What’s in your green smoothie? 5 reasons drinking a green smoothie every day for breakfast can enhance your life!

In order to have our health, we need to ensure that we are taking the right steps to take care of our bodies. This includes, but is not limited to a healthy diet and an active lifestyle. A healthy diet is key to maintaining your wellbeing and it all starts with breakfast…or does it? You will hear from people that breakfast is the most important part of your day. And you will hear others say that it just leads to unhealthy eating habits and starts your day off with bad fuel. Well the latter can be true if you are fueling yourself with sugar filled cereals or carb loaded bengals. But what if we fueled ourselves with something that could help us through our day? What if we began the day with fuel so good for our bodies that it helped us focus, burn fat and give us the energy that we needed in order to have a productive day? I think everyone would sign up for that if you asked them. Have you ever heard of a green smoothie? I’m sure you have seen them, and some of you have probably even tried one before. At first glance some of them don’t look very appetizing. I know the first time I tried one I was skeptical. But if you give them a try they can do a lot for you as you begin your day. I have put together a list of 5 reasons that drinking a green smoothie every day for breakfast can help enhance your life.

What is a green smoothie? Well, the name comes from it’s color of course. And what makes up this color you might ask? The green color comes from the vegetables and fruits that are added to it. A simple green smoothie is made up of green leafy vegetables, nutrient rich fruits with a liquid base.

5 ways drinking a green smoothie in the morning can enhance your life

With the benefits of broccoli, spinach, kale and many other leafy greens, combined with fruits green smoothies in the morning can help in a variety of ways. Here a just a few…

Rejuvenates your body

Most of the ingredients that are included in green smoothies are loaded with a substance called chlorophyll. This has very powerful antioxidant properties. This, in turn, can prevent anemia, help treat insomnia, assist in dental problems and the best part is that it helps lower your risk of infections. Those cold and flu symptoms you see your friends and family members getting will be a recent memory!

Naturally promotes weight loss

Not only are you getting the antioxidants that you need for your overall health, you are also getting the vitamins and minerals in these fruits and veggies that will curb your hunger. Abel James “ The Fat Burning Man” is quoted saying that in order to burn fat you have to eat fat. If you start your day off with fat you are telling your body this is the first thing you should burn as fuel. Good fats include Avocados, Walnuts, nut and seed butters, olives, ground flax seed, coconut oils and grass fed butter. These are just a few of the fats you can include in your smoothie.

Increases your daily fruit and vegetable intake

We all seem to lead very busy lives these days and when we get that craving to grab a snack we tend to eat the unhealthy ones forgetting the importance of fruits and veggies. When you start your day with a green smoothie you are already ahead of the game with your fruits and veggies. It is suggested that you eat 3 cups of vegetables and 2 cups of fruit per day. Green smoothies are usually high in both of these and in turn you will not have to worry about getting all of those into your diet.

Improves Hydration

To keep your body hydrated you should drink half of your body weight in ounces per day! That’s a lot of water right? But, don’t you think that since your body is already made up of water it would crave it anyway? It does after you start to consistently do this. By adding a little more water to your smoothie in the morning it will help you reach that goal of ounces per day.

Improves digestion

Many individuals are affected by some sort of digestive disorder. Unhealthy and inactive lifestyles are just a few things that cause this. Green smoothies are filled with fiber, and in turn is a great substance to help improve digestion. Some individuals even say that this aides in relief of the symptoms caused by common digestive disorders.

I drink a green smoothie every day for breakfast. It’s quick and easy and I have come to not be able to live without it. Here is my simple recipe:

1 healthy handful of spinach

1 scoop of vanilla whey protein

A splash of cinnamon

A ¼ cup of frozen mixed berries

1 avocado

Add ice and 6 oz of water, could be more depending what you are using to blend it in. I use a magic bullet so the cups provided are filled to the brim. Blend till smooth and enjoy!

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Are you persistent?

Are you persistent with things you do throughout your life? Being persistent helps to keep yourself on track. It drives you to achieve your goals, and it gives you the ability to not take no for an answer. It’s proven that people that are persistent get what they want. If you are determined to get something done, most of the time you will achieve it. You have to be relentless in your actions. 2 weeks ago was no different for my son and I when we had gone archery hunting for the elusive buck!

