH’s clinical excellence, comprehensive services and compassionate care has earned the trust of patients, their families and referring physicians. To learn more about these services and many more, visit nwhc.net.

News courtesy of Northern Westchester Hospital

Balance Training

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It may not receive much attention in the world of sports medicine and fitness, but balance should be a primary consideration when designing an exercise program. While balance is extremely important for senior citizens, all age groups can benefit from balance training.

Here’s a test: stand on one foot and see how long you can balance. Now try it with your eyes closed. It becomes a much harder test. This is because balance is comprised of three systems: vestibular, proprioceptive and visual. Most people are overly reliant on their visual system. This is partly why the majority of falls occur in low light environments. When visual input decreases, it becomes much harder to balance.

Here’s the good news – you can improve your balance. Start by simply standing on one leg. Then try it on foam or an unstable surface. At all times, have something nearby to hold onto for stability. For example, you might try standing next to a table or at the foot of your bed. Finally, try it with your eyes closed. As difficult as it is without visual input, your ability to balance can improve. It takes consistent effort; consider starting your practice a five minutes once a day.

For an advanced routine, try balancing on a foam pad while playing catch or bouncing a ball off a wall back to yourself.

Matthew Marucci PT, MSPT, OCS, CSCS is the owner of New Castle Physical Therapy and is certified as an Advanced Hip Clinician with The Hospital for Special Surgery.
New Castle Physical Therapy is located at 16 Schuman Road in Millwood. For more information, please visit newcastlept.net or call 914-488-5440

Preventing & Recognizing Concussions: Keeping Your Young Athlete Safe

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(L-R): Lisa Rusch, PT, DPT, GCS, Chari Hirshson, PhD and Sarah Todd, PT, DPT, CLT
PHOTO BY CAROLYN SIMPSON, DOUBLEVSION PHOTOGRAPHERS

With the 53rd Super Bowl behind us and a spike in media coverage on NFL players and concussions, the 2017 season saw the highest rate of diagnosed concussions (291) in NFL players in a six-year period, according to the NFL and Quintiles, an independent third-party company. Although 2018 figures showed a 29 percent decrease in the number of concussions, it still remains a serious health problem for players.

Although NFL players may be at a higher risk for sustaining a concussion, which medical researchers refer to as a type of traumatic brain injury (TBI), they are not the only athletes experiencing concussions. Many high school athletes and younger ones are also suffering from concussions in our towns and the problem seems to be county-wide. In fact, in 2016 the former County Executive Rob Astorino formed the Westchester County Concussion Task Force to address the problem.

In observance of Brain Injury Awareness Month in March coinciding with the spring sports season kicking into high gear, Inside Press spoke with leading medical practitioners at Northern Westchester Hospital (NWH) to separate fact from fiction when it comes to concussion prevention, treatment and management.

Changing Perceptions About Concussions

When many people think of concussions, they think of an athlete on a football field who perhaps has lost consciousness. While losing consciousness can certainly be a symptom of concussion, there are a host of other concussion symptoms and they don’t necessarily present themselves at the time of injury. Concussions are a type of brain injury that results from a bump, blow or jolt to the head or by a hit to the body that causes the head and brain to move back and forth. This back and forth movement can cause the brain to bounce around in the skull which can result in stretching or damaging brain cells. Many health professionals classify concussion as a mild TBI (traumatic brain injury) because the injury is usually not life-threatening and in most cases, symptoms resolve on their own. However, some patients have lingering symptoms that require treatment from a specialist trained in concussion management.

Ryan Esposito sustained a concussion falling off his scooter without a helmet

Chari Hirshson, PhD is a neuropsychologist with NWH who specializes in brain injury and treats both adults and children (ages 8 and up) who have sustained a concussion. According to Dr. Hirshson, who sees her patients at the hospital’s Ambulatory Care Center at Chappaqua Crossing, “concussion symptoms vary from patient to patient,” she explains. “It is important to take a multi-disciplinary approach with patients that have lingering symptoms because their symptoms can be multifaceted, encompassing physical, emotional and cognitive realms,” adds Lisa Rusch, PT, DPT, GCS, a Supervisor in the Concussion Rehab Program at NWH.

