Laptop Ergonomics Video

This video gives you some ideas for how to improve your posture and positioning when working on the computer. It is very brief (2 minutes).

Back Pain Prevention: Avoid Twisting

Never twist your body when holding something. It is common for me to ask a patient with low back pain how he hurt his back and he responds that he was holding a heavy box and twisted his back. This is one common way to cause a disc in the low back (lumbar spine) to bulge or herniate, which is a very common diagnosis in PT clinics. The complication associated with disc problems is that if a lumbar disc bulges out of its normal position, it can compress the nerves in the spine, causing pain and other symptoms into the leg or legs. It is much easier to prevent a disc herniation than to treat one after it occurs!

            One common way for this to happen is while doing the laundry. Many people twist their bodies when putting clothes from the washer into the dryer. This is worsened because they are holding wet clothes while twisting their backs, causing more injury than if nothing were held. Instead, step over to the dryer, then squat to throw the clothes in. It takes a conscious effort every time, but just remember "step, squat, and toss." It only takes one wrong twist to cause low back pain which could last for months or years, so avoid twisting—every time!
         Here is a video showing what not to do. I posted it a year ago, but it's funny and worth another viewing.

Ergonomics Rap with Sustainable John - Lawrence Berkeley Lab

Click on the title to view this video about workplace ergonomics! Good reminders for those of you who sit at a desk all day.

Back Pain Prevention: Proper Lifting Techniques

Photo: New York Public Library

Never lift an object if you are in a forward bent position. The picture here shows a proper squat in order to reach down to the floor. Your spine is a perfectly stable system of bones (vertebrae) with discs in between each one. This system is designed to support your body weight and has the capacity to support much more weight (for example, carrying furniture) if the spine is maintained in its neutral position. (Note, it is not designed to support excessive body weight). The neutral position of the spine is when each vertebra is stacked on the one above it, which happens when you are demonstrating proper posture. You lose the stability and strength of the spine when you are twisted or bent, which removes the vertebrae from their properly stacked resting position. When this occurs, the muscles of your back have to be used in a way they were not made for. Why not use the stability of your spine when you lift instead of straining weak back muscles? 

Back muscles can be strengthened, but strong back muscles alone cannot prevent back injuries when your spine is in a compromised position, such as bent forward. Instead, it is best to lift when your back is straight and you use your legs to do the work. This involves squatting down but maintaining a straight back position. Our leg muscles are very strong and large and are made to do the work of lifting heavy objects, if we use our legs instead of our backs. If you are familiar with weight lifting, squatting is the exercise in which one can lift the most weight, compared to dead lifts, bench press, etc. This is because the thighs and buttocks have huge, powerful muscles, which are much less prone to injury. I rarely see patients for quadriceps (anterior thigh muscle) or gluteus maximus (buttocks muscle) strains whereas low back strains are very common in outpatient PT clinics.

The Latin American Diet

Photo: State Library and Archives of Florida

I have some firsthand experience with Latin America, but if you are Latin American and have different traditions, please share in the comments section. I do not mean to over-generalize, as I know that no one wants to be stereotyped. Here are some healthy eating habits that I have seen.

1. Lots of fresh fruit and fresh-squeezed fruit juices. You may be surprised at the fresh juices because they include much more than OJ, and they are prepared and served fresh! Some varieties I have loved are cantaloupe, watermelon, blackberry, pineapple, and mango. The juice ingredients are fruit (often including the skin) and maybe a little extra water/ice or occasionally a touch of sugar. Freshly cut fruit of any sort is frequently served with dessert.

2. Rarely serve cooked vegetables but salads instead. Once I brought a green bean casserole and a broccoli casserole to a potluck at church (a Hispanic church), and they were not touched. So my poor husband who does not like broccoli had to eat broccoli casserole the entire next week. And the salads are frequently served without salad dressing! All that is needed for flavor is freshly squeezed lime and a touch of salt/pepper.

3. A variety of beans, served as a side, in a soup or cooked into other foods. Legumes are a perfect source of protein, calcium, fiber and iron. See link below for more health benefits of beans.

4. Uncommon to find creamy/milk-based sauces. Instead, meats are grilled or cooked with fresh vegetables.

5. Freshly prepared hot sauces. All it takes is roasting the peppers, then blending them.

6. Soups made with clear broth rather than cream-based and served with fresh lime. Try adding lime to your next chicken noodle soup and you will never turn back. You may not know that most Mexican restaurants (at least here in the South) serve an amazing chicken soup (usually includes pico de gallo, avocado, rice, chicken breast and lime).

7. Avocado! Frequently it is simply sliced and served with the side dishes. Of course, guacamole with fresh cilantro is the perfect addition to any Tex-Mex dish.


Additional Info:

After-40 Nutrition: The Surprising Health Benefits of Beans, from DoctorOz.com:
http://www.doctoroz.com/videos/after-40-nutrition-surprising-health-benefits-beans

5 Keys To Helping Your Child Communicate Verbally

The article that follows is written by a speech therapist I know and respect. Although it is not related to health or pain prevention, it is extremely useful for parents of young children.

5 Keys to Helping Your Child Communicate Verbally

By Rachel B. Raper, MSP, CCC-SLP, LSLS Cert AVT

1. Consistency:

Set expectations. Expect your child to continue what he/she has demonstrated in the past and to demonstrate new skills in the future. If your child says “all gone,” start to expect him to use “empty” as a synonym. If she points to ask for more, try 3 times to have her say “more.”  After the 3^rd try give her what was requested as you say “more” to demonstrate your expectation. Be consistent and do this each time. Once your child states “more” consistently, move on to name the desired items. Set boundaries and routines for behavior in the home.

