This time of year it’s easy to do nothing. The holidays are over, we’ve forgotten our New Years resolutions and it’s cold outside. These are all excuses we use to veg out and get out of shape. During the colder months we tend to slow down, put on weight and lose mobility. Unfortunately, bad habits often lead to a downward cycle of increased weight gain and additional health problems. The deeper into this cycle we fall, the harder it is to recover and every year this challenge becomes even more difficult.
By exercising regularly or starting a physical therapy program you can start slowly. There’s very little pressure at this time of year. You won’t be trying to look good in a bathing suit for a few months. Your walking tour of Italy isn’t right around the corner. You have time to get off the couch and prepare yourself at a slow and steady pace. You can build slowly so that you’re ready to run that 5K in the spring or wear heels to your daughter’s wedding in June.
The challenges of feeling good and exercising are even more extreme if you are afflicted with a chronic condition such as Rheumatoid Arthritis (RA). It’s even more important to take control of your health. Pharmaceuticals can help, but like so many other conditions, exercise is the most effective means of battling this condition. That’s why we’ve chosen to focus on RA for our WSPT University presentation this month. If you have RA or are affected by it any way we urge you attend our valuable seminar.
Whether you’ve been meaning to do something or you’ve just recently fallen off, now’s the time to take control of your health. Take care of your joints, your muscles, your weight. Sign-up to find out more.
Fibromyalgia (FM) is a chronic pain syndrome characterized by widespread non-articular pain, stiffness, multiple tender points and fatigue. Other common symptoms include diminished pain threshold, sleep disturbance, fatigue, headaches, morning stiffness, parasthesias, and anxiety. Nonrestorative sleep is common in FM. About 75% of patients report sleep disturbances, including early middle or late insomnia, hypersomnia and frequent awakening. The organic nature of the abnormal central pain processing in FM has been demonstrated in many studies.
Patients experience that symptoms have a severe impact on their function in everyday life, including such basic activities as walking and upper extremity activities of daily living (ADLs). Patients’ muscular performance is often found to be impaired(6-8).
Initially called fibrositis, the name was changed to fibromyalgia when it became evident that inflammation was not part of this condition. The prevalence of FM is reported to be 3.4% in women and 0.5% in men, affecting women from 7-10 times more than men. Demographic and social characteristics associated with the presence of FM are Western culture, female gender, failing to complete high school, low income status and depression.
The etiology and pathogenesis of FM remain relatively unknown. In different patients, FM has had differing origins. Some patients report having FM symptoms since childhood. Others slowly develop FM in adulthood or become afflicted with FM following a traumatic or stressful incident. Patients have also reported “waking one morning with flu-like aches,” but never getting ill, just staying in pain. Commonly, there is an association with childhood stress or prolonged or severe stress.
Treatment of FM often involves a combination of medication, nutrition, physical therapy (PT) and psychological counseling. PT can be challenging because the overall objective is to increase movement, activity, and function. This can initially exacerbate the symptoms of FM, particularly if too aggressive of an approach is taken. The fine line a PT normally has to take in the progression of an exercise program is even more sensitive for patients with FM.
PTs are aware of the hazards of treating patients with FM, but often find themselves without the tools to effectively treat these patients. Pain modalities and soft tissue mobilization provide short-term relief, but do little to progress the patient towards their goals. Exercise can be intolerable due to pain and many FM patients drop out of their PT program due to the pain and discomfort they experience during or after exercise.
A proven solution to this dilemma for patients with FM is aquatic therapy. The buoyancy of water provides a weightless feeling to patients that often feel “weighed down,” movement is facilitated by the viscosity of water, and a warm pool (90F) all provide relief that FM patients don’t experience elsewhere. There is no risk of dropping a weight on one’s foot, overexertion is improbable and there is minimal risk of gravity forcing a joint into an angle beyond the normal range of motion. These positive attributes all contribute to the safe environment of an aquatic exercise program, helping the patient with FM overcome the roadblocks that lead to the avoidance of exercise, making them more likely to participate.
Munguia-Izquierdo and Legaz-Arrese found that an exercise therapy program with moderate intensity performed 3 times a week for 16 weeks in a chest-high pool of warm water (32C) has no apparent negative effects and improves, pain, sleep quality, and physical and cognitive function, causing a great adherence to exercise in previously unfit women with heightened and long FM symptomatology. This shows that aquatic therapy achieves the major objectives of an FM exercise program – increased function, relief of the predominant symptoms and patient adherence to a program.
With the objective of progressing from gentle movement to increasing velocity and resistance, and eventually to functional activities, aquatic therapy should be a part of every FM patient’s program.
