The quality of your health is a direct reflection of your level of independence.

By Renee’ Fulkerson

in·de·pend·ent
/ˌindəˈpendənt/
adjective – not depending on another for livelihood or subsistence.
“I wanted to remain independent in old age”
synonyms – self-sufficientself-supportingself-sustainable.
My experience with this above mentioned topic has happened within this last year and as always got me looking around at folks moving through their daily lives.
I grew up in Southern California and spent every summer (which then was June, July and August) in Baja California at my grandparents house on the beach until I was well out of high school.
In both geographical locations the weather was mostly sunny and warm which I am a huge fan of and I spent most of my days wearing cut off Levi shorts, tank tops and flip flops. In other words closed toes shoes, socks, pants and jackets were far and few in my everyday life.
I do everything in my flip flops (called slippers here on the Hawaiian islands) probably not the best option for most of my outdoor projects. While thinking back to my 16 years living in a mountain community (including snow) I still spent a great deal of time in my flip flops. I had a large yard/ garden in the mountains as well as here on the island consequently digging, raking, weeding etc. yes in my slippers. I have also done many hikes, walks and dancing in my flip flops as a side not ipanema slippers are my favorite.
Inner Breath Yoga YogAlign Kauai Hawaii (1)
This last June as my family and myself were preparing for our annual summer mainland mountain road trip my flip flop existence took a turn for the worst. As I was outside in the garden digging with a shovel pushing down on the metal piece with the the arch of my foot I felt a stretch and pull of discomfort and my heart dropped as I knew I had injured my foot.
I hobbled into the house and began icing three to four times a day with a frozen bottle of water, lightly massaged the surrounding areas (directly massaging soft tissue injury may make it worse) and slept with my foot wrapped in an Ace bandage.
Once on the mainland I continued feeling the discomfort and the lack of stability in my foot however road tripping and camping left me little time to continue my therapy routine. As the road trip progressed I wore shoes and socks much of the time as well as my slippers I was frustrated to say the least. I was not as agile, comfortable or confident in my daily ventures and had to opt out of hiking back to camp for a boat ride back to camp – Boo Hiss Growl
Upon arriving back on Kauai and to this very day September 09/2019 I continue to feel some pain in my foot. I have continued my normal daily activities at home (although I wear shoes and socks now while gardening). YogAlign, snorkeling and continuing icing and wrapping has kept me comfortably active. In my humble opinion being sedentary after and injury is the wrong way to go – the body wants to heal and circulation is key. I have purchased a new style of flip flops during healing process OOFOS Recovery Footwear.
Inner Breath Yoga YogALign Kauai Hawaii
As I began looking around me one day while I was out running errands in my OOFOs feeling comfortable, confident a mostly pain-free when I noticed how many folks were not stable on their feet. Young and old, small and large, black or white it did not matter their health or lack of was hindering their independence. Canes, wheel chairs having to be pickup or dropped off from the car and needing a partners arm for assistance was what I was seeing. Again these were not just mature folks (which by the way can also stay very independent).
That is when it hit me The quality of your health is a direct reflection of your level of independence or lack thereof. I think most of us would agree it is hard enough to ask for help much less be reliant on somebody to get you around physically. I could not imagine my life without my physical independence.
What have I learned:
Directly – flip flops / slippers have a time and place. lol
Staying physically active is a key component to independence but not only that being in proper posture and alignment while preforming that action keeps you less likely to get an injury. What I mean by that is when I am teaching a YogAlign class and we are doing the YogAlign SIP ups (properly aligned sit ups) with SIP breath (structurally Informed Posture- informs our body of how to be in good posture by aligning from the inside out)  before students begin movement we prepare are body for optimal results and less negative impacts to the body.
Students begin by lying on their backs, knees bent toward the ceiling/ with a yoga block placed between the meaty part of the inner thighs, shoulder blades under them to create and support the natural curves in the spine (no belly button toward the back body flattening out our natural spinal curves aka springs) hand over hand palm facing up supporting the Occipital Bone on the back of the head, drawing elbows up enough to see from their Peripheral vision thus turning on the arms and with a lion’s exhale let out all their breath. Next we look up at the ceiling take in a full diaphragm SIP breath, squeeze the block between out knees, engaging the core an lifting from the core (maintaining an open front line – no chin to chest) and coming down with the S-hale like a snake. If during that practice I see a student pulling from the neck with their hands or rounding the spine by pulling the chin to the chest I request they come out of the posture immediately as they are doing more harm then good to their body. We do not want to rob Peter to pay Paul. Again it is more important to practice a yoga posture correctly to receive the optimum benefits than doing more harm then good.
I wish us all to be proactive in maintaining our personal independence – you don’t know what you have until it is gone.
See you on the mat.

