Turkey Avocado Cobb Salad at Schlotzky's

http://www.schlotzskys.com/menu/salads/turkey-avocado-cobb/

The Turkey Avocado Cobb salad at Schlotzky's is one of the best salads I have tried lately. It has a ton of fresh ingredients, such as avocado, corn, just-cooked bacon, goat cheese, and black beans. As the name states, it is topped with turkey deli meat. And, of course, it has croutons, eggs and tomatoes. The serving size of this salad bowl is larger than expected, and it has fresh garlic bread on the side. My dressing choice was Raspberry Vinaigrette, but the salad was tasty enough that I only used dressing toward the bottom of the bowl. How can you say no to a salad so full of protein and good fats? You will almost forget it's a salad.

Does Pilates Cause Or Treat Back Pain?

Photo: State Archives of Florida

Yes, Pilates can cause back pain. And yes, it can treat back pain.

Pilates and Core Strengthening

Pilates has many great benefits, including core strengthening. Core strengthening is beneficial, as it incorporates deep muscles of the abdominals and back that often are weak, especially among individuals with back pain. Having a strong core is one piece of preventing back pain, but other components include postures, body mechanics and proper treatment of present back pain.

Pilates vs. Physical Therapy

Pilates and core strengthening alone will likely not eliminate present back pain. It may play a role in preventing future episodes of back pain, but alone it is not the solution to low back or mid-back pain. If Pilates could treat back pain, I would not have a job as a Physical Therapist. Clearly, there is more to your back pain than weak core muscles, so proper treatment/prevention is urgent. If your back pain comes and goes, get it treated now, and you can learn why it happens and how to decrease the pain and prevent future episodes.  

Pilates Exercises to Avoid

There are some Pilates exercises that can actually produce or aggravate back problems, and these should generally be avoided. Any Pilates exercise that puts your back into a forward-bent (AKA flexed or rounded) position is not ideal for most individuals and can be harmful if you have back problems. Which forward-bending exercises are safe? Cat/camel (on your hands and knees and you arch your back up and down) and abdominal crunches are fairly safe for most people. 

Preferred Pilates Exercises

The Pilates exercises that bend your spine backwards (AKA extended, as in the photo above) are safe and highly recommended for most healthy people. This includes positions such as lying face-down and pressing up onto your hands or lying on your back and lifting your hips. Likely there are many extension exercises incorporated into your Pilates class, so these are generally beneficial and less likely to be harmful.

If either direction of spine movement aggravates your back pain, stop Pilates workouts, and get medical attention.

Why You Should Get Physical Therapy For Your Back Pain

I recently treated a patient with leg pain that radiates from his back. It goes into his thighs and even down below his knees. This pain began 3-4 months ago, and he is unsure how it started. Before his session, I knew his walking had been problematic because when he stood up in the lobby, he significantly stooped over and could barely get his balance. He was using furniture and walls to hold onto. So my initial goal was to find an exercise that would immediately improve his ability to stand up and walk. 

I treated him for 10 minutes with one or two exercises lying on the mat. Then he stood up tall and walked easily back to his chair. He could not believe he was walking that well because since his symptoms began, he has the most pain and difficulty with initially getting out of a chair to walk.

So if you have back pain, you could possibly be only a few minutes away from pain relief. Schedule your Physical Therapy today!

Changing Crib Sheets Without Pain

There are a few baby-related tasks that can be near-impossible without straining your back, so here is what I do for changing crib sheets.

Photo: National Media Museum

1. Buy at least 3-4 crib sheets and 3-4 waterproof pads. I promise that the price of these is far less than a back injury.

2. Take the mattress out of the crib to change the sheets.

3. Layer your waterproof pads and crib sheets over each other so that when the top layer gets wet, you simply remove it and your clean, dry one is already there.

4. As soon as possible, remove the bumper pads. For safety reasons, they are not even recommended anymore. Changing the crib sheet is much easier when there are no bumper pads in the way.

5. Consider using a sheet saver. It is a sheet that actually attaches to the bars of the crib, so it is fairly easy to snap on or off (each sheet has at least 12-15 snaps). There are some safety concerns with this because it does not fit as tightly as a fitted sheet. To get it on or off, it still takes several minutes, and you have to be able to reach all four sides of the crib.

6. For crib sheet selection, buy the T-shirt material ones that stretch a little.

7. Change the sheets for a toddler bed the same way--by taking the mattress out first.

Chick-fil-A Cobb Salad: A Healthy Review

The Cobb Salad at Chick-Fil-A is a delicious and healthy alternative to your usual fast food meal. I have enjoyed it so much that my husband now eats it as well. The cobb salad is made with Romaine and greens, not iceberg lettuce. It's additional veggies are cherry tomatoes, corn, cabbage, and carrots, which are a nice variety. The extra yummy toppings are cheese, bacon, and fried bell peppers. Another healthy addition is hard boiled eggs. And it comes with crispy chicken unless you prefer grilled. With this alone, I love it even without salad dressing. But if you need dressing, I most recommend the Avocado Lime Ranch. This salad is filling, tangy, textured, and colorful!