2. Wait time:

Your child is learning to process language (words, vocabulary, and directions). Allow him enough time to think about what was said before expecting a response. Language learning is a process that varies for all children.

3.  Modeling:

Provide your child a natural example. Children learn language by overhearing it and through listening to others talk directly to them during natural play. Family members should use “parentease” to talk to children: speak using a higher pitch with a song-like melody when completing daily activities.

Use words and word combinations you want your child to imitate. If she is at the 1-word stage and likes balls, simply say “ball” while playing ball with her. Sing about the ball while rolling it. Say “ball” at different pitches and make it sound interesting to hold her attention. If she is at the 2-word stage, combine 2 words such as “my ball” or “big ball” or “bounce ball.” Use another family member as a model. Say a word, and then have a sibling repeat it. This makes it a copy-cat game, which children love.

Once your child knows 30-50 single words, begin to expect him to use 2-word combinations. Expanding is a type of modeling. Whenever he uses a single word, add another word that is appropriate to the situation. If he says “no” to deny more milk; say “no milk.” This confirms what he said and exemplifies how to use 2 words correctly. Using words from his known vocabulary encourages him to imitate your 2-word phrase without being instructed, thus making it more natural.

Commentating is another type of modeling. Think of yourself as a commentator at a game. As she plays, talk aloud about her interests by using simple words. While playing, your child is overhearing your words and may copy some of them without being pressured.

Language (words, vocabulary) is more important than a toddler’s speech articulation (sounds in words). If she uses a word approximation consistently, then that counts as a word. Repeat that word as you respond to her as a way to naturally model the correct articulation. If your child is not 70% intelligible (understood) by age 2 ask your pediatrician for a referral to a Speech Pathologist.

4. Reason to Communicate:

Your child needs a reason to communicate or he will choose not to. Think about his environment. Are his needs anticipated and how does your family react to them? Create a need to communicate by making language more meaningful. Gain his attention and model what you want him to sign, say, or do to get his desire met. Start with everyday events such as drinking, eating, etc. Have him use his mode of communication consistently and set your expectation for him to communicate before giving him the desired object. Withholding it may work with objects he has demonstrated to request before. This method initially requires a lot of effort on your part in order to break family habits; but in the long run it teaches him to communicate.

5. Reading Aloud

Children learn language, words, and new vocabulary through overhearing words. Books expose them to new words outside of your everyday environment. Toddlers have a brief attention span, so choose short books with simple pictures displaying action.  Read 20 minutes every day (it doesn’t have to be 20 consecutive minutes in the beginning). Choose multiple books to fill this time, read books as he is interested multiple times each day, or re-read his favorites. The exact words on the page do not always have to be read. Children look at the pictures, so you should too. Meet her on her level by looking at the pictures and creating a story by talking aloud to describe the actions. If you choose to read the words on the page, do so, then talk about the pictures using simple words to model what you want her to imitate. While reading, ask her to point to pictures when you name them or to name pictures when asked, but do so in limitation.

Use shared control by holding the book together, helping him turn the pages, moving through each book from front to back, and allowing a break between books if needed. Some tricks to try when he gets squirmy include: acting out the action in the pictures, incorporating nursery rhymes and songs, selecting nursery rhyme or song-related books, and choosing books he can manipulate (open-the-flap, touch-n-feel, etc.). Once book reading becomes a habit and part of your routine, his attention span and interest in books will grow.

Echo reading also encourages natural imitation of words and phrases. Read or use a word or phrase, then have them echo what you said. Continue this back-and-forth style of reading for each page as another way to model or provide examples. Children, if given proper words they are capable of repeating, imitate without being told or pressured, thus making it more natural.  Fun ways to model echo reading are to choose books with repetitious words/phrases and to choose books with rhyme.

Two great books for parents to learn to read aloud are The Read-Aloud Handbook by Jim Trelease and Reading Magic: Why Reading Aloud to Our Children Will Change Their Lives Forever by Mem Fox.

What Pillow Is Best For Your Neck?

Photo: RelaxingMusic

What pillow should I use? This is a common question I hear from my patients with neck pain. They want to know if there is a specific pillow or type of pillow that I recommend, so here is my advice.

The height of your pillow(s) is the most important factor. For back sleepers: if your pillow is too high, your neck will be in a flexed or forward-bent position throughout the night. But if the pillow is too low, your neck will be extended or too far backwards. For right-side sleepers: if your pillow is too high, your neck will be bent toward the left while you are sleeping. So how high should your pillow be? Simply find the pillow that puts your neck in a neutral sleeping position.

The firmness of the pillow you select depends on your own comfort. If you like a firm pillow, you may only need one to attain the proper height for your head. But if you prefer soft, you might need two pillows, as your head will sink down into them.

For specific brands, I do not have a recommendation. There are some very inexpensive pillows that work well, but they obviously need to be replaced more often. The only two specialty pillows I have personally used are memory foam and down-filled. The memory foam pillow is very firm and has two curves, one of which is a little larger. So it can be used two ways, depending on the size of your head/neck. I liked the way it supported my head and neck, but it was too firm for my comfort. It could potentially be comfortable for back or side sleepers. The down-filled pillow was mildy comfortable for me, but there were two reasons I stopped using it. First, the feathers were pointy sometimes, and even extra pillowcases did not smooth out the surface. Second, the pillow sunk down too low for my preferred pillow height.

I have seen TV ads for more expensive pillows, but I have never tried them. If you have exhausted cheaper options, you may want to purchase a higher quality or specially designed pillow. However, be sure to identify if your neck pain is only a result of sleeping or if you have a neck problem that needs medical attention. If your neck pain is present during the day or before going to bed, it may not be a pillow issue. Be sure to consult your physician if you have chronic neck pain, severe neck pain and/or neck pain that shoots down the arm(s).