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 - Kate Cardamon, PT
Kate Cardamon, PT recently joined Work Systems Rehab at our downtown Des Moines clinic, serving our patients and clients there. Here are some answers to questions that we asked Kate to help others get to know her better.
Where did you go to Physical Therapy school?
I graduated from the University of Iowa Master of Physical Therapy Program in 1994. After living in Iowa City for several years, I have recently returned to Des Moines, which is where I grew up.
Where does your family live?
I have three grown children. My oldest son lives here in Des Moines and I have another son back in Iowa City. He celebrated his first wedding anniversary in September of 2011. My youngest, my daughter, lives in California. She graduated from Cal State Fullerton in 2009 and prefers sunny California to Iowa so I don’t see her moving back here much to my chagrin. My parents and four siblings live here in Des Moines.
What area of Physical Therapy have you mainly practiced in?
My focus as a Physical Therapist has been in orthopedics. After graduation, I worked as an inpatient orthopedic therapist in a hospital setting for two years. I have worked in outpatient orthopedics for 15 years and I love it.
What would you say is your treatment approach?
Philosophically, my approach is to help patients get well and to educate them on what they can do in their daily lives to prevent reoccurring musculoskeletal problems. I believe in not just getting a patient well with their problem that brought them to me in the first place, but helping them to become aware of changes they could make that would prevent their problem from returning.
When working with my patients, I try to give them a lot of information on what his/her particular problem is so that they understand what is going on with their body. I make it a point to give patients a chance to express their concerns and ask any questions relevant to their problem that they may have. I believe that understanding the how, why, and what of the diagnosis helps patients to get well and stay that way. I make it a point to look at how the patient has responded on level of function questionnaires, so that I can understand the full scope of their problem and how the patient’s life is affected by it.
How have you advanced your skills as a Physical Therapist?
As a Physical Therapist, I have continued to educate myself and further my skills by pursuing continuing education beyond the hours that are required to renew my license every two years. I have always been a lifelong learner and there is always new information in the health field and different approaches work with different people. By staying aware of Physical Therapy advances I am best able to serve those I treat. My continuing education focus over the last few years has been through the Postural Restoration Institute and International Spine and Pain Institute.
I have also advanced my skills by pursuing training to be able to provide specialized care in the area of women’s health. This involves treating pelvic floor dysfunction. The pelvic floor is a group of muscles that act as a sling to support the internal organs. It can be injured in various ways but most often by child birth. However, men can have pelvic floor dysfunction too as it can often be a source of pain that can develop from occupations that require prolonged periods of sitting or trauma such as bike or horseback riding, or even a bladder or urinary tract infection.
Over that past half year I have been pursuing specialized training to be able to dry needle. This is a pain management technique in which a solid filament needle is inserted into the skin and muscle directly at a myofascial trigger point that is causing pain. Dry needling can be used to treat a variety of musculoskeletal problems. The treatment of muscles has the greatest effect on reducing pain mechanisms in the nervous system.
What are your hobbies/interests?
Hobbies of mine are reading. Historical fiction is my favorite. Also, I make jewelry. I usually give the jewelry away as gifts rather than wear it. I don’t know why I am interested in it as I never have been much of a jewelry wearer. It is an outlet with which I can create something I suppose. I wouldn’t be successful at it if it was painting! I do play the piano as well but never to entertain anyone but myself. I am not that good.
My most special interest is my oldest son who has autism. He also has physical disabilities from a cerebral hemorrhage he experienced when he was young. He was born prematurely. Because of these problems he is nonverbal and his autism effects his motor capability so he has never been able to use sign language as a mode of communication. We have been pursuing helping him to develop the skills needed to use a keyboard independently. We are having some success with this and it is very exciting to eliminate the communication barrier for him so that he is able to interact with others. It has truly changed his life.
Kate Cardamon, PT is accepting new patients Monday through Friday at Work Systems Rehab’s Physical Therapy clinic, downtown Des Moines.
The Live Healthy Iowa 100 Day Wellness Challenge starts on Monday, January 23. There is still time to sign up for a team. Contact Work Systems Rehab today to join one of our teams. We are coordinating groups in all of our locations.
I hope you had a Merry Christmas and are looking forward to the New Year!
Now is a great time to reevaluate your health goals for 2012. Are you wanting to lose weight? Get more active? Eat healthier? Sleep an extra hour per night? All of the above? No matter your goals it is important to have a plan and to stick to it, not just for January and February, but for the long term.
