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Case Studies

  • The Cost of Physical Therapy

    The Cost of Physical Therapy >

    In today’s world of high deductibles and costly doctor’s visits, it can seem daunting to dip into your pocket for care, especially when you don’t know what to expect. In fact, one of the most common questions we receive from patients is, “How much does PT cost?”

    Though the exact answer will vary based on your specific needs, the total cost for the average episode of care, or 10 visits, is $1,000.

    Physical therapy is a cost-effective treatment designed to get you back on your feet quickly, and with lasting results.  Not only do most insurance providers cover physical therapy, it has been proven to reduce medical costs by diminishing the need for unnecessary medication, imaging scans, or surgeries.

    In fact, here’s how physical therapy stacks up compared to those other frequently prescribed interventions:

    That’s a high-level cost breakdown of PT vs. other healthcare expenses frequently prescribed for those suffering from musculoskeletal conditions, but there are a few other factors to take into consideration, like:

    Seeing your physical therapist first can reduce the total cost of care by 50%.

    If you’re in pain, your first instinct is likely to pay a visit to your primary care physician, who may then refer you to an orthopaedic specialist, who will write you a prescription for physical therapy. In fact, a 2017 Merritt Hawkins study showed that the average wait time to see a physician is 24 days, up 30% from 2014.

    That process alone can set you back a few insurance co-pays, not to mention a couple of weeks. Heading directly to your physical therapist saves money – the right physical therapy within 14 days of the onset of pain minimizes the average total cost of care by 50%.  Low back pain patients who receive physical therapy immediately after the pain begins and adhere to their treatment plan spend $3,000 a year in associated healthcare costs. Those who delay receiving physical therapy and do not adhere to their treatment plan spend $6,000 per year on all kinds of healthcare.

    Lastly, a 2015 Health Services Research study found that the average cost of care was shown to be $4,793 more if a patient had an MRI first vs. seeing a physical therapist first. The study also shows the increased use of other services like additional diagnostic imaging and medication when the MRI is done prior to physical therapy.

    A study just published in the Journal of the American Board of Family Medicine found that the patients who were sent to a physical therapy consult were 35% less likely to be prescribed opioids, even if they didn’t keep up with physical therapy after the initial evaluation.

    There’s a lot of compelling evidence that supports these points – if you’d like to see more, email us at [email protected], we’d be happy to show you!

    Physical therapy at OSPTKY costs 42% less than the national average.

    According to data from the Workers’ Compensation Research Institute in 2015, the average cost per episode of care was $1,734 (including both patient and insurance responsibility). PPTS’ average cost per episode? $1,005. That’s 42% less than the national average.

    If it didn’t work, insurance wouldn’t pay for it.

    Look no further than Humana for proof. In December, they lifted their prior authorization requirement for outpatient physical therapy.

    In layman’s terms, Humana has recognized that quick access to PT is important. As quick and fantastic as our care coordinators and front desk staff are, the authorization process can sometimes be a slow one. This is Humana’s way of eliminating the barrier that may be keeping you from getting in the door the moment you’re ready to see us.

    All that considered, we understand that the cost of healthcare can sometimes seem unmanageable, especially when it’s unexpected. OSPTKY will work with you no matter your financial situation to ensure you get the care that you need.

    Whether you have questions about your deductible or want to discuss private pay options, someone’s always available to talk! Our friendly, knowledgeable billing concierge can help. Contact Tasha Holmes-French – [email protected] or 503.912.0176.

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  • Friday FAQs

    Friday FAQs >

    This year, as part of National Physical Therapy Month, we wanted to take time to answer some of your most commonly asked questions about the physical therapy profession, what we do, and why we do it. So, every Friday in October we’ll be updating this post (and our social media!) with the answers. Be sure to check back every week! Have a question you’d like to see answered? It’s not too late! Send it our way – [email protected].

    Q: What’s the difference between orthopaedic and manual physical therapy?
    A: This is a great question. Orthopedic and Sports Physical Therapy physical therapy is the delivery of care for individuals with disorders or dysfunction of the musculoskeletal system. Orthopedic and Sports Physical Therapy physical therapists are skilled in the diagnosis, management, and prevention of musculoskeletal disorders. They are the experts in the assessment of movement and movement dysfunctions.

    Hands-on manual physical therapy is often a component of a skilled orthopedic clinician, in addition to skilled exercise prescription and specific patient education. The physical therapists at OSPTKY are highly skilled and trained in advanced manual therapy and go through extensive post-graduate training in order to evaluate and treat a variety of orthopedic conditions.

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  • #ChoosePT

    #ChoosePT >

    It’s October, and you know what that means… National Physical Therapy Month!

    The American Physical Therapy Association (APTA)’s National Physical Therapy Month (NPTM) is an annual opportunity to recognize the physical therapy profession’s efforts to “transform society by optimizing movement to improve the human experience.”

    This October, the APTA’s #ChoosePT campaign is the NPTM focus. The #ChoosePT campaign raises awareness about the dangers of prescription opioids, and encourages consumers and prescribers to follow guidelines by the Centers for Disease Control and Prevention (CDC) to choose safer alternatives with more long-term results, like physical therapy.

    Despite extensive efforts to raise awareness of and address the human toll of the opioid epidemic, Americans continue to be prescribed and to abuse opioids at alarming rates. Below are a few short and sweet key messages about opioid use, according to the APTA:

    • The increase in prescription opioid use is unmistakable. According to the CDC, in 2012 health care providers wrote 259 million prescriptions for opioid pain medication, enough for every American adult to have their own bottle of pills
    • The risk for misusing prescription opioids is real. According to the CDC, every day, over 1,000 people are treated in emergency departments for misusing prescription opioids.
    • The risk for addiction is real. According to the CDC, as many as 1 in 4 people who receive prescription opioids long-term for noncancer pain in primary care settings struggles with addiction.
    • The risk for heroin use is real. According to the CDC, among new heroin users, about 3 out of 4 report abusing prescription opioids before using heroin.
    • Physical therapy is a safe and effective alternative to opioids for long-term pain management. In March 2016, the CDC released guidelines urging nonopioid approaches for the management of chronic pain.
    • There are some situations in which opioid therapy is appropriate. The CDC guidelines indicate that opioids may be appropriates for situations including cancer treatment, palliative care, end-of-life care, and certain acute care situations. Still, the CDC guidelines also suggest pairing opioid therapy with nonopioid therapy, and their prescriber checklist recommends trying nonopioid therapy first.
    • Patients have a choice about the kind of treatment they receive. Before accepting a prescription for opioids, patients should talk to their health care providers about related risks and safer alternatives.

     

     

    Interested in learning more about the opioid epidemic and the #ChoosePT campaign? Here are a few of our favorite resources:

    If you suffer from chronic pain but aren’t sure whether PT is the right treatment option for you, schedule a free screen at your local clinic. Orthopedic and Sports Physical Therapy ’s expert physical therapists will help you determine the best course of action – one that heals your pain and doesn’t just mask it.

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  • 5 Ways Your Physical Therapist Can Help You Age Well

    5 Ways Your Physical Therapist Can Help You Age Well >

    Let’s be honest… we’ve all wanted to rewind or pause the clock, or grumbled about the “normal” aches and pains associated with getting older. But what if those aches and pains don’t have to be a typical part of aging? Fortunately, with the help of your physical therapist, there are quite a few things you can do to promote healthy aging. Sorry, no science fiction or time travel here!

    1. Chronic pain doesn’t have to be something you learn to live with forever.

    Over 100 million Americans experience chronic pain each year. That’s more than diabetes, heart disease, and cancer combined. Between lost wages and medical treatments that only mask the pain, living with chronic pain can be incredibly costly. Your physical therapist, using a combination of education, exercise, and pain management techniques, can treat chronic pain, improving your overall quality of life.

    2. You can get stronger as you age.

    Improvements in strength and physical function are absolutely possible in your 60s, 70s, and even 80s with an appropriate exercise program. With the help of resistance training, your physical therapist can help you work smarter, not harder, to get stronger and prevent frailty.

    3. You may not need surgery, medical imaging, or drugs.

    A number of conditions, including chronic pain and low back pain, are often over-treated with risky surgeries, costly medical imaging, and potentially addictive drugs, despite the CDC’s recommendation of alternate approaches like physical therapy.

    4. Your heart, bones, and brain want you to EXERCISE!

    Osteoporosis affects more than half of Americans over the age of 54. Heart disease is the number one cause of death in the US. One quarter of Americans over 60 suffer from type 1 and type 2 diabetes. More than 40% of people over 85 suffer from Alzheimer’s.

    What’s something these four diseases have in common? Physical activity is one of the best ways to prevent and manage ALL of them!

    If you’re still not convinced… nearly a third of adults over 65 fall each year and more than half report movement problems. Exercise improves movement and balance and reduces your risk of falls, keeping you independent longer.

    5. You don’t have to live with bladder problems.

    We know, it’s awkward to talk about. But more than 13 million Americans have bladder leakage. Don’t spend years relying on pads or rushing to the bathroom. Seek help from a physical therapist.

    Interested in learning more about how our expert physical therapists can help ease the pressure associated with aging? Click here to schedule an appointment!

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  • If PT is Good Enough for Jennifer Aniston…

    If PT is Good Enough for Jennifer Aniston… >

    From infrared saunas to freezing in the sub-zero temperatures of a cryotherapy machine, celebs and the fitness-obsessed will try just about anything to maintain their inner glow. And often times it’s Hollywood that introduces the rest of us to the hottest wellness trends that are about to make it mainstream. Case in point: physical therapy. This once daunting pain management therapy reserved for those recovering from surgery or injury has shifted its place in the wellness space, becoming a hot new addition to celebrities’ workout routines, whether they are injured or not.

    The physical therapy guru behind Jennifer Aniston’s fit frame and P. Diddy’s healthy lifestyle is Dr. Karen Joubert. We asked Joubert why her clients are turning to physical therapy as a compliment to their workout routines, and how it’s changing their bodies.

    “The clientele I work with are under an enormous amount of pressure and in many cases, this will manifest itself physically,” she says (pictured below). “Artists can perform 4-7 shows a week along with traveling and trying to maintain a healthy diet, it’s a lot for anyone to handle. Physical therapy teaches them proper mechanics whether its basic posture on the screen and or extreme dance moves on stage. Education and maintenance provide them with longevity and prevention of injuries. In the long run, it’s a win-win for everyone.”

    But why the sudden shift in how people are viewing the benefits of physical therapy, as opposed to just having to go to a session to heal an injury? “The desire for wellness and longevity has really helped to bring physical therapy to the forefront,” she says. “Recently, there has been a huge push in the longevity and prevention aspect of medicine. The public is turning more and more to physical therapy to help them understand and manage their pain. Who doesn’t want to feel better and do it with the guidance of a good physical therapist instead of popping addictive medications? Becoming in touch with the body can be a game changer in every aspect of one’s life.”

    As for her favorite clients who dedicate themselves to regular sessions, she has a few in mind. “My favorites, include Puffy, Jennifer Aniston, Cher, and Serena Williams,” she says. “I challenge anyone to follow their daily regimen. I can’t even keep up! They are so disciplined in all aspects of their lives, no wonder they are all successful! And YES, they all do physical therapy 3-5 times a week!”

    This information was originally posted on InStyle.com.  Click here to view it.

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  • Spring is in the air!

    Spring is in the air! >

    Spring is finally here, which means a lot of us will be spending increasing amounts of time out in the garden over the next few months. That’s good news, since an April 2014 Growing Health study found that gardening can improve a WIDE variety of health problems related to everything from obesity, inactivity, and old age to dementia and Alzheimer’s disease. It’s also a great activity for those struggling to cope with other serious health problems, like cancer.

    Since it’s physically active, it’s also full of health benefits! But all those hours knee deep in dirt and pulling weeds can be physically demanding, especially if you only break out the gardening gloves once a year.

    GARDENING LIKE A PRO…

    Before you head outside this weekend, here are a few tips for preventing sore muscles and injuries, so that one day in the garden doesn’t leave you out of commission for the rest of the spring:

    • Loosen Up. Warm up the same way you would for any other physical activity. Take a short walk and stretch your muscles, incorporating moves that involve bending, reaching out in front of you, and loosening your legs and core. If you don’t feel like walking around the block, take a few laps around your yard, picking up twigs and sticks and the like that are lying around.
    • Protect Your ElbowsDigging, pruning, and weeding can cause elbow pain, so in addition to using the right tools, it’s important to stretch your arm muscles afterwards. For a quick elbow and wrist stretch, try this easy stretch! Bend your hand and wrist toward the inside of your forearm while holding your elbow completely straight. Hold this position for 30 seconds, then repeat three more times.
    • Take A SeatWeeding, digging, and planting can involve a LOT of bending over, which can cause back pain, hip pain, and knee pain. Avoid spending more than 20 minutes at a time kneeling or squatting. Instead, try sitting on a bucket or stool and stand up every now and then to take pressure off your knees.
    • Maintain Good Mechanics. Keep your shoulders back and down at all times, don’t let them roll forward and up towards your ears. That’ll keep you from straining your shoulders and upper back! When pulling weeds, bend at the hips instead of hunching your back. When heavy lifting is involved, bend your knees and use your legs, not your back. Using the right tools for the job will also help to keep your posture correct.
    • Cool DownYou warmed up, so make sure you cool down, too. Take a short walk and do some basic stretches to prevent soreness from building. If you’re feeling soreness, pain or inflammation, ice those areas for 15-20 minutes so it doesn’t get worse.

    LET US HELP WITH THE PESKY PAINS…

    These tips should have you gardening the spring away without aches and pains! If you do notice soreness or pain that doesn’t go away after a few days, give us a call. Keeping the garden alive, however, is a totally different story –  we unfortunately can’t help with the green thumb thing. To book a free consultation with one of PPTS’s musculoskeletal experts, click here.

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  • Avoid Addictive Opioids. Choose Physical Therapy for Safe Pain Management. #ChoosePT

    Avoid Addictive Opioids. Choose Physical Therapy for Safe Pain Management. #ChoosePT >

    No one wants to live in pain. But no one should put their health at risk in an effort to be pain free.

    Since 1999, Americans have increasingly been prescribed opioids—painkillers like Vicodin, OxyContin, Opana, and methodone, and combination drugs like Percocet.

    In some situations, dosed appropriately, prescription opioids are an appropriate part of medical treatment. However, opioid risks include depression, overdose, and addiction, plus withdrawal symptoms when stopping use. And people addicted to prescription opioids are 40 times more likely to become addicted to heroin.

    The Centers for Disease Control and Prevention (CDC) is urging health care providers to reduce the use of opioids in favor of safe alternatives like physical therapy.

    Don’t just mask the pain. Treat it.

    Choose physical therapy to manage your pain without the risks and side effects of opioids.

    This information was originally posted on the American Physical Therapy Association’s website.  Click here to view it.

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  • Physical Therapist’s Guide to Chronic Obstructive Pulmonary Disease (COPD)

    Physical Therapist’s Guide to Chronic Obstructive Pulmonary Disease (COPD) >

    Chronic obstructive pulmonary disease (COPD) causes breathing difficulty and leads to other systemic problems. COPD is the tenth most prevalent disease worldwide. It’s estimated that by 2050, COPD will be the fifth leading cause of death in the world. Although COPD used to be more common among men, it now affects women nearly as equally in developed countries.

    Physical therapists can work with your pulmonary rehabilitation team or with you individually to help improve:

    • Your exercise capacity
    • Your overall strength
    • Your health and quality of life

    What Is Chronic Obstructive Pulmonary Disease (COPD)?

    In chronic obstructive pulmonary disease, the airways in your lung lose their normal shape and elasticity, and can become inflamed. The result is that the airways are less efficient at moving air in and out of your lungs. Primary risk factors for developing COPD include:

    • Smoking
    • Inhaling toxic substances
    • Indoor and outdoor pollutants
    • Genetic/environment interactions
    • Respiratory insult to the developing lungs during prenatal or early childhood stages of life

    Current research indicates that COPD is no longer considered a “smoker’s” or “older person’s” disease.

    The most common types of COPD are:

    • Chronic bronchitis—a chronic inflammation of the medium-size airways, or “bronchi” in the lungs, causing a persistent cough that produces sputum (phlegm) and mucus for at least 3 months per year, in 2 consecutive years.
    • Emphysema—a condition in which small air sacs in the lungs called “alveoli” are damaged. The body has difficulty getting all of the oxygen it needs, resulting in shortness of breath (“dyspnea”) and a chronic cough.

    In addition to causing breathing difficulty, COPD results in cough, sputum production, and other symptoms. The disease can affect the whole body and lead to:

    • Weakness in the arms and legs
    • Balance problems and increased risk of falls
    • Nutritional problems (weight loss or gain)

    People with COPD are likely to have other health problems that can occur at the same time or be related to COPD, such as:

    • Reduced blood supply to the heart (ischemic heart disease)
    • High blood pressure(hypertension)
    • Depression
    • Lung cancer
    • Osteoporosis
    • Diabetes
    • Congestive heart failure
    • Coronary artery disease
    • Atrial fibrillation
    • Asthma

    Over time, COPD leads to a progressive decline in physical function because of increased shortness of breath (dyspnea) and loss of muscle strength. There are 4 stages of COPD—mild, moderate, severe, and very severe—based on measurements of the amount or flow of air as you inhale and exhale. People with COPD may need to take medications, or may require supplemental oxygen.

    COPD-SmallCOPD: See More Detail

    How Can a Physical Therapist Help?Your physical therapist will perform an evaluation that includes:

    • A review of your history, including smoking history, exposure to toxic chemicals or dust, your medical history, and any hospitalizations related to your breathing problems
    • A review of your medications
    • Assessment of what makes your symptoms worse, and what relieves them
    • Review of lung function test results that may have been performed by your physician
    • Muscle strength tests of your arms, legs, and core
    • Walk tests to measure your exercise capacity
    • Tests of your balance and your risk of falling

    Pulmonary rehabilitation, including exercise training for at least 4 weeks, has been shown to improve shortness of breath, quality of life, and strategies for coping with COPD. Your physical therapist will serve as an important member of your health care team, and will work closely with you to design a program that takes into account your goals for treatment. Your physical therapist’s overall goal is to help you continue to do your roles in the home, at work, and in the community.

    Improve Your Ability to Be Physically Active

    Your physical therapist will design special exercises that train the muscles you use in walking and the muscles of your arms, so you can increase your aerobic capacity and reduce your shortness of breath. You may also use equipment, such as a recumbent bike, treadmill, or recumbent stepper to improve cardiovascular endurance.

    Research has shown that strength training in people with moderate to severe COPD increases muscle mass and overall strength. Your physical therapist will provide strengthening exercises for your arms and legs using resistance bands, weights, and weighted medicine balls

    Improve Your Breathing During Activity

    People with COPD often have shortness of breath and reduced strength in their “inspiratory muscles” (the muscles used to breathe in). Your physical therapist can help you with inspiratory muscle training, which has been shown to help reduce shortness of breath and increase exercise capacity. Your physical therapist can instruct you in pursed lip and diaphragmatic breathing, which can help make each breath more efficient, and helps to reduce shortness of breath during your physical activities.

    Improve Your Balance

    The decrease in function and mobility that occurs with individuals who have COPD can cause balance problems and risk of falls. People who require supplemental oxygen can be at a greater risk for a fall. If balance testing indicates that you are at risk for falling, your physical therapist can help by designing exercises aimed at improving your balance, and helping you feel steadier on your feet.

    Can this Injury or Condition be Prevented?

    One of the most important ways to prevent COPD is to stop smoking, which also can delay the onset of COPD, or delay the worsening of breathing difficulty. If you are a smoker who has a cough or shortness of breath but whose tests don’t yet show a decline in lung function, you may be able to avoid a diagnosis of COPD, if you stop smoking now! The American Lung Association offers an online Freedom From Smoking® program for adult smokers. Your physical therapist also can help you get in touch with local smoking cessation programs.

    If you already have COPD, your physical therapist can guide you to help slow the progression. The therapist will show you how to continue an exercise program at home or at a fitness center, after you’ve completed your physical therapy treatment. Regular exercise that is continued after pulmonary rehabilitation for COPD helps slow the decline in quality of life and shortness of breath during activities of daily living. It has been found that patients who continue exercising after completing a pulmonary rehabilitation program, maintained the gains that had been made, whereas those who stopped their exercise program had a major decline in their exercise endurance and physical functioning.

    When COPD is accompanied by excessive body weight, breathing can be more difficult. Excessive weight can also inhibit the ability to exercise and decrease overall quality of life. Your physical therapist can help you manage your weight, or prevent unnecessary weight gain by designing an exercise program specifically targeted to your current abilities. Your physical therapist also can also refer you to a dietician for help with proper nutrition to support a healthy lifestyle.

    Real Life Experiences

    Thomas is a 68-year-old man who recently was diagnosed with COPD. He smoked 1.5 packs of cigarettes for 40 years before quitting 2 years ago. He is referred to a cardiopulmonary physical therapist after telling his physician that he is having more difficulty climbing up and down stairs, as well as trouble golfing. He notes that he is having increased shortness of breath and now has to ride the golf course in a cart, rather than walking. He reports that his other main problem is leg fatigue with walking, which further contributes to his movement limitations.

    The physical therapist performs an evaluation and notes that Thomas has a reduced exercise capacity based on a test called the “6-minute walk test.” Based on other tests, the therapist finds that Thomas has decreased leg strength and decreased endurance. Thomas says that he feels like he doesn’t have much control over his breathing, which is affecting his quality of life.

    Over the course of his physical therapy treatment, the physical therapist teaches him how to use the treadmill, stationary bicycle, and upper-body ergometer (a kind of bicycle that’s pedaled using only the arms), and strengthening exercises with weights. The therapist instructs him in how to do pursed lip breathing and diaphragmatic breathing, how to pace himself during his activities, and how to best conserve his energy.

    At the end of his physical therapy, Thomas is able to walk 200 feet farther on the 6-minute walk test with reduced shortness of breath and leg fatigue. He resumes golfing, and is able to walk half of the course before requiring a cart. He reports that he also feels much more at ease on the stairs, and has an improved overall sense of control of his breathing. He joins a local gym, where he plans on continuing his walking program 3 times per week.

    This story was based on a real-life case. Your case may be different. Your physical therapist will tailor a treatment program to your specific case.

    This information was originally published on the American Physical Therapy Association’s website.  Please click here to view it in its original form.  

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  • How Physical Therapists Manage Pain

    How Physical Therapists Manage Pain >

    As America combats a devastating opioid epidemic, safer, non-opioid treatments have never been of greater need.

    Physical therapy is among the safe, effective alternatives recommended by the Centers for Disease Control and Prevention in guidelines urging the avoidance of opioids for most pain treatment.

    Whereas opioids only mask the sensation of pain, physical therapists treat pain through movement.

    Here’s how:

    1. Exercise. A study following 20,000 people over 11 years found that those who exercised on a regular basis, experienced less pain. And among those who exercised more than 3 times per week, chronic widespread pain was 28% less common1. Physical therapists can prescribe exercise specific to your goals and needs.

    2. Manual Therapy. Research supports a hands-on approach to treating pain. From carpal tunnel syndrome2 to low back pain3, this type of care can effectively reduce your pain and improve your movement. Physical therapists may use manipulation, joint and soft tissue mobilizations, and dry needling, as well as other strategies in your care.

    3. Education. A large study conducted with military personnel4 demonstrated that those with back pain who received a 45 minute educational session about pain, were less likely to seek treatment than their peers who didn’t receive education about pain. Physical therapists will talk with you to make sure they understand your pain history, and help set realistic expectations about your treatment.

    4. Teamwork. Recent studies have shown that developing a positive relationship with your physical therapist and being an active participant in your own recovery can impact your success. This is likely because physical therapists are able to directly work with you and assess how your pain responds to treatment.

    Read more about Pain and Chronic Pain Syndromes.

    The American Physical Therapy Association launched a national campaign to raise awareness about the risks of opioids and the safe alternative of physical therapy for long-term pain management. Learn more at our #ChoosePT page.

    This article was originally published on the American Physical Therapy Association’s website.  Click here to view it.

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  • Physical Therapist’s Guide to Shoulder Impingement

    Physical Therapist’s Guide to Shoulder Impingement >

    Shoulder impingement syndrome occurs as the result of chronic and repetitive compression or “impingement” of the rotator-cuff tendons in the shoulder, causing pain and movement problems. It can also be caused by an injury to the shoulder. People who perform repetitive or overhead arm movements, such as manual laborers or athletes who raise their arms repeatedly overhead (ie, weightlifters and baseball pitchers), are most at risk for developing a shoulder impingement. Poor posture can also contribute to its development. If left untreated, a shoulder impingement can lead to more serious conditions, such as a rotator cuff tear. Physical therapists can help decrease pain, and improve shoulder motion and strength in people with shoulder impingements.

    What is Shoulder Impingement?

    Shoulder impingement syndrome is a condition that develops when the rotator-cuff tendons in the shoulder are overused or injured, causing pain and movement impairments. Shoulder impingement syndrome may also be referred to as “subacromial” impingement syndrome because the tendons, ligaments, and bursa under the “acromion” can become pinched or compressed. The shoulder is made up of 3 bones called the humerus, the scapula, and the clavicle. The acromion is a bony prominence on the top of the scapula, which can be felt as a bump at the tip of the shoulder.

    The rotator cuff tendon and the bursa sit beneath the acromion. The bursa is a fluid-filled sac that provides a cushion between the bony acromion and the rotator cuff tendon, and it can become compressed underneath the acromion. Impingement symptoms can occur when compression and microtrauma harm the tendons. There are several causes to shoulder impingement syndrome including:

    • Repetitive overhead movements, such as golfing, throwing, racquet sports, and swimming, or frequent overhead reaching or lifting.
    • Injury, such as a fall, where the shoulder gets compressed.
    • Bony abnormalities of the acromion, which narrow the subacromial space.
    • Osteoarthritis in the shoulder region.
    • Poor rotator cuff and shoulder blade muscle strength, causing the humeral head to move abnormally.
    • Thickening of the bursa.
    • Thickening of the ligaments in the area.
    • Tightness of the soft tissue around the shoulder joint called the joint capsule.

    How Does it Feel?

    Individuals with shoulder impingement may experience:

    • Restriction in shoulder motion with associated weakness in movement patterns, such as reaching overhead, behind the body, or out to the side.
    • Pain in the shoulder when moving the arm overhead, out to the side, and beside the body.
    • Pain and discomfort when attempting to sleep on the involved side.
    • Pain with throwing motions and other dynamic movement patterns.

    How Is It Diagnosed?

    A physical therapist will perform an evaluation and ask you questions about the pain you are feeling, and other symptoms. Your physical therapist may perform strength and motion tests on your shoulder, ask about your job duties and hobbies, evaluate your posture, and check for any muscle imbalances and weakness that can occur between the shoulder and the scapular muscles.

    Special tests involving gentle movements of your arm and shoulder may be performed to determine exactly which tendons are involved. X-rays may also be taken to identify other conditions that could be contributing to your discomfort, such as bony spurs or abnormalities, or arthritis.

    How Can a Physical Therapist Help?

    It is important to get proper treatment for shoulder impingement as soon as it occurs. Secondary conditions can result from the impingement of the tissues in the shoulder, including irritation of the bursa and rotator-cuff tendinitis or tears.

    Physical therapy can be very successful in treating shoulder impingement syndrome. You will work with your physical therapist to devise a treatment plan that is specific to your condition and goals. Your individual treatment program may include:

    Pain Management. Your physical therapist will help you identify and avoid painful movements, as well as correct abnormal postures to reduce impingement compression. Therapeutic modalities, like iontophoresis (medication delivered through an electrically charged patch) and ultrasound may be applied. Ice may also be helpful to reduce pain.

    Manual Therapy. Your physical therapist may use manual techniques, such as gentle joint movements, soft-tissue massage, and shoulder stretches to get your shoulder moving properly, so that the tendons and bursa avoid impingement.

    Range-of-Motion Exercises. You will learn exercises and stretches to help your shoulder and shoulder blade move properly, so you can return to reaching and lifting without pain.

    Strengthening Exercises. Your physical therapist will determine which strengthening exercises are right for you, depending on your specific condition. Often with shoulder impingement syndrome, the head of the humerus tends to drift forward and upward due to the rotator-cuff muscles becoming weak. Strengthening the rotator-cuff and scapular muscles helps position the head of the humerus bone down and back to ease the impingement. You may also perform resistance training exercises to strengthen your weaker muscles. You will receive a home-exercise program to continue your strengthening long after you have completed your formal physical therapy.

    Patient Education. Learning proper posture is an important part of rehabilitation. For example, when your shoulders roll forward as you lean over a computer, the tendons in the front of the shoulder can become impinged. Your physical therapist will work with you to help improve your posture, and may suggest adjustments to your work station and work habits.

    Functional Training. As your symptoms improve, your physical therapist will teach you how to correctly perform a range of functions using proper shoulder mechanics, such as lifting an object onto a shelf or throwing a ball. This training will help you return to pain-free function on the job, at home, and when playing sports.

    Can this Injury or Condition be Prevented?

    Shoulder impingement syndrome can be prevented by:

    • Maintaining proper strength in the shoulder and shoulder-blade muscles.
    • Regularly stretching the shoulders, neck, and middle-back region.
    • Maintaining proper posture and shoulder alignment when performing reaching and throwing motions.
    • Avoiding forward-head and rounded-shoulder postures (being hunched over) when spending long periods of time sitting at a desk or computer.

    This article was originally published on the American Physical Therapy Association website.  Click here to view it.

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  • Strong Men Put Their Heart Health First

    Strong Men Put Their Heart Health First >

    Along with Valentine’s Day, February marks American Heart Month, a great time to commit to a healthy lifestyle and make small changes that can lead to a lifetime of heart health.

