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:
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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
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Padded arm slings relieve pressure on shoulders and chest
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Padded backing prevents books or sharp objects from digging into the child’s back
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Waist and chest belts help distribute the weight of the pack and hold it close to the child’s body
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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:
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Pack heavy objects close to the child’s body
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Have them use both shoulder straps and the chest and/or waist belt
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Tighten straps after putting the pack on your child’s back
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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.
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Tighten the strap so the bag is close to the body
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Wear the strap across your chest
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Occasionally switch sides to allow for rest
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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.
Posted by
Jeni P. on Tue, Jun 26, 2012 @ 01:52 PM
Achilles Tendinitis is the chronic inflammation of the Achilles tendon, the band of tissue that connects the calf muscles at the back of the lower leg to the heel bone. It is also the strongest tendon in the body. Most often the result of an exercise that strains the tendon and calf muscles, such as running and jumping, Achilles Tendinitis can also occur from limb malalignments and hyperpronation (losing the arch in the foot).
Hyperpronation is most commonly caused by the following conditions:
- Plantar Fascitis- Occurs when the thick tissue at the base of the foot is overextended or inflamed. Symptoms may include pain and stiffness at the bottom of the heel.
- Hallux Valgus- More commonly known as “bunions.” The big toe begins to point towards the second toe, creating a bump along the outside of the big toe. Narrow, ill-fitting shoes are usually to blame. Can be very painful and may require surgery if other methods bring no relief.
- Posterior Tibial Tendon Dysfunction- The tendon becomes torn or inflamed. In this state, the tendon may not be able to provided the required stability and pain may ensue along the ankle and foot.
- Metatarsalgia- Pain or inflammation in the ball of foot.
Although the pain associated with AT is normally acute, the nervous system will occasionally be unable to locate the exact source of the pain, and the patient will suffer from was is called, “referred pain,” a dull pain that is felt in multiple places.
Interventions for Achilles Tendinitis is most often non-operative. Orthopedic treatment can help reduce symptoms and improve malalignments. A physical therapist may employ eccentric calf stretching - stretches that actively lengthen the muscles - along with Podiatric insoles and/or heel cushioning.
There are multiple causes for foot pain. If you or someone you know if suffering and would like their questions answered, RSVP to our Foot & Ankle Seminar today! It's free and informative, (also available as a Webinar). We are also offering four free assessments after the program!
Many people, myself included, constantly think we're living a healthy lifestyle, even as experts warn us that that is not the case and current lifestyles will have consequences down the road.
Too much fast food, alcohol and/or sugary drinks are putting people at an increased risk for heart disease and stroke.
Begin your journey to a healthy heart Today!
In an attempt to ensure my healthy heart, I decided to research what changes needed to be made in order to stay healthy and came across a great article from the American Heart Association... check out the snippet below:
...Your lifestyle is not only your best defense against heart disease and stroke, it's also your responsibility. A heart-healthy lifestyle includes the ideas listed in the heart below.
Stop Smoking
If you smoke, quit. If someone in your household smokes, encourage them to quit. We know it's tough. But it's tougher to recover from a heart attack or stroke or to live with chronic heart disease. Commit to quit. We're here to help if you need it.
Choose good nutrition
A healthy diet is one of the best weapons you have to fight cardiovascular disease. The food you eat (and the amount) can affect other controllable risk factors: cholesterol, blood pressure, diabetes and overweight. Choose nutrient-rich foods — which have vitamins, minerals, fiber and other nutrients but are lower in calories — over nutrient-poor foods. A diet rich in vegetables, fruits, whole-grain and high-fiber foods, fish, lean protein and fat-free or low-fat dairy products is the key. And to maintain a healthy weight, coordinate your diet with your physical activity level so you're using up as many calories as you take in.
Reduce blood cholesterol
Fat lodged in your arteries is a disaster waiting to happen. Sooner or later it could trigger a heart attack or stroke. You've got to reduce your intake of saturated fat, trans fat and cholesterol and get moving. If diet and physical activity alone don't get those numbers down, then medication may be the key. Take it just like the doctor orders. Here's the lowdown on where those numbers need to be:
- Total Cholesterol: Less than 200 mg/dL
- LDL (bad) Cholesterol:
- If you're at low risk for heart disease: Less than 160 mg/dL
- If you're at intermediate risk for heart disease: Less than 130 mg/dL
- If you're at high risk for heart disease (including those with existing heart disease or diabetes): Less than 100mg/dL
- HDL (good) Cholesterol: 40 mg/dL or higher for men and 50 mg/dL or higher for women
- Triglycerides: Less than 150 mg/dL
Lower high blood pressure
It's the single largest risk factor for stroke. Stroke is the No. 3 killer and one of the leading causes of disability in the United States. Stroke recovery is difficult at best and you could be disabled for life. Shake that salt habit, take your medications as recommended by your doctor and get moving. Those numbers need to get down and stay down. Your goal is less than 120/80 mmHg.
