10 Easy Ways To Add Exercise To Your Busy Day

Photo: NOAA's National Ocean Service

1. Do push-ups when you first wake up. Take 10-20 seconds to jump start your morning and your metabolism!

2. Hold a squat position while you brush your teeth. Or do a set of squats.

3. Stand on one leg to put on your socks and shoes by holding a squat position and crossing one leg over the other knee (be sure your back is straight).

4. Do straight leg raises while doing hair, makeup or other grooming activities. Stand on one leg and kick the other leg forward, sideways or backwards, keeping the knee straight.

5. Squat several times while making the bed. It will strengthen your legs and help with your body mechanics.

6. Do knee extensions (kicks) while eating breakfast. Sit toward the back of your chair, with your thighs fully supported. Then extend one knee 10-15 times and repeat with the other leg.

7. Do back arches while driving to work. Change from slump sitting to overarching your back. Then relax back down to a neutral posture (back straight) and arch again. Repeat 15-30 times.

8. Roll your shoulders backwards while sitting at your desk. Repeat 20 times.

9. Raise up onto your toes (calf raises) while washing your hands. For a challenge, do this on one leg at a time.

10. Take a few minutes to do jumping jacks or mountain climbers while watching TV.


Exercise does not do itself. If you don't make extra effort to exercise, it will simply disappear from your lifestyle. Whether you need to lose weight or not, exercise is critical for the health of your entire body. Ideally, it is recommended that adults exercise >30 minutes/day, 5-7x/week (or more for weight loss). But honestly, some individuals are too busy to do 30 straight minutes of exercise. If that person is you, the only way to exercise will be a few minutes at a time. Please add in comments if you have additional exercises to share.

Plantar Fasciitis: Self-Treatment

If you have plantar fasciitis, it is very painful and can last a long time (months-years), but the more you do the following, likely the sooner your foot pain will go away. Here are some of the components of a Physical Therapy treatment plan and home exercise program. If you do these consistently and aggressively, you may be able to avoid PT.

Rest: Avoid aggravating activities, such as excessive walking. Avoid jogging and any exercises that increase your foot pain. If you want to exercise, try biking or swimming laps.

Motion Exercises: Move your ankles around (up/down, side to side, circles) whenever you are sitting or lying down, especially just before you stand up (for example: before getting out of bed in the mornings). Or spell out the alphabet using your ankles/feet (spell each letter of the alphabet 1-2 times before standing up).

Calf/Achilles Stretching: Hold each stretch for 20-30 seconds, and repeat 3-4 times. Do this several times throughout the day (3-5 or more times per day). The first 3 pictures show various ways to stretch the calf muscle (gastroc), so choose at least 1-2 of these. The fourth picture is a soleus stretch (lower part of calf) which is also important. The last photo is a plantar fascia stretch which is easy to perform anywhere in the sitting position.

Photo: foothealth.about.com

Photo: www.runwithholly.com

Photo: fitbie.msn.com

Photo: www.dailystoke.com

Photo: www.drwolgin.com

Deep Tissue Massage: Massage your heel and arch with very firm, deep pressure for 10-15 minutes, 1-2x/day.

Ice Massage: Rub an ice cube on your heel/arch for 5 minutes or until it becomes numb. Do this 1-2x/day.

Modification of shoewear: Modify your shoes if they aggravate your pain. Find the shoes that give the most relief. Ideally, stay off your feet as much as possible. It may be helpful to try various shoe inserts if you need additional arch support.

Disney World: Tips For a Pain-Free Vacation

Photo: wickedboy_007

We recently headed to sunny Orlando with 5 adults and 5 kids under age 4 to enjoy a fun-filled adventure at Disney World, so out of my own experience and observations, here are some tips to keep you and your family pain-free on your next Disney vacation.