Dreams and Aspirations
What are your dreams and aspirations? Dreams can be as broad as traveling in Europe, climbing Mt. Everest, owning your own home, having a family, or retiring early. Fitness oriented dreams may be losing weight, exercising for more than two weeks at the beginning of each year, running a marathon, making the basketball team, or trying to get out on the golf course every week. I am going to use my story about my dream of doing an iron-distance triathlon to talk about turning those dreams reality.
Step One
The first step is to figure out what your dreams are. Write them down as you brainstorm about this issue. When I was in graduate school, I had a classmate who had been a college swimmer, and she had done an Ironman triathlon (2.4 mile swim, 112 mile bike, 26.2 mile run). I thought if she as a person with only a swimming background could do it, the dream might be possible for me. I defined my dream.
Attainable
From your list of dreams you need to pick which ones are attainable. I once heard that goals are dreams with a deadline. So set a deadline to a few of your dreams and they will become goals for you to reach. This may be picking a day a week to golf or setting aside an hour a week to practice your favorite sport or even making time for a few 30 minute walks with your neighbor. For me it was 10 years ago when I decided that I would sign up to do an iron-distance triathlon in 2002. That put the deadline on the dream, and I started looking for a race. In December 2001 I found about the Ultramax Triathlon in Lake of the Ozarks, MO, which was to be an inaugural event. My deadline was set for September 28, 2002.
Goals
When you have your goals in place, you can start to plan how the details will all work out. If your goal is to work out at the gym three days a week, you need to make a point of what days those will be so that your plan materializes. If your goal is to ride your exercise bike daily you need to make time in each day to get that activity in. My plan was to fit my swim, bike, and run workouts around my busy life of work, church, family, and friends. If you have a plan you will stick with it, and the goal becomes possible.
Reality
The reality of the dream is the capstone of the process. Your planning, hard work, and dedication have been worthwhile. Reality for you may be sticking with your aerobics program for a month, or going for a walk over lunch for the whole summer, or even attending a weekly group bike ride all season. For me it was almost 10 years ago when I crossed the finishline after completing the iron-distance triathlon event. What starts out as a dream becomes a reality. The whole process is important. Enjoy every minute of it.
What’s Next?
After you reach your dreams what do you do? You evaluate them and take that knowledge with you to the next task in life. You dream some more and set new goals for the future.
Some important things to remember are to be flexible and do not get down if things do not go as planned. Find accountability to make the process meaningful. Encourage others along the way. Invite someone to play tennis with you, check out cross-country skiing with a family member, or go walk the mall with some friends. Try planning your dreams into reality.
 Image by angie.doyle via Flikr
I am amazed at this question when eating with friends and family. When there is a table full of food of many varieties there must be a more appropriate question. Especially when thinking of improving your health and eating the right portion of food for your needs, a question about enough should be changed to, did anyone eat too much? A better approach may be to encourage everyone at the beginning of the meal to enjoy the food without over indulging. Please read on for a few specific tips on how to be thankful this Thanksgiving without regretting eating too much after the
big meal.
Eating and Feasting
It is possible to enjoy some holiday food without loading up on the calories and adding on a few pounds. Consider these tips and plan ahead prior to being tempted to make decisions that were not a part of your health goals.
- Eat a healthy breakfast. Start the day by getting your metabolism going. This will help you burn calories most effectively.
- Go for the healthier foods first. Whether this is putting the turkey on your plate, followed by the vegetables and fruits, and then whole grain breads, pick the foods with a higher nutritional value.
- Be easy on the less healthy, creamy and saucy foods. Let these foods fill in the spaces on your plate without heaping on a second layer.
- Watch portions. Overall only take smaller portions of each food. This way you get to enjoy the taste without getting all the calories of a larger portion. Consider not going back for seconds and instead just enjoying firsts. You will be able to try the food again later in the day or the next.
- Drink water before and during the meal to help create a fuller feeling and decrease the total amount of calories consumed.
- Keep your dessert slice small. Ask for a small piece or a half slice so you can enjoy the taste without feeling stuffed from eating too much.
Activity and Exercise
Being active is another important thing to consider to help with burning the extra calories and preventing the holiday food from hanging around. Plan on at least 30 minutes of exercise on Thanksgiving Day. Here are some options.
- Encourage a family walk/hike 2-3 hours after eating.