I didn’t start hunting until about 10 years ago. Growing up I had uncles that were big into hunting, but my mom hated guns and would never allow me to go. I eventually stopped asking and moved on to other outdoor activities. About 10 years ago my father in law told me to buy my license and he would provide me with everything else. If I didn’t like it I would just be out the price of the license. So that’s what I did. I remember opening day of rifle season in PA. It was raining that morning and continued the entire day. We went out and only saw one doe the entire day, but for some reason I loved it! I enjoy being outdoors, but something about it really got me going. I hunted a few more times that season with my uncle and saw a few more doe, but never had a shot. The following year I decided to buy a compound bow and take up archery. A friend of mine helped get me started and tought me how to shoot. That season I saw so many deer it was amazing. I even shot at a few, but missed! It was very hard for me to accept the fact that I didn’t get a deer. It was unlike anything that I had done in the past. It was much more difficult to get gratification. After that season I practiced shooting a lot that summer into the fall. I shot from all different heights and even thought about standing on my roof a time or two. I was determined to get a deer the next season. And I did, my first doe! It wasn’t the biggest deer, but I was very proud of what I had accomplished! 3 years later I got my first buck and 2 more since then. It proved to me that being persistent with what you wanted will pay off in the end.

Last year I got my son his first mentorship hunting license. He had been out with me a hand full of times to sit, but this time he was able to shoot a crossbow. We saw deer last year, and even had a spike at about 60 yards. He just never came to a comfortable distance for him to shoot. That day my son got his first taste of Buck Fever! When he set up to look through the scope he was breathing so heavy and his knees were shaking. After the buck left and he sat down he asked me “Dad, why was I doing that?” I said that’s called buck fever and if that ever leaves you then you need to stop hunting. He just laughed and still couldn’t stop shaking. That was a great day that I will never forget.

Fast forward to this year and he was even more excited than before. He would get mad if I would sneak out in the morning and not take him. We practiced a bit more this year than last to try and get even better at shooting. 2 weeks ago it just felt like a great evening to hunt. The wind was right, the temps were comfortable and the woods were quiet. We sat for about 2 and a half hours and hadn’t seen anything. Right before dark a deer came from our right. I saw that it was a buck, and since he is 9 he can shoot any size. I whispered “it’s a buck buddy get ready!” He grabbed the crossbow and turned to his right. The buck came right out into the path at 25 yards and stopped dead. I said he’s broad side so shoot when your ready. No sooner did I say that and he pulled the trigger. It was like slow motion watching the lighted nock fly through the air and then you heard it hit, THUMP! The deer kicked and ran down the hill. He sat down breathing so heavy and said “Dad did I hit it, did I hit it?” I smiled and said yeah buddy you hit him! A fist pump in the air and a high five made my day! It was awesome seeing how he reacted to his hard work! I had a feeling he might have hit him a little far back and when we got down to get the arrow I was right. We decided to wait an hour and look. We had good blood but followed him for about 200 yards or so and lost blood. We decided to back out and come back the next morning…

He was up early ready to go and find his deer which was very nice to see. His friend also wanted to come and help so the 3 of us searched the woods for about an hour and a half. It didn’t look good and it had rained the night before. We decided that we were not going to give up though so we just kept on walking down a trail we thought he might have went. Sure enough about 150 yards from where we last saw blood a 4 point was laying on the side of the trail, and the fist pumps started! It was awesome!

It felt good showing my son that persistence pays off. He was dedicated to shoot better this year. He was determined to go out as many times as he could every chance he had. And we were both relentless in our quest to find this deer!

When you have injuries or you are in pain the last thing you want to do is just give up. You have to be persistent in your efforts to get well. Set goals and strive for them. Don’t take no for an answer. And if someone tells you no then you change your approach until you get what you want.

Things that motivate me to lead a healthy lifestyle

Embracing an active, healthy lifestyle can be much harder than the alternative. You need to have dedication, preparation, and most importantly motivation. You are much more likely to actually achieve something when you are motivated to do it.

What inspires most people to live a healthy lifestyle? Is it to be a great competitor? Is it to look good? Is it to feel better? I have been thinking about this over the past week or so and decided to come up with some of my motivating factors on why I try to lead a healthy lifestyle.

Family: This is always at the top of my list for everything in life! If I didn’t have my family I would have nothing! My family motivates me to want to live healthy. I want to set a good example for my kids as to why they should follow suit. I want to be able to do things that they want me to do. If I come home and they want me to jump in the trampoline I want to be able to do it. Or if they decide they want to take a walk, or even play basketball in the driveway I never want to tell them that I can’t. If my wife wants me to go for a run I want to be able to do it, even though she kicks my ass every time! These things are so important to me and when I think about not being healthy these are the things that put me back on track.  

