Wellness Blog
Wellness Resources

Giving Thanks for Balance

At the start of this holiday season, we’d like to give thanks for Balance(d). I named my practice Balanced because I believe in a measured approached to things – to the body, to patient care, and to life. It serves as a reminder to me as much as I hope it does for my patients. Last year I wrote about the importance of balance during the holidays, and you can read about it here. This year, I thought I’d share how I keep my balance during the holidays. Keeping your holidays stress free is great advice, but I want to talk a bit about how you actually do it.

Schedules

For me, as an introvert, I’ve learned it is really important not to over schedule myself. If I do, it can really wear me out. So I keep track of my schedule in a calendar, and when I consider any invitation I look at the time slot and see what’s around it. If attending the event doesn’t leave me any recharge time, or there’s too much travel time, or if it means I’ll miss too much of my exercise plans, it’s likely a pass for me. Of course for those with children, schedules can be more complicated. You just have to keep your mind on the balance.

Food

Another consideration around the holidays is food. I love food. You can often hear me talking about cooking, restaurants, and value-driven ingredients. To balance food around this time of year, I try to keep lunch light and very healthy – especially if I have plans for dinner or a party later. Then there are the oh-so-tempting sweets that pop up everywhere during the season. So, I eat a healthy snack before I head out since counting calories doesn’t work for me. When I am trying to relax and enjoy a party the last thing I want to think about is how healthy the food is I am eating. Filling up a little on healthier foods before I go can also help ease the guilt along with the managing how much I eat. I gain weight easily if I’m not careful, so I tend to stick with my plans.

Exercise

I’m a big proponent of exercise, as many of my colleagues in the healthcare field are. If you’re trying to keep from gaining weight, or if you’re trying to lose weight during the holiday season, you’ve got to pay attention to your diet the most. However, exercising during the holidays will also help keep your weight in check as well as help to alleviate stress and keep you in a better mood overall. Of course, if you’re on a set plan for a competition, stick with your plan. If you’re like most people, you exercise more because you should and less because you love it – or perhaps you don’t exercise at all. Time is a big factor for those who don’t, but it doesn’t need to be all or nothing. The key thing is to keep your body moving. If during the holidays, you drop from four days a week to three, that’s a good trade-off. Another way to make the most of your time is to consider high-intensity interval training to make your exercise shorter but more intense. You’ll still build muscle, improve your cardiovascular function, and get all those wonderful stress relieving chemicals – going hard for 10-15 minutes can be as useful as an hour of moderate exercise on the bike or a long walk.

So, take these tips and find your balance this holiday season:

  • Look at your calendar frequently and make sure you aren’t overloading yourself and the family
  • Stick to a healthy breakfast and lunch and have a healthy snack so you don’t have to watch too much at a party
  • Keep up with some amount of exercise, even if it’s less than you normally do

Sam Spillman, DC

A Balancing Act: How Does Balance Work?

The balance system is one of the most important systems the body uses. Throughout the day it helps us to drive a car without getting dizzy; slip on a slick surface without tearing ligaments; go up and down stairs without looking at every step; and walk down the sidewalk without tripping on uneven cracks. Balance is a complex masterpiece that can be honed to help every person function at their highest level. Have you ever wondered how gymnasts balance on the balance beam, or hockey players skate on ice while handling the puck, or how skiers tear manage to slalom downhill without falling? It all has to do with practice and creating a balance set to fit their unique sporting needs. There are three different balance systems that work together to create a wholly balanced world.

Somatosensation

This is the feeling that we have in our feet, and is sometimes intertwined with proprioception. Somatosensation and proprioception are defined as how the sensors within the skin on our feet, joints, muscles and tendons sense where we are in space. These sensors constantly give feedback to different parts of the brain and brain-stem to correct movement, and ensure that the proper muscles are contracting to stabilize and move our body. This system can be disrupted by nerve damage (often called peripheral neuropathy), which often occurs with diabetes and some artery diseases. It can also be disrupted by pain, which is why anyone who has had an ankle sprain will tell you that they sprain the ankle over and over after the first injury. This is because the system is disrupted in the presence of pain so the ability of the ankle muscles to contract and prevent further sprains is impaired. When this system is disrupted due to lack of sensation or pain, the body relies on the other two systems below.

Vision

Simply put, vision gives us our picture of the world and integrates with the other systems to adjust muscle activity and movement to match what we see. We rely most of our vision during balance.

