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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!

Tips for a Stress-less Holiday

The holidays. Some would say it is the most wonderful time of the year. Others might argue it’s actually the most stressful time of the year. To stress, or not to stress – that is the question.

Whatever you stance, here are my 6 tips to a stress-less holiday season:

6. Think of others in this season of giving – from your community, place of worship, family, friends, neighbors, and even those you’ve never met – give of yourself, give what you can. What you get in return will be a comfort of knowing you made a difference.

5. Plan for holiday of tradition that fits your family – introduce activities and traditions that mean the most. Remember you can’t make everyone happy all of the time, so be sure to find happiness for you as you plan your festivities.

4. Just say no. There may be some holiday events you simply cannot make. It’s OK. After all, you’re only human!

3. Prioritize your parties. As you look at the calendar of events, try organizing against opportunities to see all of your friends and family at least once. Aunt Sally’s brunch? Yes. Visit to your great-grandmother? Absolutely. Champagne with your best friend? Yes. That co-worker who invited the whole office to her holiday gathering? Maybe not.

2. Set aside time for your immediate family – your partner, your kids. Create special memories from those unforgettable moments with those closest to you.

1. Make time for yourself. To be your best self during the fun and festivities, be sure to maintain healthy sleep and exercise schedules. Take a break from the chores – maybe schedule a healing massage – and seize opportunity to steal away enjoy a little ‘me-time’.

If you stay true to yourself and manage your stress, you’ll enjoy this time of year much more and limit your personal health risks.

Happy, and Stress-Less, Holidays!

Parkinson’s Disease: Who, What, Why

What is Parkinson’s Disease?

To better understand Parkinson’s, it is first beneficial to know about the populations it affects, what part of the brain it affects, and some hallmark signs and symptoms. Parkinson’s disease is categorized as a disorder of the basal ganglia (a cluster of neurons in the brain). More than 1,000,000 people in the United States are affected by this disease and it can affect people as early as adolescence, but has an average age of onset of about 60 years old. The cause of the disease is currently unknown, but researchers think environmental toxins, genetics, and a history of depression may be factors. The disease has been found to be caused by a loss of Dopamine (a neurotransmitter) in the basal ganglia. Parkinson’s is progressive in nature and there has been no cure found to date. Characteristics of Parkinson’s include small movements, quiet speech, postural Parkinson’s affects everyone in a different way and progression usually varies from person to person.

What is a Basal Ganglia and a Dopamine?

The basal ganglia are a collection of clustered cell nuclei that control movement. They are divided into two different pathways, each with different functions. The one pathway receives input from the muscles of the body about how a movement is being performed. This information is then interpreted to determine if the movement that is being performed matches what was intended by the brain. In other words, this pathway determines if the movement is of the right amplitude (big enough or small enough) for the intended task. If the movement does not match the picture the brain wanted, the first pathway sends this information to the second pathway. In the second pathway, the nuclei interpret the information received, and send signals to the brain to adjust the movement. Areas that can be adjusted from this information include consciousness, muscle tone, and appropriate “gain” of movement (bigger or smaller movements). To make it simple this corrective information can either ramp up (increase) the intended movements or it can ramp down (decrease) unintended movements.

The two systems use a complex loop to provide a system of checks and balances. The messenger that relays information between the two systems is called dopamine. This substance is classified as a neurotransmitter and provides a way for cells to communicate. Since Parkinson’s is characterized by a loss of dopamine in the two pathways, they essentially lose their messenger and are unable to communicate properly with each other. This can lead to faulty movement patterns or small movements and quiet speech, which are often a characteristic of Parkinson’s.

Current treatments for Parkinson’s vary from pharmacological treatments to increase the amount of dopamine in the brain to exercise therapy. Stay tuned later this month for a blog post about the LSVT BIG program and how it can help decrease the rate of progression of the disease and improve overall function in the population affected by Parkinson’s.

Bryan Esherick PT, DPT

Why Chiropractic or Physical Therapy before Opioids?

Opioid prescriptions have skyrocketed over the last 25 years. Originally they were intended for post surgical patients and those in the end stages of cancer. In 1991 there were around 76 million prescriptions but by 2013 that number had risen to almost 207 million prescriptions.

There are strong ties in rises of opioid use and heroin use.