Is your yoga practice sustainable? If we are moving through a yoga practice that is harming or damaging our human body what would be the point?

By Renee’ Fulkerson

SUSTAINABLE | definition in the Cambridge English Dictionary
https://dictionary.cambridge.org › dictionary › english › sustainable
sustainable meaning: 1. able to continue over a period of time: 2. causing little or no damage to the environment and therefore able to continue for a long time.
We could exchange the word environment for human body.  By the above definition the question could be re-worded to – Is your yoga practice causing little to no damage to your human body? Will you be able to continue this yoga practice for along time?
The answer for me is yes at this current time as my yoga practice is The Yoga Align Method – pain-free yoga from your inner core focuses on proper body alignment and real life movement.
I have found whether young or mature of age we all want to feel good and be happy in our mind, body and spirit.
In my teaching and personal experience most of use can connect to the physical body easily we can touch it, see it and feel it. Where as the mind takes time to connect with with in regard to meditation and stillness. The spirit for some is altogether unattainable in the tangible sense and they cannot find the connection. So doing some physical movement seems like a rational place to find some joy and happiness.
For some yoga practice means only physical movement (asana) for others it is only meditation they seek and actually in this day and age yoga can come in many forms. For this blog lets stick with yoga practice in the physical sense.
When you are in your next yoga practice/ class ask your self some important questions:
  • Am I able to take a full deep breath in this posture?
  • Does my spine and sacrum maintain their curves and integrity?
  • Does this posture simulate functional movement, am I comfortable and stable?

We have been exploring in my public YogAlign practice that some folks do not and have not ever felt comfortable and stable in a forward lunge. A lunge is a lower-body exercise that works several muscle groups at once. The targeted muscles include the glutes in your hips and butt along with the hamstrings and quadriceps in your thighs. The calf muscles in your lower legs, your abdominal muscles and your back muscles act as stabilizers during this exercise.

Not feeling stable in the forward lunge restricts deep breath, alignment and there for is not comfortable or stable. The solution is simple we have placed a yoga block under the back foot which has a double duty purpose. One it allows the student to get alignment from the foot to the hip, raises the heel to a comfortable level and creates the stability the student was lacking and once they are in a stable lunge everything else falls into place.

Inner Breath Yoga Yogalign kauai hawaii

I have also had students lunge with the assist of the wall. Placing their right foot forward big toe close to the wall be not touching, left foot back on a block or heel lifted once they feel stable (foot in alignment with hip) I have them check to see if the back of the head the Occipital bone and the sacrum are in alignment creating even more stability and bonus proper alignment. Next when alignment and stability are solid we sink into the front knee and place the pads of our fingers (fingers open to turn on the arm muscles) against the wall upper chest height and start our SIP breath (structurally Informed Posture- informs our body of how to be in good posture by aligning from the inside out). Allowing this core breath to stabilize the body along with drawing the shoulder blades together creating even more stability.

When properly aligned in a posture with effective breathing and feeling stable and comfortable then and only then will we reap all the benefits the posture has to offer. I would say the above described YogAlign Power Lunge is sustainable for the human body as it ticks all our boxes.

If we are moving through a yoga practice that is harming or damaging our human body what would be the point? Although sometimes this may happen and we do not even realize it is happening. Be careful when an instructor cues a posture is supposed to be painful and to breath through the pain. That may be somewhat true for a person who has had a debilitating accident and is in recovery (physical therapy) and even then I would question the motive and benefits.

We can create a happy healthy mind, body and spirit well into a mature age by putting our body in breathable, aligned, functional, comfortable and stable yoga postures.

Now go out and use your sustainable body for good!

See you on the mat.

How does to much time sitting in chairs damages our ocean’s reefs? 

By Renee’ Fulkerson

You might be thinking what does sitting in a chair haft to do with an ocean’s reefs? I would be thinking the same thing if I had not made the connection personally on my last adventure out snorkeling.

