A study conducted by researchers at Harvard University showed that both heel width and height contribute to torque and stress placed on the knees and back. A lower, wider heel puts less stress on the body than a higher, thinner heel such as a stiletto.

A similar study at Iowa State University found that the time spent in high-heeled shoes as well as step size also contribute to the stress placed on the feet, knees and back. Prolonged wear of high-heeled shoes can cause problems for several days. Years of high-heel wear increase the likelihood of osteoarthritis in the knees as well as joint degeneration, the study concluded.

Young high school women who are sports-minded should also beware of the short-term stress that wearing high-heels could put on their muscles and joints, which puts them at risk for injury on the sports field.

Here are some tips for young women and parents for wearing high heels to prom:
Shopping:
• Look for shoes with straps; they increase the body’s stability.
• Wear insoles, not only for cushioning but to spread out the pressure on the foot.
• Make sure the shoes have leather lining to prevent the foot from slipping in the shoe.
• Stay away from pointed toes if you choose high heels. As a rule, the higher the heels should have a more squared toe.
• Avoid a heel height of more than two inches.
• Shop for a second pair of flat shoes for dancing and walking distances.
Pre-Prom:
• Before donning that lovely outfit, do some calf stretches and lower back stretches
During Prom:
• Take along your flats. Reserve the high heels for “picture” time and entry into the grand event.
• Take smaller steps to avoid injury when wearing heels.
Post-Prom:
• Repeat the pre-prom stretches.
• Ice the sore area twice a day for 10minutes and refrain from joint stressing activities for a few days
• If the pain continues for more than a day or two, visit a physical therapist. They can provide you with special exercises to stabilize your legs and back. Don’t “tough it out” as you may injure yourself further.

Dr. Novak has these recommendations from the American Physical Therapy Association:
• Lift smaller loads of snow, rather than heavy shovelfuls.
• Bend your knees and lift with your legs rather than with your back.
• Use a shovel with a shaft that lets you keep your back straight while lifting. A short shaft will cause you to bend more to lift the load. Using a shovel that’s too long makes the weight at the end heavier.
• Step in the direction in which you are throwing the snow to prevent the low back from twisting. This will help prevent “next-day back fatigue.”
• Take frequent breaks and periodically stand up straight and walk around to extend the lower back.
• Backward bending exercises while standing will help reverse the excessive forward bending of shoveling: stand straight and tall, place your hands toward the back of your hips, and bend backwards slightly for several seconds.
• If you experience back pain, consult a licensed physical therapist.

To avoid injury in this and other activities, you may also need to learn some new habits. A physical therapist can evaluate your strength and flexibility and design a fitness program that meets your needs.

Who wants to finally reach retirement and be looking forward to enjoying yourself, only to dread a fall and the fractured bones that go with osteoporosis?

The good news is that osteoporosis, a loss of bone density that makes bones highly susceptible to fractures, can be minimized through exercise.

Who is at risk?

If you’re a woman over the age of 50, you’re four times more likely than a man to develop osteoporosis! Additionally, men and women over 50 who have thin bone frames–or who lose weight during their 50s and 60s–are more vulnerable to osteoporosis, according to WebMD .

Exercise Programs: the Key to Prevention

Amber Hill Physical Therapy’s experienced professionals can design an exercise program that strengthens and improves the health of your bones, improves your posture and enhances your core stability and balance. If you’re in a high-risk category for osteoporosis, set up an appointment at Amber Hill.  We can create an exercise program that will fit your lifestyle and can be done in the convenience of your own home.

Incorporate Your Own Healthy Lifestyle Program

If you feel you’re not at high risk but simply want to follow exercise tips that help bone strength, incorporate activity into your day-to-day life.

Something as simple as walking, classified as a weight-bearing exercise, builds and maintains healthy bones. Exercises that nurture muscle strength can stimulate bone growth and be part of your osteoporosis prevention program.

Other weight-bearing exercises, such as jogging, dancing, hiking and stair climbing, use the weight of the body to counter gravity. Set a goal of 45 minutes or more per session, three to five times a week.

Resistance exercises are recommended for anyone over age 14, and include working out with free weights, exercise machines and resistance bands. These exercises should be done several times a week, but space them out with days in between.

If you have osteoporosis, if you are at high risk for a fall or fracture, or have a medical condition, first consult your physician or an Amber Hill physical therapist before beginning an exercise program, or call Amber Hill’s main office at 301-663-1157.

Donald Novak, P.T., D.P.T., has owned Amber Hill since 2000, and has served as a physical therapist at the practice since 1989.

Sedentary Lifestyles Cause More Issues Today

“An aging population and the fact that many people have sedentary jobs and long commutes causes more issues today than they did in the past,” observed Dr. Novak. He also noted that Amber Hill’s skilled therapists teach patients with sedentary-related injuries stretches and sitting techniques to reduce future problems.

