Static and Dynamic Stretches

According to Mayo Clinic, stretching has proven to help improve your muscle flexibility and increase performance. If you’re about to begin intense physical activity, you’ll want to first create a pre-workout routine that incorporates stretching relevant to the work you’ll be putting in. Stretches are categorized into two types, static stretches and dynamic stretches. Both types of stretches have benefits to your overall health.

Static Stretching

In a static stretch, you hold your stretch in a set position for a short amount of time. Most people add in static stretches before a run or heavy lifting. Static stretches are held for about 20-45 seconds.

static stretches

Some examples of static stretches include:

  • Posterior capsule stretch: Relax your shoulder and stretch one arm across your body. Use the other arm to hold the outstretched arm in place. This stretch is helpful for anyone using overhead or throwing motions.
  • Hamstring stretch: Place one leg on a stool and the other on a flat surface. Lean forward, keeping your hips and knees straight.
  • Quadriceps stretch: Bend your knee back and hold your ankle with the same-sided hand. Keep your stomach muscles tight to prevent your back from creating an arch and causing injury.
Benefits of Static Stretches

Static stretches are useful for:

  • Improving flexibility and range of motion
  • Decreasing muscle soreness
  • Increasing blood flow
  • Providing relaxation

In order to maintain its health benefits, you should utilize static stretching often. It can be used to warmup or cool down from an exercise, or even if you are stuck behind a desk. Stretching routinely increases your blood flow and helps maintain flexibility progression. Failing to continue using static stretches for an extended period can negate your improvements.

Dynamic Stretching

Dynamic stretches apply your muscles to their full range of motion. Like static stretches, dynamic stretches are useful when preparing for a workout, but can be especially important in sports. They tighten muscles that will be used the most during specific movements, such as twists, lunges, and squats.

dynamic stretches

Some examples of dynamic stretches include:

  • Torso twists: Stand with your feet facing forward and shoulder width apart. Bend your elbows to a 90-degree angle. While staying controlled, twist your torso from side to side. Do not force any movements.
  • Walking lunge: Put your hands on your waist and take a step forward and make a lunge. During your lunge, keep your plant knee in front of your hip and ankle and place your back knee into the ground as if to kneel. Keep your back straight throughout the motion.
  • Leg swing: Swing your leg either front-to-back or side-to-side in a controlled fashion. Start with a small swing and work your way up until you extend your leg through its full range of motion. Your abdomen should feel engaged and your back should be straight.
Benefits of Dynamic Stretches

Dynamic stretches are useful for:

  • Engaging muscles to their full range of motion
  • Preparing for high-level activity
  • Optimizing muscle groups for peak performance
  • Improving flexibility and circulation
  • Decreasing soreness and potential risk of injury

Dynamic stretches are reflective of the activity you will be performing. For example, walking and then slowly increasing your pace prepares your muscles for a long run or jog. Prior to any physical activity, you should gradually prepare your muscles to prevent injury and increase performance.

Choosing Your Stretch

Static and dynamic stretching can be used to prepare for sports, heavy workouts, or even for improving your health from behind a desk. The stretch you choose should go together with the activity you are about to perform.

In the unfortunate circumstance that you are injured, you may be advised to begin a physical therapy program that includes a variety of stretches.

To learn more about physical therapy at Elite, click here.

Improve Your Health by Practicing Good Posture

You’ve probably been told that good posture is important, but have never been explained why. Sitting and standing up straight can impact your overall physical health.

Benefits of Good Posture

By keeping your spine properly aligned, you can minimize the risk of injury to your back, shoulders, and other areas. This is because when your body is upright, you place less strain on these muscles. Good posture may also help alleviate conditions such as headaches, fatigue, and trouble breathing.

How to Sit and Stand Properly

It may be difficult to sit or stand up straight after years of slouching. It may feel normal to let your muscles slack, especially if you sit for a large portion of your day. Here are some tips to help you sit and stand with good posture:


  • Keep your feet on the floor or on a foot rest
  • Don’t cross your legs and keep your ankles aligned with your knees
  • Keep a gap between your knees and your seat
  • Adjust your seat to help your lower and mid-back
    • If you need more back support, add a cushion between your back and the backrest of the chair
    • If you are sitting too high or low in a desk it could harm your posture
  • Relax your shoulders and keep them parallel to the ground
  • Avoid sitting in the same position for long periods of time


  • Try to rest your weight on the balls of your feet
  • Keep your knees slightly bent
  • Keep your feet shoulder length apart
  • Let your arms hang naturally
  • Keep your head level and your ears in line with your shoulders
  • Shift your weight between feet if you start to feel uncomfortable

Improving your posture can go a long way. You may notice that ailments such as headaches, fatigue, and breathing problems become less frequent. Pain in the back, neck, knee, hip, foot, shoulder, and jaw may even decrease. Practicing good posture is an important step you can take to improve your health by reducing strain on your body.