Practice what you preach: I talk about fitness, health and fueling your body with the right things to my patients, in my social media posts and in my blogs all the time. What type of person would I be if I just talked about it? I want to practice what I am talking about to show that I too am doing what I suggest. It’s a struggle sometimes and it would be easier just to be lazy, but what would that be teaching people?  

Seeing someone else’s results: Seeing someone go from not being able to walk a mile and being able to run a 5k is one of the most motivating things to me. I see people on Facebook, in my clinic or even just friends that have decided to be healthy and start something new. When you see their results it makes you want to be better. It’s like a domino effect. You want to compete and get better at what you are doing right now. This always helps motivate me to stay on track and knock me out of my funk.  

Being able to stay active: The idea of being able to stay active is a huge motivator for me. I know that if I take care of myself I will be able to do everything that I want to do. I will never have to sit out and watch others enjoy. Just knowing this helps me focus and realize what I am doing is worth it.  

Fitness: This is always a motivator for me because who doesn’t like to see results? I love being able to see increases in my performance, in my waist line and on the scale. I also love to see my energy levels stay high because of a workout I did at 5:00 A.M. Even though it kills me to get up and go I always use results to get me out of bed and stop hitting the snooze.  

I know it can be tough to stay motivated to try and be healthy. It just seems so much easier to not have to try. But in my opinion just like with anything habit and routine always take over. If you get yourself in that mindset and have a continued routine to follow it makes it a lot easier to succeed. What are some of the things that keep you motivated to lead a healthy lifestyle? Leave them in the comments section below! Have a great week! 

Don’t be afraid to try new things


It’s easy to be the one to shy away from something new. Sure, when something is unfamiliar it can be intimidating and make you want to just say no. I used to be like that. If something made me uncomfortable I would just not do it. Until I realized that in order to experience things throughout life you have to try them. You can’t just do the same thing over and over again. I get so many patients in my clinic that have never picked up a weight in their life and it can be very intimidating to them. Especially when they are in the gym area and have to perform an exercise in front of people.

I try to make it to the gym at least 4 days a week. I enjoy working out because it relieves my stresses from the day. I also like the way it makes me feel after I’m done. But lately it’s been getting kind of boring. I found myself in that rut of doing the same sorts of exercises for different body parts. It can make you feel bored and unsatisfied. This is when I would tell someone to try something new. So I decided to take my own advice.

This past weekend I went to a continuing education course for work. The course was about ways to assess and treat the fitness athlete. The fitness athlete is also known as an athlete that does “Crossfit”. But the things learned in this course can be broken down to be used with just about any patient or even the highest of fitness athletes. I’ve always wanted to do Crossfit, but I always felt a little intimidated by it. So this course fit right in to my plan because here I could learn about it, how to do things properly to assess someone and use this to help program patients to get stronger.

The course was held at Recharge Ho-Co Crossfit in Elliot City, MD. What a fantastic facility. It made me wish I lived closer to this place. Institute of Clinical Excellence is the company that put on the course and I can’t say enough about it. From the time I walked in to the time I left I felt inspired. The energy from the instructors Ryan Smith and Mitch Babcock was infectious. Ryan is part owner of Recharge and Mitch runs his business out of a Crossfit box he trains at in Michigan. Both were so knowledgeable and had an amazing ability to break down each movement so that it was easily understandable. And the best part about it, they are both Physical Therapists! I knew it was going to be a great weekend.

By the middle of the first day I felt more comfortable with different Olympic lifts that in the past I just did because I was told to do them. I was never properly instructed on every detail of form like I was this past weekend. And if there was a break down in form what was I going to do in order to fix it. At the end of day one we all participated in a workout. I was excited and a bit hesitant like most people are when they try something new. But I didn’t need to convince myself because I knew this is what I wanted to experience. At the beginning I was thinking I can get used to this. By the middle of the workout I was thinking when the F$@% is this going to end? And by the end I was thinking thank god! I was excited about a few things. First, that the workout was finally over! Second, I was proud of myself for trying something new. And third, I can’t wait to do another one! It was just so much different than any other workout I had done. And it encompassed every part of my body. This is how it started. We did a dynamic warmup for about 5-10 minutes that consisted of bear crawl/squatting lunges, walk out to push up and walk up into a pike position, sideways squat lunges, high knees, butt kicks and maybe something else I’m drawing a blank. After that we set up the bars with 55 lb for women and 75 lb for men total including the bar. Now, this may not seem like much, but when you have to do as many thrusters as you can it kills your lungs and your body. We had a partner an one started on the rower and the other had to do thrusters. You had to row 250 meters while your partner did as many thrusters as they could until you reached that distance. Then you switched and did the same thing for them. On and off for 10 minutes. That was the longest 10 minutes EVER! But, when I was done I felt awesome! Well, not right away, but about 10 minutes later it was great!

