Horizon Rehabilitation Blog

Osteoporosis is a major cause of disability in older women. So what can you do to prevent the condition? Or if you have it, how can you reduce your risk of the spinal problems and broken bones that osteoporosis makes you susceptible to?

The answer: Exercise.

If you’ve always been physically active, good for you. Even though your bones may lose some density as you age, they’re less likely to become brittle enough to break if you slip and fall.

But it’s not too late to start exercising after menopause, when the pace of bone loss really picks up. Even then, exercise will increase your muscle strength, improve your balance and help you avoid falls – and it may keep your bones from getting weaker.

The key to exercising with osteoporosis is to find the safest, most enjoyable activities you can do, given your overall health and degree of bone loss. There’s no one-size-fits-all prescription.

Choosing the right form of exercise

Three types of activities are often recommended for people with osteoporosis: strength training exercises – especially those for the back – weight-bearing aerobic activities and flexibility exercises.

Because of the varying degrees of osteoporosis and the risk of fracture, certain strength training, aerobic and flexibility exercises may be unsuitable. Ask your doctor or physical therapist whether you’re at risk of osteoporosis-related problems, and find out what exercises are appropriate for you.

Compression fractures resulting from osteoporosis often lead to a stooped posture and increase pressure along your spine, resulting in even more compression fractures. Exercises that gently stretch your upper back, improve your posture and focus on strengthening the muscles between your shoulder blades can all help to reduce harmful stress on your bones and maintain bone density.

Swimming and water aerobics have many benefits, but they don’t have the impact your bones need to slow mineral loss. In cases of extreme osteoporosis or during rehabilitation following a fracture, however, these activities can be useful.

If you’re not sure how healthy your bones are, talk to your doctor. If you would like to find out more specifically about proper exercises and stretches to perform for your osteoporosis, please contact the Horizon Rehabilitation and Sports Medicine’s Women’s Health Center to assist you in establishing an appropriate program to meet your needs. Don’t let fear of fractures keep you from having fun and being active.

By: Matt Clark MSPT, MBA, ATC

Maintaining balance is the result of a complex interaction of many systems in the human body. With aging, changes occur that reduce how efficient these systems work. Many identifying risk factors for falling can be, but are not limited to, balance/gait problems, prior falls, vision, limited ability to perform Activities of Daily Living (ADL’s), depression/dementia and medications. But, intervention programs work! Evidence shows 20 percent to 75 percent lower fall rates with a systematic program of evaluation, exercise and environment.

Balance is so complex; an exercise program can reduce the risk of falls. Exercise performed at a moderate intensity or progressing from low to moderate intensity two to three times a week is recommended.

Muscle groups that can affect function:

• Tight hip flexors (occur when sitting too long) can be stretched to help alleviate low back pain.
• Tight hamstring muscles can also lead to low back pain, so strengthening the quadriceps and hamstrings will help.
• Tight calf muscles can cause knees to internally rotate; stretching will improve balance.

Muscle imbalance occurs when muscles on one side of the joint are string and tight, and the opposing muscles on the other side are weak. Muscle imbalances can be corrected with strength training. Stretch short, tight muscles, strengthen the weak muscles and continue to train both muscles equally. Other muscles affected include weak abdominals, gluteus medius and maximus, tight pectoralis muscles, tight lumbar spine, etc.

Physical action and thought assists in balance:

• Review your medications with your pharmacist for possible interactions.
• Consider having your vision checked or your prescription updated.
• When getting up from a reclining position, count to five before getting up to avoid feeling light-headed and dizzy; take your time.

Keep in mind these are only a few exercises or considerations. Most exercises require supervision to avoid injury, especially if doing it for the first time. If you believe you balance is suspect or if you are at risk for falls, please contact our Balance and Fall Prevention Center at 671-7342.

By: Matt Clark MSPT, MBA, ATC

It’s been called everything from aerobic water exercise to aquatic therapy and water aerobics. However, it’s more than just kicking up and down the local pool or spending some time in a hot, bubbling spa. Used correctly, aquatic therapy is a marvelous tool to complement your regular training, or for assisting recovery from injury or surgery.

