Have an (Exercise) Snack..

If you’ve met me, been treated by me or ever visited my social media, you’re probably already aware that I strongly believe that Exercise is Medicine and that every adult should strive to meet the recommended 150-300 minutes a week of moderate intense exercise to prevent disease and better manage chronic conditions. However, only 1 of every 3 American Adults meet this recommendation, the rest, achieving less than that recommended dosage on a regular basis and placing themselves at increased risk for cardiovascular disease, diabetes and more. 

A new study, published by Preventative Medicine Reports looks at a new approach to encouraging regular exercise in older adults. Given many older adults cite lack of time as a prohibiting factor, this study looked at prescribing exercise ‘snacks’ or small bouts of regular exercise every day. Participants in this study completed one minute of functional exercise (30 seconds of body-weight push ups and 30 seconds of squats), each and every day for 24 weeks. 75% of these of this group completed at least half of the sessions, and as a group, significant improvements were noted at the end of the trial in maximal push-up and squat performance.

You can read this study in it’s entirety here: 

Feasibility and impact of a 1-minute daily functional exercise regimen prescribed to older adults by their primary care physician - ScienceDirect

Take-home message? Even a little effort can yield positive results. Every day, I work with people limited by pain, disability and fear. Issuing an exercise program, and expecting compliance, to an older adult who hasn’t participated in regular exercise since they were young or who associates exercise with pain, fatigue or fall risk is one of the biggest challenges faced by Physical Therapists on a daily basis. 

I frequently apply this idea of exercise ‘snacks’ to my patients, to help them gradually adjust to a more active lifestyle and too help them learn to see that exercise doesn’t have to be painful, exhausting or scary. I try to link these small bouts of exercise with everyday habits to make  remembering to exercise second nature, and improve compliance. Whether you’re older and trying to get more active, or a therapist or other healthcare professional trying to help your client become healthier, you can try my top five favorite exercise snacks to get the ball rolling.

1. Sit to Stands - Every time you stand up off a chair, do it 5 times instead.

2. Counter Push Ups - Every time you walk by the kitchen sink, do 10 Counter Push Ups.

3. Single Leg Stand - Every time you brush your teeth, try to stand on one leg as long as you can.

4. Loaded Carries - After each meal, carry a soup cans in each hand and walk 5 laps back and forth across the kitchen.

5. Wall Angels - Put a post it note on a spot in the hallway and every time you pass it, perform 5 Wall Angels.
   

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Happy 100th Birthday to the American Physical Therapy Association!

Happy 100 Years to the American Physical Therapy Association!

The APTA celebrates it’s 100th Birthday this year, though the roots of Physical Therapy go back way further. To honor this profession I’m so proud to be a part of, I wanted to share some interesting history on how it began and how it has continued to develop. The APTA has also developed some really cool resources on their APTA Centennial Page, like this timeline of 100 Milestones of Physical Therapy – APTA Centennial.

Old Old School History: In the BC times, even Hippocrates was hip to the benefits of manual therapy. In 460 BC, he documented the benefits of manual manipulation for pain relief and during the same era, in Ancient Greece, hydrotherapy became a thing when Hector began using water treatment to help people heal.

Old School History: Throughout the 1800’s, Sweden actually became the first country to establish an official PT registration through the National Health and Welfare Board and Physiotherapists used massage, manipulation and exercise to help gymnasts heal from injuries and illness.

Back in a century we actually lived in: The early 1900’s brought Physical Therapy to America. Rehabilitation aides and rehabilitation therapy was used to help soldiers recover after traumatic injuries sustained in World War 1, but the Polio epidemic in the 1920’s was where the benefits of Physical Therapy really took hold. Much like the current pandemic crisis we are living through, Polio shook our nation because in the absence of a vaccine, this paralytic virus had little mercy and killed thousands, and left many others paralyzed and often unable to breathe effectively without assistance - see the picture below of the Iron Lung! Physical Therapists helped people with polio learn to walk again with braces and crutches, and regain strength to get back to their normal lives. In 1921, Mary McMillan, the ‘Mother of Physical Therapy,’ established the American Women’s Physical Therapeutic Association, and the papers began to be published regarding the effects of physical therapy on healing and recovery. 

