The Custom Physical Therapy Challenge Rules


If you dare ….. get fitter, stronger and healthier with the monthly Custom Physical Therapy Challenge.

Every month we will have a daily series of exercises to do for anyone and all who would like to join us. Employees, friends and family may join in.

Here are the rules:

  1. You complete all repetitions of each exercise every day and check it off the schedule of exercises.
  2. If you miss a day you may double up the next day – not advisable particularly towards the end of the series.
  3. It is purely the honor system.
  4. If you complete all exercises for the entire month you let us know by faxing the checked schedule to Custom Physical Therapy (775-331-1180) or emailing it to us with your name on it and contact number: customptchallenge@gmail.com
  5. Prize: $50-$75 gift certificate from a local business (Previously: Great Full Gardens Restaurant, 1 hour massage).

Exercise technique can be seen on our Youtube Custom Physical Therapy Challenge Channel. Here is the URL:

Let us know how you like it and what you would like to challenge in future months. For example, an arm challenge, butt challenge, core challenge, chest challenge, aerobic challenge, rope jump challenge.

If you have any concerns about doing the exercises and need help modifying them feel free to call us at the Sparks location: 775-331-1199. You can also email us with questions: customptchallenge@gmail.com

Have fun, be safe and get strong!

The Custom Physical Therapy Challenge Department

www.custom-pt.com

http://www.customphysicaltherapy.wordpress.com/

Smoking, Health and Forest Fires.


Living in Reno, Nevada, we are frequently engulfed in smoke from forest fires around the area. Last year it was the big Yosemite fire, this year we were living under a blanket of smoke from the massive King Fire just east of Sacramento, California. Air quality was in the unhealthy range day in and day out. With clean air in the Truckee Meadows so dependent on the wind direction, we were praying for wind direction changes and the return of our Nevada blue skies.

Someone told me about a scene he saw at his work during the time we were blanketed in smoke. He left for lunch and walked past the smoking area outside the building. He saw two people smoking outside in the already smoky air and one waving her hand, cigarette in the other, “This smoke is killing me!” We humans are a funny bunch!

So I thought I would have some fun with that and take a photo. My disclaimer: I am not a smoker and never have been and boy did I learn something about smoking in the brief 10 minutes I had cigarettes going for the photograph!

  1. My tongue felt fury.
  2. My wife did not enjoy our first kiss.
  3. My clothes smelt of smoke immediately afterwards and this did not disappear until I washed them.
  4. I coughed immediately.
  5. I had to brush my teeth and take a shower right away.
  6. If I disliked it so much then it must be addicting as I struggle to believe those who have chosen to smoke don’t eventually bypass these sensations and thereby continue to smoke.
Smoking and our Reno Air Quality

Smoking and our Reno Air Quality

My Dad was a thoracic surgeon with a specialty in lung and esophageal cancer. As a consequence, I have always been very aware of the health issues related to smoking. I have never been addicted to anything (some who know me well may say I am addicted to exercise, talking to strangers and coffee!). I have seen numerous patients who smoke despite having significant reasons not to. For example, one person I recall had COPD, was on oxygen, had cardiovascular disease and had recently had a spine fusion (smoking delays healing) and was still smoking. Some of these smokers are in the healthcare profession too. Putting these factors together suggests to me that whether we like it or not, smoking must be incredibly addicting. Everyone who smokes knows it is bad for their health but they continue doing it. This begs the question: “What makes people change?”

People change because the pain of their present situation (smoking) is more than the pain of making the change (the withdrawals after stopping?). The pain of smoking depends on the individual and is different for each person. Some may see their wife pregnant and decide to stop smoking on account of the youngster about to be born. Some will have significant ongoing disease and still keep smoking (not painful enough yet). I have even spoken with someone who had simply given up as the disease process had gone too far.

I feel somewhat cheap talking about smoking cessation as I am not a cessation specialist nor am I a smoker who has kicked the habit. I have a real interest in why people change. This is the reason for my post. That being said, I recently met an incredible man. During his lifetime he stopped alcohol, methamphetamine, smoking and violence all cold turkey!

How is it he was so strong and quit all those things and many of us struggle?

It is not osteoporosis that causes fractures.


We all know someone who has had a bone mineral density test and been diagnosed with osteopenia or osteoporosis.  This means they have lower than normal bone mineral density and hence their bones may be more fragile.  This in itself does not necessarily cause fractures but does need to be addressed.

A comprehensive, multifaceted approach to the treatment of osteopenia and osteoporosis will have a significant impact on bone density.  Clearly there are suitable medications one can take which your physician can address (beyond my scope of practice for sure).  I am sure you have all seen the numerous commercials on TV for these medications with that classic … “Ask your doctor about Boniva (or whatever medication they are advertising)” at the end.