Day 2 consisted of more technique on pull-ups, kipping pull-ups, clean and snatches. All great exercises that involve the entire body if done correctly. Each movement was broken down and encouraged to do to practice correctly. If there was a breakdown things were incorporated into the movement in order to cue the athlete to do it correctly. If things were still not clicking, then another activity was done to break down the movement. This was key to understand what exactly was hindering the movement and what can be done to fix it. There was no day 2 workout, but I did enough snatches and cleans to last me for a while. I know because for the next 2 days I felt it everywhere! What a great feeling too!

I left that day inspired! Not only to be able to take back the knowledge to my clinic and incorporate it with my patients. But this course opened up my eyes to an entire new way to look at things! It made me want to be able to master what I learned and use that to drive my treatments. I would have never learned any of this if I hadn’t tried something new. This is what I always encourage my patients to do in order to challenge themselves. You never know what you might learn.

Thank you again Ryan Smith and Mitch Babcock for being great instructors and coaches! You have both inspired me to be more. Not only with my workouts, but with my patients! And in my opinion, when you can do that for someone you are on the track to greatness! Thank you Recharge Ho-Co Crossfit for hosting the class you have an awesome facility! And finally Institute of Clinical Excellence, you have some great content and instructors! From what I hear all courses you put on are class act!

A little bit about me

Many people including patients ask me what got me into this field? Why I chose physical therapy over something else in the healthcare field? And the most frequently asked question…do you like what you do? I can’t even count how many times someone has asked me one or all of these questions, but my answers never change, especially the last one.

Ever since I can remember I knew I wanted to do something in the healthcare field. I didn’t always know that physical therapy would be my calling. When I was younger I always said I wanted to deliver babies. If anyone asked me that is what I was going to do. It wasn’t until later when I found out exactly what had to be done when I decided that just wasn’t for me! That didn’t switch my focus because I wanted to be a helper. I wanted to be someone that could make a difference in someone’s life. Now, there are many ways to do that outside of healthcare, but the body just always fascinated me.

I can still remember in high school I wanted to take an anatomy and physiology class. I was a B/C student. I even had gotten a D in a few classes. I wasn’t a bad student, I just never really applied myself unless it was in something I enjoyed to learn about. You could tell in my grades, math and science were always my strong suit. History and language arts not so much. I will never forget when I signed up for the anatomy class and the teacher who was going to be in the class called me to her class room during a study hall. She asked me why I signed up for the class. I explained to her that I wanted to learn more about the body and I planned on being in the healthcare field at some point and this would help me get started. She looked at me with a very serious look and said, you know this is an advanced class to take right? Looking at your grades I’m not sure this would fit you. She said I take my position here serious and try to make sure that I have the right students. So you know what I did? I said yes I know that this is an advanced class and my grades don’t reflect the type of student that I can be. My grade will show you how serious I am when I’m done with this class. She agreed to allow me to take the class even though she was hesitant. Well, needless to say I got an “A” in the class and proved her wrong! I knew I would do well because I enjoyed what I was learning. This started my obsession of the human body and after this one class I realized that health care was going to be my route.

I played baseball and basketball in high school and eventually played baseball in college. Before applying to schools for college I decided that I wanted to go into Athletic Training. I loved sports and this seemed like the right fit for me. I knew I didn’t want to go far, but I didn’t want to commute either. I had applied to 5 colleges and got accepted to 4 of them. Waynesburg University was at the top of my list. They had a great AT program, it was only about an hour and 15 minutes away and I was going to play baseball there. So I decided to accept my acceptance and move to Green County PA. This is also where I met my wife who is really responsible for my grades in college. If it wasn’t for her studying with me, I would have never made it through some of those classes I had to take!

