A Time For Change: INTRODUCTION

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. 

1.  http://www.arthritisselfmanagement.com/newsletter/12-15-2011/time-for-a-change/

Posture and Sitting Series Article IV: Ergonomically Optimize Your Workspace

In this article I hope to give you as much information as I can to help you set up your desk, whether it is at your home or office.  As mentioned before your posture is a result of how you treated your body over the last 20, 30, or 40 years of your life.  If you are like 80% of Americans, you sit 80% of the day whether it is for work or for surfing the internet; if you do this sitting activity incorrectly you will create postural deficits ultimately leading to pain.  Let’s break down your desk space and see if we can make some changes.

                 Mouse and Keyboard:

Most people will take their mouse and keyboard and place it on the desk and think that is where it should be.  Also, people like things to be centered and clean (most of the time) and this will make people place the keyboard right in the middle of the desk lined up with the monitor.  In reality you should place your keyboard so the alphanumeric part is in the center; do not worry about the added number pad and arrow keys that are often to the right of the keyboard.  The “B” key should be right in front of you when you are sitting at the desk.   The mouse should be as close to your keyboard as comfortably possible.  This will limit the amount you need to reach for your mouse.  If you have a keyboard tray make sure the mouse is on the tray alongside the keyboard.  The ultimate goal is to have your elbows bent at about 90 degrees when you are using your mouse and keyboard.  This will decrease the amount of bend you will have to have in your wrist, decreasing overuse injures such as carpel tunnel syndrome. 

                Monitor:

It would be best if all of our monitors were adjustable or not attached to our keyboard in the case of the laptop.  If your monitor is not adjustable you will need to get creative with books, monitor stands, or wedges to have your monitor in the correct position.  There are many do-it-yourself (DIY) websites out there that have information on how you can accomplish this.  Your first goal is to have the monitor at an arm’s length away from you.  Secondly it is optimal to have your eye level to be about 2 inches below the top of the monitor.  Even though this article is about ergonomics it would be smart to follow the advice of an ophthalmologist and look at an object far away from your monitor each 30-60 minutes to help “rest your eyes.”

                Desk Height:

I can sit here and explain how each element of your desk should be set up but by the time I was done I would surely have a 20 page informational packet.  Measurements of correct height of objects on your desk can easily be found with this informational website.  Just enter your desk set-up (sitting or standing) and your height and the website automatically calculates desk height for you.  It even gives you information on your chair positioning.  Other chair information is to follow…

               Your Chair:

You chair should have a pair of sturdy arm rests.  Arm rest height is crucial so that you keep the correct length-tension relationships of your neck and shoulder muscles.  The height of your arm rests should be at a height where your shoulders can be relaxed and your elbows bent at about 90 degrees.  When looking at back rests on your chair you should have it forward enough so that you are not “slouching back” and it gives you support to sit up straight.  The back rest should have some sort of lumbar support built in and if this is not the case, a relatively cheap low back support can be purchased online or at many local stores.  Your low back should have a slight curve forward and this support helps you keep this position.  “Do-it-yourself” (DIY) options are available.  You can always roll up a towel and place it on your back rest to help support your lower spine.  A semi-soft breathable cushion on your chair will make you feel more comfortable while sitting at your desk.  If a cushion is too soft it can make your pelvis sit in an incorrect position which can put extra stress on your low back.  When adjusting your seat height you should aim for a position where your thighs are parallel with the ground while your feet are flat on the floor.  As you can see there are many different configurations and options for your chair.  It is always best to have a physical therapist or certified ergonomist take a look at your setup.  The information here is only a general guideline to your workstation. 

     General Rule:

You could have the best, most expensive, perfect set up and still fail when it comes to sitting correctly at work.  The most important piece to the puzzle is your brain.  It is imperative that you recognize how you are sitting at your desk and constantly fine tune your posture.  The human body is an amazing “cheater”.  Your body will find a way to slouch at your desk no matter what kind of equipment you have.   Set an alarm on your watch, computer, or calendar to remind you to think of your posture every 20 minutes so that you can correct any problem areas that may have arose when you were busy typing an email or talking on the phone.  It is also a good idea to get up every 40 minutes and take a short walk.  Patients always tell me “I can’t just get up and walk around; my boss would fire me.”  I can understand this.  At the very least you should stand up every 40 minutes to “re-set” your body.

As you can see there are many factors to think about as you begin to change your desk setup.

