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Healthy Snacking

It is back to school time! That means busy schedules, last minute plan changes and sleeping in to the last possible minute. Nutrition and healthy meals can easily slip through the cracks. Having healthy meals and snacks planned can greatly help you and your family work through this busy and transitional time. Having a nutritious snack in between meals is a great way to incorporate nutrient dense foods into your day. Often we are so busy during the day and either we ignore our hunger cues and inhale our lunch or dinner or we go visit our receptionist friend and get some candy from their basket. There is nothing wrong with the occasional candy, it is just that candy is not going to give you the nutrition you need to stay focused, have energy or be satisfied. Snacks are just as important for our kiddos. Let’s be real, kids are not worried about their nutrition or what type of snack they are eating. Their priority is not being late for their next class, their pop quiz that they are totally unprepared for, or the game they are playing at recess.

snacks for healthy snackingSo what makes a nutritious snack? Snacks need to be a combination of both protein and healthy carbohydrates. Carbohydrates give our bodies energy, provide fiber and help raise our blood sugar levels. Proteins also give us energy, though not as quickly, makes enzymes and hormones and also keeps our blood sugar levels from crashing. The combination of both protein and carbohydrates is critical to keep your blood sugar levels stable to give you sustained energy.

Below is a list of some great snacks that you can easily bring with you to work or pack in your kiddos bag.

  • Half nut butter sandwich on whole wheat bread
  • Fruit + handful of nuts
  • Cheese stick + fruit
  • Small salad with beans
  • Plain whole fat greek yogurt
  • Roasted chick peas or soy beans
  • Cottage cheese + fruit

Happy snacking!

Guest BloggerAmanda Terillo, is a Registered Dietitian Nutritionist (RDN) who specializes in integrative practices.

How To Fit a Backpack

Back to school is right around the corner, which means it’s time to break out the shopping lists and load the carts up with pens, folders, notebooks, crayons, glue sticks and – of course – the backpack. To help your little (or not so little!) one carry that load, it’s important to have the right size pack. We’re here to help!



The first consideration for a good fit will be the the torso sizing. To measure the torso, start from the base of their neck and bring the tape to their hip bones:

  • From a standing position, have your child tilt their head forward and look down. At the base of the neck there will be a big bump (totally normal, called C7). Measure vertically from there to the top of their hip bones. Have them put their hands on their hips and draw an imaginary line across their back – from thumb to thumb. This distance from this line to that C7 bump is your measurement. You want to find a back pack with that length. A few extra inches longer to accommodate growth is fine.

The second consideration will be the multitude of features. You’ll want to be sure whichever backpack you choose has the following elements:

  • Adjustable straps
  • Hip belt
  • Chest strap
  • If your child will carry any electronic devices, you may also want to examine options that include a padded laptop compartment with a waterproof feature

Once you’ve identified the appropriate features, and measured your child’s torso, you’re ready for the fitting to make your final selection. Have your child put on the back pack, and follow these steps:

  • Adjust the waist belt – it should sit up on top of the hip bones, and shouldn’t be so tight that it pinches or so loose that it slides down onto their hips.
  • Adjust the chest strap – it should feel snug, but not so tight that it makes it hard to breathe.  When your child is wearing the full back pack (with books in it), they should not feel any pinching in their low back, or burning between the shoulder blades. They also shouldn’t feel straps digging into them.  If they feel any of those things, you need to keep making small adjustments.
  • Check to be sure your child is able to carry the pack standing up right, without it pulling them backward or forcing them to lean forward.

Be sure to steer clear of these ‘don’ts’:

  • Don’t – drag the bag on the ground
  • Don’t – wear only one strap
  • Don’t – use the chest strap but not the hip belt
  • Don’t – choose a messenger bag
  • Don’t- put more than 20% of the child’s weight in the back pack.

So, if you’ve selected a backpack that fits the torso, has all of the right features, and has been adjusted to a good, comfortable fit, you’re ready to go. DO have a fun and safe return to school!