A little back story:

Last year in the middle of April 2018 Kauai received 50 inches of rain in 24 hours that devastated the island. The north shore communities of Wainiha and Haena were cut off from the rest of the island due to countless mudslides that covered the only two lane road in or out of these communities. It took over a year to repair the road to a safety standard that would allow all non Wainiha and Haena residents to re-enter the area.

YogAlign Inner Breath Yoga Kauai (18)

During this one year period the only folks allowed in and out of the above mentioned communities while massive road repair was taking place were the full time residents. As a full time resident living in Haena I saw with my own eyes the land transform.

Myself and many of the locals had an opportunity of a lifetime to spend time on the secluded and empty beaches. We began to see the fish returning, turtles nesting that had not been there since folks could remember and the reefs were coming alive again.

DCIM100GOPRO  DCIM100GOPRO

This is when I began my regular snorkeling adventures!

During this time I continued teaching and practicing YogAlign – pain-free yoga from your inner core. I began realizing much of my movements in the water reflected my movements in YogAlign. Not to mention breathing through the snorkel replicated the SIP breath in my practice. Like snorkeling a full body activity we too in YogAlign engage the entire body in practice and view the body as a whole.

The primary muscle groups engaged while snorkeling include:

Hip flexors, ham strings, upper and lower abdominal’s, quads and gluteul muscles

A fair amount of flexibility in the ankle region as well as the ability to point the toes like a dancer is necessary (if you prefer to avoid leg and foot cramps).

A  strong core (abdominal, Oblique and back muscles) help to create a stable platform for legs to kick as well as a balance in your front and back leg strength.

Here is were the sitting in a chair comes in as none of the above mentioned muscle groups are engaged during sitting – it is quite the opposite. (the average American spends 7.7 hours a day sitting)

Having said that you take an average person who sits 7.7 hours a day in a chair and he or she decides one day to go snorkeling chances are the ocean reefs (fragile underwater ecosystem) and themselves are going to suffer.

How because he or she would be expecting their bodies to preform in a way it is incapable of preforming. The primary muscle groups that need to be engaged while snorkeling have amnesia from sitting. Flexibility in the ankles and pointing of the toes  would be limited – due to the shortening and tightening of the front line while sitting. Their core would be void creating an unstable platform for their legs to kick not to mention the unbalance between the back and front leg muscles.

How does all of this effect the oceans reefs?

On my last snorkeling adventure I realized I had gained greater endurance, strength and stamina (all supported by my regular YogAlign practice). However when I looked all around me as far as my eye could see people were STANDING ON THE REEFS! Why? Because they were tired and or had leg/ foot cramps and difficulty breathing (and yes I asked).

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I swam up and said do you realize you are standing on a fragile underwater ecosystem that has had a years gift to repair itself from the endless years of damage it has received? Usually the response was I was so tired I could not get back to shore or I was having trouble breathing and got a leg cramp. lol

I encourage everyone to get out and get moving including snorkeling however, not at the sake of our ocean reefs (fragile underwater ecosystems) or their safety. #getupstandupforyourlife

See you on the mat!

Top 10 benefits of Snorkeling 

Golf injuries: Play it safe with these tips

Golf injuries are common but avoidable. Learn how to protect yourself.

By Mayo Clinic Staff

Although golf is a low-impact sport, it’s associated with a significant number of injuries. Many golfing-related injuries are a result of poor mechanics or overuse. The most commonly injured area is the lower back, followed by the elbow, wrist and hand, and shoulder.

Follow these tips to stay in shape on the course.

Adjust your swing

The entire body is used to execute a golf swing in a complex and coordinated movement. When this movement is repeated frequently, significant stress is placed on the same muscles, tendons and joints. Over time, this can result in injury.

Understanding the mechanics behind your golf swing can help you prevent golf injuries. Try to:

  • Use proper posture. Stand with your feet shoulder-width apart and rotated slightly outward, and with your knees slightly bent. Hold your spine relatively straight; your trunk should be tilted forward, but most of that movement should come from your hips. Avoid hunching over the ball, which may contribute to neck and back strain.
  • Stay smooth. The power of a golf swing comes from force transferred smoothly through all the muscle groups, from your ankles to your wrists. If you depend on one part of your body for your hitting power, you may be more prone to injuries. For example, overemphasizing your wrists during your swing can lead to golfer’s elbow — a strain of the muscles on the inside of the forearm.
  • Don’t overswing. If you swing the club too hard or too fast, you may stress your joints. Relax and take a nice, easy swing at the ball. The best golfers have consistent — not necessarily fast — swing tempos.

