Category Archives: Successful Aging & Elder Care

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Longevity Through Physical Therapy

Healthy aging looks different for everyone.  A person’s prior health status, genetics, and life experiences can all weigh heavily on one’s ability to age well.  Part of a healthy aging process is maintaining independence in your later years.  One important component to healthy aging is how well you can maintain your mobility.  Aspects of maintaining mobility include adequate balance, strength, and endurance.

As you age, the likelihood that additional co-morbidities (other complicating medical conditions) is also likely higher.  This means that addressing the foundations of mobility (such as balance, strength, and endurance) may not be a straight forward proposition when seeking to maintain your activity level.  Research concludes that appropriate strength training and cardiovascular exercise training is a key component to the treatment and management of most chronic illnesses that affect the aging adult.

For many, the main barrier to implementing an exercise as medicine approach is uncertainty and the fear of causing more harm.  How can you properly perform the exercises needed to address the impairments requiring treatment while working around other complicating medical conditions including arthritis, joint pain (knee pain), back pain or shoulder pain?

A physical therapist (PT) is uniquely qualified to understand your individual medical history as well as the difference between “abnormal” and “normal” aging and physiology.  A properly trained PT can guide you on how to best and safely improve the foundations of mobility in the presence of complicating medical conditions.

Physical therapists and the field of physical therapy can help lead the way for those desiring to age well.  Physical therapy can even be used as a preventative medicine to ward off many of the prominent illnesses attributed to aging.

Listen to my past guest appearance on The Longevity and Biohacking Show, in which I discuss Longevity through Physical Therapy.  Jason Hartman and I specifically discuss how physical therapy can be used to manage and prevent conditions such as diabetes, osteoporosis, heart disease, and dementia.  Humans were designed to move much more than our current lifestyles afford us.  Maintaining your mobility is critical for all body functions and is fundamental in avoiding chronic illness.

As the exercise as medicine approach is coming to the forefront of recommended treatment options for chronic disease management and treatment, so has the concept of the medical fitness center (which are also known as medically oriented gyms or medically integrated health centers).  These facilities are now being recognized as an important part of a healthcare system’s continuum of care.  They are run by physicians, hospital groups, exercise physiologists or other ancillary health professionals (physical therapists).  The staff is qualified to teach, help guide, and monitor each individual on how to safely implement the proper exercise prescription to improve quality of life and prevent or manage chronic disease and illness in order to age well.

Maybe most importantly, medical fitness centers are places where people with multiple medical risk factors, diseases or illnesses (such as diabetes, obesity, and osteoporosis) can feel comfortable with the care and instruction provided in a safe and appropriate environment.

If you desire to live a long healthful life, take personal responsibility and embrace the importance of a proper exercise and diet prescription while focusing attention on how to best age well.  Seek the assistance of a medical professional who can guide you through this process.  We are all capable of successfully aging if we are intentional about the process. 

If you’re interested in learning more about how physical therapy can help you to age successfully and improve your health span, 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!

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Why Medical Fitness?

The United States spends more money (by a wide margin) than any other country on health care.  Our health care system is set up to keep us from dying, not thriving!  Sadly, our average life span barely makes it in the top 30 when compared to other nations.  Worse yet, life expectancy in the United States has decreased two years in a row!  Both 2016 and 2017 mark life span expectancy declines.  As it stands now, the American health care system is poorly equipped to help us maximize our health span.  Health span is defined as a period of time in which a person is generally healthy and free from serious disease.

Health care costs in America continue to increase without actual positive change in our health status as patients and consumers.  It is imperative that we take back control of our own health care by continuing to be proactive.  Part of being proactive is learning how to care for and manage common injuries and illnesses.  The medical system is not designed to help you to maximize your health and well-being.  It is designed to prevent you from dying and to maximize profits for the corporatocracy that controls our health care system.

Health care costs in the United States continue to outpace almost any other sector for inflation.  Unfortunately, this increase in cost has not shown any actual positive change in health status.  Not only are costs within our healthcare systems rising at near exponential levels, but we are also in the midst of a giant generational shift that will forever change the demographics of the United States and the Western World.  During this shift, the Baby Boomers are rapidly approaching elder status.  At the present pace, over 8,000 baby boomers are turning 65 every day!

Many have turned to science to find the fountain of youth to help us all live longer (without much success so far).  Maybe more importantly we must remember that, health span is just as important as life span.  How you spend your years is just as (if not more) important than your actual age.  One of the most critical components to aging well and improving health span is physical activity.

We are all capable of navigating a successful aging process if we are intentional with our behaviors.  Although successful aging has a different meaning for each of us and outcomes will vary, commonalities exist in most scenarios.  In order to age successfully, you will need to fully embrace what it will take to accomplish the goal of living safely, independently, and comfortably within your community.  We know our present healthcare system is not designed to help individuals age well, only to prevent dying.  So how then can we age well?  Enter the rise of the medical fitness centers!

We all know that exercise is good for us and that mobility is vital to independence as we age.  In fact, many of the most chronic devastating diseases individuals suffer from are actually best managed through lifestyle choices (including proper diet and exercise).

Examples of illnesses that are in many cases best managed with an exercise and diet prescription rather than medication include:

  • Diabetes
  • Obesity
  • Cardiac Disease
  • Many auto-immune diseases
  • Osteoporosis
  • Sarcopenia

While this is not an exhaustive list, it is actually difficult to find an illness that wouldn’t be better managed through improved lifestyle choices including proper exercise and diet prescriptions.

So what exactly is a medical fitness center, and how is it different from a traditional gym?

Medical fitness centers are designed to use evidence-based practices to help individuals manage many of today’s most common illnesses.