To learn more about the spine physicians at Elite, click here.
To learn more about physical therapy at Elite, click here.

The Importance of Good Shoes

Choosing your next pair of shoes comes down to more than just picking out the trendiest option. These shoes will be the foundation every step you take, affecting your feet, ankles, back, and more! This is why it is vital that you pick the right pair.

Benefits of Proper Shoes

Wearing good shoes can prevent your feet and joints from experiencing pain. Other foot conditions you can avoid with good shoes include:

  • Corns and calluses
  • Ingrown toenails
  • Fungal nail infections
  • Athlete’s foot
  • Bunions
  • Plantar fasciitis
  • Collapsing arches

Choosing the Right Shoe

Typically you should change your shoes every three months or 300 miles. If you feel that your shoes are wearing out their support faster, you can change out the inserts as a more cost-effective method.

When picking your shoes, choose a pair that will not wear down as quickly. Choose shoes that:

  • The back of the shoe is stiff – If you press on the back of the shoe from top to bottom you will only be able to twist it slightly.
  • You can slight twist the body of the shoe – If your shoe is inflexible or too flexible it can cause problems with your feet or become uncomfortable.
  • The shoe has arch support – If your shoes do not have the proper arch support it can cause your arches to hurt or even fall

If your shoes do not meet these criteria, you won’t be able to count on them for the long haul.

One Size Doesn’t Fit All

Because no size fits all, finding the best fit can be a process. Here are few tips to keep in mind during your search:

  1. Shop at the end of the day as your feet tend to swell and get a little bigger throughout the day
  2. Wear the socks you plan to wear with your new shoes
  3. Make sure the soles provide enough support. There should be support for your heel and the rest of your foot.
  4. Consider orthotic inserts. Inserts can help your shoes properly support your feet and increase comfort levels.

We’ve long been told that shoes need to be broken in, but your shoes should feel comfortable as soon as you put them on. If you buy a pair of shoes that feel like they need to be broken in, it could cause pain or discomfort in your feet.

Understand Your Pronation

Pronation is how your foot lands when you walk or run. If while move you are overpronating or subpronating you may cause more stress on your feet than necessary. If you overpronate while walking or running motion controlled shoes or orthotics may be recommended to you. If you subpronate you should look for a flexible and cushioned shoe. If you are unsure if you are an overpronator, subpronator, or neutral consult your doctor or an athletic shoe expert. An athletic shoe expert has been trained to help you find the best type of shoe for your different walking and running styles.

Choosing good shoes is an easy way to provide your body with the support it needs. Your shoes need to be able to absorb shock while run or walk, or risk your body absorbing the shock instead. If you have further questions, ask your doctor about what kind of shoes you need. Activities like running and hiking will require different types of support.

To learn more about the foot and ankle physicians at Elite, click here.

What Is an ACL Tear?

While ACL tears are associated with athletics, they can happen to just about anyone. Age, gender, and activity level are variables that may increase your risk of tearing your ACL. Suddenly stopping or changing directions are among the leading causes of ACL tears, explaining the higher rate of injury in sports like football, soccer, and basketball. If you suffer an ACL tear, it may limit your everyday lifestyle, but it doesn’t require you to put your entire life on hold.

What Is Your ACL?

The ACL or, anterior cruciate ligament, is located at the back of the patella (knee cap), and assists knee rotation and stability.

ACL injuries are divided into three different grades:

  • Grade I: The ligament has suffered sprain, but there is no tear.
  • Grade II: The ligament has suffered more damage than a sprain and is partially torn.
  • Grade III: The ligament has suffered severe damage and is completely torn.

Signs of an ACL Tear

If you hear or feel a pop in your knee during sudden movements, you may have torn your ACL. Usually there will be some swelling, as well. Due to weakness and instability in your knees, you may have trouble walking after tearing your ACL.


Your physician will provide treatment based on the severity of your ACL tear. Immediately following your injury, it is recommended to use R.I.C.E, or Rest, Ice, Compression, and Elevation. You can expect to wear a brace or use crutches for stability.

Physical Therapy

Depending on your activity level and the severity of your injury, your physician may recommend physical therapy. Your physical therapist will help you restore strength and knee stability. In many cases, patients can return to light sports and activities following physical therapy.