    Heart disease is the leading cause of death for men and women.1 While Americans of all backgrounds can be at risk for heart disease, African American men, especially those who live in the southeast region of the United States, are at the highest risk for heart disease.2 Additionally, more than 40 percent of African Americans have high blood pressure, a leading cause of heart disease and stroke.3 That’s why this February during American Heart Month, Million Hearts® is encouraging African American men to take charge of their health and start one new, heart-healthy behavior that can help reduce their risk of heart disease and stroke.

    Small Changes Can Make a Big Difference

    African American men can make a big difference in their heart health by taking these small steps during the month of February and beyond.

    • Schedule a visit with your doctor to talk about heart health. It’s important to schedule regular check-ups even if you think you are not sick. Partner with your doctor and health care team to set goals[275 KB] for improving your heart health, and don’t be afraid to ask questions[178 KB] and trust their advice.
    • Add exercise to your daily routine. Start off the month by walking 15 minutes, 3 times each week. By mid-month, increase your time to 30 minutes, 3 times each week.
    • Increase healthy eating. Cook heart-healthy meals at home at least 3 times each week and make your favorite recipe lower sodium. For example, swap out salt for fresh or dried herbs and spices.
    • Take steps to quit smoking. If you currently smoke, quitting can cut your risk for heart disease and stroke. Learn more at CDC’s Smoking and Tobacco Use website .
    • Take medication as prescribed. Talk with your doctor about the importance of high blood pressure and cholesterol medications[1.6 MB]. If you’re having trouble taking your medicines on time or if you’re having side effects, ask your doctor for help.

    Strong Men Make Heart Health a Priority

    After undergoing triple coronary bypass surgery in 1999, Louisiana native, Clarence Ancar made the decision to make his heart health a priority. Before he had surgery, Clarence knew he had high cholesterol but had dismissed his doctor’s advice on adopting a healthy lifestyle and taking his medication. Clarence’s cardiologist, Dr. Keith C. Ferdinand, taught him that heart disease was not a death sentence and that he could still live a long, healthy life if he committed to making a few changes and respected his heart condition. Working together with his health care team, Clarence developed a plan to start and stay heart healthy.

    By setting small, achievable goals and tracking those goals, Clarence made a big and lasting difference in his health. He learned the importance of taking his high blood pressure and cholesterol medications. With the help of a dietitian Dr. Ferdinand referred him to, he started eating less of the fatty, salty, and greasy food and added more fruits and vegetables. He also began walking 2-3 miles each day. After his surgery, Clarence lost a significant amount of weight and kept it off.

    Today, Dr. Ferdinand continues to motivate and support Clarence in his heart health journey. By having a strong and trusting relationship with his doctor, Clarence was able to adopt and maintain a healthy lifestyle. Clarence encourages African American men to be strong and commit to making one heart-healthy lifestyle change during American Heart Month.

    This article was originally published on the Centers for Disease Control and Prevention (CDC) website.  Click here to view it.

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  • Physical Therapist’s Guide to Cancer

    Physical Therapist’s Guide to Cancer >

    Cancer is the growth of abnormal cells in the body that causes destruction of normal, healthy cells. This process affects the health and function of the body or body parts, and can cause death. Cancer affects 39.6% of people in the United States (US) at some point in their lives, with more than 1.5 million new cases diagnosed each year. Cancer deaths are higher among men than women in the US—highest in African-American men, and lowest in Asian/Pacific Islander women. Worldwide, approximately 14 million new cancer cases are diagnosed each year, and 8.2 million deaths from cancer are recorded.

    Cancer, and the treatments for it, can cause physical problems such as pain, numbness, swelling, weakness, loss of balance, and difficulty moving or walking. Physical therapists help people manage cancer-related problems, improve their health and functional abilities, and return to work and other activities.

    What is Cancer?

    Cancer is an uncontrolled growth of abnormal cells in the body. The abnormal cells interfere with normal cells, and can spread throughout the body.

    Cancer is diagnosed in adults and children. It can affect any part of the body, including organs, bones, and muscles. The most common types of cancer diagnosed in the US (in descending order) are:

    • Breast
    • Lung
    • Prostate
    • Colon
    • Bladder
    • Skin
    • Thyroid

    Cancer death rates in the US have declined since the early 1990s; more Americans are surviving cancer than ever before.

    Conventional treatment for cancer includes surgery, chemotherapy, radiation, and gene therapy. Cancer and the side effects of treatment can cause physical problems, such as:

    • Pain
    • Numbness in feet and hands
    • Swelling of lymph nodes (lymphedema)
    • Swelling of arms, legs, torso, or face
    • Muscle weakness
    • Joint stiffness
    • Fatigue
    • Loss of endurance
    • Loss of bone density (strength)
    • Difficulty walking
    • Loss of balance
    • Weight gain
    • Brain fog
    • Heart problems
    Signs and Symptoms

    Sometimes cancer does not cause any signs or symptoms, and is discovered during a medical examination or screening.

    Common signs and symptoms of cancer can include:

    Signs:

    • Unexplained weight loss
    • Unexplained bleeding
    • Skin changes

    Symptoms:

    • Fever
    • Fatigue
    • Pain
    • Numbness
    • Nagging cough
    • Headaches
    • Vision problems

    More information on the signs and symptoms of cancer can be found at the American Cancer Society’s website.

    How Is It Diagnosed?

    Cancer is diagnosed by a physician. A physical therapist can examine a person who has been diagnosed with cancer for physical problems that cause discomfort or difficulty with movement. The physical therapy examination tests a person’s strength, flexibility, balance, sensation, coordination, endurance, and ability to walk and get around. Physical therapists create specialized treatment plans to address the needs and goals of people affected by cancer.

    How Can a Physical Therapist Help?Physical therapists are trained and educated to understand all of your health conditions, including a cancer diagnosis. Your physical therapist will work with you to develop a specialized treatment program to address your specific needs and goals.

    The American Cancer Society recommends people undergoing cancer treatment, and cancer survivors, perform consistent physical exercise to decrease fatigue, and improve the ability to perform normal daily activities. Studies show that exercise can improve an individual’s chances of surviving cancer. Physical therapists can design individualized exercise and treatment programs to reduce or prevent many cancer-related problems.

    Physical therapists help people diagnosed with cancer before and after surgery. Before surgery, they evaluate individuals for any of the problems listed above, and help address them. After surgery, they can help with the healing of the incision site, improve circulation, reduce pain, and minimize scarring. They evaluate individuals for any physical therapy treatment needs, and, by designing individualized treatment programs, help them recover and heal faster than they would on their own.

    Your physical therapist may work with you to improve your:

    Comfort and well-being. Cancer and cancer treatments can cause symptoms such as pain, burning sensations, numbness, tingling (neuropathy), cramps, spasms, and weakness. Your physical therapist may apply hands-on techniques (manual therapy) or technologies like electrical stimulation to help decrease your pain and alleviate your symptoms. The physical therapist may teach you gentle exercises or techniques to perform at home to aid your recovery. All of these options may reduce or eliminate the need for opioid pain medication.

    Aerobic capacity. Cancer or cancer treatment may have decreased your ability to process oxygen (aerobic capacity), causing fatigue. Research shows that aerobic exercise, such as walking on a treadmill for at least 20 minutes 3 times per week, may help improve aerobic capacity, reduce fatigue, and optimize healing. Your physical therapist can assess your aerobic capacity and determine the best aerobic activities for you.

    Bone density. Lack of activity and certain cancer treatments can cause weakening of your bones, which could lead to bone fractures. Certain types of exercise can prevent bone loss and maintain bone strength. Your physical therapist can teach you safe and effective exercises to help steadily build your bone strength.

    Lymphedema and swelling. Certain cancer treatments can result in lymphedema (swelling in the arms or legs) or other types of swelling. Your physical therapist can use several methods to reduce, control, and prevent lymphedema and swelling, such as specialized gentle massage, special movements and exercises, and application of compressive garments such as arm sleeves, gloves, and leg stockings.

    Surgical incisions. Your physical therapist can help you care for any surgical incisions and sutured areas, by checking for infection and assisting with dressing changes. The physical therapist also can help prevent some kinds of scarring and skin tightness as the suture line heals. Your physical therapist can use very gentle massage or certain technologies to keep the skin as soft and pliable as possible.

    Body weight. By creating an exercise and physical activity program tailored just for you, your physical therapist will help you reduce body fat and maintain a healthy body weight, which can improve your energy levels.

    Mood. Exercise helps elevate mood and reduce depression in everyone, including cancer patients and survivors. A diagnosis of cancer, and cancer treatment, can be stressful and cause mood changes in anyone. Proper exercise, individualized for each person by a physical therapist, can help reduce stress and improve mood.

    Brain fog. Exercise helps relieve brain fog. Your physical therapist can design an individualized program of exercise that can help reduce memory loss and brain fog.

    Daily activities. Your physical therapist will discuss activity goals with you and use them to design your treatment program. Cancer survivors usually increase their physical activity gradually; your treatment program will help you reach your goals in the safest, fastest, and most effective way possible.

    Walking. Your physical therapist will help improve your ability to walk using techniques such as strengthening exercises, walking training, and balance activities. If you have nerve damage (neuropathy), your physical therapist may provide bracing and other techniques to make it easier or safer for you to walk. Your physical therapist also may recommend using an assistive device, such as a walker or cane.

    Sports training ability. Athletes undergoing cancer treatment can continue to train for their sport to a degree, depending on the type of cancer and treatment. Physical therapists design safe, challenging, sport-specific training programs to help athletes reduce loss of fitness and strength during cancer treatment.

    Motion. Your physical therapist will choose specific activities and treatments to help restore normal movement in any stiff joints. These might begin with “passive” motions that the physical therapist performs for you, and progress to active exercises and stretches that you do yourself. You can perform these motions at home to help hasten healing and pain relief.

    Flexibility. Your physical therapist will determine if any muscles are tight, start helping you to stretch them, and teach you how to stretch them at home.

    Strength. If your physical therapist finds any weak or injured muscles, the physical therapist will choose, and teach you, the correct exercises to steadily restore your strength and agility.

    Coordination. Your physical therapist will help you improve and regain your coordination and agility, so you can perform household, community, and sports activities with greater ease.

    Balance. Your physical therapist will examine your balance, and choose specific exercises that you can perform in the clinic and at home to improve your balance and prevent falls. Your physical therapist may also teach you how to use a cane or walker to help maintain your balance when walking and standing.

    Home program. Your physical therapist will teach you strengthening, stretching, and pain reduction exercises to perform at home. These exercises will be designed specifically for your needs.

    Can this Injury or Condition be Prevented?The risk of cancer can be reduced by:

    • Maintaining a healthy diet
    • Engaging in consistent exercise and physical activity throughout life
    • Keeping your weight at a healthy level
    • Avoiding tobacco in any form
    • Avoiding too much sun exposure

    More information on preventing cancer can be found at the American Cancer Society’s website.

    Side effects of cancer treatment may be reduced or prevented by:

    • Staying active every day
    • Avoiding too much bedrest
    • Keeping active and participating in activities and exercises that you like to do, as often and as vigorously as possible

    Your physical therapist can help you choose the safest, most effective exercises to perform before, during, and after cancer treatment.

    Real Life ExperiencesMary Lynn is a 60-year-old nurse who was recently diagnosed with uterine cancer. Prior to her diagnosis, Mary Lynn was an active person, working full-time at the local hospital, gardening on the weekends, and enjoying ballroom dancing several evenings a week. She also liked to travel and work out at her neighborhood gym.

    Mary Lynn wanted to minimize the side effects of her treatment as early as possible, so she met with her physical therapist following her diagnosis and prior to her surgery.

    Mary Lynn’s physical therapist conducted a full evaluation of her strength, flexibility, balance, sensation, coordination, and endurance. He observed how well she could walk, go up and down stairs, and get into and out of a chair.

    He designed a treatment program to address her specific problems, which included posture, muscle strength and flexibility problems, mild balance loss, and low endurance. He taught her exercises to strengthen her weakened muscles, stretch them gently, regain her balance, and rebuild her aerobic endurance. Mary Lynn completed several sessions with her physical therapist before her surgery. She felt stronger and more confident about the surgery because of her improved physical condition.

    Mary Lynn’s cancer treatment included a hysterectomy, chemotherapy, and radiation therapy. She continued to receive treatments from her physical therapist after her surgery and during her chemotherapy treatments.

    Mary Lynn’s physical therapist repeated her full examination every few weeks, or whenever she felt new symptoms. At each visit, he asked her to describe any current problems or side effects. He examined her surgical incision to monitor healing. Shortly following surgery, Mary Lynn said she felt some pelvic discomfort and had experienced some incontinence. After she started the chemotherapy, she described experiencing numbness and burning in her feet, and a loss of balance when standing or walking. She also noted that she wasn’t hearing as well, had gained weight, and was feeling fatigue throughout the day.

    Mary Lynn’s physical therapist regularly updated her treatment program to address any new problems. He applied gentle electrical stimulation to her feet to help relieve her discomfort. He taught her exercises to strengthen and reactivate the muscles in her pelvic region, and relieve her pain and incontinence. He gave her a simple, easy home program to do for a few minutes each day. Mary Lynn readily agreed to the treatment, and stuck with her home program; she knew that doing so would speed her recovery.

    With the help of her physical therapist, Mary Lynn improved steadily over the next few months. She noticed that she always felt better after her treatment in the physical therapy clinic, and after exercising.

    Mary Lynn was able to continue her gym workouts in a modified way, during her cancer treatment, with the advice and guidance of her physical therapist. She continued her physical therapy and exercise program throughout her chemotherapy and radiation therapy, and increased her exercise level back to her precancer levels within a few weeks after the end of chemotherapy.

    Her physician was pleased to see how active and strong Mary Lynn was just a few weeks after finishing her cancer treatment. Because she was able to maintain a good level of fitness during treatment, she was able to get back to the ballroom dance studio, as well.

    And just this week, Mary Lynn was proud to share her latest crop of tomatoes and peppers with her neighbors!

    This article was originally published on the American Physical Therapy Association website.  Click here to view it.

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  • Choose Physical Therapy

    Choose Physical Therapy >

    Check out the latest OSPTKY Commercial and learn why choosing Physical Therapy is a smart move.

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  • Is chocolate good or bad for health?

    Is chocolate good or bad for health? >

    Who doesn’t love chocolate? Even if it’s not your favorite sweet treat, you can probably agree that the confection conjures thoughts of love, pleasure and reward.

    But in case you need one more reason (or 10) to celebrate chocolate, just look to science. Studies of chocolate lovers — and even some self-proclaimed “chocoholics” — suggest that it could lower blood pressure and reduce the risk of heart disease, help control blood sugar and slash stress. The list goes on.
    Research has even backed up some of the more bizarre health benefits that have been ascribed to cocoa. The Mayans used chocolate powder to relieve the runs, and in the last decade, researchers have identified possible diarrhea-blocking chemicals in chocolate. But as for prescribing cocoa to combat syphilis sores, Victorian-era doctors probably missed the mark.
    Various chocolate
    “(Chocolate) is a good antioxidant, it has a good effect on inflammation. We think most of the beneficial effects are because of this,” said Dr. Owais Khawaja, a cardiology fellow at St. Vincent Mercy Medical Center in Toledo, Ohio. These benefits might include reducing the risk of cancer and dementia, Khawaja said.
    However, not all chocolate is created equal. The antioxidant and anti-inflammatory power of chocolate is thought to come from a class of plant nutrients found in cocoa beans called flavonoids. Dark chocolate has more of these than milk chocolate, and white chocolate — which does not actually contain chocolate — is not a good source of flavonoids.
    Even a chocolate bar that is 70% cocoa, generally considered dark chocolate, can have varying levels of flavonoid compounds, depending on how it was processed. For example, chocolate that has gone through a chemical step known as dutching, also known as Dutch chocolate, has essentially lost all traces of these compounds.
    Then there is the milk and sugar. “What we get commercially is not just the pure chocolate. … I don’t think the milk and sugar in milk chocolate would be that good for you,” Khawaja said.
    That could be bad news for those who hope to harness the power of chocolate when they grab a Hershey’s or Snickers bar. Contrary to what the ads said when milk chocolate was first introduced in Europe and the United States in the late 1800s, it may not be a nutritious part of our diet.
    But we need more research looking at the effects of consuming all kinds of chocolate, including milk. “There is not enough data as to what form of chocolate is good,” and how much chocolate is good, Khawaja said. Studies tend to ask participants about whether they consume chocolate or dark chocolate, but not what kind. To make matters worse, people often forget or misrepresent how much they really eat.
    For now, it is probably safe to say that dark chocolate is good — or at least, not bad. “But until we have more data, don’t eat too much. If you’re having a serving once or twice a day, fine. But don’t start having it six times a day,” Khawaja said.
    Here’s a look at what doctors, rulers and businesspeople have thought of chocolate through the ages.

    500 B.C. ‘God food’ for everyone

    The word “cocoa” comes from “kakawa,” which meant “God food” to the Olmec people who lived in what is now Central America between 1500 and 500 B.C. The ancient Mayan people in what is present-day Mexico apparently agreed. Researchers have detected chemicals from chocolate in Mayan ceramic vessels dating as far back as 600 B.C. Chocolate, which was often consumed as a thick, foamy beverage, probably only increased in popularity over the following centuries. By the time Europeans discovered the Mayans, chocolate was not just for the gods and the rich. Everyone was drinking it.

    1500: Chocolate is the original energy drink

    The chocolate beverage scored a huge endorsement when Aztec Emperor Montezuma II, who reigned from 1502 to 1520, called it “(t)he divine drink, which builds up resistance and fights fatigue. A cup of this precious drink (cocoa) permits man to walk for a whole day without food.”

    1577: Got the runs? Take some chocolate

    By the 16th century, chocolate was racking up a reputation both in the Americas and Europe for treating many medical ails, including fever, cough, and stomach and liver problems. In 1577, Spanish explorer Francisco Hernandez wrote about how Mexicans toasted cacao beans and ground them into a medicinal powder that “contained dysentery.” Five centuries later, in 2005, researchers found that flavonoid antioxidants in chocolate can block fluid secretion in intestinal cells, at least in the lab, suggesting that cocoa could provide natural diarrheal relief.

    1719: Chocolate, it’s what’s for dinner

    In his book “The Natural History of Chocolate,” Frenchman D. De Quelus recounted his 15-year-stay in the Americas and concluded that an ounce of chocolate had “as much nourishment as a pound of beef.” Perhaps as evidence to his point, he described a woman who could not chew because of a jaw injury and had to subsist on a diet of only chocolate dissolved in hot water with sugar and cinnamon. She was “more lively and robust than before (her) accident,” De Quelus wrote.

    1825: A spoonful of chocolate helps the medicine go down

    A French pharmacist by the name of Jean-Antoine Brutus Menier opened a factory that coated less palatable pills with chocolate. When his sons took over, they dropped the medicinal side and turned it into Menier Chocolate (which was eventually sold to Nestle).

    1864: Slather chocolate on your syphilis sores

    Chocolate was the most pleasant of the ingredients in a balm given to syphilis patients that also included corrosive materials. Chocolate was also used as an antidote for infections with parasitic worms — for that prescription, it was mixed with sugar, cinnamon, tree oil and an antifungal agent called calomel.

    1875: Milk chocolate is born

    After nearly a decade of experimentation, Swiss inventor Daniel Peter unveiled the “original” milk chocolate, a combination of cocoa, cocoa butter, condensed milk and sugar. Ads proclaimed the product to be a dietary staple more nutritious than coffee, and also a luxury that was “as distinct from ordinary eating chocolate as the Alps are from foot-hills.” Switzerland had the corner on milk chocolate until Cadbury hit the scene in England in 1904, promising to make “strong men stronger” and generally to be the superlative milk chocolate in terms of nutrition, sustenance and refreshment.

    1900: Hershey brings milk chocolate goodness to American soil

    Milton S. Hershey first made a name for himself in the 1880s by developing a caramel candy so tasty, it killed all competition. By the turn of the century, the famous confectioner had moved on to chocolate. After a reconnaissance mission to Switzerland, the birthplace of milk chocolate, Hershey introduced the 5-cent bar from, where else, Pennsylvania. Similar to its European predecessors, the bar was marketed as a daily dietary requirement that was “more sustaining than meat.”

    1989: Antidepressant could cure chocoholics

    Throughout the 1800s and 1900s, texts piled up describing the everything-under-the-sun medicinal purposes of chocolate. But what if you needed medicine to stop yourself from indulging in chocolate? For the first time in medical literature, doctors reported successfully treating two patients with possible chocolate addiction using the then-new antidepressant bupropion, known as Wellbutrin. One of the patients, a middle-aged woman who also suffered from depression, went from eating 2 pounds of chocolate candy a day to having no interest in chocolate after taking bupropion. (She still had a normal appetite for other foods, though.)

    1996: Is chocoholism really an addiction?

    Research has concluded what most of us already know: Chocolate is the most craved of all foods. The power of chocolate is probably only boosted by the sweetness and creaminess of most chocolate treats. But could it really be addictive in the same way that drugs and alcohol are? Psychologists argue against this possibility. Although chocolate contains caffeine and substances similar to those found in marijuana, it probably does not contain high enough levels to have long-term effects on brain chemistry.

    1998: Chocolate is the ultimate comfort food

    Forget pizza and French fries; chocolate may be the ultimate of all comfort foods. A study of 330 adults in the United Kingdom suggests that people tend to crave chocolate when they are feeling down, upset or stressed. Experts speculate this is because eating chocolate, like all enjoyable foods, gives us a rush of endorphins. These are the same feel-good chemicals that our bodies release when we exercise.

    2002: Is chocolate a cancer-fighting food?

    Is it too good to be true that chocolate fights cancer? Maybe not, according to some emerging data. An antioxidant found in chocolate called catechin was linked with lower rates of lung cancer in a study of elderly Dutch men. A year later, a study of postmenopausal women in the United States found that those who consumed the highest level of catechin had 45% lower risk of rectal cancer, compared with those who consumed the lowest level. However, the authors of the studies pointed out that other foods and drinks, especially tea, apples and pears, are richer sources of catechin than chocolate, and the lower rates of cancer could have more to do with people consuming them.

    2004: Like giving chocolate to a crying baby

    Pregnant women might want to give in to their chocolate cravings. Women who report eating chocolate every day during their pregnancy go on to describe their babies as being more active and having a better temperament when they are 6 months old. The researchers who conducted the study suggest that chocolate may help mitigate prenatal stress in moms-to-be.

    2005: Dark chocolate may fend off diabetes

    It’s hard to imagine that chocolate could keep your blood sugar in check, but dark chocolate might have just that effect. In a small study of healthy adults, those who ate half an ounce of dark chocolate a day for 15 days had better insulin sensitivity, and lower blood pressure to boot, than adults who ate a similar amount of white chocolate.

    2006: Chocolate is Indians’ secret to a healthy heart

    Researchers from the United States traveled to a remote island in Panama to solve a medical mystery: Why are the Kuna Indians that live there free from high blood pressure and other medical ailments, even though they ate as much salt as Americans? The likely explanation, researchers found, is that this population consumes a lot of cocoa-containing beverages, about 10 times the amount of the less traditional Kuna living in Panama City. Previous researchsuggested that antioxidants in the cocoa plant called flavanols could cause blood vessels to dilate, reducing blood pressure.

    2006: This is your brain on chocolate

    If chocolate is a drug, at least it doesn’t seem to have scary effects on your brain like in those 1980s public service announcements. A 2006 study carried out brain imaging of young womenand observed increased blood flow to the brain after the women drank a cocoa beverage high in flavanol antioxidants for five days. Studies over the next several years found that young women had faster reaction times after consuming dark chocolate and that older adults performed better on a memory test after drinking high-flavanol cocoa beverages for three months.

    2006: Maybe chocolate is not an aphrodisiac after all

    The Aztec Emperor Montezuma II is said to have sipped on the “divine drink” of chocolate “before visiting his wives.” However, science has not yet supported a role for chocolate in the bedroom. A study of women in Northern Italy did find that those who reported eating the most chocolate had higher levels of sexual desire and satisfaction. But these women were also younger than the non-chocolate eaters, and researchers concluded that age rather than chocolate consumption probably explained the sexual differences.

    2008: Chocolate takes a bite out of inflammation

    study of adults in Italy found that those who ate small to moderate amounts of dark chocolate — up to 0.3 ounces a day, the equivalent of about one and a half Hershey’s Kisses — had lower levels of C-reactive protein, a marker of inflammation that has been linked to heart disease. But there was a catch. Those who ate more than one-third of an ounce of chocolate a day did not appear to reap any inflammation-lowering benefit.

    2010: Chocolate buzz could help chronic fatigue syndrome sufferers

    Montezuma II might have been onto something when he deemed chocolate a remedy for fatigue. A small study found that people with severe chronic fatigue syndrome got relief from their symptoms — and some were even able to return to work — after consuming chocolate rich in polyphenol antioxidants for eight weeks.

    2011: To be addicting or not to be. That is the chocolate question.

    Ever lament how chocolate is the perfect food, except when you want to stop eating it? Don’t worry, science understands. A study implicated both the sugar and the cocoa in chocolate for making adults less able to keep themselves from going back for seconds. Tasting chocolate even triggered feelings of euphoria and well-being in these adults, just as addictive drugs can.
    But even though chocolate may trigger loss of control, it is probably not addictive, said Jennifer Nasser, associate professor of nutrition sciences at Drexel University and lead author of the study. For one thing, it takes too long for chemicals from chocolate to enter our bloodstream, she said. However, other researchers say that sugar can be addicting and can change brain chemistry in a way that resembles drug addiction.

    2012: Chocolate could save your skin

    Chocolate could team up with beverages such as coffee, tea and cola to drive down your risk of skin cancer. A study of more than 120,000 nurses in the United States revealed that women and men who guzzled the highest amount of these beverages and ate the most chocolate had an 18% and 13% lower risk of developing skin cancer, respectively, presumably because of the caffeine they contain. But, the caffeine in a serving of chocolate is piddly compared with that in a cup of coffee — 7 milligrams, vs. 137 milligrams.

    2015: Is chocolate good for your heart? Let us count the ways.

    The blood pressure-lowering power of chocolate could be just the beginning. Researchers uncovered other heart benefits in a large analysis of more than 150,000 men and women in the United States, Europe and Australia who reported eating up to 3.5 ounces of chocolate a day. Chocolate consumption was associated with a 21% lower risk of stroke, 29% lower risk of developing heart disease and 45% lower risk of dying of heart disease.
    Even better news for some, the study found that consuming milk chocolate, often regarded as less healthy than dark chocolate, was also associated with lower risk of heart disease. The authors speculate that ingredients such as calcium in milk chocolate may contribute to this beneficial effect.
    Although the authors say the benefits they observed could be due to other foods in the participants’ diets, they do at least take the findings to mean that there “does not appear to be any evidence to say that chocolate should be avoided in those who are concerned about cardiovascular risk.”
    This article was originally published on CNN.com in February 2016. Click here to view it.

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  • Physical Therapist’s Guide to Knee Pain

    Physical Therapist’s Guide to Knee Pain >

    Knee pain can be caused by disease or injury. The most common disease affecting the knee is osteoarthritis. Knee injuries can occur as the result of a direct blow or sudden movement that strains the knee beyond its normal range of movement. Knee pain caused by an injury is most often associated with knee cartilage tears, such as meniscal tears, or ligament tears, such as anterior cruciate ligament tears.

    What is Knee Pain?

    Knee pain can be caused by disease or injury. Knee pain can restrict movement, affect muscle control in the sore leg, and reduce the strength and endurance of the muscles that support the knee.

    The most common disease affecting the knee is osteoarthritis, which is caused by the cartilage in the knee gradually wearing away, resulting in pain and swelling.

    Knee injuries can occur as the result of a direct blow or sudden movement that strains the knee beyond its normal range of motion, as can happen in sports, recreational activities, a fall, or a motor vehicle accident. Knee pain caused by an injury often is associated with tears in the knee cartilage or ligaments. Knee pain also can be the result of repeated stress, as often occurs with the kneecap, also known as patellofemoral pain syndrome. Very rarely, with extreme trauma, a bone may break at the knee.

    How Does it Feel?

    You may feel knee pain in different parts of your knee joint, depending on the problem affecting you. Identifying the location of your pain can help your physical therapist determine its cause.

    How Is It Diagnosed?

    Your physical therapist will make a diagnosis based on your symptoms, medical history, and a thorough examination. X-ray and magnetic resonance imaging (MRI) results may also be used to complete the diagnosis.

    To help diagnose your condition, your physical therapist may ask you questions like these:

    • Where exactly on your knee is the pain?
    • Did you twist your knee?
    • Did you feel a “tearing” sensation at the time of injury?
    • Do you notice swelling?
    • Have you ever felt like your knee joint is “catching,” or “locking,” or will give way?
    • Do you have difficulty walking up and down stairs?
    • Do you have difficulty sitting with your knee bent for long periods, as on an airplane or at the movies?
    • Does your pain increase when you straighten or bend your knee?
    • Does your knee hurt if you have to twist or turn quickly?

    The physical therapist will perform tests to find out whether you have:

    • Pain or discomfort with bending or straightening your knee
    • Tenderness at the knee joint
    • Limited motion in your knee
    • Weakness in the muscles around your knee
    • Difficulty putting weight on your knee when standing or walking

    The physical therapist also is concerned about how well you are able to use your injured knee in daily life. To assess this, the therapist may use such tests as a single-limb hop test, a 6-minute walk test, or a timed up and go test.

    How Can a Physical Therapist Help?

    Based on the evaluation, your physical therapist will develop a customized rehabilitation program, including a specific set of knee exercises, for you.

    If you already have knee problems, your physical therapist can help with a plan of exercise that will strengthen your knee without increasing the risk of injury or further damage. As a general rule, you should choose gentle exercises such as swimming, aquatic exercise, or walking rather than jarring exercises such as jogging or high-impact aerobics.