Many “typical” large chain and smaller gyms focus on programs that tend to be based on what the public perceives as “the new thing” or what feels right to them.  Typical gyms most often cater toward a younger population that does not already have medical issues.  Such gyms may not have educated staff available to help those trying to manage chronic disease and/or illness.

Medical fitness centers (which are also known as medically oriented gyms or medically integrated health centers) are now being recognized as part of a healthcare system’s continuum of care.  They are run by physicians, hospital groups, exercise physiologists or other ancillary health professionals (physical therapists).  The staff is qualified to teach, help guide, and monitor each individual on how to safely implement the proper exercise prescription to improve quality of life and prevent or manage chronic disease and illness in order to age well.

Maybe most importantly, medical fitness centers are places where people with multiple medical risk factors, diseases or illnesses (such as diabetes, obesity, and osteoporosis) can feel comfortable with the care and instruction provided in a safe and appropriate environment.

The benefit of selecting a medical fitness center versus a traditional gym is that you will be given an individualized workout routine that is right for you in addition to a personal assessment.  Rather than jumping right in without guidance or instruction, your personal baseline and needs will be assessed so you can be coached and guided through a fitness, mobility, and disease prevention and management program in order to help you to minimize the risk of injury while improving all aspects of your health.

If you’re interested in learning more about how physical therapy can help you to age successfully and improve your health span, 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!

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My Top 3 Most Popular Posts of 2017!

As 2017 comes to a close, I become increasingly more excited for the years to come!  As science evolves and its understanding of how the human body functions, we’re seeing more technology that can help to enhance our lives and optimize function.  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.  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.

Image courtesy of Unsplash.

My Top 3 Most Popular Posts of 2017:

  1. Why You Won’t Heal – Poor Nutrition (Part 4) – You will discover why consuming the proper nutrients is critical in order to fully heal and recover from an injury or illness in part 4 of my very popular 6-part series, Why You Won’t Heal.  The feedback was so positive that I written an even more thorough book on the topic!  Keep an eye out for Why You Won’t Heal (and What YOU Can Do About It) to be published in spring of 2018.
  1. How to Become a Resilient Runner – You will learn how to become a resilient runner so you can avoid injury, train more, recover quicker, and save money.  The Resilient Runner program, which includes prevention and self-treatment for running injuries, is a collaboration with Angie Spencer (RN and Certified Running Coach) and Trevor Spencer (co-host of the Marathon Training Academy Podcast).  The program is a virtual library of self-treatment protocols including downloadable podcasts, videos, and .pdf files of rehabilitation guides.  It also includes a 320 page eBook, The Resilient Runner, Prevention and Self-Treatment Guide to Common Running Related Injuries.  This is a must have program in order to learn how to prevent and/or self-treat lower extremity pains and injuries.
  1. Why Does My Shoulder Hurt? – I discuss the most common reasons why you may develop shoulder pain.  You will discover the key to treating most common shoulder related pain.  In addition, learn how to improve your posture while focusing on thoracic mobility and proper shoulder strengthening.  I offer simple stretches and exercises that you can use to eliminate the pain.

2017 has been an exciting year!  I have successfully published three books (which are now available on Amazon in Kindle and paperback formats) with wonderful feedback!  I am so grateful that more people are beginning to understand that many of the most common aches, pains, and musculoskeletal injuries can be safely managed and self-treated with proper guidance.

In Treating Ankle Sprains and Strains, I show you how to effectively self-treat and manage an ankle sprain and/or strain in order to resume your training and normal activities while minimizing the risk of additional damage, injury or re-injury.  When you can confidently self-treat, you can limit pain levels, return to activity faster, prevent reoccurrences, and save money!  A proper rehabilitation from the initial injury to the full return to sport and/or activity must include a full return to strength, mobility, and balance.

In Treating Low Back Pain during Exercise and Athletics, I share very specific strategies for general LBP prevention among athletes such as sport enthusiasts, CrossFitters, weightlifters, and runners.  These principles are helpful for anyone participating in athletics as well as those implementing a healthy lifestyle.  You’ll learn how to address specific causes of LBP as well as the best practices on how to prevent and self-treat when you experience an episode of LBP. 

In Preventing and Treating Overtraining Syndrome, I show you how to recognize the risk factors and symptoms of Overtraining Syndrome (OTS).  You’ll learn how to utilize prevention strategies to help you develop a personal training strategy that will allow you to push past your limits and prior plateau points in order to reach a state of what is known as overreaching (your body’s ability to “supercompensate”).  This will speed up your results, so that you can train harder and more effectively than ever before!

Be sure to stay tuned for upcoming books including Why You Won’t Heal (and What YOU Can Do About It) and Running an Injury-Free Marathon (Complete with Training and Rehabilitation Strategies)!

Thank you for supporting The Physical Therapy Advisor!  I look forward to serving you in 2018!  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.  Be sure to subscribe to my e-mail list and join our community on Facebook by liking The Physical Therapy Advisor!

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How You can keep Moving with a Busy Schedule

While juggling to have a happy personal life and getting through the burdens of an office job, we forget to do one little thing: move enough during the day.  Technology has made everything simpler, which also means less moving and a more sedentary lifestyle.

We forget that in order to be active, we don’t necessarily have to run to the gym and sign for a membership.  There are other simpler ways that we can adopt in order to make sure we are getting enough movement during the day.  It could be from parking a little further away from your grocery story and walking to it to taking the stairs for one or two floors.  Such little changes have positive impacts in our lives in the long run.

In this guest post for The Diabetes Council, you will discover the different ways in which you can ensure that you are moving enough for the day.