Summer Fitness: 4 Injury Warning Signs

Summer is here again, and with it comes the feeling of needing to get into shape. We want to look our best, so naturally our activity levels increase drastically. This isn’t necessarily a bad thing – as exercise is one way to ensure a long and healthy life. Unfortunately, for a lot of us, a large increase in activity level without a sufficient ramp-up period can spell injury trouble. The good news is there are warning signs your body sends prior to actually sustaining an injury.

Warning Signs 

Our body does a great job of helping us know whether something is harming us. There are many checks and balances within the body that allow this to happen.  For one, the level of pain does not necessarily equal the level of tissue damage. A little ache in the knees could be osteoarthritis or a torn meniscus. Sharp pain may represent only a minor ligament sprain or inflammation. So, how do you know if you’re over-doing it?

Here are the warning signs to watch out for:
  1. Pain during your warm-up: Warm-ups should not be painful! They get the body primed to work. If it is painful while priming, there is likely something underlying that needs to be take care of. Think of a car “warming up” for a trip on the highway; if it is shuddering, stalling, and a lot of warning lights come on before you make it to the highway, you’re in trouble before you even start the trip.
  2. Soreness that lasts more than 2 days: Soreness following a run or session at the gym – even into the next 24-48 hours – is OK. But, when it lasts for more than three days, something’s wrong. Take a step back and see what can be done differently. Did you push too hard or forget to include a proper warm-up? Our tissue needs to be exposed to demands that it can handle before loading too much. A proper ramp-up period will allow the tissues to adapt and respond to the demands placed on them.
  3. Inability to do as much work as the previous session: We’re always on the go, but our bodies do need REST. If you notice that your performance on workouts is declining, it might be a good time to give your body a rest. When we exercise, our muscles experience small micro tears. Healing these tears allows our muscles to build up and adapt to increased weight, distance, or other demands on your body. Your body needs time to heal before exposure to the same demands that lead to the damage. This doesn’t mean exercise needs to be stopped, but it may be a good idea to target a different part of your body or different muscular subsystem. For example – if you’re a runner, take a day off from running and add strength training on off days. If you’re lifting weights, try alternating days between upper and lower body exercises. Our bodies need variety to adapt. Without it, a decline in performance is likely follow.
  4. When in doubt, listen to your body: This one is relatively straight forward. If you refuse to listen to your body, and continue experiencing pain, it’s likely you’ll suffer an injury. The ‘no-pain, no-gain’ cliche is out. There is a difference between pain stemming from muscular fatigue, buildup of lactic acid and depletion of energy supplies and pain experienced when tissue damage is occurring. Know the difference and respond appropriately to the signals your brain is sending.

Getting back into shape for the summer can be extremely rewarding to just about everyone. But, a phase-in period to safely ease into your programs will help to ensure your body has enough time to adapt. Remember – listen to your body, learn from your mistakes, and build on the progress that you have already made. Stay healthy my friends!

Bryan Esherick PT, DPT

Posture Perfect

With the increase in technological devices of late, posture has been a recurring theme in physical health news more and more. You may have even heard the term “text neck”. If you’ve ever been to a physical therapist or a chiropractor you may have even heard more sophisticated terms like “Upper Cross Syndrome” and “Lower Cross Syndrome.” If you’ve been to Pilates, yoga or barre classes you’ve also probably heard about pelvic tilts and “tucking.”

We know that a good posture is healthy for us. But, you may be asking yourself – what exactly is good posture, and how can I maintain it?

Good posture looks like this. 

Your ears should be in the middle of your shoulders – and your shoulders directly over your hips – and all of that in-line directly over your ankles. Be sure and keep your shoulders down and back, too – not rounded forward. When you’re in a good posture position, you should notice:

  • Your spine should make a gentle ‘S’ curve.
  • Your pelvis should be level and your weight should be evenly distributed through your feet.
  • You experience no pinching in your lower back.
  • You feel no discomfort or excess weight in your heels or the balls of your feet.


