The common sense DIET

1. Eat smaller portions. You may be surprised at how little food can fill you up and hold you over until the next meal. Learn to listen to your body to tell you when to eat and when to stop eating.
2. Keep yourself busy. That gives you less time to sit down and munch on junk food. Fill your free time with productive tasks, activities and hobbies. I know that if I am alone for very long and turn on the TV, I then start and continue munching indefinitely.
3. Eat slowly. My husband is naturally good and this, and he usually ends up eating much less volume than the rest of us who eat fast.
4. Replace juice with fresh fruit. 100% juice is ok, but the best choice is the fruit itself. It is packed full of nutrition and fiber!
5. To eat your 5 servings of fruits/vegetables each day, plan them into your meals/snacks. For example, have 1 serving with breakfast, 1 for a morning snack, 2 servings with lunch, 1 with supper and 1 for an evening snack.
6. Cut out soda (even diet soda). Replace it with water!!!

SAMPLE MENU
Breakfast: cereal, skim milk, 1 large banana (counts as 2 fruit servings)
Snack: yogurt
Lunch: Turkey on whole wheat with tomato/lettuce/cucumber
Snack: apple
Supper: grilled chicken, whole wheat pasta with sauteed vegetables and marinara sauce
Snack: almonds

How to LOSE WEIGHT

Losing weight is not easy. If anyone tells you it is, do not believe them or follow their diet. It takes a lot of work and effort. But if you do it right, you will get the weight off and keep it off. Your whole lifestyle and mindset will change for the better. Once you start a healthy lifestyle, it will be easier to maintain. Right now, you may have some good and bad health habits. If you have mostly bad ones, you will likely see more dramatic results of changing them. There are 4 components to lose weight. If you modify one, you might see some results. But if you modify all four at once, you will see some big results! They are:  eating, drinking, exercise, and activity levels.

Healthy eating means modifying everything you eat. Think about your food choices and try to choose a healthier option. There is always a healthier option. You do not always have to choose the healthiest one, but at least take baby steps in the right direction. The more dramatic you are in your choices, the faster and greater the WEIGHT LOSS!!!

Healthy drinking means modifying everything you drink. What do you presently drink? Is there something better, healthier or with less calories? Start cutting out the ones that give you lots of calories with no nutrition. Then start working on the others (or modifying them). DRINK MORE WATER!!!

Healthy exercise means starting or increasing your workouts. This is how a lot of people get hurt, so be wise. Work up to 30 minutes, 5x/week. Then work up to 45 minutes, 5-7x/week. Then work up to 60 minutes, 5-7x/week. Be sure to do both cardio and strength training. Consider interval training. Classes like Zumba and spinning are great tools! Jogging and/or walking (fast) are also great and convenient choices.

Healthy activity level means GETTING OFF THE COUCH! Start standing more and sitting less. Start watching less TV. Stand when you are on your laptop. Look for opportunities to stand up and walk around. See every chance to get up and move as a calorie-burner. Do more housework/yardwork. Walk the dog more. Start a more active hobby. Run around with your kids (and pets) in your backyard. BE MORE ACTIVE!!!

PREVENT PAIN to save money!

So if you are not yet on board with PAIN PREVENTION for the sake of having less pain in your future, maybe saving money will convince you.

How much do you pay when you go to the doctor's office? If you have health insurance, you probably pay $20-$30. Then you might get a small bill for some labs, x-rays, or other tests. Of course, if you have not met your deductible, you will get a big bill for these. And don't forget the prescriptions! Obviously, healthcare costs are crazy high and drive us all crazy!

So what are the costs for a major injury?

1. Initial doctor visit.
2. Prescriptions.
3. Specialist doctor visit.
4. Tests (x-ray, MRI, etc.)
5. Prescriptions
6. Physical Therapy and/or chiropractic care
7. Follow-up doctor visits
8. More prescriptions
9. Over-the-counter symptom management (Icy Hot, cold pack, heating pad, etc)
10. Surgery/hospital bills
11. Medical equipment
12. Follow-up doctor visits

You could easily reach your out-of-pocket max (which you selected to be high, not expecting to hurt yourself this year). What would you rather do with that money?

How To LOSE WEIGHT Safely

1. Do not use diet pills.
2. Do not injure yourself by exercising too hard, too fast. An injury will limit your ability to exercise, so do not risk it.
3. Do not starve yourself.
4. Do not eat so little that you are hungry all the time.
5. Find ways to not only burn calories but to boost your metabolism. (See next paragraph)
6. Do not stay on a short-term diet for long. It may help to jump start your weight loss, but you quickly need to transition to a lifestyle of healthy eating that you can stick to!
7. Buy the right shoes for the exercise you will be starting.
8. Be sure to drink enough water before, during, and/or after your workouts.
9. Always warm up and cool down with your workouts.
10. My favorite: drink more water and less of everything else.

Here are some ways to boost your metabolism:
1. Wake up early and eat breakfast early.
2. Exercise early in the day. Exercise multiple times in the day.
3. Do weight training in addition to cardio.
4. Move around a lot! Start having a more active lifestyle. Think of ways to add activity into your routine.
5. Eat small amounts throughout the day (4-6 small meals instead of 3 large ones).

BALANCE for Pain Prevention

Balance exercise helps to strengthen your legs and core, which helps to decrease your risk for joint pain and injuries. So here is one way I add balance exercise to my usual routine.

First, pick a standing activity that takes you at least one-two minutes (for me, it is blow-drying my hair, which takes much longer). Next time you do that activity, do so by standing on one leg. See if you can hold that position for at least 30 seconds before you switch legs. If you do not have good balance, be sure to stand close to a table or counter so you can catch yourself. Be careful not to fall. If you lose your balance, you can always touch your other foot down and then start again.