The predictive value of bone mineral density measurements has been called into question in that it can under or overestimate density by 20% to 50%.  If it underestimates the density of the bone, you may receive unnecessary treatment.  If it overestimates bone mineral density you may not receive the most effective treatment.  So, what should you do?

Recognize that it is the fall that causes fractures and not the osteoporosis or osteopenia.  So if you address the physical limitations causing falls you will reduce the frequency of falls and thus reduce fractures.  75% of fractures occur in people without osteoporosis.  80% of low impact fractures occur in people who do not have osteoporosis.  Yes, it is the falls.

Preventing falls among older adults reduces the incidence of fractures, sometimes by over 50%.  Scientific evidence supports a reduction in fall frequency through strength and balance training, followed by reductions in the number of psychotropic drugs, dietary supplementation with Vitamin D and calcium and, in high risk populations, assessment and modification of home hazards.

This is where physical therapy is involved.  A fall prevention program should include targeted strengthening and stretching, static and dynamic balance training, posture modification, home hazard removal and of course an ongoing home exercise program which should be completed on a daily basis.

How do you know if you, a friend or a family member may need a fall prevention (and hence fracture prevention) program?  Answer “YES” to one of the questions below and you should consult with a physical therapist.

  1. Do you have difficulty going from a sitting to a standing position?
  2. Have you fallen without a known precipitating event?
  3. Have you fallen more than once in the past 6 months?
  4. Does it take you longer than 13 seconds to get up from a seated position and walk 10 feet?
  5. Do you have osteopenia or osteoporosis?
  6. Are you unsure if you would benefit from a fall prevention program?

Do your own assessment and decide if you, a family member or a friend may need to address balance issues with a physical therapist.  You will be glad you did.

Motivated to Get Healthy Via the Cost of Healthcare.


My last post on hip pain suggests the need for us all to be educated healthcare consumers and takes us back to the original goal of this blog – to be a credible, unbiased (by selling, advertizing or marketing products, for example) healthcare information source within the expertise of the writer.  Clearly, if it takes 21 months and three providers to correctly diagnose hip pain, we must all be willing and able to ask questions of our healthcare providers (doctors, physical therapists, physicians assistants, nurses, hospitals, insurance companies).

$2.8 trillion ($2,800,000,000,000 – enough zeros?) is estimated to be spent on healthcare in 2013. In 2010, we spent just over $8000 per capita in the US and our life expectancy at birth ranks below countries that spend far less. Spain spends about $3000 per capita and has a life expectancy at birth of 82 and Japan spends $4000 per capita and has a life expectancy of 83.

Consider that the healthcare industry spent $5.36 billion lobbying Congress from 1998 to 2012 while the defense lobbyists spent $1.53 billion. Will this system change to your benefit as a patient?  I do not think it will change in the near future and will thus continue to cost us all way more than we can afford.

I suggest we make the healthcare system challenges a mute point by using this reality as motivation to take charge of our own health. For example, what small lifestyle change can you make to start on the road to a healthier you today?

As a physical therapist I am partial to movement so why not move more each day. That means doing little things such as walking stairs, walking at lunchtime, taking family time and walking around your neighborhood after work with your kids, standing up from your office chair 10 times every two hours, anything you can think of that will increase your activity level.

A dietician may have ideas such as portion control, cutting out refined and fatty foods, eating more fruits and vegetables, drinking more water.  All you dieticians out there, feel free to post your ideas of simple, easy ideas people can use to start the process of improving their health.

What about a wellness visit to your primary care doctor?  Dr Ronald Hicks in Sparks, Nevada has been my primary care physician for almost 17 years.  Every visit I have with him involves discussions about some form of healthy living (sun block, exercise, diet, stress), and I am a health person.  He tells me he has many diabetic patients who do not control their blood glucose using simple dietary restrictions, exercise, regular montoring and medication use.  I am floored by this.  If we know what we need to do to control a disease which is potentially fatal, why do we not do it? (A lead into a future post maybe?)

In conclusion, at Custom Physical Therapy I have the priviledge of working with a variety of wonderful people all of whom have different needs.  Everyday, there are people who can make small changes in lifestyle and thus have large gains in health.  However, such lifestyle changes do not come easy and require motivation.  With this post, I am suggesting we use the cost of healthcare as motivation to make the needed changes to become healthier.  You will save on  healthcare costs down the road as we will only use the expensive healthcare system when we truly need to.  Prevention is the word.

YOUR TO DO LIST:

  1. What one aspect of your lifestyle will you change today to start on the road to a healthier you? 
  2. Post your idea on this blog – I would love to read about it.
  3. Send this post to someone you would like to join with on the quest to save $$$ by becoming a healthier you.
  4. Schedule a wellness checkup with your primary care physician – let the doc know your desire to become healthier.
  5. Be happy and get healthy!