PT 360 March 2018

Getting you back to the life you want to live.


M arch 2018

In Touch

F eeling L ucky ?

Shelly Coffman

2018 is starting out with some bright spots, and for that, I feel lucky. Last year felt like a bad-luck year gone awry. Due to the weather extremes, we had to close a whopping 10 days last winter. On top of that, my daughter suffered a disastrous spinal injury in January, followed by doctors appointments, testing, and a recommendation for surgery. At the same time, in the midst of this personal chaos, we’ve been growing as a clinic, so our schedule was bursting at the seams. My natural response to chaos is to right the ship, get out the maps, chart a course, and try to stay ahead of the weather, all while whistling a happy tune — and that’s just what I did. My daughter is now doing well, thanks to lots of physical therapy and her newfound passion for hip-hop. She’s not out of the woods, but at least she’s on the edge of the woods instead of lost in the middle. At the clinic, our team is bigger and better than ever, and we’re poised for even more growth and joy at work. And for myself, despite loading up my plate even more than usual, I’ve managed to make time for myself by scheduling friend dates and heading back to the gym. Vinegar water is my new wine, and I actually like it! As a PT, I see a lot of people who have suffered from accidents. Car accidents, work accidents, falls, you name it. I have definitely noticed a phenomenon over the years:

The folks who embrace the PT experience as an opportunity to get better will be more successful than patients who focus on the accident, which was out of their control. They dig in to embrace the process and their own involvement, which is key to being successful in achieving PT goals. But they often also see the silver lining — the things they would never have discovered about themselves if they had never gotten hurt. They would never have a deeper understanding of how their body works. They would never have developed healthy lifelong habits to keep them from getting injured in the future were it not for this “bad” luck. Luck is subjective — it’s the outlook that’s not. Luck comes in both good and bad waves. Being able to ride a good wave allows us to enjoy the experience the joy of surfing, and dodging the crash of a rough wave keeps us afloat. Just floating is sometimes the best thing you can do for yourself at the moment — until that perfect wave comes. Feel that joy you weren’t expecting, and always ride.

Running is a great way to stay in shape and reap the benefits of cardiovascular exercise, but unfortunately, it’s not for everyone. If you’re recovering from an injury or experiencing chronic pain from inflammation, running might be too intense of an exercise for you. These limitations affect more than just physical fitness — they limit your overall quality of life. Running is a high-impact workout that takes a severe toll on muscles and joints. In many cases, the inflammation caused by the impact of running can be so severe that simple tasks like walking or getting out of bed become major challenges. Even if running is possible, it might not be the best workout strategy for you. Here are four low-impact exercises that will keep you fit and help you L ow -I mpact A lternatives to R unning K eep Y ourself A ctive W ithout the I nflammation

achieve your training goals. A lternatives to R unning Elliptical

An elliptical machine gives you all the benefits of running without the impact. It gives you the ability to push your cardio barriers while working similar muscle groups. Many adults with joint pain thrive on the elliptical because of how easy it is to use.

–-Shelly Coffman

Continued on page 2 ...


Continued from cover ... It’s a running machine that keeps your feet from ever hitting the ground. The lack of impact translates to much less stress on your joints and bones, and less pain overall. Yoga Yoga is a great way to get an awesome workout while avoiding the constant shock of running. The benefits are different, but it drastically minimizes joint stress. The wide array of classes allows you to get the exact workout you need. Whether it’s a casual class to get you loosened up or an intense hot yoga session, this ancient practice is an amazing way to sustain peak physical fitness. Swimming Swimming has been described as the ultimate full-body workout. It does wonders for your cardiovascular system and works your upper and lower body simultaneously. It’s great for keeping your muscles strong and active. The challenge with swimming is learning to perfect the technical aspects. While other activities can

be picked up with ease, swimming requires a great deal of repetition to develop the skill necessary for a great workout. However, once you have it, it’s hard to find an exercise that will do more for you. Biking Biking provides another incredible way to work out while limiting the impact on your joints. You don’t just take your body up a hill or down the street — you carry your body and the added weight of a bike. This requires a great deal of lower-body strength and lung capacity, which makes for a great workout. R educe I nflammation While the benefits of these exercises will keep you fit and prevent injuries caused by sustained impact, without proper diet and recovery treatment, it could be all for naught. The inflammation you prevent from doing low-impact workouts is just as likely to be brought on by the wrong diet. That’s why we’ve provided three foods to avoid if you’re looking to limit inflammation.