Your ACL tear may require surgery if:

  • You are an athlete
  • Physical therapy did not fully rehabilitate your knee
  • You have multiple ligament tears
  • Your knee is no longer stable

Following surgery, you will work with a physical therapist to help rebuild strength and flexibility in your knee.

Fully recovering from your injury may take up to a year if the tear was severe. It’s important to remain committed to your physical therapy but not overdo it. Returning to activities before you are ready may lead to a reinjury of your ACL.

If you’ve recently suffered a knee injury, give us a call at 615-324-1600.
For more information about Elite’s knee physicians, click here.

Spine Injuries in Sports

While you may love the game, you should know the dangers behind the sport you play when it comes to protecting your spine. In a 2008 study investigating spinal injuries in sports, Boden & Jarvis found that sports account for over eight percent of new spinal cord problems each year. This number could be reduced with proper training, protection, and avoiding sports that cause spine stress altogether.

What Leads to Spine Injuries in Sports?

Your first guess might be high-impact sports like football and rugby. However, high-impact sports are not the only causes of spinal injury in sports. Lower-impact sports that involve using the same movements over and over like running, tennis, and golf are harmful when not executed properly. This leads to overuse with immediate or long-term ramifications later in life.

Other back injuries may be caused by improper form during activities like tackling and swinging, lack of stretching, and direct impact to the spinal cord.

Types of Spine Injuries:

In order to avoid spine injuries, you might want to know a few common ones that occur in sport:

Spondylolysis is a stress fracture of the vertebra that strikes athletes whose sport involves bends and rotations. It is common amongst adolescents and in sports such as golf, wrestling, and gymnastics.

A stinger is frequent in high contact sports. Also known as burners, stingers are not as catastrophic as an injury to the spinal cord. Stingers occur if the back or neck is twisted quickly, like from a hard tackle or over extending during a game. If left unattended, stringers may reoccur and cause severe pain.

Herniated disks occur when the outer part of your disc tears, exposing the inner portion. A herniated disk may be extremely painful and limit your activity. This injury is more common amongst older athletes and is caused by overusing back muscles, according to Mayo Clinic.

Preventing Spine Injuries

While there is no way to out-and-out eliminate spinal injuries, there are measures you can take to limit them:

  1. Warm up and stretch – Warm up any areas that will be used during your sporting activities. If your sport involves heavy usage of your back, make sure to incorporate back stretches.
  2. Wear protective gear – Use protective gear if provided or necessary. Back belts and braces are helpful during heavy lifting.
  3. Know your surroundings – Sports like diving require you to know your surroundings. You are most likely safe if you are diving at an event, however, if you’re somewhere unfamiliar, ensure the water is deep enough for diving.
  4. Maintain good posture– A lot of back injuries are caused by over pressure. It is good to keep your posture as good as possible to lessen the pressure on your back and reduce injury risk.

Spine Injury Symptoms

You may find it challenging to distinguish between a spine injury or general pain. Here are some common symptoms of spinal cord injuries:

  • Difficulty walking
  • Trouble moving your limbs
  • Numbness or tingling that spreads through extremities
  • Headaches
  • Stiffness located in the back or neck
  • Unnatural head positioning
  • Shock

If you are experiencing any combination of these symptoms, you should contact an orthopedic physician to rule out spine injury. Some spine injuries are more serious than others and should be treated immediately.

Spine Conditions: Scoliosis

Scoliosis is a spinal condition that causes the spine to curve sideways, forming a C or S shape and leading to back pain or impaired movements. Severe cases of scoliosis may limit normal functionality and even affect breathing. However, most cases of scoliosis are minor in nature. Conditions range from mild to severe and should be monitored case-by-case. According to OrthoInfo, surgery is usually recommended for curves 40° or greater.

Causes of Scoliosis

Not every case of scoliosis has a known cause, but many can be attributed to certain factors such as genetics or birth defects. Disorders, such as cerebral palsy and Marfan syndrome, can lead to scoliosis. Other known, but less common, causes of scoliosis include tumors and infections.

Signs of Scoliosis

While these conditions do not necessarily indicate scoliosis, if one or more of these conditions are present, further testing should be done:

  • Uneven shoulders
  • Uneven waist
  • Offset eye alignment
  • Tilted body shape

Treating Scoliosis

Scoliosis treatment varies by the severity of the condition. Doctors use x-rays to determine the amount of curvature the spine has undergone.

Mild scoliosis may require no treatment at all. Generally, it is still recommended to check-in with your doctor every 4-6 weeks to ensure the condition hasn’t worsened.

Other cases of scoliosis, where the curvature is prominent, may require more imaging. MRIs can be used in addition to the x-rays for more detail. A child at risk for developing curvature may be given a brace to help realign their spine. This brace can be worn for years, until the child has finished their growth spurt.

