1. Remain Active: Hands down this is number one on the list. Staying fit and active has the potential to add years, maybe even decades to your life. Regular exercise helps to reduce body fat, increase muscle mass, decrease blood pressure, and drops your risk of diseases of all kinds, such as diabetes and cancer. Plus, exercise doesn’t have to be a run-until-you-drop daily grind. It can be anything you enjoy, such as dancing, gardening, cycling, aerobics, or anything else that gets you up and moving.

2. Weight Train: Not only does weight training protect against lost strength and muscle mass as you age, it helps build bone density and decreases your risk of a fracture (all of which are important for maintaining independence as you get older). Weight training doesn’t have to be done in a gym either. Resistance bands and calisthenics (body weight exercises) make strength training easy to do at home (for more info, see my blog post on strength building).

3. Eat Less: The average adult gains 2-5 lbs. each year. Over time, this adds up to startling amounts and leads us down the scary path of obesity-related diseases. But why does this happen? As we age, our caloric requirements decrease, but most of us persist in eating the same foods in the same portions as we always have. Focus on lean protein and whole grain carbs, but make fruit and vegetables the foundation of your eating. See your doctor or nutritionist if you have special dietary needs or want more information on what kind of eating plan is best for you.

4. Find a Challenge: Everyone likes to have something to look forward to – a goal to reach. Whether it’s a taking a new class at a community college or finishing a 5k run/walk, challenges keep us motivated to improve ourselves.

5. Embrace Change: By the time we reach middle age or retirement, many of us are pretty set in our ways. But even at that late age, our lives are still changing, and the young-at-heart people that I’ve met over the years weren’t afraid to adjust their habits if they felt they could be doing something better. Maybe it was a late in life change to whole grain bread over their usual slice of white, or finally embracing the fact that their day goes a lot smoother if they get to bed on time the night before. Whatever it may be, if you’re stuck in a rut, don’t be afraid to get out.

Who says our age has to define us? Every day I see reasons why our golden years should be the best of our lives. Keep moving, my friends!

- Alan

Based on observations during my 25 year (so far!) career as a physical therapist, here is my list of the top 5 things that make us feel old. And best of all? Each of these causes is changeable by YOU!

1. Smoking: This had to be number one. Smoking increases blood pressure, damages lung tissue, and decreases cellular elasticity (including that in your blood veins), which means your cardiopulmonary system must work increasingly harder to do the thankless task of keeping you alive. It also discolors teeth, wrinkles skin, and yellows fingernails, so you will look much older than you actually are. Step one towards the fountain of youth? Kick the nicotine habit (get support here).

2. Moving Less: As kids, we ran around and played. As adults, we sit on the porch watching the kids run around and play. This is accepted as a very natural part of aging, but it is in fact the root of oldness (items 3, 4, & 5 on this list are directly linked to decreased activity levels). When we reduce our movement and become more sedentary, we set ourselves up for weight gain and lost physical fitness – a negative double whammy that contributes toward statements like, “I just can’t do (insert activity here) like I used to.”

3. Shrinking Muscle Mass: Muscle strictly adheres to the “use it or lose it” principle, so one of the direct consequences of an increasingly sedentary lifestyle is decreased muscle mass. The less muscle you have, the weaker you will be. The weaker you are, the less you can do things for yourself. The less you can do things for yourself, the less likely you will be able to live independently in your senior years. For everything from picking up your grandkids to carrying in your own groceries, you need muscle mass.

4. Inflexibility: When many people think of flexibility, they might think of the old bend-down-and-touch-your-toes test, but flexibility encompasses much more than that. Can you reach your back in the shower? Can you look over your shoulder while driving? Can you complete your daily activities without trouble? It’s true that muscles and tendons do shorten as a result of aging, but this is exasperated by being sedentary. A further danger of inflexibility is an increased risk of injury as your body is not prepared to withstand any sudden or unexpected motion.

5. Painful Joints: After a lifetime of use, it’s only expected that the body’s natural cushioning for your joints (called cartilage) should begin to break down. This is called arthritis, and though it may seem counter-intuitive, moving painful, arthritic joints is actually the best thing for them. Check out our FREE arthritis article here.

Aging is a somewhat arbitrary thing. You’re only as old as you feel, or so the saying goes. Yet some people run marathons into their 70s and 80s while others resign themselves to rocking chairs by 50. You don’t have to be part of the former group, but don’t let yourself join the latter. Fight aging by addressing these top 5 “feel old” causes, and you may just give your grandkids a run for their money. Keep moving, my friends!