Since then: The profession of Physical Therapy has continued to grow, specialize and diversify since then. Influential therapists have conducted careful research on the benefits of therapy and our profession has grown from women in dresses in black and white images helping children learn to walk to Doctors of Physical Therapy with advanced educations and certifications who hold Direct Access to see patients first because of our competence not only in healing, but in effectively triaging those who are appropriate and can benefit from conservative care from those who need further medical workup and treatment first. We are specialists in our respective fields: the APTA offers board-certified specialization in Cardiovascular and Pulmonary care, Geriatrics, Orthopedics, Neurology, Oncology, Pediatrics, Sports, Women’s Health and Wound Management. We work in hospitals, emergency rooms, private practices, on sports fields and in people’s homes. We help people of all ages recover strength and motor control, develop critical skills like mobility and walking after traumatic injuries, manage pain and teach self-management of chronic conditions and work with patients to live their fullest and best lives despite whatever physical limitations they may develop. I’m as proud as I’ve ever been to be part of this wonderful profession full of compassionate and caring individuals who truly live to make people feel better. 

FAQ # 4: How Do I Know if I’m at ‘Fall Risk?’

As you know, I love to counter a question with another question, or in this case, three:

1 ) Have you fallen in the past year?

2) Do you feel unsteady with standing or walking?

3) Do you worry about falling?

If the answer to any of these is yes, research has shown that you are likely at an increased risk for falling. Now while this may seem like a short and sweet, the actual answer is a bit longer and more involved. This is where I come in. When I check to see if a patient of mine is at increased risk of falls, I’m like a detective on a trail. While I may start with these questions, their answers lead me down windy trails where I pick up clues that not only determine IF you are at fall risk, but more importantly, WHY. And it’s the WHY that allows me to help you prevent them. But that’s a story for a different post.

So, back to the question at hand. What do I look at to determine if you’re at risk for falls? 

1) I look at how you move. First and foremost, I look at your mobility, in your own home environment, sometimes when you don’t even think I’m watching (‘hey, can you give me a tour of your house?’). Without even doing another test, this would probably give me the most valuable information I can get. Do you stumble over thresholds? Reach for walls? Get distracted and lose balance with turning? Are there environmental hazards (small pets, throw rugs and more egads!) that could cause you trouble down the road? Is it dark? Is it too bright? Are you moving too fast, or too slow? Are you using assistive devices or may benefit from one? Do your movement patterns indicate an area of weakness or contracture? As therapists, this is our bread and butter. If you’re every hanging with a PT and feel like you’re being watched (or judged), you are! We can’t help ourselves, and we’re truly sorry:) 

2) I look at your balance. Obvi. Your very ability to stand upright, balanced over your base of support requires an intricate and functioning relationship between your feet, your inner ear, your eyes and your brain. This combination is lovingly referred to as your somatosensory integration. It allows you to stay upright, and then allows you to control your body as it moves both purposely outside your base of support - and unpurposely (is that a word?), as in the case of a loss of balance. By putting you in a series of different foot positions, with different degrees of challenge to each of these systems (somatosensory, vestibular, visual), I can identify which system is working and which system could work better - and then develop a plan of action to improve your balance over all. 

3) I look at aaaaallll other systems that are involved with your balance. Do you have pain that surprises you and knocks you off your feet? Limited range of motion in places that make your feet more likely to catch on the stair? Do you get tired easily or have impairments in cardiovascular function that make it more likely for you to pass out? Are you taking medicines that could make you dizzy, or confused or sleepy? Are you taking medicines that make it more likely to get injured from a fall like steroids that can make your bones more brittle or a blood thinner that could put you at risk for a head injury? Do you have other comorbidities that could play a role? Diabetes with fluctuating blood sugars? COPD with oxygen rates that drop when you move? Covid that has left you exhausted and uncertain on your feet? 

Before this FAQ becomes a book, I’ll stop there. As you can tell, there is a lot that goes into answering this seemingly simple question. Fortunately, there are Physical Therapists, like me, who train for years to become Fall Risk Detection experts and are happy to help you figure it out. If you’d like to learn more about fall risk, fall prevention and how I figure this all out, please join me Tuesday night for a Zoom webinar titled ‘So You’ve Been Told You’re UNSTEADI. Now What?’ During this one-hour seminar, I’ll dive deeper into the fall risk assessment process, explain the STEADI initiative, and how it is used by your medical team to determine fall risk and address modifiable risk factors and give you tools to make changes on your own to help you stay on your feet.

To register ahead, please click the link below and you’ll receive the zoom link from there.  

So You've Been Told You're UNSTEADI Zoom Registration

Happy New Year - and the Rule of Fives

I’ve gone back and forth what to post all day. Do I do the thing ‘I’m supposed to do’ and post a nice ‘Happy New Year you graphic? Do I write about how guilty I feel thinking about expressing gratitude to have made it through this year relatively scratch-free, when I’ve seen so many friends struggle with loss this year? Do I sit back and make Big Goals and Resolutions then share them with the world? (The possibilities are endless..)

When it comes down to it, we’ve all been changed by this year. Our children have been changed this year. The entire world we lived in has changed and I don’t know if will ever be the same.