    Consult your physical therapist about specific ways to maintain your knee health following injury or surgery. Your physical therapist has the relevant educational background and expertise to evaluate your knee health and to refer you to another health care provider if necessary.

    Depending on the severity of your knee problem, your age, and your lifestyle, the therapist may select such treatments as:

    Strength training and functional exercises, which are designed to increase strength, endurance, and function of your leg muscles (quadriceps and hamstrings). This in turn helps support the knee and reduce stress to the knee joint.

    Electrical stimulation of the knee, which further increases leg muscle strength and can help reduce knee pain. To increase strength, electrical impulses are generated by a device and delivered through electrodes to stimulate the primary muscle that supports the knee, the quadriceps femoris. To reduce your knee pain, the electrodes are placed on the skin to gently stimulate the nerves around the knee.

    Your physical therapist can determine just how much you may need to limit physical activity involving the affected knee. He or she also can gauge your knee’s progress in function during your rehabilitation.

    How Can a Physical Therapist Help Before & After Surgery?

    Your physical therapist, in consultation with your surgeon, will be able to tell you how much activity you can do depending on the type of knee surgery (such as total knee replacement) you undergo. Your therapist and surgeon also might have you participate in physical therapy prior to surgery to increase your strength and motion. This can sometimes help with recovery after surgery.

    Following surgery, your physical therapist will design a personalized rehabilitation program for you and help you gain the strength, movement, and endurance you need to return to performing the daily activities you did before.

    Can this Injury or Condition be Prevented?

    Ideally, everyone should regularly get 3 types of exercise to prevent injury to all parts of the body, including the knees:

    • Range-of-motion exercises to help maintain normal joint movement and relieve stiffness.
    • Strengthening exercises to keep or increase muscle strength.
    • Aerobic or endurance exercises (such as walking or swimming) to improve function of the heart and circulation and to help control weight. Weight control can be important to people who have arthritis because extra weight puts pressure on many joints, including the knee.

    To keep knee pain and other musculoskeletal pain at bay, it’s important to maintain an overall healthy lifestyle, exercise, get adequate rest, and eat healthy foods. It’s also important for runners and other athletes to perform physical therapist-approved stretching and warm-up exercises on a daily basis—especially before beginning physical activity.

    This article was originally published on the American Physical Therapy Association website.  Click here to view it.

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  • This 90-second trick will energize you for your whole day

    This 90-second trick will energize you for your whole day >

    Nothing beats a nice hot shower in the morning to get you awake and ready to take on the day, right?

    Wrong! According to an article from Entrepeneur, a standard hot shower is exactly what you want … if you plan on going back to sleep.

    Instead, says contributor Phil Dumontet, there’s an easy way to get clean and send yourself out the door ready to tackle the morning — and it only takes 90 seconds.

    In the article he says you should:

    1. Go through your regular cleaning routine in the shower.
    2. Crank the cold all the way up and stand under the water for 30 seconds. “Scream if it helps,” he says.
    3. Crank the hot up as far as you can stand it for another 30 seconds.
    4. Go back to cold for a final 30 seconds.

    Notes Dumontet, the cycles are what matter. “Hot and cold hydrotherapy has been used for thousands of years,” particularly by the Finns. He adds, “it provides a full-body tuneup” that has benefits of reducing stress, a stronger immune system, improved blood circulation, a greater ability to burn fat and helps some people battle depression.

    This article was originally posted on TodayShow.com. Click here to view it.  

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  • 21 achievable New Year’s resolutions for your health

    21 achievable New Year’s resolutions for your health >

    If you’re like almost half of all adults, you have a New Year’s resolution. But once the champagne flutes are back on the shelf, it’s hard to make that pledge stick. A week into the new year, just 77 percent of resolution makers are still on track, and after six months, only about 40 percent will have stayed the course, according to University of Pennsylvania research.

    Why New Year’s resolutions fail

    Why is maintaining resolutions so tough? Researchers have ID’d several culprits, such as setting a goal that’s too vague or having unrealistic expectations (lose 30 pounds by March 1—ha!). But perhaps the biggest challenge is turning your wishes into immediate action, then keeping with it. “It’s easy to change your attitude but difficult to change your behavior,” explains Christine Whelan, PhD, clinical professor in the School of Human Ecology at the University of Wisconsin, Madison. “If you’re committed to it, however, you can make a new habit or behavior permanent.”

    How to set manageable goals

    Outsmarting the odds means setting doable goals (go from couch to 10K, not a triathalon), then breaking them down into reasonable steps. A new you in the new year starts right here.
    Find out how to reboot your diet, your workout, your stressful days, and your energy, and how you can make those resolutions stick.

    Reboot your diet

    When it comes to cleaning up your eating, take a tip from the Boy Scouts: Be prepared. If you want to rise above temptation, like a yummy app spread at a party, you have to think one step ahead, says New York City nutritionist Joy Bauer, RD, Today show contributor and founder of Nourish Snacks. It also helps to have no-deprivation strategies, she adds: “Eating better is often associated with misery, so it’s no wonder that so many people throw in the towel.” Use these tactics to eat healthier, long-term.

    Figure out your “why”

    Maybe you hope to set a good example for your kids. Or you’re just tired of not fitting into your old jeans. If you know the reason that’s fueling your desire to eat better, you can use it to motivate yourself when you’re eyeing the dessert menu, says Whelan.

    Don’t focus on subtracting food

    “Instead of making an ‘I want to lose weight’ pledge, try ‘I’m going to put more fruits and vegetables on my plate,'” says Bauer, “so the resolution is a positive action that you can perform over and over.” Art Markman, PhD, professor of psychology and marketing at the University of Texas at Austin and author of Smart Change, agrees. “If it’s an addition instead of a takeaway, you’re more likely to repeat it until the action becomes an automatic habit,” he says.

    Do a kitchen cleanse

    Toss unhealthy products (chips, sugary granolas, sodas) from your pantry, fridge, car and office, advises Maggie Moon, RDN, owner of Everyday Healthy Eating in Los Angeles. Then restock with good-for-you options, like carrots and air-popped popcorn. Make sure you don’t have to dig deep to find them: Last year, Cornell University researchers found that women who kept healthy food visible in the kitchen had lower BMIs than those who left junky products out on their countertops.

    Plan for snack attacks

    “The hours between mid-afternoon and dinnertime are when cravings kick in hard,” says Moon. Before leaving for work, pack a 200-calorie protein-complex carb snack in your purse. Think: hummus and pita chips or pistachios and a pear. Then, when a snack jones strikes, you’ll have a go-to treat to avoid unhealthy office snacks.

    Reboot your workout

    Get-in-shape goals tend to fizzle as early as the third week of January, per recent data based on Facebook searches. Yet some keep at it. What’s their secret? “People who are successful are more likely to view fitness as a permanent lifestyle change, not an activity they can give up once they reach a number on the scale,” says Kirsten McCormick, founder of Running with Forks, a wellness coaching company in Seattle.

    Take it a week at a time

    “It’s easier to make a plan to go running three times this week than vow to run three times a week indefinitely,” says Whelan. “If you make your fitness goals week by week rather than so far-reaching, you’ll have more success, and that in itself is motivating.”

    Raise the stakes

    Research shows that anticipating rewards may help you be more devoted to your goal. Sure, it’s a bribe of sorts, but experiment with promising yourself a mani-pedi after a week of true commitment, or a new gym outfit after two. Or put a penalty on the table: Promise to go TV-less for a week if you don’t follow through. A 2012 study by the National Bureau of Economic Research found that a financial pledge is another effective incentive.

    Bundle your workout

    You may be more likely to participate in a behavior you’re not so into—such as exercising—if you combine it with an activity you really enjoy, like catching up on House of Cards. This strategy is called “temptation bundling,” and a 2013 study published in Management Science suggested it works.

    Reboot your stressful days

    “One big problem with making stress reduction your New Year’s resolution is that it’s so abstract,” says Markman. “You can’t just vow to relax without being more specific.” And since you’re not about to quit your job and hightail it to a peaceful island (you aren’t, right?), it’s crucial to learn the tools that will make your everyday tension less toxic.

    Say no to something every week

    A simple “I can’t, sorry” is a helpful immediate fix. Regularly overextending yourself forces you to put your own needs behind others’ requests, says Pedram Shojai, an Eastern medicine expert in Orange County, Calif., and author of The Urban Monk.

    Take a time-out daily

    Vow to disconnect at least once a day, suggests Shojai. Close your eyes and take 10 deep breaths in your office, or crank up a soothing playlist on your commute.

    Try meditation

    “Meditating is like your brain’s virus checker, detecting toxic stress and blocking its effects on your physical and emotional health,” says Shojai. A 2013 study found that adults who were taught the basics of mindful meditation had lower levels of the stress hormone cortisol.

    Reboot your energy

    One 2015 U.K. study showed that the main reason people were unable to make a change was that they were too tired to focus. Here’s how to get yourself juiced for a great year.

    Keep a fatigue diary

    Once you pinpoint the time of day you feel draggy, you can make adjustments. “For example, if you’re tired in the afternoon, you need to rethink what you eat for lunch or try to drink more water, ” says Holly Phillips, MD, author of The Exhaustion Breakthrough.

    Make a to-don’t list

    After you write out your to-do list for the day, ask yourself which tasks really need to get done—and which aren’t realistic or important. The latter constitute your to-don’t list. Drawing a line through them “removes energy-draining clutter from your mind,” says Dr. Phillips.

    Pencil in bedtime

    Most of us don’t think of sleeping as actively doing something, so we don’t plan it. “When you put it in your calendar,” explains Dr. Phillips, “it becomes a priority, the same way your gym time and work meetings are priorities.” Set a reminder to go off a half hour before you plan to hit the sack.

    Download an app

    Free apps can lend a digital hand by keeping track of your progress, texting reminders or putting you in touch with crowdsourced support. A few to try: Balanced, Coach.me and Pact.

    Share your battle

    Social networks function as an audience to cheer you on and offer advice. A 2013 study found that when Twitter users looking to lose weight tweeted about their goals, they shed more pounds than those who didn’t; research out of Northwestern University showed that CalorieKing users who “friended” others on the site lost at least 7 percent more body weight than the less social folks.

    Do more with Google

    It’s not just a search engine. Google Calendar lets you set a firm bedtime, and it can ping you when it’s time for your time-out. Google Maps helps you gauge the distance, terrain and incline of a new running route. Download the Google app to turn your phone into a nutrition database or fitness class finder. Wherever you are, simply ask, “Where’s the nearest barre studio?” and you’ll get your answer.
    This article was originally published on CNN.com. Click here to view it.

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  • The most popular — and best — days to start a diet

    The most popular — and best — days to start a diet >

    Maligned Mondays are actually days that tap into the “fresh start effect,” when we feel like “a new person,” ready to take on a change in habits, according to a report.

    “On certain days, called temporal landmarks, you just have a different view of yourself,” said Jason Riis, visiting professor at the Wharton School at the University of Pennsylvania and co-author of report. “You become more forward looking.”

    People think, “I am going to be a new person and … I am no longer going to be a part of the path of failure,” said Hengchen Dai, a co-author of the paper and doctoral student at Penn. “It’s changing the perception of the self.”

    To determine these temporal landmarks, the Wharton researchers conducted three experiments: they scoured Google analytics to see when and how often people searched for diet and exercise; then they tracked the most popular days at the University of Pennsylvania gym; finally, they examined a website where people made contracts with themselves to change a behavior — they lost money if they failed.

    The Wharton researchers didn’t study whether people achieved their goals, but psychologist John Norcross of the University of Scranton says people who make New Year’s resolutions or quit smoking during events like the Great American Smokeout actually are more successful than expected.

    Here are the most popular days for starting a diet, beginning a new workout program, or even switching your 401K into an IRA, according to Wharton researchers.

    Mondays

    “Monday is going to be a fresh start,” Dai said. Ann Kearney-Cooke agreed that Mondays motivate people.

    “I think it gives an energy surge to people,” said Kearney-Cooke, the psychologist at the Cincinnati Psychotherapy Institute.

    Mondays do have drawbacks. People can use all their energy and willpower up early on, meaning they can burn out later in the week. If you fall off track by Thursday, don’t wait until Monday for a new start, says Kearney-Cooke.

    Little changes can bring big results. Sign up for our One Small Thing Newsletter here

    “The key to change is at the next meal or the next morning, starting over,” said Kearney-Cooke.

    There’s no evidence of a “bad day” to start a new behavior, but she says don’t start something new when you feel low energy and willpower.

    Birthdays and anniversaries

    Dai realized that she made promises on her birthday and anniversary and wondered if others did, too.

    “Every year I make birthday resolutions, I make resolutions on my anniversary. For me, I feel like those are the landmarks that I would like to seize upon,” she said.

    It turns out she’s not alone.

    The researchers found that day after a birthday many people hit the gym, with the exception of the 21st birthday (too many people are nursing hangovers to consider a workout after that birthday).

    “[Birthdays] are meaningful events looking forward,” Riis said, adding that they spur changes in behaviors.

    Birthdays also can serve as a time to revisit an earlier goal.

    “I think humans like to be reminded ‘here is an opportunity, go for it,’” said John Norcross, a distinguished professor of psychology at the University of Scranton. “We ask people to start on a day that signifies a new beginning or a meaningfully important date.”

    First day of the month

    Gym attendance is up in the beginning of the month, according to Google search data. So don’t be surprised if workout classes are more crowded or you have to wait for a popular exercise machine.

    New season or new semester

    Many people make changes at the beginning of the seasons, researchers found. Spring is a time to clear clutter from our lives, or a reminder that bathing suit season is coming. Fall brings the start of a new school year.

    One of the times students are more likely to work out is at the start of the semester, Wharton researchers found.

    New Year’s

    It’s a cliché, but people have made New Year’s resolutions since ancient Roman times.

    “It is the get out of jail free card … Here is the socially acceptable time to start anew,” said Norcross.

    He has studied New Year’s resolutions and found that about 40 percent of people who make them, stick to their resolutions.

    “Success rates are better than most people imagine,” Norcross said.

    He finds that while a new year gives people an opportunity to think about the future and their future selves, it also helps them reflect on the past and their negative behaviors. He believes people need both perspectives to change.

    “Using both sources tends to be associated with success — not just being disgusted [but] looking forward and saying ‘here is my new life.’”

    People are more likely to change around the new year because there is more social support and more information available, he added.

    But you don’t have to wait for New Year’s. Patients modify habits on many holidays, including Mother’s Day, Cinco de Mayo, Lent, Yom Kippur or any other holiday that holds meaning for them.

    This article was originally published on TodayShow.com.  Click here to view it.

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  • Physical Therapist’s Guide to Shoulder Bursitis

    Physical Therapist’s Guide to Shoulder Bursitis >

    Shoulder bursitis is a painful condition that affects people of all ages. The condition tends to develop more in middle-aged, elderly, and individuals who have muscle weakness. Shoulder bursitis can have many causes, but the most common is a repetitive activity, such as overhead reaching, throwing, or arm-twisting, which creates friction in the upper shoulder area. Athletes often develop shoulder bursitis after throwing, pitching, or swimming repetitively. The condition can happen gradually or suddenly, or can be a result of an autoimmune disease. It can also occur without any specific cause. Physical therapy can be a very effective treatment for shoulder bursitis to reduce pain, swelling, stiffness, and associated weakness in the shoulder, arm, neck, and upper back.

    Shoulder impingement and tendinitis can occur along with shoulder bursitis. A physical therapist can effectively treat all of these conditions together.

    What is Shoulder Bursitis?

    Shoulder bursitis (also called subacromial bursitis) occurs when the bursa (a fluid-filled sac on the side of the shoulder) becomes damaged, irritated, or inflamed. Bursitis (“-itis”); means “inflammation”) means the bursa has become irritated and inflamed, which causes pain. Normally, the bursa acts as a cushion for the rotator cuff tendon of the supraspinatus muscle that sits under the bursa, and prevents the tendon from rubbing on the acromion bone above the bursa. Certain positions, motions, or disease processes can cause friction or stress on the bursa, leading to the development of bursitis. When the bursa becomes injured, the tendon doesn’t glide smoothly over it, and can become painful.

    Shoulder bursitis can be caused by:

    • Repetitive motions (overhead reaching or lifting, throwing, or twisting of the arm)
    • Muscle weakness or poor muscle coordination
    • Incorrect posture
    • Direct trauma (being hit, or falling on, the side of the shoulder)
    • Shoulder surgery or replacement
    • Calcium deposits in the shoulder
    • Overgrowth or bone spurs in the acromion bone
    • Infection
    • Autoimmune diseases, such as rheumatoid arthritis, gout, psoriasis, or thyroid disease
    • Muscles or tendons in the shoulder area rubbing the bursa and causing irritation

    How Does it Feel?

    With shoulder bursitis, you may experience:

    • Pain on the outer side or tip of the shoulder
    • Pain when you push with your finger on the tip of the shoulder
    • Pain when lying on the affected shoulder
    • Pain that worsens when lifting the arm to the side
    • Pain when rotating the arm
    • Pain when pushing or pulling open a door

    How Is It Diagnosed?

    If you see your physical therapist first, the physical therapist will conduct a thorough evaluation that includes taking your health history. Your physical therapist also will ask you detailed questions about your injury, such as:

    • How and when did you notice the pain?
    • Have you been performing any repetitive activity?
    • Did you receive a direct hit to the shoulder, or fall on it?

    Your physical therapist also will perform special tests to help determine the likelihood that you have shoulder bursitis. Your physical therapist will gently press on the outer side of the shoulder to see if it is painful to the touch, and may use additional tests to determine if other parts of your shoulder are injured. The physical therapist also will observe your posture, and how you lift your arm.

    Your physical therapist will test and screen for other, more serious conditions that could cause shoulder pain. To provide a definitive diagnosis, your physical therapist may collaborate with an orthopedic physician or other health care provider, who may order further tests, such as an X-ray to confirm the diagnosis and to rule out other damage to the shoulder, such as a fracture.

    How Can a Physical Therapist Help?

    Your physical therapist will work with you to design a specific treatment program that will speed your recovery, including exercises and treatments that you can do at home. Physical therapy will help you return to your normal lifestyle and activities. The time it takes to heal the condition varies, but results can often be achieved in 2 to 8 weeks, when a proper stretching and strengthening program is implemented.

    During the first 24 to 48 hours following your diagnosis, your physical therapist may advise you to:

    • Rest the area by avoiding lifting or reaching overhead, or any activity that causes pain.
    • Apply ice packs to the area for 15 to 20 minutes every 2 hours.
    • Consult with a physician for further services, such as medication or diagnostic tests.

    Your physical therapist will work with you to:

    Reduce Pain and Swelling. If repetitive activities have caused the shoulder bursitis, your physical therapist will help you understand how to avoid or modify the activities to allow healing to begin. Your physical therapist may use different types of treatments and technologies to control and reduce your pain and swelling, including ice, heat, ultrasound, electrical stimulation, taping, specific exercises, and hands-on therapy, such as specialized massage.

    Improve Motion. Your physical therapist will choose specific activities and treatments to help restore normal movement in the shoulder and arm. These might begin with “passive” motions that the physical therapist performs for you to gently move your shoulder joint, and progress to active exercises and stretches that you do yourself.

    Improve Flexibility. Your physical therapist will determine if any shoulder, arm, chest, or neck muscles are tight, start helping you to stretch them, and teaching you how to stretch them.

    Improve posture. If posture problems are found to be related to your condition, your physical therapist will work with you to help improve your posture to help alleviate your pain, and prevent future recurrence.

    Improve Strength. Shoulder bursitis is often related to weak, injured, or uncoordinated shoulder muscles. Certain exercises will aid healing at each stage of recovery; your physical therapist will choose and teach you the correct exercises and equipment to use to steadily restore your strength and agility. These may include using cuff weights, stretch bands, and weight lifting equipment.

    Improve Endurance. Regaining your muscular endurance in the shoulder is important after an injury. Your physical therapist will teach you exercises to improve your muscular endurance, so you can return to your normal activities. Cardio-exercise equipment may be used, such as upper-body ergometers, treadmills, or stationary bicycles.

    Learn a Home Program. Your physical therapist will teach you strengthening and stretching exercises to perform at home. These exercises will be specific for your needs; if you do them as prescribed by your physical therapist, you can speed your recovery.

    Return to Activities. Your physical therapist will discuss your activity goals with you and use them to set your work, sport, and home-life recovery goals. Your treatment program will help you reach your goals in the safest, fastest, and most effective way possible. Your physical therapist will teach you exercises, work retraining activities, and sport-specific techniques and drills to help you achieve your goals.

    Speed Recovery Time. Your physical therapist is trained and experienced in choosing the best treatments and exercises to help you safely heal, return to your normal lifestyle, and reach your goals faster than you are likely to do on your own.

    If Surgery Is Necessary

    Surgery is not commonly required for shoulder bursitis. But if surgery is needed, you will follow a recovery program over several weeks, guided by your physical therapist. Your physical therapist will help you minimize pain, regain motion and strength, and return to normal activities in the safest and speediest manner possible.

    Can this Injury or Condition be Prevented?

    Your physical therapist can recommend a home-exercise program to strengthen and stretch the muscles around your shoulder, arm, chest, and neck to help prevent future injury. These may include strength and flexibility exercises for the shoulder, arm, chest, neck, and core muscles.

    To help prevent a recurrence of the injury, your physical therapist may advise you to:

    • Follow a consistent flexibility and strengthening exercise program, especially for the shoulder muscles, to maintain good physical conditioning, even in a sport’s off-season or after you retire from sports.
    • Always warm up before starting a sport or heavy physical activity.
    • Learn and maintain good posture.
    • Gradually increase any demanding activity, rather than suddenly increasing the activity amount or intensity. This includes household activities, office work, or athletics.
    • Learn and maintain correct posture.

    This article was originally published on the American Physical Therapy Association website.  Click here to view it.

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  • 9 Healthy Holiday-Eating Strategies

    9 Healthy Holiday-Eating Strategies >

    Fend off holiday weight gain with these easy eating tricks.

    The Strategy: Bring Your Own Food

    Contribute a healthy dish to a gathering to ensure there’s something you can indulge in.

    Tricks to Try

    Eat the best-for-you offerings first. For example, hot soup as a first course―especially when it’s broth-based, not cream-based―can help you avoid eating too much during the main course.

    Stand more than an arm’s length away from munchies, like a bowl of nuts or chips, while you chat so you’re not tempted to raise your hand to your mouth every few seconds.

    Concentrate on your meal while you’re eating it. Focus on chewing your food well and enjoying the smell, taste, and texture of each item. Research shows that mealtime multitasking (whether at home or at a party) can make you pop mindless calories into your mouth. Of course, dinner-party conversation is only natural, but try to set your food down until you’re finished chatting so you are more aware of what you’re taking in.


    The Strategy: Don’t Go Hungry to the Mall

    To cut down on the lure of the food court, never go to the mall on an empty stomach.

    Tricks to Try

    Plan your shopping route so you don’t pass the Cinnabon stand a dozen times. The obvious reason? Both sights and smells can coax you to eat, and with some vendors purposefully wafting their aromas your way, saying no can feel impossible.

    Choose a proper restaurant over the grab-and-go food court whenever you can. And request a table away from loud sounds and distractions, which can cause you to eat more. The bright lights and noisy hard surfaces can speed up the rate at which you eat and lead to overeating.

    Avoid fast-food places that emphasize red in their color schemes. Red has been shown to stimulate the appetite more than many other colors, and many restaurants add it to their decor, in everything from the flowers on the table to the squiggles on the plates.


    The Strategy: Keep Track of What You Eat

    Maintain a food diary to help you stay committed to your goals during this risky eating period.

    Tricks to Try

    Weigh yourself daily and use that number to guide your actions. (Food diaries are helpful, but only if you’re totally honest and diligent about recording every morsel you eat.) Research has shown that women who step on the scale every day and then act accordingly, either increasing their exercise or being stricter about their eating, are 82 percent less likely to regain lost weight than those who don’t weigh in as often.

    Zip yourself into your favorite pair of slim-fitting pants once a week and note how they fit. Too tight? Adjust your eating and exercise habits. Just right? Keep up the good work.


    The Strategy: Eat Before Going to a Party

    Tricks to Try

    Eat breakfast. This has been shown to prevent overeating later in the day.

    Limit the number of high-calorie foods on your party plate. Research has shown that when faced with a variety of foods with different tastes, textures, smells, shapes, and colors, people eat more―regardless of their true hunger level. Cutting down on your personal smorgasbord can decrease what you end up eating by 20 to 40 percent.

    Choose foods wisely, filling your plate with low-calorie items, such as leafy green salads, vegetable dishes, and lean proteins, and taking smaller portions of the richer ones. That way, you can eat a larger amount of food for fewer calories and not feel deprived.

    Pop a sugar-free mint in your mouth. When you’ve had enough (and don’t want to eat more), the feeling of a fresh palate can curb additional noshing.


    The Strategy: Keep Healthy Snacks at the Office

    Stash healthy foods in your desk at work so you’re not as tempted by the treats piling up at the office.

    Tricks to Try

    Try to keep communal office goodies out of view, either in an area that isn’t as highly trafficked as the kitchen or the break room, or in dark containers or covered dishes. In one study, people ate 26 percent more Hershey’s Kisses when the candies were in clear dishes versus white ones. And when the chocolates were placed six feet away, the average person ate only four a day, as opposed to nine a day when they were within arm’s reach.

    Before you allow yourself a splurge, do something healthy,like eating a piece of fruit, walking around the office for five minutes, or climbing a few flights of stairs.

    Plan on taking whatever tempts you home, and delay the daily indulgence until just before bedtime. At that point, you’re less likely to crave another treat immediately than you would during your afternoon coffee break, especially if the whole box is no longer around.


    The Strategy: Manage Portion Size

    Take sensible portions so you don’t end up eating too much.

    Tricks to Try

    Use smaller plates and serving utensils. Try a salad or dessert plate for the main course and a teaspoon to serve yourself. What looks like a normal portion on a 12-inch plate or a troughlike bowl can, in fact, be sinfully huge. In one study conducted at the Food and Brand Lab at Cornell University, even nutrition experts served themselves 31 percent more ice cream when using oversize bowls compared with smaller bowls. The size of the serving utensil mattered, too: Subjects served themselves 57 percent more when they used a three-ounce scoop versus a smaller scoop.

    Pour drinks into tall, skinny glasses,
     not the fat, wide kind. Other studies at Cornell have shown that people are more likely to pour 30 percent more liquid into squatter vessels.


    The Strategy: Control Your Environment

    You plan to use sheer willpower during large family dinners.

    Tricks to Try

    Eat with a small group when you can. One study found that dining with six or more people can cause you to eat 76 percent more, most likely because the meal can last so long. (After an hour of staring at the stuffing, you’re more likely to have seconds.) At a big sit-down supper, be the last one to start and the second one to stop eating.

    Sit next to a fellow healthy eater(there’s strength in numbers). Or sidle up to that uncle who eats slowly, so his pace can slow yours.

    Wait for all the food to be on the table before making your selections. People who make their choices all at once eat about 14 percent less than do those who keep refilling when each plate is passed.

    Keep visual evidence around of what you’ve consumed so you don’t forget. Leave an empty bottle of wine or beer in view and you’ll be less tempted to drink more.


    The Strategy: Keep Up the Exercise

    You’re determined to squeeze in at least one or two workouts a week, no matter how busy you get.

    Tricks to Try

    Break it up. If you don’t have time for your daily four-mile walk, do a few 10- or 15-minute spurts of exercise throughout the day (to accumulate the surgeon general’s recommendation of 30 minutes a day). They can be just as effective at maintaining overall fitness as one continuous workout.

    Tell yourself that all the running around you’re doing (cleaning for houseguests, dashing through a million stores to find the perfect presents) can help keep your weight in check. In one Harvard study, people who were simply told that they did enough in their daily lives to meet the surgeon general’s recommendations lost weight and body fat without consciously changing a thing. A possible reason? Believing that what they were doing was having a positive effect may have led to subtle changes in their overall health behaviors.


    The Strategy: Choose Your Indulgences

    You intend to stave off feelings of deprivation by allowing yourself a “cheat” day a week.

    Tricks to Try

    Plan in advance to eat a little more and be a little more flexible at this time of year, when you face daily temptations. That way, you can savor the culinary joys of the holidays a little more often and you’ll be less likely to binge. For instance, rather than inhaling four sugar cookies on your cheat day, allow yourself one as a dessert when the mood strikes. Then make one little switch during the day to account for those calories―maybe skipping that morning latte or cutting out an afternoon snack.

    Choose your indulgences wisely.Instead of wasting calories on foods that you can have at any time of the year, pick items that are truly special and unique to the season, like your grandmother’s candied yams or your daughter’s first batch of Christmas cookies.

    This article was originally published on Real Simple’s website. Click here to view it.

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  • 4 ‘healthy’ habits to ditch right now

    4 ‘healthy’ habits to ditch right now >

    You grind it out at the gym, you chop your kale like a warrior and you pre-portion your snacks every Sunday night. You’re a wellness rock star. Or, not? What if some of your tireless efforts were in vain? What if your workouts and your snacks were working against you? Here are four healthy habits that may be sabotaging your health status.

    1. Being an exercise warrior

    “Wait, what? Exercise can be bad for me?” Like most things in life, too much of anything is, well, too much.

    Exercise causes our bodies to produce free radicals, cells famous for causing everything from cancer to heart disease. This part is actually OK, because, in turn, our bodies produce more antioxidants, which are the good guy compounds that fight free radicals. In other words, our bodies become stronger and build our internal defense system.

    However, too much exercise can result in too many free radicals and lead to damage of our muscle cells and cause fatigue.

    The American Heart Association recommends 150 minutes per week of moderate exercise (30 minutes, five times per week). I like to tell clients to move every day in some way, shape or form, such as a 30-minute run or a 45-minute spin class. The intensity and variety will vary based on age and fitness level, but don’t think that you need to double up on those HIIT classes every day or train for an ultramarathon — those choices may actually hurt your health.