- Alan

For reasons not yet entirely understood, there is a correlation between spending long amounts of time sitting and an increased risk of death (you can read two such articles here and here). What’s more, the correlation holds even if you exercise regularly. This isn’t just important news for coach potatoes, but also those who work 8-10 hours a day at a desk job. All of us can (and should) decrease the amount of time we spend watching TV, surfing the internet, and playing video games, but we can’t so easily quit our jobs. So what can we do to combat this scary statistic?

Some businesses are installing standing desks and treadmill desks to help their employees spend less time sitting, but if your office can’t afford that kind of investment, there’s a simple solution – just stand up. At least once per hour (set a timer if you need to), stand up from your desk. Spend a few moments walking around and gently stretching before returning to your chair. Pretty easy, right?

It will also help to reduce your risk in other areas. Even though it won’t protect you from the dangers of excessive sitting, make sure you do get the recommended amount of exercise (30 min of moderate level physical activity at least four days a week, but more is even better). In addition, stay away from the cigarettes, junk food, and excessive alcohol that we know to be harmful and receive annual checkups from your doctor.

Death by sitting sounds too ridiculous to take seriously, but it’s a legitimate (and fortunately, easily preventable) hazard of our modern world. Starting right now, take standing breaks every hour – or more often – so you can stick around long enough to find out what else science will surprise us with. Keep moving, my friends!

- Alan

I’m borrowing an idea from Pat Croce here. Croce is an icon in the physical therapy and business worlds. He’s an entrepreneur, writer, and TV personality. He’s a former owner of the Philadelphia 76ers and recently opened a pirate-themed museum. But what first drew me to his advice was his business savvy. As a physical therapist, he grew a chain of 40 physical therapy centers and later sold it for $40 million. As the saying goes, not too shabby.

As Croce asserts (I’m adapting his ideas here), fitness can be achieved by following three steps:
1. Analyze, 2. Commit, 3. Schedule.

1. Analyze: When creating a financial budget, you analyze what you have to work with – your income and your bills – and you identify areas in which you can trim spending and increase savings. Exercise is much the same. Your fitness program should begin with a trip to your doctor to analyze what you have to work with, i.e. your cholesterol, resting heart rate, blood pressure, body fat percentage, etc. Then you identify areas that you can improve in, such as lowering your cholesterol and your blood pressure. Rather than just saying, “I want to lose 15 lbs,” this approach gives you many areas to succeed in. That way, if those 15 lbs. are coming off a little slower than you’d like, you can look at your new lower resting heart rate and improved blood pressure as markers that you are healthier and heading in the right direction.

2. Commit: A budget won’t work unless you commit to following it. A fitness program is the same way. Current guidelines suggest that adults need 30 minutes of exercise on most days of the week (for those of you doing the math, this means at least four days each week). To accomplish this, you need to commit to two hours of weekly exercise. Considering there are 168 hours each week, this should be relatively simple (it amounts to only about 1% of your time). But if you don’t prioritize it, those two hours will seem as impossible to find as an extra 70 hours. Without legitimate commitment, success is impossible.

3. Schedule: Many aspects of our financial lives are decidedly inflexible. For example, that credit card bill is due on the 6th, not “sometime around the 6th.” If your payment is late, you get late fees. While I do advocate for a certain amount of flexibility in work-outs (it helps keep it fun and prevents burn-out), you also have to be honest with yourself. If you know that you easily find excuses to skip exercise, you might need to schedule your workouts with the same “no choice” quality that bill due-dates have. Write it on your calendar and put reminders in your smart phone. That way, you won’t be able to schedule other commitments at the same time.

Achieving fitness already requires hard work, so why complicate it any more than we need to? Follow these three steps for physical (and financial) success this new year. Keep moving, my friends!

- Alan

1. Portable TENS unit. Officially called “transcutaneous electrical nerve stimulation,” these handy little units produce gentle electrical currents that massage muscles and nerves via electrode pads placed on the skin. When coupled with an ice pack, you have the ultimate in drug-free pain relief! Just apply to painful areas for 15-20 minutes at a time, as often as you like. While TENS units will often sell for $100 or more, you can purchase one at our office for only $35.
2. Jump rope. Jump ropes are cheap, portable, and perfect for on-the-go, do-anywhere cardio.
3. Kitchen timer. This is a gift that might need to be accompanied by some explanation. Believe it or not, in our clinic we use dozens of kitchen timers all day long. They’re an essential physical therapy accessory. While we typically use them to time exercises and stretches, they can also be used as an activity reminder (set for one hour intervals to remind you to get up from your desk/couch and move around; this helps prevent back pain, blood clots, and other sedentary-related ailments) or a posture checker (set for shorter intervals to remind you to re-evaluate your posture; good for neck and back pain sufferers).
4. Sunscreen. Yes, it’s winter, but let’s not forget that Boise ranks #1 in the nation for skin cancer deaths. Wear sunscreen with SPF 15 or greater. Every. Single. Day.
5. A weekly activity date. It’s one of the most common pieces of advice for those trying to begin or maintain a consistent exercise program – get a workout buddy. But don’t let words like “exercise” or “workout” intimidate you. The idea of a weekly activity date is just to set a regular time where you and your loved one do something active that you enjoy. It can be dancing, cycling, walking – anything you find fun that gets you moving. You can even give them a calendar with your weekly activity dates already marked inside.