If any major problems arise or you need professional help with your set-up be sure to see your local physical therapist for the proper set up or treatments if necessary.

Reference: http://lifehacker.com/#!5755870/how-to-ergonomically-optimize-your-workspace

Posture and Sitting Series: Article III – How to Correct Your Posture

As we have been talking about your posture we can see how prolonged sitting especially with poor posture can lead to aches and pains in your legs, back, shoulders, and neck.  It can be hard to change these seated and standing postures; the way you sit or stand today is a product of years of incorrect muscle use.  The key is to be in positions that decrease the strain put on your body.  "Good posture involves training your body to stand, walk, sit and lie in positions where the least strain is placed on supporting muscles and ligaments during movement or weight-bearing activities."¹  Lets look into a couple ways we can do this.

The first key is to understand what needs to be changed.  This is hard to do.  It is difficult to see your posture and to be able to understand how it may be leading to your aches and pains.  The best way to understand changes would be to see a physical therapist for a biomechanical screen and receive a prescribed treatment plan.  Others may be able to have their friends or family observe their static or dynamic posture. 

I will break down my advice by first looking into standing posture and then educate you on sitting posture.

STANDING POSTURE

While standing your shoulders should be slightly back.  Many people have the tendency to lean forward.  While standing place your hands in your front pockets. Feel how your shoulders start to gravitate forward; this position will lead to strain on the shoulders, neck and chest.  We should also have our feet at about shoulder width apart.

SITTING POSTURE

While sitting we need to make sure that we have support to our low back (commonly referred to the "small of your back").   When your low back is in the correct position the rest of your spine will line up correctly.  Secondly make sure that you don't begin to gravitate towards your computer screen, this will place increased stress on your shoulders, upper back, and neck.  Make sure to keep your eye level even with the top of your monitor. 

As mentioned before seeing your physical therapist is the optimal way to make changes to your faulty posture.  Your physical therapist can use passive techniques to correct your posture including the use of McConnell® or Kinesio® Taping techniques.  An extensive and personalized exercise program can be prescribed to help with your postural problems.  Along with this, your physical therapist can apply manual techniques to loosen your stiff joints, stretch your tight muscles while strengthening your weak ones.  Many people think this would be the job of a Chiropractor, but many chiropractors do not address the muscles and will not give out preventative exercises, so their patients will need constant care to feel better.

1. http://lifehacker.com/#!5732064/how-can-i-improve-my-posture

Posture and Sitting Series: Article I - Avoid Computer Hunch

In the upcoming months I plan on bringing you a series of blog entries focused on how sitting and posture can affect your body and health. Many patients who I see in the clinic could have avoided their injuries and/or dysfunctions if they would have listened to their elders who always preached “sit up straight.”  The majority of the population sit for prolonged periods of time either for their job or to unwind in front of the television.  While we are sitting or standing many of us have incorrect posture which increases stress on our joints leading to degeneration and pain.  So stay tuned over the next couple months for all the information you can handle on sitting and posture corrections.  As with any exercise program make sure to talk to your physician or physical therapist to be cleared for these types of exercises.

Step 1: Avoid the dreaded “computer hunch”

You just adjusted your posture didn’t you?”  Whether it’s your primary task at work or your favorite way to pass the time, hunching over the computer can cause a gamut of hip, back, neck, and shoulder problems.  I myself sit at the computer to do patient documentation and then sit longer to do online shopping, read the news and write blog articles for you.  It takes a lot of will power to maintain good posture during all of this; completing some relatively easy stretches throughout your day will help avoid “the hunch”.

1.          1.  Shoulder Blade Squeezes – This exercise will help avoid having “rounded shoulders.”  Sit up straight, engage your abdominal muscles as if you were bracing for a punch.  Make sure your shoulders are relaxed and that your shoulders are not shrugging up to your ears.  Squeeze your shoulder blades together and down. Hold for 5 seconds. Repeat 10x each hour.

2.        2.  Chin Tucks – This exercise will help reduce “forward head posture” where your head is sticking forward toward the monitor; this posture can increase strain on the neck.   Tuck your chin straight back as if you were making a double chin.  Hold for 5 seconds. Repeat 10x each hour.

 

3.       3.  Wrist Circles – Ok, this one won’t correct your posture but it will keep you from getting stiff in the wrists and decrease your chance of getting a repetitive use injury.  Turn your wrists in one direction 10x, repeat in the other direction.  Repeat every hour.