The affects of not maintaining correct posture can be significant. Bad posture can lead to pain, injury and even degeneration of the spine. So, take heed and be mindful of your posture in during everyday activities – including how you are holding your head and neck while texting.

Stay tuned for more in our series on posture – the positive, and negative, affects it can have on your health.

Break the Injury Cycle

You’ve recently recovered from an injury, so you started a new workout program, and now you’ve just suffered another injury. Sound familiar? You’re not alone. It’s a common problem that lots of people face. The trick to breaking the cycle is in understanding the cause.

Exercise and rehabilitation is predicated on the SAID principle. This refers to the Specific Adaptation to Imposed Demand. Let’s break it down. We all have our own unique stress line – that limit within each of us that, if breached, will result in injury. This holds true for each system in our body – cardiovascular (heart, blood vessels, lungs) and musculoskeletal (bones, joints, muscles, ligaments, tendons). When we start a new exercise program, we start stressing these two systems. We push too hard and we suffer injury, don’t push hard enough and we don’t gain any results. So how do you overcome this conundrum? Strike a balance on exertion load over time.

When we safely exert ourselves up to the point of our unique stress line, our bodies adapt over time to tolerate increased levels of strain – elevating our individual limits. Think of it like this – you get winded while walking to get the mail, but you keep doing the activity for a week and in the end, you’re less winded over time. On the flip side, exerting yourself below your systems’ stress line, and your body has no reason to adapt and adjust. The key is to operate between the lines.

Here are a few injury risk signs that indicate need for increased recovery time:
  • Experiencing pain during your activity
  • Experiencing pain after your activity
  • Muscle stiffness the next day

It’s important to listen to your body and not overdo it. The concept of “no pain, no gain” is a fallacy. When starting a new program, it’s a good idea to meet with your chiropractor or physical therapist. They should evaluate your fitness, sleep patterns, and diet – and can help you learn the best movements for your fitness level to avoid risk and injury.

Food Can Make Us Strong

In honor of National Nutrition Month, I’d like to share a few thoughts on one of trickier health subjects – food.

Food is, at its core, emotional. It’s tied to all kinds of emotions. Emotions can be positive, happy, warm and fuzzy. But they can also be negative, sad, guilt-ridden and bring about compulsive behavior. The science on nutrition is very difficult, because it has so many factors and variables involved. Not to mention, it’s a very popular topic, and just one new study can launch a myriad of commentary from wellness blogs to news publications, and everything in between. What gets lost in the mix is that the new study is just that – one new study – but sometimes it is treated like the latest, broadly accepted scientific opinion. Remember when carbs were good for you… and then they weren’t… and then they were good again?

With so many different types of dietary models: Paleo, Atkins, Vegan, etc., it can be hard to figure out what’s right for you. There are merits behind so many of them, but the way we think about what we eat is what’s most critical.

Too often we think of food in black and white – as bad for you (but delicious and wonderful) and good for you (but so unappetizing).  A few weeks ago, I enjoyed opportunity to discuss nutrition with a patient in the office. Her name is Christa Bennett, and something she said really struck a chord with me.  She was telling me that she doesn’t talk about food with her children in terms of good or bad. Instead she frames it like this: “is it strong food or weak food?” It made me think – will this food make me strong or make me weak. I really liked it.

When we think of food in terms of good or bad, we are placing an emotional value on it. This isn’t always a healthy thing for our bodies, our minds, or our hearts. Let’s take a note from Christa. As we sit down to our next meal, consider what’s on the plate. “Will this make me strong? Will it make me weak?”

