How to Stay Healthy Around the Holidays

The end of the year is quickly approaching. This is a joyous time filled with holiday celebrations and end of the year parties, but it’s also when people stress, overindulge and healthy practices take a back seat.

Below are several ways to survive the holiday season while still maintaining a healthy lifestyle.

Hydrate:

Dry air, as we often see here in Arizona, dries out the mucous membranes in your body, which, in turn, allows bugs into our systems. Also, travelling via airplane, puts us at risk for getting ill as the inside of airplane cabins provides for low humidity at high altitudes. Hydrating also regulates your body temperature, lubricates your joints, and allows for transportation of nutrients.

Stay active:

Exercise is just as important during the holiday as it is during the rest of the year. Try to do something physically active 4-5 times a week. This will also allow the body to burn calories as our caloric intake increases. Find creative ways to incorporate physical activity, and even better, including friends and family as well.

Get sleep:

People have a tendency to wear themselves out during the holiday season. Not getting a good night’s sleep, puts one at risk for getting ill because you’ve worn down your immune system.

Practice healthy nutrition:

Eating healthy can be very challenging with the abundance of cookies and cakes and various other sweets everywhere we look. My advice is to eat junk food in moderation and make sure to incorporate the “good” foods including fruits, vegetables, protein and fiber, that allow your body function optimally.

Alcohol:

Alcoholic drinks go hand in hand with most holiday get togethers. When drinking alcoholic drinks, I recommend alternating between alcohol and non-alcoholic drinks. This will minimize the chance of a hangover the next day.

Know Stress Points:

Stress is something that is unavoidable. Know your stress points then find ways of dealing with them. Deal with them by incorporating breaks when you’re in stressful situations. Also, do something you enjoy before and/or after dealing with stressful situations.

Relaxation:

Relaxation is key during the holidays since so much of the holiday season is the opposite of relaxing. Find time to sit on the couch and read your favorite book or watch TV. This will balance out all of the busy activity.

Get Rid of the Germs:

Washing your hands before and after eating, after using the restroom, and other times during the day, can help minimize transferring germs from someone or something to you. The holiday season is when colds and flu bugs are at their peak. Using hand sanitizer throughout the day is also helpful, but don’t use it as a complete substitute for handwashing. Hands should still be washed several times per day.

Following the previously mentioned pointers will help improve your ability to stay healthy during the holiday season so you can focus on enjoying the celebratory time, while still incorporating healthy behaviors.

Hiking in Arizona? Here's How To Prevent Injury

One of the best things about living in Arizona is the abundance of hiking trails. With sunny skies the majority of the year, Arizonans are able to enjoy the outdoors virtually year round.

On many occasions, I have seen patients with either a new injury from hiking, or from a previously resolved injury that got exacerbated by hiking. Due to the physical demand of even the smallest and easiest hiking trails, it is not uncommon to develop some aches and pains resulting from a hike. Over the years, I have offered advice to minimize risk of injury.

Bring Water
This one is, or at least should be, obvious. Often people underestimate the dehydrating effect of a hike. Also, don’t think this only applies to the summers. Cooler weather days in Arizona are often very dry as well. In addition, excessive sweating, no matter what the ambient temperature is, can lead to dehydration. Dehydration can lead to headaches, muscle cramping, dizziness, confusion and fainting. So, bring water with you on your hike and drink before, during, and after your hike.

Stretch
Flexibility is key to prevent injury in any type of exercise. Flexibility of the joints that are involved in hiking (specifically hips, knees, ankles) allows for full range of motion. Lack of flexibility in joints can lead to injury when the joints are forced to move out of their normal range of motion. This can lead to sprain/strains or even worse, tears.

Rest
Taking breaks when hiking will allow for muscles to recover. When muscles are too fatigued, this makes them vulnerable, and can ultimately, lead to injury.

Dress right
Focus on utilitarian and function rather than fashion (sorry Lululemon). Wear good supportive shoes, proper clothing, a hat and sunscreen.