Once you are good at balancing on one leg and can do so for 30-60 seconds easily, here is the next step. Stand on your left leg and slowly kick your right leg straight out to the side. Kick slowly (about 1-2 seconds up and 1-2 seconds back down). Do not kick very high (about 2 feet). Repeat at least 10x on each side (try to not use arm support if you can do so safely). This exercise is great for improving balance and hip muscle strength!

12 Ways To LOSE WEIGHT

1. Drink more water! It is calorie-free and actually burns calories.
2. Eat more fruits/vegetables. Try to eat 5 servings every day.
3. Eat less red meat. Replace it with white meat, fish and/or legumes (pinto beans, kidney beans, lentils, etc).
4. Exercise more! Start a habit of exercise in your daily life. If you presently do not exercise, think of ways to exercise at least 1-2x/week. If you exercise 1-2x/week, work up to 4x/week. If you exercise 4x/week, work up to 6x! Try to do at least 30 minutes of exercise each time.
5. Eat less processed foods. They are full of preservatives and sodium.
6. Squat more! This will build up your leg strength and save your back! Squat whenever you reach down to the floor. Keep your back straight when you do.
7. Stand up straight. It will make you look taller!
8. Start off your morning with a healthy breakfast. Eat it soon after you wake up.
9. Take the stairs.
10. Park in the first parking place you see.
11. Don't lie down if you can sit. Don't sit if you can stand. Don't stand if you can walk. Don't walk if you can run. Some people are paralyzed and wish they could run. So don't take it for granted.
12. Find someone to work out with. You can motivate each other!

How I gained and lost 25 lbs

For those of you trying to lose weight, here is my story.

I have always been slender, and I weighed 125 lbs. when I finished high school. But when I got to college, I started gaining weight. Freshman 15 turned into more for me. My eating, sleeping and snacking habits totally changed. I lived on campus at a small college, so I had free reign of the dining hall and snack bars. At mealtimes, I did not overeat, but between meals and at night I constantly snacked. Our hangout was Perkins, and we usually went around midnight. There was a cafe in the student center, so my friends and I always met there for milkshakes.

So there is no doubt as to why I gained weight. I went from 125 lbs to around 150 lbs (at my highest). I kept exercising as usual because it has always been a hobby for me. But I became much more self-conscious about my body since I was 25 lbs heavier than I had ever been in my life. I got stretch marks, so I even stopped wearing shorts for several years. Another thing that changed was I stayed up much later and woke up much later. I usually woke up around 10 AM and went to bed around 2 AM.

So how did I lose the weight? When I got to graduate school, my sleeping and eating habits returned to normal. I woke up around 6:30 AM and went to bed around 11 PM. I ate 3 meals a day and small, healthy snacks in between. I ate salads and healthy sandwiches daily. At night, my only snack was Icy Pops. I did not keep any other snack foods in the house. I ate tons of fruits and vegetables and always drank water.

So by the time I got married (last year of grad school), I was back down to 125!

How to PREVENT PAIN when relaxing

If you are like my husband, you like to sit back and chill when you get the chance. Of course, with two babies, he doesn't get that chance very often... (I am the opposite; when the kids are asleep, I start cooking, cleaning and blogging).

So while you are watching your favorite team or holiday movie, here are some tips for future PAIN PREVENTION.

1. What position are you sitting in when you watch TV? Instead of slumping, try sitting up with a small pillow behind your low back. Or lie on your side for awhile. Or lie on your tummy on the floor.
2. What are you snacking on? If you start bad eating habits when you are younger (when your metabolism is higher), they are hard to break later in life (when your metabolism slows).
3. Make a healthy eating rule for yourself. No junk food until you have had 5 servings of fruits or vegetables that day. So at 10 pm if you want to snack, you may need 3 cups of berries.
4. What are you drinking? Make a healthy drinking rule. No calorie-filled drinks until you have had 6-8 glasses of water that day.
5. Enjoy your relaxation time, but try to add more activity. Exercise is a great form of stress relief! And it helps you to sleep better.

A busy mom's PAINFUL Christmas

This is a true story.

There was a busy mom who had four children. She hurt her back one day when she was at work. Her work was pretty strenuous; she cleaned houses. This was no minor back injury--she could barely stand up and walk. So working was out of the question. But how could she take care of her kids and maintain her home? She was used to doing all the cooking for their family of six, in addition to all the usual activities busy moms do.

It turns out she needed back surgery! While recovering, her children often found her lying on her side on the living room sofa. At least that way she could be in the same room with the rest of the family. She could not believe this happened, but all she could do was pray for a fast recovery. She was powerless to do anything for her children during that time. For once, her kids and husband had to serve her instead of the usual way of life.

The worst part was that she had been the only parent working full-time because her husband was in graduate school full-time. Christmas was coming, and they did not have money for presents; they barely had enough for groceries. But God answered that busy mom's prayers and provided some gifts for the children to open up that year.

That family truly felt the cost of a major injury. Hopefully you never will, so practice PAIN PREVENTION today!

Back trauma and future PAIN

There are two basic forms of trauma to the back: major trauma, such as a one-time event and repeated micro-trauma. The good news is that both can be avoided (at least most of the time).

Major back trauma can be avoided by proper body mechanics (every time), caution with activities (such as moving heavier objects), good technique with strenuous tasks, and a lifestyle focused on safety. PREVENTING FALLS is key!

