In the realm of sports–related injuries, the hamstring is one that most people are at least somewhat familiar with. This makes sense, as a pulled hamstring—or hamstring strain—is one of the more common injuries in sports. The pain and movement restrictions that result from this type of injury usually prevents an athlete from participating in their respective sport for some time, but following a course of physical therapy can lead to a fast recovery and safe return to sports for patients dealing with a hamstring strain.

Although it might be assumed to be a single muscle by some, the hamstring is a muscle group consisting of three separate muscles—the semitendinosus, semimembranosus, and biceps femoris—that run down the back of the thigh from the lower part of the pelvis to the back of the shinbone. These three muscles serve a crucial role, as they help the knee joint to bend (flex) and the hip joint to straighten (extend). The hamstring is balanced by the quadriceps muscles in the front of the thigh, which are responsible for the opposite function: extending the leg at the knee joint and flexing the thigh at the hip joint. Together, they control the power and stability of the knee joint and allow for running and other activities.

A hamstring strain can involve any of the three hamstring muscles, and the most common cause for an injury is overloading one or more of these muscles. This can occur when a muscle is stretched beyond its capacity or challenged with a sudden load, which is why hamstring strains are so common in sports, especially those that involve lots of sprinting or sudden changes in direction. Therefore, athletes who participate in basketball, football, tennis, soccer, and the sprinting events of track—as well as dancers and gymnasts—have the highest risk for sustaining a hamstring strain. Other risk factors include prior hamstring injury, muscle tightness, poor conditioning, and older age.

When a hamstring strain occurs, the most common symptom is a sharp pain in the back of the thigh that may be felt immediately. Patients may also feel a “popping” or tearing sensation in this region, which may be followed by tenderness or swelling that may develop within a few hours. Some patients may experience bruising or discoloration on the back of the thigh or persistent weakness in this area as well.

Physical therapists always ensure patients are ready to return to sports

A hamstring strain may sound like a daunting injury, but for most patients, conservative (non–surgical) treatment and some time away from sports is all that’s needed. Physical therapists are uniquely positioned to manage patients with hamstring strains and can help them recover quickly and safely through individualized and evidence–based treatment. A standard treatment program for a patient with a hamstring strain will consist of the following:

• Range of motion exercises: once initial pain and swelling have subsided, the patient will start with some gentle stretching exercises like a hamstring stretch to improve flexibility
• Strengthening exercises: includes various strengthening exercises to build back strength in any areas that are weak
• Manual therapy: involves the therapist applying hands–on techniques to the patient’s muscles and joints to alleviate pain and improve range of motion and strength
• Functional training: this type of training includes exercises that are specifically catered to the sport or activity that the patient is returning to

Another significant benefit of having physical therapy for a hamstring strain is that therapists always take every measure to ensure that athletes don’t return to sports until they have completed their rehabilitation and can do so with a minimal risk for injury. This is accomplished by structuring the timeline of programs based on the average time needed to recover from a hamstring strain, closely evaluating the athlete’s progress along the way, and then assessing the athlete when they are nearing a return to ensure they fulfill all appropriate criteria. Only then will the therapist provide the go–ahead that the athlete can safely return to his or her sport.

According to a proposed algorithm for hamstring strains, an athlete will be ready to return to their sport once they meet the following criteria:

• No tenderness when pressure is applied to the hamstring
• Adequate muscle strength based on strength testing
• No insecurity on the active hamstring test, which is done by performing a straight leg raise as fast as possible to the highest point without fear of injury
• Ability to complete 30 or more repetitions of the single leg bridge test
• No pain or hesitation with sport–specific movement testing (eg, accelerations, decelerations, rotations, sprinting, cutting, pivoting, jumping, or hopping)

So if you’ve recently injured yourself and your symptoms sound similar to a hamstring strain, we strongly recommend seeing a physical therapist to help you get started on your path to recovery.

If you have a tough time ending your day without reaching for a piece of chocolate—or four—to satisfy your sweet tooth and give you that blissful boost that few other foods can provide, you might want to up. Although dark chocolate certainly tastes good and may provide several health benefits due to its high concentration of antioxidants—which can improve heart health and other conditions—a recent study has shown that several dark chocolate bars contain lead and cadmium, two heavy metals that have been linked to a variety of health conditions.