Q.  I have a full day of work, running around on errands. What are the simple ways to make sure I am moving enough for the day?

A.  It’s easy to let the busyness of life keep us from taking the steps necessary to insure a long life span and health span.  The good news is that frequent short bouts of exercise can be effective for maintaining general health.  The key is to incorporate frequent movement into your daily routine.

Get up and move at least every two hours during the day.  One option is to perform ten sit to stand exercises every hour.  (Simply, move from sitting to standing for ten repetitions.)  Another option is to walk at least every two hours for a minute or two.  The faster the walk, the better!  If stairs are available, walk up and down.  Combining the sit to stand exercises with walking is an excellent and fast way to elevate your heart rate no matter where you are!  Try parking further out in the parking lot when you’re out running errands.  It will force you to walk further.

Finally, make time to connect with not only yourself, but loved ones, too.  Walking after meals has been shown to stabilize blood sugar levels.  It’s also an excellent way to boost metabolism and connect with friends and family.  Frequent walking is the most important physical activity you can engage in.

Continue reading for more great responses from fitness experts about the ways in which you can ensure that you are moving enough for the day.

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Why You Keep Getting Hurt

Have you ever wondered why some people seem to always get injured while others are resilient and seemingly bullet proof?  Injury can be the biggest obstacle you face when trying to be healthy.  Acknowledging that you’re injury prone is the first step.  Instead of letting the fear of getting hurt stop you from achieving your goals, learn how to take precautions and stop being injury prone.

In my series on Why You Won’t Heal, I addressed the six categories of common reasons why a person will not heal or recover from injury.  If you’re frequently injured, it’s time to take a step backward in order to understand why you keep getting hurt in the first place.  Avoiding injury is always best.  When it comes to injury, there are factors, like genetics and luck (whether good or bad), that are out of your control.  There are also many factors that are definitely in your control.

The power of good genetics cannot be understated.  Some people just were lucky and won the genetic lottery.  They picked their parents well!  We all know that one person who seemingly can do whatever he/she wants without ever seeming to have an ill consequence.  That may go for all kinds of questionable behaviors from those who smoke for fifty years, yet still live to be 100 years old.  Good genetics are definitely a gift for some, while the opposite can be true for others.

Like good genetics, you can’t eliminate the effect luck (whether good or bad) may have on your life.  I’m sure that you have known those people who always seem to win contests or drawings or that seem to always be at the right place at the right time.  While others seem to be the ones that if something bad is going to happen, then it happens to them.  Now I’m not a superstitious person, but I think that some people seem to have either more bad or good luck than others.  Louis Pasteur said of his seemingly serendipitous scientific discoveries, “Chance favors the prepared mind.”  Are you prepared?

How can you learn to avoid injury?  Consider the following factors that make you more prone to injury:

Poorly Designed Training Program 

Overtraining syndrome (OTS) occurs when the intensity and/or volume of training/exercise becomes too much for the body to properly recover.  This is usually the result of a poorly designed and/or executed training program.  Pushing your training to the point of overtraining will at best, impede your performance.  At worst, it can lead to serious injury and burn out.  A weekend warrior (those that cram a week’s worth of exercise into just two days) is at high risk of injury because the body can no longer recover from the training stimulus being imparted on it.  To learn how to avoid OTS, please refer to 12 Tips to Prevent Overtraining Syndrome.

Poor Nutrition

The importance of proper nutrition cannot be overstated.  It’s critical in order to insure that your body is functioning at a high level and is capable of recovering from stress.  Your body relies on the stress, recovery, and adaptation cycle to progress forward.  Proper nutrition is a critical component to proper recovery.  Without proper recovery, your body cannot adapt and becomes more prone to injury.  Then you not only suffer from poor performance, but a lack of progress.

Poor Sleep Quality

Like proper nutrition, adequate sleep is a critical component to the recovery process.  Again, a body that cannot recover fully cannot adapt to the training loads being placed on it.  This impedes performance and increases your risk of injury.

Poor Posture 

The effects of chronic poor posture on western society cannot be overstated.  A vast majority of all low back pain (LBP), thoracic pain, and cervical pain is directly related to chronically poor sitting posture.  The effect of a low load long duration stretch on the muscles, ligaments, and discs of your spine can be devastating.  Our bodies were built for frequent movement and activity, not prolonged sitting (especially, with poor posture).  As a physical therapist, I have treated more people who are suffering from back and neck related pain from poor posture than any other injury.  For tips on avoiding poor posture, please refer to How to Improve Posture and Eliminate Pain.

The Wrong Equipment

Can you imagine trying to play basketball in hiking boots or soccer cleats?  Using the proper equipment for a particular sport or activity is critical to avoiding injury.  Wear properly fitting shoes if your sport involves running and jumping.  It’s not necessary to have the most expensive equipment, but it needs to be kept in good working condition and fit properly in order to maximize your safety.  Always wear a helmet when you are skiing or bike riding.

Common Sense 

This may be the most obvious and least used of all of our senses.  Many injuries could be avoided if one just took an extra second or two to think through his/her actions and decisions prior to acting.  Have a purpose and a reason for every action, and be intentional about those actions.  If your common sense tells you to think twice, listen!

Muscle Imbalances 

Although many muscle imbalances are due to poor posture, some can be attributed to other chronically repeated movement patterns.  Often when developing a certain motor skill, one will practice and practice that skill only.  This causes muscles imbalances to occur which will ultimately result in pain.  This can be easily oversimplified though.  Muscle imbalances can form for a variety of reasons including: chronic movement (habits) or sitting postures; neurologic input; overuse; and purposeful development.