4.       4.  Chair Twist – Begin by sitting in a chair with good posture (looking straight ahead and with your chest up).  You back should be against the back rest and you should be sitting "tall".  Reach with one arm around you to the back rest.  In this tall posture twist using your arm to help you pull.  Hold for 20 seconds and then repeat on the other side.  Repeat this for both sides every hour.

5.      5.  Back Extension - Standing, place your hands on your lower back.  Squeeze your gluts (your bottom) tight to stabilize your pelvis and then lean backward.  Only go as far as is comfortable and not into painful ranges.  Hold for 5 seconds and repeat 5 times every hour.

It is important to do these exercises throughout the day if you are sitting at a desk.  It is recommended that you perform these exercises for 5 minutes for every hour that you are sitting in your desk.   If any pain or complications should occur make sure to talk to you physician or physical therapist before continuing. 

Reference: http://lifehacker.com/#!5715136/avoid-succumbing-to-computer-hunch-posture-with-these-easy-stretches

Backpack Safety

Believe it or not the summer is coming to a close and children are returning to school in the next few weeks.  This is a great time of year when kids of all ages get to see their friends and begin a new chapter in their lives.  However, this new time can bring aches and pains to many children and adults.  Due to weak muscles and heavy backpacks, children often walk around with stooped posture.  This can lead to shoulder, neck, and back pain along with numbness and tingling in the arms and hands. 

When I was attending school regularly there were many “backpack fads” that came and went.  First, it was cool to wear your backpack over one shoulder; then it was only cool to “sag” your backpack and have it hang as low as it could.  Both activities can cause multiple musculoskeletal problems.

Follow these easy tips to help your child prevent pain and risk of injury:

-- Lighten the Load – A full backpack should not be more than 10-15% of one’s weight.  Make sure not to carry items that will not be used that day.  When placing heavy items in a backpack, organize them so that the heaviest items are closest to the body.

--Wear Both Shoulder Straps – If you only use one shoulder strap you place a large amount of the stress on one side of the body causing muscles to be overloaded.  It is important to wear both shoulder straps so that the weight is distributed evenly.  Although most children find it “un-cool” it is also a good idea to wear support straps across the chest or hips.

--Position the Backpack Correctly – The backpack should be over the middle of the back where the muscles are the strongest.  In this position the low back does not have to overwork to carry the load.

Good luck with your new beginnings and if you or your child have shoulder, neck, or back pain make sure to see your physical therapist at Hayashida and Associates Physical Therapy.

Reference: www.APTA.org

Posture for New Parents

The birds and the bees have come and gone; spring is over and we are in the heart of summer, the time of the year when the most births take place (at least in America).  This means that there will be a lot of new mothers and fathers out there playing with their children.  Having children can lead to a large amount of added tasks for new parents.  These caregivers will need to lift their children from the floor or bed, carry them for prolonged periods of time, and bend over repetitively to pick up toys or food from the ground.  We all know the old adages: When lifting a box bend the knees, keep the load close, do not use your back to lift.  However, when there is a child involved we all too often throw out these rules of correct body mechanics.  Here are some simple pointers to keep you out of pain with your new activities.

Lifting Your Child

When lifting your child from the floor you should come down to one knee with the one foot slightly forward of the other while keeping your back flat.  You should try to keep your child close to you, using two hands to grasp him or her.  Before attempting to lift you should tighten the core musculature (stomach muscles) in order to keep the back straight.  You should lift with the muscles of the legs to safely return to a standing position.

 

Carrying Your Child

Often we see mothers and fathers hold their children in one arm with the child resting on their hip.  This can put a lot of stain on the low back since the weighted object (your child) is all to one side.  Instead you should hold your child balanced in the center of your body, holding them closely. 

Picking up Objects from the Floor

There will be many times when you need to bend over and grab toys or fallen food from the floor.  If this repetitive motion is done incorrectly you can cause yourself back pain relatively quickly.  In order to avoid back pain you should keep your back straight with your head in line with your back.  The bending action should take place at your hips, extending one leg straight behind you as a counter balance.  By reaching to the floor in the manner you maintain the low back in a neutral position decreasing any abnormal stresses to your back. 

If you do find yourself with back pain be sure to see a Physical Therapist at Hayashida & Associates for a thorough evaluation and quick recovery. 

“Please be aware that even if your state requires a physician’s referral before you can see a physical therapist, you always have the right to see the physical therapist of your choice.” -APTA

Resource:  www.apta.org