How to Improve Your Sleep Quality

The ability of the human body to heal and recover is nothing short of amazing. The body has an innate way of healing and thriving. Sleep is one of the most important aspects to thriving and aging well. Your body thrives on a routine, so preparing for bed shouldn’t be any different than your other daily routines.

Although I am not a sleep expert, I have regular discussions with my physical therapy clients regarding sleep quality and hygiene. Adequate sleep is one of the most important components to a person’s recovery post illness and injury in addition to thriving and aging well. Continue reading for tips on how to get a better night of rest.

Epigenetics: Choose to Optimize Your Aging Process

How you age will in part be determined by genetic forces. These forces are strongly influenced by the lives we have led and the choices we continue to make. The key to successful aging is to be prepared and intentional as to how you want the journey to unfold.

With the sequencing of the human genome, we continue to learn more about epigenetics. Epigenetics is the science of how the modification of gene expression (rather than the alteration of the genetic code itself) can lead to vastly different outcomes in disease processes or a successful aging process.

What this new scientific field has really taught us is that nothing is known for sure. How we treat our bodies, effectively the choices we make, will potentially lead to different outcomes. In other words, we get to have a say in how we age. Our genetics are not set in stone, but instead can be influenced by our lifestyle choices. With this knowledge, we can choose to optimize our aging process. Continue Reading

Osteoarthritis vs. Rheumatoid Arthritis

What’s the Difference?

By Dr. Matthew Crooks

Arthritis is a condition involving tenderness and swelling in your joints, and it’s often coupled with inflammation as well. With over 100 different types of arthritis, the two most common forms are Osteoarthritis (OA) and Rheumatoid Arthritis (RA). Both of these involve inflammation in the joints; however, learn how these conditions differ.

Breaking Down the Differences

The main differentiator between Osteoarthritis and Rheumatoid Arthritis is that RA is an autoimmune disorder while OA is a degenerative disease. Another major difference between the two is that RA is a type of polyarticular arthritis meaning that it affects multiple joints as well as different sides of the body. Osteoarthritis affects only a few joints and just one side of the body.

Autoimmune

An autoimmune disease is one that causes your body to think there is an issue in a particular area. As a result, it attacks and damages healthy tissue. In the case of RA, it causes your body to attack the tissue surrounding the affected joints. Your immune system will produce antibodies that will attach themselves to the joints. Your body will then attack these joints which then cause inflammation, swelling, and pain in the area.

Degenerative

Being a degenerative disease, OA is one that affects you as you begin to age as well as prolonged wear and tear on your joints. Over time, the protective cartilage that pads and protects the ends of your bones begins to wear down. As this cartilage begins to wear down, the bones within the joint will start to rub together, resulting in pain and stiffness.

Osteoarthritis Symptoms:

Pain and stiffness within the joints are the most common symptoms of Osteoarthritis. These two symptoms typically appear in the morning or after a period of rest.

Some other symptoms that you will notice with OA: 

  • A limited range of motion or stiffness that tends to go away after activity.
  • Clicking or cracking sounds when bending a joint.
  • Mild swelling in the joint area.
  • Tenderness to touch.
  • Pain in the joint that gets worse with activity and at the end of the day.

The most common areas that are affected are hands, fingers, knees, hips, and spine. Over time these symptoms will increase and build up rather than show up suddenly and out of nowhere. However, if the stressors that are causing the wearing and breaking down of the joint cartilage are continued, you may notice a sudden increase in the symptoms.

Rheumatoid Arthritis Symptoms:

Like Osteoarthritis and other forms of arthritis, pain and stiffness will be associated with Rheumatoid Arthritis. Besides this, RA will bring with it: swelling; tenderness; and more than one joint that is affected or the same joint on either side of the body is affected. Fatigue and loss of appetite can also be symptoms of RA.

Other areas of the body can also be affected when dealing with RA besides your joints. The prolonged inflammation that comes with the disease can cause the following:

  • Dryness, pain, and redness in your eyes.
  • Dry mouth.
  • Gum irritation.
  • Small lumps under your skin called rheumatoid nodules.
  • Shortness of breath.
  • Anemia.

Osteoarthritis Prognosis

The prognosis for those with Osteoarthritis will vary from person to person and case to case. There are some cases where patients will not be adversely affected much at all by OA while others are severely affected. The fact that it’s a degenerative disease carries the assumption that the condition will continue to get worse over time.