Acknowledging that concussions can be diagnosed by urgent care specialists, pediatricians or in the ER, an MRI or CT scan rarely shows signs of concussion. “Most of the time, these tests come back normal. It is not like with an X-ray that shows a broken bone. This can make it difficult to gauge the severity of the injury,” says Dr. Hirshson.

Varying Symptoms

Patients with a concussion can experience observable signs such as:

  • Appearing dazed and confused
  • Forgetting instructions
  • Moving clumsily
  • Answering questions slowly
  • Losing consciousness (even briefly)
  • Showing mood, behavior or personality changes
Ryan recovering from his concussion. PHOTOS COURTESY OF FAINE ESPOSITO

Patients with a concussion may also report these symptoms:

  • Headache or “pressure” in the head
  • Nausea or vomiting
  • Balance problems or dizziness/blurred vision
  • Bothered by light or noise
  • Feeling sluggish, hazy, foggy or groggy
  • Confusion, concentration or memory problems
  • “Feeling down,” irritable or anxious
  • Changes in sleep patterns

Some patients do not exhibit any symptoms until a few hours or even a few days after the injury. That was the case with Ryan Esposito, an Armonk child who decided to take his scooter down the porch and ride it without a helmet and unsupervised when he was five years old. He fell down the stairs by his driveway and while his head was bruised and bloody, he did not exhibit any concussion symptoms that afternoon upon examination by a pediatrician. “The doctor did not want to give him an MRI because he was so young but told us to take him to the ER if he starts vomiting,” recalls his mother Faine Esposito. Sure enough, at midnight Ryan started vomiting and was taken to NWH and diagnosed with a concussion.

Falls: A Leading Cause of Concussion

Despite many people believing that contact sports are a leading cause of concussion in children, more than 55 percent, in children up to 14 years old, are actually due to falls like Ryan’s. Hirshson adds, many of her adult patients sustain their concussion as a result of falls which could have been easily prevented. “I’ve seen falls resulting in concussion from women wearing jeans that are too long, or men who are carrying messenger bags with a strap that is too long and they trip. These injuries are not related to football, or skiing. These are things that can happen in everyday life,” she says.

Nevertheless, sports-related concussions due to being struck by an object or person is the second-leading cause of concussion in youth, accounting for 24 percent of cases in children up to 14 years old. In addition, 71 percent of sports and recreation-related TBI emergency department visits are among patients 10-19 years old. According to 2017 statistics from the US Centers for Disease Control and Prevention (CDC), 15 percent of high school students have had one or more concussions and 6 percent experienced two or more as a result of either playing a sport or being physically active. The rates were higher among males and the more sports a child played the higher the prevalence of concussion. Even more troubling was the fact that 40 percent of high school athletes reported that their coach was unaware of their symptoms. The researchers also found that some high school athletes tried to hide their symptoms from their coaches so that they would not get reduced playing time.

“I’ve seen falls resulting in concussion from women wearing jeans that are too long, or men who are carrying messenger bags with a strap that is too long and they trip. These are things that can happen in everyday life,” Hirshson says. PHOTO BY RAWPIXEL ON UNSPLASH

Gender Disparities in High School Athletes and Concussion Prevalence

There also appears to be a gender disparity in terms of the prevalence of concussion when high school athletes of both genders are playing the same sport. Females are more likely to suffer from concussion when playing soccer, basketball and lacrosse. Some of the reasons may be due to proper safety equipment. Boys are required to wear helmets in lacrosse while girls are not. Lauren Dinhofer, a senior who plays varsity lacrosse at Horace Greeley High School feels that helmets for her teammates should not be mandatory. “The use of helmets for me gives off the idea that girls are more protected, so you can be more aggressive on the field. However, helmets for girls don’t really have adequate materials for protection. Unlike boy helmets, girl helmets are soft and won’t make a difference against a check to the head. They invite more contact instead of offering protection.” But Melissa Mykytiuk, an Armonk mother of three boys who played lacrosse and ice hockey fervently disagrees. “Why don’t girls who play lacrosse wear helmets? Those sticks and balls are hard. It’s crazy to me.”

