Wednesday, November 14, 2012

Avoid Hip Surgery

Often times people go to their primary care physician and/or orthopedic surgeon with complaints of hip pain only to be told they are "bone on bone" and need a cortisone shot or hip replacement surgery. Before jumping into more invasive procedures like surgery, a trial of PT can be amazingly beneficial in reducing pain, improving function, and avoiding hip surgery.

In a recent trial of 109 patients meeting criteria for hip osteoarthritis, the patients were split into 2 groups both with different outcomes. The first group received physical therapy exercises and the second group received a specialized program of manual hands on care combined with specific physical therapy exercise. For the patients in the second group improvements in pain, hip function,  ROM, and quality of life improved, was significantly higher, and remained after a 7 month follow-up (Hoeksma et al).

The physical therapists at HAPT have all been trained in the specific hands on treatment combined with exercises that were provided in this randomized controlled treatment trial. Please contact us if you have questions about hip pain and want to know if we can help. Having a detailed examination of your hip, low back and pelvis can keep you from needing invasive procedures and improve with low cost simple solutions.

Hoeksma, HL et al. Comparison of Manual Therapy and Exercise Therapy in Osteoarthritis of the Hip: A Randomized Clinical Trial. Arthritis & Rheumatism. 2004; 51: 722-729.

Written By John Kangas, PT, OCS

Research Institute of Human Movement

The Research Institute of Human Movement (RIHM) is a non-profit, charitable organization that was formed this year by Dr. Maury Hayashida. RIHM is the first non-profit organization of its kind with the sole purpose of conducting and publishing research on how human movement influences the quality and performance of life. RIHM seeks to provide the Santa Barbara community resources and education on how to better their lives by applying good research in human movement.

This has been an exciting past few months for RIHM as it received its official non-profit status in August and is now able to turn its attention toward finding partnerships and funding in order to mobilize many months of planning. Many research projects have been set forth and several initiated, examples include: athletic injury prevention/prediction testing, cognitive learning in elementary age children and its relationship to physical movement, relationship between genetic leg length discrepancy and lumbar spine mobility and many more. Currently, RIHM is finalizing 8 months of data collection on a study comparing the use of a visual feedback device compared to traditional verbal feedback on interventions for lumbar spine mobility exercise. This study hopes to provide insight into the effectiveness of both methods of teaching motor control of the lumbar spine in individuals who suffer from non-specific low back pain. The manuscript is anticipated to be submitted for publication in the Spring of 2013.
RIHM invites community participation. For further information about donating to its cause or to learn more about RIHM, go to our website:

Written By: Maury Hayashida, PT, DPT, OCS, CSCS

Sunday, November 11, 2012

Physical Exercise Can Make You Smarter

Exercise is good for your body. – We have heard this before.

Exercise releases endorphins and improves your mood. – We have heard this before.

Exercise makes you smarter.  This may be something new to us.  New research from the journal, Genes, Brain, and Behavior shows that regular exercise not only helps with overall health but it can actually be essential in getting smarter and could help with cognitive activities.

In this study the researchers saw that “mice who exercised regularly were not only better able to complete cognitive tasks than those that didn't, but even more than mice that were provided with other cognitive games and toys. They loved the toys, but unless the mice exercised (eg, had access to a running wheel in their habitat), the researchers didn't see the changes in their brain that corresponded with the improved cognitive performance on their tests.”

It is always hard to compare animal studies with real life situations but the research in this article does point to the need for exercise for improvement in cognitive activities.  There obviously needs to be more research on humans to have conclusive evidence on cause and effect but this research reinforces a common thread that we have covered in this blog; we are moving beings and are built to be moving and active.  Physical activity leads to a more healthy life physically, mentally, and cognitively.  Contact your physical therapist at Hayashida and Associates Physical Therapy for information on our fitness programs.




Thursday, October 18, 2012

Hayashida PT's are Making Strides Against Breast Cancer

On October 6, 2012 Hayashida & Associates physical therapists and trainers joined up with other community leaders in the fight against Breast Cancer by participating in a 5k non-competitive walk in Santa Ynez. The walk was a beautiful one with many great supporters of this just cause. As you may notice the Hayashida & Associates Physical Therapy team was honored to wear blue ribbons as they were one of the top fundraisers for the event.  HAPT thanks all of our friends, families, patients and clients for helping raise over $2700.  This money will go directly to patients for counseling, treatment, and research. This small event is held in Santa Ynez annually and raised a record setting amount this year, over $22,000. We were proud to be a part of this event and look forward to participating again next year.