Chocolate makers are aware of this issue for some time and have been trying to find ways to reduce the levels of these metals for some time, but it’s been unclear whether they’ve succeeded. Therefore, scientists at Consumer Reports performed a study in which they measured the amounts of heavy metals in 28 dark chocolate bars, and the results were less than encouraging.

The scientists tested various brands of dark chocolate bars, including lesser–known brands as well as popular brands like Dove and Ghirardelli. They found lead and cadmium to be present in all 28 bars, and for 23 of these bars, eating just one ounce of chocolate per day would put an adult over the level that experts say can be harmful to one’s health. Consistent, long–term exposure to heavy metals like lead and cadmium can lead to numerous health conditions, such as nervous system issues, hypertension, immune system suppression, and kidney damage. The risk for health problems is highest in pregnant women and young children, as exposure to these metals can affect brain development and cause developmental delays.

Lead and cadmium? How did they get in my chocolate?

As you’re processing the—probable—shock of reading that your favorite dark chocolate bar likely contains unhealthy levels of lead or cadmium, your next question might be: why are these metals found in chocolate?

Chocolate is made from the cacao bean, which is composed of cocoa solids and cocoa butter, which are together called cacao or cocoa. Dark chocolates are generally at least 65% cacao by weight, which means they have high concentrations of cocoa solids. These cocoa solids are where the nutritional value of dark chocolate is derived, since they are packed with antioxidants called flavanols that are associated with better blood vessel function and lower cholesterol and inflammation. But the cocoa solids are also where heavy metals like lead and cadmium are found, which is why levels are so high in dark chocolate.

These two metals get into chocolate through different mechanisms. Cacao plants take up cadmium from the soil and the metal accumulates in the cacao beans as the tree grows, while lead appears to enter cacao after the beans are removed from pods and dried out, during which time lead–filled dust and dirt accumulates on the outer shells of the beans. But because of these different entry methods, the techniques used to reduce lead and cadmium levels are also different. For lead, changes are needed in harvesting and manufacturing practices to minimize the amount of lead–contaminated dust that lands on gets into the beans as they’re processed, while reducing cadmium levels is more difficult and may require carefully breeding or genetically engineering plants to take up fewer heavy metals, which will take much longer. Chocolate producers can also survey the areas in which they grow cacao and favor beans grown from regions with lower levels, or blend beans from high–level areas with lower–level areas.

And for you, the consumer, here are some tips to help you navigate this new bombshell on your favorite treat:

• Choose dark chocolates with the lowest levels of heavy metals (see the Consumer Reports article for more details)
• Limit your chocolate intake to only a few days per week, at most
• Try dark chocolates with lower cacao percentages (eg, 65–70%), and consider alternating it with milk chocolate (but remember that milk chocolate is higher in sugar)
• Don’t give kids much dark chocolate
• Eat a well–rounded diet that’s high in whole grains and fruits and vegetables, and low in processed foods and those that are high in refined carbs and sugars

The long and short here: there’s no need to ditch your chocolate habit altogether because of these findings, but you should reevaluate your chocolate intake and make necessary changes to ensure that you’re limiting the amount of lead and cadmium you’re consuming.

About 25,000 people sprain their ankle every day, and in most of these incidents, sports are involved. Ankle sprains represent the most common injury in sports, as they account for a whopping 45% of all sports–related injuries. But this risk varies widely between sports, with football, basketball, and soccer being associated with the highest rates of ankle sprains because they involve high speeds and frequent changes in direction. In football, for example, ankle sprains occur at a rate of 1/1,000 hours, meaning that one ankle sprain occurs for every 1,000 hours of participation.

These statistics may seem daunting, but a recently published review has shown, most ankle sprains can be effectively treated with a conservative treatment program that involves evidence–based rehabilitation.