Repeated micro-trauma can come from:
1. Poor posture over the years
2. Multiple minor back injuries
3. Limping for excessive periods of time
4. Obesity
5. A sedentary lifestyle/lack of exercise (starting early in life)
6. Improper bending, twisting and lifting
7. Playing certain sports

A case for PAIN PREVENTION

Why prevent pain? Why do you need to take the time to think about how to prevent pain? You are busy, and you have important things on your to-do list.

First, now is the time to think about pain. Think about it before it happens. If you think through every movement and every activity, you can prevent accidents, injuries and therefore prevent pain. You can prevent pain now, which will also prevent pain later in life. If you injure your knee playing soccer at age 20, you may end up with arthritis in that knee when you are 40. If you practice poor posture now, you will end up with back or neck pain in the future. If you are sedentary now, you may not be able to walk later.

Many accidents can truly be avoided. Have you ever been in a car accident? Think back to that day and how it all happened. Were you at fault? If so, is there something you could have done differently? Were you driving too fast or talking on the phone or trying to quiet the screaming kids in the back seat?

Think of the last time you hurt yourself. How did it happen? If you could rewind time, could you have done anything to prevent the pain? I propose that most injuries are preventable because I have worked with so many patients with preventable injuries over the years. So before you become my next patient, think ahead and practice pain prevention today!

PAIN PREVENTION in the Christmas story

1. Joseph practicing his carpentry (with good technique).
2. The wise men walking a long way from the East.
3. The shepherds hurrying to see baby Jesus.
4. Mary and Joseph walking/riding to Bethlehem for the census.
5. All the visitors squatting or kneeling down to see Jesus in the manger (with their backs straight :)
6. The shepherds stretching their necks by looking up at the angels.
7. The wise men stretching by looking up at the star over the stable.

Please add to the list if you can think of any others! Merry Christmas!

ABC's of PAIN PREVENTION

This was my 2-year-old's idea, when I asked him what to blog about today.

Always Be Cautious (especially when lifting).
Do Everything with a safety Focus.
Get out of the House and Into shape!
Jump into preventive medicine/wellness!
Keep your body moving.
Look for More Nutrition.
Over-exaggerate Proper body mechanics (even when your spouse teases you).
Quit making excuses.
Eat Right most of the time.
Splurge on occasion without feeling guilty.
Think like a PT!!!
U can have a more Vibrant body: With more eXercise!
Yoga, pilates and Zumba are great tools to improve your health!

Why PREVENT PAIN when you are YOUNG?

1. So that you do not have to get your knees replaced later in life. That is no fun--I promise!
2. To avoid having a rotator cuff repair. That and knee replacement are fighting for the title: most difficult surgery to recover from.
3. To be able to stand upright when you are 80. A lifetime of poor posture leads to losing the proper curves of your spine.
4. To live a longer and healthier life!
5. To be happier both now and in your future!
6. Because you hate pain.
7. To avoid chronic back pain when you are older.
8. Because it is easier to prevent it now than to treat it later in life.
9. To avoid becoming friends with your Physical Therapist. :)
10. To save money! Pain is expensive!

Why is KNEE PAIN so common? Part 2

Knee trauma can be prevented with increased caution in these areas.

1. When you are standing up from a low surface, do so slowly. 

2. Avoid standing up and turning at the same time. 

3. Add leg stretching and strengthening to your exercise routine. 

4. Be very careful getting on/off the floor. 

5. Avoid leaning forward excessively if your knees are straight (example: reaching into the back seat of your car). 

6. Do all that you can to prevent falling! Stairs and bathrooms are higher risk areas. 

7. Be more cautious when you stand on step stools, chairs and ladders. Be cautious as you get up and down from those as well.

8. Do not stand on any surface that is questionable (ex: standing on a book shelf in order to install a curtain).

9. If you play sports, do specific exercises to prepare yourself. Warm up well before you start practicing or playing. Stay warm during your breaks (ex: baseball, football).

10. Listen to your body. If your knees start hurting when you are exercising, take a break from the painful exercise. Do not exercise through an injury because it will get worse.

Why is KNEE PAIN so common?

There are many causes of knee pain, which I will not go into because they are very technical and somewhat boring to talk about. But here are some things to watch out for.

1. Twisting your knee. This can be even more risky if you twist it quickly (sports).
2. Wearing unsupportive shoes. You need shoes with arch support! This is especially true when you will be walking a lot. Do not go cheap on shoes because your body will suffer for it.
3. Not wearing orthotics. Not everyone needs orthotics, but those who do should wear them all the time. If you have one or more of these, you may need orthotics:  flat feet, high arches, knock-knees, bow-legged, pigeon-toes, scoliosis (this list is not comprehensive).
4. Single knee trauma (car accident, fall, sports injury, etc). High risk sports are soccer, tennis, football, etc.
5. Thigh muscle weakness. Here is a simple exercise to get started with strengthening: straighten your leg in front of you (heel of foot can be on the floor). Lock your knee by squeezing/contracting your thigh muscles for 5-10 seconds. Repeat at least 10x.

To be continued!

Healthier Dessert Options

Keeping your weight down is one of the best ways to prevent pain in your future! It helps to decrease wear and tear on your back and joints. So here are some ideas for tasty desserts that are a little healthier than usual.

1. Serve your favorite berries with some low-fat whipped topping and a graham cracker on the side.
2. Bake your cake mix using applesauce instead of oil. Instead of frosting, mix low-fat whipped topping with pudding mix (pistachio is my flavor of choice) and crushed pineapple. Be sure to fold in the whipped topping last.
3. Oatmeal raisin cookies made with margarine instead of butter.
4. Hot chocolate made with skim milk.
5. Make a parfait with fresh fruit and low-fat yogurt.
6. Top a few animal crackers with peanut butter and some sprinkles.
7. Pudding made with low-fat milk.
8. Cut out some calories from your pies by not eating the crust (I don't like pastry crust much anyways).
9. Make a fruit dip by mixing low-fat cream cheese with a little powdered sugar.
10. Homemade trail mix with dried fruit, granola, nuts, cereal, and/or a few chocolate chips.