But there can be goodness in change. There can be silver linings and lessons learned. There can be redirection and new purpose and path-righting.

I don’t have it all together, but I strive to keep most of it together, some of the time:) I took a huge leap this year snd am literally still figuring things out, as I go, every single day.

One thing I do know is I can’t thrive, and my business can’t thrive, and my family can’t thrive, if I don’t take care of myself first.

Have I been perfect this year? Nope. Have I tried my best to eat healthy and stay active despite all this chaos? Yes, for sure. Could I do better. Absolutely.

As a physical therapist, and a human, I can attest that the first step in achieving any of your goals, is caring for your body. Putting good things in, keeping bad things out. Keeping it moving snd active.

Should I make business goals and other more concrete resolutions? Probably. (It’s on my to-do list. Don’t judge:) ) But, I have decided, that all that ‘stuff’ needs to comes after this: my rule of FIVES - five things I think i can commit to that will make me a healthier person. This stuff isn’t earth shattering, and it isn’t even that hard. But it’s the stuff that matters and the things that WORK.

I, for one, am looking forward to 2021. This year turned our lives upside down, tossed our kids out of their schools and little kid worlds. It tossed everything into a giant socially-isolated quarantine bowl and spun it around. We, like all of you, have found a new way to live, to get through, to change and persevere in a new, very bizarre pandemic-world. I’ll use these five rules to center myself, keep focused on my health first and seek consistency in a totally-inconsistent world.

I wish for all of you a year of health, happiness and growth. I hope we can celebrate, instead of seclude, this time next year. And I hope we can take all the lessons and silver linings from this year and hold them close even after Covid is a thought far in the rear view.

Happy 2021, Katie

Deep Thoughts at the Dentist

Guys I have a confession to make…

I haven’t been to the dentist in over a year. Between Covid-related closures and life, it just didn’t happen. But I went this morning, and am so glad I did. And it got me thinking about a few things.

Leading up to my appointment, I found myself having apprehensive thoughts, like dreading the visit in fear I’d be told I have seventeen cavities and need a root canal because I missed my regular visit. I considered cancelling and waiting till the Covid-risk is lower. But, fortunately, I had the insight to realize that when it comes to your health, Ignorance ISN’T bliss and I made it to my 9am at the Future of Dentistry - Wakefield (shout out for a super-clean, comfortable experience this morning!

When we avoid facing a reality out of fear, it doesn’t make that reality magically disappear. And when it comes to caring for your body and your health (and in this case, my teeth!), what may seem innocent enough, like postponing regular healthcare prevention visits, can actually make the problem worse!

So back to my teeth. Did you know that good oral hygiene is about more than pearly whites and avoiding the pain and nuisance of a filling? Oral health not only affects your mouth, but can cause other, bigger, health problems. Bacteria living in your mouth can travel, impacting other systems, like your heart and lungs. Poor oral hygiene can increase your risk of endocarditis (an infection in the lining of your heart), cardiovascular disease and pneumonia.

As a Physical Therapist, I’d 100% rather see a patient BEFORE they have a problem, than work with them to fix it after. Unfortunately, our healthcare system historically promotes rehabilitation and medical management over prevention. While there has been some within the physician treatment model to do better in this area, this hasn’t trickled down as much as I’d like to see within the practice of Physical Therapy. We, as a profession, have so much to offer in the realm of PREVENTION and it is my hope, that in 2021, payers like Medicare and other Managed Plans begin to see this, and offer better reimbursement for visits designed to address issues before they arise.

In the meantime, you have a choice. You can CHOOSE prevention. You can CHOOSE to put healthy things in your body, keep unhealthy things out, and to make exercise a regular part of your health maintenance (just like taking vitamins or seeing your primary care physician regularly). You can even CHOOSE to see a Physical Therapist before problems arise. PT’s like HAE offer Annual Physicals, just like your physician, and can help you take a clear and comprehensive look at your current health, your health behaviors and help you construct a plan that will set you on a path towards Healthy Aging.

“When you have to make a choice and don’t make it, that is in itself a choice.” -William James

So, as we turn the corner to 2021 (Good riddance, 2020…), let’s do some thinking. How could we treat our bodies better this year? 2020 has not been easy on any of us, and our collective health has suffered as a result. What problems could we choose to face, head on, instead of ignore, as we enter the new year?

If you like the idea of a Physical Therapy Annual Check-Up, and think it could help you start 2021 on the right track, call me:) I’m more than happy to help.

#haept #stronger #fitter #functional #physicaltherapist #physiotherapist #physicaltherapy #physiotherapy #exercise #health #wellness #aging #healthyaging #optimalaging #successfulaging #exerciseismedicine #insurance #medicare #momboss #annualcheckup #prevention #rehabilitation