Hayashida PT In the Community: Westmont Physicals

Every Fall, the physical therapists of Hayashida and Associates participate in an injury prevention program at Westmont College; this year screening over 250 athletes. The therapists use the Biomechanical Scan (BMS), to efficiently scan each body region and identify any impairments and/or faulty movement patterns. These impairments, if not addressed, often cause abnormal wear and tear throughout the season and can predispose these athletes for injury. The therapists then work with the athletic trainers of Westmont College in designing and implementing individualized and proactive exercise programs to address the faulty patterns to optimize the athletic careers of each athlete.

Monday, October 15, 2012

Check Your Posture Before It Is A Problem

Postural issues and dysfunctions run rampant in our society, especially for those who sit all day and are hunched over their keyboards, staring at computer screens.  Many patients and clients come into the clinic not aware that their posture is an issue. Correct posture is something that is often overlooked in our society but it is an issue that affects us in many areas of life.  I can lead to headaches  shoulder and arm pain, low back pain, and leg pain.  Posture is the first thing evaluated during at our physical therapy clinic to make sure the patient and/or client is setup for optimal healing from their movement dysfunction.

It would not be a bad idea to examine your posture before you're at to the point of pain and dysfunction.  There is an easy way to grossly analyze your posture.  Have a friend of family member take a picture of you from the front and side.  Then compare your normal standing posture with the graphic above.

There may be some issues that can be addressed on your own and some of these corrections can be found in a recent Men’s Health’s article.  Found here.  But for any medical or fitness related problem you should contact your physical therapist or physician prior to initiating anything mentioned in the magazine article.


Monday, September 10, 2012

Physical Therapy for Migraines

The Migraine Action and Headache Clinics of the UK recently conducted a survey which showed that although around half of headache (HA) sufferers were referred to a headache specialist or neurologist by their primary physician less that 15% were offered any sort of physical therapy services.  Of those with migraines surveyed, 88% said they would prefer physical therapy to other treatment methods but it was never offered by their primary physician.

“Migraine headaches remain a condition which is under diagnosed, under-treated and the impact on quality of life is under estimated.  With no cure, it is a condition which many have to manage for a number of year (over 60% of those surveyed had lived with the condition for 20 years or more.)”

There is a vast amount of research and studies that have shown that evidence based physical therapy for migraine and other headaches is as good as common migraine medications, but with the advantages of fewer side effects.  One example stands out.  In 2000, a randomized controlled trial of spinal manipulation therapy for migraines showed “22% of participants receiving treatment reported more than a 90% reduction in migraines after two months of treatment, with a further 50% reporting a significant improvement in the morbidity of each episode.”

The take home message should be that a hands on approach from a physical therapist can often be as successful as common prescribed medications with much fewer side effects.  The issue is that primary care physicians rarely offer or suggest the use of physical therapy in the treatment plan.  It may have to be up to the patient to take control of their care and discuss the role of physical therapy with their primary care physician.


Friday, August 31, 2012

Should Lack Of Exercise Be Considered A Medical Condition?

When was the last time that you heard a medical doctor tell a patient, “you have a bad case of deconditioning?”  Many of you out there may ask; what is deconditioning?  Deconditioning is actually a large problem in our society; it is the unnatural state of being physically inactive. When the transition occurred no one knows, but the human race quickly went from being a species that was active most of the time to one that is increasingly sedentary.

"The Lancet recently called it an inactivity pandemic responsible for 1 in 10 deaths worldwide."  When looked at it this way, inactivity, and therefore deconditioning sounds a little bit more serious than one might have first thought. Think about that, 1 in 10 deaths worldwide! From previous blog posts, research articles, and the news, we know that inactivity leads to many issues such as heart disease, diabetes, cancer and much more.

This month in the Journal of Physiology, physiologists at the Mayo Clinic explain that in order to deal with the problem we need to make physical inactivity a mainstream medical diagnosis. "This is one of the most common preventable causes of illness and death... that there is one universally effective treatment for, exercise training." The problem with this is the change needs to come from many facets of life. Our entire medical system relies on inactivity. Insurance companies reimburse billions of dollars a year for pills for diseases related to inactivity but rarely help pay for exercise training, wellness programs, and even physical therapy without a diagnosis of pain.

In the past century medical doctors have had great influence on their patients, educating patients that smoking causes cancer and kills. It was even the medical doctors who started educating patients on using seatbelts and car seats in cars to decrease mortality rates. Why can't the lack of exercise be a mainstream diagnosis given to patients and explained to them that it can actually kill them?

This is a call to all healthcare providers; medical doctors, doctors of physical therapy, athletic trainers, and personal trainers to push their patients and clients to get out there and exercise. These medical professionals can also help in the community by showing patients that there are alternatives to gyms, which often cost a lot of money, such as showing them where the nearest bike lanes or parks may be.

Let's change the way we look at inactivity.  It can kill you!