While this is the case with some patients, other times the disease tends to stabilize at a certain point. While some patients will eventually need to undergo some sort of joint replacement surgery, it’s rare for the condition to progress enough for this to be the recommended course of action.

Osteoarthritis is not a condition that can be reversed. However, it is a condition that can be treated. When experiencing symptoms of OA, limiting the activity in those joints and the amount of stress you put on them will help. The most effective strategies you can take are to maintain a healthy weight and exercise regularly.

Rheumatoid Arthritis Prognosis

In the past, Rheumatoid Arthritis carried a more negative prognosis than it does today. Typically, patients can now live a productive and healthy life while continuing to go to work, school and partake in social and physical activities.

Like most conditions though, the prognosis will vary from case to case. In some patients, the symptoms will go through periods of dormancy while others will experience chronic symptoms. In some severe cases, life expectancy can decrease but this is not as common.

Common prognoses associated with RA include: persistent joint inflammation; a decline in mobility/range of motion in the affected area; and pain and stiffness that does not improve with treatment.

Like OA, it can affect other areas of the body as well, outside of the joints. Some patients will experience psoriasis; heart disease; eye inflammation; osteoporosis; anemia; respiratory complications; and depression. Patients with RA will need constant medical care and should be in contact with their primary care physician as well as a rheumatologist regularly.

Treatment

While both of these conditions are chronic and neither can be cured, both are treatable. Treatment can make living with the disease more comfortable (and in some cases, normal).

Reducing inflammation is an important part of treatment. A doctor may suggest anti-inflammatory drugs which will also alleviate the pain and stiffness in the joint. Other forms of treatment are physical therapy or injections depending on your specific area of pain.

Increasing the mobility and range of motion in the affected area will help slow down the progression of the disease. It’s important to be in contact with your doctor if you are experiencing any of these symptoms. There are always options to improve your quality of life.

For more information on RA and OA, please refer to Q and A: Exercises Beneficial to Managing Rheumatoid Arthritis and 4 Key Strategies for Preventing and Treating Osteoarthritis.

About Dr. Matthew Crooks

Dr. Matthew Crooks is a double board certified, fellowship trained interventional pain specialist. He has had the distinction of training with leading experts in pain medicine at two of the nation’s top hospitals, with extensive training in acute and chronic pain management, completing residency in Anesthesiology at Johns Hopkins Hospital. While at Johns Hopkins, he had the honor of being selected Chief Resident of the Department of Anesthesiology and Critical Care Medicine for the 2008-2009 year.

 

Is Resiliency the Key to Aging?

Resiliency is defined as an object’s ability to return to an original form or position after being bent, compressed or stretched. When this definition is applied to a person, it gives us a clue as to why some people recover quickly after illness or injury. It can even help describe why some people age well while others do not. This more scientific definition helps us understand why resiliency is nothing more than your own margin for error in life. The greater margin for error you have, then the less likely something catastrophic will occur.

However, for this definition to be useful, we must have an understanding as to what makes a person resilient. Are there tried and true methods in making a person more resilient? Discussing resiliency in an object is quite easy. You just have to understand the characteristics of the object in question. Understanding what make a person resilient is a very complicated discussion because of the multifaceted nature of being human.

Resiliency in humans is not just a physical characteristic. It’s comprised of emotional (psychological), mental (cognitive), social (relationships), and spiritual characteristics.

Each characteristic of human resiliency impacts the others. Understanding the interplay of the five different aspects helps in understanding a person’s true resiliency. The patterns of resiliency in others can offer valuable clues on how we can all become more resilient and age well. Continue Reading to discover how to improve your resiliency.

Aging Well Takes Initiative

Successful aging is a worthy goal for all of us to strive toward. To be successful in the aging process, great initiative is necessary as we are solely responsible for our health. Each person’s journey will be different. Those who choose to rely on others or our modern day healthcare system will likely miss the mark and unfortunately, the opportunity for a wonderful journey of aging well.

Differences in backgrounds, life experiences, upbringings, and genetics are what make us all so unique and wonderful. It also means there is not a set path to aging well, but instead options to do it differently (to do it your way). In order to age successfully and well, be intentional and take initiative. Although each person’s path is different, consider the following in order to insure a successful process. Continue Reading

7 Strategies to Renew Your Health in the New Year

I often hear others comment, “It’s too late to make a change now. I’m too old!” Worse yet, so many people actually believe that, but I don’t! I believe that it is never too late to change. You are never too old or out of shape to make improvements and renew your life. Being healthy and aging well is not a single choice to be made once and then never re-visited. It is a series of constant choices that add up to a way of living and constant renewal.