I started baseball about 2 weeks after school started and it was great! It took up a lot of my free time, but I didn’t mind because I loved to play. The other part of my time was spent in class as well as trying to get hours in the clinic for AT. It turned out that in order to start doing anything with athletes you needed a minimum of 2,000 hours in the clinic observing! I thought wow! How am I going to find time for this? Well, after a long time thinking about what I wanted to do I made the decision to change my major. I know what you are thinking. You changed your major because you didn’t want to do the observation hours? I thought you wanted to do something in the health care field? Well, you have to realize that I was 18 at the time. My number 1 priority besides baseball was socializing and of course partying. Baseball took up most of my time, class took up the other and I wanted to have fun. Something had to give. So I switched to Biology (pre-physical therapy). This was kind of like a pre-med degree and gave me avenues to go to.

My freshman year anatomy teacher was Dr. Giles! He was an awesome teacher! He made things fun and easy to learn. And since I loved anatomy he made the class that much better. But Dr. Giles was not only an anatomy teacher…he was also a Chiropractor. I thought, this might be my calling. It just seemed like a good idea. He had great stories of how he made patients well and how he helped so many people. It got me thinking. Over the next few years I thought about what I wanted to do after college. I knew I was going to go on to grad school it was just a matter of where. In my second to last semester I had to do 200 observation hours in a health care facility. It could have been anywhere. They gave me a list to choose from. The list included chiropractic, medical doctor, surgical center, dentist and then physical therapy. At this point I had been tossing up chiropractic and physical therapy. I just was not sure about the differences. So I decided to go to a PT clinic. I had had PT in the past on 2 different occasions for my knee and my elbow. From what I remember about it I really enjoyed it and it helped get me back to playing baseball of course!

During my time at the clinic I met so many different people who had so many different injuries and pains. Some worse than others. I loved the fact that patients would come in with problems and leave able to do the things that they couldn’t before. Physical therapy was able to get patients back to doing what they loved. I wanted to do that! I wanted to be a helper, a healer and a person that people came to to get them well. Needless to say, after my 200 hours, which took me about 4 months to get, I was dead set on physical therapy school. I started applying right away. I had 3 choices for where I wanted to go. Chatham University was my first choice, Pitt was my second and Slippery Rock was my last. I remember where I was when I found out I got accepted. I was in Cocoa Beach Flordia on spring training for baseball. I called home daily to talk to my parents and my mom had said I got a letter from Chatham. I told her open it. She opened it and read that I had been accepted to Chatham University’s Physical Therapy program! And you can say the rest is history!

Here I am today 12 plus years in the field and I love being a helper, a healer and most importantly a person someone can come to to get them well! There is nothing like seeing someone come into the clinic miserable, visibly in pain, unable to do the things they love and on crutches. And months later seeing them smile because they are running, walking, playing with their kids and doing everything they love to do because of something that you were able to do for them! So to answer the question of do I like what I do? The answer will always be yes!

Quick tips to better computer ergonomics 

I treat a lot of patients that have low back pain. Their pain can come from a variety of different things, but there is always one that sticks out to me the most. Bad posture and work station ergonomics. This one is the most frustrating one because it’s something that can be avoided if the proper steps are taken. But, it is also very easy for patients to go right back into their old habits again. So how can you start to help your back pain today? Here are a few tips that you can do starting today.

Let’s start with your chair: You want to push yourself all the way back into the chair. They make the seat that big for a reason so use it. You want your feet sitting flat on the floor adjust the height of the seat so that this can occur. Make sure your upper and lower back are supported. If the chair does not allow for that, then get a small towel roll or pillow to put behind our back. Allow for the natural lordosis of you lumbar spine to occur and keep it like that with the roll. Lastly you want your arms to be relaxed on the arm rests. Make sure your shoulders are not in a constant shrugged position.

Next, adjust your keyboard and mouse position: You want your keyboard to be the center of your workstation. Palm supports can help keep your wrists maintain the same position but are not necessary. Place the mouse as close to the side of the keyboard as possible. Lastly adjust the monitor. You want the monitor to be at eye level. You don’t want your head to be tilting up or looking down as you stare at it all day. Place your telephone at an easy reach so that you do not have to go far. An ear piece can come in handy so that you do not have to hold anything or tilt your head to one side.