So what is actually meant when someone talks of aerobic water exercise or aquatic therapy? In its broadest sense, aquatic therapy can be any activity that is performed in water. However, I like to break these activities into two major areas that relate specifically to sport, exercise, fitness and health.

Firstly, aquatic therapy is any exercises done in water to complement and enhance your regular training and exercise. Secondly, aquatic therapy is any activity performed in water to assist in rehabilitation and recovery from hard training or serious injury.

One of the main features of aquatic therapy is that it allows you to exercise without the jarring and jolting experienced when training on land. It is estimated that body weight is compounded up to five times during the heel strike when running or jogging. This does not occur during deep water or aquatic exercise. The buoyant properties of water mean that you are able to perform exercise without any significant impact at all.

This feature alone makes aquatic therapy stand out from a number of other recovery and rehabilitation exercises. When injured it is extremely difficult to find exercises and activities that allow you to maintain your current level of fitness and don’t jeopardize or risk further injury. However, the use of aquatic therapy or deep-water exercises puts the body in a near zero gravity environment. Meaning there is virtually no impact or jarring on any of the body’s joints, muscles, ligament, tendons or bones.

Another important feature of aquatic therapy is that water increases the resistance experienced while training. The great thing about this increased resistance is that it’s variable. Meaning, the faster and harder you work against the water, the greater the resistance you encounter and the harder the work out. So, if you’re injured or just looking for an easy work out, you can take it slow and gently move your limbs against the water. However, if you want a tough work out, go as hard and as fast as you can, the water will always return an equal resistance.

From the two features mentioned previously, you can see that aquatic therapy is a very safe and beneficial form of exercise. As well as a number of cardiovascular and respiratory benefits, aquatic therapy also helps to:

• Increase and maintain muscular flexibility;
• Improve mobility and range of motion;
• Increase muscular strength; and
• Improve coordination, balance and postural alignment.

Other benefits include:

• A high calorie consumption;
• A massaging effect on your muscles;
• The ability to train during very hot weather, (using an outdoor pool or freshwater lake;
• The ability to train during very cold weather, (using an indoor heated pool);
• A great supplement or alternative to regular training;
• Is usually pleasurable and very relaxing; and
• Because your body is supported by water your heart rate is slightly lower, meaning aquatic therapy is relatively safe for obese individuals, pregnant ladies and those suffering from hypertension and heart disease.

If you believe aquatic therapy would be helpful for you or if you are interested in speaking with one of our aquatic therapists, please give our office a call at 843-671-7342 as we are proud to offer this service to our patients at several locations around the island.

By: Matt Clark, MSPT, MBA, ATC

Do you have a New Year’s Resolution? Well, if you’re like most Americans (88 percent in 2001 according to a General Nutrition Centers poll), you have at least one resolution. And, if you are like the majority of these promise-makers, your resolution is probably related to health and fitness. In 2001 (according to GNC), 55 percent promised to eat healthier, 50 percent resolved to exercise more, and 38 percent wanted to lose weight.

While resolutions are well intentioned, unfortunately most people fail at keeping them. With all the hype surrounding these promises, it’s easy to get caught up in them without really taking them seriously.

We live in a throwaway society and even our resolutions, I’m afraid, are not immune. However, especially for promises that include improving our health it’s in our best interest to not take them lightly.

So, what’s the secret to successful resolutions? While you can’t wave a magic wand and make your resolution come true, there are some easy steps to take to make it easier to fulfill your promise to yourself.