Please Support Us in the Fight Against Breast Cancer

Hayashida & Associates is joining in the fight against Breast Cancer by participating in a 5k non-competitive walk in Santa Ynez Oct. 6. We would love your support! Donating is easy and will help many women enjoy more birthdays. Please use the following link to donate and please share it with family, friends and co-workers. If you would like to join our team and walk with us we would love to walk with you! We have already helped raise over $1500 and our goal is to raise $5000. Any amount helps our efforts against Breast Cancer. 

Sunday, August 26, 2012

Redcord Treatment at HAPT

Suspension exercise using Redcord equipment is an efficient tool for both functional training and management of orthopedic injuries. Redcord equipment is used to treat or train elite competitive athletes all over the world.

Exercises on Redcord equipment, Neurac Treatment, can help anyone who wishes to enhance strength, balance and function. Neurac, the Norwegian-developed physical therapy sensation, has proven to be an efficient way to prevent injuries and treat musculoskeletal disorders. Neurac Treatment can deliver extraordinary results for elite athletes and patients suffering from chronic and acute pain. Neurac Treatment is excellent for treating:

Lower back pain
Neck pain
Shoulder pain
"Tennis elbow"/carpal tunnel syndrome
Knee & ankle pain
And Much more...

Hayashida & Associates Physical Therapy, Inc. was the first physical therapy practice in the United States to offer the Redcord system, and most of our therapists are certified on Redcord equipment.  We want you to move without pain and  get stronger so you can avoid future injuries. So what would you like to do again without pain? Play tennis or golf? Dance? Enjoy a hobby? Get back to living your life?

To learn more how we can help you discover the benefits of Neurac Treatment training for athletic performance and injury treatment call Hayashida and Associates Physical Therapy or visit us at

Sunday, August 5, 2012

Lift Light Weights..Realize The Same Potential

Recently researchers  turned weightlifting conventional wisdom on its head. The researchers found that lifting less weight more times was just as effective at building muscle when compared to training with heavier weights.

The research, which was published in the Journal of Applied Physiology challenged the widely accepted idea that training with heavy weights at low repetitions was the best way to increase muscle growth. Although lifting with heavier weights does increase muscle growth and strength many people in the population, including older adults, have joint problems that prevent them from training with these heavy loads. With this new research we find that those subjects who cannot safely lift heavy weights can still increase muscle growth and strength with lower loads.

This study consisted of grouping participants into three different programs. The first program consisted of one set at 80% of the maximal load.  The second program had each participant lift three sets at 80% of the maximum and the last group was required to lift three sets at 30% of the maximum load.

" After 10 weeks of training, three times per week, the heavy and light groups that lifted three sets saw significant gains in muscle volume – as measured by MRI – with no difference among the groups."1

So the next time that you go to the gym, if you have musculoskeletal problems, remember that you can lift lighter weights and still benefit with increased muscle mass and strength.

Ref: C. J. Mitchell, T. A. Churchward-Venne, D. D. W. West, N. A. Burd, L. Breen, S. K. Baker, S. M. Phillips. Resistance exercise load does not determine training-mediated hypertrophic gains in young men. Journal of Applied Physiology, 2012

Tuesday, July 31, 2012

Should I Wear Running Shoes?

Wait, I thought running shoes were bad for me

Over the past few years you may have heard many proponents of barefoot running arguing that today's running shoes are 'overkill' and compromise our natural running mechanics.  A new study now shows us that under certain circumstances, running shoes may actually decrease the energy cost when compared to going barefoot.

In a recent study conducted at the University of Colorado at Boulder researchers wanted to find if wearing running shoes required more energy than going barefoot. The researchers recruited 12 well-trained barefoot runners. Choosing well-trained barefoot runners was important since novice barefoot runners have a much different running pattern when compared to the veteran.

Many believe that running with shoes increases energy demands during running since they add weight to your feet and you have to push that weight through space every step.

Researchers in this study had runners wear a relatively lightweight (~100 grams)cushioned shoe versus not wearing shoes at all. The participants in the study ran multiple times on treadmills while either wearing the shoes or running barefoot.  The runners also were tested with 100 gram weights to the top of the runners bare foot.  By adding equal amounts of weight to the barefoot runner's foot, effectively taking weight of the shoe out of the equation, they could learn if barefoot running really was physiologically more efficient than wearing shoes.

The researchers found that during barefoot running, runners used almost 4% more energy during every step when compared to those who were in shoes.

It is important to note that the study looked at only metabolic efficiency of wearing shoes when compared to running barefoot. The study did not take into account the common claims that barefoot running lowers injury risk.  Researchers did agree that wearing heavy shoes increases the metabolic cost of running and so those trying to decrease the metabolic cost of running should look for more lightweight models of shoes.  The research still supports the use of running shoes to improve running efficiency.