Vestibular function

The vestibular system is an integral part to the balance system. It activates postural muscles throughout the day and also helps us move our eyes independent of head movement. This allows us to focus on one thing while there may be a lot of other things going on around us – think about reading a street sign while driving on the highway, for example. If both of your vestibular systems were non-functioning (you have two, one in each ear), the horizon would bounce up and down instead of being still when walking. Mismatches in information within this system is usually what causes motion sickness. The reason people get nauseous with motion sickness is that the brain has trouble with deciding which input to use – vestibular, somatosensory, or vision. Nausea is your brain’s way of saying: we need to sit down and take a break so I can figure this out. When this system is not functioning correctly, patients generally experience dizziness – defined as feeling off, light-headed, or spacey – and vertigo, which gives the sensation that the world is spinning around you. This system is most important for balance at night when vision can be eliminated.

Balance may not be as straightforward as it seems. It requires a lot of input and processing within our nervous system to work well. The good news is that our balance system can adapt to use one part of the system more than the other through training and practice. The bad news is that as we age, we generally lose sensation in our feet and vision leading to increased risks for falls.

We can help you find your balance before issues develop. Give us a call for your balance screening today!

Bryan Esherick, DPT

Concussions and a Safe Return to Sport

Concussions. They can have lasting effects later in adulthood, so prompt treatment is essential to mitigate long-term effects. While the end of summer draws near, and fall sports get underway at the start of a new school year, it’s important for parents, trainers, and coaches to remain vigilant in watching for signs and symptoms of concussion in young athletes.

Here some tips to help you recognize concussions:

  1. Your child isn’t acting quite like themselves: Look for changes in your child’s usual mood, cognition, ability to pay attention, and energy level. When your child isn’t acting like he/she normally does following a game, it’s a safe bet they may have suffered a concussion.
  2. They sustained a jarring hit: Any hit, whether it is to the head or body, has the possibility of causing a concussion. Hits to the head are obviously related to concussions, but hits to the body can also cause concussions through whiplash-like mechanisms.
  3. Nausea or sensitivity to light or sound: These are some very common signs seen following a concussion.
  4. Dizziness while using their phone or watching TV: This can be caused by a sensory issue within the vestibular system. Also watch out for dizziness or imbalance while driving and walking in busy areas.
  5. IF YOU SUSPECT A CONCUSSION SEEK MEDICAL ADVICE: Waiting to seek medical advice can have an impact on the overall time it takes for your child to recover. Seeking medical advise as soon as you suspect your child may have a concussion is key.

One of the best things that you can do for your athlete as a parent or coach is to be sure that they have baseline testing consisting of physical, cognitive, and equilibrium tests prior to participation in practice and games. Should an injury occur, baseline testing allows the coach and trainer to know when it is safe to allow the athlete to return to sport after an injury has occurred. Also be sure that the testing for your athlete is comprehensive, and not performed only using the IMPACT computer-based test that doesn’t take into account the other functions of the body that may be impacted through concussion.

When seeking medical advice, remember that advice can come from a variety of medical practitioners including medical doctors, physical therapists, athletic trainers, etc. Medical examination usually consists of some tests and measures to determine the severity of the injury. Examination is necessary to rule out other serious pathologies, including a brain hemorrhage. Usual care for a concussion is a brief period of rest (1-3 days), followed by a graded return to sport and school, and then rest. Rest is essential for the brain to heal itself in the early stages, although activity should be resumed as quickly as possible while maintaining little to no symptoms. Physical therapists can help by determining a safe level of activity for the athlete and developing a sport specific training plan. Before your child returns to sport, ensure all testing compares to baseline, that physical activity has been progressed, and that your child is symptom-free with sport specific training.

By following these key steps after sustaining a concussion, your athlete can return to sport as quickly and safely as possible.

Note: This blog is not considered medical advice that should be used if you suspect a concussion in your child. If you believe your child may have suffered a concussion or would like to receive baseline testing, contact our clinic at 434-293-3800.

Sleep and School Performance Go Hand-in-Hand

Want to do better in school? Get more, restful sleep! We all know sleep is important but we might think of it more as an “eat your vegetables” important kind of way. In reality, we should be thinking about it more in a “this could impact my life, hopes and dreams” kind of way. That’s exactly what researchers are finding as we learn more and more about sleep and the value it brings.