Patients Come First at Amber Hill

“Our longevity and success can be attributed to our motto ‘Patients Come First’,” said Dr. Novak. “All of our staff is dedicated to providing the most professional and pleasant experience possible. We also go the extra step by helping patients with insurance questions, and offering a wide range of morning, afternoon and Saturday appointment times.”

Many loyal patients come back and refer their friends to Amber Hill after they experience our flexible, user-friendly practice.

To learn more about Amber Hill’s patient-first philosophy, hear from Amber Hill’s clinic visitors!

Nearly all cases of low back pain, or lumbar degenerative disc disease, a common cause of low back pain (LBP), can be treated with physical therapy and anti-inflammatory drugs without having to resort to surgical intervention, according to a review in the Journal of the American Academy of Orthopaedic Surgeons.

“Patients are relieved at the results they get after we treat them and teach the appropriate exercises,” said Donald J. Novak, P.T., D.P.T., owner of Amber Hill Physical Therapy. “Too often, people turn to surgery as a “cure-all”, but patients find it very satisfying to know that working their body correctly is something that that they can control.”

Strengthening core muscle groups, including the abdominal wall and lumbar musculature, helps relieve lower back pain. Amber Hill therapists will recommend exercises that focus especially on motor control. The goal is for patients to regain control of their trunk muscles (also known as the transversus abdominis and multifidus) which support and control the spine. Therapists teach patients exercises that isolate and “switch on” these muscles and incorporate these movements into their normal activities.

Symptomatic lumbar degenerative disc disease develops when a disc weakens (often due to repetitive strain), is injured, or deteriorates from aging. As a result, the disc is unable to hold the vertebrae as it should and the lack of stability can cause back pain.

Approximately 75 to 85 percent of adults will be affected by low back pain during their lifetimes.

Talk to your physical therapist or check out Amber Hill’s services  to see the types of common back injuries our staff treats.

 Millions of Americans run for fun, sport and exercise.  It’s an excellent form of exercise, but can take a toll on the lower extremities, especially the feet.  The American Physical Therapy Association (APTA www.apta.org) educates runners about proper foot care and how to prevent injuries.  Here are their tips:

 Start slow and increase distance and speed gradually.

• React to pain and discomfort immediately by using ice, rest and adjusting your training routine. Ignoring a problem only makes it a chronic condition.
• Running surface is key, so avoid hard surfaces and too many hills, as this can lead to painful problems.  Build up to hills slowly.
• Rotate in other types of endurance exercise other than running, to give your feet a break.
• Treat redness or blisters immediately.
• Hydrate, hydrate, hydrate.
• Seek evaluation and treatment from a physical therapist if needed by calling Amber Hill Physical Therapy at 301-663-1157 or go to their website at www.amberhillpt.com

 The most important first step is to invest in a good pair of running shoes that fit well and offer your feet proper cushioning and support.  Running shoes are specially designed to absorb and minimize the traumatic force that running puts on the body.  And remember, your running shoes have a limited lifespan.  The shock absorption runs out long before the outside of the shoe looks like it is worn.  Generally, the support of a running shoe lasts 500 miles.

 Running provides immediate health benefits, including cardiovascular health, lower blood pressure, lower cholesterol, an increased metabolism, and a positive sense of self-esteem and well-being. 

 For running events in and around the Frederick area, check out the Maryland Running Guide at www.marylandrunning.com; for avid runners may want to visit the Frederick Steeplechasers Running Club website at http://www.steeplechasers.org/ for more information and summer running events.

There are no equipment costs other than a pair of supportive shoes associated with walking, you can walk solo, with a friend, with a pet, or in a large group.  Walking exercises almost every muscle to some degree, including your peace of mind.  For walking trails in and around Frederick, Maryland, go to www.md-frederickcounty.civicplus.com.

Sunshine, warm weather and a little free time are all the motivation many of us need to enjoy the benefits of a walk.  These include:

• It’s free & can be done anywhere
• Burns calories with your first step
• Strengthens back muscles
• Slims waist
• Strengthens bone mass
• Lowers blood pressure
• Shapes and tones legs
• Cuts cholesterol
• Reduces risk of heart disease & diabetes
• Lowers stress level
• Sleep sounder
• Improves mood

 Starting a Walking Program

Begin walking slow and steady, especially if you are not normally active.  Just walk at a comfortable pace as fast and far as you can, gradually increasing your pace and distance in time. 

Try to walk 30 minutes per day.  If you cannot do it all at one time, break it up throughout the day.

Location, location, location … can make all the difference in keeping you motivated.  You can walk out your own front door, head to an indoor mall, or map out a fun and scenic route by going to www.mapmyrun.com.   This simple mapping website is designed to empower the active lifestyle and simplify your planning.  You can follow  local pre-planned routes, or create your own based on location, distance or type of walk.  Try it and then share your experience!