As prescriptions have risen, so have abuses. According to the CDC more than 1000 people a day are treated in emergency rooms for inappropriate opioid use.  As many as 1 in 4 people using opioids long term struggle with addiction. In 2015 there were nearly 60,000 drug overdose deaths, nearly half of those were from opioid drugs and opioid prescriptions frequently lead to other narcotic abuse. The economic costs of opioid abuse is estimated to be$75 billion a year. On top of all of that, there is no research to suggest that the amount of opioids has had any impact on people suffering from chronic pain. Patients who take opioids for even 1 day have a 6% chance of using them a year later, a 13% chance if they are used more than 8 days and a 30% chance if they are used for a month.

This year the American College of Physicians updated its guidelines for the treatment of acute and chronic back pain to recommend first using non-invasive, non-drug treatments before resorting to drug therapies.

The Joint Commission (the organization that accredits hospitals) has also added chiropractic treatment to its pain management recommendations. The guidelines were published in the Annals of Internal Medicine and based on reviews of randomized controlled trials and observational studies, and recommend spinal manipulation, massage and therapeutic exercise as first treatments for low back pain. Multiple studies support manual therapies and exercise to both resolve acute and chronic pain, but also for conditions you might not expect to see a chiropractor or physical therapist for: Parkinson’s, balance disorders, arthritis, and many others.

Chiropractors and physical therapists have excellent patient satisfaction scores.

A typical treatment plan for a chiropractor or a physical therapist costs less than an MRI.  Chiropractors and physical therapists are neuromusculoskeletal experts, and do far more than just pain relief, they create treatment plans that correct problems. You’ll be stronger, have better range of motion, and in general be more functional and be better able to do the things you love and your chance of recurrence will be lower. Do you have pain? Give us a call and see how we can help!

More Than Just a Bump on the Head

Concussions have become more and more “hot topic” in sports in the United States over the last decade. They have been put in the spotlight by the media and even become the subject of major Hollywood films. According to the International Symposia of Concussion in sport, a concussion is defined traumatic brain injury induced by biomechanical forces. That’s right, a concussion is now considered a traumatic brain injury which represents the seriousness of the condition.

Concussions occur in many different ways ranging from sports related impact to car accidents. Many people do not understand that a concussion can occur by either contact with the head or contact with the body causing head movement (whiplash from a car accident). Sports concussions will be expanded on in the rest of this blog post, but remember they can occur in a variety of ways.

Sports concussions are of particular concern in the present day. Athletes in higher level athletics are becoming bigger, faster, and stronger. This increase in athletic ability has allowed the games to move at a higher pace than in the past. This has led an increased risk for injury for athletes because of the decreased amount of time to brace and react before being hit.

Although helmets are designed to aid in the risk reduction for concussion, their main function is to prevent skull fractures not concussions. Even with improvement in helmet padding through innovation, concussion rates continue to increase. This increase in occurrence is partially related to both the increase in athletic ability and an improvement of sideline diagnosis of the condition. Football continues to be the sport that puts athletes at the highest risk for concussion. To the right is a graph representing concussions by sport in both high school and collegiate players.


What to Watch For

Symptoms of concussion vary from person to person. To the left is a list of symptoms that are commonly associated with concussions. If you are a coach, parent, athlete, or spectator and notice a player that present any of these symptoms following a hit, the trainer should be notified and the player should be removed from the game. It is important to get the athlete out of the game to prevent a second contact from happening. If a second contact happens during the same game or if the person is returned to sport before the injury has had time to fully heal, brain damage or even sudden death can occur. This has been seen a number of times in high school and collegiate sports. It is better to be more conservative and keep the athlete out of the game, than to return them too soon and risk injury or death.


What to do If you think you or someone else has experienced a concussion?

Get that person to a medical professional ASAP! Getting an examination by a medical professional allows for early diagnosis and treatment. Early treatment generally consists of mental rest. This means time away from the TV, computer, cell phones, work, and school. This usually lasts for 1-3 days until symptoms resolve and then these activities can be reintroduced gradually as symptoms allow. Most concussions resolve within 10 days for the majority of people.

Sometimes symptoms may last past the first 1-2 weeks following the injury. When symptoms present past a week or two, the person should seek out additional support to treat possible symptoms stemming from the cervical spine or vestibular system. With treatment of these areas, symptoms generally resolve within the first month of treatment.

In summary, concussions are a serious condition and are now classified as a mild traumatic brain injury. When someone is suspected of having a concussion, medical assistance should be sought out immediately for prompt diagnosis and counseling on appropriate rest procedures. Do not hesitate to reach out for help if a concussion is suspected. It is more important to protect the brain for the future than to stay in the game and risk further damage!

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.