If you want to reduce the risk of golf injuries, consider taking lessons. What you learn about your golf swing may even help you shave strokes from your score.

Other tips to keep you on the course

There’s more to golf than your golf swing. Consider other ways to lower your risk of golf injuries:

  • Warm up. Before you practice your swing or play a round of golf, warm up for at least 10 minutes with a brisk walk or a set of jumping jacks. Stretch your hands, wrists, forearms, elbows, shoulders, spine and pelvis. Swing your golf club a few times, gradually increasing your range of motion.
  • Start slowly. You might start out by practicing your swing for hours, believing it’s helping your game. But if your body isn’t conditioned for the strain, repetitively practicing your golf swing may do more harm than good. Work up to your desired level of activity instead.
  • Strengthen your muscles. You don’t need bulging muscles to hit a long drive — but the stronger your muscles, the greater your club speed. Stronger muscles are also less prone to injury. For best results, do strength training exercises year-round.
  • Focus on flexibility. Regular stretching can improve your range of motion and lead to a more fluid golf swing.
  • Build up your endurance. Regular aerobic activity can give you staying power on the course. Try walking, jogging, bicycling or swimming.
  • Lift and carry clubs carefully. Golfers who carry their own bags have higher rates of shoulder and back injuries than do other golfers. If you jerk heavy clubs out of the trunk of your car, you could injure yourself before you reach the first tee. Use proper lifting technique: Keep your back straight and use the strength of your legs to lift.
  • Try to avoid hitting objects other than the ball. Elbow and wrist injuries are often the result of hitting the ground or the rough.
  • Choose proper footwear. Dress for comfort and protection from the elements. Wear golf shoes with short cleats. Long cleats dig into the sod and hold your feet planted as you swing, which may strain your knees or ankles.

Watch out for hazards on the course

Be careful to limit your sun exposure while golfing. Remember to:

  • Use sunscreen.
  • Wear sunglasses to filter out UVA and UVB rays.
  • Wear a hat with a visor to shade your eyes and face.

Watch for signs and symptoms of dehydration, heat exhaustion and heatstroke. Drink plenty of water, whether you feel thirsty or not, and cut your game short if necessary. Red flags for heat-related injury might include:

  • Headache
  • Weakness
  • Dizziness
  • Nausea
  • Muscle cramps
  • Rapid heartbeat
  • Confusion

When riding in a golf cart, keep your feet inside the cart. Golfers have suffered broken ankles when their feet have been caught in the moving parts of golf carts.

Keep an eye out for storms. Call it quits at the first sign of threatening skies or lightning.

Play smart

Whether golf is a new interest or a lifelong passion, make the most of your time on the course by protecting yourself from golf injuries. Consider it all part of the game.

“Hey Doc. I’ve lost my core”. Spinal Stability explained.

Article written by Healthfocus Physiotherapist Dr Mandy Hobbs PhD.

Have you ever been told that you need to work on your “core” by a health professional or fitness instructor? Does your “core” just disappear because you didn’t know it was there in the first place or did you just misplace it one day?

So what does the term core stability mean? Like so many terms related to health, it has various meanings to different health professionals.  Some clients with back pain will roll their eyes when I suggest using an exercise approach to low back pain.” I’ve done it all before and it doesn’t work” they lament.  What can be difficult, is determining what they have been shown as exercise  previously and how this relates to their particular back problem. Whilst no one approach to back pain works for all people, understanding the concepts used to treat low back pain is useful.

The concept of spinal stability has evolved  through the 20th century.  Joseph Pilates devised his “Pilates” system of exercise , that emphasised control of movement, in the first half of last century. The idea  of spinal pain resulting from  poor control of spinal stability, developed in the 1970s. This suggested that repetitive microtrauma damages spinal tissue because the spine looses stability. In the 1990s Manohar Panjabi, a researcher in the US described a system of spinal stability that further enhanced this knowledge .

If the spine is considered an unstable stack of bones that buckles without muscle control, Panjabi’s spinal stability theory relies on 3 subsystems that all work together .