Because I enjoy the taste of salads, I usually try them wherever I dine. Some other good, fast salads are at Which Wich, McAlister's Deli, Moe's, and Zaxby's. But the fact that my husband eats this one at Chick-fil-A means that it is likeable even for meat-and-potato fans. Lastly, I like it too much to even try their other salads.

Reference: www.Chick-fil-A.com

Unexplained Arm and Leg Symptoms

This post is about Central Cord Syndrome; please see the article from my last post for reference.

There is one diagnosis that is often not discovered until it is too late. It is called central cord syndrome or central cord compression. Your spinal cord is being compressed within a part of the neck, so you experience not only neck/arm symptoms but other symptoms in the lower body as well.

Neck Pain
Usual neck problems can cause neck pain and/or refer pain to the shoulder or down the arm. If this is your only symptom, you likely do not have anything compressing your spinal cord in the neck. You may have a neck diagnosis that can be treated with usual medical treatments such as medicine, Physical Therapy, injections, surgery, or other alternatives.

Back Pain
Similarly, low back problems can produce back pain and symptoms radiating into the buttock(s), hip(s) and/or leg(s). If this is your only symptom, you likely do not have Central Cord Syndrome. I highly recommend you request a prescription for Physical Therapy from your doctor in order to treat your back/leg symptoms.

Neck/arm AND Back/leg Symptoms
If you have neck/arm symptoms AND leg symptoms at the same time, you may need further medical attention quickly! Some leg symptoms are: difficulty walking, progressive loss of balance/falls, leg pain, and numbness/tingling in the leg. Other symptoms include loss of bowel/bladder control/function and/or loss of sensation in the pelvic region.

Examples:
1. You have a neck injury that appears to have resolved. But now you have progressive weakness in one or both of your legs.
2. You have knee pain that started without a knee injury. Actually it started around the time that you were in a car accident and hurt your neck. It keeps getting worse despite treatment for knee pain.
3. You have what feels like carpal tunnel syndrome in your hand(s). It has been going on for several years but is not improving with treatment. Also, your neck hurts and you have numbness in your leg(s) during the same period of time.
4. You have been treated for neck pain and it is mildly improving, but you recently notice that you cannot control your bladder like usual.
5. You have a neck injury that radiates pain and tingling down your arm. You did not notice at first, but you feel the same symptoms in your leg(s), which began at the same time.

Neck/Back Pain
If you have both neck/arm symptoms and back/leg symptoms that began at different times, then you may have 2 different problems that need to be diagnosed/treated separately. In this case, be sure to inform your doctor about all your symptoms so he/she can rule out a more serious problem such as Central Cord Syndrome.

Central Cord Syndrome: Arm/Leg Pain Coming From Neck

The following article is from NIH, and it summarizes a serious condition that can go undiagnosed for several months-years. So if you experience any or all of these symptoms, get medical attention immediately! I have seen this many times, and when symptoms are ignored for too long, they can become permanent.

What is Central Cord Syndrome?

Central cord syndrome is the most common form of incomplete spinal cord injury characterized by impairment in the arms and hands and to a lesser extent in the legs. The brain's ability to send and receive signals to and from parts of the body below the site of injury is reduced but not entirely blocked. This syndrome is associated with damage to the large nerve fibers that carry information directly from the cerebral cortex to the spinal cord.  These nerves are particularly important for hand and arm function. Symptoms may include paralysis or loss of fine control of movements in the arms and hands, with relatively less impairment of leg movements. Sensory loss below the site of the injury and loss of bladder control may also occur, as well as painful sensations such as tinging, burning, or dull ache.  The overall amount and type of functional loss is dependent upon the severity of nerve damage.  Central cord syndrome is usually the result of trauma that causes damage to the vertebrae in the neck or herniation of the vertebral discs.  It also may develop in persons over the age of 50 due to gradual weakening of the vertebrae and discs, which narrows the spinal column and may contribute to compression of the spinal cord when the neck is hyper-extended. 

Is there any treatment?

There is no cure for central cord syndrome although some people recover near-normal function. There is no standard course of treatment, although drug therapy, surgery, and rest are often part of the program.  Magnetic resonance imaging (MRI) is used to indicate the degree of spinal cord compression and vertebral instability.  Vertebral instability due to acute traumatic injury or cervical disc herniation is often treated by surgery to prevent further damage to the spinal cord.  Recent reports indicate that earlier surgery may improve chances for recovery.  Numerous recent studies suggest that surgery also can be beneficial in individuals with persistent compression of the spinal cord and ongoing neurological deterioration.

What is the prognosis?

The prognosis for central cord syndrome varies, but most people whose syndrome is caused by trauma have some recovery of neurological function. Evaluation of abnormal signals on MRI images can help predict he likelihood that neurological recovery may occur naturally.  Those who receive medical intervention soon after their injury often have good outcomes.  Many people with the disorder recover substantial function after their initial injury, and the ability to walk is recovered in most cases, although some impairment may remain.  Improvement occurs first in the legs, then the bladder, and may be seen in the arms.  Hand function recovers last, if at all.  Recovery is generally better in younger patients, compared to those over the age of 50.

Reference: NIH: National Institute of Neurological Disorders and Stroke. <http://www.ninds.nih.gov/disorders/central_cord/central_cord.htm>