• Sugar. An oversaturation of sugar can increase levels of inflammatory messengers called cytokines. • Fried foods. Fried food contains high levels of compounds that increase your overall inflammation levels. • Saturated fats. Saturated fats are known to increase the inflammation of your fat tissue. Recovery is also key to making sure your workouts achieve their full effect. This means not only getting a proper amount of sleep, but also engaging in a light cool-down and recovery session. Foam rolling, massage, and light stretching will help keep your muscles ready and receptive to the changes you put them through. It’ll also help limit lactic acid buildup and reduce post-workout inflammation. Whether it’s for medical reasons or personal preference, we hope these strategies can benefit your quality of life. By limiting impact, adhering to a proper diet, and engaging in recovery activities, you can live an active lifestyle without pain.

K eeping U p W ith Y our N ew Y ear ' s R esolutions W hat Y ou N eed to D o to S tay O n T rack and P ush F orward

Look to the people around you for accountability — your family,

March is the month of spring time and rejuvenation. It’s also the time when most people have forgotten about the resolutions and goals they set earlier in the year. Have you neglected or given up your goals? If you have, you are far from alone. Most people let their goals fall to the wayside at least by March, if not long before. It comes down to four simple reasons. 1. They set goals that were out of reach or unrealistic. 2. They had zero accountability. Setting goals is the easy part. A lot of people say they want to lose weight, eat better, learn a new skill, or try a new hobby, but they don’t define their goals any further. Vague goals aren’t really goals at all. The best way to stay on track is to be as specific as possible. Understand what you need to do to accomplish your goals. Make sure you have access to the appropriate resources that will help you make progress. Resources come in all forms. 3. They set abstract goals. 4. They didn’t track progress.

friends, neighbors, or colleagues.If you don’t want to involve anyone

else, keep a notebook or diary to track progress. Or if you are learning a new skill, such as a foreign language for a trip next year, the resource you need may be an app on your phone. When you bring specific goals together with the necessary resources, achieving your dreams becomes more possible than ever before. You just have to take steps to avoid falling into the mistakes listed above. Set attainable concrete goals, track your progress, and check in with someone to keep you accountable. Since it’s been a few months, take a moment to review how far you’ve come since January. What do you need to do to make 2018 your best year yet?


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H eart A ttack S ymptoms in W omen

N ausea or V omiting Often, women who experience nausea or vomiting think they have food poisoning, gastrointestinal issues, or a bug. However, these are common heart attack symptoms and should be

When people think of heart attack symptoms, they often think of stabbing chest pain. However, that’s not always how symptoms manifest, particularly in women. The following are serious symptoms that can indicate a looming heart attack. If any of these symptoms are present, consider seeking medical attention. C hest D iscomfort The most common symptom is chest discomfort, including pain, tightness, squeezing, or pressure. In women, chest discomfort is more likely to feel like pressure or tightness. R adiating P ain Pain isn’t necessarily restricted to the center of the chest. It may be felt at the sides or even in the upper abdomen or back. It can also radiate into your shoulders, jaw, neck, or arms. Remember, anything above the waist could be related to the heart. S hortness of B reath Sometimes your body will present symptoms well before an attack. For instance, you may experience shortness of breath during normal activities. If you notice this symptom, your doctor may run blood pressure, cholesterol, and glucose tests and administer an EKG. F eeling F aint , L ightheaded , or D izzy Feeling like you’re going to faint or actually fainting are both warning signs of a heart attack or other cardiac issue. This is especially worrying if it happens while exercising. S udden S weating Sudden sweating can easily be confused with night sweats or hot flashes. However, sweating that indicates a heart attack is particularly extreme, doesn’t go away, or can make it difficult to sleep.