Severe cases of scoliosis require surgery to straighten the spine. Surgery may help correct the curve and alleviate pain.

Johns Hopkins Medicine finds there are nearly three million new scoliosis cases each year in the United States alone. Many cases are deemed mild and thus require little treatment. However, scoliosis can be a severely debilitating condition, especially if you don’t act. If you are showing signs of scoliosis, it is best to play it safe and visit a spine specialist, such as an orthopedic surgeon. staff (2014). “Medical gallery of Blausen Medical 2014”. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. [CC BY 3.0], via Wikimedia Commons

Ankle Arthritis and Ankle Replacement

Dr. A. Brian Thomson

Ankle arthritis is a degenerative joint process involving the ankle joint that leads to stiffness and pain with exercise and activities of daily life. It can be caused by prior trauma or injury, leg deformity, chronic instability, and inflammatory conditions such as rheumatoid arthritis or gout. Arthritis affects millions of US citizens every year. Although not as common, ankle arthritis has been shown to be just as debilitating as hip or knee arthritis1.

There are several conservative options for treating ankle arthritis. These options include exercise, braces, anti-inflammatory medications, and steroid injections to name a few. There are surgical options for patients who have tried different treatment options, but still have pain that limits their daily activities, sports, or quality of life.

Mild ankle arthritis can sometimes be treated surgically with ankle arthroscopy with debridement of inflammatory joint tissue or scar, coupled with removing bone spurs that may be blocking joint motion. For patients with more advanced ankle arthritis, an ankle fusion has traditionally been recommended. An ankle fusion can give excellent pain relief and improve a patient’s function. However, it does create stiffness in the joint which can be somewhat limiting for certain activities. This increased stiffness can also potentially lead to degenerative changes or arthritis in other joints of the foot near the ankle joint.

Ankle arthroplasty, or total ankle replacement, is another alternative for patients with moderate to severe ankle arthritis. Refinements in the technique of this surgery and improvements in the implants have led to greater success with ankle replacement and increased use of this procedure in the U.S. Hip and knee replacement has become the gold standard for the surgical treatment of hip and knee arthritis. Given the improved outcomes with ankle replacement, more patients are seeking out ankle replacement.

If you are suffering from chronic ankle pain, you can make an appointment to be evaluated by our foot and ankle specialists, Dr. Jeffrey Willers and Dr. A. Brian Thomson.

We will be glad to evaluate you and discuss the treatment options available to you for your ankle pain. Treatment recommendations are tailored to each patient’s specific condition and functional concerns.


Comparison of health-related quality of life between pateints with end-stage ankle and hip arthrosis. Glazebrook, M et al. JBJS 2008 Mar; 90(3) 499-505


Ankle Arthritis by footEducation
Arthritis of the Foot and Ankle by OrthoInfo

3 Signs You Need a Joint Replacement

Warning signs that you need a joint replacement aren’t exactly clear-cut. Unlike a break or muscle tear, conditions that lead to a joint replacement often involve a gradual lifestyle change where the cartilage in your joints break down. It could be years before you really start to feel the impact of your condition.

It may be difficult to determine whether a joint replacement is right for you. If you are experiencing any of the following signs, you should consider speaking with your doctor about this procedure:

1. Joint Pain Has Grown Increasingly Worse Over the Years

If you are experiencing overwhelming joint pain that has worsened in recent years, it could be a sign that you need a joint replacement. Simple movements getting in and out of a car, going up and down stairs, bending over, rising from a seated position, or even getting out of bed might be harder than they used to be.
Unfortunately, without proper treatment, joint pain will continue to worsen and negatively impact your lifestyle. Joint replacement may or may not be your best option, but it’s best to consult your doctor about options to decrease your pain.

2. Other Treatments Aren’t Relieving Joint Pain

If you’re considering a joint replacement, you’re likely already in contact with your doctor about other treatments options. There are several methods for treating joint pain including diet, exercise, physical therapy, injections, and medication.

While non-surgical treatment works for some, you may not have seen the results you were hoping for from these options. You may find temporary relief only for your joint pain to revisit later. If you are still experiencing pain following non-surgical treatment, your doctor may suggest surgery.

3. Your Mental Health Is Affected by Joint Pain

Joint pain can affect more than just your physical wellbeing. Physical pain can be exhaustive and ignoring it can be a risk to your mental health. If your joint pain is preventing you from getting enough sleep or doing the activities you love, a joint replacement could lead to a healthier mental state.