BODY MECHANICS in the Restroom

This may be unheard of, but consider your BODY MECHANICS when you are in the restroom/bathroom! I bet there is something you can improve on whenever you go to the bathroom. Here are some areas to consider:

1. Washing your hands or face. Do you bend forward from your back? Squat instead!

2. Brushing your teeth. What position is your back in? Try to squat...it helps if you stick out your buttocks.

3. Drying off after bathing. Check your back position when drying your legs and feet. Also, tubs/showers are high risk areas for falling.

4. Cleaning the toilet. Don't forget to squat instead of bending your back.

5. Cleaning the tub/shower. Try squatting inside the tub when scrubbing. Or sit on a step stool inside the tub. Try using a scrubbing mop. There are even some self-cleaning shower products (I have never tried them though).

6. Shaving. You may need to get creative, but find a way to shave and rinse without bending forward from your back. Try squatting or holding a lunge position when you need to rinse. Men--could you shave in the shower? Women--could you sit when shaving your legs?

7. How do I say this politely? Wiping... Just check your back position and see if you can improve it.

PAIN PREVENTION for Parents/Grandparents Part 2

Here are some more activities involving the young children in your life that could put you at risk for injury.

1. Bathing the child (in the bathtub). Sit or kneel next to the tub. Do not try to stay in a squat position for an extended period of time. Do not bend forward from your back. Use a proper squat to put the child in/out of the tub (squat using your legs and keep your back straight).

2. Playing with the children. Sit on the floor (cross-legged). Or sit on a chair/sofa and have them come up that height. As soon as they can, have them climb up to your lap instead of you lifting them up. Get on your hands and knees (keeping your back straight) for a few minutes. Lie on your back on the floor (with your knees bent). Or lie on your tummy as you play/read with them.

3. Lifting the child into a high chair or car seat. Squat down to pick up the child, keeping your back straight. Do not twist your back. Squat or kneel as you fasten the strap. When putting the child into the car, you may need to divide it into several steps in order to modify your position. This is very tricky, but you must find a way to do it without twisting your back. You may need to partially kneel or squat with one or both legs in the car.

4. Washing their hands/face. If they are old enough, have them stand on a step stool. Otherwise, use your body in a semi-squat position to support the baby's lower body. Use one arm to support the torso. Use the other hand for the washing. Be sure to keep your back straight! (Do I sound like a broken record?!!)

Pain Prevention for parents/grandparents

I have two young children, so I know how hard they can be on your back (and your nerves at times...jk). Here are some activities you may have noticed to be difficult and some ideas for improved BODY MECHANICS.

1. Getting your child out of the crib. As soon as your babies are able, have them stand up before you lift them out. Have them stand at the part of the crib closest to you. Squat using your legs and keep your back straight as you lift them. If you must bend down, lean your tummy on the front of the crib and go down or come up very slowly. Do not twist your back.

2. Putting sheets on the crib mattress. The best tool I have seen for this is a sheet saver. It is a sheet that attaches to the bars on the crib itself. So you can change the sheet by simply kneeling down and attaching the loops around the bars (a total of about 8 loops). If you have traditional sheets, you may find it easier to take the mattress out of the crib before changing them. Use two people if possible because that is difficult in itself! Also you could put several fitted sheets on at once, each with a waterproof pad underneath. If the top one gets soiled, you can simply remove it and you still have a few clean ones below.

3. Picking up the child. Squat down every time! It is an exercise! Squat using your legs, and keep your back straight. You will feel your legs getting stronger! Do this whenever you pick up the child. Start picking them up less once they can do things like climb into the car seat by themselves. They will appreciate the independence.


To be continued!

Walking more for EXERCISE

My husband and I just returned from a great trip to Charleston, SC! We were celebrating our 6th wedding anniversary! While we were down there, we did a ton of walking. If you have ever been to Charleston, you know what I mean.

It is a very beautiful and historic town with lots to see, so we walked everywhere.
We walked around the battery, the market, did some Christmas shopping, King Street, Waterfront Park, art galleries, etc.  We even went to a tuba concert!

All this is to say that walking is such great EXERCISE!!! It is an exercise that you can do anywhere! You can walk in your neighborhood or the mall or at a park. If you get bored in your neighborhood, you can walk in the next one over. Some parks have hiking trails, which can add a challenge for your body, especially if they have hills. Trails are nice because they are softer than walking on sidewalks. Finlay Park (downtown Columbia, SC) even has stairs, which can further increase your workout.

One last thought: Before you go walking, be sure to wear the right shoes! I definitely did not walk around Charleston in high heels!

How to avoid PAIN this Christmas!

Christmas is almost here! So as you prepare, consider your BODY MECHANICS as you do these tasks. I don't want you to end up hurting yourself during this joyful season!

1. Decorating the tree. Be extra careful when you put ornaments on the low branches.
2. Putting up lights outside. Be extra careful if you have to use a ladder.
3. Baking. Watch your body mechanics as you put the cookies into the oven. Be more cautious as you load/unload the turkey or ham from the oven.
4. Picking up the babies in your extended family. Keep your back straight and lift with your legs!
5. Raking leaves (in the South we are still doing this). Keep your back straight and avoid twisting. Shift your body weight from side-side. Take lots of steps.
6. Shoveling snow (unheard of here in SC, but this one is for my Canadian and Russian readers). Keep your back straight, use your legs, take your time, don't twist your back.
7. Loading/unloading the dishwasher. Don't bend forward from your back!