Be physically active every day
Be physically active every day. Research has shown that getting at least 30 minutes of physical activity on 5 or more days of the week can help lower blood pressure, lower cholesterol and keep your weight at a healthy level. But something IS better than nothing. If you're doing nothing now, start out slow. Even 10 minutes at a time may offer some health benefits. Studies show that people who have achieved even a moderate level of fitness are much less likely to die early than those with a low fitness level.
Aim for a healthy weight
Obesity is an epidemic in America, not only for adults but also for children. An epidemic is when a health problem is out of control and many people are affected by it. Fad diets and supplements are not the answer. Good nutrition, controlling calorie intake and physical activity are the only way to maintain a healthy weight. Obesity places you at risk for high cholesterol, high blood pressure and insulin resistance, a precursor of type 2 diabetes — the very factors that heighten your risk of cardiovascular disease. Your Body Mass Index (BMI) can help tell you if your weight is healthy.
Manage diabetes
Cardiovascular disease is the leading cause of diabetes-related death. People with diabetes are two to four times more likely to develop cardiovascular disease due to a variety of risk factors, including high blood pressure, high cholesterol, smoking, obesity and lack of physical activity.
Reduce stress
Some scientists have noted a relationship between coronary heart disease risk and stress in a person's life that may affect the risk factors for heart disease and stroke. For example, people under stress may overeat, start smoking or smoke more than they otherwise would. Research has even shown that stress reaction in young adults predicts middle-age blood pressure risk.
Limit alcohol
Drinking too much alcohol can raise blood pressure and lead to heart failure or stroke. It can contribute to high triglycerides, produce irregular heartbeats and affect cancer and other diseases. It contributes to obesity, alcoholism, suicide and accidents. The risk of heart disease in people who drink moderate amounts of alcohol (an average of one drink for women or two drinks for men per day) is lower than in nondrinkers. However, it's not recommended that nondrinkers start using alcohol or that drinkers increase the amount they drink.
Often, making lifestyle changes is all that's need to reduces the risk of heart related problem. So whatever your age, start taking steps to improve your heart health. I know I will!

This is a video of a 27 year-old woman who underwent an L4-5 total disc replacement using the Maverick disc prosthesis.
This video is awesome, right? You can see the stability of the prosthesis as well as its mobility. The patient moves above and below the implant. All is good. Unfortunately, all is not so good. This marvel of modern medicine may be the appropriate treatment of choice for some patients, but it is being severely over utilized and the results are far from stellar.
According to Trang, et al in Spine, “This Lumbar fusion for the diagnoses of disc degeneration, disc herniation, and/or radiculopathy in a WC setting is associated with significant increase in disability, opiate use, prolonged work loss, and poor return to work status. The article goes on to say that “If we do this surgery you have a 1 in 4 chance of a repeat surgery, a 1 in 3 chance of a complication, and 3 in 4 chance of never working again.”
Dr Timothy Flynn, a Fellow of the American Academy of Orthopaedic Manual Physical Therapists, points out that the surgical decision-making process is often heavily influenced by the enthusiasm of the performing surgeon – Redirecting Our Enthusiasm. This is much like a mechanic telling you that you need your transmission replaced and you have no idea if that’s the best solution to get your car back on the road. Flynn suggests that patients need a more objective resource they can depend upon to inform them of the most effective, least risky, and least expensive solutions to their problems of back pain. This can certainly be extrapolated into other elective orthopedic surgeries, as well.
Before you make any rash decisions, speak to your primary physician and consult your physical therapist. They may have some information that you need to hear……….
Our Physical Therapist can provide you with essential information prior to your surgery.
Would you like to see a Physical Therapist before your surgery?
The bad news: If you have not ever injured your back, odds are that you will. 80% of people have a lower back injury at some point in their life.
The good news: If you have not had a back injury, then you are less likely to have one in the future than someone who has, and the chances are that your injury will be less severe than if you have a history of back injuries. Most lower back pain responds well to treatment and is often fully resolved within a month.
A back injury can result from a congenital deformity, repetitive strain, traumatic incident, or any combination of the three. I’m often asked, “Is back pain genetic?” In most cases, certain people have a predisposition to back pain and they don’t consciously do anything to prevent it. They may live a sedentary lifestyle, not exercise regularly, and even work at a job where they sit all day or lift heavy boxes. This would be like being born with a genetic likelihood of acquiring diabetes and living on a sugar-laden/high carb diet. Your chances of avoiding the affliction would be very unlikely.