    2. Eating low fat

    One of my favorite things to tell my clients is “fat is your friend!” Yes, fat can be your weight-loss (and healthy) BFF. On the other side, low- or fat-free foods can be your enemy. When fat is removed from food, it’s often replaced with sugar for flavor and additional chemicals (thickeners and additives) to retain the taste. You end up with a product that’s higher in calories and sugar, and packed with chemicals. That can lead to overall health and weight problems.

    Aside from fat helping you to burn fat, protecting your organs and keeping you satisfied, it’s also necessary to absorb fat-soluble vitamins. Skipping salad dressing because it’s too “fattening”? You’ll also miss out on some of those vitamins found in the salad itself!

    3. Drinking green juice only

    Sipping green juice five times a day and ducking out on all other foods sounds like a great idea to lose weight and improve your health — for about one hot second. When you juice to lose, you’re missing out on protein (which can lead to muscle loss versus fat loss) and you’re also losing out on fats. Also, the juice is lacking fiber, which can cause constipation and disrupt your gut flora. You’re also likely missing out on calories.

    All of the above, plus the lack of chewing, can lead to irritability, fatigue, yo-yo dieting and mental distress. The end of a cleanse can be synonymous with a big binge (insert bacon cheeseburger here) leading to weight gain, often even more than you had lost while sipping greens.

    Instead of juicing, cleanse the right way. Eat real, whole foods including fats, protein and carbohydrates, skip all packaged and processed foods and alcohol, and use a few “clean” days as an opportunity to mentally take your nutrition up a notch and lay the foundation for long-term behaviors.

    4. Washing produce like Mr. Clean

    Are you shopping for produce, coming home and washing, scrubbing, chopping and prepping like a good health soldier? Awesome, just skip one part: There’s no need to go crazy with washing those fruits and veggies. Although the FDA recommends washing even “pre-washed” produce at home, washing fruits and vegetables with soap or commercial produce wash is not recommended.

    Studies have even shown that plain water can be just as effective as other cleansing agents and products. I recommend buying organic produce, following food safety guidelines and rinsing with water.

    When it comes to living a healthy lifestyle, anything extreme will just fatigue you and make you want to quit. Instead, make changes and create habits that are manageable and that you can follow for the long term!

    This article was originally posted on TodayShow.com. Click here to view it.

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  • Back Pain Is Often Over-Treated

    Back Pain Is Often Over-Treated >

    BackPain

    Despite abundant evidence and published guidelines calling for conservative initial treatment of most back pain through methods including physical therapy and over-the-counter medications such as ibuprofen and acetaminophen, a study published in JAMA Internal Medicine (“Worsening Trends in the Management and Treatment of Back Pain” – September 23, 2013) indicates that physicians often over-treat back pain, with increases in use of imaging, narcotics, and referrals to other physicians. The over-treatment leads to unnecessary expenses.

    Early physical therapy has been shown to be a cost-effective treatment for low back pain.

    Helpful Resources:

    This information was originally published on the American Physical Therapy Association website.  Click here to view it.

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  • How to Build a Healthier Thanksgiving Plate

    How to Build a Healthier Thanksgiving Plate >

    No one ever said Thanksgiving dinner was healthy. But there are certain tricks to make it a little healthier—and to avoid riding out an uncomfortable food coma on the couch for the rest of the night. Whether you’re doling out your own portions, or you’re at the mercy of Aunt Ida passing out plates piled high with “a little bit of everything,” knowing which foods you should be eating more of—and which you should only enjoy a few bites of—will help you make the best possible choices.


    Start by filling half your plate with vegetables, then pile one-quarter up with turkey breast, and leave the remaining one-quarter for starchy sides. Here, some more expert-approved guidelines for keeping portions in check this Thanksgiving Day.

    Start with soup.

    Pour yourself a bowl of seasonal veggie soup, suggests Katherine Tallmadge, RD, author of Diet Simple:195 Mental Tricks, Substitutions, Habits & Inspirations. She recommends a butternut squash soup, or a broccoli and carrot soup with potatoes and thyme. Kicking off your meal with soup will help you slow down while eating, and research has shown it may even reduce the number of calories you consume at your main meal.

    Go crazy with the right veggies.

    Fill up 50 percent of your plate with non-starchy veggies. This may include Brussels sprouts, green beans, carrots, bell peppers, or a green salad, says Lori Zanini, RD, spokesperson for the Academy of Nutrition and Dietetics. Stick with smaller portions of starchy (read: higher-calorie) veggies, such as corn, potatoes, green peas, and winter squashes.

    In charge of the prep? Put colorful vegetables together in dishes and use herbs, spices, onions and garlic to flavor them with fewer calories—try cooked carrots and cumin or Brussels sprouts with garlic. You can also add a healthy twist to classic comfort foods, like replacing green bean casserole with some grilled green beans flavored with garlic and red pepper flakes, Zanini says.

    Make an array of interesting vegetable dishes, instead of lots of starchy dishes, suggests Tallmadge. “We tend to passively overeat when presented with variety, so if you want to give your guests a medley of dishes, have them be veggie-based,” she says.

    Fill up on skinless turkey breast.

    The turkey itself is relatively low in calories if you stick to skinless white meat, so most of our nutritionists don’t mind if you eat a little more than the recommended 3 ounces of protein (about a size of a deck of cards or an iPhone 6 Plus, which is 5.5 inches long). “I have certainly seen individuals pile their plates with more than three times the appropriate portion size on Thanksgiving Day,” says Zanini.

    “I am a big fan of protein because it keeps you fuller for longer so I would serve myself the equivalent of nearly two decks of playing cards of turkey,” says Liz Ward, RD, author of MyPlate for Moms, How to Feed Yourself & Your Family Better.

    Scoop sides on sparingly.

    Choose your favorite “special” sides that you only see around the holidays and keep servings to a half-cup. Stuffing? Worth it. A plain-old everyday roll? Not so much. One serving of starchy sides like mashed potatoes, stuffing, yams, and cranberry sauce is equal to ½ cup, which would look like half of a baseball.

    Count “casseroles” of any type as your starch. “Since I am originally from the South, I know too well that even ‘veggie’ casseroles, like broccoli casserole and green bean casserole, often call for creamy soups, sticks of butter, and large amounts of cheese in their ingredient lists,” says Zanini. “Not only do these types of dishes contribute excessive amounts of calories, but they’re also very high in sodium.” Remember sodium leads to water retention and belly bloat (a.k.a. one more reason your pants won’t button tomorrow).

    Practice portion control with your favorite dessert.

    Most 9-inch pies are meant to be cut into eight slices. If your pie is only sliced into six pieces, your portions are probably too large. One trick if you’re trying to cut back? Tallmadge recommends limiting variety—if there’s only one type of pie to choose from, you’ll probably stick to one slice. Don’t feel like additional ice cream or whipped topping is a requirement, but if you are going to finish a slice off with some, keep it to a golf ball-sized amount.

    Beware sneaky calories.

    You might be patting yourself on the back for bypassing the stuffing and gravy, but if you munched on cheese and crackers all day while cooking, know that those calories add up, as well. If you’re hungry while cooking, nosh on raw veggies and hummus or fruit, suggests Tallmadge.

    Drinks count, too. Many of us have large wine goblets and beer mugs and don’t even know what a proper serving looks like in those glasses. Using a measuring cup if you need to, pour 5 ounces of wine into a glass so you know the line that marks one serving.  “And never refill your wine glass when you’ve had just a few sips,” Ward says. “Drink it to the last drop and then pour some more. That’s how you keep track.”  A serving of beer is 12 ounces, and a serving of 80-proof distilled spirits (like gin, vodka, whiskey) is 1.5 ounces. The American Heart Association recommends limiting daily intake to one drink for women and two for men.

    And remember, the first couple of bites of any food are often the most enjoyable. “Don’t waste your calories, but don’t avoid your favorite foods, either,” Ward says. “Eat foods that you love and that aren’t available at other times of the year, like homemade cranberry sauce, specialty sides, and pumpkin pie, and forgo everyday foods like chips, rolls, and mashed potatoes.”

    This information was originally published on Real Simple’s website.  Click here to view it.

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  • Healthy Thanksgiving Recipes

    Healthy Thanksgiving Recipes >

    Planning your Thanksgiving Feast?  Check out these recipes that pack bold flavors without packing on the pounds!

    Whether you’re following a special diet or just want to take it easy on Turkey Day, try these simple, lighter takes on classic Thanksgiving recipes.  Click here to check out recipes from the Food Network.

    Food &Wine’s best healthy recipes for Thanksgiving include lightened classics that taste indulgent, plus a range of healthy Thanksgiving recipes that don’t rely on fat for flavor.  Click here to check them out.

    Create a healthy Thanksgiving Day menu with these Thanksgiving recipes from the Mayo Clinic.  Click here to view.

    This year, make healthy, fall produce the real star at your Thanksgiving table.  Click here to view recipes on Health.com.

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  • 60% of Adults Prescribed Opioids Have Leftover Pills

    60% of Adults Prescribed Opioids Have Leftover Pills >

    Prescription opioid deaths have quadrupled since 1999, yet even as the heartbreaking effect of the opioid epidemic increases, Americans are holding on to—and sharing—their pills.

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    A Johns Hopkins Bloomberg School of Public Health survey found that 60% of American adults prescribed opioids keep leftover pills, and 1 in 5 reported sharing their medication with someone else.

    “Until recently, we have treated these medications like they’re not dangerous,” said the study’s senior author Colleen L. Barry, PhD, MPP, in ScienceDaily (“Six in ten adults prescribed opioid painkillers have leftover pills” – June 13, 2016). “But the public, the medical community, and policymakers are now beginning to understand that these are dangerous medications and need to be treated as such. If we don’t change our approach, we are going to continue to see the epidemic grow.”

    Barry told Kaiser Health News (“By Sharing Painkillers, Friends And Family Members Can Fuel Opioid Epidemic: Study” – June 13, 2016) that prescribers and the public need to rememeber that prescription opioids “are not like Tylenol — these are highly addictive meds.”

    The US Food and Drug Administration has recommendations for safe disposal of medicine, including drug take-back days.

    The Centers for Disease Control and Prevention (CDC) warns that the United States is in the midst of a “prescription painkiller overdose epidemic” and recommends safe alternatives like physical therapy for most pain management.

    The American Physical Therapy Association launched a national campaign to raise awareness about the risks of opioids and the safe alternative of physical therapy for long-term pain management.

    This information was originally published on the American Physical Therapy Association website.  Click here to view it.

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  • Physical Therapist’s Guide to Rheumatoid Arthritis

    Physical Therapist’s Guide to Rheumatoid Arthritis >

    Rheumatoid arthritis (RA) is a chronic inflammatory disease that affects approximately 1% of the United States population. RA often results in pain and inflammation in joints on both sides of the body, and can become disabling due to its effect on the immune system. A physical therapist can help manage the symptoms of RA, enhancing an individual’s quality of life.

    What is Rheumatoid Arthritis?

    RA is classified as an autoimmune disease—a condition where the body’s immune system attacks its own tissues. Although the exact cause of RA is not known, multiple theories have been proposed to identify who is most likely to develop it. The cause may be related to a combination of genetics and environmental or hormonal factors. Women are more likely to develop the disease; women are diagnosed with RA 3 times more than men. Although RA may begin at any age, most research suggests it often begins in midlife.

    How Does it Feel?

    RA symptoms can flare up and then quiet down (go into remission). Research shows that early diagnosis and treatment is important for easing symptoms and flare-ups.

    People with RA may experience:

    • Stiff joints that feel worse in the morning.
    • Painful and swollen joints on both sides of the body.
    • Bouts of fatigue and general discomfort.
    • Fever.
    • Loss of joint function.
    • Redness, warmth, and tenderness in the joint areas.

    How Is It Diagnosed?

    RA is generally diagnosed by a rheumatologist. Diagnosis is based upon factors, such as inflammation of the tissues that line the joints, the number of joints involved, and blood-test results. A physical therapist may be the first practitioner to recognize the onset of RA; the physical therapist will refer an individual with suspected symptoms to an appropriate clinician for further tests.

    How Can a Physical Therapist Help?

    Physical therapists play a vital role in improving and maintaining function that may be limited by RA. Your physical therapist will work with you to develop a treatment plan to help address your specific needs and goals.

    Because the signs and symptoms of RA can vary, the approach to care will also vary. Your physical therapist may provide the following recommendations and care:

    Aerobic Activities. Studies have shown that group-based exercise and educational programs for people with RA have beneficial effects on individual strength and function.

    Goal-Oriented Exercise. Studies also show that achievement of personal physical activity goals helps reduce pain and increase the general quality of life in people diagnosed with RA.

    Modalities. Your physical therapist may use modalities, such as gentle heat and electrical stimulation to help manage your RA symptoms.

    Can this Injury or Condition be Prevented?

    Unfortunately, the actual mechanisms that cause RA are not completely understood. There currently is no sure way to predict or prevent the onset of RA. However, the early detection of the signs and symptoms will help you and your medical providers begin early management of RA, which may enhance your long-term well-being.

    Upon diagnosis, your physical therapist will work with you to develop strategies to better understand and manage your symptoms.

    As with many conditions, education is key. Understanding the underlying mechanisms of RA, so you can recognize early signs and symptoms (eg, morning stiffness, painful and swollen joints), may help you better manage the condition.

    Above all, it is important to keep moving. Maintaining or increasing your activity levels will help improve your function and maintain a better quality of life.

    This article was originally posted on the American Physical Therapy Association website.  Click here to view it.

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  • 5 Foods You Should Eat This Fall

    5 Foods You Should Eat This Fall >

    Your mom probably never gave you better advice than when she said, “Eat your fruits and veggies.”

    But eating healthy may seem harder come fall, when favorite produce options dwindle and less familiar ones appear.

    Never fear. Now that warm months are gone — and with them the berries, corn and other produce we find easier to incorporate into our diets — a new menu of foods is available to keep you healthy and happy.

    Foods in season during fall may appear less appealing — especially if you aren’t sure how to prepare them, or are feeding a family of less adventurous eaters. But in addition to the nutritional benefits of foods such as Brussels sprouts and sweet potatoes, you’ll find another positive: the exponential number of tasty ways in which they can be prepared.

    Take advantage of the opportunity and think outside the box in your fall food preparation.

    Here are five foods that you should eat this season:

    1.  Pumpkin— Thanksgiving and pumpkin pie are traditionally associated with this fruit, but there are other ways to incorporate pumpkin into your daily life.

    The meat of the pumpkin is worth having more than one day a year thanks to its high percentage of vitamin A, carotenoids and fiber. But pumpkin seeds shouldn’t be overlooked either. The seeds, a great snack, are concentrated sources of vitamins, fiber, minerals and antioxidants. They also contain an amino acid proven to boost your mood.

    Simply roast up some pumpkin seeds and keep them on hand as your go-to fall snack.

    1. Brussels sprouts— Brussels sprouts have seen a recent rise in popularity, and that’s a good thing as their buds are exceptionally rich in protein, dietary fiber, vitamins, minerals and antioxidants.

    Sprouts offer protection from vitamin A deficiency, bone loss and iron-deficiency anemia. They are also believed to help protect against cardiovascular diseases as well as colon and prostate cancer.

    If the taste isn’t for you, try roasting instead of steaming: Roasting Brussels sprouts with a bit of olive oil, salt and pepper caramelizes their natural sugars and brings out a sweetness that you won’t be able to resist.

    1. Pears— When you’re looking for a healthy snack to munch on, turn to a pear.

    One of the highest fiber fruits, pears offer about six grams that’ll help you meet your daily requirement of 25 to 30 grams. A high-fiber diet helps to keep your blood sugar level stable, cholesterol levels down, and is linked to heart benefits as well as a reduced risk of certain cancers.

    Pears also contain vitamins C, K, B2, B3 and B6 in addition to calcium, copper, magnesium, potassium and manganese.

    Pears are easy to incorporate into your fall menu as they’ll add a sweet kick to any dish. Try them on their own, baked or poached, chopped in a salad or in a soup.

    1. Cauliflower— Bored with side salads but want to up the nutritional value of your side dish? Look no further than cauliflower.

    Cauliflower is low in calories with only 26 per 100 grams, and the health benefits are top-notch. A flower head contains several anti-cancer phytochemicals and is an excellent source of vitamin C; 100 grams provides about 80% of the daily recommended value.

    It also has a proven antioxidant that helps fight against free radicals while boosting immunity and preventing infections.

    Fans of mashed potatoes can mash cauliflower instead for an easy alternative with about a quarter of the calories and an equal amount of deliciousness.

    1. Sweet potatoes — Another Thanksgiving classic, sweet potatoes don’t need to be candied to be enjoyed. Full of natural sweetness, nothing tastes better than simply baking them. Top ’em with a dollop of low-fat Greek yogurt and a sprinkle of nutmeg for added enjoyment.

    Sweet potatoes are packed with calcium, potassium and vitamins. A medium-size sweet potato contains more than your daily requirement of vitamin A, nearly a third the vitamin C you need, almost 15% of your daily dietary fiber intake and 10% of the necessary potassium.

    The plentiful antioxidants found in sweet potatoes have anti-inflammatory properties, beneficial to those suffering from asthma or arthritis. You’ll never even miss the candied ones.

    This article was originally published on CNN.com.  Click here to view it.

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  • We’re All Responsible For Our Opioid Reliance—Even Patients

    We’re All Responsible For Our Opioid Reliance—Even Patients >

    Blame our healthcare ecosystem and our quick-fix culture. Opioids are remarkable.

    For the treatment of severe acute pain, opioids can be the key to success. I was once administered opioid treatment, via intravenous injection, for 12 hours after undergoing major surgery. They took the pain away. I could get out of bed, move around and do respiratory therapy. I was out of the ICU in 24 hours. Opioids—briefly—were a key factor in my recovery.

    But for some people, opioids are a little too remarkable. The well-being sensation from a pill prescribed after a surgical procedure can be life-changing. And some patients come back for more. As my mentor told me, prescribing opioid is like an airplane that is easy to take off the ground—but very difficult to land.

    In the U.S., prescription opioid sales have increased 300 percent since 1999—despite no substantial improvement in health and quality of life. Also increasing are overdose deaths. Nearly 30,000 people died from opioids in 2014, the highest on record. More than half involved a prescription opioid.

    This crisis is a failure of our healthcare ecosystem and our quick-fix culture. We can all share the blame: physicians who feel anxious to meet patients’ expectations, pharma companies that oversell opioid benefits (and downplay the risks), insurers that fail to flag patients receiving high volumes of opioid prescriptions (and not properly reimbursing therapy) and patients who demand passive treatment.

    While many are taking positive steps to reverse this trend, the problem will remain severe for years—unless we change a fundamental mindset among physicians, patients, payers and regulatory organizations.

    Metrics—and Incentives—Drive Outcomes

    In order to achieve significant change, we will need to make difficult, possibly unpopular, decisions. We must reconsider metrics and incentives.

    The outcome metrics we share with our patients may not be productive. If we fail to reduce the amount of a patient’s back or leg pain, the patient and I can conclude that treatment was not helpful. But what if the patient can walk more and go back to work despite a moderate pain level? Can we call that success?

    Think of the opposite scenario. What if we succeed in cutting the pain to a three on a one-to-ten scale—but that “cure” is misleading? Even if the pain is erased, the patient may not be active, still dependent and gradually loosing function from inactivity. Could opioids help in the short-term and harm in the long-term? Our crisis indicates that it may.

    We also need to recognize the role incentives play in healthcare delivery. By incentivizing (or punishing) hospitals based on how patients subjectively rate a physician’s effort to control pain, we might unintentionally push providers to start or increase opioid medications.

    And what about patients? Belief in a Magic Pill and a reluctance to exercise, lose weight or eat broccoli is their incentive. Additionally, out-of-pocket payments for physical therapy and counseling continue to be more expensive than medications.

    So what is the incentive to seek active—rather than passive—treatment?

    A (Not So) New Prescription for Pain Management

    An old adage proclaims, Pain is inevitable. Suffering is optional. Certainly, no one likes pain. And those who suffer chronic pain often endure levels of anguish that rob them of life’s many joys. But fighting chronic pain—and focusing exclusively on pain—can become a harmful exercise in futility.

    But there’s a different approach to chronic pain care. The methodology is hardly revolutionary. You might even call it innovation-less.

    In order to change outcomes, we all need to first change the metric of success. That means that in the initial stages of treatment, we become:

    • Less reliant on MRI imaging and procedures;
    • More prudent in prescribing non-opioid medications for long-term treatment;
    • Insistent on the use of physical therapy as an integral treatment component; and
    • Advocates for the use of mental health experts to put pain in perspective, because not everything that hurts harms

    The final point will be the toughest. Despite knowing for decades that pain and behavior are intimately connected, mental health therapy remains taboo for many Americans—which is too bad, because chronic pain will not simply vanish through the surgeon’s scalpel and some magic pills. Managing pain sometimes requires pills and surgery, but it always takes hard work, and the patient must do his or her part.

    The Beginning of a New Program

    A well-structured long-term approach that caters to the right metrics and incentives will reap greater rewards than the quilt of exams and quick-fixes patients have come to expect.

    And the old-school, innovation-less approach is about to be tested. On August 1, the Cleveland Clinic, where I work, launched a large-scale pilot program to treat more than 1,000 patients with chronic back and leg pain. All patients will undergo the same two treatments initially—physical therapy and counseling. And our key metric will be the restoration of function.

    Patients will not be denied surgery, procedures or pain medication if the diagnosis calls for them. But those won’t be our starting point. We will also change the metric for assessing the efficacy of these treatment modalities. Rather than utilizing procedures as the “treatment of last resort,” they will be used as a means to an end. That is, the goal will be to help patients go through physical (and mental) rehabilitation so they can do the activities they used to take for granted: move, care for themselves, work and care for their loved ones.

    Ultimately, this methodology should serve to lessen the community’s reliance on opioids and improve the utilization—and timing—of invasive procedures. If it works, the clinic plans to extend this approach to the treatment of other chronic illnesses.

    Innovative? Hardly. The right course of action? I am convinced that it is. We’ll soon see.

    This article was originally posted on Time.com.  Click here to view it.

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  • Opioid Overload

    Opioid Overload >

    When it comes to back and neck pain alone, 1-2% of patients with low back pain who seek treatment have a serious disorder and require surgery, while 5-10% of patients warrant further investigation through imaging.  That means a whopping 90% of patients suffering from neck and back pain would do best long-term with specific education and intervention with a physical therapist. Too many of these patients are currently being treated with opioids, medical imaging, and surgeries.

    After rapid growth in recent years, the opioid epidemic is now among the leading causes of death in the United States. Opioids, a category of drugs that includes prescription painkillers, killed more than 28,000 people in 2014, with the rate of overdoses tripling since 2000, according to the Centers for Disease Control and Prevention. Almost two million Americans abused or were dependent on these drugs in 2014.

    Although long overdue, the issue is finally moving to the forefront in both federal and state governments. The Senate recently approved a comprehensive bill while the House passed 18 opioid-related bills, and several states have already adopted policies to reduce the prescribing of opioids.

    While the federal government can make the biggest difference by expanding high-quality treatment programs, states, which have more pull over doctors and hospitals, can reduce the prescribing of opioids by encouraging doctors to order alternative pain treatments like physical therapy.

    If you are suffering from musculoskeletal pain, call 866.866.3839 or go online to proactivept1.wpengine.com to set up an appointment with one of PPTS’s expert physical therapists. We’ll come up with a plan to get (and keep!) you healthy, active, and pain free without time-consuming or costly imaging and procedures.

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  • Physical Therapist’s Guide to Osteoarthritis of the Spine

    Physical Therapist’s Guide to Osteoarthritis of the Spine >

    Osteoarthritis (OA) of the spine is a condition that usually occurs with aging and is typically diagnosed after age 50. Its causes include injury to the spine, wear and tear on the discs of the spine (often associated with obesity), or an inherited tendency to develop OA. Sometimes the cause is unknown. OA of the spine may cause pain and stiffness; and make it difficult to bend over, perform weight-bearing activities such as walking, and accomplish daily tasks such as dressing and bathing. Your physical therapist will help you manage your condition, lessen your discomfort, and get moving again.

    What is Osteoarthritis of the Spine?

    As we age, the discs in our spine can wear, begin to bulge, and become narrowed. These changes can put strain on the cartilage, ligaments, and joints at the involved level of the spine and may cause pain. The narrowing of the disc also results in narrowing of the space between the spinal joints, called the “facet” joints. Weight-bearing forces on the joints increase because of these disc changes. As a result, the cartilage covering the joint surface can begin to fray and wear away over time. If your cartilage wears down so that your bones begin to rub together, it can result in enlarged joints, inflammation, stiffness, and pain.

    As OA of the spine progresses, your body will try to repair it by growing new bone. This bony growth is called a “bone spur.” Spur development can result in a condition known as spinal stenosis. Most often this disorder affects men and women over 50 years of age. If the spurs enlarge, they can create a narrowing of the spaces in the spine. The narrowing can involve small or large areas and can result in pressure on nerves near the involved joints, resulting in symptoms that may include pain, tingling, numbness, or burning.

    How Does it Feel?

    Symptoms of OA of the spine vary from person to person and can range from mild to disabling. You may not have symptoms even though the condition is present. Its onset and progression can be quite slow.

    With early or mild disease, symptoms will be intermittent, or come and go. You might feel stiffness or aching after sitting a long time, on waking in the morning, or after vigorous activity. You or your family may notice changes in your posture. Some people will bend forward or shift to the side. With more advanced OA of the spine, symptoms will become more constant and tend to interfere more with your daily activity, especially with walking and standing.

    Common symptoms of OA of the spine include:

    • Pain in the back or neck
    • Pain that is worse after prolonged inactivity, on getting up in the morning, or after physical activity
    • Pain that worsens with standing and walking, and gets better with sitting or lying down
    • Stiffness after prolonged inactivity, on getting up in the morning, or with movement of the involved area of the spine
    • With a more advanced condition, symptoms that do not improve with rest and that interfere with sleep
    • Pain, burning, or tingling sensations that spread to the shoulder or arm, or to the buttocks or leg
    • Difficulty performing normal daily activities, such as dressing and bathing, as well as walking and standing as the condition progresses
    • Pain caused by the weakening of muscles surrounding the joint, due to inactivity

    How Is It Diagnosed?

    Your physical therapist will perform a thorough evaluation and may:

    • Ask specific questions about your past and current health and use of medication
    • Have you complete a questionnaire about how you are functioning in your daily life
    • Ask how your symptoms came about, how long you have had them, where they are located, how and when the pain occurs, and other questions, to form a clear picture of your individual situation

    Your physical therapist will then conduct a physical examination and may:

    • Evaluate your posture and spinal alignment, and measure the range of motion and flexibility of your spine and the extremities (arms or legs) in the involved area
    • Check your nerve function with reflex, sensation, and strength testing
    • Observe how you use your body for home, work, and social/leisure activities
    • Check your balance to determine your risk of falling

    The information learned in your evaluation will help your physical therapist prescribe a program to ease your discomfort, boost your quality of life, and get you moving your best.

    Imaging tests such as x-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) may be requested but are not necessary in every case. However, if your physical therapist suspects that your pain might be caused by an underlying condition, he or she may request testing from your physician and/or refer you to your physician for further evaluation. Your physical therapist will work with your physician to provide the best diagnosis and treatment.

    How Can a Physical Therapist Help?

    Your physical therapist will help you set goals to reduce your symptoms and slow the progression of the disease. You’ll learn how to safely exercise and continue to participate in your normal daily activities.

    Your physical therapist can help with a variety of treatment options, including:

    • Exercise: Exercise is the most important treatment to lessen your pain and improve your mobility. Your physical therapist will prescribe specific low-impact activities that will strengthen your spine, abdomen, and hip muscles—to improve your ability to stand, walk, and balance, and lower your risk of falling.

    Caution: Please consult your physical therapist or doctor before starting any exercise program.

    • Stretching: Your physical therapist will prescribe specific stretching exercises for your spine, arms, or legs based on the results of your initial evaluation. Obese individuals are in special need of stretching and exercises. Combined with strengthening, stretching may help slow the progression of the disease.
    • Symptom management: Symptom management means learning to feel better and remain active. Sometimes people are fearful that increased activity will worsen their symptoms or increase their pain. Your physical therapist will help you learn how to be more active without worsening your symptoms. He or she will help you find your appropriate activity levels, and develop a unique program to keep you moving.
    • Daily activity training: Your physical therapist can teach you how to get in and out of bed, in and out of the bathtub, or out of a chair, and how to bend and walk with more ease.
    • Use of modalities: Treatment “modalities” such as heat or ice may be used to help manage your symptoms.
      • Manual therapy: Your physical therapist may use gentle hands-on techniques (manual therapy) to help improve your spinal flexibility and ease stiffness.
      • Balance and walking training: Exercises and instruction may be used to improve your balance safely,and reduce your risk of falls.
      • Specialized braces or taping:Your physical therapist may use taping or specialized braces to help support your joints. Back bracing is used most in more advanced conditions.
      • Weight control: If you are obese, you are likely to have more spinal impairment in your upper back. Your physical therapist can help you improve your activity levels, and refer you to nutritional experts.

    Remember, all cases of OA of the spine are different. Your physical therapist will choose the best treatment options for you based on his or her evaluation of your specific problem.

    Following Surgery

    The predominant treatment for OA of the spine is non-surgical. However, symptoms that interfere with bowel or bladder function and cause problems with the nervous system may require surgery.

    Immediately after surgery, a physical therapist will visit you in the hospital to help you get out of bed and walk, and possibly use a cane or walker for safety. When adequate healing has occurred, you may be sent for outpatient physical therapy to continue to improve your walking, and to progress your exercise program.

    Can this Injury or Condition be Prevented?