To learn more about Fibromyalgia and effective treatment, join us for an informative seminar on Wednesday December 19, 2012 at Noon.
Ray Kurzweil blew my mind the other night. His credentials as an inventor, scientist and entrepreneur are rivaled only by Edison and Einstein. He has his hand in so many arenas, all related to his world view of the exponential growth of technology in juxtaposition to our linear view of time. He talked about how rapidly something like computer processing is currently progressing. An iphone is billions times more powerful than the most advanced computer of 50 years ago - and it’s a million times less expensive. A teenager with a smartphone in Africa has access to more information than President Clinton did when he was the ruler of the free world.
Kurzweil’s massive theory, his “relativity,” is Singularity. He didn’t invent the concept, but he has popularized it in his writing. For Kurzweil, the Singularity is defined by a massive expansion of human intelligence and the potential for immortality facilitated by computer superintelligence.
Factors influencing this nearing possibility are:
- The falling cost of manufacturing transistors
- The rising clock speed of microprocessors
- The plummeting price of dynamic RAM
- The falling cost of sequencing DNA
- The decreasing cost of wireless data service
- The rising numbers of Internet hosts and nanotechnology patents
If these predictable trends continue, he anticipates the Singularity to occur around 2045.
What does that mean for our physical existence? I can foresee a distant future where we just download our brains onto a hard drive and exist as heads in a jar. Even the benefits of exercise could potentially be simulated with software programming. Isn’t all experience just our perception of what is happening? How is doing something any different than simply thinking, feeling and believing that we are actually doing it?
Imagine your brain could be programmed to simulate the experience of you riding a mountain bike through the woods of Aspen, programmed in such detail that you experience every sensation that you would if you were actually on that trail. You could even have the full sensation smelling the trees and feeling the bumps or falling off your bike and bruising your shoulder. Except your shoulder wouldn’t be bruised and you could get right back on the trail, at least in your mind.
That may be a bit far-fetched. So, more realistic is the arriving prevalence of nanotechnology in medicine. As per Sahoo in “Nanomedicine: Nanotechnology, Biology and Medicine,” “...materials and devices designed to interact with the body at subcellular (i.e., molecular) scales with a high degree of specificity. This can be potentially translated into targeted cellular and tissue-specific clinical applications designed to achieve maximal therapeutic efficacy with minimal side effects.” The applications are endless. What if there were procedures that instantly cured patients with either rejuvenating cell injections or microbots that mended broken bones and ligaments and eradicated diseases. That time may not be far off. It may be sooner than you think.
I have to wonder when PTs will become obsolete. (Hopefully, not in my lifetime.) For now, we help our patients recover from injuries, regain normal function, and manage arthritis and complications from diabetes. We are an adjunct to medications and surgery for many patients. We are an essential piece of the medical puzzle. Even if physical recovery is significantly expedited, neural and muscular re-education still has to occur. People still need to relearn how to walk, run, throw a ball.
Technology has the ability to change lives with health improvements, but even an amputee with a new arm faces the massive challenge of learning how to integrate it into their life. A NY Times article this week told the story of a US Marine with a $110,000 prosthetic arm and the work he’s doing with his therapists to learn how to use it.
In Kurzweil’s world, maybe technology advances us to the point where the Marine is given injections to recreate his original arm, but we’re not there yet. Maybe there won’t even be any more war. We’re definitely not there yet. For now, we still have injuries, diseases and traditional rehabilitation. Medicine and surgery works wonders and PT is an important piece of the medical solution.
People with diabetes often experience the effects of diabetic neuropathy. Symptoms include pain, tingling and numbness. As a result, diabetic neuropathy often leads sufferers to become less active which only makes the symptoms worse. Neuropathy can’t be cured, but if you do have it, the good news is that it can be managed and you can lead a normal life.
With a few simple tips, you can effectively decrease your diabetic neuropathy symptoms.
The 6 most effective ways to manage Diabetic Neuropathy:
- Examine your feet every day. A small cut or blister can turn into an ulcer in less than a week. Inspect both feet entirely either using a mirror or having a family member assist you.
- Wear properly fitting footwear. Large or small shoes can cause blisters that lead to larger complications.
- Eat a healthy diet. Large fluctuations in sugar levels can exacerbate symptoms associated with diabetic neuropathy.
- Physical therapy modalities, including massage and infrared light treatment (often referred to as Anodyne Therapy) can reduce pain and enable increased activity.