Lastly, you want to take breaks as the day goes on. Every 30 minutes take a few minutes to refocus. After each hour of work take a break or change your task for at least 5 minutes. Always try to get away from the computer during your lunch break. You are there long enough during the day. Resting your eyes is a good idea as well. No, I don’t mean take a nap. Although, Europeans have it right taking a siesta for 2 hours during the day! If you are able to then I suggest that you do it. But if you are unable to take that snooze in a nap pod like those at google I advise you to rest your eyes by simply closing them for about 30 seconds. This helps reset and focus as well as giving them a break from the computer screen.

It’s very important to have some sort of plan as to how you are going to set up your work station. Developing bad posture at work will lead to back problems in the future. Make sure that you are always moving and getting up from your chair every 45-60 minutes. It’s not only good for your back but it helps with circulation throughout your body. Take these steps and you will feel better than you did yesterday!

What to do when you experience low back pain


I get this question a lot. “Nick I have no idea what I did to my back but here is what is going on”. “What should I be doing?” “What should I be avoiding?” Unfortunately, it’s really not that simple when it comes down to it. Without first evaluating someone I can’t just give out things to do, but I can suggest things that are pretty common in the treatment of low back pain. This can be a starting point to see if they get any relief. Once we have accomplished that, then we can look into more detail as to what the problem is. So what should you be doing if you start to experience low back pain? And what should you avoid so that the symptoms don’t get any worse?

Rest: how much is too much? In my opinion, rest with any injury is needed to allow for the inflammatory process to subside as well as for the tissues to start to heal themselves. Now, when I say rest I don’t mean bed rest. I am talking about rest from activities like running, lifting, carrying or any activity that seems to irritate your low back. And the length of time is important as well. 1-2 days is plenty because I then want you to slowly get back into your routine. Light walking, lifting, carrying activities.

Ice or Heat: I always advice ice for the first 48-72 hours. At that point you can mix the 2 back and forth if you want to. Some people, like myself, love ice. I hate being hot and ice always makes me feel better. So after that initial few days I say whatever makes you feel better is what I would recommend.

Change positions: you want to change positions frequently. If not you will tend to stiffen up or cause yourself more pain. When you are in pain your body and muscles are most comfortable tight. This, in turn, will cause you more pain and discomfort. If you sit for your job I suggest to not sit for more that 45 minutes before changing your position. Move in your chair, or get up and take a walk to change the position of your spine. This will decrease stiffness and load the spine and injured tissues so that they do not get stiff.

Light stretching activity: a light stretching program can help as long as you are not causing new symptoms to occur. Stretching also keeps the spine loose as well as the structures that surround it. As I said above your muscles like to stay tight when your body is in pain and this will help combat that. Sometimes back pain is accompanied by leg pain and we don’t want that. I always suggest to see your physical therapist to get evaluated and determine what best suits your back when you have these types of symptoms.

Avoid lifting heavy: If you work in an environment that you do a lot of heavy lifting this should be avoided for at least 2 days. Like I said about rest, it’s good for a short amount of time and then we need to start to load these tissues in order for them not to continue to get weak.

See your physical therapist: I suggest that you see a physical therapist right away when you experience low back pain. Our profession is so underutilized in this aspect considering that only 7% of patients with low back pain are referred from their physician to come to physical therapy. Where are the other 93% going? Or better yet are the other 93% not even doing anything about it? These are great questions and should be thought about in order to fully understand what it is that you can do when experiencing low back pain.

Do I need a prescription for physical therapy?


For the longest time, to come to physical therapy you had to get a prescription. First you had to make an appointment with your PCP and take time out of your day. They would take a look at you and say I think you should go see a physical therapist. They would write you a prescription and send you on your way. Nowadays, there is something called direct access for physical therapy. Patients can come right off the street without seeing a physician and get physical therapy treatment. So does this mean that you no longer have to see a physician to be able to come to physical therapy? Well it kind of depends.  

The short answer to if you need a prescription is no. Direct access is meant for just that, to not have to worry about seeing a physician to get permission to come to physical therapy. Now, what will decide that is your insurance. Some insurance companies still require you to get a prescription, Medicare being one of them. My best advice to people that are wondering if their insurance accepts direct access is to call the number on the back of their card and ask. If patients do call in we can check for them, but it is much easier for them to call on their own.

How does direct access help the patient? For one, it takes an extra visit to the PCP away. This means they can just come straight to the PT and not worry about seeing an extra health care provider. Another way direct access helps is that it cuts costs for the insurance companies. Unnecessary visits are avoided and this in turn makes them happy. Direct access also saves patients time. Again taking away another visit can be the difference in an entire afternoon or evening for some patients. Busy schedules require efficiency and direct access does just that. And finally, it eliminates barriers to entry. If a patient wants PT, there should not be anything that stands in their way of getting it. This, in turn, opens of and enables people to seek this service without having restriction.