    OA occurs as you age, but is not a direct result of getting older. There are many factors that put you at risk of developing OA, including your family history. Other factors include previous injury, heavy use of your spine over a period of time, and obesity.

    If you are obese, you have a higher likelihood of having OA in the spine. Weight loss is important to lower joint stress, and possibly prevent the onset of OA. If you already have OA, weight loss may prevent worsening of the condition. Exercise and increasing your physical function along with dietary modifications can also decrease your pain.

    Prevention of injuries, especially sports injuries, may prevent the onset of OA. It is important to perform your physical activities or exercises to the point of fatigue, but not to force yourself beyond that point. Regular conditioning and strengthening exercises will improve the ability of your muscles to work, easing the stress on your joints.

    This article was originally published on the American Physical Therapy Association’s website.  Check it out here.

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  • 8 Fall Steps for Healthy Living

    8 Fall Steps for Healthy Living >

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    Give your health a boost this fall with eight tips so simple you’ll hardly know they’re healthy.

    As the days get shorter and the temperatures drop, change is in the air. That’s what makes fall a great time for renewal and fresh starts. It’s time to fine-tune your health by making one or two small changes that yield big results.

    1. Let Beans Be a Part of Your Diet

    If you do one thing to improve your diet this fall, eat 3 cups of beans each week. Besides being a comfort food, beans add flavor and texture to soups, chili, and casseroles. They’re also a great salad topper.

    Beans are rich in protein, iron, folic acid, fiber, and potassium. So pick a bean, any bean — lima, black, garbanzo, pinto, or others — and enjoy.

    2. Defuse Stress With Friendship

    Fall is a good time to come back together after the summer scattering of vacations and busy schedules — a great time to relax with friends.

    Soothe away stress by making contact in person or by phone with someone you care about, someone you haven’t talked to in awhile because life got in the way. The positive emotions will make you feel good, and when joy and stress meet up, the joy wins out.

    3. Be Tender With Your Teeth

    If you do one thing to improve your dental health this fall, turn over a new leaf by ditching habits that are hard on your teeth.

    That means no more chewing on ice or popcorn kernels. Ice is a crystal and tooth enamel is a crystal — when the two meet, one of them has to give. Sometimes it’s the tooth. Popcorn kernels can break teeth or fillings too, and the hull, if lodged in gum tissue, can irritate and cause bacteria buildup.

    4. Have Fun With Fitness

    Improve your fitness this fall: Try a less-conventional workout to spruce up your regimen.

    Break out of your fitness rut by taking a ballroom dance class or a mind-body workout such as yoga, Pilates, or Tai chi. You’ll be energized and more likely to stick with it.

    5. A Checkup: The Eyes Have It

    If you do one thing to improve your vision, take a cue from kids, who often need back-to-school vision exams. Schedule a checkup with your eye doctor.

    A comprehensive exam should include an evaluation of how clearly you see, how well your eyes work together, and an assessment of your overall eye health.

    6. Heart Health: Know Your Numbers

    Give your heart health a boost this fall, capitalize on the seasonal sense of renewal to focus on prevention.

    That means scheduling an appointment with your doctor to get your blood pressure and cholesterol checked, and to see if your bloodglucose levels are healthy. Knowing your numbers will help you figure out your personal risk for heart disease.

    7. Warm Up With Wine

    Diversify your alcohol choice with a room temperature glass of table wine. The warmer drink will take the chill off and the wine, especially red, has heart health benefits.

    Remember a standard size glass of wine is just 4 ounces. Pregnantwomen and others with health reasons who should not to drink should abstain.

    8. Synchronize Your Sleep

    Manage the more demanding fall schedules by synchronizing your internal sleep-wake clock to the outside environment.

    In the morning, get outside within 5 minutes of getting up and expose yourself to bright light for 30 minutes. At night, avoid bright light within two to three hours of bedtime because it might delay your sleep onset. This will keep you alert in the morning and make you sleepy at bedtime.

    It’s time to renew yourself! Try these eight easy health-boosting tips — they’re sure to give you a fresh start this fall.

    These tips were originally posted on WebMD.com.  Click here to check them out.

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  • Physical Therapy Plays a Key Role in Reducing Frequency of ACL Injuries

    Physical Therapy Plays a Key Role in Reducing Frequency of ACL Injuries >

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    For many families, sending your kids back to school also means sending them back out onto the field as fall sports begin. But did you know that according to the Journal of Orthopedic and Sports Physical Therapy and Sports Physical Therapy, as many as 250,000 ACL injuries occur every year in the United States and that the incidence has surged in recent years alongside the spike in youth sports participation?

    No matter how healthy your student is, a quick change in direction on the soccer or football field or a shaky landing following an explosive jump on the volleyball or basketball court can spell trouble. The populations most at risk for an ACL tear are young female athletes—who sustain ACL injuries nearly 10 times more often than males—and young athletes who specialize in a single sport at an early age.

    Many think of physical therapists when it comes to treating ACL injuries, but the latest research shows rehab professionals can play an even bigger role in prevention. A recent American Journal of Sports Medicine study concluded that incidents of ACL injury drop by about 50% at the hands of neuromuscular and educational interventions led by physical therapists.

    Contrary to popular belief, three-quarters of all ACL tears are non-contact injuries, occurring when an athlete cuts, decelerates or jumps. Why are these routine moves so harmful? The biggest culprit is often muscle imbalance. PPTS’s physical therapists, particularly those who have earned their Sports Certified Specialist (SCS) designation, are trained to develop individually tailored programs based on an assessment of your student athlete’s functional deficits in motion, strength, and control. The special program will address strength, flexibility and coordination, and correct existing movement patterns that may be damaging to joints.

    It’s important to remember that regular evaluations with a physical therapist can help identify impairments and reduce the risk of ACL and other injuries. And, there’s a lot at stake: post-operative rehabilitation will set an athlete back nine months on average, delay their return to sport, and in some cases, prevent a return to prior intensity and skill level. Keep your student athlete healthy – go online to proactivept1.wpengine.com today to schedule your complimentary evaluation with one of our experts in sports physical therapy!

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  • World Physical Therapy Day

    World Physical Therapy Day >

    Today is World Physical Therapy Day! World Physical Therapy Day is a yearly event that promotes physical therapy’s contribution to global health and recognizes crucial role the profession makes to keep people well, mobile and independent.

    You’re likely aware that physical therapists can treat a variety of conditions from neck, back, and shoulder pain to carpal tunnel syndrome and Achilles tendinitis, but that’s not all we can do. In honor of World Physical Therapy Day, we’re sharing a few things you may not have known about our profession.

    Intensive Education and Clinical Expertise

    Physical therapists apply evidence-based research and proven techniques to help get you back to life quickly and effectively. Not just anyone is qualified to practice physical therapy, either. All physical therapists are required to receive a graduate degree – either a master’s degree or a clinical doctorate — from an accredited physical therapist program before taking the national licensure examination that allows them to practice and state licensure is required in each state in which a physical therapist practices. We are trusted health care professionals with extensive clinical experience who examine, diagnose, and then prevent or treat conditions that limit the body’s ability to move and function in daily life.

    Each member of our staff completes a minimum of 40 continuing education hours annually to stay at the top of the field, and many are involved in Residency, Fellowship, and Certification programs.

    Professional, Compassionate Care

    In most states, you can make an appointment with a physical therapist without a physician’s referral. Although we are an outpatient practice, physical therapists can provide care for people in a variety of settings, including hospitals, private practices, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes.

    We can diagnose and treat people of all ages, and will work in conjunction with your doctors to help you improve your mobility. Physical therapists are musculoskeletal experts who treat a wide variety of symptoms and conditions, often while reducing the cost of care and avoiding costly surgeries and addictive prescription drugs.

    Your physical therapist will teach you how to prevent or manage a health condition and help motivate you during your treatment so you can function optimally. At your first appointment, your physical therapist will examine you and develop a plan of care using a variety of treatment techniques that help you move, reduce pain, restore function, and prevent disability. They can also help you prevent loss of mobility and motion by developing a fitness- and wellness-oriented program tailored to your specific needs.

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  • 7 Safety Tips for an Injury-Free Labor Day

    7 Safety Tips for an Injury-Free Labor Day >

    Labor Day is synonymous with the end of summer, and the long holiday weekend is upon us. Labor Day is typically packed with celebratory events like backyard barbecues, final excursions to the lake, picnics at the park, and beach parties. But even festive events like these present hazards you should be aware of.
    Whether you’re planning a final summer outing or staying home to wrap up summer chores, we want you and your family to enjoy a safe close to the season. To help you do so, we’ve gathered these helpful Labor Day weekend safety tips.

    1. Road-trip, anyone?

    According to the National Safety Council, nearly 400 deaths result from motor vehicle collisions over Labor Day Weekend. A notorious road-trip weekend, it’s one of the busiest on the road. If you’re planning a weekend excursion make sure you’re well rested, plan for frequent rest stops, and divide driving duties if possible. You should also have your car checked by a registered mechanic to avoid a break down on the road. Don’t forget to pack a vehicle emergency kit that contains items like a flashlight, jumper cables, a tool kit, tire gauge and flares.

    2. Festive Fireworks

    They are fun, flashy and festive, but many of us overlook the injury fireworks can cause. The National Safety Council reports that children 10 to 14 years of age are at three times the risk of being injured by fireworks than the population as a whole. Even sparklers can inflict serious injury. If you choose to use fireworks be sure you only light one at a time, maintain the recommended distance from spectators, and never allow any horseplay while fireworks are being set up or ignited. If a firework malfunctions, don’t re-light it. Above all, never allow young children handle fireworks and never use fireworks while under the influence of drugs or alcohol.

    3. Alcohol in Moderation

    Alcohol and parties often go hand in hand, but beware that drinking impacts your decision making, coordination, reaction time and vision which makes you vulnerable to a number of hazards. If you plan on consuming alcohol, setting a limit on how much you will consume. And the time to set your limit is before you arrive at the neighborhood cookout. Once you set an alcohol limit, stick to it. Drink one glass of water in between alcoholic drinks to help keep hydrated and pace your alcohol consumption. If you drink more than you planned, ask for help getting home. And keep in mind that operating a motor vehicle after just a drink or two is dangerous.

    4. Boating Safety

    Boating is a quintessential Labor Day event. Make sure you keep it safe by ensuring the boat is in good mechanical condition, and carries all safety equipment including personal flotation devices, an emergency kit and a first aid kit. Keep away from restricted areas, be sure that you’re familiar with the rules of the water, and tell someone on land where you’re heading and what time you expect to return.

    5. Conquering Outdoor Chores

    Lots of us look forward to relaxing on Labor Day weekend, but if you’re tackling outdoor chores instead, we hope you’ll keep these safety tips in mind. Before you use any power tool make sure the cord isn’t frayed, that it is free of cuts and appears to be in good condition. If you need an extension cord be sure it is designed for outdoor use. Additionally, be sure that the extension cord’s amperage can handle the demand of the power tool you’re using. Cleaning gutters, trimming trees and painting are just a few common outdoor chores that require a ladder, and ladders are notoriously dangerous. Only use a ladder when there’s someone else at home and if you’re using a metal ladder be careful that it does not come into contact with an electrical source.

    6. Prevent Food-borne Illnesses

    What’s a Labor Day holiday without lots of food? Picnics, barbeques, and neighborhood pot-lucks are plentiful and that means so is the chance of food-borne illness. To minimize the chance of cross-contamination, wash your hands before and after you touch raw meat. Dry your hands on paper towels instead of cloth towels, and discard immediately. Refrigerate meat that’s waiting to hit the grill. Never leave food that requires refrigeration (think potato salad, coleslaw or chicken salad) out in the sun. Instead, set the item the bowl is in on top of a pan filled with ice, and serve from a shaded area. Return the item to the refrigerator as soon as party-goers have been served.

    7. Hydration and sun protection

    Soda and juice might be a bit tastier, but you should hydrate your body with water instead. If you’re having a party, set out a few tubs full of bottled water and encourage your guests to drink small amounts often. Remember the golden rule: If your urine is yellow, you’re not drinking enough water.

    It’s the end of summer, but in many parts of the country the sun is still raging. Apply sunscreen before you head out in the sun and reapply as necessary. Remember that the elderly and the young have especially sensitive skin and don’t forget that some medications can increase your skin’s sensitivity to the sun.

    Whether you’re splashing in a pool, enjoying the ultimate picnic or knocking out those household chores, we want you to stay safe this Labor Day weekend. Remember: An accident is never planned. But keeping out safety tips in mind may help prevent one.

    This information was originally published on SafeWise.com.  Click here to view it.

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  • Using Opioids for More Than 30 Days Could Increase Depression Risk

    Using Opioids for More Than 30 Days Could Increase Depression Risk >

    People who use opioids for 30 days or more in an effort to treat pain could be increasing their risk of developing depression, according to a new study.

    As reported by the Pain News Network (“Long Term Opioid Use May Cause Depression” – January 14, 2016), a study published in the Annals of Family Medicine analyzed data from more than 100,000 patients, who had not been diagnosed with depression prior to being prescribed opioid treatment. “About 10% of them developed depression after using opioids for more than 30 days.”

    Other recent research has examined the dangerous amounts of opioids being prescribed.

    The Centers for Disease Control and Prevention warns that the United States is in the midst of a “prescription painkiller overdose epidemic” and recommends safe alternatives like physical therapy for most pain management.

    The American Physical Therapy Association launched a national campaign to raise awareness about the risks of opioids and the safe alternative of physical therapy for long-term pain management. Learn more at our #ChoosePT page.

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  • Physical Therapist’s Guide to Osteoarthritis of the Shoulder

    Physical Therapist’s Guide to Osteoarthritis of the Shoulder >

    Shoulder osteoarthritis (OA) is a condition that occurs when the cartilage that lines the sides of the shoulder joint is worn or torn away. It may be caused by injury or dislocation of the shoulder, or “wear and tear” of the shoulder over time. Shoulder OA develops most often in people in their 50s and beyond. As people misuse or overuse their joints over time, more cases are seen with each advancing decade of life. However, shoulder OA can also develop in younger people after trauma or surgery to a joint. The condition occurs more frequently in women than men. Physical therapists treat shoulder OA with hands-on therapy and individualized exercise programs.

    What is Osteoarthritis of the Shoulder?

    Shoulder osteoarthritis (OA) occurs when the cartilage that lines the opposite sides of the shoulder joint becomes worn or torn. In the early stages of the condition, small pits develop in the smooth cartilage that lines each side of the joint. Eventually, small protrusions of bone, or “bone spurs” develop at the edges of the joint surfaces. Joint fluid may also accumulate under the cartilage, forming cysts, which can put pressure on the bone and may contribute to pain. In the late stages of the condition, the cartilage can wear away completely, allowing bone-to-bone contact.

    Two bones make up the shoulder joint. The bone at the top of the arm, the humerus, has a round, ball-shaped head, covered in cartilage. The bone on the body side of the joint is the scapula, or shoulder blade. The flat, cartilage-covered surface on the scapula that makes the other half of the shoulder joint is called the glenoid. The 2 sides of the shoulder joint are surrounded and connected by ligaments that control motion in the joint. The ligaments at the front of the shoulder become tightened as OA progresses. In addition, the four main muscles that surround the shoulder, known as the rotator cuff, may be over-used, weaken, or even tear. Rotator cuff conditions occur in about 90% of people with shoulder OA.

    How Does it Feel?

    Shoulder OA may cause you to experience:

    • Pain with activities that relieves with rest
    • Decreased shoulder movement (range of motion), especially when reaching back as if grabbing a seat belt
    • Weakness
    • Stiffness and eventual difficulty using the affected arm
    • Pain at rest and difficulty sleeping as the condition worsens

    How Is It Diagnosed?

    Your doctor may order an x-ray to determine the amount of change in the joint. As the cartilage wears down, it decreases the space between the bones visible on these images. Bone spurs or cysts may also be present. Apparent damage often does not directly correlate with your pain. If there is suspected loss of bone, a CAT scan (computerized topography) may be ordered to get a clearer picture of the area.

    Your physical therapist will ask questions about how the shoulder problem is affecting your life, and what activities are now difficult for you. Describing your pain will help determine the best plan for your treatment. Your physical therapist will evaluate how far the shoulder can move, both as you move your arm and as he or she moves it for you. The examination will include evaluating the strength of the muscles of the rotator cuff and those that support the shoulder blade. The physical therapist may look at your posture and how you perform certain activities and movements to see how they affect your shoulder.

    How Can a Physical Therapist Help?

    Without Surgery

    When someone develops shoulder pain, the first recommended treatment is physical therapy. The following treatments can help decrease pain, improve movement, and allow increased use of your shoulder for daily activities. They may prolong the time until surgery is needed, or help you avoid it altogether.

    • Improving tolerance of daily activities. Your physical therapist will work with you to help you get back to performing your daily tasks. Just changing your posture can reduce the pressure and forces at the joint and help reduce your pain. He or she may recommend the use of physical therapy “modalities” such as heat and cold, teach you about proper movement, and help you modify your activities to control your pain.
    • Improving shoulder mobility. Your physical therapist can recommend ways to restore shoulder movement (range of motion). Stretching can lengthen tight muscles and ligaments, improving your posture and movement. Shoulder-joint mobilization may help improve movement and ease your pain. Your physical therapist may gently move your shoulder (manual therapy), to stretch the ligaments in ways normal stretching or arm motions do not.
    • Improving the strength of your muscles. Strengthening the rotator cuff muscles can reduce the friction caused by the rough arthritic surfaces of the shoulder joint rubbing together. Support from the muscles that maintain your posture can help reduce forces on the shoulder joint.

    Other options for treatment may include medications such as steroids or nonsteroidal anti-inflammatory drugs (NSAIDs). Injections of steroid or anesthetic medications may also help.

    Following Surgery

    There are several surgical options for treating shoulder OA, depending on the degree of damage at the joint and its surrounding structures, and your age, activity level, and occupation.

    Palliative Options: The goal of this surgery is to resolve symptoms; it does not restore or reconstruct the arthritic area. This option is best for people under the age of 65 with minimal cartilage problems, or people in their 20s to 40s with many active years ahead.

    Reparative, Restorative, and Reconstructive Options: Over the last several years, surgeons have developed new “biologic resurfacing” techniques for younger people who have shoulder OA who are not yet ready for total shoulder replacement. Your doctor and physical therapist can describe them in detail for you.

    Total Shoulder Arthroplasty (TSA): Total shoulder arthroplasty is the medical term for a shoulder replacement. This is the best surgical technique for older patients with advanced OA who have good quality of bone at the shoulder joint and intact rotator cuff muscles. This procedure is best for people who do not plan to do high-level activities (overhead work at a job, overhead sports, or significant amounts of heavy lifting).

    Shoulder Hemiarthroplasty: Shoulder hemiarthroplasty is a partial replacement of the joint. It is an option if the muscles that make up the rotator cuff of the shoulder are too weak or damaged to properly support and move the joint.

    Reverse (Inverse) Total Shoulder Arthroplasty (rTSA): This surgery is also an option when the muscles that make up the rotator cuff of the shoulder have failed or are irreparable, or a complex fracture is present.

    Arthroscopy: Many shoulder surgeries can be done via arthroscopy, a less invasive surgery by which the surgeon makes small incisions in the skin and inserts pencil-sized instruments (with a camera) into the joint to repair damage.

    Postsurgical physical therapy varies based on the procedure performed. It may include:

    • Ensuring your safety as you heal. Your surgeon and physical therapist work together as a team to return your shoulder to health. After the surgeon completes his or her work, your work begins. You will perform specific activities and exercises at the correct time to allow for optimal healing. All surgical procedures modify your shoulder joint and surrounding tissues. Restorative and reconstructive options may take several months to heal, with longer precautions.
    • Aiding motion of the shoulder. After surgery, your shoulder will be sore and swollen, and you may not feel like moving your arm. However, gentle motion is often recommended. Your physical therapist may move your arm or assist you in moving your arm to begin to gently restore movement. After some surgeries, movement is restricted during healing; your physical therapist and surgeon will choose the best options for recovery and guide you through the process.
    • Strengthening the shoulder. Due to prior disuse or postoperative pain, your muscles may not be as strong as normal. If the muscle was repaired during surgery, you will have to let it heal for a period of time, and your physical therapist can let you know what activity is safe to help the healing along.
    • Relieving your pain. Using manual (hands-on) therapies and other modalities, your physical therapist can help reduce your pain during exercise and daily activities.
    • Getting back to work and activities of daily living. Returning to work and daily activities may be slow, and your physical therapist will guide you through the process to achieve the best results.

    Can this Injury or Condition be Prevented?

    There is no way to prevent shoulder OA. You may reduce your risk by staying moderately active, keeping the shoulder strong, and keeping the shoulder muscles the appropriate length with stretching. Your physical therapist can help you determine what exercises will keep your shoulder healthy. Eating healthy and exercising will help you manage a healthy weight and healthy joints.  Avoiding injuries to the shoulder joint will help reduce your risk of OA as well.

    This article was originally published on the American Physical Therapy Association website.  Click here to check it out.

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  • Backpack Safety Tips

    Backpack Safety Tips >

    School, backpack, back

    School is just around the corner!  Check out these backpack safety tips from the American Academy of Pediatrics and reach out to us if your student experiences any back issues- we are happy to help!

    • Choose a backpack with wide, padded shoulder straps and a padded back.
    • Pack light. Organize the backpack to use all of its compartments. Pack heavier items closest to the center of the back. The backpack should never weigh more than 10 to 20 percent of your child’s body weight.
    • Always use both shoulder straps. Slinging a backpack over one shoulder can strain muscles.
    • If your school allows, consider a rolling backpack. This type of backpack may be a good choice for students who must tote a heavy load. Remember that rolling backpacks still must be carried up stairs, they may be difficult to roll in snow, and they may not fit in some lockers.

    To view this entire article on the American Academy of Pediatrics website, click here.

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  • Summer Snack Ideas from the American Heart Association

    Summer Snack Ideas from the American Heart Association >

    Fresh berries

    Try some fun and refreshing summer snacks that the entire family can enjoy:

    • Fruit pops: Homemade freezer pops are an easy, fun treat for kids to make. Mash up fruit like peaches, grapes, berries or watermelon and put them in paper cups, insert a popsicle stick, freeze overnight and enjoy!
    • Cool and crisp: keep a variety of colorful veggies on hand that stay cool and crunchy for a refreshing treat – baby carrots, cucumber slices, and celery sticks are just a few ideas.
    • Fruit smoothies: blend your favorite fresh fruits with fat-free or low-fat yogurt and ice for a refreshing drink or freeze and eat with a spoon like a frozen ice chill.
    • Mix it up: make your own trail mix using your favorite unsalted or lightly salted nuts, seeds and unsweetened dried fruits (just be sure to keep your servings to 1.5 ounces or 1/3 cup).
    • Just slice and serve: summer months are peak season for most fruits, just slice and serve – the whole family will enjoy the refreshing natural sweetness and juices just the way nature made ‘em!

    This information was originally published on the American Heart Association Website.  Click here to view it.

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  • Physical Therapist’s Guide to Osteoarthritis of the Knee

    Physical Therapist’s Guide to Osteoarthritis of the Knee >

    Osteoarthritis of the knee (knee OA) is the inflammation and degeneration of the bones that form the knee joint (osteo=bone, arthro=joint, itis=inflammation). The diagnosis of knee OA is based on 2 primary findings: radiographic evidence of changes in bone health (through medical images such as x-ray and MRI) and an individual’s symptoms (how you feel). Approximately 14% of adults aged 25+ and 34% of adults aged 65+ are diagnosed with radiographic osteoarthritis. Specifically, about 16% of adults aged 45+ have knee OA.

    What is Osteoarthritis of Knee?

    Osteoarthritis of the knee (knee OA) is a progressive disease causing inflammation and degeneration of the knee joint that worsens over time. It affects the entire joint, including bone, cartilage, ligament, and muscle. Its progression is influenced by age, body mass index (BMI), bone structure, genetics, strength, and activity level. Knee OA also may develop as a secondary condition following a traumatic knee injury. Depending on the stage of the disease and whether there are associated injuries or conditions, knee OA can be managed with physical therapy. More severe or advanced cases may require surgery.

    How Does it Feel?

    Individuals who develop knee OA experience a wide range of symptoms based on the progression of the disease. Pain occurs when the cartilage covering the bones of the knee joint wears down. This narrows the space between the bones and causes friction. Because the knee is a weight-bearing joint, your activity level, and the type and duration of your activities usually have a direct impact on your symptoms.

    Symptoms of knee OA may include:

    • Worsening pain during or following activity, particularly with walking, climbing, or descending stairs, or moving from a sitting to standing position
    • Pain or stiffness after sitting with the knee bent or straight for a prolonged period of time
    • A feeling of popping, cracking, or grinding when moving the knee
    • Swelling following activity
    • Tenderness to touch along the knee joint

    Typically these symptoms do not occur suddenly or all at once, but instead they develop gradually over time. Sometimes individuals do not recognize they have osteoarthritis because they cannot remember a specific time or injury that caused their symptoms. If you have had worsening knee pain for several months that is not responding to rest, it is best to seek the advice of a medical provider.

    How Is It Diagnosed?

    Knee OA is diagnosed by 2 primary methods. The first is based on your symptoms and a clinical examination. Your physical therapist will ask you questions about your medical history and activity routine. He or she will perform a physical exam to measure your knee’s movement (range of motion), strength, mobility, and flexibility. You might also be asked to perform various movements to provoke the pain you are experiencing.

    The second tool used to diagnose knee OA is diagnostic imaging. Your physical therapist may refer you to a physician, who will order x-rays of the knee in a variety of positions to assess the effect of weight-bearing (walking, standing, etc) on your knee joint. If more severe joint damage is suspected, an MRI may be ordered to look more closely at the overall status of the joint and surrounding tissues.

    How Can a Physical Therapist Help?

    Your physical therapist will design an individualized treatment program specific to the exact nature of your condition and your goals.

    Range of Motion

    Often, abnormal motion of the knee joint can lead to a progression of OA when there is more contact between, and wear on, the bones. Your therapist will assess your motion compared with expected normal motion and the motion of the knee on your uninvolved leg.

    Muscle Strength

    Strengthening the muscles around your knee will be an essential part of your rehabilitation program. Individuals with OA who adhere to strengthening programs have been shown to have less pain and an improved overall quality of life. There are several factors that influence the health of a joint: the quality of the cartilage that lines the bones, the tissue within and around the joints, and the associated muscles. Due to the wear and tear on cartilage associated with knee OA, maintaining strength in the muscles near the joint is crucial to preserve joint health. For example, as the muscles along the front and back of your thigh (quadriceps and hamstrings), cross the knee joint, they help control the motion and forces that are applied to the bones.

    Strengthening the hip and core muscles also can help balance the amount of force on the knee joint, particularly during walking or running. The “core” refers to the muscles of the abdomen, low back, and pelvis. A strong core will increase stability through your body as you move your arms and legs. Your physical therapist will assess these different muscle groups, compare the strength in each limb, and prescribe specific exercises to target your areas of weakness.

    Manual Therapy

    Physical therapists are trained in manual (hands-on) therapy. Your physical therapist will gently move and mobilize your muscles and joints to improve their motion, flexibility, and strength. These techniques can target areas that are difficult to treat on your own. In patients with knee OA, the addition of manual therapy techniques to exercise has been shown to decrease pain and increase function.

    Modalities

    Your physical therapist may recommend therapeutic modalities, such as ice and heat, to aid in pain management.

    Bracing

    Compressive sleeves placed around the knee may help reduce pain and swelling. Devices such as realignment braces are used to modify the forces placed on the knee. These braces can help “unload” certain areas of your knee and move contact to less painful areas of the joint during weight-bearing activities.

    Activity Recommendations

    Physical therapists are trained to understand how to prescribe exercises to individuals with injuries or pain. Since OA is a progressive disease, it is important to develop a specific plan to perform enough activity to address the problem while avoiding increases in stress on the knee joint. Activity must be prescribed and monitored based on type, frequency, duration, and intensity, with adequate time allotted for rest and recovery. Your physical therapist will consider the stage and extent of your arthritis and prescribe an individualized exercise program to address your needs and maximize the function of your knee.

    What if I Need Surgery?

    In some cases of knee OA, the meniscus (shock absorber of the knee) may be involved. In the past, surgery to repair or remove parts or all of this cartilage was common. Current research, however, has shown in a group of patients who were deemed surgical candidates, 60-70% of those who participated in a physical therapy program, instead of surgery, did not go on to have surgery. Further, after 1 year those outcomes were unchanged. This study suggests that physical therapy may be an effective alternative for those patients who would like to avoid surgery.

    Sometimes conservative management strategies are not successful. When these strategies fail surgical intervention such as arthroscopy or a total knee replacement, may be recommended. There are many factors to consider when determining the appropriate surgical treatment, including the nature of your condition, and your age, activity level, and overall health. Your physical therapist will refer you to an orthopedic surgeon to discuss your surgical options.

    This article was originally published on the American Physical Therapy Association website. Click here to view it.

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  • Exercise Your Brain

    Exercise Your Brain >

    A couple months ago we talked about how exercise can help reduce your risk for cancer, but what about your brain? A wealth of information supports the idea that physical activity is good for the brain, but exactly how remains somewhat of a mystery.

    A new study, published this month in the journal eLIFE, suggests that strenuous exercise beneficially changes how certain genes work inside a mouse’s brain. Though the study was conducted with mice, and not people, there are encouraging signs that we’re also seeing similar benefits!

    Scientists have known for years that the brains of both animals and people who regularly exercise are different than the brains of those who are sedentary. For instance, experiments in animals show that exercise induces the creation of new cells in the hippocampus, a part of the brain essential for memory and learning.

