Hitting the Links

Did you know that the Scottish government banned golf for years because they thought it interfered with military training? Rightly so! Golf is a fun interference in our daily lives that gets us outside and on the fairways. In this blog, we will discuss some basics of golf including warming up properly, attire on the course, proper club grips and variations, set up and swing posture, set up approach, swing mechanics, and proper ball placement in your stance. 

Warming Up

Many of us, including myself, don’t properly warm are bodies, joints, and muscles up before playing a round of golf. As an athlete my entire life I cannot think of another sport maybe besides pool, ping pong, and bowling that I didn’t do an active warm up before I played. Not warming up increases our chances of injuring ourselves by possibly straining a muscle, tweaking a joint, or worse. Check out my golf warm up handout link I have attached to this blog!!

Also wearing the proper attire will help you improve your golf game. I like to wear flexible, stretchy fabrics that wick away sweat. I always wear a hat to protect me from ultraviolet rays. I have a golf glove to protect my main grip hand from blisters, L hand for R handed players and R hand for L handed players. I wear golf shoes with small spikes to help me plant my feet especially in unstable or wet surfaces like grass and sand. I usually keep a light waterproof jacket in my bag for the windy and drizzly days as well. 

Gripping the Club

If you haven’t golfed much before you may think “Why does it matter how I hold this silly club?” A seasoned golfer knows that every little detail matters in golf, from your grip, to your stance, all the way down to where the ball is in your stance depending on the club and lie of the ball, which we will discuss later. There are three grips you should know for golfing. They are Overlapping, Interlocking, and Baseball. Let’s break these down. 

Overlapping Grip

This type of grip starts with both of your hands palm open. Rest your club in your palms. Take your lower pinky finger and wrap it around the top of your upper hands index finger. For R handed golfers this is the R pinky overlapping the L index finger. For L handed golfers this is the L pinky overlapping the R index finger. 

Interlocking Grip

The interlocking grip is good grip for golfers with smaller hands or weaker grip strength. For an interlocking grip place the index finger of your lead hand, L for R handed golfers and R for L handed golfers in between the pinky and ring finger of the trail hand. This will lock the two hands together. The club grip fill fall at the base of the fingers of both hands. 

Baseball Grip 

This grip is also known as the Ten-Finger Grip since all 10 fingers are touching the grip of the club. This is considered the most basic grip and is used mostly by children and beginners. The club is gripped with the lead hand, L hand for R handed golfers and R for L handed golfers. All the fingers of the lead hand wrap around the grip and the thumb will run on the side of the club. The pinky finger of the trail hand will align next to the thumb of the lead hand. 

Optimal Golf Posture

A few things to remember when addressing your ball to hit your shot is that you cannot get optimal movement in your muscles and joints if you are too stiff. Think about having your head down 45 degrees toward the ball. Keep your shoulders back. Keep your lead arm straight. L arm for R handed golfers and R arm for L handed golfers. Hinge at your hips and have your spine about 45 degrees forward. Bend in your knees slightly. Keep your feet about shoulder width apart or slightly more for driving. Keep your feet fairly square with minimal toeing out. 

Ball Placement in Stance

I often see beginner golfers approach their ball and put the ball in the middle of their stance with every club and every shot. In order to increase your control, trajectory, spin for different shots and clubs you want to vary where the ball is in your stance. For woods and drivers you typically want the ball forward in your stance to increase the distance and improve the launch angle of the ball. For Irons moving the ball back in your stance can reduce the launch angle and increase the roll of the ball. This is good for shots where your want to decrease the height of the ball possibly due to trees or other obstacles. With wedges placing the ball back in your stance can help you control the spin and roll of the ball for chipping and pitching. 

Hopefully these tips on grip, stance, posture, and ball position help you in your golf game and give you some insight to help you cut some strokes off your score.  Remember to get a good warm up in and also HAVE FUN! 

Here is a Warm-up Handout to use before the next time you hit the green.

Perry Hicks, PT, DPT is a caring, compassionate, skilled Doctor of Physical Therapy at Langford Sports and Physical Therapy. Perry is a proficient Spanish speaker and has years of experience working in outpatient physical therapy. He enjoys rehabilitating athletes and active populations of all ages. Perry has played competitive soccer for his entire life, appreciates being outdoors in his leisure time, hiking, camping, and backpacking.

A Day in the Life of a Langford Physical Therapist

A typical day at Langford PT starts bright and early. My first patient usually arrives at 7:30 am, so I make it a point to get to the clinic 10-15 minutes beforehand. This extra time allows me to review the day's schedule, prepare for my patients, and wrap up any remaining tasks from the previous day. On any given day, I see between 10 to 13 patients, each receiving 40 minutes of dedicated, one-on-one care.