I hope you enjoy a safe and happy holiday season with your friends and family! Keep moving, my friends!

- Alan

This was our fourth medical mission trip with Chapel Missions India. In many ways, this tour was the same as previous ones, and there are some things I’ll probably never get used to. Homeless children are as common (and treated worse) than the feral cats we have here. Women are still viewed as property, and daughters are essentially worthless if the family doesn’t have at least one son. And everywhere you can see evidence of an easily-treatable or easily-preventable medical condition that has been allowed to progress to debilitating levels.

But this trip was also very different than the others. Our total focus was treating lepers. We spent five days at the Scheffelin Leprosy Institute & Research Center, the world’s most premier leprosy facility (I was seriously geeking out), while the remainder of our trip was spent in two different leprosy communities – one government run, the other sponsored by Calvary Chapel.

Since many people in India go their whole lives without ever seeing a doctor, we are usually welcomed with open arms, but I was not prepared for our greeting at the Calvary Chapel leprosy community. There was music and dancing, banners and food – we were even adorned with flowers. The lepers broke out the best of everything they had just for us. It was a wonderful celebration, but at the same time, it was very humbling.

I’ve never seen ant hills that reached 6-8 feet tall before! And there were mongoose everywhere – big mongoose. We were told they grew so big because there were “many cobras to eat.” That must’ve been very true; in fact, we were forbidden to walk the grounds after dark because of the danger of encountering the deadly snakes.

Despite their poverty and crippling condition, the lepers at the Calvary Chapel community were joyful. They had good food and good facilities, but they also supported, prayed, and cared for each other. The government-run leprosy community, however, was startlingly opposite. Patients lay dying in horrific pain, alone, receiving only minimal medical care (or none at all). It was pretty much the worst situation I could imagine.

Leprosy is a condition which affects, among other things, peripheral nerves, such as those in the hands, feet, and face. As sensation is lost, it becomes harder to realize when you have hurt yourself, and once injury does occur, the healing process is difficult and complicated. As expected, the wound care portion of our medical team was overwhelmed with the number of patients needing treatment, but physical therapy was just as in demand.

In addition to the residents of the two leprosy communities we visited, we treated an incredible number of people who traveled from a leprosy community 10 hours away, most of whom had already had their legs amputated. We gave away 75 wheelchairs (courtesy of Free Wheelchair Mission), as well as many canes, crutches, and walkers.

As always, we feel blessed to be given the opportunity to go across the world to help those in need, and we feel just as blessed to be able to come back. Thank you all for your prayers and well-wishes. We’ll need them again next year! Keep moving, my friends!

- Alan

Typically these missions are centered around medical camps provided for orphans, HIV/AIDS patients, and those in the slums. I approach them with the knowledge that I’m going to see relatively the same conditions I treat here at home (back and neck pain, arthritis, carpel tunnel syndrome, etc.) mixed with a few more unusual cases (complications from polio, malformations due to nutritional deficiencies, etc.). I arrive armed with exercises and stretches to teach to patients, as well as canes, walkers, and crutches, so they can manage their condition after the medical team has gone.

But the focus of this year’s trip is leprosy communities. We’ll be spending 3-5 days at the Christian Medical College & Hospital in Vellore (where Dr. Paul Brand did his world-famous research on hand, foot, and facial reconstruction). We’ll stay another two days in a leper community itself, then stay in a monastery the rest of the time. We have 75 wheelchairs to give out (courtesy of Free Wheelchair Mission), and for those patients who’ve lost fingers to their disease, we have 600 leather straps (handmade by members of Calvary Chapel Boise) that can be fitted with a utensil and looped around hands or wrists to aid in eating and personal hygiene.

And that’s all I know.