Aging well encompasses all of the following aspects of our being: physical, mental, emotional, and spiritual. It also includes the community around us. This year, choose to make small consistent choices to renew these areas of your life. This will make all of the difference in aging well. Each person’s physical journey as he/she ages is different. Taking consistent and appropriate action now can vastly change future outcomes.

7 Strategies to Renew Your Health in the New Year: 

Walk more!

Walking is one of the most fundamental activities we perform as humans. Research is very clear that frequent movements (like walking) are the key to avoiding many chronic conditions. Walking lowers your risk of Alzheimer’s disease, heart disease, stroke, and diabetes. It can lower blood sugar levels when performed directly after meals. Elevated blood sugar levels are a major contributing factor to excessive internal inflammation which is associated with most chronic illnesses. Walking can also be an essential component in psychological well-being. Walking as exercise and generally walking more during the day should be considered the first line defense in slowing the aging process and maintaining functional independence.

Embrace fashion.

The first step in adopting a new healthy behavior is to envision and feel what it would be like as if you had already adopted that new behavior. This allows your brain an opportunity to already feel what it would be like to make a change without fully doing so. This can be very motivating. Investing in gadgets or new work out attire, including new walking shoes, can be both motivating and fun. Get in the mindset of adopting the new behavior. Envision how you will look and feel once you have made the changes. Then go for it!

Take control.

There is nothing more important than your health. You have control over most of the aspects in your life that affect your health and well-being. Take charge, and empower yourself. You must be your greatest advocate. Western medicine is designed to keep you alive, not to help you thrive. Taking a passive role in your health is not a wise choice in America’s current health care environment. Only you are responsible for your health. Decisions now will determine how successful you age in the future.

Make the decision.

Research on willpower has shown that it is a finite resource. We actually use up our willpower during the day and have to replenish it daily. This is why you are more likely to “fall off the wagon” later in the day rather than earlier. Decide on the change and commit to the decision. Then implement structure to your day that causes the behavior to be more automatic. Therefore, eliminating the need to rely solely on willpower.

Maintain your strength.

Although all muscle fibers decline some as you age, the fast twitch (Type II) fibers show the most declines. Some loss of strength is anticipated as you age. Losing strength to the point of complete debility or loss of mobility and independence is not a normal aging process.

Strength training is a critical component to maintaining and growing additional Type II muscle fibers. The stronger you are, the more resistant to injury you are. You are more likely to maintain proper functional mobility. Also, strengthening of the core area (the abdominals and back extensors) helps to manage low back pain.

Perform high intensity training (HIT).

The research on the effectiveness of HIT continues to grow. Even more impressive are the findings that HIT can be safely performed at any age and with almost every medical condition. It is now even being implemented in many progressive Cardiopulmonary Rehabilitation Programs, where people are recovering from all kinds of cardiac and pulmonary disorders such as COPD, heart attacks, and heart valve replacements.

Perform your cardio activity in short bursts (ranging from 30-60 seconds at a time) followed by a one to two minute recovery. The 30-60 seconds should be at a high intensity, meaning your rate of perceived exertion (RPE) is high. You should be breathing heavy. Accommodations can be made for almost any type of medical condition. For example, HIT may be performed while using a stationary bicycle, an upper body only bicycle, a rowing machine or in the pool. You can also walk uphill at a quick pace, then stop and rest. The point is to get your heart rate up, and then bring it back down for a full recovery prior to repeating.

If you feel unsure as to how to safely perform this type of training, please seek the help of a competent cardiopulmonary trained physical therapist or exercise physiologist.

Get started!

Make 2021 your year to renew your commitment to make the necessary changes that will empower you to age well. Most importantly, just get started! It’s never too late to maximize your health and well-being in 2021 by implementing these 7 strategies.

Which strategy can you implement in order to age well in 2021? Please leave your comments below.

Thank you for supporting The Physical Therapy Advisor! I look forward to serving you in 2021! If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by liking The Physical Therapy Advisor!

My Top 3 Most Popular Posts of 2019!

As 2019 comes to a close, more and more people are realizing the value of taking control of their health care and personal well-being. In today’s health care environment, we all need to learn how to treat common aches and pains proactively instead of reactively. We must get to the root of the issue instead of placing a Band-Aid over it. We must realize that our individual health is our responsibility. We cannot rely on others to make decisions for us. Our present health care system in America is not designed to help you optimize your health–that is your job!   