Merry Christmas! May you be healthy, safe and PAIN-FREE!!!

Bringing the SAFE Home! Funny dudes...

Major Preventable Injuries

You hear about injuries and accidents every day. But are they truly accidents? Which ones could be prevented?

1. Burns
2. Falls
3. Diving accidents (esp. diving into shallow water)
4. Alcohol-related accidents
5. Unsafe driving
6. Rotator cuff tears
7. Back strains

Safety and injury prevention is your individual responsibility. If you truly want to live with minimal physical pain, you must practice safety at all times. This is true whether you are at home, at work, in the car or at the mall. Do not expect your employer to make your work environment or work station safe. Your manager will not be the one experiencing your pain if you get hurt at work. Do whatever it takes to keep yourself safe from these types of injuries. I do not want you to end up being my next P.T. patient, and trust me--you do not want that either.

How to decrease PAIN with a minor INJURY

It is common for family/friends to ask me how to manage a minor injury. "Hey, Liz--my back hurts" is a pretty common one. "I hurt my shoulder the other day." "For some reason my knee is bothering me."  I won't give any names, but some family members have a new area of pain every time I see them :)

My answer is the same for almost all of them. It involves a few easy steps.

1. Ice the painful area. Put a cold pack, a bag of ice, or a bag of frozen vegetables in a pillowcase and place it on the area of pain for 10-15 minutes, at least 1-2x/day.

2. Avoid the aggravating activities. If there are activities that bother your pain, try to avoid them or modify them for the next week.

3. Manage your pain with over-the-counter medicine if needed (check with your doctor and/or pharmacist for further  guidance)

4. Call me back in 1-2 weeks if it is getting worse.

Cardio EXERCISE and WEIGHT LOSS

I highly recommend cardio exercise as one piece of a weight management program. Here are some tips:

Be sure your cardio workouts are challenging! You should be sweating and breathing moderately hard throughout (unless you have medical conditions--please consult your physician). Your heart rate should be 50-70% of your maximum heart rate (220 minus your age).

Try alternating cardio with strengthening. Maybe do a total of 30 minutes of cardio and 15-20 minutes of weight training, which will boost your metabolism. You can even do cardio intervals of 5-10 minutes with weight intervals for 5-10 minutes. Good, challenging weight training will increase your muscle mass and therefore you will burn more calories throughout the day (not just when exercising).

If you really prefer cardio and not weights, then try changing around the type of cardio you do (spinning, walking, running, aerobics, swimming, hiking, sports, etc). And be sure to increase the intensity or resistance of the cardio as you progress. If it feels too hard, then bump it up and down to your tolerance.

Healthy snacks for WEIGHT LOSS and PAIN PREVENTION

One of the best ways to decrease stress on your joints (and therefore decrease PAIN) is to maintain a healthy weight. So here are some healthy snack options to consider. Always remember to check your portion sizes, even with healthy or low-fat foods. A serving size is often much less than you would expect. This is good news for fruit servings but bad news for dessert servings.

1. 1/2 of a large fruit, or 1 small-medium sized fruit. Or eat the whole large fruit and that counts as 2 of your fruit servings for the day!
2. Icy Pops. They are inexpensive, take several minutes to eat, and are very low in calories.
3. Yogurt. This could be a good replacement for ice cream.
4. Jello. It's low calories, sweet, and fun!
5. Nuts or seeds. Check your serving sizes before you begin munching though.
6. Triscuits. They have only 3 ingredients!
7. Hummus. It is full of protein! This is actually my son's favorite food!
8. Raw veggies, such as carrots, celery, cucumbers, etc. If you like to dip them, try hummus or fat-free sour cream (may want to add lemon pepper or another seasoning to the sour cream).
9. Deli meats (a few thin slices rolled up). These are usually high in sodium, so not the best option for those with high blood pressure.
10. Cereal. A serving with low-fat or skim milk might get you through your next sweet tooth.
11. Sauteed vegetables. Whenever I make them, I can't help but munch on them, especially if they are seasoned right (pepper, garlic powder, fresh lime juice, etc)

Starting an EXERCISE program

Whether you enjoy it or not, EXERCISE is vital for your health and well-being! It strengthens your heart and lungs, increases circulation, boosts your metabolism, strengthens muscles and improves your endurance, among many other benefits. So there is no question that you should exercise... But do you?

There are two ways to look at exercise-related pain. One is the health problems you will encounter if you do not exercise, such as type 2 diabetes, high blood pressure, high cholesterol, obesity, heart disease, etc. Exercise can be as easy as walking your dog or using a treadmill. Find an exercise that is convenient and enjoyable for you; otherwise you will probably not stick with it. If finances are the constraint, just start a walking program.

The other form of exercise-related pain is injury during/after the workout. If you are going to start a new form of exercise, prepare yourself with proper footwear. Then start with a little at a time. Do not jump to running 5 miles (or even 2 miles) the first day. Be sure to warm up for 5 minutes by walking or doing some light cardio exercise. If you need to stretch before your main  exercise, do so after your warmup. Stretching after your workout can be very helpful, even if you do so for 3-5 minutes. If you only have time to exercise for 30 minutes, your first few minutes and last few minutes should be done a little slower than the bulk of your routine.

When was the last time you exercised???  I will mail a FREE PRIZE for the best and worst responses (within the USA)! Reply in comments section below! This contest lasts for 24 hours!