Know your limits
It’s ok to challenge yourself, but pushing yourself when hiking on Arizona trails, especially when you’re deconditioned, not prepared, or have a medical condition, can lead to injury.

So, next time you decide to take advantage of one of Arizona’s beautiful hiking trails, be smart and follow the pointers provided above. Also, ask the advice of your Physical Therapist at ReThrive to determine whether you are physically capable.

How To Stay Healthy As You Age

One of the most common questions I get as a Physical Therapist is from people over the age of sixty, asking what they can do to stay healthy as they age. This is a loaded question as there are so many things that can be done or modified in one’s life to assure for healthy aging. I have been able to condense this answer down to just a few key points.

Stay Busy

There is no question that people that keep themselves busy have a tendency to be healthier. Part of the reason is because when one is busy doing things, they don’t have the opportunity to think about or dwell on other things (like physical ailments, stressors in their life, etc). I encourage seniors to make sure they socialize with family and friends, volunteer, etc. A general rule of thumb that works is to make sure you see at least one person every day.

Exercise

It’s no secret that exercise has endless benefits for your health and wellbeing. Regular exercise can help prevent heart disease, diabetes and pain associated with arthritis. The focus of the exercise routine should be on flexibility, strength, endurance, and

balance. This will aid in the prevention of falls. I recommend thirty minute cardiovascular exercises performed daily which will help burn calories, lower blood pressure and cholesterol, and increase energy levels. Strengthening exercises using weights or other forms of resistance training will help build muscle, which will assist in balance. Strengthening exercises include (but not limited to) squats, arm raises, bicep curls, rows, side and back leg raises, and heel raises. Stretching exercises should target large muscle groups including the quadriceps, hamstrings, calf muscles, arms and

chest muscles. For individuals with limited mobility and/or pain, low impact exercises like swimming, yoga, and tai chi are great options. Exercise benefits are more than just body, but also benefit emotional health by maintaining an active lifestyle.

Diet

Providing your body with a good diet can help you stay active and remain active. As you age, your metabolism slows down, which means you need fewer calories than before. It’s important to choose foods that provide the best nutritional value, such as lean proteins, fruits and vegetables, whole grains, and low fat dairy. In order to maintain your weight, it’s important that you use the recommended servings. Lastly, staying hydrated is crucial to prevent dehydration, fatigue and to maintain an adequate fluid balance in the body.

When in good health, seniors can stay active and do more. As health needs change, healthy living is the best way to avoid disease, improve one’s quality of life, and live longer.

You Can Get Relief From Jaw Pain with PT

Over the years, I’ve seen quite a few patients with temporomandibular disorder, or TMD. TMD is a dysfunction of the temporomandibular joint and/or the surrounding muscles. Often TMD, is incorrectly addressed as TMJ. TMJ is the temporomandibular joint, or the joint that connects the jaw to the skull.

Throughout my career as Physical Therapist, I have had conversations with various dentists and orthodontists regarding the treatment of temporomandibular disorder (or TMD). The thing that I hear over and over from dentists and orthodontists is that they often don’t know exactly what to do with these patients, other than providing them a splint and referring them to a TMD specialist. Physical Therapy for TMD can be quite effective as a conservative option for treatment, and if needed, often can be used in conjunction with splinting and/or referral to a specialist.

Patients with TMD can present differently from person to person. I have seen patients with very severe symptoms including intense pain on one or both sides of the jaw, the inability to chew or even open their mouth to get food into their mouth, clicking or popping of the TMJ, or a locking or inability to move the jaw. I have seen great outcomes in working with TMD patients resulting in a significant reduction in pain and dysfunction, and often complete resolution of symptoms. When working with a TMD patient, I do a comprehensive evaluation followed by a 4 step treatment approach.

Evaluation:

During the evaluation, the assessment is focused on posture (including head, neck, and shoulders), ROM of the cervical spine (neck), thoracic spine (mid back) and TMJ, strength of muscles in the previously mentioned areas, and joint mobility and soft tissue flexibility of the previously mentioned areas.