Ankle anatomy and grading system

Ankle sprains involve the ligaments of the ankle joint, which are flexible bands of tissue that connect one bone to another. Ligaments are elastic and can be stretched to a certain length and then return to their original position, but they have a limit. When any ankle ligament is stretched beyond its maximum range of motion, damage will occur, and the result is an ankle sprain. Ankle sprains are generally categorized into the following three groups:

• Grade 1 (mild): ligament(s) stretched but there is no tear; symptoms involve mild pain and tenderness, some swelling and stiffness
• Grade 2 (moderate): most common type of sprain; ligament(s) partially torn; symptoms include significant swelling and bruising, moderate pain, and trouble walking
• Grade 3 (severe): ligament(s) completely torn; symptoms involve severe swelling and pain, especially while walking, instability of joint, extreme loss of motion, possible difficulty bearing weight on foot

Depending on its location in the ankle, a sprain can be further categorized as either lateral, medial, or high. Lateral ankle sprains take place on the outside part of the ankle, which is the most common site for a sprain (about 80% of all sprains). High ankle sprains are less common (up to 15% of sprains) and are often seen in football, downhill skiing, and other field sports, while medial sprains are the least common (about 6%).

Most patients will make a complete recovery after sustaining an initial ankle sprain, but up to 70% of those who experience a lateral ankle sprain will go on to develop chronic ankle instability. Patients with this condition experience changes in the function of their nervous system that may lead to decreased postural control, joint position awareness, and more ankle instability. The combined result of these changes is an increased risk for recurring pain and other symptoms, as well as greater odds for sustaining a second ankle. And with each additional sprain, the risk continues to rise.

Appropriate rehabilitation is key to successful outcomes

This underlines the importance of proper treatment after the first ankle sprain, which can significantly reduce the risk for chronic ankle instability. Fortunately, most ankle sprains can be effectively treated with conservative (nonsurgical) interventions, and patients can expect to experience good to excellent outcomes when following this approach. One of the only possible exceptions is grade 3 lateral ankle sprains, as surgery may be beneficial for some elite athletes dealing with this injury to accelerate their recovery; however, conservative treatment is still preferred over surgery in most cases.

Physical therapy is generally regarded as the best way to deliver conservative treatment to patients, since therapists utilize individualized and evidence–based rehabilitation programs to achieve the highest level of care. Ankle sprain rehabilitation typically begins with alleviating swelling and further injury during the initial inflammatory phase of recovery, which is achieved with the POLICE (protect, optimal loading, ice, compression, elevation) protocol for the first 2–7 days. Short–term immobilization with a removable cast or boot may also be helpful for severe ankle sprains during this period. After inflammation has subsided, patients are advised to wear an ankle brace and will begin an exercise therapy program, which typically includes early active range of motion exercises, followed by strengthening exercises, proprioceptive training, and functional exercises. Exercises should simulate the physical demands of the patient’s sport and become more challenging as the program progresses.

After an ankle sprain, the top concern of most patients is when they will be able to return to their respective sport. But unfortunately, this decision is often difficult, as returning a player too soon can lead to residual disability and additional injuries in the future. Therefore, it is the physical therapist’s responsibility to ensure that athletes do not return too soon by ensuring that certain functional markers are met.

There are currently no formal criteria to clearly determine when an athlete is ready to return to sports, but several tests can be used to assist in this decision. When analyzing patients, therapists must ensure that all functional limitations from the sprain have been restored, cardiovascular fitness is equal to or greater than pre–injury status, and that there is no apprehension from the athlete or other members of the rehabilitation team concerning their safety. For patients with a history of ankle sprain, extra caution is required since the risk for chronic ankle instability is higher.

All patients must also recognize that although an extended recovery can be frustrating, taking the adequate time to heal and recover will increase their chances of long–term success. We will work to manage your expectations and ensure that you’re getting back to the field or court as quickly, but also as safely, as possible

Every 34 seconds, one American dies from cardiovascular disease. This makes cardiovascular disease—or heart disease—the leading cause of death in the U.S. for men and women and for most ethnic and racial groups, with about 700,000 people dying from it each year.

The magnitude of this problem cannot be overstated, but it’s equally important to note that many of these deaths can be prevented through certain lifestyle changes.

One of the leading factors risk factors for heart disease is high blood pressure (or hypertension). Often referred to as “the silent killer,” hypertension is a disease in which blood flows through arteries at a pressure that is higher than normal. Blood pressure is measured with two numbers, and normal pressure is 120/80 or lower, while stage 1 high blood pressure is any reading 130/80 or higher and stage 2 is 140/90 or higher. High blood pressure may not cause any symptoms—which explains its nickname—but it significantly increases one’s risk for heart disease, heart failure, stroke, and other cardiovascular complications.