Regardless of how the muscle imbalance occurs, once present, you are definitely at a higher risk of injury.  In runners, I often see an imbalance in strength within the rotators of the hip.  The hip’s internal rotators will be stronger than the external rotators.  This can lead to altered movement patterns and excessive strain and stress throughout the lower kinetic chain.  This often results in injuries like patellar femoral pain syndrome, shin splints, and plantar fasciitis.  This is why cross training is such an important component to any training plan.  With the right advice, training plan and cross training, you can avoid muscle imbalances and prevent injury.

Poor Mobility and Stability 

Poor mobility and stability can be components of muscle imbalance, but not necessarily.  One can have symmetrically poor mobility.  Poor mobility (and particularly, asymmetric mobility) can lead to injury.  It’s not necessary or desired to have excessive mobility.  Excessive mobility can also lead to injury as it’s usually accompanied with poor stability for the task at hand.  In the case of mobility, you just need enough in order to safely complete the desired task without over stressing and/or stretching the system.  More than just enough mobility will not provide an additional benefit.  However, there must be enough reserve mobility to accommodate for any unexpected movements that may occur.  There must always be an appropriate amount of stability or strength needed to safely complete the task without overloading the body system being utilized. 

Overuse Injuries 

Overuse injuries (also called repetitive motion injuries) tend to occur when a specific structure is subjective to a repetitive straining over and over again.  This eventually causes the structure to break down and results in injury.  Often, muscle imbalances are to blame for overuse injuries.

Weekend warriors are famous for getting overuse injuries as many people attempt to make up for a week of chronic poor sitting posture at their job in one afternoon of activity.  An example may be developing a case of tennis elbow after attempting to build a deck when you’re not used to swinging a hammer.  It can also happen when a runner tapers up the mileage a little too quickly and suffers a stress fracture.

Overuse injuries are almost always preventable by using common sense, sticking to a proper training plan, and implementing preventative maintenance and cross training.  An overuse injury can be frustrating because it could have been prevented initially with the right advice.

In order to be successful in meeting your movement, exercise, and training goals, injury must be avoided.  Other than lack of time, injury is the number one reason why people report not completing their exercise and training goals.  With the right training advice and preventative maintenance, most injuries can be avoided.

Avoiding injury in the near term is not only a critical component to reaching your training goals, but it’s also an important strategy as you try to optimize your health and truly learn how to age well.  This insures that you not only have a long life span, but also a long health span.

My goal is to help proactive adults like you to understand how to safely self-treat and manage common musculoskeletal, neurological, and mobility related conditions in a timely manner so you can reach your optimal health.

The following comprehensive programs are designed to help you not only save money on health care costs, but also learn how to be proactive in managing your current aches, pains, and injuries.  And more importantly, how to prevent them in the future!

The Resilient Runner

 

Treating Low Back Pain during Exercise and Athletics

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Why You Won’t Heal – Part 6

Risk Factors and Causative Factors are still affecting the Condition

During the recovery process, it’s important to reflect on how the injury or illness occurred.  What were the causative factors that led to the specific injury?  What choices did you make that would have caused this illness?  In order to optimize the healing response, all risk factors and causative factors must be addressed.  In the final Part 6 of the series, Why You Won’t Heal, you will learn how to discern if the risk factors and causative factors that led to the injury and/or illness are still present and affecting your current condition.

You may be getting the best quality care and treatment regime for your specific condition, but if the original causative factors are still present then your ability to recover is significantly impaired.  When possible, always address the root cause of the problem and then determine the appropriate rehabilitation program.

The ultimate goal is to eliminate the leading causative factors and then establish the proper care and treatment.  This includes addressing any potential psychological beliefs associated with the injury as well as insuring that you are consuming quality nutrients and getting enough sleep in order to recover properly.

As a physical therapist, I continue to see countless examples of individuals who may be getting the right treatment, but yet he/she still struggles to heal because the risk factors and causative factors that led to the injury and/or illness are still present and affecting his/her current condition.

The following example illustrates what happened to one of my prior physical therapy clients.

A 30 year old man presents with frequent headache pain and neck pain.  Together we work on restoring proper thoracic and cervical (neck) range of motion as well as proper strength through the cervical and thoracic spine.  He feels much better, but yet he continues to experience intermittent pain and headache symptoms.

His pain levels are worse while at work.  He takes pictures of his office, and a coworker records a short video of him working at his desk.  Upon viewing, I discover that his office set up is incorrect with the keyboard and monitor not properly positioned (poor ergonomics).  He’s working in a slouched posture which causes a forward head and rounded shoulders.

If this is his typical posture throughout a majority of his work day, is there any wonder why his headaches persist?  His posture is causing excessive strain on his neck and upper back every day while at work.

Once his work ergonomics were improved and he was more mindful about his posture, he was pain-free and headache-free.  If the underlying reason for his ongoing pain and headaches hadn’t been correctly addressed, then his recovery would have been less than optimal and his symptoms would have likely persisted or eventually worsened.

The reasons why a person may not recover are vast and complicated.  Your rehabilitation protocol will vary and is dependent on the type of injury or illness you have.  Regardless of the specific injury or illness, it’s critical that the following six categories of common reasons why a person will not fully heal and recover or take an extended time are addressed.

6 Categories of Common Reasons Why You Won’t Heal:

  1. You’re getting the wrong treatment for your condition.
  2. The injury or condition isn’t capable of healing.
  3. Physiological and social conditions are affecting your healing.
  4. Poor nutrition.
  5. Poor sleep quality.
  6. The risk factors and causative factors that led to the disease and injury are still present and affecting the current condition.

