Treating Chefs Aches And Pains

Ever cut yourself cooking? Been there! Burned by a pot or grabbing something out of the over? Sure have. Well imagine working in a kitchen day in and day out, sometimes up to 16 hours a day. Such is the life for professional Chefs. With full time kitchen work can come injuries the home cook may or may not ever encounter. NYC-based Physical therapist Karena Wu (http://activecarephysicaltherapy.com/) has treated her share of Chefs in the past. Even well-known chefs like Wylie Dufresne (WD-50 & Top Chef, Iron Chef) and Seamus Mullen (Tertulia & Chopped judge) have worked with the famous physical therapist to heal their aches and pains. Both Dufresne and Mullen have frequented Wu's office for years to treat injuries they've sustained in their kitchens. Now they are encouraging other Chefs to seek help. When you think of physical activity the life of a Chef may not come right to mind, but in actuality a Chef's life requires standing all day long, with very little time to rest your muscles. This means it's easy to injure yourself in the kitchen. Karena has treated Chefs for conditions like arthritis and general wear and tear from the life of a Chef. The Manhattan PT specialist even writes a monthly column for the culinary industry magazine "Total Food Service." Ched Dufresnse summed up their work together this way: " Working in a kitchen for twenty years takes the same toll on your body as being a stuntman. My point being any sort of respective physical activity is going to do some wear and tear. We are lifting lots with our hands, I would bet there's some kind of common problems between almost all Chefs. Lots of bad posture, bending over. I think lifting heavy things takes a toll. We don't have a good history of taking care of ourselves when we aren't working. When I met Karena I couldn't even shake her hand, my arms hurt so badly. Knee problems, back problems, shoulder problems. This would be the kind of thing (physical therapy) virtually any cook would benefit from." Seamus Mullen also said, "I think the biggest problem I have is that working in a kitchen you are in the same position for a long time and then I go right home & go to sleep in the same position all night. Standing on one position for 8 hours non-stop over time creates natural compression. Then to go right home & go to sleep, I wake up stiff because I'm in the same position again." "Hardest thing for me working in a kitchen is that you bend over so much. Last week I had an event that wrecked me for a couple days where I couldn't even bend over at all." I got a chance to ask Karena lots more about treating Chefs: What are the most common injuries that you see with chefs? Neck and low back pain from chronic posturing and standing all day; Tennis elbow from repetitive stress of whisking, mixing, holding pans/sauté; Shoulder pain from lifting heavy items, OH reaching; Hip/Knee/Ankle pains from slips, missteps, prolonged standing, deep squats and sports play (if they participate). A chef's day can be very stressful. Do you have suggestions for how a chef can stretch or strengthen their core to prevent injuries? Daily dynamic stretching when on the job to bring blood flow to the tissues/joints, move the muscle tissue. I know they really can't do much when standing at their station, but when they hit the head and it's more private, they can do a couple leg stretches. At their station, they can do neck and shoulder stretches (during prep) and hip and ankle active range of motion movements. Continuous postural correction, engaging abdominals to support lumbar spine, utilizing correct body mechanics and THINKING before they just act/react. What is the cause of those injuries for a chef and how can they be avoided? Prolonged positioning and lifting/carrying heavy loads or being put in awkward positions with/without additional load. They can avoid injuries by learning about their proprioception (awareness of the body in space) with postural awareness and knowledge of long-term damage if they think they are invincible. They must think before they move or perform a task. You offer a couple of different types of Taping. How did those evolve and how can they help the chef? Became Certified Kinesio Tape Practitioner in 2005 because of my interest in the product and the application and its benefits. The longer I've worked, the more I've seen patient's abilities and patient's limitations-both physically and psychologically. We use this as an adjunct when in an acute phase (significant pain or sudden injury) or if they need additional assistance for chronic issues or poor compliance with HEP and avoidance of aggravating activities. It is an adjunct, not something that corrects the underlying dysfunction. I'm now a spokesperson for Spidertech and think it's the best therapeutic tape out there because it is really user friendly. It's pre-cut so it's easy for me to use, but it's also easy for patients to use on their own. For more on Karena Wu and her practice visit: http://activecarephysicaltherapy.com/ or call (212) 777-4374 What is Myofascial release and how does that impact the chef? It is a type of soft tissue mobilization that affects the fascial (connective tissue with a 3D matrix with no orientation) more than the muscle tissue. Like a massage without lotion. Anyone can get and pay for a cheap massage. Feels good temporarily but if you don't correct underlying joint restrictions or fascial restrictions, stiffness/tightness/pain will come back guaranteed. This affects superficial AND deep tissues. Like an over microwaved plate of food with saran wrap. When overdone, it binds down on the underlying structures, which restricts blood flow, circulation and movement. Release it and there is movement and flow, which allows for better muscle activation and range of motion. Talk about what a chef can expect to find at your facility in Midtown? Intimate care from start to finish. One-on-one hands on application and individualized manual therapy and exercise prescription for home exercise program (HEP), especially taking into account the occupational demands. Exercises in-house are on Pilates equipment and all treatment and exercise have a more holistic emphasis. Do you take the place of a chiropractor? No. Chiropractors are healthcare professionals with an emphasis on spinal alignment. They can do joint manipulations on the spine as well as extremities, although in NYS, they are supposed to be limited to the spine. They also do high velocity low amplitude (HVLA) thrust manipulations (the 'crack') versus lower grade mobilizations. PT's do high grade as well as low grade joint mobilizations. Benefit here is that if someone is acutely painful or extremely stiff, the HVLA might be too traumatic to the joint so a lower grade would be easier for a patient to handle. PT's also focus on exercises as well as the hands on joint and soft tissue mobilization. We treat all joints/body parts without the legal restrictions. We also emphasize specific activities for return to higher level function as well as sports-specific agility drills/plyometric exercises/balance and proprioceptive activities. In your years of working with chefs, do they eat properly and if they don't can you help them build a nutrition program to help them get the most out of their day? Yes and no. It really depends on the individual. If they are constantly trying food and dishes that are full fat and heavier in nature and don't exercise on top of that, then they're probably not getting the proper nutrition. We are not nutritionists. We can refer them to one and we can guide them in the common sense knowledge of eating healthy and in moderation and to research it online themselves. Our take is that we have to look at the work, psychosocial demands, fixed ideas as well as the patient's own knowledge base about nutrition and habits and overall health and see what the best method of instruction would be for them.