• Choose an obtainable goal. Resolving to look like a super model is not realistic for the majority of us, but promising to include daily physical activity in our lives is very possible.
• Avoid choosing a resolution that you’ve been unsuccessful at achieving year after year. This will only set you up for failure, frustration and disappointment. If you are still tempted to make a promise that you’ve made before, then try altering it. For example, instead of stating that you are going to lose 30 pounds, try promising to eat healthier and increase your weekly exercise.
• Create a game plan. At the beginning of January, write a comprehensive plan. All successful businesses start with a business plan that describes their mission and specifics on how they will achieve it. Write your own personal plan and you’ll be more likely to succeed as well.
• Break it down and make it less intimidating. Rather than one BIG end goal, dissect it into smaller pieces. Set several smaller goals to achieve throughout the year that will help you to reach the ultimate goal. Then even if you aren’t able to reach your final goal, you will have many smaller, but still significant, achievements along the way. For example, if your goal is to complete a 10K race, your smaller goals could be running a 5K in less than 30 minutes, adding upper and lower body strength training to increase your muscular endurance, and running 2 miles with a personal best completion time.
• Ask friends and family members to help you so you have someone to be accountable to. Just be sure to set limits so that this doesn’t backfire and become more irritating than helpful. For example, if you resolve to be more positive ask them to gently remind you when you start talking negatively.
• Reward yourself with each milestone. If you’ve stuck with your resolution for 2 months, treat yourself to something special. But, be careful of your reward type. If you’ve lost 5 pounds, don’t give yourself a piece of cake as an award. Instead, treat yourself to a something non-food related, like a professional massage.
• Don’t go it alone! Get professional assistance. Everyone needs help and sometimes a friend just isn’t enough. Sometimes you need the help of a trained professional. Don’t feel that seeking help is a way of copping out. Especially when it comes to fitness, research studies have shown that assistance from a fitness professional greatly improves peoples success rate.
• Limit your number of promises. You’ll spread yourself too thin trying to make multiple changes in your life. This will just lead to failure of all of the resolutions.

On average only about 20% of us keep our New Year’s resolutions. Unfortunately, some of the biggest failures are found in fitness resolutions. But don’t let the statistics get you down. By following the tips above you’ll be better equipped to fall into the successful 20% category. Good luck, and happy 2010!

By: Matt Clark, MSPT, MBA, ATC

If you have had a recent injury one of your main concerns may be how soon you can return to play. The answer to this question is not always easy because each athlete and each injury is unique. Returning too soon can increase your risk of re-injury or developing a chronic problem that will lead to a longer recovery. Waiting too long, however, can lead to unnecessary de-conditioning.

Proper Conditioning Aids Injury Recover Time

One thing that can improve your recovery from an injury is a high level of conditioning prior to injury. Not only will being in great shape reduce your risk of injury and lessen the severity of an injury, but it also has been shown to reduce recovery time. This is a good enough reason to stay in shape and try to avoid the “weekend warrior” syndrome.

Phases of Injury Recovery

During the acute recovery phase you should be following the R.I.C.E Principles (rest, ice, compression and elevation), limiting your activity, allowing yourself time to heal. Depending on the type and severity of your injury, treatment may also include medical care, surgery, various taping, bracing, or physical therapy treatments.
While your injury heals try to maintain overall conditioning if possible. Try alternate forms of training such as water running, swimming, cycling, rowing or weight training of the non-injured parts.

Regaining range of motion and strength should be started as soon as possible as directed by your physician or therapist. Use discomfort as a guide and avoid movements that cause pain. Once muscle strength and flexibility return you can slowly get back into your sport, working at about 50 to 70 percent max capacity for a few weeks. During this re-entry phase, functional drills for balance, agility, and speed can be added as tolerated.

Guidelines for Safe Return to Sports

• You are pain free
• You have no swelling
• You have full range of motion (compare the injured part with the uninjured opposite side)
• You have full or close to full (90 percent) strength (compare with the uninjured side)
• For lower body injuries – you can perform full weight bearing on injured hips, knees, and ankles without limping
• For upper body injuries – you can perform throwing movements with proper form and no pain

Keep in mind that even when you feel 100 percent you may have deficits in strength, joint stability, flexibility or skill. Take extra care with the injured part for some time following to injury to ensure a full recovery.

* These are guidelines only; you should follow your physician’s advice regarding return to sports.