Sleep is vital for so many functions and processes in the body: memory, cognitive function, blood pressure, hormone regulation (cortisol, insulin, leptin, grehlin, testosterone), healing, muscle recovery, immune system, etc., etc.,. And, it is especially important for children. Sleep deprivation can significantly impact a child’s performance in school.

So, how do you know if your child is getting enough rest? Here’s a good rule of thumb:

  • Children aged 6-13 should be getting 9-11 hours of sleep each night
  • Teens should be getting 8-10 hours

While these are good gauges to check patters in your household, that’s just a starting place. Behavior can be a great clue.

Signs of sleep deprivation are similar to symptoms of ADHD. They include:

  • easily distracted
  • difficulty focusing
  • yawning
  • moodiness
  • irritability
  • fatigue
  • depression
  • difficulty learning new concepts
  • forgetfulness
  • feeling “fuzzy”
  • unmotivated
  • clumsy
  • increased appetite
  • overweight

Most likely, we could all make a few adjustments to get a better night’s sleep.

The best rules work for both children and adults:

  • keep a consistent, daily bedtime
  • avoid eating within three hours of bedtime
  • discontinue screen time at least an hour before bed
  • can the caffeine after noon
  • maintain a set bedtime routine for children

With these simple tips, you and your little ones will be sleeping sounding and reaping the benefits in no time!

Sam Spillman, DC

Backpack Safety Tips

Backpacks. They’re necessary, but they also need to be safe. A child may lug to school more than 10 percent of his or her body weight which can be a serious pain in the back!

Here are some backpack tips to lighten the load:

  1. Choose a backpack that has two wide straps with good padding to distribute the load evenly.
  2. Adjust the height. Tighten straps so the bag is centered on the back, ideally above the lower curve of the spine.
  3. Use both straps. The one-shoulder method may be cool, but it adds serious pressure and throws body alignment out of whack.
  4. Weigh the bag. It should weigh no more than 10% of the child’s weight. If your child regularly has to carry more than that then you should get them one of those rolling backpacks that they can pull.
  5. Have your child checked. If your kid complains of back pain-even if it seems minor-talk to your doc. No amount of achiness is normal, and a physician can recommend strengthening exercises to help ease it.

Happy backpacking!

Research Leads to a Better Practice

Research. It’s the core of success. In our clinic, we pride ourselves on evidence based practice.  But what does that really mean to the patient? Evidence based practice combines three things: clinical experience; research; and patient preference or values.  So how do the articles we read from the research that’s done in universities filter down to affect our actual patient care?

One way we use research is to apply what we read to inform our thinking.

For an example, the Journal of Orthopaedic and Sports Therapy published this article that looks at using the drop vertical jump task as a way to predict an ACL injury.  What we learn is that this task isn’t a good indicator of predicting a possible injury. So many variables are involved in athletic injuries that it is very difficult to predict an injury from just one factor.

However, we also learn that increasing the cognitive demand on an athlete when performing the vertical drop jump task, makes the activity more difficult – and therefore, likely increases an athlete’s risk of injury. While this isn’t a perfect simulation of what might be happening on a soccer field or basketball court, it can help guide our rehabilitation of patients.

The result? We’re adding increased cognitive demands in the rehab process for our athlete patients before returning to sport.

Just another example of how research informs on how we care for our patients, through evidence based practice, in the “real world.”

 

Spring Vegetable Challenge: What’s New to You?

While there have been several mornings that have felt like winter instead of spring, spring is indeed upon us! What comes to your mind when you think of spring? Mine is sunshine, being outdoors without a coat and my of course seasonal spring vegetables! Now is the time we will find a variety of vegetables at the farmers market. Having an abundance of fresh and local vegetables is a great time to play around and experiment in the kitchen. Having a variety of vegetables in the diet is very important for health! Your GI tract will be healthier as it will have more diverse and beneficial gut bacteria and you will also be providing your body with more micronutrients that are critical for good function. Challenge yourself this spring to try several new vegetables, or using the vegetables in a different way.

Below I have highlighted some of my favorite spring vegetables.