The risk for hypertension increases with age, and it’s more likely to occur in men before the age of 64 but more common in women after the age of 65. It is also more common in Black individuals—often developing at an earlier age compared to White individuals—and in those who have a parent or sibling with the condition. These are all considered “nonmodifiable” risk factors for hypertension because they are out of each patient’s control; however, there are also many modifiable risk factors for hypertension that every individual has the power to address.

Some of the most dangerous modifiable risk factors for hypertension are being overweight or obese, not exercising, eating a poor diet, having high levels of stress, and smoking. We’re going to focus on diet and exercise since addressing these factors is not only helpful for reducing one’s risk for hypertension, but also essential for good overall health.

Diet

Reducing inflammation and oxidative stress are keys to mitigating the risk for hypertension, which is primarily accomplished through a well‐balanced diet and regular exercise. Knowing how to eat right may seem overwhelming, but the basic tenets or a good diet are fairly straightforward. Overall, your goal should be to eat a diet that is rich in whole foods, unrefined starches, and fruits and vegetables, while limiting your consumption of processed foods and those that are high in sugar and/or salt. Here are some other key dietary tips:

• Eat foods that are high in fiber and essential minerals like potassium, calcium, and magnesium (a relaxation mineral that’s very important for regulating blood pressure)
• Cut down on starches and foods with a high sugar content, especially for breakfast, when you should be eating protein, fat, and some fiber
• Aim to consume primarily fruits and vegetables for your carbohydrate intake while avoiding refined carbohydrates like white bread, pasta, and cereal
• Focus on eating good fats like omega‐3 fatty acids; foods that are high in omega3s include fish, vegetable oils, nuts (especially walnuts), flax seeds, flaxseed oil, and leafy vegetables
• Reduce or eliminate your consumption of processed foods Try to avoid inflammatory foods that may be triggers for you, like gluten and dairy Try to always stay hydrated

Exercise/physical activity

Regular exercise and physical activity are also crucial for reducing one’s risk for hypertension and heart disease. The American Heart Association, CDC, and guidelines from most other authority sources recommend that all adults aim for the following each week:

• At least 150 minutes of moderate‐intensity aerobic physical activity

OR

• At least 75 minutes of vigorous‐intensity aerobic physical activity

AND

• At least two sessions of muscle‐strengthening exercises

A moderate‐intensity aerobic physical activity is one that causes you to work hard enough to raise your heart rate and break a sweat, which essentially means that you’ll be able to talk, but not sing, the words to your favorite song. Examples include brisk walking, water aerobics, mowing your lawn, and playing doubles tennis. Vigorousintensity aerobic physical activities increase your heart rate more noticeably, causing you to breathe harder and faster, and usually prevent you from saying more than a few words without pausing for a breath. Examples include running/jogging, swimming laps, playing basketball, and playing singles tennis. Any exercise or activity that builds strength is classified as a strengthening exercise, and lifting weights, bodyweight exercises (eg, pushups and sit‐ups), and resistance bands exercises all count.

Making changes to your diet and exercise habits is often difficult, but considering the alternative and the devastating risks associated with hypertension and heart disease should help you put matters in perspective. And if you’re interested in exercising more but don’t know where to start, we’re more than happy to help get you started.

Adhesive capsulitis, or frozen shoulder, is a condition that occurs when scar tissue forms within the shoulder. This causes the shoulder capsule to thicken and tighten around the shoulder joint and reduces the amount of space for the shoulder to move within. Although frozen shoulder affects up to 5% of the population, it is not yet clear why it develops. Common consensus suggests that one of the leading factors is not moving the shoulder normally for long periods of time, as most people who get frozen shoulder have kept their shoulder immobilized due to a recent injury, surgery, or pain. It is most likely to develop between the ages of 40–60, and patients with arthritis, diabetes, cardiovascular disease, and other health conditions are also more likely to have the condition.

Frozen shoulder usually comes on slowly and gets progressively worse over time with more pain and loss of motion. It is typically divided into four stages, with the onset of symptoms occurring in Stage 1 over 1–3 months, and symptoms resolving by Stage 4—the “thawing” stage—which occurs within 12–15 months of onset. Physical therapy is commonly recommended for frozen shoulder, as research consistently shows that it provides numerous benefits at every stage; however, there is a lack of consensus about which interventions are most effective. Therefore, a powerful study called a systematic review and meta–analysis was conducted with two goals: 1) compare the effectiveness of exercise alone versus exercise with other interventions, and 2) compare the different methods of exercise to determine which were most effective.