If you are experiencing serious joint pain that has gotten worse over the years and it is taking a toll on your mental health, ask your doctor about joint replacement. A joint replacement may be your best option for easing joint pain when other treatment won’t work. Check to see if joint replacement is right for you.

The above signs are only a few of many that you should seek treatment for your joint pain. If you are experiencing severe pain, speak to your doctor immediately.

Joint Replacement: Returning to Sport

After a joint replacement, you may want to return to the activities you love right away. However, your new joint may not be ready to handle that level of stress quite yet. Here’s what you can expect from your return to sport following a joint replacement:


Both hip replacements and knee replacements typically call for low impact activities post-operation. During the first six weeks after your joint replacement, your focus should be on building strength, balance, and walking without help. After the first six weeks, your goals will shift toward returning to daily activities. At this point, if your recovery is going smoothly, your doctor may clear you for normal function.

Everyone rehabilitates at a different pace, so it is important to listen to your body and not push before you’re ready.

Returning to Sports

Hip and knee replacements typically require 3-6 months of recovery prior to returning to athletics, although, it can take up to a year to fully heal. We recommend easing back into a fitness routine and avoiding high impact sports. Generally, sports such as swimming, doubles tennis, and golf are acceptable. Don’t be discouraged if you are experiencing difficulties returning to sport; instead, give yourself some extra time.

Before returning to sports, it is important to understand your body’s limitations. Any sport or activity that you could not physically perform prior to your replacement should be avoided. That said, you should be able to return to lower impact activities. If you are suffering from aches and occasional pain, stop activities immediately and contact your physician.

Low and High Impact Sports

Low impact sports are a great way to stay healthy and keep your joint in shape. Consult your doctor before returning to sport, so you can keep your joint healthy for years to come! Here are a few low impact activities your doctor may recommend:

  • Cycling
  • Swimming
  • Walking
  • Gentle aerobics-style calisthenics
  • Low-resistance weightlifting

While low impact sports can keep your joint healthy, high impact sports can cause harm to your new joint. Consult your doctor before performing any high impact activities. Your doctor may advise against these activities:

  • Baseball
  • Basketball
  • Football
  • Hockey
  • Soccer
  • High-impact aerobics
  • Gymnastics
  • Jogging
  • Powerlifting

Regaining the strength and mobility following your joint replacement takes time. You will find that certain sports will be easier on your new joint than others. You should keep this in mind when discussing your situation with your doctor.

For more information about joint replacement at Elite, click here.

What Is a Joint Replacement?

Lingering joint pain is a frustrating experience felt by millions of Americans. It is a debilitating condition that limits your everyday activities and often requires seeking out treatment. If you are undergoing pain that limits your quality of life, it may be time to consider arthroplasty, also known as a joint replacement.

Joint replacement is most frequent in the hip and knee. Other joints that may require replacement include the ankle, elbow, parts of the hand and feet, spine, and wrists. Along with this, there are two major types of joint replacement patients undergo: partial and total.

What is Partial Joint Replacement?

Occasionally, most of your joint may appear to be fine despite another part being damaged. In this circumstance, it’s only necessary to replace the damaged part of the joint. For example, the knee is divided into three sections: the medial (inside), the lateral (outside), and the patella (knee cap). A partial knee replacement occurs when one of these three sections are replaced. In hip and shoulder replacements, the ball joint is typically the part that gets replaced.

What is Total Joint Replacement?

When a joint requires completely new parts, each compartment is replaced. This procedure is called a total joint replacement. In our previous example with the knee, all three sections of the knee – medial, lateral, and patella – would be replaced. For a total shoulder or hip replacement, both the socket and ball joint are replaced.

What to Expect from Joint Replacement:

Joint replacement is performed to return function to the joint and help the patient get back to a higher quality of life. Typically, joint replacements take six weeks to heal fully and last for many years. Research into longevity rates suggests that 95% knee replacements are expected to last ten years and most will last up to 15-17 years. To maximize your joint replacement’s lifespan, follow your doctor and physical therapist’s instructions and stray from high impact activities.

Other things to keep in mind:

  • A joint replacement may not relieve pain caused by nerve or muscle damage.
  • Joint replacement will not give you a “young” joint, rather it will function at a higher quality than it did before.
  • Not all recoveries are the same. Speak with your doctor about your limitations following joint replacement.

Why Joint Replacement?

If you are suffering from debilitating joint pain caused by arthritis, fracture, genetics, or any other condition, it may be time to consider joint replacement.

Elite is home to some of the leading joint replacement physicians in Tennessee. We specialize in total joint replacements in the knee, hip, shoulder, and ankle. Learn more about these physicians here.