Radishes – Radishes have a slight spicy flavor and make a great addition to salads. Simply cut then thinly and add then to a large salad with your favorite dressings. My favorite dressing is a mix of olive oil, red wine vinegar, salt, pepper and a little bit of honey.  Radishes can also be roasted! Simply cut them in half, drizzle with olive oil salt and pepper and roast in the oven for about 20 – 25 minutes. Then just pair them with your favorite protein dish.
Rhubarb – I’m sure we have all tried a strawberry rhubarb pie, but have you ever tried making a savory rhubarb sauce?!

This delicious sauce can be used for chicken, fish and pork either as a marinade or just on top after cooking.

Ingredients: 1 onion, finely chopped; 2 cups rhubarb, chopped into 1cm lengths; 1 cup white wine; 2 tbsp grated fresh ginger; 1 tbsp honey; olive oil; salt and pepper
Directions:
1. In a medium saucepan, gently fry the onion in a little olive oil until softened.
2. Add chopped rhubarb, wine, ginger and honey.
3. Season and cook over low heat for 8 to 10 minutes until the rhubarb is cooked and the sauce is reduced.
I’ve got some leftover rhubarb from the crumble this month.
Asparagus – Asparagus are in season for a very short time, so got to catch them quickly! Asparagus are a very versatile vegetable and pairs well with most dishes. Some of the ways I like to cook with them is to cut them in small pieces and add them to a risotto, they also taste great added to a quiche, or of course you can just simply roast them and sprinkle some Parmesan cheese on top!
Beets – Beets are my favorite! I find that you either love beets or hate them. I’m hoping to convert you to LOVE them! If you find the taste too ‘Earthy’ try grating them with a cheese grater and mixing it in a salad. You won’t be overwhelmed with their flavor because they are cut so thin and will be mixed with a bunch of other veggies from a salad. Don’t forget to eat the beet greens! They are totally edible and gives any salad a great kick!
Happy vegetable shopping (or growing)!
Guest BCPT Blogger

Four Ways to a Healthier Heart

Did you know heart disease and stroke cause 1 in 3 deaths among women each year – more than all cancers combined. The good news is that 80 percent of those deaths may be prevented. Your heart is the engine that keeps you going – supplying the ‘oil’ for your full body machine – so it’s important to take care of your heart.

February is heart health month, and we’re celebrating by sharing tips to help you keep your ticker ticking!

  1. Exercise daily. You should get 30-minutes of moderate exercise each day – and 1-hour per day for children. Moderate exercise includes things like a brisk walk, biking, weight lifting, or recreational sports. Exercise is important to keep your heart strong, much like you would for other muscles in your body. Check out our other recent blog posts about different types of aerobic exercises and heart rate zones.
  1. Eat Right. This may be the best, but also the hardest, thing to do to keep your heart healthy. Check the labels at your grocery store and choose foods high in fiber as well as vegetables – try to pass on foods high in fat, simple sugars, salt, and cholesterol. This will help ensure arteries stay open and your ticker stays healthy.
  1. Lessen the stress in your life. Stress can create a large burden on your heart by increasing blood pressure and releasing cortisol, and other stress chemicals. This can all have a negative effect on both the heart itself and the arteries it uses to transport blood. When you can’t eliminate the stress, try to manage it with a few breathing techniques; meditation; and even exercise! Find what works for you and try to work it into your daily routine.
  1. Stay positive with friends and family. Want to live a longer life? Positive relationships with those closest to you has been linked to be the #1 factor in living a longer life – ahead of quitting smoking and drinking; exercising; and eating right. As humans, we are meant to be social animals and look for opportunities to build relationships. So when you are done reading this, pick-up the phone and call a friend or family member and set up a time to get together and reconnect.
Some of the best indicators of a healthy cardiovascular system include a normal heart rate, low blood pressure, low cholesterol and A1c levels.

So, remember to take care of yourself, and keep your heart in check!

Bryan Esherick PT, DPT

Resolutions Checklist for Health in 2018

Trying to focus on your health in 2018? According to research, almost 25% of people will abandon their New Year’s resolutions by the second week in January and almost 60% will quit before six months. Starting resolutions that are too vague, large, or unrealistic will only set you up for failure. If this has happened to you in the past, try setting up specific and actionable goals for yourself this New Year. For example, instead of saying “I want to get healthy in 2018”, break it down into smaller goals that you can attain by gradually changing some of your daily habits. Need some ideas?

We’ve rounded up a checklist to help create realistic, actionable, and attainable goals for a healthier lifestyle in 2018.