    Researchers believe that exercise helps in part by increasing the body’s production of a substance called brain-derived neurotrophic factor (B.D.N.F.), a protein sometimes referred to as “Miracle-Gro” for the brain. B.D.N.F. helps neurons grow and strengthens the synapses that connect them, allowing for better brain function.

    To complete the eLife study, researchers used a group of healthy mice to microscopically examine and reverse engineer the steps that lead to a surge in B.D.N.F. after exercise. Half of the mice were put into cages that contained running wheels, while the others were not. Over the course of a month, those living with wheels ran often, generally covering several miles a day, while the others remained sedentary. B.D.N.F. levels were much higher in the brains of the runners and the particular gene known to create B.D.N.F was more active among the mice that exercised than those that did not.

    Whether the same mechanisms that occur in mice occur in our own brains when we exercise is still unknown. Generally, however, this process requires exerting yourself for an hour or more. If the thought of an hour or more of exercise each day seems daunting, make an appointment at your local PPTS clinic going online to proactivept1.wpengine.com. If you’re ready to begin an exercise routine, one of our expert physical therapists can help ensure your body is strong enough to take on physical activity and help you come up with a plan to get moving!

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  • Tips for a Healthy Road Trip

    Tips for a Healthy Road Trip >

    Family Planning their Driving Route

    Road trips can take a toll on everyone – here are some ideas from the American Heart Association to keep things healthier while on the open road:

    • Make “rest breaks” active: pick a road stop or park and get the family out of the car to take a brisk 10-minute walk and move around. Not only will it burn off some energy, but it can also help the driver feel rejuvenated and more alert.
    • Pack healthy snacks: finding healthier snacks at road stops can be difficult. Pack apples, oranges, grapes, raisins, whole grain fiber-rich crackers or another favorite healthy snack to take with you.
    • Pack to play: plan to incorporate regular physical activity into your daily routine while you’re away from home. Pack a football, soccer ball, Frisbee, or paddle balls so that you can be physically active throughout your downtime.
    • Reach for water: sitting in the car for long periods of time can make it tempting to drink soda, which has extra calories and added sugar. Pack water (flavored or regular), fat free or lowfat (1%) milk and small portions of 100% juice to quench your thirst.

    This information was originally published on the American Heart Association Website.  Click here to view it.

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  • 7 Staggering Statistics About America’s Opioid Epidemic

    7 Staggering Statistics About America’s Opioid Epidemic >

    America’s prescription opioid epidemic is a topic of national news.

    How bad is the problem? Here are some statistics via The Centers for Disease Control and Prevention (CDC), which released guidelines in March 2016 encouraging health care providers to try safer alternatives like physical therapy for most pain management:

    1. In 2012, health care providers wrote 259 million prescriptions for opioid pain medication, enough for every American adult to have their own bottle of pills.

    2. As many as 1 in 4 people who receive prescription opioids long term for noncancer pain in primary care settings struggles with addiction.

    3. Sales of prescription opioids have nearly quadrupled since 1999.

    4. Deaths related to prescription opioids have quadrupled.

    5. Heroin-related overdose deaths more than quadrupled between 2002 and 2014, and people addicted to prescription opioids are 40 times more likely to be addicted to heroin.

    6. More than 165,000 persons in the United States have died from opioid pain-medication-related overdoses since 1999.

    7. Every day, more than 1,000 people are treated in emergency departments for misusing prescription opioids.

    Do you know someone in pain? Encourage them to talk to their physician or physical therapist about safe ways to manage pain.

    The American Physical Therapy Association launched a national campaign to raise awareness about the risks of opioids and the safe alternative of physical therapy for long-term pain management. Learn more at our #ChoosePT page.

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  • Heart Healthy Cookout Ideas

    Heart Healthy Cookout Ideas >

    healthy grilled vegetables on chopping board

    Warmer weather may mean it’s time to break out the grill, here are some tips and ideas from the American Heart Association for a healthier grilling cookout:

    • Go fish! Fish, especially oily fish like tuna and salmon have great nutritional benefits including omega-3 fatty acids. Rub a fillet with lemon juice and parsley or rosemary for enhanced flavor.
    • Make a better burger: if you’re grilling burgers, be sure to buy lean or extra lean beef, drain off the excess fat after cooking and avoid making huge patties – remember that a serving of meat is about the size of a deck of cards (3 oz). Add finely chopped green pepper to your beef to get in some veggies.
    • Baked fries: Slice white or sweet potatoes into sticks, lightly spray with olive oil cooking spray, pepper and paprika and bake on a cookie sheet for 40 minutes at 375 degrees.
    • Veggie kabobs: load up skewers with mushrooms, peppers, cherry tomatoes, zucchini, yellow squash or other veggies. Spray lightly with olive oil cooking spray and grill until slightly blackened.
    • Try grilled corn on the cob: leave the husks on, and grill for about 30 minutes over medium flame, rotating occasionally. Remove from grill, let cool for about 5 minutes, remove husks and enjoy!

    This information was originally published on the American Heart Association Website.  Click here to view it.

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  • Stay Safe on the 4th of July and All Summer Long

    Stay Safe on the 4th of July and All Summer Long >

    woman

    Whether you’re at the beach or in your own backyard, keep in mind that about 90 percent of nonmelanoma skin cancers and about 86 percent of melanomas can be attributed to exposure to ultraviolet (UV) radiation from the sun.

    People heading to the beach should be particularly vigilant, because water reflects up to 10 percent of the sun’s rays, seafoam about 25 percent, and sand about 15 percent, adding to your overall exposure.

    At backyard picnics and barbecues, seek shade under leafy green trees, and schedule Independence Day celebrations when the sun is less intense (before 10 AM and after 4 PM).

    The Skin Cancer Foundation recommends using a broad-spectrum (UVA/UVB) sunscreen with an SPF 15 or higher daily. For extended outdoor activity, use a water resistant, broad-spectrum (UVA/UVB) sunscreen with an SPF of 30 or higher. Sunscreen alone is not enough, however.

    Here is the full list of skin cancer prevention tips, for use July 4th weekend and all year long:

    • Seek the shade, especially between 10 AM and 4 PM.
    • Do not burn.
    • Avoid tanning and UV tanning booths.
    • Cover up with clothing, including a broad-brimmed hat and UV-blocking sunglasses.
    • Use a broad spectrum (UVA/UVB) sunscreen with an SPF of 15 or higher every day. For extended outdoor activity, use a water-resistant, broad spectrum (UVA/UVB) sunscreen with an SPF of 30 or higher.
    • Apply 1 ounce (2 tablespoons) of sunscreen to your entire body 30 minutes before going outside. Reapply every two hours or immediately after swimming or excessive sweating.
    • Keep newborns out of the sun. Sunscreens should be used on babies over the age of six months.
    • Examine your skin head-to-toe every month.
    • See your doctor every year for a professional skin exam.

    With a few simple precautions, you can celebrate Independence Day and enjoy time outdoors without risking your skin’s health.

    This article was originally published on skin cancer.org.  Click here to view it.

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  • Earlier Intervention, Higher Savings

    Earlier Intervention, Higher Savings >

    A recent ConsumerReports.org article noted that doctors oftentimes order more tests, drugs, and surgeries than necessary while sometimes overlooking proven treatments. While the article touched on a couple different underutilized treatments, including the shingles vaccine, we want to expand on our favorite point – physical therapy for low back pain!

    People suffering from a new occurrence of low back pain that were referred to physical therapy within 14 days were less likely to be prescribed painkilling opioids, according to a 2015 BMC Health Services Research study, but only 24 percent of those people actuallyreceived physical therapy within 14 days.

    How does that affect our patients? An estimated 60-80% of the population will suffer persistent back pain at some point in their lives, with 13 million Americans seeing their doctor each year for relief from chronic low back pain. Patients who were referred to physical therapy within 14 days and adhered to their treatment plan spent $3,000 a year in associated healthcare costs. Those who suffered from low back pain and delayed receiving physical therapy or did not adhere to their treatment plan spent double – $6,000 a year in associated healthcare costs.

    PPTS provides early intervention for patients with a wide range of orthopaedic issues including low back pain, which leads to a reduction in costly imaging, prescription drugs, and unnecessary surgeries. Our physical therapists are experts in the management of musculoskeletal disorders and are committed to providing you with superior healthcare from start to finish. If you’re suffering from low back pain and ready to get back to a healthy, active, pain-free lifestyle, go online to proactivept1.wpengine.com today to schedule an appointment!

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  • Physical Therapist’s Guide to Osteoarthritis of the Hip

    Physical Therapist’s Guide to Osteoarthritis of the Hip >

    Hip osteoarthritis is inflammation of the hip joint. It can develop at any age, although it is more commonly diagnosed in older adults. Hip osteoarthritis can make everyday activities such as walking or climbing stairs difficult.

    The Centers for Disease Control and Prevention reports that 25% of all people may develop painful hip osteoarthritis by age 85. There is no known specific cause of the condition; everyone is at equal risk of developing it. Recent research found no difference in the rate of occurrence of hip osteoarthritis in the general public based on race, gender, weight, or educational level.

    More severe cases may require hip joint replacement surgery. Whether or not patients have surgery, however, physical therapists design specific exercise and treatment programs to get people with hip osteoarthritis moving again.

    What is Osteoarthritis of the Hip?

    Hip osteoarthritis is inflammation of the hip joint, a condition that is more likely to develop as people age. Osteoarthritis results when injury or inflammation in a joint causes the soft, shock-absorbing cartilage that lines and cushions the joint surfaces to break down. When the cartilage is damaged, the joint can become painful and swollen. Over time, this condition can cause stiffness and more pain.

    How Does it Feel?

    Hip osteoarthritis may cause:

    • Sharp, shooting pain or dull, achy pain in the hip, groin, thigh, knee, or buttocks
    • Stiffness in the hip joint, which is worse after sleeping or sitting
    • A “crunching”; sound when the hip joint is moved, caused by bone rubbing on bone
    • Difficulty and pain when getting out of bed, standing up from a sitting position, walking, or climbing stairs
    • Difficulty performing normal daily activities, such as putting on socks and shoes

    How Is It Diagnosed?

    If you see your physical therapist first, the therapist will conduct a full evaluation that includes your medical history, and will ask you questions such as:

    • When and how frequently do you feel pain and/or stiffness?
    • What activities in your life are made difficult by this pain and stiffness?

    He or she will perform special tests to help determine whether you have hip osteoarthritis, such as:

    • Gently moving your leg in all directions (range of motion test)
    • Asking you to resist against her hand as she tries to gently push your leg and hip in different directions (muscle strength test)
    • Watching you walk to check for limping
    • Asking you to balance while standing (balance test)

    Your physical therapist may use additional tests to look for problems in other parts of your body, such as your lower back. He or she may recommend that you consult with an orthopedist, who can order diagnostic testing such as an x-ray or MRI, to confirm the diagnosis.

    How Can a Physical Therapist Help?

    Your physical therapist will explain what hip osteoarthritis is, how it is treated, the benefits of exercise, the importance of increasing overall daily physical activity, and how to protect the hip joint while walking, sitting, stair climbing, standing, load carrying, and lying in bed.

    Testing will reveal any specific physical problems you have that are related to hip osteoarthritis, such as loss of motion, muscle weakness, or balance problems.

    The pain of hip osteoarthritis can be reduced through simple, safe, and effective physical activities such as walking, riding a bike, or swimming.

    Although physical activity can delay the onset of disability from osteoarthritis, people may avoid being physically active because of their pain and stiffness, confusion about how much and what to do, and not knowing when they will see benefits. Your physical therapist will be able to guide you in learning a personal exercise program that will help reduce your pain and stiffness.

    Your physical therapist will work with you to:

    • Reduce your pain
    • Improve your leg, hip, and back motion
    • Improve your strength, standing balance, and walking ability
    • Speed healing and your return to activity and sport

    Reduce Pain

    Your physical therapist can use different types of treatments and technologies to control and reduce your pain, including ice, heat, ultrasound, electrical stimulation, taping, exercises, and hands-on (manual) therapy techniques, such as massage.

    Improve Motion

    Your physical therapist will choose specific activities and treatments to help restore normal movement in the leg and hip. These might begin with “passive” motions that the therapist performs for you to gently move your leg and hip joint, and progress to active exercises and stretches that you perform yourself. The physical therapist may use sustained stretches and manual therapy techniques that gently move the joint and stretch the muscles around the joint.

    Improve Strength

    Certain exercises will benefit healing at each stage of recovery; your physical therapist will choose and teach you the appropriate exercises to steadily restore your strength and agility. These may include using cuff weights, stretchy resistance bands, weight-lifting equipment, and cardio exercise equipment such as treadmills or stationary bicycles.

    Speed Recovery Time

    Your physical therapist will design a specific treatment program to speed your recovery. He or she is trained and experienced in choosing the right treatments and exercises to help you heal, return to your normal lifestyle, and reach your goals faster than you are likely to do on your own.

    Return to Activities

    Your physical therapist will design your treatment program to help you return to work or sport in the safest, fastest, and most effective way possible. You may engage in work re-training activities, or learn sport-specific techniques and drills to help you achieve your goals.

    If Surgery Is Necessary

    In severe cases of hip osteoarthritis, the hip joint degenerates until bone is rubbing on bone. This condition can require hip joint replacement surgery. Physical therapy is an essential part of postsurgical recovery, which can take several months.

    If you undergo hip joint replacement surgery, your physical therapist will visit you in your hospital room to help you get out of bed and walk, and will explain any movements that you must avoid to protect the healing hip area.

    He or she will work with you daily in the hospital and then in the clinic once you are discharged. He or she will be an integral part of your treatment and recoveries – helping you minimize pain, restore motion and strength, and return to normal activities in the speediest yet safest manner possible after surgery.

    Can this Injury or Condition be Prevented?

    Hip osteoarthritis may be prevented or limited by keeping the hip and leg muscles strong and flexible, maintaining a healthy body weight, and using proper balance skills. Research shows that strengthening and stretching exercises for the hip, core and leg can minimize and reduce osteoarthritis pain and stiffness, so it is reasonable to conclude that keeping those muscles strong and limber will help prevent painful osteoarthritis symptoms and problems.

    When you seek help once hip osteoarthritis develops, your physical therapist can recommend a home exercise program to strengthen and stretch the muscles around your hip, upper leg, and abdomen to help prevent future hip pain and problems. These may include strength and flexibility exercises.

    This article was originally posted on the American Physical Therapy Association website.  Click here to view it.

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  • We can help alleviate pain, without medication.

    We can help alleviate pain, without medication. >

    After rapid growth in recent years, the opioid epidemic is now among the leading causes of death in the United States. Opioids, a category of drugs that includes prescription painkillers, killed more than 28,000 people in 2014, with the rate of overdoses tripling since 2000, according to the Centers for Disease Control and Prevention. Almost two million Americans abused or were dependent on these drugs in 2014.

    Although long overdue, the issue is finally moving to the forefront in both federal and state governments. The Senate recently approved a comprehensive bill while the House passed 18 opioid-related bills, and several states have already adopted policies to reduce the prescribing of opioids.

    While the federal government can make the biggest difference by expanding high-quality treatment programs, states, which have more pull over doctors and hospitals, can reduce the prescribing of opioids by encouraging doctors to order alternative pain treatments like physical therapy.

    When it comes to neck and back and neck pain alone, only 1-2% of patients with low back pain who seek treatment have a serious disorder and require surgery, while 5-10% of patients warrant further investigation through imaging. That means a whopping 90% of patients suffering from neck and back pain would do best long-term with specific education and intervention with a physical therapist. Too many of these patients are currently being treated with opioids, medical imaging, and surgeries.

    If you are suffering from musculoskeletal pain, call us to set up an appointment with one of OSPTKY’s expert physical therapists. We’ll come up with a plan to get (and keep!) you healthy, active, and pain free without time-consuming or costly imaging and procedures.

     

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  • Are You In Pain? Watch This.

    Are You In Pain? Watch This. >

    If you’re in pain, #ChoosePT. Questions? Call OSPTKY today to learn more or to schedule an appointment with one of our experts in musculoskeletal care – (866) 866-3893.

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  • Tips for Staying Active This Summer

    Tips for Staying Active This Summer >

    The arrival of spring and summer means days at the pool, family picnics, baseball and other outdoor activities. Here are some tips from the American Heart Association to keep your family physically active in the warmer months:

    • Hydrate! Drink plenty of water before, during and after physical activity to avoid dehydration. For low-calorie flavor, add slices of your favorite fruits such as melon, oranges, berries or even cucumber or mint to a pitcher of water and refrigerate for two hours. Read The American Heart Association’s Staying Active in Warm Weather and Staying Hydrated – Staying Healthy information too.
    • Protect your family from the sun: wear wide-brimmed hats, always apply water-resistant sunscreen with at least SPF 15 and reapply sunscreen every 2 hours.
    • Heat safety: avoid intense activities between noon and 3 p.m. when the sun is at its strongest.
    • Dress for the heat: wear lightweight, light colored clothing, choose light, breathable fabrics such as cotton, and wear sunglasses to protect your eyes.
    • Head indoors: when the heat gets unbearable, try indoor activities at your local YMCA or rec center like basketball, swimming, yoga or racquetball.

    This information was originally published on the American Heart Association Website.  Click here to view it.

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  • Healthy Father’s Day Gifts for All Dads

    Healthy Father’s Day Gifts for All Dads >

    Father’s Day is just around the corner, which means it’s time to put on those thinking caps. And don’t even think about getting him a tie—30% of dads report that a tie is what they want least, according to a Families Online Magazine survey. This Father’s Day, impress Dad by knowing just what he wants. Health.com has handpicked healthy gift items for every type of dad (and budget).

    Click here to view health.com’s gift guide.

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  • Physical Therapist’s Guide to Osteoarthritis

    Physical Therapist’s Guide to Osteoarthritis >

    “Arthritis” is a term used to describe inflammation of the joints. Osteoarthritis (OA) is the most common form of arthritis and usually is caused by the deterioration of a joint. Typically, the weight-bearing joints are affected, with the knee and the hip being the most common.

    An estimated 27 million Americans have some form of OA. According to the Centers for Disease Control and Prevention, 1 in 2 people in the United States may develop knee OA by age 85, and 1 in 4 may develop hip OA in their lifetime. Until age 50, men and women are equally affected by OA; after age 50, women are affected more than men. Over their lifetimes, 21% of overweight and 31% of obese adults are diagnosed with arthritis.

    OA affects daily activity and is the most common cause of disability in the US adult population. Although OA does not always require surgery, such as a joint replacement, it has been estimated that the use of total joint replacement in the United States will increase 174% for hips and 673% for knees by 2030.

    Physical therapists can help patients understand OA and its complications, and provide treatments to lessen pain and improve movement. Additionally, physical therapists can provide information about healthy lifestyle choices and obesity education. This is important because some research shows that weight loss can reduce the chance of getting OA. One study showed that an 11-pound weight loss reduced the risk of OA in women.

    What is Osteoarthritis?

    Your bones are connected at joints such as the hip and knee. A rubbery substance called cartilage coats the bones at these joints and helps reduce friction when you move. A protective oily substance called synovial fluid is also contained within the joint, helping to ease movement. When these protective coverings break down, the bones begin to rub together during movement. This can cause pain, and the process itself can lead to more damage in the remaining cartilage and the bones themselves.

    The cause of OA is unknown. Current research points to aging as the main cause. Factors that may increase your risk for OA include:

    • Age. Growing older increases your risk for developing OA because of the amount of time you’ve used your joints.
    • Genetics. Research indicates that some people’s bodies have difficulty forming cartilage. Individuals can pass this problem on to their children.
    • Past Injury. Individuals with prior injury to a specific joint, especially a weight-bearing joint (such as the hip or knee), are at increased risk for developing OA.
    • Occupation. Jobs that require repetitive squatting, bending, and twisting are risk factors for OA. People who perform jobs that require prolonged kneeling (miners, flooring specialists) are at high risk for developing OA.
    • Sports. Athletes who repeatedly use a specific joint in extreme ways (pitchers, football linemen, ballet dancers) may increase their risk for developing OA later in life.
    • Obesity. Being overweight causes increased stress to the weight-bearing joints (such as knees), increasing the risk for development of OA.
    How Does it Feel?

    Typically, OA causes pain and stiffness in the joint. Common symptoms include:

    • Stiffness in the joint, especially in the morning, which eases in less than 30 minutes
    • Stiffness in the joint after sitting or lying down for long periods
    • Pain during activity that is relieved by rest
    • Cracking, creaking, crunching, or other types of joint noise
    • Pain when you press on the joint
    • Increased bone growth around the joint that you may be able to feel

    Caution: Swelling and warmth around the joint is not usually seen with OA and may indicate a different condition or signs of an inflammation. Please consult with your doctor if you have swelling, redness, and warmth in the joint.

    How Is It Diagnosed?

    Osteoarthritis is typically diagnosed by your doctor using an x-ray, but there are signs that may lead your physical therapist to suspect you have OA. Joint stiffness, difficulty moving, joint creaking or cracking, and pain that is relieved with rest are typical symptoms.

    How Can a Physical Therapist Help?

    Your physical therapist can effectively treat OA. Depending on how severe the OA is, physical therapy may help you avoid surgery. Although the symptoms and progression of OA are different for each person, starting an individualized exercise program and addressing risk factors can help relieve your symptoms and slow the condition’s advance. Here are a few ways your physical therapist can help:

    • Your therapist will do a thorough examination to determine your symptoms and what activities are difficult for you. He or she will design an exercise program to address those activities and improve your movement.
    • Your therapist may use manual (hands-on) therapy to improve movement of the affected joint.
    • Your physical therapist may offer suggestions for adjusting your work area to lessen the strain on your joints.
    • Your physical therapist can teach you an aerobic exercise program to improve your movement and overall health, and offer instructions for continuing the program at home.
    • If you are overweight, your physical therapist can teach you an exercise program for safe weight loss, and recommend simple lifestyle changes that will help keep the weight off.

    In cases of severe OA that are not helped by physical therapy alone, surgery, such as a knee or hip replacement, may be necessary. Your physical therapist will refer you to an orthopedic surgeon to discuss the possibility of surgery.

    Can this Injury or Condition be Prevented?

    The best way to prevent or slow the onset of OA is to choose a healthy lifestyle, avoid obesity, and participate in regular exercise.

    This article was originally published on the American Physical Therapy Association’s website.  Click here to view it.

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  • 5 Tips to Healthier Food Choices this Memorial Day Weekend

    5 Tips to Healthier Food Choices this Memorial Day Weekend >

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    Whether you call it a cook out, barbecue, or picnic, this weekend Americans will celebrate the start of summer with a plethora of delicious foods that while tasty, may hold back your plans for a rocking summer beach body.

    It’s obvious that having a salad is much healthier than eating a double bacon cheeseburger, but some of the choices at your family feast won’t be so simple. Following these five easy steps will help you enjoy the delicious food this holiday weekend, and still feel good about yourself the next day. From appetizers to desserts these tips can help you survive the temptation to splurge.

    1. Appetizers: Eat before you go to your family cook out.

    “Eat before you go to your family function,” says Moli Dui personal trainer at , adding that “This way you won’t feel so hungry and are less likely to overindulge.”

    Have some healthy snacks or small meal at home before you leave your house to avoid overeating once you get to that family gathering.

    While easy to serve because all you have to do is open a bag and you’re done, potato chips are probably the most popular snack at any cookout, but also the unhealthiest. A small bag of potato chips can have up to 400 calories depending on the brand. Try substituting almonds, or unsalted plain popcorn as a healthier alternative.

    2. Side dishes: When faced with a tough choice, take the lesser of the evils.

    Baked beans, mac n’ cheese, and potato salad will probably be the three most popular side dishes in America this Memorial Day. Unfortunately, they are also probably the worst for you. None of these are a healthy side dish. It is Memorial Day, so don’t have a little of all of them just have a little of one.

    “If I had to choose one, I would go with the beans.” said Dui. “They offer some protein and are the best of the three.”

    While you may disagree with the acoustic side effects of the baked beans it is the better way to go.

    3. Main course: Try an old favorite with a new twist.

    “Try a hamburger with no bun, and wrapped in lettuce,” says Dui. “I will probably eat a burger like this, but ideally you would want to eat grilled chicken.”

    A typical burger has about 500 calories, without the bun you could cut those calories by about a third. Remember to stick to just one burger patty. Portion size also makes a big difference.

    4. Keep alcoholic drinks to a minimum.

    It’s no secret that beer, margaritas, and daiquiris are filled with empty calories. Even light beer has about 100 calories per serving. If you absolutely must have a drink, try to limit yourself to a couple and no more than one alcoholic drink per hour. Also beware of heavily sugared drinks such as sodas, lemonade, and some fruit juices. Making your own iced tea is a great alternative.

    “Slow down,” says Dui. “Sip, and don’t chug.”

    5. Have some fruit for dessert.

    Watermelon or pineapple make a great dessert and will satisfy your sweet tooth. Watermelon is another staple to any barbecue so choose this for something sweet after your meal instead of having cookies or ice cream.

    Try following at three of these tips this holiday weekend, and your body will thank you when reality sets in on Tuesday!

    This article was originally posted on patch.com.  Click here to view it.

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  • Physical Therapy vs Opioids: When to Choose Physical Therapy for Pain Management

    Physical Therapy vs Opioids: When to Choose Physical Therapy for Pain Management >

    According to the Centers for Disease Control and Prevention (CDC), sales of prescription opioids have quadrupled in the United States, even though “there has not been an overall change in the amount of pain that Americans report.”

    In response to a growing opioid epidemic, the CDC released opioid prescription guidelines in March 2016. The guidelines recognize that prescription opioids are appropriate in certain cases, including cancer treatment, palliative care, and end-of-life care, and also in certain acute care situations, if properly dosed.

    But for other pain management, the CDC recommends nonopioid approaches including physical therapy.

    Patients should choose physical therapy when …

    • … Patients are concerned about the risks of opioid use.
      “Given the substantial evidence gaps on opioids, uncertain benefits of long-term use, and potential for serious harms, patient education and discussion before starting opioid therapy are critical so that patient preferences and values can be understood and used to inform clinical decisions,” the CDC states. Physical therapists can play a valuable role in the patient education process, including setting realistic expectations for recovery with or without opioids. As the CDC guidelines note, even in cases when evidence on the long-term benefits of nonopioid therapies is limited, “risks are much lower” with nonopioid treatment plans.
    • … Pain or function problems are related to low back painhip or knee osteoarthritis, or fibromyalgia.
      The CDC cited “high-quality evidence” supporting exercise as part of a physical therapy treatment plan for those familiar conditions.
    • … Opioids are prescribed for pain. 
      Even in situations when opioids are prescribed, the CDC recommends that patients should receive “the lowest effective dosage,” and opioids “should be combined” with nonopioid therapies, such as physical therapy.
    • … Pain lasts 90 days.
      At this point, the pain is considered “chronic,” and the risks for continued opioid use increase. An estimated 116 million Americans have chronic pain each year. The CDC guidelines note that nonopioid therapies are “preferred” for chronic pain and that “clinicians should consider opioid therapy only if expected benefits for both pain and function are anticipated to outweigh risks to the patient.”

    Before you agree to a prescription for opioids, consult with a physical therapist to discuss options for nonopioid treatment.

    Related Resources:

    This article was originally published on the American Physical Therapy Association website.  Click here to view it.

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  • Did you know? Physical Activity Plays a Greater Role in Obesity Than Caloric Intake

    Did you know? Physical Activity Plays a Greater Role in Obesity Than Caloric Intake >

    Physical activity, not caloric intake, is the bottom line about what happens to your waistline, according to a new study.

    According to an August 2014 article published in the American Journal of Medicine, “Obesity, Abdominal Obesity, Physical Activity, and Caloric Intake in US Adults: 1988 to 2010,” researchers found that while rates of obesity climbed, caloric intake “did not change significantly over time for women or men as a whole, or when stratified by race/ethnicity.” Yet the number of Americans who reported engaging in no leisure-time physical activity tripled, from 15.3% to 47.6%.

    Authors believe that the results lend more support to the Institute of Medicine‘s efforts to link physical activity to obesity reduction. The American Physical Therapy Association strongly supports the promotion of physical activity, and the value of physical fitness to prevent obesity.

    This information was originally published on the American Physical Therapy Association’s website.  Click here to view it.

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  • F.A.S.T Thinking is Key to Detecting the Signs of a Stroke

    F.A.S.T Thinking is Key to Detecting the Signs of a Stroke >

    This photo was originally published on APTA.org.

    This photo was originally published on APTA.org.

    Fewer than 25% of individuals who suffer a stroke arrive at an emergency room within 3 hours of symptom onset. But a recent study published in the American Heart Association’s Stroke journal, suggests that education can improve an individual’s ability to recognize stroke symptoms to reduce the delay in care (“Stroke education aids in symptom recognition, faster responses” – June 11, 2015).

    Stroke is the third leading cause of death in the United States, and is a leading cause of serious, long-term disability in adults. Stroke can happen to anyone at any time—regardless of race, sex, or even age—but more women than men have a stroke each year, and African Americans have almost twice the risk of first-ever stroke than whites do.

    When someone experiences a stroke, the more time that passes, the more damage occurs in the brain. Emergency treatment with a clot-buster drug called t-PA can help reduce or even eliminate problems from stroke, but it must be given within 3 hours of when you start having symptoms.

    Participants in the study received intensive education, but the American Heart Association and American Stroke Association offer a simple method for detecting signs of a stroke: think “F.A.S.T.”!

    F = Face Drooping. Ask the person to smile. Is their smile uneven? Is one side of their face numb?
    A = Arm Weakness. Ask the person to raise both arms. Does 1 arm drift downward? Is 1 arm weak or numb?
    S = Speech Difficult. Ask the person to repeat a simple phrase. Does the speech sound slurred or strange?
    T = Time to call 9-1-1. If you observe any of these signs, even if the symptoms go away, call 9-1-1 and get the person to the emergency room.

    Related Resources:

    This article was originally posted on the American Physical Therapy Association website.  Click here to view it.