Monday, July 23, 2012

What is the BMS?

The Biomechanical Scan (BMS)TM is a head to toe micro-mobility (arthrokinematic) assessment of the 3 primary loco-motor systems of the body: Nervous, Muscular, and Skeletal.  The scan is used to screen for serious pathology and identify faults in one’s flexibility, joint passive range of motion, motor patterns, strength, core stability, and proprioception; all of which have been cited as risk factors that can contribute to injury.  Over the past 10 years, tremendous research has been performed as to why certain injuries occur, particularly the non-contact ACL knee injury.  By diagnosing limited joint loading or faulty movement patterns, a skilled physical therapist is able to explain how these deficits can influence task execution and the relative risk of injury.  Research has shown implementation of the proper intervention addressing risk factors has reduced the incidence and risk of injury.  The BMSTM is currently being used by the physical therapists (PT) at Hayashida and Associates as a proactive versus re-active intervention to guide athletic performance for many athletes from age-grade athletics to the Olympic athlete. If you know of an organization, business, or team that could benefit from preventative screening contact your local physical therapist at Hayashida & Associates Physical Therapy.

Written By: Riley O'Hagan, PT, DPT, OCS, CSCS

HAPT Hosts World Renowned Dr. Powers

Hayashida and Associates Physical Therapy (HAPT) recently hosted world renowned Dr. Chris Powers, PT, PhD, FACSM, FAPTA for a one day course that was individually designed for HAPT to enhance the clinician’s clinical reasoning regarding proximal factors as they relate to patients and clients with knee pain.  The course focused on development of clinical reasoning regarding return to running in those patients with knee pain as well as patients status-post ACL reconstruction. During lab, the physical therapists at HAPT demonstrated and practiced selected physical examination procedures and interventions that will reduce that patient’s risk of reinjury and improve their return to sport.  HAPT regularly hosts courses throughout the year to make sure that their physical therapists continue to provide the region’s highest level of clinical care and expertise. Physical therapists from surrounding areas are also invited, as it is our mission to better the physical therapy profession as a whole.

Written By: Andrew Bisaccia, PT, DPT, OCS

Tuesday, July 17, 2012

Should You Have An MRI for Back Pain?

"The over utilization of Magnetic Resonance Imaging (MRI) in low back pain is well established and numerous guidelines have been developed to educate clinicians on when appropriate imaging is warranted.  Unfortunately MRIs for acute low back pain continue to be one of the most over utilized imaging modalities.  This is driven not just by the provider side but also by patient expectation and desires to "do something."  I believe one of the most important roles of a physical therapist is to educate patients by managing expectations and reframing their belief system on what pictures tell us.  I frequently use the phrase "that is just a wrinkle on the inside" when discussing the common MRI findings that are not consistent with a patient's presentation.  As you know wrinkles do not hurt but are outward signs of aging, we also have inward signs of aging (normal age related changes) that show as disk bulges, herniations, spondylosis, etc." - Tim Flynn, PT, PhD.   

If you have low back pain and you think you need an MRI to "know what is wrong" or "find the best treatment" you may be wrong.  Please watch this Video and pass it on!

Tuesday, July 10, 2012

Change Your Running Style!

Recently researchers from the Department of Exercise and Sport Science at the University of Copenhagen conducted a research project that shows that small changes in your running routine can improve your "running performance and health, despite a significant reduction in the total amount of training."1
The research project, which was eventually published in the Journal of Applied Physiology, took two groups of moderately trained runners.  In one experimental group the runners trained in a 10-20-30 concept.  This consisted of a 1 km warm up at low intensity followed by short 5 minute blocks that were separated into 10, 20, and 30 seconds of running at maximal, moderate and low intensity, respectively.    The other group ran at a moderate pace for more than 45 minutes.  Over a short period of 7 weeks  runners in the '10-20-30' group "were able to improve performance on a 1500 meter run by 23 seconds and almost a minute on a 5 km run."1  Interestingly those in this experimental group also had decreased cholesterol levels and lowered blood pressure, both predictors of heart disease.  These changes were compounded by the fact that all the runners in the study were seasoned veterans, running on a regular basis for years. 

The interesting point in the research, especially for the working class who seem to be more and more crunched for time, was that a 20-30 minute workout was all that was needed to see the beneficial changes.  So go out there and change your running routine to one that mimics a high intensity interval training (HIIT) type of running; it could make you healthier and shave time off your runs if you are training for an event.

Be sure to contact your local physical therapist if you have any questions or concerns regarding entering a new exercise program or changing your existing one.

Tuesday, June 19, 2012

Did You Know HAPT Has A Clinic In Montecito?