The body’s ability to heal and recover is dependent on many things.  To maximize your ability to heal and recover from illness and recovery, it’s important to be proactive and help your body in any way possible.  Getting to the root cause by utilizing these strategies for recovery will insure that you will heal and recover and/or effectively be able to manage your injury or medical condition.

Have you experienced a prolonged recovery or rehabilitation process?  If so, can you share any strategies that helped you to handle it?  Please leave your comments below.

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.  Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

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Why You Won’t Heal – Part 5

Poor 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 despite our actions.  However, it’s important to realize that what we do and how we treat an injury or illness can significantly affect how well the body is able to heal and recover from it.  In Part 5 of the series, Why You Won’t Heal, I address how poor sleep quality can negatively impact how one heals from an injury or illness.

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.  On average, a person requires between 7-9 hours of sleep.

Although there are different stages of sleep cycles, a typical sleep cycle lasts between 70-120 minutes.  The actual amount of sleep needed will vary and is dependent on how long your particular cycles are.

It’s interesting to note that if you wake up just as you are coming out of a sleep cycle that you will typically feel more rested and alert.  On the other hand, if you wake at the start or halfway through a cycle, you will probably wake up feeling tired and grumpy (hence the term “waking up on the wrong side of the bed”).  We should probably term this “waking up on the wrong half of the sleep cycle” instead.

Throughout your recovery and rehabilitation, try to sleep and rest more than you typically would.  This shouldn’t be confused with bed rest though.  As a physical therapist, I rarely encourage bed rest, but at times, bed rest can be medically necessary.

Activity and frequent movement is extremely important during your recovery as is getting adequate rest and sleep.  Many important body processes occur while you sleep.  One of the most important aspects of sleep is how it affects your hormonal regulation.  Hormones, such as human growth hormone (HGH), play a critical role in how you will recover from injury.  Adequate rest and sleep is necessary for HGH and other critical hormone systems to be at the optimal level.

Poor sleep or inadequate amounts of sleep not only affect the healing response, but are also a risk factor for many chronic diseases and illnesses including:

  • Metabolic syndrome
  • Diabetes
  • Heart disease
  • Depression
  • Chronic pain
  • Dementia

How to Improve Your Sleep Quality

If your recovery and rehabilitation is starting to slow down or just not progressing like you would expect, taking a look at your sleep quality is an important next step.  In order to insure quality sleep, be proactive about the environment you sleep in and how you prepare to sleep.  This is known as your sleep hygiene.  The following tips can help you to get a better night of rest:

  • Avoid caffeine later in the day.
  • Black out your room.  Darkness sends important hormonal signals to the brain to prepare for sleep.  Even small amounts of light can disrupt sleep patterns, so cover up any potential sources of lights (even those that may be present on smoke detectors or electronic equipment).
  • Avoid any use of electronic equipment for at least two hours before bed as the light (in particular, the blue light) emitted by the screen is very stimulatory to your system.
  • Avoid watching television for at least two hours prior to bed as the light emitted by the screen is also stimulatory.
  • Establish a rule of no electronic equipment in your bedroom.  Many of us feel as though we must have our TV or tablet, but your sleep quality will improve without it.
  • Do not read or watch anything (like the evening news) that would be stimulating or anxiety producing prior to bed.
  • Try supplementing with magnesium prior to bed.  Most people are deficient in the amount of magnesium they consume on a regular basis.  Magnesium can help reduce muscle soreness and improve your quality of sleep.  I recommend beginning with a dose of 200 mg (before bedtime) and increasing the dose in 100 mg intervals as needed.  I would caution you that taking too much magnesium can lead to diarrhea.  Mag Glycinate in its oral form is the most highly absorbable.  Although not as absorbable, Thorne Research Magnesium Citrate can also be beneficial.
  • Get on a schedule.  Your body thrives on a routine, so preparing for bed shouldn’t be any different than your other daily routines.  Try to go to bed at the same time each day.  In order to increase your time sleeping, go to bed a little earlier (like 5-10 minutes) each day versus sleeping in longer in the morning.  Try to gain extra rest at the beginning, not the end, of the sleep cycles.
  • Keep your room cooler.  If your room temperature is too hot, you are likely not to sleep well.  Usually cooler is better than warmer, but not cold.
  • Get regular exercise.  Regular exercise can help to keep you on a good sleep schedule.  Just don’t exercise right before bed.  When recovering from an injury, the type of exercise may vary and is dependent on your specific injury.

An adequate amount of sleep shouldn’t be considered a luxury, but instead as a critical component to proper healing and recovery.  An adequate amount of quality sleep is one of the most critical factors when you’re trying to recover from injury and illness.  It’s also a critical component to avoiding overtraining syndrome.  Don’t underestimate the importance of sleep in your recovery!

Which tip can you implement in order to get a better night of rest?  Do you have any tips to share?  Please leave your comments below.

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.  Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

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Why You Won’t Heal – Part 4

Poor Nutrition

There are many reasons and factors that affect a person’s ability to heal and recover from an injury or illness.  One of the most common, yet the most basic, reason is poor nutrition.  The healing tissue and the body may not be receiving the proper base components to actually heal.  In Part 4 of the series, Why You Won’t Heal, I address how poor nutrition can negatively impact how one heals from an injury or illness.  Consuming the right foods to provide the proper nutrients for your body is critical in order to fully heal and recover from an injury or illness.

Two Reasons Why Nutrients aren’t getting to the Injured Area:

1. The injured area or tissue just isn’t getting adequate nutritional and growth factors to the actual tissue. 

This is a logistical delivery issue.  For example, the blood supply to the injured area may be compromised.  Without a proper blood supply to the healing tissues, the area will not receive vital nutrients and healing factors which is a critical component of the healing process.