Keep Yourself Loose 

Our physical therapists at Amber Hill Physical Therapy, www.amberhillpt.com, recommend that you include warm ups and stretching to minimize any risk of injury.

Warm up by walking at a low intensity to get your blood circulating.

1. Warm up by walking at a low intensity to get your blood circulating.
2. Perform flexibility exercises such as toe points, ankle circles, leg stretches and side stretches.
3. As you begin your walk, move at a quick pace that elevates your breathing, but does not leave you gasping for air. 
4. Cool down the final five minutes by walking at a slower pace.  As your overall walking time increases, so should your cool down time.
5. Finally, repeat all of your initial stretches to loosen muscles that tightened up during your walk.

Annual Bike to Work Participant, Mike Johnston, P.T., Clinical Manager at the Amber Hill Physical Therapy Clinic will join the bikers again this year. Mike is an avid biker with over 10 years experience.  His 20 years as a physical therapist have provided him with an overall awareness of the value and joy of biking. 

-         Biking is an ageless exercise – it is easy on the body (no pounding).  Even those with arthritis can benefit from this non-weight bearing exercise.

-         Group rides make it a healthy and fun social experience.

-         Scenic routes make it a beautiful way to get your heart rate up.

-         Stretching before and after a ride is key, especially the quadriceps, hamstrings and neck muscles.

-         Padded bike shorts are a number one purchase, after the helmet of course.  And breathable clothing that protects from the sun and limits perspiration is ideal.  Bike gloves serve two purposes – protecting the nerves in the hands and limiting hand abrasions in case of a fall.

-         Call Mike with any questions or additional tips at 301-271-9230 or visit the Amber Hill Physical Therapy website at www.amberhillpt.com.

“National Capitol Region Pit Stop” in Frederick, MD

The City of Frederick is participating with one of the National Capitol Region “Pit Stops” at the East Street MARC Train Station.  Free food and promotional items will be offered by local sponsors Bicycle Escape and The Market Street New York Bagel and Deli.  All commuters with a bicycle will ride the MARC Train for free on Bike to Work Day.  Local officials and all those who love to bike will join the festivities from 6:30-8:30 a.m.

 A “Ceremonial Ride” from Frederick City Hall, 7:00 a.m.  The festivities commence at 101 North Court Street and proceed to the East Street MARC Train Station.  All are welcome to join in this exciting ride!  Tips for bicyclists commuting on TransIT buses and trains can be found at www.co.frederick.md.us/Transit/BikeBrochure.pdf.

 Weeding, digging, raking and spreading mulch all take quite a toll on our shoulders, neck, back and knees.  The American Association of Physical Therapy (www.moveforwardpt.com) gives some quick and easy tips to escape the aching muscles and potential injuries that come with gardening, especially “opening day.”

 Warm-up Your Muscles

Start with a warm-up just as you would before a workout at the gym – a quick walk, stretching or a jog around the yard – these all get your blood moving.  Remember, gardening can be more of a workout than you’ve had all winter, so start slow and steady and if you feel pain, stop

 It is helpful to think of it as a workout. You wouldn’t go run a marathon on the first day of running. Working on a couple short tasks over a couple of days to a week will allow your body to get use to the new activity level.

 Change Things Up

Break your tasks into short time intervals, changing tasks frequently.  Then you can return to finish tasks later. This allows you to change positions often and minimizes the stiffness that occurs when muscles and joints are locked in one position. By varying your tasks, you don’t overload any one particular group of muscles. This helps decrease the probability of sore muscles and joints.

 If you are the “ I just want to get it done!” type, using a timer set for 10-15 minutes can be helpful reminding you to take a break before you get painful.

 Use Caution When Lifting

Lift very cautiously, using your legs and lifting small amounts at a time.  If possible, use a wheelbarrow, wagon or garden cart for the heavy plants and tools, and ask for a second set of hands if you need them. 

 Take Care of the Knees

Protect your knees by avoiding kneeling on both knees at the same time.  Keep one foot on the ground to steady your back … this simple step takes half the pressure off your knees.  Gardening pads or a cushion can also absorb some of the pressure when kneeling for prolonged jobs.

 Tools of the Trade

Sometimes you need a little extra help. Sitting on a gardening stool or even an empty bucket for low-to-the-ground jobs helps decrease the strain on knees, legs and low back. Scott Quackenbush, Physical Therapist with Amber Hill Physical Therapy and avid gardener recommends several of the new adaptive tools available such as long handled trowels and forks that decrease the need to bend over. There are also varied types of handles that allow for decreased strain on the wrist and hands.

 Gardening is a favorite spring and summer activity for all age groups.  Following a few easy tips can lead to both beautiful blooms and a pain-free season!

 For more tips on avoiding strain this spring and summer, talk to your Amber Hill physical therapists .  Visit our website for more information on the office closest to you!

For complete information on Amber Hill Physical Therapy and the many services we offer, please visit our website, www.amberhillpt.com.