Our newest Hayashida and Associates clinic, nestled in the Montecito hills, opened its doors on the picturesque Westmont College campus about three years ago.  While the majority of our patients are Westmont students and athletes, the clinic is open to the public.  We serve numerous individuals, of all ages and abilities, from the Montecito community and surrounding areas.  With two therapists on-site, Dr. Erica Camardella and Dr. Tom Walters, the Montecito clinic provides highly educated therapists in an intimate and friendly environment.  Our staff also includes one full time and one part time Athletic Trainer, who assist the therapists in implementing programs to bridge the gap for our athletes between rehabilitation and their return to sport.  At our Montecito location, not only do we have a Redcord system; we also have the benefit of being able to utilize the college’s ample resources including a heated pool, full weight room with an assortment of free weights and weight machines, and a rubberized track.  Our Montecito clinic provides the quality care expected from Hayashida and Associates at a location that is convenient for Montecito and surrounding community residents, as well as Westmont students, athletes, faculty and staff.  Whether you are a weekend warrior, a recreational athlete, or just looking to improve your quality of life, our talented staff at our Montecito clinic will help you successfully get out of pain, move healthier and perform better.

Written By: Erica Camardella, PT, DPT


Monday, June 11, 2012

3 Fitness/Exercise Tips

Everyone gets in exercise ruts but now is the time to change how you have been exercising.  Just as physical and surgical medicine has changed over the last 10 years so have some concepts in the fitness world.  For example, a surgeon does not prescribe the same medications as he or she did 10 years ago or do a surgery the same way he or she had in the past.  We all advance as our knowledge base advances.  Here are a couple of tips to help bring your training or rehabilitation to the next level.

TRADE SLOW CARDIO FOR INTERVAL TRAINING – If you are looking to lose a couple pounds here or there with your cardio routine the goal is not to just run as far as you can hoping those calories will burn off.  Research has shown that “bursts of high-intensity effort pared with slower, recovery efforts”1 have the potential to burn more calories.  Get the most bang for your buck.  20 minutes of interval training can burn the same amount of calories as an hour of slow paced running.

USE YOUR CORE DURING EVERY EXERCISE – If you have ever been to physical therapy at Hayashida and Associates Physical Therapy you will know the true meaning of core work.  We are not just talking about your “six-pack” but also muscles that surround your abdomen and control your trunk, stabilizing the spine.  You should activate these muscles before any activity or exercise.  This muscle activity could be graded based on what you are doing (i.e. lifting a 1 lb weight vs doing a squat with weight overhead).  This will help avoid injury and at the same time get a great workout for your midsection.  If you need help understanding how to do this you should visit your local physical therapist for ideas.

TRADE MACHINE EXERCISES FOR FREE WEIGHTS – If we were all machines and moved in a set path then machine exercises would make sense.  But each individual moves differently, has a different posture and needs focus in different areas.  If you use the fixed path of many machines you will increase your likelihood of injury.  It would be best to use dumbbells or medicine balls to build strength since these objects allow you to move in the way your specific body is meant to move.  Be sure to get your form looked at by a physical therapist though, to make sure you are moving in the correct patterns.
Listed here a just a couple of ways that you can improve your exercise regimen and/or get more out of your workouts.  We will include more tips in future blog posts.  Contact your local physical therapist if you have any fitness or rehabilitation questions.

Wednesday, May 23, 2012

It's Not Rocket Science!

Another example came across my desk of the need and common sense behind direct access to physical therapy services.  A story of workers at an Intel plant showed that may workers who spend their majority of their days on their feet had back pain.  The majority of these people suffered with this pain because they knew that it would take several weeks to get to their doctors appointment and get a referral to physical therapy.  By the time this happened pain was so bad that they needed less conservative care or their pain disappeared.  It is not a good outcome to have a patient tell you that their pain just disappeared when you hear the flip side that they were in pain at work for more than a month at a time. 

Times have changed at Intel and now rather than waiting to see a doctor may employees with routine back pain see a physical therapist within 2 days.  This is in comparison to the 19 days on average that they took to get in to see a medical doctor.  Overall these patients were completing their program and out of pain within 21 days rather than the average of 52 days with the old system. 

Another issue, not apparent to the public, was that the cost per patient dropped on average 20% secondarily to fewer unnecessary doctor visits and diagnostic tests.  Every patient was more satisfied with this trial system and returned to work faster.

Why can't we adopt this simple and effective model in our health care system. "Early access to low cost effective care seems so simple yet in our current health care system it remains exception and not the rule."1  Whenever you see anything regarding direct access to physical therapy we at Hayashida and Associates urge you  to support it...for your own good.