1. Wear tennis shoes. I know that women may prefer to look cute, but 12-15 hours of standing/walking in anything other than tennis shoes will likely cause you more pain throughout the day. At Disney, your feet and legs will be tired regardless of your shoes, but you will feel better with good, supportive sneakers. I once wore flip flops at Carowinds all day, thinking I would get on a lot of water rides. But at the end of the day I could barely walk because my legs ached so much.

2. Use sunscreen and re-apply it frequently. Vacation is no fun if you or your kids get sunburned.

3. Do not try a new sunscreen on your first day of vacation. Thankfully we tested out a new sunscreen the week before vacation and learned that my son was allergic to it. So on vacation we resorted to our usual Banana Boat, and it worked great, just like last year. An allergic reaction to any new skin product can cause terrible itching, discomfort, redness, rash, etc, so don't risk it.

4. Wear a hat. This is one of the best ways to prevent getting a sunburn on your face.

5. Pack a ton of bottled water. Disney allows you to bring coolers (under a certain size), so pack them full of drinks. This will save you a load of money and will keep you hydrated. Trust me, you will need a drink even as you wait for the shuttle out of the parking lot. Then you will have to wait in line for the ferry or monorail, so you will likely finish your first bottle before you even enter the front gate of the park itself. If this was true for us in May, it will only get worse during the hottest summer months.

6. Arrive early at your favorite events to get good seats. Otherwise you will strain to see and you will hurt your neck from holding your child on your shoulders for the duration of the parade, show, etc. If you want a good view of the Electric Parade, arrive around Main Street more than an hour before the show starts in order to get a first or second-row view.

7. Take rest days between park days. Or plan water parks or smaller outings on those days. You will have to wake up early on park days, if you want to enter the park around opening time (9:00 am). This means arriving at the parking lot between 7 and 8 am. And likely you will not leave until after 10 pm, so you will be exhausted even on day 1 of your vacation. Try to build rest into your vacation, or you will truly need another vacation to recover.

8. Have sufficient stroller seats for all younger children. Our double stroller is not comfortable for sleeping, so we rented a double stroller for the week, and the kids slept great in it. It was well worth the cost. It is not comfortable to hold a sleeping baby for a long period of time. There are benefits to using infant carriers, in which your baby is strapped onto your chest or back, but I would not recommend them at Disney, simply for your own comfort. A stroller is ideal both for you and your baby. Plus it gives much-needed storage space!

Swimwear Tips For New Moms

If you are a new mom, you may have a little trouble finding the right swimsuit this summer season. It was hard enough finding maternity swimwear, but likely it will be even more daunting now because your tummy has not yet returned to its pre-baby state. Believe me--even though I have lost most of my baby weight before getting pregnant again, there is still some excess belly that may or may not disappear in the next few months-years. So here are my recommendations.

1. Buy a 2-piece swimsuit if you are breastfeeding. It does not have to be a bikini, but a 2-piece will make nursing your infant much easier, especially if you use a cover-up while nursing (which I recommend for your general modesty and the comfort of everyone around you). Try to find a top for your 2-piece that covers your belly, if you are self-conscious about it. There are a lot of cute tankini tops that cover most or all of your tummy. 

2. Buy a 1-piece for the most effective tummy coverage, if that is your goal. You never know when a wave or water slide may reveal the tummy you are trying to hide.

3. Buy a decent quality swimsuit. All cheaper suits either stretch out, thin out and/or fade. I once bought a swimsuit from Penney's, and I could only wear it twice because it stretched out and became too big. There was no savings there because I had to immediately buy another one. Don't forget the fact that swimsuit shopping is more frustrating than fun, so you should only have to do it once per year (or less). 

4. Don't walk around stores looking for modest swimsuit bottoms. Just find out your size and the brand(s) you like, and shop online. Even if you find something modest (such as shorts or a skirt to cover your suit), it is unlikely you will find the color and size you need. 