PAIN PREVENTION while sitting

This is dedicated to Marti Bedell and her real estate team!

Do you sit a lot at work? Do you drive a lot at work? Excessive sitting over a lifetime can lead to back problems later in life. This is especially true if you habitually slouch. So how can you maintain a HEALTHY BACK over a lifetime of sitting?

First, try not to sit all day. Are there a few activities that you could do standing up? Mail, email, phone calls, etc? If you have a desk job, you are likely in the habit of sitting for almost all your daily tasks. But if you are creative, you could easily find at least a few minutes each hour to either stand or walk around.

Second, whenever you sit, be sure to sit with good posture. There should be a small arch in your low back, and your neck should not be strained forward. Your shoulders should be relaxed, and your forearms resting on your desk or keyboard. Your wrists should be straight.

Happy sitting (and standing)!

How to decrease BACK/NECK PAIN at work

Two easy ways to decrease back/neck pain at work are to improve your posture and to change positions more often.  So for those of you who sit at work most of the day, here are some legitimate excuses for getting away from your desk at least once every hour.

1. To go to the bathroom.
2. To get your morning coffee.
3. To refill your water bottle.
4. To get some fresh air.
5. To stand up and stretch (stand up and lean backwards at least 1-2 times).
6. To ask a coworker a question (instead of an email).
7. To walk around the building (it may be better not to do this every hour if you want to keep your job).
8. To rally up your lunch crew.
9. To simply rest your brain and eyes for a moment.
10. To talk on your cell phone briefly or to send a text (pending work regulations, of course).

If you have to sit most of the day at work, be sure to use low back support in your chair. If your work chair is not ergonomic, take the initiative to find or request a new one. Your back will thank you.

Maintain a HEALTHY WEIGHT for future Pain Prevention

You may not experience pain right now, but you will as you age. Don't you remember growing up and hearing your parents or grandparents say it hurts to grow older? "My back hurts...I'm just getting old." But do you have to hurt as you grow older? Maybe. But what steps can you take to decrease the chance of arthritis pain later in life? Here is a list of tips for maintaining a HEALTHY WEIGHT (no matter how old you are).

1. If you are going to snack, snack on healthier foods!
2. Drink more water!
3. Drink less sugar-filled, calorie-filled drinks!
4. Be more active!
5. Start exercising (you can even start with 5-10 minutes of walking)!
6. Decrease your fried food intake!
7. Replace red meat with white meat or fish at least 1x/week.
8. Stand up more. It burns more calories than sitting.
9. Eat more fruits and veggies!
10. Think of ways to decrease your volume of food consumption!

Please share any success stories or additional tips that have worked for you!

Fall prevention for PAIN PREVENTION

Falls should be prevented at all costs for those who want to prevent pain. This is true at any age. So here are some common risk areas for falls.

1.  Wet floors (bathroom, kitchen, restaurants, stores).
2.  Walking in the dark (walking to bathroom in the middle of the night, walking outside in unlit areas)
3.  Walking in the rain, ice or snow.
4.  Walking too fast or being in a rush.
5.  Doing multiple tasks at once (carrying something while reaching for something else and turning at the same time)
6.  Stairs.
7.  Doorways.
8.  Curbs.
9.  Changing ground surfaces (from sidewalk to grass or tile to carpet, etc.)
10. Obstacles/objects on the floor in your home.
11. Getting in/out of bathtub or shower.
12. Sitting down/standing up carelessly.
13. Walking/running on uneven surfaces.

So start thinking about SAFETY and FALL PREVENTION today! Your body will thank you.

Foot Pain from PLANTAR FASCIITIS

If you already have plantar fasciitis, here are some things you can do to help treat it. These things can also be done regularly to help prevent plantar fasciitis (foot pain in the arch and/or heel from inflammation of the plantar fascia).

1. Wear proper shoewear, especially when doing excessive walking, running or exercising.
2. Stretch your plantar fascia and calf frequently, especially before/after exercise.
3. Use ice or an ice pack for 5-10 minutes at least 1-2x/day.
4. Massage the arch/heel of your foot with deep pressure for 10-20 minutes at least 1x/day.
5. Avoid the activities that aggravate your pain (excessive walking/standing activities).
6. Move your ankles around a lot, especially upwards (toes up toward your nose). Do this when you are sitting or lying down, right before you stand up.
7. If you notice pain just starting, prevent it from getting worse by increasing the amount you do numbers 1-6.

Daily tasks that cause LOW BACK PAIN

These are some specific types of injuries that cause low back pain.

1. Falls. Falling can cause numerous injuries, from broken bones to torn muscles/tendons to internal bleeding and worse. So do whatever it takes to prevent falling.
2. Lifts. Lifting wrong is a major cause of low back pain. The heavier the object you are lifting, the higher the risk for injury. So be sure to lift the right way, whether you are lifting a 5-lb. or a 50-lb. object.
3. Housework. Doing housework can easily cause low back pain if you do it incorrectly. So be sure to check your body mechanics with every part of your housework.
4. Yardwork. Similar to housework, yardwork also needs to be performed with caution and with intentionally good technique. This is especially true when working with heavier equipment or with strenuous outdoor tasks.
5. Exercise. Exercise is so important for improved health, and I recommend it to all my patients. However, I have also treated many patients who injured their backs from exercising. So be sure to learn the proper exercise techniques. Then check your technique every time you do the exercise.
6. Sports. Some sports injuries are pure, unavoidable accidents. But many are preventable, with proper warm-ups, stretching, staying warm (ex: baseball), shoewear (ex: running), slowly working up to higher levels, and/or sports-specific strengthening.