The structure in the lower back that is injured more than any other is the disc. Discs
are tough, fibrous shock-absorbing pads. They rest between each of the spinal vertebrae, providing support and facilitating normal movement. If extraordinary force is placed on a disc at the proper angle, it can either wear down over time or immediately rupture. Either way, the result can be local pain, radiating pain, leg numbness, leg weakness, or any combination depending upon the severity and impingement on adjacent nerves.
If you are experiencing any of these symptoms, the most effective form of treatment is to address it in the early stages. Conservative treatment by a physical therapist will often help relieve these symptoms in 2 weeks or less. A PT will also teach you how to manage a chronic condition and prevent future injury.
For a direct consult with a PT...
If you don’t have back pain and you want to keep it that way, several factors can work in your favor:
- Regular exercise emphasizing cardiovascular fitness
- Core stabilization exercises
- Utilizing safe postures during work and recreational activities
- Maintaining a normal weight for your body type
Get started today. Don’t be 1 of the 80%.

On Sunday March 27th at WSPT I took the TRX Sports Medicine Suspension Training Course to understand more about the TRX and how it can help patients. The course was a lot of fun and the instructors Brian Bettendorf and Perry Nickelston did a great job helping me understand how to use the TRX and help other’s use it as well. The next day from the course I felt sore. My legs and arms suffered the most.
Since taking the took the course, I've been helping more patients with their exercises and helping the PTs @ WSPT with the TRX. I have also been able to show a few coworkers that use the TRX with me some new stuff that I learned that they didn’t know and should help all of us here on the gym floor. Hey who knows maybe Danny will have a hardcore class that Xavier and I can setup in the future @ WSPT. ;)

Since I love playing sportsI also have a TRX at home and I use it to get in to shape . I also got my younger brother into the mix of using it, he's crazy about it!.
Taking the TRX course opened my eyes to become a personal trainer and take it to the next level of helping other’s get better and reach there goals to recovery.
*Submitted by William. A
For years patients suffering from arthritis looked at joint replacements as the last resort after medication, physical therapy, arthroscopies and injections. In addition, orthopedists had always coached patients to “hold out as long as possible” before electing for a joint replacement as the replacement joints were thought to last 10-15years, after which a revision surgery would be necessary.
This trend has changed recently as half of all hip replacements this year will be patients under 65, and the majority of them are extremely active people. This same statistic will be true of knee replacement patients by 2016. 
Weekend warriors who are not ready to give up basketball, surfing, skiing and tennis are opting to have surgery in order to be able to continue with the activities that have become an integral part of their life. The thought of adjusting their lifestyle in order to avoid having an additional surgery later in life does not make sense to this new breed. They would rather be able to continue with these recreational activities, some of which are high impact, and live a more fulfilling life now, and worry about what happens down the line when they get there.
The orthopedic community seems to be a bit split on this new line of thinking. Some surgeons have given their patients the go ahead to return to skiing, surfing and basketball, while others have warned their patients that if they want to maximize the use of their new knee or hip that they’ll need to find a new outlet for their athletic needs.
In order to accommodate this new breed, manufacturers of the hardware that is implanted in these patients are attempting to come up with material that will last longer under higher impact conditions. Most implants use a combo of metal and polyethylene parts, and continuous motion wears away at the polyethylene portions. Researchers have found that irradiating the polyethylene parts removes free oxygen radicals that contribute to degeneration, and as a result allow for longer use.
Both patient and doctor agree that another new trend that has shown improved post op results is “Pre-hab” ; that is maximizing range of motion and strength prior to surgery. There is no getting around the intense, often painful rehab that awaits these patients following surgery, however looking at the pros and cons, and determining what activities are most important to them, many patients are opting to have surgery now and face the consequences later. The new mantra seems to be, do what you love to do while you can still do it.
Joints got you down?
*submitted by Jason Ruta, MSPT
Arthritis affects over 50 million Americans, a number that rises each year as the U.S population ages. It attacks joints such as the knees or hands, and can make everyday tasks painful or impossible. Living with arthritis is a day-to-day struggle, but there are steps you can take to alleviate the symptoms and prevent painful inflammation. They don’t require prescription or advanced medicines either, they are the cornerstones of healthy living: Diet and Exercise.
How does my diet affect my condition?
Many people who suffer from arthritis aren’t aware of how their diets can impact their condition. But recent research has shown that there are foods which can reduce in frequency and severity the harmful reactions that occur within the body that lead to arthritis aches and pains.
Popular Nutrition Questions:
People with arthritis often ask ‘Are there certain foods I should eat to improve my arthritis symptoms? Are there foods I should avoid to prevent my arthritis symptoms from worsening?’” says Maria Romano MS RD CDN, WSPT’s resident dietician. “These are million-dollar questions.” Maria notes that there are no studies that result in conclusive evidence of one food being more beneficial than another, but there are some studies that have revealed promising results.