Written By: Andrew Bisaccia, PT, DPT

Monday, May 21, 2012

Hayashida's Commitment to the Community

Hayashida is committed to providing the Bishop Garcia Diego High School community with a high level of physical therapy care and screening for potential orthopedic injuries. We recently had one of our Doctors of Physical Therapy and Athletic Trainers present at spring physicals assisting team physicians in screening for orthopedic injuries. The turnout was very successful and we were able to help screen over 125 students for orthopedic injuries and movement dysfunctions. Screening is an integral part of preventing serious season ending injuries. It allows medical personnel to identify movement dysfunctions before injuries occur. This provides the opportunity to communicate with parents and athletes regarding appropriate stretching and strengthening programs to help them perform at their highest level. Hayashida and Associates Physical Therapy is honored to be the exclusive provider of physical therapy and athletic training services to the coaches, parents and athletes of the Bishop community. We look forward to being more involved with school athletic events in the near future.

Written By: Ted Carter, PT, DPT

Saturday, May 19, 2012

A Time for Change: Final Stage – Maintenance

This may be the most important stage of them all.  You have now made the change in your life and your healthy behavior is starting to become normal rather than something that you HAVE to do.  At this point you have been doing your new activity or have changed your behavior for at least six months.  Your focus now is to stick with this activity indefinitely, at least in some form.  You need to be very vigilant at this time as you may fall back to old habits as you start to take advantage of the great change you notice in your life.  The more you are tempted by how good you look, how great your feel, or how others may comment on your attitude the easier it will be to think it will always be this way.

This being said, it is normal to have setbacks at anytime, even years after your initial change.  “But the longer you let them continue, the more likely it is that little setbacks will grow into big ones.”1 As time passes you will feel more confident in your change and it will become routine, something you may not even need to think about. 

Enjoy the benefits you have gained over this time frame.  If you continue to focus on the positive change in your life you will succeed in your new behavior.  Along with this, you are ready to be successful the next time your lifestyle needs some change.

If you need any help with this process of change, especially if it is regarding pain that you have or your current fitness level make sure to visit Hayashida and Associates for a jump start.

Monday, April 30, 2012

A Time for Change: Stage 4 – ACTION!

You have made it!  You are now putting your plan in motion and you are probably already completing new activities and changing your behaviors.  In the previous stage you made the necessary changes to fit your new behaviors into your schedule.  The change that you are now engaged in may take some effort since it may take more time than you previously thought.  For example, you may have joined a fitness class and you are now realizing that you have to stretch or fix your posture throughout the day, while away from the class.  This is the time that you need to adapt and make room for these small differences in your original plan to change. 

This stage usually lasts about 6 months and is the time where the change is still new to you.  This can be beneficial because people may notice the change right off the bat.  Say you are beginning a new diet; people may compliment you on how you are looking.  If your change was to get a more healthy dose of sleep (i.e. 7-8 hours) people may find that you are more alert and in a better mood.  There are some draw backs.  You will be more distractible at this stage and may slip back into your old habits.  Do not panic if this happens, as it most likely will.  The most important part is that you get back on track as soon as possible. 

Here are the steps you need to take in order to move on to the last stage; Maintenance.

Make Goals! – If you have goals for your action then you can work each and every day to get closer to them.  Do not make hard to obtain goals at first.  If you have never worked out in your life do not have a marathon be your first goal, start with running a mile. As you reach each relatively easy goal you can set a new one for the future. 

Give yourself Credit – It has been shown that those that are rewarded tend to thrive with change. It is like giving a weekly/monthly allowance to a teenager for doing chores; they are more likely to complete their chores since there is a reward.  Give yourself a small “cheat day” if you have exercised or dieted as you had planned for 2 or more weeks.  Be sure to give yourself some self-praise, you deserve it. 

In our next and final installment you will have the keys to actually maintain the change in your life.

Friday, April 13, 2012

A Time for Change: Stage 3 – Preparation

At this point on our journey to change you are most likely committed to making an alteration in your lifestyle.  You have thought about the changes that need to take place and you may already be taking the correct steps to decrease your pain, move better, and live healthier.  Preparation, the next step for complete change is a very important one.  You have the best chance of success if you take your time in this stage and develop a comprehensive plan.  People in this stage often have big motivators for change; your pain has either gotten out of control or you have consistently become more unhealthy to the point that you notice seemingly easy daily tasks have become more difficult. 

Here are the steps you need to take in order to move on to the second-to-last stage; Action.

Set a Date! – Grab your calendar and pick a date to start your change.  When you look at your calendar make it look like any other important engagement you may have; something that you cannot miss.  Prepare for this day so when it comes you are ready to take action.  If you plan on starting a fitness class, make sure you have all the contact information of that fitness class.  If you plan on changing your diet, make sure to have the correct foods in your home to start the change.