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  • Health Center on Opioid Use for Pain Management

    Health Center on Opioid Use for Pain Management >

    Opioids are a classification of drugs that includes hydrocodone (eg, Vicodin), oxycodone (eg, OxyContin), oxymorphone (eg, Opana), and methadone.

    Since 1999, sales of prescription opioids have quadrupled in the United States.

    As sales have skyrocketed, so has abuse, addiction, and overdose. According to the Centers for Disease Control and Prevention (CDC), nearly 2 million Americans abused or were dependent on prescription opioids in 2014, and more than 165,000 people died from related overdose between 1999 and 2014. Meanwhile, use of heroin, an illegal opioid, has also increased.

    In response to the “heartbreaking toll,” in February 2016 President Obama proposed $1.1 billion in new funding to address the national public health epidemic.

    The CDC released guidelines for prescribing opioids for chronic pain in March 2016.

    Symptoms & Conditions

    Explore other symptoms and conditions.

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    Expore other Health Centers for additional resources on exercise, health, and wellness.

    This information was originally posted on the American Physical Therapy Association’s website.  Click here to view it.

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  • Teens Need More Exercise In School

    Teens Need More Exercise In School >

    On school days, young adolescents (12 to 16 years) get 55% of their physical activity on school grounds. But recent research suggests that’s not enough.

    As reported by the Los Angeles Times (“More exercise at school may be key to improving teens’ health” – December 2015), only 8% of students get the recommended 60 minutes of exercise per day. To make up the difference, “a typical school would need to devote 7.5% of its instructional time to physical fitness,” instead of the 4.8% found to be the average in a recent study published in Pediatrics (“Locations of Physical Activity as Assessed by GPS in Young Adolescents” – January 2016).

    “Because adolescents spend so much time at school, even a small increase in the proportion of at-school time spent physically active could lead to meaningful increases in overall physical activity and metabolic health,” the study authors wrote.

    This information was originally published on the American Physical Therapy Association website.  Click here to view it.

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  • 5 Tips to Stay Healthy and Active When Life Gets Busy

    5 Tips to Stay Healthy and Active When Life Gets Busy >

    The following blog post was originally published on RunningRachel.com.  Click here to view it in its original form.

    As a busy mom, I often get asked the question, “How do you stay active while wrestling those monkeys!?”  Okay, they don’t exactly use those same words, but you get the picture.  Staying healthy and active as a woman, wife, mother, and person is key for me to feel good about myself.

    Please keep in mind that I am still working (daily) on these five healthy and active tips.  Be a product of the product and live the advice I share, right?  I am on this same healthy living journey as many of you.  These tips are many which you (and I) have heard before.  They are what works.  We just need to do them that is the key.

    Five tips on how I stay healthy and active.

    1.  Find a group of girlfriends that you can workout with and be active together.  I am currently working out with a group of girlfriends doing a 6 week boot camp style challenge called the Fab5.  We are meeting every Monday morning to workout, be accountable, learn and grow together.  I am looking forward to the growth and change in myself (and my girlfriends) over the next few weeks.

    2.  Make a goal and put it on the calendar.  Do you have a goal of completing a 5K?  Running a half marathon?  Losing a certain number pounds?  Put it on the calendar so you can SEE your goal and make a PLAN to reach your goal!

    3.  Plan your workouts AND meals.  Having a plan is planning for success.  When you plan your workouts for the week, put them in your planner like you would your doctors appointment (or kids sports schedule).  It is there already, work your day around your workout, and do it!

    The same goes for meals.  Plan them.  Grocery shop for the week so when it comes to dinner (or meal) time… you have a plan and food on hand.  No more driving through the drive through or calling for take out.  You have a plan… stick with it.

    4. Record your nutrition.  You bite it you write it.  You drink it you ink it.  This is the hardest for me.  You can always premeasure your food, if you feel the need to do so.  If you ball park it even, that method does work.  Be honest with your recordings.  If you eat it, bite it, lick it, drink it, taste it… write it down.  Your body keeps an accurate food journal of what you eat… whether you choose to write it down or not.

    5.  Focus on your nutrition.  What goes in your body is super important.  Whether you are living a gluten free lifestyle or not, there are amazing products out there that are good for you and taste great also!

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  • 12 Changes You Can Make For Heart Health

    12 Changes You Can Make For Heart Health >

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    These tips and the graphic above were originally published on Jeanette’s Health Living Blog.  Click here to view it.

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  • Exercise Makes Our Muscles Work Better With Age

    Exercise Makes Our Muscles Work Better With Age >

    To keep our muscles healthy deep into retirement, we may need to start working out more now, according to a new study of world-class octogenarian athletes. The study found substantial differences at a cellular level between the athletes’ muscles and those of less active people.

    Muscular health is, of course, essential for successful aging. As young adults, we generally have scads of robust muscle mass. But that situation doesn’t last.

    Muscles consist of fibers, each attached to a motor neuron in our spinal column by long, skinny nerve threads called axons. The fiber and its neuron are known as a muscle unit.

    When this muscle unit is intact, the neuron sends commands to the muscle fiber to contract. The muscle fiber responds, and your leg, eyelid, pinky finger or other body part moves.

    However, motor neurons die as we age, beginning as early as in our 30s, abruptly marooning the attached muscle fiber, leaving it disconnected from the nervous system. In younger people, another neuron can come to the rescue, snaking out a new axon and re-attaching the fiber to the spinal cord

    But with each passing decade, we have fewer motor neurons. So some muscle fibers, bereft of their original neuron, do not get another. These fibers wither and die and we lose muscle mass, becoming more frail. This process speeds up substantially once we reach age 60 or so.

    Scientists have not known whether the decline in muscular health with age is inevitable or whether it might be slowed or altered.

    There have been encouraging hints that exercise changes the trajectory of muscle aging. A 2010 study of recreational runners in their 60s, for instance, found that their leg muscles contained far more intact muscle units than the muscles of sedentary people of the same age.

    But whether exercise would continue to protect muscles in people decades older than 60, for whom healthy muscles might be the difference between independence and institutionalization, had never been examined.

    So for the new study, which was published last week in the Journal of Applied Physiology, researchers from McGill University in Canada and other schools contacted 29 world-class track and field athletes in their 80s and invited them to the university’s performance lab. They also recruited a separate group of healthy but relatively inactive people of the same age to act as controls.

    At the lab, the scientists measured muscle size and then had the athletes and those in the control group complete a simple test of muscular strength and function in which they pressed their right foot against a movable platform as forcefully as possible. While they pressed, the scientists used sensors to track electrical activity within a leg muscle.

    Using mathematical formulas involving muscle size and electrical activity, the scientists then determined precisely how many muscle units were alive and functioning in each volunteer’s leg muscle. They also examined the electrical signal plots to see how effectively each motor neuron was communicating with its attached muscle fiber.

    Unsurprisingly, the elite masters athletes’ legs were much stronger than the legs of the other volunteers, by an average of about 25 percent. The athletes had about 14 percent more total muscle mass than the control group.

    More interesting to the researchers, the athletes also had almost 30 percent more motor units in their leg muscle tissue, and these units were functioning better than those of people in the sedentary group. In the control group, many of the electrical messages from the motor neuron to the muscle showed signs of “jitter and jiggle,” which are actual scientific terms for signals that stutter and degrade before reaching the muscle fiber. Such weak signaling often indicates a motor neuron that is approaching death.

    In essence, the sedentary elderly people had fewer motor units in their muscles, and more of the units that remained seemed to be feeling their age than in the athletes’ legs.

    The athletes’ leg muscles were much healthier at the cellular level.

    “They resembled the muscles of people decades younger,” said Geoffrey Power, who led the study while a graduate student at McGill and is now an assistant professor at the University of Guelph in Ontario.

    Of course, this type of single-snapshot-in-time study can’t tell us whether the athletes’ training actually changed their muscle health over the years or if the athletes were somehow blessed from birth with better muscles, allowing them to become superb masters athletes.

    But Dr. Power, who also led the 2010 study, said that he believes exercise does add to the numbers and improve the function of our muscle units as we grow older.

    Whether we have to work out like a world-class 80-year-old athlete to benefit, however, remains in question. Most of these competitors train intensely for several hours every week, Dr. Power said. But on the plus side, some of them did not start their competitive regimens until they had reached their 50s, providing hope for the dilatory among us.

    This article was originally published on the New York Times website on 3/30/2016 and written by Gretchen Reynolds.  To view it, click here.

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  • Choosing the Right Exercise to Keep Your Bones Healthy and Strong

    Choosing the Right Exercise to Keep Your Bones Healthy and Strong >

    With spring in the air, many of us will respond to the extra hours of sunlight and warmer weather by spending more time exercising. While any type of physical activity is beneficial to our health, it’s important for both men and women to know what type of exercise makes our bones stronger and protects against bone disease.

    Weight-bearing exercise builds bone.

    Our bones are a living, hard tissue composed of a mix of protein and minerals. Not all exercises have the same effect on the density of bone tissue. Only weight-bearing exercises, which stress both your bones and muscles, can stimulate bone formation. While high-intensity strength training with weights is considered the most effective way to strengthen your bones, there are many other weight-bearing exercises that use your own body weight to achieve the same result. These activities include fast walking/jogging/running; hiking hills; yard work, especially mowing the lawn and planting a garden; stair climbing; jumping rope; tennis; and team sports like soccer or basketball. While swimming and cycling are great for cardiovascular health, they are not considered weight-bearing and have little effect on building strong bones.

    I work as a rehabilitation medicine specialist at Montefiore Health System in the Bronx, New York. Diana is a 67-year-old woman who came to me after she fractured her wrist when she slipped on ice. She underwent a physical therapy program to support her healing, improve her range of motion and get back strength in her wrist. Before discharging her from physical therapy, I ordered a bone scan that revealed underlying osteopenia (weak bones) throughout her skeleton. I asked about her normal exercise routine and learned that while before her accident she was swimming two to three times a week, she never worked out with weights and walked a minimal amount every day. Thus, Diana was barely engaged in any weight-bearing activities, which likely contributed to her osteopenia. To help prevent future bone breaks, Diana opted for adding light weight-lifting exercises and daily walking to her routine. During the warmer months, she added gardening, progressed her walking to light jogging and also slowly increased her weight-lifting exercises to avoid any potential injury.

    Exercise slows down bone loss as we age.

    Starting weight-bearing exercises at a young age – adolescence or teenage years – helps build strong bones and decrease the chances of osteopenia or osteoporosis later in life. Osteopenia and osteoporosis can be hereditary and more prevalent among women than men. Also, a small body frame and ethnic origins, either Caucasian or Asian, will place you at greater risk.

    Bone mass density peaks at around age 30. While starting young will reap benefits later in life, it’s never too late to add weight-bearing exercise to strengthen bones.

    Bone tissue is continuously remodeling; new bone tissue is forming, and at the same time, old bone tissue is being removed. Later in life, the process of bone tissue removal is faster than new bone formation. As adults, we lose more bone tissue than we gain, which is why our bones may get weaker and thinner as we age. Exercise is a natural way to slow down the process of weakening of our bones, and there’s no upper age limit to start to exercise to benefit the skeletal system.

    Ensure the safety of exercise.

    While exercise is great for your health, you should speak with your health care professional to make sure weight-bearing exercise is appropriate for you. And prepare to start at lower intensity and progress slowly to more intense exercises over a few weeks. This will help you avoid sprains and strains.

    When exercising indoors, choose free space away from any objects that could potentially present a hazard. For outdoor activity, be mindful that the surfaces are clear of bumps or holes.

    Always wear appropriate athletic shoes, or exercise barefoot if the surface allows. Try to avoid slippery surfaces unless you have the proper gear to prevent or protect against falls.

    Include physical activity in your daily routine.

    Even simple exercises such as walking or stair climbing can help you build strong bones. Try walking instead of driving whenever possible, and choose stairs over elevators.

    Invite your family and friends to participate in your new physical activities. Jumping rope, jogging, high-impact aerobic exercises, dancing and gardening with other people is more fun and will motivate you to stay on track.

    The next time you choose to take a walk, climb a flight of stairs or challenge a friend to a game of tennis, know that you are also doing your bones a favor – and in turn, your stronger bones are helping you.

    This article was originally published on USNews and World Report.  Click here to view it.

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  • Good News: Eating Chocolate Could Be Good for Your Brain

    Good News: Eating Chocolate Could Be Good for Your Brain >

    Craving chocolate? Go ahead and indulge. According to a new study published in the journal Appetite, consuming chocolate on a weekly basis could improve cognitive function.

    The researchers examined the data of 968 participants of the Maine-Syracuse Longitudinal Study (MSLS), which looks at cardiovascular risk factors and cognitive functioning in adults. The participants ranged in age from 23 to 98.

    A Nutrition and Health questionnaire was used to measure the participants’ demographics and lifestyle characteristics, as well as their dietary intake. They self-reported how frequently they consumed a list of foods, including meat, fish, eggs, breads, vegetables, nuts, and chocolate. Their cognitive function was assessed using the MSLS neuropsychological test battery.

    The researchers found that cognitive performance, across a range of cognitive domains, was significantly higher in those who consumed chocolate at least once per week than in those who never or rarely consumed chocolate. These domains include the Global Composite Score, Visual-Spatial Memory and Organization, Working Memory, Scanning and Tracking, Abstract Reasoning, and the Mini-Mental State Examination.

    “The findings suggest that it’s not just a global ability that’s affected by eating chocolate, but also specific abilities are being affected,” said Merrill Elias, one of the study’s authors. “It’s not too surprising to me, because generally when we have these kinds of variables that effect things either negatively or positively, they effect multiple abilities.”

    In a secondary analysis of 333 participants, the researchers considered whether it was cognitive performance that determined chocolate consumption, rather than the other way around. However, there were no significant predictions of chocolate consumption based on cognition. The authors are also planning to conduct a follow-up study that would differentiate between various types of chocolate (dark, milk, white, etc).

    Previous studies have linked chocolate consumption to cardiovascular health benefits and reduced levels of stress, but little has been known about its effects on human cognitive performance—until now. But just how much chocolate should we eat to reap the benefits?

    “We don’t want people to start eating six candy bars a night,” Elias said. “People think, if a little bit is good for me, then a lot is better, but it generally doesn’t work out that way. We’re not looking at people eating chocolate for breakfast, lunch, and supper. We’re saying that if you’re consuming chocolate and you’re doing it sensibly, that may not be bad. It actually may be good for you.”

    This article was originally published on RealSimple.com.  Click here to check it out.

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  • A Quick, Cheap, and Effective Way to Fight Symptoms of Depression and Anxiety

    A Quick, Cheap, and Effective Way to Fight Symptoms of Depression and Anxiety >

    Meditation is good for depression. And so is exercise. But, according to a small new study from Rutgers University, together—in a twice a week regime—they might be better than the sum of their parts.

    For the study, published in Translational Psychiatry, researchers  set out to understand how meditation and exercise would affect depression symptoms for 22 participants with clinical depression and 30 mentally healthy participants. Each participant completed a MAP (mental and physical) behavioral therapy regime twice-a-week for eight weeks: 30 minutes of meditation where they were directed to refocus on breathing if they thought about the past or the future. They then exercised for 30 minutes. At the end of the study, participants reported 40 percent fewer depressive systems and less negative thoughts and overall worrying.

    “We know these therapies can be practiced over a lifetime and that they will be effective in improving mental and cognitive health,” Brandon Alderman, assistant professor at Rutgers University and lead study author, said in a statement. “The good news is that this intervention can be practiced by anyone at any time and at no cost.”

    Not sure how to get started with meditation? Here are six ways to meditate without anyone finding out what you’re doing.

    This article was originally published on RealSimple.com.  Click here to check it out.

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  • 9 Things You Should Know About Pain

    9 Things You Should Know About Pain >

    1. Pain is output from the brain. While we used to believe that pain originated within the tissues of our body, we now understand that pain does not exist until the brain determines it does. The brain uses a virtual “road map” to direct an output of pain to tissues that it suspects may be in danger. This process acts as a means of communication between the brain and the tissues of the body, to serve as a defense against possible injury or disease.

    iStock_000071662255_Small

    2. The degree of injury does not always equal the degree of pain. Research has demonstrated that we all experience pain in individual ways. While some of us experience major injuries with little pain, others experience minor injuries with a lot of pain (think of a paper cut).

    3. Despite what diagnostic imaging (MRIs, x-rays, CT scans) shows us, the finding may not be the cause of your pain. A study performed on individuals 60 years or older who had no symptoms of low back pain found that 36% had a herniated disc, 21% had spinal stenosis, and more than 90% had a degenerated or bulging disc, upon diagnostic imaging.

    4. Psychological factors, such as depression and anxiety, can make your pain worse. Pain can be influenced by many different factors, such as psychological conditions. A recent study in the Journal of Pain showed that psychological variables that existed prior to a total knee replacement were related to a patient’s experience of long-term pain following the operation.

    5. Your social environment may influence your perception of pain. Many patients state their pain increases when they are at work or in a stressful situation. Pain messages can be generated when an individual is in an environment or situation that the brain interprets as unsafe. It is a fundamental form of self-protection.

    6. Understanding pain through education may reduce your need for care. A large study conducted with military personnel demonstrated that those who were given a 45-minute educational session about pain sought care for low back pain less than their counterparts.

    7. Our brains can be tricked into developing pain in prosthetic limbs. Studies have shown that our brains can be tricked into developing a “referred” sensation in a limb that has been amputated, causing a feeling of pain that seems to come from the prosthetic limb – or from the “phantom” limb. The sensation is generated by the association of the brain’s perception of what the body is from birth (whole and complete) and what it currently is (post-amputation).

    8. The ability to determine left from right may be altered when you experience pain. Networks within the brain that assist you in determining left from right can be affected when you experience severe pain. If you have been experiencing pain, and have noticed your sense of direction is a bit off, it may be because a “roadmap” within the brain that details a path to each part of the body may be a bit “smudged.” (This is a term we use to describe a part of the brain’s virtual roadmap that isn’t clear. Imagine spilling ink onto part of a roadmap and then trying to use that map to get to your destination.)

    9. There is no way of knowing whether you have a high tolerance for pain or not. Science has yet to determine whether we all experience pain in the same way. While some people claim to have a “high tolerance” for pain, there is no accurate way to measure or compare pain tolerance among individuals. While some tools exist to measure how much force you can resist before experiencing pain, it can’t be determined what your pain “feels like.”

    Read more about Pain and Chronic Pain Syndromes.

    Author: Joseph Brence, PT, DPT, FAAOMPT, COMT, DAC

    This article was originally published on the American Physical Therapy Association website.  Click here to view it.

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  • Did you know? Physical Activity Plays a Greater Role in Obesity Than Caloric Intake

    Did you know? Physical Activity Plays a Greater Role in Obesity Than Caloric Intake >

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    Physical activity, not caloric intake, is the bottom line about what happens to your waistline, according to a new study.

    According to an August 2014 article published in the American Journal of Medicine, “Obesity, Abdominal Obesity, Physical Activity, and Caloric Intake in US Adults: 1988 to 2010,” researchers found that while rates of obesity climbed, caloric intake “did not change significantly over time for women or men as a whole, or when stratified by race/ethnicity.” Yet the number of Americans who reported engaging in no leisure-time physical activity tripled, from 15.3% to 47.6%.

    Authors believe that the results lend more support to the Institute of Medicine‘s efforts to link physical activity to obesity reduction. The American Physical Therapy Association strongly supports the promotion of physical activity, and the value of physical fitness to prevent obesity.

    Related Resources:

    This article was originally published on the American Physical Therapy Association (APTA) website and this photo is courtesy of the APTA.  Click here to view it.

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  • Preventing Skiing-Related Knee Injuries

    Preventing Skiing-Related Knee Injuries >

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    Planning a trip to go skiing before Spring sets in?  Check out this article from the American Physical Therapy Association for tips on preventing knee injuries.

    The most common injuries in skiing happen to the lower limb, most commonly the knee. The introduction of releasable bindings has decreased the rate of leg fractures by 90% in the past 30 years, but knee sprains (including ACL and/or MCL tears) are on the rise accounting for about 30% of all skiing injuries.

    The most common injury is the medial collateral ligament (MCL) tear, which is typically treated without surgery.  In skiing, the MCL is often torn when the ski tips are pointed toward one another in a snowplow position (the common slow or stop position) and the skier falls down the hill. MCL tears are more common among beginning and intermediate skiers than advanced and elite skiers.  When skiing you may prevent an MCL tear by:

    • Making sure that your weight is balanced when you are in the snowplow position.
    • Sticking to terrain that is a comfortable challenge but not overwhelming.

    The second most common injury is the anterior cruciate ligament (ACL) tear. Given the importance of the ACL to the functional stability of the knee, ACL tears often require surgery (however in some cases patients can avoid surgery). ACL tears are common in sports, but most of them are the result of “non-contact” injuries.

    There are two ways that skiers most commonly tear the ACL:

    • Landing a jump in poor form. When skiers land from a jump with their weight back, so the back of the boot is pushing on the calf, the force from landing can tear the ACL.  The best way to avoid this injury is to learn to land safely, with your weight forward, by starting with simple jumps and gradually advancing to more difficult jumps.
    • The “phantom foot” phenomenon often happens when skiers try to stand up to prevent an unavoidable fall. As the skier falls, all the weight goes on the outside of one ski, and the arms and trunk rotate away from that leg. When a skier falls into this position, an ACL injury is often the result. Avoid this position by never trying to stand up during a fall and accepting an unavoidable fall. Skiers should “go” with the momentum of a fall and maintaining good ski technique.

    Preventing injury on the slopes

    • Remember the keys to effective skiing technique: hands and weight forward, legs parallel, and hips, knees, and ankles flexing equally.
    • Stay on marked trails: Going off trail can take you into ungroomed territory with many possible obstacles (such as trees and rocks) that can contribute to injuries.

    Getting ready for the slopes:

    • Prepare your body. A few simple exercises (listed below) can prepare your core and lower extremities for skiing. Three to four weeks of aerobic training such as walking, elliptical, or biking can be excellent ways to help you tolerate a full day on the slopes.
    • Ensure you have proper equipment: Make sure ski boots, bindings, and ski length are fit and appropriate for your height and skill level. Wear a helmet. Wrist guards are a good idea if snowboarding.
    • Learn proper technique: Take a skiing technique class with a professional before you hit the slopes.
    • Rest: If you are tired, rest.  Injuries happen more commonly when skiers are fatigued.

    Click here to view exercises to condition your core and lower extremities.

     

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  • Stand Up Straight

    Stand Up Straight >

    Has anyone ever told you, “Stand up straight!” or scolded you for slouching at a family dinner? Comments like that might be annoying—but they’re not wrong. Your posture is the foundation for every movement your body makes and can determine how well your body adapts to the stresses on it. Murat Dalkilinç gives the pros of good posture in the video below.

    Make sure to contact OSPTKY today if you could use some additional help- our physical therapists are experts in this area!  Click here to check out all of our convenient locations.

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  • 5 Ways to Prepare Your Body for Pregnancy

    5 Ways to Prepare Your Body for Pregnancy >

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    Ensure that your body is ready to carry a baby by addressing before pregnancy any pain or problems associated with posture or weakness. Here are some physical therapist tips for helping to prepare your body for pregnancy and to guard against musculoskeletal pain and dysfunction during and after it.

    1. Strengthen your pelvic muscles. To strengthen your muscles, use pelvic floor contractions (commonly referred to as Kegels), which involve gently squeezing the sphincter muscles (rather than the buttocks and thighs). These tightening exercises help prevent leakage when a woman sneezes, coughs, etc, and also can help reduce pelvic pain during pregnancy. However, many women do Kegels incorrectly (perhaps because muscles are too tight and need to be relaxed before strengthening). Doing Kegels incorrectly can worsen conditions such as incontinence, pelvic pain, and even low back pain. This is why it is important to consult a women’s health physical therapist before beginning an exercise program. Physical therapists who specialize in women’s health can instruct women in how to perform these exercises safely and correctly.

    2. Prepare for “baby belly” by focusing on your core. Core exercises can help prevent diastasis recti —abdominal muscle separation. As your belly grows, the abdominal muscles that run vertically along either side of the belly button can be forced apart, like a zipper opening. If these abdominal muscles separate from each other too much, the result can be low back pain, pelvic pain, or other injuries as your body tries to compensate for its weaker core. This also can result in the postpregnancy “pooch” many women find undesirable.

    Some exercises, such as sit ups, increase the likelihood of developing diastasis recti, incontinence, and back pain during and after pregnancy. It is important, therefore, to work with your physical therapist on the right exercise strategy for establishing a strong core.

    3. Take a breath! Learning proper breathing and relaxation techniques from your physical therapist will help prepare your body and mind for a healthy pregnancy. It is important to learn to properly exhale before performing any exercise. With proper technique, your core and pelvic floor muscles will contract automatically, and this will lead to optimal stability and injury protection.

    4. Begin a regular fitness routine. Exercise will help reduce the amount of cortisol (stress hormone) in your body and will boost your muscle and cardiovascular strength—strength you’ll need to carry that extra baby weight. Once you become pregnant, consider engaging in relatively low-impact activities, such as swimming, walking on even surfaces, biking, or using an elliptical machine. Runners should be aware that loosening of their ligaments may make them more susceptible to knee and ankle injuries. Also, when the muscles and ligaments that support a woman’s pelvic organs weaken, the repetitive jarring of running can cause these organs to descend. This is known as pelvic organ prolapse. Physical therapists strongly recommend that, to prevent this condition, women wear undergarments that offer pelvic floor support, or compression shorts that support the pelvic floor, both during and after pregnancy.

    5. Practice good posture. Poor posture can have a major effect on every part of your body, particularly with regard to pain during pregnancy. A physical therapist can evaluate your posture and suggest muscle-strengthening exercises and lifestyle education (such as not sitting at a desk for long periods, and carrying grocery bags properly). Establishing healthy posture habits—pre-baby—will better prepare your body for the extra weight of pregnancy and lessen your chances of low back and pelvic pain.

    Acknowledgement: Marianne Ryan, PT, OCS

    This article was originally posted on the American Physical Therapy Association website.  Click here to view it.

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  • Workplace Wellness

    Workplace Wellness >

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    Working at a computer work station all day can take a toll on the body. Repetitive activities and lack of mobility can contribute to aches, pains, and eventual injuries.

    Sitting at a desk while using the keyboard for hours on a day to day basis can result in poor circulation to joints and muscles, it can also create an imbalance in strength and flexibility of certain muscles, and muscle strain. These issues can be easily remedied by taking frequent short breaks, or “micro breaks,” throughout your day.

    • Get out of your chair several times a day and move around—even for 30 seconds
    • Roll your shoulders backwards
    • Turn your head side to side
    • Stretch out your forearms and your legs

    Additionally, specific guidelines for your work station can help maximize your comfort and safety.

    Your chair should have the following:

    • Wheels (5 for better mobility)
    • The ability to twist freely on its base
    • Adjustable height
    • Adjustable arm rests that will allow you to sit close to your desk
    • Lumbar support
    • Seat base that adjusts to a comfortable angle and allows you to sit up straight

    The position of the keyboard is critical:

    • The keyboard should be at a height that allows you to have your forearms slightly below a horizontal line—or your elbows at slightly more than a 90 degree angle.
    • You should be able to slide your knees under the keyboard tray or desk.
    • Avoid reaching for the keyboard by extending your arms or raising your shoulders.
    • Try to avoid having the keyboard on top of your desk. That is too high for almost everyone—unless you can raise your seat. The elbow angle is the best test of keyboard position.

    The position of your computer monitor is important:

    • The monitor should be directly in front of you.
    • The top of the monitor should be at your eye level, and at a distance where you can see it clearly without squinting, or leaning forward or backward.
    • If you need glasses for reading, you may need to have a special pair for use at your computer to avoid tipping your head backward to see through bi-focals or other types of reading glasses.

    How can a physical therapist help?

    Many physical therapists are experts at modifying work stations to increase efficiency and prevent or relieve pain. Additionally, if you are experiencing pain that isn’t relieved by modifications to your work station, you should see a physical therapist who can help develop a treatment plan to relieve your pain and improve your mobility.

    Click here to check out videos of exercises you can do in the workplace.

    This article was originally published on the American Physical Therapy Association website.  Click here to view it in its original form.WorkPlaceWellness-250x300

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  • They Call it Prehab: Starting Cancer Patients on Rehab Before Treatment

    They Call it Prehab: Starting Cancer Patients on Rehab Before Treatment >

    Cancer patients who start rehabilitation before they begin treatment may recover more quickly from surgery, chemotherapy or radiation, some specialists say. But insurance coverage for “prehabilitation,” as it’s called, can be spotty, especially if the aim is to prevent problems rather than treat existing ones.

    It seems intuitive that people’s health during and after invasive surgery or a toxic course of chemo or radiation can be improved by being as physically and psychologically fit as possible going into it. But research to examine the impact of prehab is only in the beginning stages.

    Prehabilitation is commonly associated with orthopedic operations such as knee and hip replacements or cardiac procedures. Now there’s growing interest in also using prehab in cancer care to prepare for treatment and minimize some of its potential long-term physical impairments, such as heart and balance problems.

    “It’s really the philosophy of rehab, rebranded,” says Samman Shahpar, a physiatrist at the Rehabilitation Institute of Chicago. (Physiatrists are doctors who specialize in physical medicine and rehabilitation.)

    The main component of cancer prehab is often a structured exercise program to improve the patient’s endurance, strength or cardiorespiratory health. The clinician establishes baseline measurements, such as determining how far a patient can walk on a treadmill in six minutes, and may set a goal for improvement. He also evaluates and addresses physical impairments, such as limited shoulder mobility, which could be problematic for a breast cancer patient who will need to hold her shoulder in a particular position for radiation. Depending on the program, patients may also receive psychological and nutritional counseling or other services.