Following the evaluation, the treatment consists of the following:

Step 1: Control inflammation and irritation with the use modalities

Modalities, such as ultrasound and electric stimulation can be used to reduce swelling and muscle spasms to decrease pain levels. Also dry needling can be quite beneficial in improving range of motion and decreasing pain.

Step 2: Patient education on the specifics of the injury and proper self management

Patient education is crucial and begins on the first day of physical therapy. If the patient doesn’t understand what they have, what is causing it and how to alleviate it, then they won’t get better in the long run and they definitely won’t understand how to self manage. It is our job as PT’s to provide that knowledge to the patient. A customized home exercise program will be provided that addresses all impairments that were found as well.

Step 3: Manual therapy including joint mobilizations and stretching of tight/inflexible muscles
As PT’s, we have the knowledge and skillset to assess and treat most joints and muscles of the body. Our goal is to restore normal joint mechanics and tissue flexibility. Also, a home exercise program that re-emphasizes that manual work, will be provided.

Step 4: Therapeutic exercises to address weak muscles

Muscle groups pertinent to the TMD include the muscles of the head, neck, mid back, shoulders and jaw. All impaired tissues will be addressed and a home exercise program that addresses the weak areas will be provided as well.

The results of TMD treatment with physical therapy can be significant. As a PT, I greatly value the benefits of using physical therapy to alleviate patients’ symptoms with conservative means of treatment.

Bad Headache? Your Posture Might Be To Blame

What is a cervicogenic headache?

A cervicogenic headache is head and/or neck pain that is referred from the bony structures or soft tissues of the neck including the muscles or joints. Referred pain is pain that is felt at a site other than where the cause is located. These kinds of headaches can present on their own, or in conjunction with other types of headaches, such as migraines.

While these headaches can be seen after a traumatic event such as a motor vehicle accident or assault, these headaches are often seen without a precursor of trauma or specific injury. In fact, many people with cervicogenic headaches have sedentary jobs that often include sitting at a desk or computer for most of the day.

Cervicogenic headaches often appear in conjunction with other types of headaches. Some experts say there are as many as 150 different types of headaches. Also, a person can experience more than one type of headaches and many are hard to tell apart. The different headaches can affect each other as well (ie: cervicogenic headaches can be worsened by migraines and vice versa).

Symptoms Physical Therapists can Help

-Pain localized to the base, side or front of the skull
-Pain localized above or behind the eye, jaw/ear area
-Pain into the head or neck that is intermittent and lasts hours to days
-Pain that worsens with head/neck movement, or sustained or awkward positions - range of motion is often limited
-Can have any of these symptoms with nausea and visual disturbances as well

How to prevent or minimize cervicogenic headaches

Often, people who suffer from cervicogenic headaches, sit at desks for the majority of the day. This contributes to a forward head and rounded shoulders posture. As a result, this can lead to shortening and weakening of the muscles around the neck and shoulder blades. Below are ways to prevent/minimize headaches.

Posture:

Sit up tall
Pull back shoulder blades Stand up every 30 minutes

Massage:

Massage from neck to mid back

Exercises:

Chin tucks- hold 5 sec, repeat 5x (insert chin tuck pic)
Neck stretches- pull ear to shoulder & chin to shoulder, do 2x, 30 sec holds (insert neck stretch pic)
Rows: pull shoulder blades back, do 2 sets of 10 (insert row pic)

When evaluating a patient with cervicogenic headaches, a Physical Therapist performs an assessment of the following:
-Posture of head, neck, shoulder blades, and mid back
-Range of motion of neck, mid back, and shoulder

-Flexibility of soft tissues surrounding the neck, shoulders, shoulder blades, and spine -Strength of muscles around neck, shoulders, and shoulder blades
-Joint mobility of the neck, mid back, ribs, and shoulders

After assessing the patient, the Physical Therapist will treat the patient. When treating my patients, I utilize 5 methods:

  1. Modalities such as ultrasound or electric stimulation to promote blood flow and healing and decrease inflammation

  2. Exercises to strengthen/stretch muscles in the neck, rotator cuff, also postural exercises.

  3. Education- instructions on body mechanics when sitting (in car or at desk), standing, bending/lifting, sleeping (proper use of pillow)

  4. Manual Therapy- joint mobilization and muscle stretching to improve joint and muscle flexibility

  5. Home exercises to reinforce program

Physical Therapy can be a very effective means in the reduction and often complete resolution of cervicogenic headaches. If you are unsure as to whether you’re a candidate for physical therapy, ReThrive can help determine the best course of action. If you’re interested, contact ReThrive, and schedule an evaluation.

Think You Have Whiplash? Read On.

Whiplash is an injury to the neck region caused by a sudden forward and backward force of the head and neck. Most often, this is from a motor vehicle accident.

Cause of whiplash
Most of the time, whiplash is caused by a motor vehicle accident where someone is rear ended. This force pushes the car seat the person’s torso forward which causes a relative backward motion of the head. Following this, the head and neck are forced forward. This forced, unexpected motion can lead to stress/strain to the soft tissues surrounding the neck region.

How long does whiplash pain last?
Whiplash pain can last from a couple days to several years depending on the severity of the injury and also the condition of the individual prior to the injury.

Symptoms of whiplash
There are a variety of whiplash symptoms. Some symptoms that might be experienced include: neck pain, arm pain, shoulder pain, back pain, headaches, dizziness, nausea, blurred vision, or numbness or tingling into the arm/hand.

What to do if you think you have whiplash
Go to your doctor or Physical Therapist. An x-ray might be recommended to rule out a more severe injury such as a fracture. Sometimes, other diagnostic tests may be recommended to rule out other issues such as a tear, disc herniation, etc. Often, after a motor vehicle accident, the individual is taken directly to the hospital where the above tests are performed immediately.

Treatment for whiplash
Physical Therapy is often recommended for whiplash. The physical therapist has the skills and knowledge to effectively diagnose and treat whiplash. Physical Therapists can expedite the healing process and provide for the best possible outcome by addressing the problems and building up strength and flexibility, which, in turn, can prevent/minimize the chance of future injury.

How Physical Therapists treat whiplash
The physical therapist’s goal is to get the patient back to their prior level of function. Often, patients finish their physical therapy course of treatments feeling better than they did prior to the whiplash injury.

After completing a full, comprehensive evaluation, treatment for whiplash has a four step process.

  1. Patient education - teaching the patient body positions to avoid which can impede healing. Also, will teach good body positions to utilize while active during the day, when at work, or when lying in bed. This will allow for optimal healing by minimizing irritation and providing an adequate healing environment.

  2. Manual therapy - manual therapy is physical therapist’s use of their hands to address flexibility and joint mobility. This is done by stretching muscles and fascia and by mobilizing joints of the neck and mid back. There are many different manual therapy techniques, including use of dry needling, that can be utilized and significantly improve the patient’s pain and improve function.

  3. Exercise: exercises will emphasize the upper body to improve strength and stamina. This can improve function and reduce pain by providing adequate support to the upper body specifically around the shoulder blades and neck.

  4. Modalities - various modalities such as electric stimulation or ultrasound can help in the reduction of inflammation, reduction of pain, and increase of blood flow to promote the healing process.

Contact ReThrive if you have any questions and/or need treatment for whiplash. It’s never too early to consult with a PT.

After Spine Surgery, Physical Therapy is Key

There are many reasons people undergo spinal surgery. Whether spine surgery was due to an acute injury, a structural anomaly, or a chronic issue, physical therapy is an integral component of the rehabilitation process. Often physical therapy begins immediately after the surgical procedure. Other times, physical therapy isn’t started until several days or weeks following the surgery. When exactly physical therapy begins is determined by the spine surgeon and is based on numerous factors including: time needed for healing, physical condition prior to surgery and the type of spinal surgery performed. Physical therapy plays a crucial role in the process of getting you back to doing your daily routine, including completing activities of daily living, and work related tasks.