At Langford PT, our patient base is quite diverse. We primarily see moderate- to high-functioning individuals, including weekend warriors, athletes, teenagers, active adults, and even seniors who are keen on returning to their sports or daily activities safely and swiftly. Mornings are usually filled with patients who work full-time jobs and prefer to schedule their appointments early to avoid missing work. These patients often present with various orthopedic issues such as knee, hip, shoulder, and neck pain. I utilize a variety of techniques and tools, including manual therapy and targeted exercises, to help them return to the activities they love. I also make sure to provide each patient with home exercises that are specific and relevant to their needs.

Midday, I typically work with seniors or those who have more flexible schedules. These patients may be recovering from surgery or dealing with chronic pain that impacts their quality of life. My goal is to guide them through their rehabilitation, helping them regain the ability to enjoy their favorite activities.

Lunchtime is a great opportunity to decompress from the busy morning. I use this time to catch up on documentation and patient communication. Lunch breaks at Langford PT are staggered, so some of us spend time together discussing patient care strategies or simply catching up on life outside of work. One of the things I truly appreciate about Langford PT is the sense of community among the staff. We support one another, share insights, and collaborate to provide the best care possible.

In the afternoons, my schedule typically shifts to teenagers who come in after school. The injuries I see often vary based on the sports season—think soccer, football, or volleyball in the fall. When treating athletes of any age, a key focus for me is injury prevention. I aim to keep them active throughout their season by incorporating prevention programs into their care, whether it's through customized plans they can follow after PT or workshops tailored for entire teams.

My day wraps up with some final documentation, ensuring all patient notes are completed before heading home around 5:00 pm. It’s a full day of helping people get back to doing what they love, and there's nothing more rewarding than that. At Langford PT, we're not just treating injuries; we're improving lives, one patient at a time.

Dr. Cesca Picchi-Wilson, PT, DPT received her Doctorate of Physical Therapy from the University of New Mexico in 2021. 

Cesca is a member of both our state and national professional organizations, the American Physical Therapy Association (APTA) as well as a member of the Academy of Orthopaedic Physical Therapy (AOPT). She graduated from University of New Mexico Physical Therapy Orthopaedic residency program in 2022 and became an Orthopedic Clinical Specialist (OCS) in 2023 after sitting for her boards.

In her spare time, Cesca enjoys working out, running Spartan races, hiking, playing and watching sports, and finding fun things to do around Albuquerque with her friends and family.

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Weightlifting and the Pelvic Floor

Weightlifting and the Pelvic Floor

Weightlifting can be intimidating on its own; now add in pregnancy, post partum, sleepless nights, back pain, and God forbid peeing your pants every time you lift something heavy!! NO THANK YOU. Count me out on going to the gym! Having some sort of pelvic floor dysfunction can feel lonely, mostly because nobody talks about it. I am here to not only talk about it, but let you know it’s more common than you think. In June and in coming up in late August, Langford hosted a workshop with me, Morgan Kerschen PT, DPT about how to lift with considering the pelvic floor. In this blog will break down and discuss what the pelvic floor is and what should be happening with weight training.

The pelvic floor is a group of muscles located at the bottom of the pelvis that provides support to the internal organs, pelvis and hips. The pelvic floor has 3 main roles in the most basic description: sexual, sphincteric, and supportive. Both the sphincter and supportive functions play a huge role in the ability to weight lift without pain or urinary incontinence and even properly gain muscle around our hips, buttocks and core. The pelvic floor muscles have a close relationship with our deep core muscles. The deep core are our built in back brace! They help to avoid that ‘wow, my back is sore from lifting legs yesterday’ feeling, which nobody likes. The pelvic floor and core also helps our body perform proper breathing mechanics, which if you have ever weight lifted heavy or at a high intensity, breathing mechanics can be the difference between achieving a lift and not! 

When we breathe, the pelvic floor needs to be able to move up and down with our diaphragm. With an inhale the pelvic floor will move down and expand. With an exhale the pelvic floor will lift and contract. This is very important for movement needed for weight lifting and jumping. Let’s break down why this matters with weight lifting. If we cannot achieve a proper breath, we may not be able to recruit the muscles needed to lift the weight in front of us. Mechanically, if the pelvic floor is too tight, or we are gripping (sucking in our belly), holding our breath or squeezing the pelvic floor or core muscles, then there is no expansion with the inhale. This is almost the same as not having the range of motion in our buttocks and legs to lower down into the squat. Not only would you not be able to stretch the muscles needed to get low into the squat, but you also would not be able to contract them to stand up, because they would already be tight!! 

Lets next break down why pelvic floor movement is needed for jumping. If you jump up in the air then come back down and land, what happens at the ankles, hips and knees? Not sure? Stand up, try it. They all bend! The joints in your body are absorbing all the impact from landing. So now let’s think about pelvic floor. Maybe you pee a little every time you jump. When does it happen? I bet when you land. If the pelvic floor is really tight, rigid, immobile it won’t move with a jump. As you jump up into the air, the whole body, including the bladder goes up and when your body comes down, so does the bladder, running right into that really tight and rigid pelvic floor causing an impact or ‘stress’ to the bladder. This ‘stress’ from the bladder running into pelvic floor when landing leads to a little bit of leakage called Stress Urinary Incontinence (SUI). So what should we do to reduce this? Allow the pelvic floor to move with the whole body as you jump! The pelvic floor lifts as you take off and jump (exhale) and expands (inhale) as you land and the joints absorb the impact. Then the bladder never runs into anything!!! Having a mobile pelvic floor is step one to achieve proper weight lifting and jumping mechanics. Part two has to do with coordination and strength. Achieving pelvic floor mobility gets you  more than halfway there! Once pelvic floor can move properly and well, it becomes easy to recruit and strengthen the muscles, just like anywhere else in the body. 