The Road to Recovery: Part 1: Return to School

Many of the patients who visit Dr. Hirshson or Rusch have been referred by a physician or a pediatrician. With a comprehensive approach tailored so that each patient can return to school and/or play, the team in the Concussion Management Program at NWH offers physical therapy, speech therapy, occupational therapy and neuropsychology. A coordinated team with their colleague Sarah Todd, PT, DPT, CLT who is the manager of Outpatient Rehabilitation Program at the hospital’s Chappaqua Crossing site, demonstrates why specific training in concussion management and a multi-disciplinary approach to care is critical to successful treatment. They often find a patient will seek treatment for one symptom, for example balance disturbance, and upon evaluation and assessment, additional effects of the concussion, such as memory issues, are uncovered and able to be treated.

Dr. Hirshson specializes in neuropsychology. The neuropsychological tests she performs can last from 4-8 hours and are designed to assess a patient’s cognitive strengths and weaknesses. “Typically, we don’t do neuropsychological testing until three months post-injury if cognitive symptoms have lingered,” explains Dr. Hirshson. If necessary, Dr. Hirshson will help young students manage their symptoms post-concussion before that 3-month period and help them transition back to school. The rigorous demands of high school, college applications and entrance exams can be very taxing on a student with lingering concussion symptoms. In certain cases and upon Dr. Hirshson’s clinical observations, some students may require support from the school, and she will work with the district to advocate for this, if necessary.

It is really important for a student suffering from concussion to get what medical professionals call adequate “cognitive rest” because this helps the brain recover. For example, if a student has an important test coming up, studying for it uses a lot of brain power and instead of using that energy for the brain to recover, it gets depleted which can ultimately delay recovery. Dr. Hirshson assesses each student and makes recommendations for returning to school on an individual basis “Take your cues from your kids,” advises Mytkiuk. Each of her three sons had a different recovery time from their concussion. “It’s frustrating because you don’t have control over when your kid’s brain gets better.”

Dr. Hirshson always tells her patients, “Don’t do something that doesn’t feel good. Don’t look at a screen if it hurts your head. Slowly build up tolerance. If you got a concussion over the weekend skiing, then don’t play soccer on Tuesday. Allow yourself the proper time to recover.”

Road to Recovery: Part 2: Return to Play

While the priority for all students recovering from concussion is to get them to return to school, for high school athletes returning to the field is often a main goal of recovery. With more than 4,000 New York based students under 19 treated at hospitals for sports-related traumatic brain injuries, following a return to play protocol is very important. In 2013, all states were mandated to pass laws to address concussion management in school athletics.

NY state school nurses, certified athletic trainers, coaches, and physical education teachers are mandated to complete sports concussion management training every two years. In addition, in both the Byram Hills School District and the Chappaqua Central School District, high school athletes undergo IMPACT (Immediate Post Concussion Assessment & Cognitive Testing) pre-season for a baseline assessment and upon returning to the field. Not all New York State school districts conduct IMPACT testing. Before a student returns to play, they must have medical clearance from a physician permitting it.

While Dr. Hirshson helps students return to the classroom, Rusch and Todd help students return to athletic endeavors. They help students suffering from symptoms such as neck pain, vestibular (inner ear) dizziness or disorientation and provide therapy to help them strengthen their eyes or restore equilibrium in addition to several other modalities. Todd often works on improving the vestibular system which can affect balance. “We retrain and recalibrate the vestibular system with dynamic exercises such as hopping on one foot on a foam board,” explains Todd. “We are part of that return to play conversation with the athletic trainers. We ensure that the athlete takes on exercises with increasing intensity in a controlled setting and then we make recommendations regarding return to play,” notes Rusch. “Interestingly, the research is indicating that patients who sustain a concussion are three times more likely to sustain a lower extremity injury of the knee or lower leg,” adds Todd.

“Each specific discipline that is part of the Concussion Management Program uses measurement tools to identify symptoms, measure their severity and develop a plan to progress so that patients return back to school and/or the field,” sums up Todd. “Because each concussion and its symptoms are unique, see a medical professional with credentials in concussion management who understands all the nuances,” advises Dr. Hirshson.

Ryan like most concussion patients had his symptoms resolve quickly and is now a happy six-year old back to playing on scooters and riding bikes. “But he remembers the injury and tells all his friends to be careful and of course wear a helmet,” his mother adds.