- Be active. Decreased activity leads to weak muscles and stiff joints. Movement and activity increases healthy blood flow to the extremities, minimizing the effects of neuropathy.
- Rest and repair. Sleep deprivation has been shown to increase susceptibility to diabetes and increase symptoms. Consistently get 7-8 hours of sleep per night to reverse that effect.
If you have diabetes and diabetic neuropathy, follow these simple rules and you’ll find that your symptoms will reduce significantly. If you’d like more information on the management of diabetic neuropathy visit us at http://www.wspt.org/diabetes/. For Anodyne Therapy treatment call 914.771.9666 to schedule an appointment.
Kids are back in school and that means they’re carrying loads like pack mules between home and class. The backpack could be one of the great inventions of the last century, but a tool is only effective if used properly. Slung over 1 shoulder, a backpack causes the carrier to lean to 1 side and put excessive stress on 1 side of the spine, leading to imbalances and potentially to significant injury.
Have your child use both arms of their backpack and be sure that the bag is tightened enough that it doesn’t hang down. It should be close to their back, almost like an extension of their body. To prove how significant this is, take a heavy book and hold it close to your chest with both hands for 15-seconds. This probably is not much of a strain for you. Now hold that same book at arm’s length for another 15-seconds. You likely feel your arm, shoulder and back muscles starting to quiver a little. Now imagine walking around with 3 or 4 more books suspended like that.
Wrong- Strap on one shoulder of body weight
Correct- Wide, padded straps on both shoulders
Some other tips for choosing an appropriate backpack:
Make sure the bag is the proper size for the child. The bottom of the pack should come down to the small of the child’s back
Padded arm slings relieve pressure on shoulders and chest
Padded backing prevents books or sharp objects from digging into the child’s back
Waist and chest belts help distribute the weight of the pack and hold it close to the child’s body
Reflective material provides additional safety for walking outside in the dark
These tips obviously apply to adults as well, especially when traveling or hiking with a heavy pack. A backpack can be an extremely efficient means of carrying heavy loads. It’s important that it’s used properly or those loads can cause loads of pain. A few simple adjustments can make a backpack more comfortable:
Pack heavy objects close to the child’s body
Have them use both shoulder straps and the chest and/or waist belt
Tighten straps after putting the pack on your child’s back
They should only carry what they need for that day - assess the contents at least weekly. Sometimes we leave many extras in our bags that we haven’t used in months, unnecessarily adding to the weight of the bag.
Tighten the strap so the bag is close to the body
Wear the strap across your chest
Occasionally switch sides to allow for rest
Use a bag with a padded shoulder strap to reduce the strain on the shoulder.
Regardless of the bag you or your child use, be aware of pain caused by excessive carrying. If you or your child experience prolonged pain associated with carrying a backpack or other bag, consult a PT for treatment and advice on how to carry safely.
Temperatures are cooling. Leaves are browning and starting to fall. Kids are returning to school. This can only mean 1 thing - it’s running season. Any runner who lives in the northeast will tell you that this time of year is ideal for running, especially if you’re a road racer. Running coach Jack Daniels believes that pace is affected by 03-04 per mile for every 5 degrees over 60F. Another prominent coach, Jeff Galloway suggests that a runner should pace as much :30 slower per mile for every 5 degrees. Regardless of the formula, we can all agree that it’s easier to run at cooler temperatures. So get outside and exercise in these comfortable conditions.
If you’ve never been a runner, but have always wanted to try it follow these rules of thumb:
1. Ramp up gradually
Start by walking
Mix in a minute of slow jogging for every minute of walking
Gradually increase to 2 minutes of jogging for every minute of walking until you can jog consistently for 15-minutes straight. Then you’re on your way.
2. Always warm-up
Active movements are the best way to loosen up your joints and get your blood flowing
Start by moving all of your major joints through their range of motion
Gradually increase the range and speed of movement until you feel ready to go
You should have a light sweat before starting your jog
3. If the shoe fits.......
Wear running shoes that fit you well and feel good while running
It’s best to get fitted at a running shop, even better if they do video analysis that breaks down your stride
Lace your shoes snugly, but not so tight that your toes tingle
4. Function follows form
There is no ideal stride, but efficiency increases pace and prevents injuries
Try to stay centered on your feet
Keep your hips forward and stand upright
Hold your elbows at approximately a 90 degree angle and piston
Aim for 90 steps per minute
Lastly, have fun - running is great exercise and an excellent way to get in touch with your body and your environment. Make the most of the opportunity.
For more detailed, hands-on running instruction, contact me about the Treadmill Running Program at WSPT - firstname.lastname@example.org.