In this workshop we practiced these exact movements with the concept of pelvic floor mobility and related it to four basic weightlifting moves: overhead press, squatting, dead lifting, and lunging. Practiced how to breathe when performing each of these moves and what it should feel like to have pelvic floor relax to expand during the inhale as the body lowers down into the squat, the lunge etc. and contract the core, lift the pelvic floor with the exhale as the body is lifted up with the weight. By learning how to use the core, pelvic floor and breathe together, the body can function more efficiently and achieve the movement you desire to do.

Dr. Morgan Kerschen, PT, DPT, graduated from the University of New Mexico in 2021. She is one of Langford’s two physical therapists who treat patients with pelvic health concerns. Morgan works with women pre- and post-partum, and sees a wide variety of individuals with orthopedic pain, pelvic pain, trouble with incontinence and more.

Morgan enjoys working with individuals of all abilities and backgrounds. She is also a certified cycling instructor who teaches group cycling classes. She loves to bake, and decorates sugar cookies for all sorts of occasions. In her free time, Morgan loves to be active by playing soccer, kickboxing and running as well as being outdoors with both her dog and husband.

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Bone Health: Osteoporosis, What is it, and how can Physical Therapy Help?

Bone Health: Osteoporosis, what is it and how can Physical Therapy help?

Osteoporosis, or extremely low bone mineral density, is a condition that makes bone more brittle and causes people to be more likely to suffer a fracture. A related condition, osteopenia, indicates that you are beginning to lose bone mineral density, but it has not yet progressed to osteoporosis. Osteoporosis affects about 54 million Americans. Up to 1 in 2 women and 1 in 4 men over the age of 50 will have a fracture secondary to low mineral density.  Osteoporosis results in an estimated 2 million fractures each year, and an estimated $19 billion in healthcare costs each year.  Osteoporosis is a concern because fractures and weakening of bones can lead to loss of height, pain, loss of mobility, and social isolation, in extreme cases leading at times to nursing home placement and death. 

Osteoporosis can be difficult to detect, because the first “symptom” you’ll feel is often a fracture. You cannot feel your bones getting more brittle, so it is important to work with your doctor to be screened appropriately and ensure that you know the status of your bone health. You should be screened if you are a female over the age of 65, a male over the age of 70, you are over the age of 50 and have had a fracture, or you are between the ages of 50-64 (females) or 50-69 (males) and have factors that put you at increased risk for bone density problems. The most commonly performed screening test is •Dual-energy X-ray absorptiometry, or a Dxa scan, similar to an X-ray. It is very safe, and actually results in less radiation exposure than flying on a plane across the US.

Problems with bone density are more common as we age. Genetics plays a huge role in determining bone health as we age, so not all problems with bone density are 100% preventable, which is why screening is so important. Hormonal changes as we age make us more likely to have an imbalance between bone break down and bone building, leading to less density and strength in our bones. Other factors that put us at risk for bone density problems include:

-Gastrointestinal problems
-Use of medications such as gluocorticoids, steroids, or anti-rejections medications following a transplant
-Treatment for cancer (chemo, radiation)
-Cancer metastases to the bone
-Treatment for cancer (chemo, radiation)
-Cancer metastases to the bone
-Thyroid conditions
-Being extremely underweight or overweight
-Tobacco use
-Excessive alcohol use
-A sedentary lifestyle
-Poor diet
-Disordered eating

The good news is that there are interventions that can help to slow or prevent bone loss, or in some cases even rebuild bone. In addition to medications that your endocrinologist or primary care provider may recommend, physical activity is an important part of prevention of and treatment for bone density problems. Learning how to move safely with good body mechanics can greatly reduce risk of fractures. Exercise to load your bones, especially resistance training for all your major muscle groups with an appropriate load, and balance, cardiovascular, and flexibility training to help maintain your mobility are important interventions that are easy to implement with some guidance from a physical therapist.  Even if you have had a fracture, a physical therapist can help you rehabilitate to reduce pain, improve your mobility, and reduce your risk for future fractures.

While bone density can be a common and scary problem as you age, you’re not alone!  Make sure you’ve undergone the appropriate screening tests with an endocrinologist, and call a physical therapist at Langford today to be assessed and start a customized exercise program to improve your posture, strength, flexibility, balance, and endurance to help you begin moving better and more confidently, and reduce your risk for fracture.