Over the next few days I will talk more about these areas in greater detail. Stay tuned! You do not have to live with low back pain if you take the necessary steps to prevent it!

Lumbar Support for BACK PAIN

There is one simple and easy way to sit with improved posture, no matter what chair you are sitting in: to use a lumbar support or lumbar roll. Here are a variety of things you could use for back support. Just place them behind your low back, no matter where you are sitting. You could buy a lumbar roll, but here are some things you probably have around the house that will be just as effective.

1. Roll up a medium-sized bath towel.
2. Fold or roll up a small blanket.
3. Fold up a tablecloth or sheet.
4. Find a small, decorative pillow.
5. If you are in public and do not have a pillow, roll up your sweater or jacket.
6. For women--try using your purse.

The important thing to remember is to use lumbar support consistently. This includes in the car, in your recliner, in waiting rooms, at lunch, when reading, when watching TV, when on your computer, at work, and any other time you have to sit, especially for long periods of time.

Slumped posture may not cause you back pain right now, but it will in the future. So make a choice today to start new posture habits! Your back will thank you.

Healthier Ways to Watch Football

This is dedicated to my husband.

Do you like to watch football? If so, here are some ideas for you. If you don't watch it, share these tips with someone you know.

1. Lie on your tummy for a few minutes while watching.
2. Do ab crunches while watching.
3. Do push-ups on the commercial breaks.
4. Have a push-ups competition with your buddies on commercial breaks.
5. Use your stationary bike or treadmill while watching.
6. If you don't have a stationary bike, lie on your back and bicycle with your legs for an ab workout.
7. Check your back position right now (if you are watching football as you are on your laptop) and see if you can improve it.
8. Munch on something that is tasty and nutritious (grapes, chicken tacos, trail mix, etc.).
9. Choose the light or lower calorie version of your favorite gameday drink.

Enjoy your team! Be thankful for your health! And enjoy a healthier football weekend!

Neck pain prevention for a multi-computer work station

If you work at a desk where you have to read multiple computer monitors, here are some posture/body mechanics tips!

1. Get a chair that can easily raise up and down (the more it can go up the better). Be sure when you have to look up to raise the height of the chair so that you can look more straight forward. Or if you have to, maybe stand sometimes, when you have to read the higher monitors.

2. Get a chair that rolls easily, so that you can roll side to side when reading monitors that are farther away from the middle.

3. Get a wireless keyboard so that you can have it on your lap when you have to scoot toward the sides of the desk.

4. Get several wireless mice and position them on different parts of the table.

5. Stand up or walk around at least 1-2x every hour.

6. Consider a keyboard slideout mechanism (at least one for the center part of the desk) and maybe even 2-3 of them for when you scoot to different parts of the desk.

7. Keep your neck in a neutral position. Try not to strain your neck forward. Keep your ears lined up with your shoulders.

8. Make sure your shoulders are in a relaxed position while you are sitting/typing. You should not have your shoulders shrugged up when sitting at the compter.

9. Use a lumbar roll for low back support (or roll up a towel and place it behind your low back) when sitting to help your posture (from the bottom up).

I am happy to welcome comments/questions!

Low Back Pain with laundry

Home chores, if done incorrectly, can cause major low back pain. I personally know many people who have injured their backs in this way. So what are some specific housework activities that you should check your body mechanics for? Today let's focus on laundry! Even if you do not do the laundry, these are still tips you can use with other activities.

When loading the washing machine, keep your back straight! Pick up the entire basket (via squatting, not bending) and hold it in front of you at waist height, while loading the clothes. You can use one leg to help hold the basket between your body and the front of the washer. Another option is to do your squats for the day and squat down several times (without bending your back forward) to pick up the clothes out of the basket. Another option is to carefully lift the entire basket and pour all the clothes into the washer. Just remember to keep your back straight as you lift and lower the basket.

When taking wet clothes out of the washer, lift one leg back behind you as you lean forward and try to keep the straight position of your spine as you reach down. This is the same technique golfers use when picking up a golf ball. Then stand upright with feet spread apart. Squat with your back straight and toss the clothes into the dryer. Be extra careful not to twist your back during the transfer of clothes from washer to dryer.

To remove clothes from the dryer, either squat, kneel or sit on a step stool in order to keep your back straight. Don't forget to keep your back straight as you lift the full laundry basket (via a squat). And do not twist your back to turn with the basket. Just take small steps whenever you need to turn.

Can you think of housework activities that you have been doing wrong?

Preventing Shoulder Pain Part 2

Here are some simple exercises that you can do to prevent shoulder pain and keep your shoulders mobile and strong.

1. Roll your shoulders in backwards circles. This is most easily done in the standing position with your arms down at your sides. Repeat 10 times.
2. Squeeze your shoulder blades backwards and together. Hold the position for 5-10 seconds. Repeat 5-10 times.
3. With your thumbs pointed upward, reach up in front of you until your arms are stretched overhead. Hold the position for 3 seconds. Repeat 3 times.

Be sure to do all of these in a slow and controlled way, in order to minimize risk for injury during the exercise. If you already do shoulder exercises, be sure to check your technique. I go to a gym regularly, and I often see people performing exercises incorrectly, which increases their risk for pain and injury. If you hurt yourself, you will limit your ability to work out in the future, so prevention is the key!

Preventing Shoulder Pain 101

Good news! The best way to prevent shoulder pain is to use proper body mechanics. This is something you have likely heard about for the back, but it is just as important for your the rest of your body. So here are a few tips on how to protect your shoulders and prevent shoulder pain/injury.