The purpose of The Physical Therapy Advisor is to help people like you to take control of your health and to save money by learning how to safely self-treat and manage common musculoskeletal, neurological, and mobility related conditions safely and effectively.

My Top 3 Most Popular Posts of 2019:

5 Tips to Ease Neck and Shoulder Pain – Neck and shoulder pain are one the most common ailments faced by people these days. That having been said, it can be mysterious, too. Pinpointing the exact cause for shoulder or neck problems can be particularly tricky as the underlying cause of the pain may be due to many differing factors. Discover the most common causes of neck and shoulder pain and tips on how to prevent and eliminate the pain.

Aging Well is Aging Gracefully – Aging gracefully is possible and will be different for everyone. You must be your greatest advocate. You have control over most of the aspects in your life that affect your ability to age well and gracefully. Start today by implementing these 4 tips to help you stay active and age gracefully!

An Easy Exercise to Prevent and Treat Shoulder Pain and Instability – Proper rotator cuff and scapular muscle strength is critical to preventing and treating shoulder pain. In this video post, I demonstrate one of my favorite rotator cuff and scapular stabilizing exercises using an exercise band. It works the lower trapezius, deltoid and rotator cuff muscles.

2019 has been an exciting year! Thank you for supporting The Physical Therapy Advisor!  I look forward to serving you in 2020! If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by liking The Physical Therapy Advisor!

Autoimmune Disease and Physical Therapy

Autoimmune conditions and physical therapy are two topics not often mentioned in the same sentence. However, as incidences of autoimmune conditions continue to rise, it’s only natural that physical therapy treatment and practice would evolve to help address an ever increasing cohort of patients. With a list of over 100 known autoimmune diseases and more illnesses being associated with some form of autoimmunity, the chances that either you or a loved one will be affected by an autoimmune condition is quite high.

I was honored to be interviewed in a recent PT in Motion article, Treating Patients with Autoimmune Conditions, by Greg Gargiulo. He highlights many autoimmune conditions treated by physical therapists and explains how physical therapists are in a unique position to help patients manage and thrive in spite of his/her illness.

During my interview, I specifically spoke with him about the importance of knowing and understanding how autoimmune disease can affect physical therapy treatment.

Physical therapists must understand all types of autoimmune conditions in order to help patients understand that his/her condition may impact the physical therapy plan of care and the duration it takes for a complete recovery. For example, conditions such as Crohn’s Disease can affect nutrient absorption which ultimately will affect a person’s ability to heal.

To read the entire article, please click: Treating Patients with Autoimmune Conditions. A special thanks to Greg Gargiulo for his excellent article and for spreading the word on physical therapy and autoimmune conditions!

5 Tips for Living a Long and Blessed Life

As we approach the holiday season, it’s important to take the time to remember the truly important things in life. Aging well is a blessing we all hope for.  Successful aging is a lifelong ever evolving process. It’s a process that can begin at any time regardless of your age or health status.

Demands and expectations of what it means to age successfully are different now compared to past generations. This presents an interesting dichotomy between the old and the new way of thinking with the desire to live longer, stay active, and age in place. Living longer and healthier is definitely a blessing. When planned for, aging well is a blessing we all can experience.

We are all capable of successfully aging if we are intentional about the process. Successful aging has a different meaning for each of us, but commonalities exist in most scenarios. In order to live safely, independently, and comfortably, consider your physical, mental, and emotional health as well as your community and any financial implications.  Continue Reading for 5 tips for living a long and blessed life.

Aging Well is Aging Gracefully

What it means to each generation to age well has changed throughout the decades. As societal norms change, expectations for how people should feel or act also change. The goal of successful aging is always to age gracefully.

So what does it mean to age well or gracefully? Aging gracefully is finding the optimal balance between the physical, social (friendships), mental (cognitive), psychological, and spiritual aspects of aging. Each aspect of aging is important and interacts with the other.

We must be intentional in how we grow, develop, and maintain these five aspects of aging because of the multifaceted nature of our beings. Each aspect will likely be a focus at different times and seasons. Like a garden, our lives (and specifically these five basic attributes to graceful aging) go through the necessary seasons and cycles.

As a physical therapist, my primary role is to help older adults improve their physical abilities so they can continue to participate in the other aspects of living a full and graceful life. Daily activity and maintaining strength are vital components to aging well. Continue reading for tips for staying active and aging gracefully.