One possible reason for poor blood supply may be due to dysfunction in one’s cardiovascular system (such as heart disease or atherosclerosis, the hardening and narrowing of the arteries).  Another reason may be that the injury is to a tissue that inherently has a poor blood supply such as cartilage tissue.  In the case of lumbar discs, they rely more on movement than blood supply to circulate nutrients.

If it’s not a delivery issue, then there are cases where it may be an absorption issue.  This can occur in the case of a digestive related issue that affects the body’s ability to actually get the needed nutrients from the consumed food into a useable form in the body.  This includes conditions such as Crohn’s disease and leaky gut syndrome.

2. A person’s food choices and lifestyle are not allowing for the body to have the base nutrients needed to actually heal from the injury. 

Sadly even in western societies where food is overly abundant, so is malnutrition.  I work with clients who are obese and have access to an adequate amount of food with plenty of caloric intake to survive, yet they are so nutrient deficient that their rehabilitation potential is very poor.  An abundance of food and calories does not necessarily equal adequate amounts of nutrients and micronutrients to be healthy.  This is the primary problem behind our obesity epidemic including metabolic syndrome, diabetes, and heart disease.

As a physical therapist, I help to educate my clients about a wide variety of strategies from advice on exercise, hands-on techniques (such as myofascial and joint mobilizations), and self-care techniques (such as basic nutrition) because it’s a critical component in how a person can heal and recover from an injury or illness.

Many of my clients have the following conditions which have a nutritional component to them:  osteoporosis; sarcopenia; autoimmune diseases; metabolic syndrome; diabetes; and heart disease.  Even when a client doesn’t have a specific systemic condition, proper nutrition is still a factor on how an injury will heal whether it’s from an ankle sprain or from a knee or a shoulder surgery.

Often times, I will work with a physician, registered dietitian or nutritionist to help educate my client on proper eating habits.  I also commonly refer clients to certain books, such as Dr. Josh Axe’s Eat Dirt: Why Leaky Gut May Be the Root Cause of Your Health Problems and 5 Surprising Steps to Cure It, which can help to educate them on number of different topics.

As a physical therapist, it’s not uncommon for me to see someone who is struggling with healing from an injury.  He/she may be performing the right exercises and receiving the proper treatment, yet he/she is unable to properly heal because his/her body doesn’t have the proper nutrition level to allow the healing to occur.  It is important to remember that poor eating habits not only sabotage your results, but can also lead to severe chronic illnesses.

Focus on your Recovery Nutrition

In order to fully heal and recover from an injury or illness, consuming the right foods to provide the proper nutrients for your body is critical.  The majority of your diet should be from real food.  My personal belief is that food which is minimally processed, organic and/or home grown is likely to have a higher nutrient load and will therefore be healthier for you.  Your body simply cannot heal and recover quickly or adequately when substandard fuel “food” is consumed.

In today’s society, it’s possible to have an overabundance of calories and still be nutritionally deficient and malnourished.  It’s critical to focus on nutrient rich food and avoid “empty” calories.  That includes food which has no nutritional value (junk-food).

Maintaining muscle mass is critical for recovery and rehabilitation as well as for injury prevention.  Initially, focus on macronutrients (fat, protein, and carbohydrates) when it comes to food.  During the rehabilitation process, focus on a diet high in protein from many sources (plant and animal-based), high in fruits and vegetables, and low in processed carbohydrates.

Newer research concludes that as a person ages, his/her protein needs do not actually decrease, but remain elevated as the body’s ability to process protein decreases.  It’s important to have higher amounts of protein available for use.  During recovery, additional protein is often needed to insure healing tissues have the building blocks necessary for recovery.  For more information on protein supplementation, please refer to How Much Protein Do I Really Need?

Each person is different as is the recovery process and one’s prior health status.  The diet should be tailored to your individual needs.  There isn’t just one perfect diet plan—these are only guidelines.  Please discuss your dietary concerns with your medical provider.

Supplementation

The ultimate goal with supplements is to aid your body in improving health and nutritional status.  Try to choose the most natural products as possible and experiment to see what works best for you.  Look for supplements that don’t contain extra fillers, sweeteners or additives.

The following list includes my most common recommended supplements to take during the rehabilitation process:

Protein

Protein is a critical macronutrient that is highly important in maintaining the building blocks needed to support the muscular system (including skin and tissue).  Additional protein is often helpful during the recovery process if you have experienced a muscle or tissue injury.  Additional protein in your diet can stabilize blood sugars and satiate your appetite.

Capraflex

My most recommended supplement to help recover from injury is CapraFlex by Mt. Capra.  It combines an organic glucosamine and chondroitin supplement with other natural herbs which are designed to reduce inflammation.  CapraFlex can be taken long term or intermittently.  I use it to help recover from acute injury.

Magnesium

Magnesium is a critical component of bone health and health in general.  Magnesium helps the body to regulate calcium levels.  This has a positive effect on bone health and also has been proven to reduce the risk of kidney stones.

You can take Mag Glycinate in pill form or by eating foods higher in magnesium such as spinach, artichokes, and dates.  Most people are deficient in the amount of magnesium they consume on a regular basis.  I recommend beginning with a dose of 200 mg (before bedtime) and increasing the dose in 100 mg intervals as needed.  I would caution you that taking too much magnesium can lead to diarrhea.  Mag Glycinate in its oral form is the most highly absorbable.  Although not as absorbable, Thorne Research Magnesium Citrate and magnesium oxide can also be beneficial.