Case Study
A study at Mount Sinai medical center revealed that foods cooked at high temperatures, such as grilled meats, fried eggs and microwaved meals, increase levels of advanced glycation end products (AGEs). AGEs are a naturally-occurring compound in the body that are believed to be linked to inflammation of joints and tissues. Replacing such foods in your diet with steamed, simmered or broiled options reduces the AGEs and, potentially, the symptoms of arthritis.
Omega -3 and Arthritis
The correlation (between Omega-3 and arthritis) has not yet been proven in clinical trials, but anecdotal data appears promising. Some foods rich in Omega 3 fatty acids include: salmon, walnuts, ground flaxseeds, flaxseed oil, olive oil, sardines, anchovies, mackerel, avocados, etc.,” says Maria. She also recommends keeping Omega-3 fish oil supplements in the freezer to reduce unpleasant, fishy burps.
Olive Oil
Another beneficial food for arthritis sufferers is olive oil, which was recently discovered to contain high levels of the same anti-inflammatory compounds found in ibuprofen. One Monell Chemical Senses Center in Philadelphia study found that 3 1/2 tablespoons of extra-virgin olive oil is equivalent to 200mg of ibuprofen.
What else can I do?
It is recommended that people with arthritis begin doing a warm-water therapy treatment. Aqua therapy is low-impact, increases strength and flexibility, and can provide a robust exercise session without wearing on joints and bones. The warm water also provides relief to aching joints.
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WSPT recently launched the
BronxFit diet and exercise program, a 12-week course designed for people who are just beginning to work on losing weight and improving the way they eat. Maria Romano, MS, RD, CDN teaches 6 1-hour nutrition classes throughout the program and our Personal Trainer, Jason Bonilla provides 6 1-hour fitness sessions. The objective of the program is to deliver a well-rounded, accessible program for fitness beginners. The course involves a combination of:
- 6 1-hour Personal Training sessions
- 6 1-hour Nutrition classes
- Full Gym Access for the 12-week length of the program
Visit BronxFit for more information.
The average Physical Therapy practice generally sees patients after they've already injured themselves in some way. They do their best to reduce the patient's pain, allow them to regain their movement and strength, and hopefully restore their ability to function as they did prior to their injury. It has become more challenging for PTs to do this every year as patients are being granted less visits by their insurance companies, and are being asked to assume a greater portion of the bill through copayments.
As a result of these factors, education on prevention of injuries is what health care providers must begin providing more of to their patients. WSPT has taken this initiative, and begun a monthly Educational Series that aims to educate its patients, and the residents of the Bronx about their bodies.
Each month a different body part will be featured, and WSPT's staff of physical therapists will educate the attendees on what bones, joints and muscles make up that body part, what injuries are common to that body part, and what they can do to prevent or treat themselves before they have to seek the attention of a Physician or Physical Therapist. It's an open forum where questions are encouraged and participation in the discussion is welcome.
The Series will be conducted on the last Thursday of every month @ 6:30pm.
For more info: 
WSPT uses a variety of treatments and techniques to treat our patients. In an effort to increase understanding and raise awareness, we’ve chosen to spotlight one of our latest treatment techniques: Kinesio Taping.

What is Kinesio Taping? The Kinesio Taping Method is designed to facilitate the body’s natural healing process while providing support and stability to muscles and joints without restricting the body’s range of motion. It also provides extended soft tissue manipulation to prolong the benefits of manual therapy. Latex-free and wearable for days at a time, Kinesio Tex Tape is safe for populations ranging from pediatric to geriatric, and successfully treats a variety of orthopedic, neuromuscular, neurological and other medical conditions.
It’s important to note that Kinesio Tape is different than standard athletic tape. Athletic strapping tape is used mostly to limit ranges of motion and to constrict muscle movement. The effect of this method is to create a bridge over the areas that are injured so that athletes can perform sport movements and have either prophylactic support or support to an injured part of the body. Athletic tape is typically removed after the end of an athletic event.
Kinesio Taping is used by therapists to change muscle tone, move lymphatic fluids, correct movement patterns, and improve posture. The Kinesio Taping Method has been developed specifically to be used in conjunction with Kinesio Tape. The Kinesio Taping Association certifies practitioners of the Kinesio Taping Method. Kinesio Tape can be identified by the words "Kinesio Tex" printed on the back of the tape. All of WSPT’s therapists are familiar with the application of Kinesio Taping, and several are on their way to being certified practioners.
For more on Kinesio Taping read Stephanie Gannello’s blog here.