The first known as the  passive system is the bony and soft tissue structures including the ligaments and discs, and joints of the spine that keep the spine together particularly at the extremes of movement.

The muscles that act on the spine, know as the active system, is  the second. Muscles can generate forces that control how the spine moves. This however is only as good as the computer that drives it. Relying on the third system known as the control system, muscles can only work when receiving correct messages from the brain.

Confused? You’re not alone. But essentially, a break down in any one of these three systems can lead to poor spinal control and potential damage and pain. So what can we do to improve this when things go wrong and can exercise help?

One approach is to identify which muscles are not working  well and then retrain them so that they return to doing  their job of controlling the spine. Because in the “normal” healthy  spine  these work on automatic pilot without us thinking about them, learning to turn them on during activity is not necessarily easy. It is not a case of just bracing everything and hoping for the best. Too much force and pain can actually increase, and mobility can be lost.

Thorough assessment by a physiotherapist can identify those muscle that have stopped working , and those that may be overworking because the brain has identified an error in the system and has started to recruit the incorrect  muscles. Technology such as  real time ultrasound can be utilized to accurately  visualise  how the deep muscles are working. This can  assist in prescribing the correct exercise program for each individual.

So for those of you that are lucky enough to not have back pain, breathe a sigh of relief that this wonderful, complex system of motor control continues to work and protect your spine without having to think about it too much.

When flexibility becomes a liability: The downside of being super bendy.

By Cassie White for Life Matters

Have you ever had a friend whose party trick is to bend their thumb to their wrist, or contort a limb into a position that’s just wrong (and a bit gross)?

Well, I’ve always been that person.

Most of my life I’ve been told I’m “double jointed”, without even knowing what that meant, other than that I’m really flexible.

Turns out, there’s a clinical definition for being too flexible — generalised joint hypermobility (GJH). So much clearer, right?

Hypermobility is both a genetic and acquired condition that affects the body’s connective tissue, making it much more elastic than it should be.

This can be a problem because connective tissue is the stuff that holds us together.

It’s in your organs, skin, muscles, blood vessels – pretty much everywhere. And it surrounds your muscles, joints, tendons and ligaments.

Loose limbs and injuries

When connective tissue has too much elasticity, you’re at risk of injury because you need more control around your joints.

“You’re constantly going further than what’s considered the normal end range of a joint,” explains Dr Verity Pacey, a physiotherapist and expert in GJH from Macquarie University and The Children’s Hospital at Westmead.

This puts a lot of strain on your tendons, which attach muscles to bones, and your ligaments, which connect bones to each other at the joint.

By repeatedly pushing past “normal” range, you’re getting micro traumas, which can lead to more serious injury, such as joint dislocation, ligament strains and tears, or tendon inflammation.

There’s flexible and there’s flexible

So the hyperflexible among us move far too much in our knees, hips, shoulders, elbows and ankles. We also tend to get joint pain, when our stretch-fests have gone out of hand.

One of the issues with GJH is that most people have no idea that they are too flexible.

It can be seen as a positive when it comes to certain activities – such as yoga, dancing and gymnastics. All that stretching feels really good.

It’s not until we’re injured and see a physiotherapist that we realise what’s going on.

“There are plenty of people who don’t show symptoms . . . and you may be drawn to a sport because of your flexibility,” Dr Pacey says.

It’s worth pointing out, there’s a difference between GJH and hypermobile Ehlers Danlos Syndrome (EDS), which is much more serious.

Those with EDS often live with severe joint and muscle pain, have loose skin that bruises easily, suffer extreme fatigue, and are at risk of prolapses and hernias.

A cautionary tale

Yoga is my sport of choice and after a decade of stretching my limbs into “enviable” depths, I’ve been left with shoulder and hip issues that mean I am spending far too much time on rehabilitation.

Over the years I kept stretching myself further, until my already loose connective tissue probably resembled an old elastic band.

It wasn’t until I became a personal trainer that I understood that hanging out on my joints was bad. Like most people, I thought my flexibility was cool. Now I see it as the karmic debt I’m repaying in this lifetime.

It’s hard to know how many people have GJH because the criteria are so broad, explains Associate Professor Leslie Nicholson, leader of the Hypermobility and Performance Lab at the University of Sydney.

“There are figures at between 4 and 30 per cent of the population,” she says.