So the next time you get injured call your physical therapist so that they can properly evaluate you and get you on the right path to better health!

When can I get rid of my knee brace after surgery?


There are a number of different braces given out after surgery for your knee. Most of the time it’s for support of the joint due to weakness. Braces can be cumbersome and bulky and very hard to deal with. The first question I usually get from patients with a brace is when can I get rid of this thing? I understand, your already in pain due to surgery and now you have to lug this thing around with you everywhere you go.

Each surgery to your knee is different and depending what was done will determine when you get out of the brace. A few different surgeries that I see commonly are ACL repair and patellar fracture. Other injuries that require a brace are quadriceps tendon rupture and femoral fractures. All of these surgeries end up with a common problem…atrophy. Atrophy is the wasting away of a muscle and in turn it becomes weaker and does not work as efficient as it once did. Your quadriceps muscles are what help support your knee from collapsing when walking, and when they are not working properly is when the brace is needed. The brace is usually locked at first to take up the slack of any weakness.

So what causes atrophy to happen? When you have surgery on your knee it becomes inflamed. That inflammation works it’s way into the quad and causes it to shut down. When the muscle stops working it starts to atrophy. Have you ever heard the saying “ if you don’t use it you lose it”? Well this statement holds true, especially after surgery. Another reason atrophy occurs is after surgery the last thing you want to do is move your knee or even put weight into it. When you are not working the muscle like it is used to, you start to atrophy. It’s the same move it or lose it atmosphere.

What do we do in the clinic to determine when you can stop wearing the brace? We want to make sure that you have proper strength in your quad muscle to support your knee when you walk. One way we determine this is to have you perform a quad set. You are instructed to keep your leg straight and push the back of your knee down into the table or the bed. We look at if your quad muscle is firing properly and moving your knee cap as it’s activated. We then ask you to perform a SLR. This is done by laying on your back and doing a quad set. Then while keeping your leg straight, lift it up off of the table. If you can keep the leg straight without the knee bending in the air you are ready to be out of the brace.

So the next time you are wondering when that pesky brace can be thrown out ask your physical therapist. The more you do your home exercises the faster you will be able to get rid of it.

Why is form so important with exercise?

I have people ask me this question a lot especially if I am correcting them as they do a specific exercise. Why do I have to do it this way? This way is harder for me to do it. It’s easier if I do it this way. These are just some of the things my patients say during their time with me. Now I’m all for doing something a certain way if it is easier and more efficient. But when it comes to exercise there is some form that we all must follow. So why is it so important that we follow proper form while doing exercise? And what can happen if we don’t?

Injury prevention: this is the number one reason why form during exercise is important. If you continue to do an exercise incorrectly, you run the risk of injury. In my world of physical therapy most people that come to see me are already injured or have some form of pain. The last thing we want to do is cause another problem.

Efficiency: with proper form comes efficiency. We all want to be efficient with things because this makes things work more smoothly, it saves time and helps to not overwork yourself. Being efficient with exercise allows our body to adjust quicker and avoid fatigue. This, in turn, will prevent injury as we talked about above.

Accessory muscle use: if proper form is not used this can cause you to use accessory muscles. These muscles are the ones that start to kick in if the other is either too weak or your form is not correct. The best example I can give is when someone is doing a bicep curl with a barbell. If the weight is too heavy or their biceps are just weaker they start to rock their back and extend back and forth. This causes them to start using muscles in their back and increases risk of injury. My advice is always quality reps increased weight. It’s better to do 20 quality reps with a lighter weight than 10 reps of heavy weight with poor form.

Increased joint mobility: form plays a role in mobility of our joints. Deep squats for instance, are a great example. Deep squats are an excellent exercise to get more mobility in your hips, knees and ankles. If the goal is to increase the mobility in those joints then this exercise is for you. But if we decide to just do squats to 90 degrees of knee flexion this could cause a decrease in the mobility of the hips because they are not going through that entire range of motion. Now mini squats and squats to 90 are great for strengthening but if you want increased mobility this will cause those structures to tighten and not allow for full mobility. In turn, causing you limitation and sometimes pain.

As I tell all of my patients. I am not interested in how much weight that you can do or how many reps. I just want you to have proper form while doing your program.