  • Decrease processed sugar intake (cookies, cakes, candy, juices, jelly, etc). Women should aim to consume less than 25g per day and men should eat no more than 37g per day.
  • Decrease refined carbohydrate intake (white flour, white pasta, white rice). Replace these unhealthy calories with whole grain bread, brown rice, and whole grain pasta.
  • Decrease red meat and dairy intake. Replace red meat with fish, and substitute almond or soy milk for dairy products. To ensure adequate protein intake, be sure to eat plenty of beans, lentils, nuts, and seeds.
  • Eat more fruits and veggies. It is recommended everyone strive for 9+ servings per day of nutrient-rich fruits and vegetables.
  • Drink more water. Reduce or cut out carbonated, caffeinated, or calorie-containing beverages and replace them with water. Aim for 6-8 glasses per day.
  • Prepare healthy meals ahead of time. Pick one morning or afternoon each week to shop for healthy foods, then prepare them in advance for more convenient meals and snacks throughout the week.
  • Practice proper portion control. Protein portions should be the size of your palm. A portion of fat should be the size of your thumb. Fruit and vegetable servings should be the largest, and roughly the size of your hand. Eat slowly and only until you are satisfied, not stuffed.
  • Include both aerobic and resistance-type exercises. Start slowly and gradually build some form of exercise into your daily regimen. Ultimately, shoot for 30 minutes each day at 4-6 days per week.
  • Stretch more. Stretch your muscles daily, especially after exercising.
  • Sit less. Sitting for prolonged periods of time is detrimental to your health. Move your body more each day, even if it means intentionally parking farther away at the grocery store or taking the stairs instead of the elevator.
  • Stress less. Carve out daily time for yourself that allows you to relax and unwind. Plan ahead and stay organized to ward off additional stresses when life gets busy.
  • Quit smoking. Consider using nicotine-replacement therapy and avoid triggers. Celebrate small successes along the way.
  • Get more sleep. Aim for 7-9 hours every night. Sleep-proof your bedroom (get rid of lights, noise, and distractions) and create a bedtime ritual to help induce quality sleep. Avoid computer, tablet, or smartphone screen-time in the hours before bed.
  • Improve Posture. Whether you’re sitting, standing, or sleeping, become more mindful in keeping your spine in its natural “S” curve. Imagine that you are being held up by a string attached to the top of your head.
Remember that you should not try to achieve every one of these goals all at once. Living a healthy lifestyle begins with one simple choice after another. Even choosing just a few of these to help you create better habits for yourself will put you on the right path.

4 Tips for Sticking to Your Resolutions

New year. New resolutions. But will we stick to them this year?

Here are four tips for helping you stay true to you.

Start by making it a habit. Habits take about 21 days to form. If you stay true to trying to achieve your goals for at least 21 days, keeping up the habit after that should be as easy as pie… well, easier anyway!

Set specific achievements. Sometimes we make resolutions that follow the trends in society – to be healthier; to exercise more; to join a gym. But, it will be far easier to stick to your goals if they are personal, and specific, to you. To set a specific goal, try thinking of those things that cause you to feel anxious when the do or don’t happen as planned. If falling behind on your work causes stress, resolve to set a goal of creating a daily time keeper tracker to help you more proactively manage your projects. This makes the goal specific to you and directly helps to address a negative feeling you have. This correction will make you feel better, and you will be more likely to stick to it as a result.

Create SMART goals. SMART is an acronym that can help us manage our personalized goals:

  • Specific. Make the goals as specific as possible to increase the likelihood of seeing it through.
  • Measurable. Make the goals measurable so that you are able to see the progress you are making along the way.
  • Attainable. Making the goals realistic and something you can attain helps to keep you on track without feeling stressed out while trying to achieve them.
  • Realistic. Make the goals realistic and your progress will follow suite. For example, if you’re not an avid gym goer, try committing yourself to going three times a week, and go from there. You can work your way up to what is realistic for you – what fits in with your lifestyle.
  • Timely. Set a time frame for your goals. This is another opportunity to be realistic. Be sure to give yourself appropriate guidelines to realistically accomplish your goals.

Finally, don’t fret if you stray from your goal occasionally.

It’s part of human nature and the society we live in. We all get busy. Life has a way of interjecting its own plans, and some days that might mean not finding the time to go to the gym or prepare that healthy meal you were planning. It’s OK to slip on your resolutions occasionally… just don’t make it a habit!