Try to incorporate a few of these foods and tips into your meal prep routine:
  • Fish or poultry three or more times per week
  • Whole grains and fruits daily
  • Vegetables – lots and lots of vegetables
  • Healthy fats, like olive oil
  • Pair proteins with fats
  • Design meals that feature a variety of rich, vibrant colors

We want to eat better so we can feel better, and we want to eat food that tastes good. But we can do without the calorie counting, countless hours preparing in the kitchen, and ultimately feeling deprived and hungry. With a little bit of will power and some slight adjustments to how we think about food, we can feel strong and fuel our bodies right. I have been getting ready for a new jiu-jitsu belt test lately and eating a lot of strong foods, because I want to feel strong. And thanks to Christa, I do. I hope you do to!


Healthy Sleep Habits, Happy Back

Sleep is important. Yet, despite our awareness of sleep benefits, we often don’t make getting enough of it a priority. Sleep loss costs the U.S. $4.2 billion dollars a year – an equivalent of 1.2 million work days a year. But there is more to sleep than getting enough. How you sleep can be just as important to your health.

Stomach sleeping.

Many people sleep on their stomachs. And while stomach sleeping can help with snoring, it can also exacerbate and prolong neck and shoulder pain from a recent or recurring injury.

Side sleeping.

Side sleeping – with your arms below chest  level – is better. But, also brings risk of waking with numbness and tingling in your arms from having them in the wrong spot. I recommend sleeping on your side with your arms down, and your legs almost straight, with a pillow between your knees. Many people have a tendency to bring their chin toward their chest in this position. Try to keep your neck straight, and be sure your pillow is thick enough to keep your spine straight. Side sleeping requires a thicker pillow than sleeping on your back.

So, what’s the best sleep position to cover by best?

Back sleeping.

As a chiropractor, I like back sleeping with your arms down best. It keeps your spine straight and level. This is the ideal position for back health and injury recovery. Tucking a pillow below underneath your knees can be a good extra measure as well. However, if you snore or have sleep apnea, this may not be the best position for you.

So, be sure to get your sleep – and be mindful about how your body is feeling when you wake up – you might need to make some adjustments. If you have pain or stiffness when you wake that’s a good sign that you’ve some adjusting to do. When we wake we should feel our best.

Healthy Life, Healthy Back

Patients often ask: “What caused my problem and how do I keep it from returning?” The origin of a condition may be easily identified as an accident or injury. However, more than half the time, the exact cause is more difficult to pinpoint – because the problem was generated by a series of seemingly harmless events and circumstances (e.g. your posture; increased activity; mild repetitive strains; etc). In fact, most conditions are started by a “recipe” of irritants rather than any single “ingredient”. From a slight increase in your daily exercise routine coupled with less than ideal posture in an old office chair, to a few extra trips up and down the stairs and layering on the Spring chores, all add up to: “Ouch, my back…!”

When life’s physical demands exceed your body’s tolerance for those challenges, muscle, bone, joint and nerve problems begin. So, how do you prevent recurring injury?

Here are five tips to help keep the back strain away.

  1. Lift with your legs. The strongest among us are still at risk of back injury when we lift heavy objects incorrectly. Be sure to squat down, grab the item and use your leg muscles to lift up.
  2. Exercise your core. Your core muscles are key to supporting your lower back. Low-impact activities, like walking, will get your heart-rate up, deliver increased oxygen to your spine, and help keep your middle fit.
  3. Practice your good posture. Much like poor posture can lead to painful back problems, good posture can help prevent injury and strain. Set reminders for yourself throughout the day to check your posture – get up and walk around from time to time – and avoid slouching.
  4. Reduce your stress. We hold tension in our back muscles, and this type of constant stress can cause back pain. Try introducing stress-relieving activities into your daily routine – meditation, yoga, tai chi – the list of options is long. The trick is finding something that works for you.
  5. Be the healthiest You that you can be. Think of your spine as an indicator of your body’s overall health and well-being. So, practicing activities that have a positive affect on your health will also have a positive impact on your back. Drink lots of water; minimize alcohol; avoid nicotine; and limit inflammatory foods (sugar, flour, dairy, processed meats, fried and saturated fats).