    Some early research suggests prehab may improve people’s ability to tolerate cancer treatment and return to normal physical functioning more quickly. In one randomized controlled trial, 77 people who were awaiting surgery for colorectal cancer participated in an exercise, relaxation and nutritional counseling program. Half went through the program in the four weeks before surgery and half in the eight weeks after it.

    Eight weeks after their surgery, 84 percent of prehab patients had matched or exceeded their baseline performance on a six-minute walking test, compared with 62 percent of rehab patients.

    “Prehab could be a relatively cheap way to get people ready for cancer treatment and surgery, both of them stressors,” says study co-author Francesco Carli, a professor of anesthesiology at McGill University in Montreal.

    More study is needed to determine whether prehab actually improves cancer patients’ outcomes, experts say.

    “There are some physiatrists who don’t believe in prehab,” says Catherine Alfano, vice president of survivorship at the American Cancer Society. “They feel like the science isn’t there yet.”

    Insurance plans typically cover rehabilitation services such as physical therapy and occupational therapy. But patients can face coverage problems such as preauthorization requirements and limits on visits.

    This article is produced through a collaboration between The Washington Post and Kaiser Health News, an editorially independent news service that is a program of the Kaiser Family Foundation. Click here to view it in its original form.

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  • Here’s How Much You Should Stand Each Day

    Here’s How Much You Should Stand Each Day >

    We know that the amount of time we spend sitting each day wreaks havoc on our health, and in a new paper, researchers show that spending just two hours standing or moving around instead of sitting may have a real positive impact on our health.

    In the new study published Thursday in the European Heart Journal, researchers had 782 men and women wear activity trackers 24 hours a day for seven days. The monitors tracked how much time the men and women spent stepping, sitting, standing, sleeping or lying down. The participants also provided blood samples and other measurements like blood pressure and weight.

    With the data gathered from the trackers, the researchers used a mathematical model to estimate how the allotted time in each condition would impact the men and women’s health. Interestingly, they found that spending two extra hours a day standing instead of sitting was linked to better blood sugar levels and lower levels of fat in the blood (triglycerides). Specifically, more time spent standing was associated with a 2% lower average blood sugar levels and a 11% lower levels of triglycerides. Cholesterol levels showed improvement as well.

    The findings also showed that spending an extra two hours moving instead of sitting was linked to a significant lower body mass index (BMI) and waist circumference.

    The study cannot definitely prove that these tweaks to the amount of time spent sitting directly causes improvements in health markers, but the researchers note that the findings do fall in line with what’s known about the impact on the body of being active (or at least not being sedentary).

    More research is still needed, but the findings support the longstanding advice that moving around is better for our health than lounging around, and suggest that any decisions to purchase a standing desk are not made in vain.

    This article was originally posted on TIME Magazine’s website.  Click here to view it.

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  • LET WHO PUT WHAT WHERE? FINDING A CURE FOR PELVIC PAIN

    LET WHO PUT WHAT WHERE? FINDING A CURE FOR PELVIC PAIN >

    My condition first presented as a harm- less, if painful, urinary tract infection. I was on a work getaway in the New England woods, far from my regular doctor, when the symptoms began. “I just need some antibiotics,” I told the regional clinic’s nurse-practitioner. I’d had many UTIs in the past, I assured her. I knew what they felt like, and they felt exactly like this. Nonetheless, she insisted on testing my urine. She returned to the exam room, perplexed. She’d found no bacteria, she said, but wanted to send my sample to another lab. “If that test also comes back negative, you might have interstitial cystitis.” She gave me some handouts about “IC,” and refused to write me a prescription for antibiotics until she received my lab results in two days. Two days? Had this woman ever had a UTI? The burning pain, as anyone who has had one knows, impedes your every waking millisecond. Your consciousness relocates to your crotch. A friend of mine—a doctor, in fact—suffered UTI-like burning for months before he had surgery to correct a problem with his urethra. Afterward he told me, “I’d rather cut off one arm than experience that pain again.”

    Later that night, I looked through the IC information the nurse-practitioner had given me. IC is a chronic inflammation of the bladder wall. No one knows why you get it, and there is no cure or treatment. There is no reliable way—or sometimes no way at all—to relieve the pain. Do not read those handouts! I admonished myself. You have a UTI!

    I did not have a UTI. The culture came back negative. According to the nurse and her pamphlets, all signs were pointing to the cystitis. In a panic, I called my doctor in New York; New York doctors have cures for everything. “You’ll just have to ride it out,” my GP said when I described my symptoms and the preliminary diagnosis. “If women ruled the world, we might have a cure for interstitial cystitis,” he said, sighing. “But they don’t.”

    Happy times. I turned to the Internet for solace. I learned that diet can cause “flares,” i.e., more intensely painful episodes. I learned that sex can cause flares (not that sex interested me). I spent the next few days weeping in the woods about all the sex I should have had. Why had I ever claimed I was “too tired”? What was wrong with me? I had a perfectly good vagina back then, why hadn’t I used it more?

    Not that the problem was my vagina. Or, well, not exactly. A week after my first symptoms appeared, I returned to New York City and began the testing hell of “diagnosis by exclusion.” IC is a diagnosis you receive by not receiving any other. One by one, my urologist crossed off the alternatives—not kidney stones, not a yeast infection. Soon we were left with just one grim option: bladder cancer. But my bladder-cancer test was more than a week away, and even a day in chronic-pain terms might as well be a decade. I asked my urologist if, in the meantime, I might start some of the treatments she’d suggested I could try to “lower my pain baseline” if I proved to have the condition. One was acupuncture. (You know you’re in uncharted medical territory when your Western doctor cites acupuncture as your best pain-relief option.) The other was pelvic- floor physical therapy. She didn’t tell me what it entailed; I didn’t ask. I was too desperate to be curious.

    Which meant that I walked in to my first appointment without the slightest clue what I’d encounter. Would I have to take off my clothes? Yes, I would. Would I have to allow a woman to put her rubber-gloved hand inside my vagina and reach so far into it that I was pretty sure she’d entered a hidden compartment that no longer qualified as “my vagina”? Yes to both. Yes to anything, if it would get me out of pain. Prior to this, I thought of myself as—had even bragged about being—a person with a high pain threshold. I’d stoically endured regular migraines for more than 30 years; I’d had two natural childbirths. But this burning around my urethra (and clitoris) stripped me of my identity. I became nothing but a nerve-ending receptor. During my darkest hours, I’d been reduced to scary math. How many years must I live this way? How old must my children be before my suicide won’t psychologically destroy them?

    While I lay on the exam table, my therapist, Sarah Emannuel, explained that the pelvic floor is like a braided hammock of muscles suspended beneath your pelvic bone. Because quarters are so close down there—your urethra, your vagina, and your bowel are all near neighbors—the pelvic-floor muscles, when they misbehave, can disrupt the normal functioning of all three.

    She conducted a thorough interview involving everything from my reproductive history to my diet to my sleep patterns. She asked me to describe the pain and where it was located. I still felt the burning, but I’d also developed a terrible, raw ache on the inside right wall of my vagina, almost like a contusion caused by the rough sex I definitely wasn’t having. “That doesn’t sound like IC,” she said of this last symptom. Emannuel put her hand inside me, touching my hip bone from the inside. She then hooked her fingers under my pelvic bone to access the soft tissue be- neath. “That’s it!” I said. Using her fingers, she pushed firmly into the spot. I felt as if I’d been temporarily sprung; the sensation was akin to the relief you feel after your tight shoulder muscles are given an almost painfully intense massage. I left her office in a daze. She hadn’t confirmed anything, diagnostically speaking, but she had assured me that IC really was very rare.

    And after two sessions, Emannuel was fairly certain I did not have it. (Of all the patients who’ve come to her with a diagnosis of IC, only one, she believes, really had it; another therapist I spoke with agreed that IC is overdiagnosed by doctors.) What I definitely did have was pelvic-floor dysfunction (PFD) and, more specifically, a “trigger point”—a tight and spasming muscle—in my pelvic floor, for which there are a number of possible causes. PFD is a broad category that covers a wide range of conditions such as incontinence, irritable bowel syndrome, and discomfort during sex. My trigger point might have been caused by doing Kegel exercises either obsessively or incorrectly (nope), or a past trauma to the area (not that I could recall), or pregnancy/childbirth (in my case, too long ago to be the culprit), or obesity (no). Trigger points also can be due to stress (bingo). People hold tension in their pelvis, just like they do in their shoulders or back.

    My visits to Emannuel involved a few different treatments. First, she used her hand to massage the muscle from the inside. Then from the outside she massaged my entire right side below my waist. She gave me homework: I had to lie on a hard surface with a tennis ball under my right buttock and do deep-breathing exercises to help me relax, and I needed to pay attention to whether I was holding tension in my pelvic floor and, if so, release it.

    As marginal or strange as pelvic-floor physical therapy might sound, it became clear to me quickly that it shouldn’t be viewed as a wacky last-ditch effort to solve a rare problem. The problem, for starters, is common. The National Institutes for Health notes that one in four American women suffers from a pelvic- floor issue at some point in her life. It’s also important to understand that the therapy isn’t just for post-pregnancy incontinence problems. (This was the natural assumption made by friends whom I told about my condition; it was a pleasure to correct them by saying, “Actually, the problem is that my vagina is too tight,” even if that wasn’t technically true.) According to Amy Stein, author of Heal Pelvic Pain and founder of Beyond Basics Physical Therapy in Manhattan (its tagline, “We Go Above and Beyond!,” might be more apt if it were, “We Go Below and Beyond!”), more than 90 percent of her patients have the opposite of muscle weakness. Instead, they have muscle tension that impairs bladder and bowel functions and causes sex-related pain or discomfort. “If you have pelvic pain, if your doctor keeps giving you antibiotics and telling you that you have a yeast or a urinary tract infection—if you keep going back, and you keep getting the same answer—it’s worth consulting a pelvic-floor physical therapist,” she says, then ticks off a list of symptoms that might warrant seeing one, including a diagnosis of irritable bowel syndrome, having to pee all the time (or just feel- ing like you have to; I was shocked to learn that a person with a healthy bladder should pee only once every two to three hours), or experiencing pain in or around the outside of your vagina just before, during, or after sex.

    The therapy has been around only since the late ’90s. Stein first encountered the trailblazers of the profession as a physical-therapy graduate student, when the mother of her then boyfriend developed a bladder infection following a hysterectomy. Months later, the woman’s bladder and lower-back pain persisted. Stein asked one of her professors what he thought the cause might be.

    “My school did problem-based learning,” she said. “My professor asked me, ‘What do you think it is?’ ”

    Stein laid out her books and concluded, based on the pain’s location, that it was related to the muscles in the pelvic floor. She spoke with a urologist, who recommended she consult a therapy group that specialized in pelvic-floor is- sues. In 2001, she began studying with Holly Herman, who, along with Kathe Wallace—both women are pioneers of the therapy—founded the Herman & Wallace Pelvic Rehabilitation Institute in Seattle. (Stein cites Rhonda Kotarinos as another early advocate—Kotarinos worked in a hospital and witnessed how women were sent home after childbirth with unaddressed pelvic-floor issues, such as sloppy stitching after episiotomies that would lead to excessive scar- ring and a future life of painful sex.) When Stein graduated, she worked for a sports-orthopedic practice. She started introducing pelvic-floor work and within two years had enough clients to open a dedicated practice.

    For many women with pelvic pain, finding treatment is complicated by the fact that the problem is with such a culturally sensitive part of the body. How many people will you buttonhole about your troublesome vagina in hopes that you’ll encounter someone who’s had a similar experience? Probably not too many. Also, doctors are not as informed or sensitive as they might be. Let’s take my own ob-gyn as an example. Al- though she’s part of a respected Manhattan practice on Central Park West (i.e., a fancy address), she’d never heard of pelvic-floor physical therapy. Assuming I was referring to a treatment for urinary incontinence, she said she sends her patients with “pelvic-floor” problems to urologists. When I asked about is- sues involving the vagina—painful sex, for example—she said, “Oh, you mean vulvodynia? That’s a hard one.” (Vulvodynia is excruciating pain in the vulva.) There’s no cure, she said; instead doctors try to treat the condition with surgery, nerve cauterization, and drugs. When I told her that she really should look into pelvic-floor physical therapy for her patients, and that many of them might be helped through less-invasive means, she said, running out the door, “Interesting, leave the info with my receptionist!”

    As Andrew Goldstein, MD, director of Centers for Vulvovaginal Disorders, writes in his foreword to Stein’s book, even as recently as the 1990s medical schools didn’t consider physical therapy of any kind to be a first line of defense (surgery and medication were the immediate treatments; therapy aided recovery), and ob-gyns in general weren’t interested in pelvic-floor issues. Goldstein says that of the 20,000 hours of studying he did as an intern and a resident of obstetrics and gynecology, only one hour was devoted to vulval pain and sexual dysfunction. He also notes that women who suffered pain during sex were thought to be responding psychologically to a past sexual trauma. The problem was not in their vaginas; the problem was in their heads.

    Emannuel told me of a girl suffering from vulvodynia who, despite being unable to have sex or even undergo a routine gynecological exam, was told by doctors for 10 years that the pain was psychological. When I met Emannuel, she had been working with this patient for months, and the girl was almost ready to have sex with her boyfriend.

    Lest you think that vulvodynia is rare, a study published last year in the American Journal of Obstetrics & Gynecology found that more than 8 percent of women suffer from it and concluded that the condition “is common, although rarely diagnosed.” (By way of comparison, the same percentage of people suffer from asthma—but that number includes women and men.) And of course, vulvodynia is only one type of pelvic-floor pain. A 2010 study published in BMC Family Practice concluded that “GPs expressed elements of therapeutic nihilism about [pelvic-floor pain],” and “despite practice nurses taking on increasing responsibilities for the management of patients with long term conditions, respondents did not feel that chronic pelvic pain was an area that they were comfortable in managing.” It also noted that in 35 percent of women, the pre- liminary medical diagnoses they receive (endometriosis, for example) aren’t confirmed by follow-up tests, leading these women back to square one, and into a time- and money-intensive “cycle of re-investigation and re-referral.” Doctors, the study pointed out, call women who present with chronic pelvic-pain symptoms “heartsink patients,” because this condition is so difficult to treat.

    I was fortunate enough to find a urologist who knew about pelvic-floor physical therapy, but even so, her primary focus was on testing. It was only because I pushed that I went to therapy as early as I did.

    The good news for people who catch their PFD, however it manifests, early is that a physical therapist can, in many cases and often with just a few visits, make the pain disappear. If a patient has been suffering for years—either because she was ashamed to seek help, or because she figured her urinary condition was a natural function of having kids and getting older—the treatment can take up to a year, and the pain can remain more persistent, even chronic. “You’ll have better long-term results be- fore the pain becomes processed by your brain as ‘natural,’ ” Stein said.

    After four sessions with Emannuel, I wasn’t quite cured, but I couldn’t continue seeing her. I was relocating for the summer to a rural state devoid of pelvic-floor therapists. Emannuel recommended I buy “the crystal wand”—an S-curved Lucite sex toy designed to help a woman find her G-spot that’s been re- purposed by pelvic-floor physical therapists. During our final session, she taught me how to hook the toy under my pelvic bone to find my trigger point, which I could knead with the tool’s rounded tip. Throughout the summer, that tool saved me. I became skilled at noticing the first signs of a trigger-point attack—a slight urethral pain, which, I realized, I’d experienced frequently in the past and had always before attributed to dehydration (meaning this trigger point had existed, in milder form, for years)—so that I could work at the muscles before the symptoms got worse. And work them I did. I was in the woods again; there was no one there to help me but me.

    Now more than a year after my first symptom appeared, I barely suffer at all. As I’m writing these words, I can feel a vague tightness, but this is because I’ve been sitting on a hard wooden chair in the library for the past five hours. As Stein says of PFD, “It’s similar to chronic back pain. You need to learn your limitations.” My limitations are sitting—airplane trips, car rides, long days at the library. Relaxation is key during these times. So is my wand.

    During those three weeks when I believed I had IC, I read countless online accounts by women who’d been in debilitating pain for years, women who kept strict diets and abstained from sex but who often were bedridden nonetheless, unable to work and forced to dedicate their lives to managing their suffering. After I discovered that I didn’t have IC, I despaired for these women. They number in the hundreds online, and who knows how many more thousands off-line. I couldn’t possibly reply to each of them, and so I thought instead that I’d write about it. I hope that many more women can limit their scary pain to just a few weeks, as I did, instead of suffering needlessly for the rest of their lives.

    This article was originally posted on ELLE Magazine’s website in August 2015.  Click here to view it.

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  • Too Much Sitting Can Be Deadly, Even With Exercise

    Too Much Sitting Can Be Deadly, Even With Exercise >

    Regular exercise doesn’t erase the higher risk of serious illness or premature death that comes from sitting too much each day, a new review reveals.

    Combing through 47 prior studies, Canadian researchers found that prolonged daily sitting was linked to significantly higher odds of heart diseasediabetescancer and dying.

    And even if study participants exercised regularly, the accumulated evidence still showed worse health outcomes for those who sat for long periods, the researchers said. However, those who did little or no exercise faced even higher health risks.

    “We found the association relatively consistent across all diseases. A pretty strong case can be made that sedentary behavior and sitting is probably linked with these diseases,” said study author Aviroop Biswas, a Ph.D. candidate at Toronto Rehabilitation Institute-University Health Network.

    “When we’re standing, certain muscles in our body are working very hard to keep us upright,” added Biswas, offering one theory about why sitting is detrimental. “Once we sit for a long time . . . our metabolism is not as functional, and the inactivity is associated with a lot of negative effects.”

    The research is published Jan. 19 in the online issue of Annals of Internal Medicine.

    About 3.2 million people die each year because they are not active enough, according to the World Health Organization, making physical inactivity the fourth leading risk factor for mortality worldwide.

    Among the studies reviewed by Biswas and his team, the definition of prolonged sitting ranged from eight hours a day to 12 hours or more. Sitting, or sedentary activities ubiquitous with sitting such as driving, using the computer or watching TV, shouldn’t comprise more than four to five hours of a person’s day, Biswas said, citing guidelines issued by Public Health Agency of Canada.

    “We found that exercise is very good, but it’s what we do across our day,” he said. “Exercise is just one hour in our day, if we’re diligent; we need to do something when we’re not otherwise exercising, like finding excuses to move around, take the stairs, or carry groceries rather than use the [shopping cart] at the supermarket.”

    The biggest health hazard stemming from prolonged sitting, according to the review, was a 90 percent higher risk of developing type 2 diabetes. Among studies examining cancer incidence and deaths, significant links were specifically noted between sedentary behavior and breast, colon, uterine and ovarian cancers.

    One study in the review showed that fewer than eight hours of sitting time per day was associated with a 14 percent lower risk of potentially preventable hospitalization.

    Dr. Joshua Septimus, a clinical associate professor of internal medicine at Houston Methodist Hospital in Texas, praised the new research, saying it “gives us more data to help counsel our patients.”

    “The idea that we could exercise for 15 or 20 minutes a day and that could completely erase any harms of a sedentary lifestyle for the other 23 hours a day is just too hopeful,” Septimus noted. “This showed us that yes, there is some benefit to physical activity . . . but it’s not enough.”

    Biswas and his colleagues offered additional tips to reduce sedentary time, including:

    • Taking a one- to three-minute break every half-hour during the day to stand (which burns twice as many calories as sitting) or walk around,
    • Standing or exercising while watching TV,
    • Gradually reducing daily sitting time by 15 to 20 minutes per day, aiming for two to three fewer sedentary hours over a 12-hour day.

    This article was originally posted on WebMD.com.  Click here to check it out.

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  • 9 Physical Therapist Tips to Help You Age Well

    9 Physical Therapist Tips to Help You Age Well >

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    We can’t stop time. Or can we? The right type and amount of physical activity can help stave off many age-related health problems. Physical therapists, who are movement experts, prescribe physical activity that can help you overcome pain, gain and maintain movement, and preserve your independence—often helping you avoid the need for surgery or long-term use of prescription drugs.

    Here are nine things physical therapists want you to know to #AgeWell. (Download the list in Adobe PDF)

    1. Chronic pain doesn’t have to be the boss of you.
    Each year 116 million Americans experience chronic pain from arthritis or other conditions, costing billions of dollars in medical treatment, lost work time, and lost wages. Proper exercise, mobility, and pain management techniques can ease pain while moving and at rest, improving your overall quality of life.

    2. You can get stronger when you’re older.
    Research shows that improvements in strength and physical function are possible in your 60s, 70s, and even 80s and older with an appropriate exercise program. Progressive resistance training, in which muscles are exercised against resistance that gets more difficult as strength improves, has been shown to prevent frailty.

    3. You may not need surgery or drugs for low back pain.
    Low back pain is often over-treated with surgery and drugs despite a wealth of scientific evidence demonstrating that physical therapy can be an effective alternative—and with much less risk than surgery and long-term use of prescription medications.

    4. You can lower your risk of diabetes with exercise. 
    One in four Americans over the age of 60 has diabetes. Obesity and physical inactivity can put you at risk for this disease. But a regular, appropriate physical activity routine is one of the best ways to prevent—and manage—type 1 and type 2 diabetes.

    5. Exercise can help you avoid falls—and keep your independence
    About one in three U.S. adults age 65 or older falls each year. More than half of adults over 65 report problems with movement, including walking 1/4 mile, stooping and standing. Group-based exercises led by a physical therapist can improve movement and balance and reduce your risk of falls. It can also reduce your risk of hip fractures (95 percent of which are caused by falls).

    6. Your bones want you to exercise.
    Osteoporosis or weak bones affects more than half of Americans over the age of 54. Exercises that keep you on your feet, like walking, jogging, or dancing, and exercises using resistance, such as weightlifting, can improve bone strength or reduce bone loss.

    7. Your heart wants you to exercise.
    Heart disease is the No. 1 cause of death in the US. One of the top ways of preventing it and other cardiovascular diseases? Exercise! Research shows that if you already have heart disease, appropriate exercise can improve your health.

    8. Your brain wants you to exercise. 
    People who are physically active—even later in life—are less likely to develop memory problems or Alzheimer’s disease, a condition which affects more than 40% of people over the age of 85.

    9. You don’t “just have to live with” bladder leakage.
    More than 13 million women and men in the US have bladder leakage. Don’t spend years relying on pads or rushing to the bathroom. Seek help from a physical therapist.

    This article was originally published on the American Physical Therapy Association Website.  Please click here to view it.

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  • Widespread Pain is Creating Widespread Prescription Drug Use

    Widespread Pain is Creating Widespread Prescription Drug Use >

    An estimated 126.1 million adults have felt some pain in the past 3 months, and 25.3 million adults suffer from pain daily, according to a recent study featured in the Journal of Pain (Estimates of Pain Prevalence and Severity in Adults: United States, 2012 – August 2015). Meanwhile, 14.4 million adults were classified as having “the highest level of pain,” and 23.4 million adults were classified as having “a lot of pain.”

    Even more distressing, many Americans are treating pain with dangerous prescription drugs.

    “The amount of painkillers, such as oxycodone and hydrocodone sold in the United States, has nearly quadrupled,” the Washington Post reported, citing data from the Centers for Disease Control and Prevention (CDC) (NIH: More than 1 in 10 American adults experience chronic pain – August 11, 2015). “The CDC estimates that roughly 44 people die each day in the United States as a result of prescription opioid overdose.”

    The good news is that physical therapists provide an effective, if underused, alternative to prescription drugs in the treatment of pain. Here are 9 things you should know about pain.

    This information was originally posted on the American Physical Therapy Association website.  Please click here to check it out.

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  • 4 Ways to Stick With a Fitness Plan

    4 Ways to Stick With a Fitness Plan >

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    Think tracking the numbers on the scale motivates you? Think again. “External feedback, like focusing on pounds lost or how your clothes fit, isn’t sustainable for most people,” says Michelle 

    Segar, Ph.D., a psychologist and the author of No Sweat. “You may see results one day or week, but when you don’t, you won’t want to exercise.” Segar, a University of Michigan researcher who has spent her career studying motivation and behavior change, has identified science-backed solutions that do work.

    Think of exercise as your secret weapon. You have to give physical activity extra importance if you’re going to make time for it. One way to do that: “View it as an escape from your day that brings you energy and well-being,” says Segar. “In studies I’ve conducted, women who do this make exercise a regular practice, while those who don’t end up skipping it.” Finding an activity that you love and combining it with other things that make you feel good, like running through your favorite park or listening to a funny podcast while you work out, can make it even more enjoyable, which ups the odds that you’ll do it again tomorrow.

    Be single-minded. It’s tempting to overhaul several areas of your life at once—starting a new workout the same week you cut sugar from your diet, for example. But that sets you up for failure. “We don’t have the cognitive capacity to change lots of things at one time and sustain what we’ve changed,” says Segar. If you’re new to exercise, give yourself a few months to stay consistent, then move forward with other goals.

    Ditch the weekend-warrior mentality. It’s better to exercise for 10 minutes four times a week than to hit the gym only for an hour and only on Saturday. “Research clearly shows that the people who stick with exercise for life are the ones who make it a staple of their week,” says Segar. “Consistency is what helps you keep at it during life’s ebbs and flows. When exercise is a part of your day, just like showering or sleep, barriers such as bad weather, work issues, kids, and even a bad mood don’t stop you from getting at least a little activity,” says Segar.

    Stop saying yes all the time. Life is hectic; people and events will unintentionally hijack your goals if you let them, says Segar. You don’t have to automatically say no when someone asks you to do something that interferes with your workout. But do pause before you respond and ask yourself, Is this request important enough to trump my feeling good and fueling the rest of my life? As Segar says, “You don’t want your default to be yes if it’s at the expense of your well-being.”

    This article is authored by Camille Noe Pagan and was originally posted on www.RealSimple.com.

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  • Rheumatoid Arthritis (RA)

    Rheumatoid Arthritis (RA) >

    About 1.5 million people in the United States have rheumatoid arthritis.

    Rheumatoid arthritis (RA) is a chronic autoimmune disease causing pain, swelling, stiffness and loss of function in the joints. A healthy immune system protects the body by attacking foreign bacteria and viruses, but an autoimmune disease causes the body to mistakenly attack healthy tissue.

    The Rheumatoid Arthritis Support Network (RASN) is working to ensure that the millions of people living with RA have access to the most accurate and well-researched information available.  Their website is a great resource, so make sure to check it out: www.rheumatoidarthritis.org/

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  • Soreness vs Pain: What’s the Difference?

    Soreness vs Pain: What’s the Difference? >

    There are many benefits to exercise, including the potential for improved physical and mental wellbeing. However, there may also be some physical discomfort associated with these activities due to the stresses placed on the body.

    When experiencing discomfort, it is important to understand the difference between exercise-related muscular soreness and pain. Muscular soreness is a healthy and expected result of exercise. Pain is an unhealthy and abnormal response. Experiencing pain may be indicative of injury.

    Individual Activity Threshold

    In order to make physical improvements, your body needs to be pushed to an appropriate level where gains can occur.

    Each person’s body has a different activity threshold dependent upon many factors, including age, baseline strength, and participation level. Remaining on the safe side of your threshold will result in muscular soreness. Exceeding your threshold will result in pain.

    One of the expected outcomes of exercise, when done appropriately, is that this threshold will progressively increase. For example, when an individual begins running, their safe threshold may be 5 minutes of running. After several weeks of progressive increases in duration, this runner’s threshold may increase to 20-30 minutes.

    To maximize your exercise gains and minimize injury risk, it is important to be realistic about your activity threshold and to be able to differentiate between moderate muscle soreness and pain.

    Soreness vs. Pain: How To Tell the Difference

    The chart below highlights key differences between muscle soreness and pain.

      Muscle Soreness Pain
    Type of discomfort: Tender when touching muscles, tired or burning feeling while exercising, minimal dull, tight and achy feeling at rest Ache, sharp pain at rest or when exercising
    Onset: During exercise or 24-72 hours after activity During exercise or within 24 hours of activity
    Duration: 2-3 days May linger if not addressed
    Location: Muscles Muscles or joints
    Improves with: Stretching, following movement Ice, rest
    Worsens with: Sitting still Continued activity
    Appropriate action: Resume offending activity once soreness subsides Consult with medical professional if pain is extreme or lasts >1-2 weeks

     

    Muscle Soreness

    After activity, muscular soreness typically peaks 24-72 hours after activity. This is the result of small, safe damage to muscle fibers and is called Delayed Onset Muscular Soreness (DOMS). During this time, your muscles may be tender to touch and feel tight and achy. Movement may initially be uncomfortable but moving and gently stretching your muscles will help to decrease soreness. During the few day period that you experiencing muscular soreness, you might consider performing alternate exercise activities in order to give your sore muscles an opportunity to recover while strengthening other muscles.

    Pain

    In contrast to muscular soreness, you may experience pain during or after performing exercise. This may feel sharp and be located in your muscles or joints. This pain may linger without fully going away, perhaps even after a period of rest. This may be indicative of an injury. Pushing through pain can result in injury. If you feel that your pain is extreme or is not resolving after 7-10 days you should consult with a medical professional. This person will diagnose your injury and direct you to the appropriate pathway of care.

    How a Physical Therapist Can Help

    A physical therapist can be a valuable resource to you throughout your exercise journey. Before beginning an exercise routine, your physical therapist can perform a variety of pre-activity assessments to determine your readiness for exercise. Based on this, your physical therapist may also recommend specific exercises that will best prepare you for your desired activities. They will also discuss the best strategies for introducing and progressing exercise activities while minimizing your chance of becoming injured.

    In the unfortunate situation when exercise leads to an injury, your physical therapist will assist in your recovery in many ways. They will help with initial pain management, identify and address all factors that may have contributed to your injury to prevent further problems and provide specific recommendations regarding reintegration into exercise as appropriate.

    This article was originally published on the American Physical Therapy Association website.  Click here to check it out.

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