Vitamin D3

Vitamin D3 is critical to the absorption of calcium through the intestinal wall which is important for bone health.  It’s also a critical nutrient in maintaining a healthy immune system.  However, there are potential cardiac risks to over supplementation.  A healthy varied diet will typically supply adequate calcium levels (assuming that adequate Vitamin D3 levels are present for absorption and that you are avoiding drinking soda).

Vitamin K2

Research indicates that Vitamin K can help to reduce bone loss by helping the body regulate osteoclast function within the bone.  An osteoclast is a type of bone cell that breaks down bone tissue.  These very important cells are integral in maintaining proper bone density and insuring an appropriate amount of calcium in the blood stream.  Without adequate calcium, many critical cell functions can be affected (including heart function).  Both Vitamin K1 and K2 have been proven to reduce the risk of fractures, including hip and vertebral.  Vitamin K (best found in green leafy vegetables) has anti-coagulation benefits.  If you take blood thinning medications, your physician will need to know how much you consume on a regular basis.

Coconut Oil

In past years, there has been a real push for toward a low fat diet.  However, people have forgotten that fats are a critical macronutrient when consumed at reasonable levels and via real foods (such as coconut oil or avocados).  The nervous system relies on adequate levels of fats and cholesterols to be present.  Insuring the proper amount of fat consumption is critical when healing from a neurologic injury or condition.  It’s also helpful for weight loss because it can satiate your appetite.

Super Greens

Green super foods, such as spirulina algae, chlorella algae, and wheat grass are packed high in antioxidants.  They can have a cleansing and an alkalizing effect which will decrease your inflammation level and aid in recovery.  Super greens boost your immune system and are generally good for you.  I think the argument can be made that algae is the king of “super” foods.  It is likely the most important food/supplement most people are not taking.

I am particularly fond of supplementing with algae as a super food because it addresses many of the most common nutrients needed during rehabilitation.  Algae have high levels of protein as well as magnesium and other critical micronutrients in order to help you recover.

My new favorite way to add greens and protein in general is a supplement called ENERGYbits® and RECOVERYbits®.  They are made from organically grown NON GMO spirulina algae or chlorella algae.  Spirulina algae have a high concentration of plant-based protein (64%).  It also contains 40 vitamins and minerals including iron, nitric oxide, Omega-3, and all of the B vitamins.  Chlorella is high in protein.  It also has detoxing properties and an impressive micronutrient profile.

Because of their overall nutritional profile I now consider spirulina and chlorella algae a top rehabilitation and recovery supplement.  I recommend taking 30-45 of these small tablets per serving.  I recommend swallowing them whole, but you can chew them.

If you want to learn more about algae be sure to listen to Ben Greenfield’s interview with the founder of ENERGYbits®, Catharine Arnston, on the benefits and importance of algae.  Please refer to Is This The Most Dense Source Of Nutrition On The Face Of The Planet?

In full disclosure, I am now an affiliate for ENERGYbits®.  I signed up primarily to get the same 20% discount I can offer you.  You can only purchase them online, so when you check out, just enter discount code PTAdvisor for 20% off all products.

BUY NOW

Adequate nutrition is an important component to the rehabilitation and recovery process.  There is a direct correlation between your nutritional status and your ability to heal.  Each of us has different needs based on our individual health status.

As a physical therapist, I offer general guidelines based on what has worked for my past clients.  However, I recommend that you find a nutritional expert to be part of your rehabilitation team as well.  If you are not healing from your injury, it’s very important to insure that any and all dietary concerns are properly addressed.  Don’t skip this step as poor nutrition can and will derail your recovery process.

Have your food choices positively or negatively affected your recovery from an injury or illness?  Which supplement might you consider taking?  Please leave your comments below.

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.  Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

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Why You Won’t Heal – Part 3

Psychological, Emotional, and Social Conditions are affecting your Healing

The human experience is a web of how we relate to our surroundings as a physical, social, mental, and spiritual being.  So it comes as no surprise when we recognize that a person’s ability to overcome injury and illness isn’t purely physical.  There are very strong psychological, social, and spiritual elements to it.  It’s nearly impossible to separate the different aspects of our being or experience as a human.  The human body is a complicated.  To fully recover and heal from an injury or illness, all aspects of our being must be addressed at some level.  In Part 3 of the series, Why You Won’t Heal, I address how and why physiological and social conditions can affect your healing.

Your belief in your ability to heal and recover is a critical component to how you actually will heal and recover.  If you fully believe that you will make a recovery and return back to a pre-injury state, then you truly are more likely to do so.

So often I work with individuals who have fear associated with a full recovery.  A common example is someone who has severely injured his/her low back.  It’s common to be overly fearful and afraid that the pain may return if you do the wrong thing.  Consequently, that person will not push his/her rehabilitation and recovery.  And therefore, he/she doesn’t return to his/her prior baseline and will likely never fully recover physically as well as mentally and psychologically.

Because of this large barrier to recovery, most progressive back rehabilitation programs will address fear avoidance beliefs and the fear of disability from pain versus true musculoskeletal disability from injury.  The fear of re-injury is very powerful not only to the general population, but also for elite athletes.  Many elite athletes have failed to return to pre-injury glory because of fear and psychological dysfunction associated with his/her injury.

Other psychosocial issues that I have encountered include identity issues.  Many conditions become chronic because the condition and injury lingers for a long period of time.  As a person maneuvers through the health care system, this sick phenotype becomes ingrained in who the person is at a deeper psychological level.  The person forgets what life was like without the condition and now they become a person with that particular injury or illness.