Advertise Your Plan – It is now time to tell your friends, co-workers, and family what change you intend to make.  This will not only hold you to your change but will also provide you with support if you need it.  When you successfully make changes you will have a team to cheer you on.  If you begin to slip your team will be the healthy support you need to get going again.

In our next installment you will have the keys to actually make the change and then we will give you tips and tricks on how to maintain the change in your life.

Wednesday, March 28, 2012

A Time for Change: Stage 2 – Contemplation

After reading our last two blogs you are now ready to start giving some thought to changing your behavior.  In this next stage, contemplation, you start to think “maybe I should go to a physical therapist for my back pain” or “I should start working out so I can become healthier.”    Although you are beginning to have these feelings your plans remain distant and indefinite.  “When you talk about the possibility of change, there is always a ‘but’1  You have a good reason to make a change in your life but there is always an excuse to follow such as you don’t have enough time or it may cost you some extra money that you weren’t planning on spending.

In this stage you go back and forth from wanting to change and wanting things to stay the way they are.  Many people get stuck here for weeks, months, or even years.  These are the people that every January 1st, make the same New Year’s resolution but never even begin to make the change.  It’s on your mind but you can’t get out of the rut and just make the right decision.  It is best to stop thinking about all the obstacles to change and focus more on the problems that you truly want to change.

Give your Mind a Nudge – Every time you catch yourself making a ‘but’ statement, push yourself to examine it more closely.  In the example where you’re ‘too busy’ to exercise, you might ask yourself: ‘If I don’t have a 30-minute block of time for exercise, do I have three 10-minute ones?’ or “If I like to watch TV in the evening, could I do it while walking on a treadmill?’”1

Track Your Problems and Progress – Make a daily journal and keep track of every time you are in pain or every time you think about being unfit.  Did you try to put on a pair of pants and they don’t fit the way they used to? Write it down!  You will be able to look back at this journal and find patterns.  Maybe you notice that you are more bloated after eating certain foods - Change your diet!  Maybe you find that you have more pain after being inactive and sitting for long periods of time – Go see a physical therapist! Do you become aware of gained body weight or lost muscle mass – Begin an exercise program at Hayashida & Associates Physical Therapy.

Stay Tuned: In next week’s blog we actually start to make the changes that we have been talking about this past month.  We will then follow up on the hardest stage of them all, maintaining the change in your life over the long haul.

Tuesday, March 13, 2012

A Time For Change: Stage 1 – Precontemplation

Changing our lives is not easy and as discussed in our last blog post there are five distinct stages that we must go through in order to achieve this change.  These changes can be as little as drinking one less cup of coffee each day or as big as entering a workout regimen in order to prepare for an Ironman.  Stage 1, precontemplation, is where almost 50% of the public is currently situated and getting past this stage can be very difficult.

This stage is marked by you not even thinking about change.  Your physical therapist, physician, spouse, family member, or friend may be urging you to make a change, whether it is working out more or eating better, for example.  During precontemplation you hold onto the belief that nothing needs to change and you think that things are fine the way they are.  You read a blog article or see a billboard explaining how much changing your health matters but you ignore it.  You sit there and say to yourself, “I am healthy; I am in good physical shape.”1  In your mind you are immune to any health problems that your peers or physical therapist is trying to explain to you.  If you have found yourself constantly dismissing the advice of others you may be stuck in this phase; here are some ways to move on to the next stage.

Weigh Your Options – In this stage “people tend to focus on the downside of adopting a healthy new behavior while ignoring the upside.”1  Get past this by making a pro and con list.  Take out a piece of paper.  No, I mean right now, take out a piece of paper and write five to ten pros of changing to a new healthy behavior. On the other side write five to ten cons for changing.  Look at the two columns. “Is there a stronger case for or against making a change?”1

Find a “Change Partner” – It is hard to take nutrition advice from someone who is extremely overweight.  Find someone who has made a change in their life that is somewhat similar to the change that you want to make.  If you have a physical therapist, friend, coworker or anyone else who wants to change or has changed their behaviors, start a conversation with them.

Just talking about your issue will catapult you into the next stage, Contemplation.  So start today.  Don’t worry about changing your unhealthy behavior now, just start to think about it and the consequences if you don’t change. Keep coming back as we will continue to talk about the next four steps, what they entail, what needs to be overcome and how to move to the next stage.


Tuesday, February 14, 2012


Many people in America need to change in some way or another.  Americans have become unfit, unhealthy, overweight, have high stress levels, and deal with pain and disability on a daily basis.  We all could use a little help with changing our daily routine, our diets, and our other health habits to live healthier and more comfortable lives.  Everyone out there has some room for improvement.  The new year always comes with its ‘resolutions’ but the majority of people do not hang on to these for the long haul; this is part of the reason we need to have new resolutions each and every year.  “If you try to make a change but fail to stick with it, you may feel as if there is something wrong with you and your determination”1  But there isn’t!