taken very seriously. U nusual F atigue

New, unexplained fatigue may be a warning sign of a heart attack. However, fatigue can also be a symptom of many other issues, including anemia, depression, thyroid conditions, and even cancer. So even if it’s not a heart attack, it’s still important check in with your doctor. Research suggests that women often don’t recognize heart attack symptoms simply because they don’t know what they are experiencing. The best thing a woman can do is make herself aware of heart attack symptoms and get checked out immediately if there is a concern.

Z ucchini E nchiladas ZESTY

T ake A B reak !

For a lighter take on enchiladas, go carb-free by swapping tortillas for zucchini!


4 large zucchini 1 tablespoon olive oil or ghee 1 large onion, chopped 2 cloves garlic, minced 2 teaspoons cumin

2 teaspoons chili powder 3 cups cooked, shredded chicken 2 cups shredded cheese 1 cup enchilada sauce


and spoon chicken mixture on top. Roll the zucchini “tortilla” and place on baking sheet. Repeat until all zucchini and chicken is used. with remaining sauce and sprinkle with cheese. Bake 20 minutes, and enjoy!

1. Heat oven to 350 F. In a large skillet, heat oil. Add onion, garlic, cumin, chili powder, and salt to taste. Stir to combine. Saute chicken for 2 minutes, then add 1 cup of the enchilada sauce.

3. Cover the enchiladas

2. Use vegetable peeler to thinly slice zucchini

lengthwise. Lay out three slices, slightly overlapping,



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Feeling Lucky? Use These Workouts in Place of Running Page 1 Are You Keeping Up With Your Goals? Page 2 Heart Attack Symptoms in Women Go Carb-Free for Dinner Page 3 New Evidence Comes Out Against Knee Surgery Page 4 I nside T his I ssue

W hat P atients N eed to K now B efore G etting K nee S urgery

It's Not Your Only Option

Knee osteoarthritis is one of the most prevalent causes of disability in the world, affecting an estimated 250 million people across the globe and over 10 percent of Americans at some point in their lives. If you expand this number to include tears of the meniscus, it increases to 1 in 4 people over 50 years of age. Pain from knee osteoarthritis or meniscal tears can differ in important ways, but the fact remains that both problems can result in a debilitating condition that will diminish the sufferer’s quality of life. It’s no surprise, then, that so many patients turn to their doctors for advice on treating osteoarthritis or a tear in their meniscus. It often seems that surgery is the only option for a substantial recovery. But an array of new research indicates that surgery is rarely the best course of action for these particular conditions. Just last year, the respected British Medical Journal released new recommendations strongly steering physicians away from advising their patients to undergo arthroscopic surgery for either knee osteoarthritis or meniscal tears. Instead, they suggest noninvasive treatment methods like watchful waiting, weight loss if overweight, and physical therapy.

Over the last few years, a number of studies have come out questioning the efficacy of surgery for this condition. While it’s true that arthroscopic surgery generally does result in positive outcomes for patients, they’re virtually identical to the outcomes of noninvasive exercises and treatments in the long run. Essentially, this means that expensive, painful, and potentially dangerous surgery, which forces patients off their feet for weeks, may be easily avoided. Issues as widespread as knee osteoarthritis or tears of the meniscus can be corrected in other ways. Still, a substantial number of doctors rush to surgery as the only option for their patients, perhaps because they’re unaware or disagree with these 2017 recommendations. Of course, it’s important to trust your physician and listen carefully to the advice they give, but you should consider every possible alternative. Taking a few months to see if conservative treatment will solve your knee problem can save you thousands of dollars and a lot of pain and struggle.


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