Helpful Helmet Tips

While there is no such thing as a “concussion-proof helmet,” the CDC notes that a proper fitting helmet can protect from a serious brain injury. Todd, who herself is a triathlete says that “helmet manufacturers are studying the dynamics of concussion and improving their designs based on the research.” As the biking season gears up, the CDC recommends the following tips when purchasing a helmet. The CDC also offers sports-specific guidelines for helmets available on www.cdc.gov/headsup.

Start with the Right Size

  • Bring the bike rider with you to assess fit.
  • Measure the child’s head size.
  • Sizes vary from brand to brand, so look at the helmet’s fit and sizing chart.

Get a Good Fit

  • The helmet should fit snugly all around with no spaces between the foam and bike rider’s head.
  • Ask your child how the helmet feels. A too tight helmet can cause headaches.
  • Have your child wear the hairstyle they will be wearing to ride the bike. If a long-haired child cuts their hair short, adjust the helmet accordingly.
  • The helmet should not rest too high or too low on the rider’s head.
  • Make sure your child can see straight forward and side to side.
  • The side straps should make a “V” shape under and slightly in front of the bike rider’s ears.
  • Chin straps should be centered under the bike rider’s chin and fit snugly so that no more than one or two fingers fit between the chin and strap.

Take Care of the Helmet

  • Check for damage. Do not use a cracked or broken helmet or one that is missing parts.
  • Clean it only with warm water and mild detergent.
  • Keep the helmet away from direct sunlight and do not store in a car.
  • Do not decorate with stickers or paint as this could affect the helmets safety.

Look for Labels

    • Have the date of the manufacture in case of a recall.
    • Purchase a helmet that is US Consumer Product Safety Commission (CPSC) certified.

 

Replace the helmet if it is damaged and has been involved in a crash!

Source: CDC Heads Up campaign

RX for Healthy Hips

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By Matthew Marucci

There are few muscle groups in the body more important than those of the hip. In addition to influencing the hip, these muscles can impact the health of your lumbar spine and knees.

When people think about keeping their knees healthy the most common approach is strengthening the quadriceps. While there is nothing wrong with working the quadriceps, the hip, particularly the gluteal muscles, have significantly more influence on the health of your knees. The gluteals help control the position of your femur (thigh bone) and thus the alignment with the tibia (shin bone). Misalignment between these bones can increase the stress placed on the cartilage in your knees and hips. Additionally, if you lack proper alignment between your femur and tibia, the significance of your quadriceps strength decreases even further.

Another common misperception is that activities like running and cycling strengthen your hips. To increase the strength of a muscle you must use enough weight or resistance to reach fatigue in the range of 12-15 repetitions. While running and cycling are excellent forms of cardiovascular exercise, they do little to strengthen your legs. Cardiovascular exercises also tend to engage your muscles in the sagittal plane (front to back movement), while the gluteal muscles need rotation or movement away from the body to be recruited.

The influence of the hip on the spine is simply an equation of motion. The more motion that can be derived from the hips, the less motion will be needed from the spine. Less motion in the spine results in decreased stress placed upon the vertebral discs and ligaments. Minimizing motion from the spine and adding lumbar stabilization exercises (planks, side planks) to your routine is a great recipe for a healthy spine.

Try adding these exercises to your routine.

Clamshells: Lie on your side with your hips and knees bent. Slowly lift your top knee while keeping your feet together. Stop when you feel your pelvis begin to tip backwards.

To add resistance use an ankle weight wrapped around your top thigh or an elastic exercise band around your knees. Perform 3 sets of 12 repetitions.

Side Lying Hip Abduction: Lie on your side with your bottom leg pulled up toward your chest. Lift the top leg up and slightly back. You know you are performing this properly when you feel the back half of your glutes working. You should not feel it on the side of your hip. Perform 3 sets of 12 repetitions.

Modified Side Plank with Hip Abduction: Lie on your side with your knees bent and lift your body off the ground using your elbow and knee closest to the ground. While holding this position gently lift your top leg up and slightly back. Hold the side plank for 30 seconds and try to raise your leg about 15 times during the 30 second period.

Matthew Marucci PT, MSPT, OCS, CSCS is the owner of New Castle Physical Therapy & Personal Training and is certified as an Advanced Hip Clinician with The Hospital for Special Surgery.