5. Don't take the kids with you while shopping. It is frustrating for all parties involved.

6. Don't shop separately for swimsuit tops, bottoms, cover-ups or accessories. You will end up making more trips to more stores, only to be unhappy with your final purchase (because you made it in haste, being annoyed with shopping for so long). I recently shopped for a skirt or shorts to go over my one-piece black swimsuit, and I finally found one at the third store I searched. Once it was washed and ready to wear, I went back to find my black swimsuit (from before having kids) was no longer wearable and had to be trashed. So then I had to go out again to find a tankini top to match my new, black bottoms.

7. Shop early for swimwear (long before vacations and pool trips). Vacation prep week is stressful enough, so plan ahead to make your life easier. That also gives you time to shop online, which might be the best way to go (although I have never done so before). 

8. Do not assume that your size swimsuit is easy to find. During my search, I found that the smaller sizes were impossible to find in the more modest suits. The most common sizes I found at Belk (I went there twice recently) were 10 and above (both for tops and bottoms). 

9. The best brand (and most expensive) I found at Belk was H2O Wear, which had a lot of modest one-piece and 2-piece suits to choose from. If your budget is $100, this would be a good option for you. After summer season, you likely can find these on sale/clearance. If you are going to pay $60-$80 for a decent suit anyway, you may find it's worth it to get a higher quality suit such as H2O brand for $20-$40 more. 

"Defeat Chronic Pain Now:" Book Review

I recently found Defeat Chronic Pain Now at the library and read the first chapter last night. I was happy to see that the topic of chapter one is low back pain, which is terribly common, especially among sufferers of chronic pain. It was even better reading that the authors (Bradley Galer, MD and Charles Argoff, MD) recommend Physical Therapy within the first few lines!

Myofascial Cause of Back Pain?

They talked a lot about myofascial pain and trigger points as a main cause of low back pain (and referred leg pain), which I do not completely agree with. Being trained in the McKenzie method of Physical Therapy, which involves mechanical treatment of back pain (or moving the spine in specific directions in order to decrease pain), I have found that trigger points are not a great factor in treating low back pain.

Combining Treatments for Back Pain

I agree with Galer and Argoff about the need for a combination approach to treatment, which often includes medicine and "Active PT," the term they use to describe Physical Therapy that involves active exercise and movement to treat the painful condition. They discuss various medicines used for back pain and their benefits. 

Work Injuries and Chronic Back Pain

Page 15 briefly talks about chronic back pain related to being unhappy at work. There is research that shows a correlation between chronic back pain among those who are unsatisfied in their jobs. This is among individuals who have sustained a back injury at work. I totally disagree with their discussion of this research. Their second paragraph states that if you do not like your job, you are at risk for chronic low back pain. Research does not say why there is a correlation between work satisfaction and back pain. It only shows if there is a correlation among the researched population. Clearly, the population being studied included only those with work-related injuries. There is no endnote identified about this research, so it is hard to clarify this matter.  

I have never treated someone who developed low back pain because he/she was unhappy at work. Low back pain usually has a specific cause and can be treated very effectively. Individuals with work-related back injuries are a completely different demographic than the general population and any research involving them should not be applied to those without work-related back injuries.

Active Physical Therapy for Low Back Pain

Galer and Argoff list some other possible treatment options for chronic low back pain and briefly discuss their benefits and precautions. Again, they include Active Physical Therapy at the top of the list, which I truly appreciate and also highly recommend!

One statement I must rebuttal is: "Many--if not most--physical therapists are trained in only passive, 'feel good' therapies, such as warm baths, gentle massage, and ultrasound" (page 22). This may have been more true 50 or 30 years ago but not anymore. Passive modalities such as these were only part of one class out of my three years of graduate school, so clearly we are trained in much more than that. Otherwise our "Active PT" would not be so highly recommended throughout chapter 1.

Recommended Book for Chronic Pain?

So do I recommend this book? Based on chapter 1, yes. It is worth reading if you have chronic low back pain. But you may also want to look at some other back books to see how their treatment approach is different (such as Robin McKenzie's Treat Your Own Back).

Reference: Galer BS, Argoff CE. Defeat Chronic Pain Now! 2010: Fair Winds Press. Chapter 1: Beating Your Back Pain.