Of course, prevention is always the best measure to keep your body pain-free. But, if you do encounter a mishap, partnering with your physical therapist and employing these measures to help increase strength and flexibility can also help increase your threshold for future injury.


Fitness Apps and Trackers: Is Technology Right For You?

Technology is everywhere. We consume tons of media on our phones. We adorn wearable tech that improves our posture. Sleep apps (Rested, Sleep++, Sleepbot) that use motion sensing, sound, and a smart alarm help us measure our sleep quality. All are agreed – there are some great innovations that have entered the marketplace in recent years. But there’s so much to choose from. How can we determine which technology is best to support our health and fitness goals. The trick is in finding what’s right for you.

Let’s start with apps. They are varied in scope and features. You can get some for free, while some cost extra for upgraded features.   They all work best when you’re faithful about putting in your data every day. If you’re the type of person who doesn’t like to mess with data and numbers, these apps may not work for you.  Here’s a closer look at three technology options:


  • Myfitnesspal – Like most apps, it requires you to manually input data each day, but lets you track your exercise, food and weight, and helps to create a calorie budget based on your goals. It also syncs with several other popular media and fitness devices, and even plays music while you’re working out.
  • Strava – This one is geared for the competitive runners and cyclists, allowing you to compare your achievements to everyone else using the app. This can be a great boost if a little competition is what you’re going for.
  • Spotify – A new player in the fitness app game, Spotify is allowing premium members to search for songs based on your running pace so you can use music strategically to help you train.
If you find that using an app is causing you stress and anxiety, or affecting your self-esteem, it’s a warning strategy is not good for you.

Fitness trackers are another tool for supporting your fitness goals. The philosophical idea behind them is “that which is measured, improves.” However, a new study revealed that people who used fitness trackers actually lost less weight than a control group that didn’t. The trackers and apps rely on an algorithm to determine your ideal caloric intake – but, in many cases, this one-size-fits-all approach doesn’t get it right. So, while you may be moving more, you also may be eating more.

It takes years of research and dozens, if not hundreds, of research papers before the scientific community is able to achieve consensus on what truly works and what doesn’t. These devices are only a few years old, so those studies are far from over – until then, research should be used merely as a guide to help shape personal opinions. If you want to try a fitness tracker, go for it. If it helps you, that’s great. But, if you find yourself using an app or following a tracker without the results you wanted, try making modifications. These tools should help to take the guess work out.

This technology is new and all devices currently on the market have quite a way to go before they will fulfill their promises.

While the technology gets a little better each year, it will likely still be a while before we can rely on them completely. They are a good starting point. But, if you think fitness technology might work for you, be sure to read reviews first – the good, the bad, and the ugly. If you are using one but not getting the results you want, talk to your healthcare provider about help in finding a support solution that’s right for you.

Patient Centered Care: Putting the Patient First

Lots of medical Practices and hospitals promote a patient-centered approach. It’s a hot buzzword in healthcare right now. But, what does that really mean? The IOM (Institute of Medicine) defines patient-centered care as: “Providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions.”

Patient-centered care is a custom tailored approach. It takes the individual patient into account when making care recommendations. While the practice of medicine uses a great deal of science, not all approaches will work well for every patient. That’s where this approach comes into play.  It’s more than just following intuition and the available science. It takes unique patient preferences into account – from individual challenges to lifestyle factors. As care providers, we need to listen to our patients and prescribe programs that adapt to their needs and align with what is realistic for them.

So, how do you know if your healthcare provider is truly taking a patient-centered approach? Check these three cues:
  1. Are they asking questions and engaging in a discussion around your holistic health situation?
  2. Does the program prescribed fit with your lifestyle, and feel realistic and attainable for you?
  3. Have they listened to you? Do you feel heard?

Your health and well-being requires action on both your part and that of your healthcare provider. You will achieve better results when you follow the requirements within a customized recovery and wellness plan. So, look for a partner when seeking medical assistance – and,  remember, when choosing a healthcare provider or a hospital, look for a patient-centered approach.