Experts say it’s hard pinpoint the cause of hypermobility, except that it’s genetic and can be acquired. For example, ballet dancers who train themselves to become hypermobile.

Feedback system broken

So what’s the solution to elastic-band limbs? Strengthening the muscles that surround the joints.

It won’t stop you being hypermobile, but it can help control joint movement and reduce the risk of injury.

The frustrating part for the super flexible is that when they’re strength training, they’re constantly told to stop at “normal” range of motion. Often they don’t know what that feels like.

“Ligaments, tendons and joint capsules have nerve endings that provide information on where you are in space and how much muscle activation is needed to control your joints,” explains physiotherapist Nigel Morgan.

“But when they’re chronically stretched over time, that feedback system is impaired, so your nervous system gradually receives less information. This makes it harder for you to control your movements.”

Which is why people with generalised hypermobility shouldn’t try to stop within ‘normal’ range.

“You can’t really stop yourself going into that range especially when you are fatigued, so it’s far better to learn control and strengthen your muscles in that excess range,” Associate Professor Nicholson explains.

By doing that, you’ll be training proprioception – your ability to sense the relative positions of your body parts – and improving the nervous system’s feedback system, so you get better at controlling your joints.

Which means, in a dream world, that a ballet dancer who’s super flexible will also have strength and control while doing insane things with their body.

Stay in the game for longer

In general, otherwise healthy people who have hypermobile joints can benefit from lifting weights several times a week.

The muscles you need to strengthen will depend on where you’re too mobile, but building the major muscles that surround your joints is key, especially if it’s your weight-bearing postural joints like hips, knees, shoulders and back.

Not only that, we need to learn to co-ordinate the muscles so they work in sync when moving our bones. Easier said than done.

“All muscles have a certain length where they’re at their most efficient and that’s based on typical range of motion,” Dr Pacey says.

“But when you’re hypermobile, your muscles are at a disadvantage. So when you need them most, they’re at a less-efficient position.”

Why Do So Many Runners Have Knee Pain?

BY NICOLE RADZISZEWSKI

My Knees Hurt!

Knee pain is one of the most common runner complaints. However, the knee itself—a simple hinge joint designed to bend in one direction—is rarely the root of the issue.

Often dubbed the “middle child,” the knee has the misfortune of being stuck between two problematic siblings: the feet and hips. But the poor knee’s worries don’t stop there. Even an old shoulder or back injury can add to the knee’s stress, particularly when running is involved, says Rebecca Johnson, a physical therapist in the Chicago area.

For this reason, it’s really important to look at how your entire body is moving. “If you have an overuse injury, you didn’t ‘hurt’ your knee—your knee is just a symptom that something is wrong,” she says. “Now we need to figure out how to unload the knee.”

Determining how to reduce the knee’s workload is a bit of a detective game. Typically, increased forces are due to an inefficient gait pattern, says Johnson.

Potential Causes Of Knee Pain:

  • Too much vertical movement/bouncy gait
  • Too much lateral movement
  • Left/right asymmetries, such as when hip extension is limited on one side
  • Alignment issues, such as knee valgus (when the knees cave inward) or overpronation at the foot (when the foot rolls inward and the arch flattens)
  • Inefficient or loss of reciprocal arm/leg swing

You can observe a runner’s gait and notice any of these issues. The challenge lies in determining the “why.” For instance, a bouncy gait indicates a lack of efficient hip extension—which likely results in overuse of the quads, and underuse of glutes and hamstrings, Johnson says.

She seeks the answers to several questions during an assessment: Are a runner’s glutes and hamstrings weak, or is a joint limiting their function? Could dysfunction at her core be to blame for tight hip flexors and quads? Is an old ankle injury inhibiting her toe-off and thus preventing her from getting good hip extension? Is there a range-of-motion issue—related to restrictions in the nervous, skeletal, myofascial or visceral (organ) systems? Or does the runner just need some cues to help her change her gait? Johnson says all of these potential scenarios need to be considered when knee pain is a nagging complaint.

Johnson adds that rest is rarely an adequate solution for nagging knees. “If your car alignment is off, you don’t just park in the driveway, hoping that with a little rest it will run better the next day—you take it to your mechanic. The same goes for your own body. Treatment by a skilled physical therapist will keep you up and running, not stalled on the couch.”