1. Before you raise your arms up overhead, turn your thumbs upward.

2. Before you raise your arms overhead, sit/stand up tall.

3. Avoid lifting heavy objects higher than shoulder height (use a step stool if needed).

4. Be careful not to twist your shoulders when you are holding something heavy (especially with one hand).

5. Your shoulders are in their most stable position when your arms are down, with your elbows close to your waist. This is the position they should be in if you are lifting or carrying something heavy.

6. Avoid repetitive overhead lifting of heavy objects (this can be a big problem at work, if your work station is not ergonomic).

7. In general, practice good posture, which aligns your spine, shoulder blades and shoulders. When sitting or standing upright, your shoulders should be be resting in a vertical line below your ears.

8. If an activity starts causing you shoulder pain, stop it immediately. Then modify how you do that activity the next time. If it is hurting and you continue to do it the same way, it will likely get worse and may cause more serious tissue damage. 

Tune in tomorrow for more shoulder tips.

Do you have any comments about shoulder pain you have experienced in the past and what helped you?

Low Back Pain Prevention 101

Low back pain prevention is actually quite simple and comes down to 2 main rules.

1. Don't bend your back.
2. Don't twist your back.

If you can keep these 2 rules during your daily functioning, you will not injure your low back. Low back injuries typically occur in one of these two positions. For example, bending forward to unload the dishwasher or twisting to put laundry from the washer into the dryer. The more weight you are holding when you do one of these things, the higher risk for low back injury. Obviously in your daily life you need the mobility to be able to do some bending and twisting, but if bending or twisting must be done, do it the right way. If not, you may be getting P.T. soon.

So how do you bend without hurting your back? First, you have heard the old saying: "bend with your legs, not with your back." Squat instead of bending forward. Use your legs to their advantage. They were made to do the work of lifting. Your back was not made for that. Stick out your bottom in order to keep your back straighter when squatting (such as when you brush your teeth). Keep your vertebrae in the same position as when you are sitting upright or standing tall.  That is the only stable back position.

How do you twist without hurting your back? Avoid twisting by turning your whole body instead of twisting your back. Take more steps with your legs so that your back stays straight. If you must twist, do so very slowly and without holding much weight. Take your time when doing housework or yardwork tasks in order to do them without twisting. Shift weight from one leg to the other while doing things like sweeping or raking. Be cautious with vaccuuming, laundry and outdoor power tools; check your back position as you do these tasks.

Lastly, especially avoid forward bending and twisting together!!! That is a recipe for a low back disaster.

Have you hurt yourself doing housework or yardwork the wrong way? Please share your story.

How to be healthier this Thanksgiving

Here are some ideas about how to not consume 10,000 calories this Thanksgiving...

1. Enjoy just 1 plateful of your favorite Thanksgiving foods. Pass on the 2nd and 3rd rounds.
2. Don't get every food option just because it is there. If you do not like the food that much, don't just eat it. (example don't get turkey and ham if you really prefer turkey).
3. Choose to eat only 1 or 2 starches instead of 4 (is there one that you can live without--maybe bread?).
4. Use low or non-fat creams for cooking or condiments (light sour cream, low fat milk, margarine, fat free whipped toppping).
5. Make one of your veggies outside of a casserole (steamed green beans or corn).
6. Choose only 1 slice of pie or a couple of mini-slices.
7. Save calories by drinking water instead of soda or tea.
8. Go for a walk or play ball outside on Thanksgiving afternoon.
9. Stop eating when you are full. Do not wait an hour and then fill up again. Wait until the next mealtime.
10. Be thankful for your body/health and think of how to improve it!

Low back pain related to sitting posture

Bad sitting posture may not cause you immediate pain, but down the road it will. This is especially true if you have a desk/computer job where you sit most of the day. Slouched sitting posture, done all day, every day, will cause progressive changes in your spine, making it less stable and more prone to injury in the future.

So here are a few tips for improving your sitting posture.

1. Adjust the height of your chair so that you are sitting upright.
2. Stand up for at least 1-2 minutes every hour that you are sitting.
3. Use a rolled up towel or small pillow behind your low back for lumbar support.
4. Make sure that there is a small arch in your low back most of the time when sitting.
5. If the chair you use most of the time forces you to have bad posture, find a different one that gives you better back support.
6. Good posture starts in the low back, not the shoulders. Once your low back is upright, the upper back, shoulders and neck will be more upright also.
7. If possible, do some work in the standing position.
8. Walk around during your lunch break or other breaks. Walk more when you are not working.

Do you have any other suggestions that have helped you to prevent back pain at work?

Why think like a PT?

Welcome to Think like a P.T. (Physical Therapist)! I am a Physical Therapist, and my career passion is to teach you how to prevent pain! I hate pain, and most all of us do. So why not prevent pain before it starts?!! I have learned that prevention is easier than treatment of pain. It may take a little time and effort, but it is worth the cost. Think of it as an investment in your body! It is the only body you have, so take care of it in order to prevent pain, both now and especially down the road (when you are older...).

Maybe you have pain already, in which case you need some treatment (maybe PT). But hopefully you are reading this before you experience major pain or an injury. My goal in this blog is to help you learn how to think differently. Think like I do, as a PT. My PT hat is always on, so I look at the world from that perspective. I look at how people walk and try to figure out what is wrong with them. I look at how everyone lifts things. I look at how people exercise and see their risks for injury.

If you are passionate about your career, you probably look at the world from that perspective (a dentist looks at the teeth of everyone he meets--not just in the clinic). So tune in for my tips on pain and injury prevention. Your body will thank you.

Do you have any pain or injury topics that I can address? I would love to cater my blog to your needs and requests.