Leprosy is a condition that affects, among other things, peripheral nerves, such as those in the hands, feet, and face. As sensation is lost, it becomes harder to realize when you have hurt yourself, and once injury does occur, the healing process is difficult and complicated. Contrary to myth, body parts don’t rot off if you have leprosy, but they may become damaged beyond repair and then amputation is often necessary.

I know God sometimes places us in situations where we feel inadequate so that we will learn to rely on Him. I am definitely feeling that here. If I knew I could visit the patients regularly over the course of weeks or months, I would use treatments such as electrical stimulation and ultrasound to help maintain existing nerve function and delay the spread of the disease. But in India, there will be no equipment to do this, and we’ll only get one chance to see each patient – just one chance to share some sort of medical wisdom that could improve their quality of life or even help them live longer. What will I say?

Right now, I don’t know, but I have faith that when the moment comes, God will give me the words. Your thoughts and prayers for Bette, myself, and our entire team are much appreciated, and if you’re able, every donation allows us to make an impact in the life of another impoverished person in India (you can even choose how you’d like the funds to be used!). We return home just before Thanksgiving, and I’ll let everyone know how our trip went. Until then, God bless you, and keep moving, my friends!

- Alan

Long before I even graduated from physical therapy school, I knew I wanted to go into private practice. Yes, there were risks (people tend to think of business owners as wealthy, but this isn’t always the case; if the business isn’t making money, you are the first one to go without a paycheck, and if the business fails, well…), but the benefits made any danger well worth it.

Going into private practice and becoming my own boss meant a chance for me to get out of the hospital system, to be able to focus on treatment rather than policies and politics. It meant I would never again be “down-sized” (I had been laid off three times in the past four years). It meant stability for my family (no more changing schools because Dad found a job in the next state).

Of course, it meant I had a lot to learn as well. I had to learn how to hire employees, and unfortunately, sometimes how to fire them. I had to learn about things like payroll taxes and SIMPLE IRAs and third quarter projections. Opening my clinic was a crash course in business management and marketing, so it’s a good thing I love to learn!

So much has changed since Idaho Physical Therapy opened. Back then, IPT was the only private physical therapy practice in the Treasure Valley. Now sometimes it seems PT offices are a dime a dozen. Healthcare is always changing, as are government regulations and insurance reimbursement rates, and with universal healthcare on the horizon, the status quo is primed to be turned on its head. We used to get the bulk of our patients via referrals from doctors, but hospitals have taken away a huge chunk of that pie (see more of my thoughts on that here). Fortunately what now keeps the doors open is what has always made IPT great – we don’t just help our patients get better, we create relationships with them.

This is an area that has always been important to me. When you come to Idaho Physical Therapy, you’re not “account number 316055.” You’re not “53 year-old female with osteoarthritis.” You’re Jan, opera enthusiast and mother of three, or Frank, retiree who is teaching his grandson how to fish. We remember your name without having to check your chart. As a small business, we have the flexibility and immediacy of response to send birthday cards or congratulatory flowers or movie tickets as our thanks for referring us your friends and family members. When you call us for treatment, you don’t get put on a waiting list and you don’t have to schedule your appointment a month out. All our new patients are seen within 24 hours. When you’re in pain, why should you have to wait?

Considering that less than half of small businesses make it to their fifth anniversary, let alone survive a decade, I feel beyond blessed that Idaho Physical Therapy is still here 20 years later. I’d like to give my heartfelt thanks to my wonderful staff, my supportive family, and of course, the best patients in the world. This 20th anniversary celebration goes out to all of you. Keep moving, my friends!

- Alan

With so much volleyball all the time, we became very familiar with all the common injuries faced by volleyball players. As with most injuries, they fall neatly into two categories – acute (meaning sudden or short-term) and chronic (meaning long-term). Here’s a quick run-down of the most frequently seen ailments:

• Shoulders, shoulders, shoulders! Because so much of the game of volleyball requires overhead movements (setting, serving, hitting, and blocking), athletes must constantly battle overuse syndrome in their shoulders, especially rotator cuff tendonitis and surpascapular neuropathy (irritation and compression of the nerve along the shoulder blade). If your pain is sudden and intense, you should see your physical therapist or doctor to rule out a torn rotator cuff.
• Sprains are very common in fingers, wrists, and ankles. These generally happen when blocking (from a ball striking the fingers or when landing awkwardly, such as on the foot of a teammate) and diving (inexperienced players often try to catch themselves to lessen their impact with the floor, thus putting strain on their wrists).
• Because volleyball involves more jumping than just about any other sport (except maybe competitive trampoline), many players develop “jumper’s knee,” which is also called patella tendonitis. This is an overuse syndrome involving the tendon that connects the kneecap to the tibia. Care must always be taken to keep the tendon in good condition, lest it rupture.
• As with any sport that involves twisting, diving, and jumping, back problems occasionally develop, but they are more common in athletes with less flexibility, poorer conditioning, and improper technique.
• Speaking of flexibility, muscle strains also happen from time to time, although they are much rarer in athletes that regularly play volleyball. You are more likely to experience a pulled muscle if you play after an inadequate warm-up, return after a long lay-off, lack good physical conditioning, or are tired and/or dehydrated.
• Bruises are one of the hallmarks of a volleyball player (for those who don’t know, bruises are caused by broken capillaries that bleed under the skin); they typically appear on knees, hip bones, and elbows. Although they aren’t generally serious, care should be taken to allow damaged capillaries time to heal; repeated bashing of an already bruised area can lead to a hematoma (a swollen lump) and the risk of compartment syndrome (where blood flow is cut off to the involved tissue).
• Of course, every sport has the risk of more serious injuries, and volleyball is no exception – knee ligaments may tear from a sudden change in direction, wrists and/or fingers may break or dislocate, and players may collide with one another and receive a concussion.

Fortunately volleyball is not a true contact sport, so it’s relatively easy to prevent these injuries.

• Stay in shape, with adequate cardiovascular, strengthening, flexibility, and plyometric components to your workouts.
• Wear protective gear. This usually means kneepads, but you can also wear ankle, knee, and wrist braces, mouth guards, and athletic tape (for areas that just need a little help rather than injuries that require more substantial support).
• Learn proper technique for all activities.
• Be aware of your surroundings on the court so you do not run into another player or other obstacle.
• Get adequate rest, and treat all minor injuries with R.I.C.E. (Rest, Ice, Compression, and Elevation). Remember that in general, the longer you’ve had an injury, the longer it will take to go away, so don’t delay treatment.

Volleyball is one of my favorite sports to watch, and for my now-grown girls, it’s still their favorite to play. Follow the above tips for a more injury-free season and make sure you’re always ready to step on the court. Keep moving, my friends!

- Alan

The good news is that nearly all children naturally want to be active. The bad news is that those desires are compromised by too much television, excessive computer time, and our own bad examples as parents. Not to sound cheesy, but children really are the future, so it’s worth it periodically to re-evaluate whether we are doing all we can to make sure they grow up healthy and happy.

September is National Childhood Obesity Awareness Month, so it’s a great time to establish some new healthy habits for your family. Here are a few starter ideas, but I’m sure you can come up with a lot more:

• Look in the mirror. Despite how it often seems, our kids will do what we do. Sometimes it can be pretty subtle too. If you lean back in your chair at mealtime, proclaim yourself “totally stuffed,” yet still reach for another slice of pizza, it sends the wrong message. Your reasons for skipping workouts (and your attitude toward exercise in general) will also be absorbed by your progeny. This month, find one area where you may not be setting the best example for your kids and work to change it.

• Don’t buy the hype. The other day in a grocery store, I passed a display that read “Fuel for School!” over boxes of Rice Krispy Treats and Fruit-by-the-Foot snacks. The sad reality is the vast majority of advertising claims about food products are meant to confuse you. Just because the package says “healthy,” “all-natural,” “energizing”, “multi-grain,” or “fortified with vitamins and minerals” doesn’t necessarily mean the product is any better for you than a king-size candy bar. Because food labels can be so baffling, remember the “More = Less” Rule – the more processed a food is and the more ingredients it has (especially if you don’t know what they are), the less nutritional value it has. Because unfortunately, the only thing Rice Krispy Treats and Fruit-by-the-Foot will fuel is a sugar rush followed by a lethargic, cranky afternoon.

• Provide active outlets. You can’t just tell someone to get more exercise; you have to show them how. This is true for adults as well as kids. Schools provide some of the activities kids need in their lives (such as recess, physical education classes, and after-school sports), but don’t count on your child’s school to give them all the exercise they need. Encourage your kids to try a variety of activities – everything from organized team sports to more individual pastimes like dance or skateboarding. Younger kids will have a wide interest level that will usually narrow as they get older, so don’t pressure them to be soccer, soccer, soccer, all the time, right now, or you risk ruining their enthusiasm for the game. Letting them choose the activities that excite them the most is one of the best ways to insure they remain active long term.

If you’re still not sure how to work more exercise into your family, why not start with a good ol’ fashioned walk? There are a variety of nearby greenbelt trails perfect for walking, jogging, biking, or skating (check out a map of Nampa trails here). For even more information on raising healthy kids, visit LetsMove.gov. Keep moving, my friends!

- Alan