Once a person takes on this type of deep routed feeling about who he/she is, it can be nearly impossible to actually heal from the condition as the condition is no longer only physical, but now psychological.  The condition and illness becomes part of his/her emotional psychological state and part of a new altered identity.  Subconsciously, this becomes an emotional and psychological paradox to recovery which affects the person physically as well.

Motivations also play a key role in a person’s ultimate recovery.  Are there secondary gain issues?  If a person dislikes his/her job, maybe he/she isn’t really motivated to return to work after a workers’ compensation injury.  Is a person depressed about other issues in his/her life, so he/she isn’t really that motivated to recover or improve?  All of these factors need to be addressed to insure optimal recovery.

However, it’s important to keep in mind that a person’s rehabilitation process can be highly variable even within those who are recovering from the same type of injury.  While most of my post rehabilitation clients have been able to move forward and live successful lives, there are other clients who took significantly longer to heal.

This is completely normal within a course of recovery.  Each person’s physical ability to heal and recover is different.  Unfortunately, there are some who were never able to recover to any significant degree.  The lack of recovery is always routed in physical as well as psychosocial reasons.  The severity of an injury is not necessarily a predictor of who will or will not recover or how the injury may affect a person physiologically.

Although I am not a psychologist, it’s my job as a physical therapist to help clients heal, recover, and/or adapt to injury or illness.  This includes addressing all aspects of the person’s recovery not only from the physical perspective, but also from an emotional, social, psychological, and spiritual perspective.  My treatment primarily focuses on the physiological issue, but I’m always aware of the other aspects and needs within the recovery process.  I help and advise where I can and when needed, I recommended other trained medical professionals.

If you are struggling to heal and recover from an injury or illness (regardless of the severity), consider the possibility that part of your recovery must include the other aspects of who you are as a person.  It’s common to include physiological, emotional, and spiritual support in your recovery.  (And I highly recommend it!)  We need to fully embrace ourselves and who we are (including our feelings and physical and psychological status) to insure that our bodies are operating at the highest level possible.  This type of self-awareness can be painful and difficult at times.  Don’t feel you have to do it alone.  Seek professional help because options are available.  Don’t give up on yourself!

Have you ever struggled to recover from an injury or illness?  How were you able to recover psychologically and emotionally?  Sharing your story can help others in their recovery process.  Please leave your comments below.

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.  Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

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Why You Won’t Heal – Part 2

The Injury or Condition isn’t Capable of Healing

People choose healthcare as a profession because we have a deep desire to assist others in times of need.  It’s our unique way to make a difference in someone’s life and to make this world a better place.  Our health and our life is the most precious asset we have.  When a person has been ill or injured, the hope is that recovery is possible.  Regardless of the condition, we hear stories of miraculous recovery as well as devastating loss.  Why do some people recover while others do not?

In Part 2 of the series, Why You Won’t Heal, I discuss a topic that no one really wants to hear.  Regardless of intent and hope, sometimes an injury or condition just isn’t capable of healing.  Our current knowledge of the human body through the use of Western or Eastern medicine may not be able to assist the person in healing.

While most of my post rehabilitation clients have been able to move forward and live successful lives, there are other clients who are unable to heal and recover.  Therapy (like speech, occupational, and physical) and assistance from physical medicine physicians and other rehabilitation specialists can help the client to live the best life possible with adaptive equipment and technology when recovery to prior function isn’t possible.

Sadly, some medical conditions are not curable, and a person will not have the ability to heal.  It’s important to keep in mind that there is wide variation of how these types of conditions will present and how a person can adapt and overcome to still lead a productive life.  It’s also important to realize that each individual responds differently to an injury.  One should always try everything he or she can to reasonably try to heal and recover.  However, if those efforts fail, then the focus needs to be on adapting (and not recovering) in order to live a productive and fulfilled life.

Below is a partial list of injuries that may not be able to heal, so other means of adaptation must be taken:

  • Spinal cord injuries
  • Severe spinal nerve root injuries causing paralysis
  • Some peripheral nerve injuries
  • Severe brain injuries
  • Some cerebral vascular accidents (CVA’s), known as brain attacks or strokes
  • Some types of infections
  • Loss of limbs
  • Some chronic progressive neurologic diseases

This list is by no means exhaustive.  No two injuries are alike, so you may have one or more of these conditions and have recovered or nearly recovered.  However, sometimes recovery just isn’t possible.  Openly discuss the injury or condition along with the associated impairments in order to acquire methods of adaptation.  Continuously looking for a cure or waiting for a complete recovery can derail your ability to adapt and move on with a productive life.

Common Traits that may Impair Your Ability to Heal: 

  • There is catastrophic neurologic involvement.  This may be from severe injury to the brain, spinal cord or larger peripheral nerves.
  • There is a chronic progressive neurologic disease which currently doesn’t have treatment methods available.
  • There is an incurable viral or other type of incurable illness.
  • There has been catastrophic injury to the musculoskeletal system to the point that repair isn’t possible (such as in the case of amputation).
  • There has been catastrophic injury to other organs of the body either through trauma or other chronic disease.  In the case of severe kidney disease, the only remaining treatment is dialysis.

If you or your loved one suffers from an illness or injury that is likely unable to heal or improve, then a heartfelt honest discussion with your medical provider is in order.  This is critical if you or your loved one wants to take the next step of learning how to adapt around the condition and continue to live a productive life.

One of the reasons I chose to be a physical therapist was to help others.  Throughout my career, I have met many clients who have been ill or injured without hope of recovery.  Yet these clients (through the use of current adaptive equipment and the will to overcome) are living very inspiring and fruitful lives.  If you can’t fix it, then adapt around it!

What has your experience been like when learning how to adapt to an injury or condition of yours or that of a loved one?  Please leave your comments below.

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.  Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!