Initially, the physical therapist will focus on pain control and patient education. The goal is to educate the patient on spinal care including positions to avoid. Also, will focus on teaching proper, more efficient ways to transfer in and out of a bed, chair, and car. Education on proper posture and movement patterns is crucial to minimize harmful positions. It’s important to incorporate positions that minimize spinal compression and allow for adequate healing. Various means of pain control that are utilized in physical therapy include: ice and different modalities such as electric stimulation. This can help with healing, improving tissue mobility, and the reduction of inflammation and pain.

Next, the physical therapist will work on exercises focusing on improving flexibility, proper body mechanics, and building up strength, power, endurance and stability in and around the spinal region. Various exercises will be instructed. The physical therapist has knowledge and skills to know what muscles need to be addressed. Also, the patient will be provided a customized home exercise program that reinforces the physical therapy provided.

As the patient continues physical therapy, exercise intensity will be increased with a goal of functional independence. Eventually, the patient will be discharged from physical therapy and advised to continue performing the home exercise program to further improve.

While the spinal surgery addresses the structural damage done, the goal in physical therapy is to learn or relearn how to move in order to prevent further injury to the area involved, or other areas of the spine.

Don't Ignore Your Neck Pain

Neck pain is one of the most common musculoskeletal ailments. The neck, is also called the cervical spine. It runs from the base of the skull, down to the area between the shoulder blades. When neck pain is present, it can be quite limiting in the ability to function. Neck pain can vary in intensity and frequency of symptoms, type of pain experienced and location of pain. Neck pain can significantly impair an individual’s ability to perform everyday activities and work related tasks.

Problems in the cervical spine region can present with various types of symptoms in the head, face, neck, between the shoulders blade, front or back of shoulders, or into the arm(s) or finger(s).

Types of neck pain experienced include (just to name a few): sharp, shooting, stabbing, numb, tingling, dull, achey, gnawing, throbbing, nagging, etc.

Causes of neck pain

Sprain/Strains: Often this is due to daily occupational/functional hazards from the cumulative effect of impaired posture in conjunction with faulty body mechanics with job related tasks such as sitting at a desk all day, and/or activities of daily living, such as leaning over the counter to brush your teeth or doing dishes. This is a very common cause of neck pain.

Degeneration: Osteoarthritis results from the gradual wear and tear that has occurred in the vertebral segments of the neck region. Often, this leads to structural changes such as stenosis. Stenosis is a narrowing of the area where the spinal cord and/or nerves are located, or degenerative disc disease which results in loss of space in between the vertebrae. .

Trauma: Often, this results from a car accident often involving a whiplash type of injury. Also, it could be from a fall, assault, or sports injury. Traumatic neck injuries can lead to an injury to the discs or nerves or the surrounding soft tissues of the neck region.

Nerve Impingement/Compression: This results from herniated discs or other structures pushing on the nerves in the cervical region.

Disease: There are many diseases of the spine that can lead to neck pain. Ankylosing Spondylitis, cancer, Rheumatoid Arthritis, meningitis, and Osteoperosis are a few examples.

Treatment of Neck Pain:
There are many different treatments for neck pain. Injections focus on the reduction of inflammation and/or pain emanating from a specific region. Surgery is very effective in circumstances where more conservative means of treatment have been, or would be, ineffective due to structural problems in the spine.

Lastly, physical therapy can be very effective in treating neck pain. The focus of physical therapy is to reduce inflammation, improve soft tissue and joint mobility, and build strength in the neck and shoulder blade region to improve mechanics and posture of the upper body. The goal of physical therapy is to not only alleviate the current pain, but also educate the patient and provide a home exercise program to prevent future issues.

Prevention of Neck Pain:
Maintaining a balance of flexibility, and strength of the neck and upper body musculature and being mindful of posture when sitting or standing still, and when moving throughout the course of the day, is key to the prevention of neck pain.

For further information regarding neck pain, consult your Physical Therapist at ReThrive.