- Go bowling as a group for a few hours.
- Plan a morning run or look for a Turkey Trot to participate in.
- Bundle up and get the bikes out for a bike trail ride.
Be Thankful
We are very blessed in the United States. There are so many people in this world that do not have enough food to eat and would be amazed at how readily available food is to us. Remember the abundance we have and be responsible for the choice we have regarding how much to eat. Focus on your foundational choice of improving your health and let your day to day choices fall in place. Make sure you are an example for others as someone who had enough, not too much.
Happy Thanksgiving!
 Whether your goal is a 5k or marathon, proper post race recovery is important to consider regarding preventing running injuries. Over the past few years I have worked with a number of runners in my clinic that were injury free with their training and goal race. Then their injury popped up while getting back into a routine too quickly in the weeks following their event.
No matter if you are Dean Karnazes and can run a marathon every day or someone who has struggled with injuries and recovery and needs more time, it is pertinent to have a recovery plan to help you prevent injury and safely return to your routine. This article covers four phases of focused recovery. The length of time for each phase will vary depending on the distance of your race and your individual needs.
Foster Formula
There are many approaches when it comes to post race recovery and prevention. One concept coined by New Zealander and former world master’s marathon record holder, Jack Foster, is the Foster Formula. Foster believed that runners should focus on recovery for one day per every mile of the distance they raced. Thus a 13 day recovery for a half marathon and treat the next 26 days after a marathon as your recovery time.
Active Rest
The first phase of recovery is active rest. Key factors to consider during this phase are rehydration, rest, and nutrition. Post race and in the days following, focus on replenishing your body’s fluid and nutrition needs. Make sure to get adequate post race sleep and rest to ensure muscle recovery.
Icing and muscle work are also great areas to target in this phase. Focus on icing irritable areas for the first 48-72 hours after a race. Ice two to three times per day for up to 15 minutes. For working out achy muscles, massage sticks and foam rollers are great tools for promoting blood flow and decreasing soreness. Emphasize work on the hamstrings, quadriceps, IT bands and calves a few minutes per day.
Regarding activity in the active rest phase, stretching and walking are probably best in the time immediately following your event. Lightly stretch out your hips, back, quadriceps and calves, focusing on breathing and pain free holds. This will help promote circulation without adding irritation beyond what has resulted from the race.
Rebalance
During the next phase of recovery it is pertinent not to push back into your routine too soon. Cross training is great to consider. Explore walking, pool running, biking, swimming, the elliptical machine or other cardio equipment to help with continued muscle recovery without the loading that may come with running.
Return
This is the phase to start back into regular running at a reduced level. With the return phase consider not running multiple days in a row, continuing to cross train to aid with your recovery and injury prevention. When you do run, keep your pace and distance down. Consider walk/run combination workouts, alternating 5-10 minute efforts. Look for softer surfaces to run on such as dirt, crushed limestone or outdoor tracks.
Rebuild
During this last phase of post race recovery the key point is to listen to your body. Remember the intensity of your race and all the training you did in the months leading up to your event. It may take you more time to feel ready to get back into a regular running schedule. If you are still depleted mentally or physically, continue to be active by cross training and gradually building your mileage.
If you are dealing with an injury or pain lingering from your training or race, consider seeking medical attention. Physical Therapists are experts in injury treatment and prevention and specialize in helping individuals with mobility issues, analyzing your problem and giving you solutions to get back to running.
Recover and Prevent
Whether you recover in a few days, weeks or months, the concepts of active rest, rebalance, return and rebuild hold true. Listen to your body and do not push back too soon. Enjoy mixing up your program and celebrate your accomplishments by treating your body well.
 Spring is here and the warm weather is following. For some runners that means that they are bumping up their mileage to train for an upcoming 20k, ½ marathon, or even a spring marathon. For others the idea of even running around the block is hard to imagine. There are a few programs out there that give hope to those starting from scratch when it comes to running.
I recommend checking out the Couch to 5k training plan. This program will guide you to a 5k goal in 9 weeks. The process starts out with mainly walking with running short intervals between walking intervals. Check out the program and consider it as an option to get you out the door and to the starting line in just a few months.
If you a have a running base from the past few months or are looking for a 5k to walk in the next few months, I would like to plug ChildServe’s Run, Walk, & Fun 4 the Kids coming up on May 14th, in Johnston, Iowa. This is a great event that focuses on supporting an organization that provides services for children with special health care needs. My wife and I utilize some of ChildServe’s services for our daughter Kate.