Mattress Firmness And Low Back Pain

Firm Mattress and Low Back Pain? Traditionally, you have heard that a firm mattress is the best for your back. I have known many individuals that have less back pain when sleeping on a very firm bed or even on the floor instead of a soft bed. Those are the same people that do not lie in bed to sleep more than 6-8 hours, even on Saturday morning! They do so after finding that sleeping in too long increases their low back pain.

Soft Mattress and Low Back Pain? There are also many individuals with low back pain that sleep on various types of mattresses that do not aggravate their backs. It would be extremely obvious to me if softer mattresses were the culprit of back issues because all my patients over the years would have reported this to me. So I cannot say that softer mattresses are bad. 

There is one statement that I have heard repeatedly from patients: "I need to replace my bed because it is old and I sink into it too much." Clearly, if you sink down into the mattress excessively, your spine is likely being pushed out of alignment (so your back is not in a comfortable, neutral resting position at night). On the other hand, a too-firm mattress could also potentially put your spine out of alignment if your hips or buttocks cannot sink in sufficiently.

Research on Mattress Firmness and Back Pain:

I recently found one research article about this topic. The study included over 300 individuals with chronic low back pain, and they were divided into two groups: firm mattress or medium firm mattress. To my surprise, the study showed a better response to medium-firm than firm mattresses. Those in the medium-firm mattress group reported better outcomes about their back pain during various daily tasks than the firm mattress group.

Conclusion: Despite common recommendations, there is not overwhelming research that associates firm mattresses with less low back pain. Clearly, there is at least one study (see above) that links a medium-firm mattress with better back outcomes than a firm one. So find what works for you. Take the time to try out a lot of beds, and save up so you can afford the one you prefer, as some are very expensive. If you shop around, you should be able to find a good-quality name brand for $300-$400 (which includes a 10-year warranty).

Specific Mattresses with Good Back Support: Out of my recent personal experience of mattress shopping, here are some mattresses that I liked. Keep in mind that there is a wide range of mattresses within each name on this list, so you will need to shop around to find the one you prefer. Higher-quality mattresses come with longer warranties, so it may be worth it to pay more for a longer-lasting mattress.
1. Sealy Posturepedic
2. Simmons Beautyrest
3. Simmons Beautysleep (a cheaper option)

Reference: Kovacs FM, Abraira V, Pena A, et al. "Effect of firmness of mattress on chronic non-specific low back pain." Evid Based Med 2004;9: 119.

4 Components of Weight Loss

            It is never too early or late to lose weight if you are overweight or obese. Even if you became obese at a young age, you can change habits now and lose weight! It takes determination, discipline and hard work, but the rewards are countless! One of the biggest benefits of weight loss is having less pain, including back pain. Moreover, it is easier to prevent obesity than to treat it. So if you have found yourself 10 or 20 lbs overweight, start working to reverse the trend. Otherwise that could turn to 50 or 100 excess pounds that you never expected to have.

4 Components of Weight Loss  

1. Change in mindset. Admit that food controls you and recognize why you overeat. Until you know what your problem is, you cannot fix it. 

2. Change in activity level. You must increase your daily amount of activity and exercise in order to lose weight. No pill or diet by itself can replace the benefits of regular exercise. 

3. Change in eating habits. You cannot eat the same amount or kinds of foods that you have been eating and lose weight. Look at your eating habits and start to modify them. 

4. Perseverance over time. There is no easy way to lose a lot of weight, no matter what the ads may say. It takes time and hard work. Do not give up! Keep working at it and you will succeed. Find the help you need, whether it is an exercise partner, a weight loss group, a gym membership or an appointment with a nutritionist or dietitian. 

Most importantly, do not leave out any of these four components or you are less likely to get the weight off and keep it off.  Do not forget to consult your physician about your weight, in case it is related to a medical problem.

Additional reading on WEIGHT LOSS:

http://thinklikeapt.blogspot.com/2012/04/weight-loss-perseverance.html