Almost everyone has trouble keeping the change in their life.  “Otherwise we would be a nation of calm thin, salad eaters.”1  We need to understand that making change is an ongoing process.  In the late 1970’s a psychology professor found that in order to completely change, especially lifestyle changes, we need to go through five distinct stages.  Precontemplation, contemplation, preparation, action, and maintenance.

"Precontemplation is the stage at which you don’t intend to change a particular behavior in the foreseeable future. In the contemplation stage, you first start considering change, but you are still undecided about when to undertake it. That’s followed by the preparation stage, during which you make firm plans to change your behavior soon. Next is the action stage, when you actually begin exercising, dieting, or adopting some other healthy behavior. Finally, you reach the maintenance stage, by which time you have kept up the new behavior for several months. At this point, you are working to make your new habits permanent and trying not to backslide."1

Does your physical therapist keep telling you that you need to correct your posture?  Does your physician tell you that you need to change your diet in order to decrease you blood pressure or control your diabetes?  Have you been thinking about losing weight?  Are you having a hard time joining or going to the gym?  If so, you are ready for change.  Let's do it!

Over the next couple blog posts we will talk about each of these steps, what they entail, what needs to be overcome and how to move to the next stage. 

Monday, January 23, 2012

California Needs Your Help!

As a continuation of the last blog I want to discuss an important issue that is being heard in the Senate Appropriations Committee right now!  Supporting this bill will help change the way the public receives health care services to the “new approach” (discussed last week) where the person with musculoskeletal pain can visit their physical therapist before seeing their primary care physician.  This would allow for immediate treatment if it is appropriate, effectively decreasing the amount of time you are in pain. The physical therapist would refer you to a primary care physician if your physical therapist thinks it’s warranted.  You get referred to a specialist for further testing only if necessary. 

“SB 924 will allow consumers to be directly treated by physical therapists just as in many other states.”1

“SB 924 will streamline health care delivery, increase consumer choice and reduce costs for consumers.”1

“SB 924 will allow patients to go directly to physical therapist, avoid extra co-pays and if appropriate for physical therapist services, begin treatment immediately.”1

“Currently, 36 states allow patients to directly access physical therapist treatment (17 with unlimited direct access and 19 with some restrictions) and they have been doing so safely for an average of 25 years. In 36 other states, Medicare pays for the direct treatment by physical therapists before a formal diagnosis is determined by a physician.”1 


In California Medicare recipients are denied their equal right to direct access to the same physical therapy services afforded to patients in those 36 other states.

“Lastly, physical therapy education and training justifies clarification and recognition by the legislature that the profession is qualified to treat patients' impairments and movement dysfunctions without a formal diagnosis of a disease.”1

Please call or write the members of the Senate Appropriations committee and  show your SUPPORT for SB 924.

Senate Appropriations Committee:

All references are from the California Physical Therapy Association (CPTA) and California PT Notes

Thursday, January 12, 2012

There Is A Fork In The Road: Which Way Will You Go?

Let me start off my asking you a question.  Would you rather have back pain for 20 days or 50 days?  This may sound like a pretty simple question but our current health care system may push you towards the 50 days of pain rather than the shorter time frame.  I will separate these two groups into the “old approach” of thinking of treatment for musculoskeletal pain vs. the “new approach” to treat these symptoms.  The reason these words are in quotation marks is because the old approach is still very prominent in our health care system and very few partake in the new approach, especially here in California where direct access to a physical therapist is not allowed.

The old approach consists of you getting some sort of musculoskeletal pain.  You may not be able to get in to see a physician for up to 1 month.  You finally get to see the general physician and they send you to a specialist for the body region where you are having pain.  That specialist may send you for diagnostic testing such as X-Rays, or a MRI.  After this you follow up with the primary physician, the specialist or both.  At this time the decision for you to see a physical therapist is made.

In the new approach you meet with your physical therapist first, maybe also seeing your primary physician if your physical therapist thinks it’s warranted.  You get immediate treatment if it is appropriate and get referred to a specialist for further testing only if necessary.  

So why has the system not changed?  Why does physical therapy direct access get denied every time it goes through congress?  It is because the American Medical Association (AMA) has too much to lose in order to change to a new patient-centered system.  Physicians can lose out on “initial visits, follow-up visits, diagnostic testing, drug prescriptions... all of those equate to profit”1

If you like the idea of the new system you can write your local assembly member or donate to CAL-PT-PAC which is the only political action committee in California representing the profession of Physical Therapy.  You can donate HERE