Hope you are encouraged to take the first step towards a 5k goal. Then don’t just stop there, use a challenge like this to help you commit to increased activity for years to come.
 I enjoyed spending some time at the Des Moines Triathlon Club expo at the YMCA Healthy Living Center today. It was great to reconnect with friends, patients, and colleagues. I also enjoyed meeting some new people who are involved with the sport of triathlon.
This year looks like a great year for triathlon in central Iowa. The Hy-Vee Triathlon continues to grow. It has changed its venue to September with the addition of a championship Olympic distance event. There are also many other local races to choose from including Copper Creek, Big Creek, Hickory Grove, and Iowa Games, just to name a few.
If you are looking for a challenge, I would recommend considering entering a triathlon. The sprint distance would be a great entry point if you are new to the sport. You don’t have to do the Ironman to be considered a triathlete. Consider joining a local club like the Des Moines Triathlon Club. Others include the Capital Striders, Triathlon Racers of Iowa, and the Altoona Triathlon Club.
I am looking forward to continuing to help local triathletes treat and prevent their injuries in 2011, by providing specialized Physical Therapy services for endurance athletes at our Des Moines clinic.
Now is the time to start laying the foundation for a healthy and fun year. Whether you commit to swimming twice a week, biking to work, or running with a group every Saturday morning, don’t think you need to wait until the ice melts to enjoy getting fit.
 Check out The World Triathlon website for up to date information on Charlie Wittmack’s triathlon adventure across Europe and Asia. I just saw that Charlie is coming back to Des Moines for the holidays, to heal up and prepare for the rest of his journey. The World Tri is doing some great things to draw awareness to global health and adventure through education.
I heard Charlie speak at the Capital Striders annual dinner this past winter. He inspired the audience to conquer their Everest, challenging us to dream and take risks. I found it a little ironic that he later mentioned that he was doing his winter running on the treadmill, as he did not want to get hurt running outside. Charlie has no fear of climbing Everest, as he has done it and is planning to do it again. I am planning on running outside in the winter. No plans to climb Mt. Everest. What is your Everest? Dream and go for it.
 One thing that some athletes do not know is that too much stretching before activity has actually been shown to decrease an individuals force output. The last thing anyone would want to do prior to exercise is impede his or her performance. Thankfully there is a better option for a pre-exercise routine…dynamic warm-ups.
Dynamic warm-ups include moving the body in various planes of motion, in order to prepare it for the sports you will be doing. One concept is to simulate the movements or muscle groups you will be using with your workout. These movements are not held, as stretches are, but are done repetitively as you move through the planes of motion.
Benefits of dynamic warm-ups include promoting blood flow and mobility as you prepare to swim, run, bike, etc. Other benefits include injury recovery and prevention, as well as improving efficiency and performance. The motions you do should prepare your muscles and joints for your sport. As you get into your workout your body will be ready for the mobility you will demand of it.
Dynamic warm-ups are great to include no matter when you work out. Include them in your routine prior to morning exercise. Those that sit a lot during the day at work will also find that dynamic warm-ups combat the sitting posture when you do them prior to heading out on a run or swimming laps.
Included here are samplings of dynamic warm-ups that I commonly use with clients that are runners. The key concepts of preparing your body for your sport can be taken into any activity, knowing you want your warm-ups to put your body through the planes and ranges of motion that you will be doing during exercise.
Regarding stretching, if you feel the need to stretch before exercise, focus on short and light stretching as a part of your routine. Save the longer holds for after your workout. Stretching will be the most beneficial if performed after a workout.
A few dynamic warm-ups include:
- Hip flexor opening (lunge position) – This drill opens up the hips, working against the sitting posture. From a standing position step forward with one leg, bending the front knee to open the hips.
- Hamstring curls (leg curls) – Great exercise to warm-up the hamstrings. Standing or walking, lifting your heel, bend one knee to 90 degrees. Repeat with the other leg.
- Hip abduction (leg swings) – This drill activates the outer hip that is commonly weak. Standing on one leg, swing the other leg out and back to the side. Repeat with the other leg.
- Hip rotation – The hip rotation drill helps warm-up the hip rotator muscles. Stand with your feet in a V position, shift your weight onto one leg, and rotate the other leg in and out. Repeat on the other side.
- Compact arm drive – This drill is more running form specific, helping runners work on proper arm form technique. Stand in a stride position, bend your elbows to 90 degrees, and drive your arms straight forward and back (alternate). Switch your stride and repeat.
Do all of your dynamic warm-ups for 10-15 repetitions with the left and right side. Make sure you feel the activities are helping you loosen up and prepare for your sport. Consult a professional to get more details on what specific dynamic warm-ups you require for your individual needs.
 Clavicle fracture Today is the 3 year anniversary of the 2nd and hopefully last time that I broke by left collarbone (clavicle). Here is an article I wrote after that event in September 2007. I was reminded of it recently as a patient of mine emailed me telling me that she had fallen running and broke her left collarbone.
Unexpected Time Off
We tend to take our bodies for granted when we are healthy and life is going well. Then when an injury happens our lives are changed and we must learn to adapt until our body is able to function normally. While riding to work on September 12th, 2007, I crashed my bike on the Bill Riley trail after hitting a patch of sand, and broke my left collarbone for the second time.
I am thankful for only a minor injury. The accident could have been worse. My helmet also hit the asphalt (Note: Always wear your helmet when bicycling!). Because of the need to let my clavicle heal, I will not be running for the next couple months. I thought there might be a few other runners out there who may face a similar situation in the future. This article will discuss the process of fracture healing and how it affects the person with the injury. I want to thank Dr. Chad Carlson for getting me in for an X-ray and exam the same day as my crash.
Fractures
The word fracture means the breaking of a bone. There are several different types of fractures. A compound fracture is when the skin is punctured, and a closed fracture is when the skin is intact. Some of the different types of fractures include: undisplaced, when the bone breaks but keeps its form; displaced, when the broken ends separate; incomplete, when the fracture only penetrates part of the bone; and complete, when the break goes through the whole bone. There are also comminuted, segmental, butterfly, spiral, and hairline fractures, all of which describe a different pattern of how the bone breaks.
Healing
When a bone breaks it goes through phases as it heals. After the initial impact these phases include inflammation, soft callus, hard callus, and remodeling. The inflammation phase lasts for 2-3 weeks from the time of the fracture. During this phase the bleeding from the bone and the surrounding soft tissues cause swelling and irritation around the fracture site. This is when immobilization of the fracture site is needed to ensure proper bone alignment.
The next phase is the soft callus phase (callus refers to bone material between the bones of the fracture site). This part of the healing lasts from week 4 to week 8 following the fracture. During this time the new bone is being formed and stiffens after being “sticky” during its initial healing.
Third is the hard callus phase, which happens between weeks 8 and 12 from the fracture. The new bone fills the whole fracture site during this time-frame.
Last is the remodeling phase. Over the next several years mechanical forces continue to help promote bone healing in proper form. This is when the callus is replaced with new bone.
Activity
During the first few phases of bone healing activity should be limited in order to ensure proper bone formation and prevent nonunion (when the fracture does not heal together) or malunion (when it heals in an improper way). Once the fracture is stable, range of motion exercises should be incorporated as to regain proper motion. As the range of motion increases and pain decreases, strength building is started to regain the muscle that has been lost during the time of decreased activity. Each fracture is different. Consult your health care provider regarding the specific details of your situation.
My plan is to take it easy for the first few weeks. Walking will be my main form of exercise at that point. At 4-6 weeks stationary bicycling may be an option. Light running can resume around the 8 week point, depending on the comfort level. If discomfort is present I will wait a few days and then try running again covering the distance that is tolerable.
Compensation
While the fractured part of the body is healing, the body starts to compensate or find new ways to do the activities that need to be done. This may mean that you now do all of your daily tasks with one arm or walk with crutches using only one leg. Because of this the injured person gets used to doing activities in a different way. After bone healing is at a point that regular activity can resume, it is important to realize these compensations. As tolerated, start to use the affected body part in order to regain proper functional ability. This concept is just as important to remember as working on specific exercises to regain the motion and strength needed to do your daily activities.
Healing tips
There are other issues to remember during the time that a fracture is healing. One is remembering to eat a balanced diet and take in your recommended allowance of daily calcium to help bone healing and vitamin D to aid the proper absorption of calcium. Make sure to get enough sleep and avoid doing too much activity during the early phases. Also, remember to be patient with the healing process and do not get discouraged. The body was created to heal itself and worrying about it will not speed things along. Before you know it, the fracture will be healed and you will be back out running.
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