Exercise improves various symptoms, but value of other interventions is unclear

Researchers performed a search of three major databases to identify high–quality studies that evaluated the effectiveness of exercise therapy and other interventions for patients with frozen shoulder. This search led to 33 studies being included in the systematic review and 19 being included in the meta–analysis. The most common types of exercises featured in these studies were strengthening exercises, stretching and range of motion exercises, muscle energy techniques, and pendulum exercises, while non–exercise–based therapies included manual therapy, ultrasound, and heat therapy, among others.

Results showed that exercise therapy was effective for reducing pain and improving range of motion and physical function in patients with frozen shoulder. In the analysis of eight studies that compared exercise therapy to multimodal programs—which involve a variety of interventions—little or no evidence was found that these multimodal programs were superior to exercise–only programs in improving range of motion, disability, or pain. In addition, multimodal programs that involved exercise were found to be more effective than multimodal programs that did not involve exercise, and two studies found that adding stretches to a multimodal program involving exercises may increase range of motion.

These findings confirm that exercise therapy is indeed an effective intervention for frozen shoulder, but adding passive modalities does not appear to offer any additional benefit to exercise treatment programs. More research is therefore needed on the relative effectiveness of various nonsurgical interventions for frozen shoulder, but in the meantime, patients are encouraged to continue seeing a physical therapist, where they can count on receiving an exercise–based and highly personalized treatment program.

Knee osteoarthritis is an extremely common disorder that involves the cartilage in a knee joint. In a normal knee, the ends of each bone are covered by cartilage, a smooth substance that protects the bones from one another and absorbs shock during impact. In knee osteoarthritis, this cartilage becomes stiff and loses its elasticity, which makes it more vulnerable to damage. As cartilage wears away over time, it loses its ability to absorb shock, thereby reducing the amount of space between bones and increasing the chances that the two bones will contact one another. The most common symptom of knee osteoarthritis is pain that gets worse with activity, while swelling, tenderness, and stiffness may also occur in some patients.

Knee osteoarthritis is particularly common in older adults, as it affects about 45% of individuals and represents the most common cause of pain in this population. Although no treatment can slow or stop this loss of cartilage, physical therapy is strongly recommended as an initial intervention for all patients with knee osteoarthritis. Undergoing a course of physical therapy can help reduce pain levels and preserve knee function through movement–based strategies like stretching and strengthening exercises, hands–on (manual) therapy, bracing, and lifestyle recommendations.

Patients with knee osteoarthritis are also encouraged to increase their physical activity levels to reduce their pain levels and improve functional capacity, but some healthcare providers—and patients—are uncertain how physical activity affects the structural integrity of the knee and if it can be safely performed by patients. Therefore, a study was conducted to examine the safety of physical activity for patients with knee osteoarthritis.

Consistent evidence shows that many common forms of physical activity are safe

Researchers performed a search of the PubMed database for reviews and high–quality studies that evaluated the biological effects of physical activity on the knee in patients with knee osteoarthritis, and the search led to 20 reviews and 12 original studies being included. Upon reviewing these studies, researchers found consistent evidence that many common forms of physical activity—like walking, running, and certain recreational sports—are not associated with structural progression of knee osteoarthritis. Based on their findings, researchers stated that these types of physical activity can be safely recommended for patients with knee osteoarthritis and those at risk for getting it. Evidence was also found that some patients with knee osteoarthritis may benefit from specific recommendations that address other risk factors present, such as weight–loss strategies and treating previous knee injuries.

From here, researchers went on to make the following recommendations for patients with knee osteoarthritis:

• Brisk walking is strongly recommended for all patients; to meet the World Health Organization’s guidelines for ≥150 weekly minutes of moderate–intensity physical activity, patients can consider going on 5 30–minute walks each week
• Patients with knee osteoarthritis who are already runners are encouraged to continue running, as recreational running for up to 25 miles per week was not associated with an increased risk of structural progression of knee osteoarthritis
• Recreational sports are generally encouraged, but patients should speak to their healthcare providers about which sports are safest, since some sports (eg, soccer, weightlifting, wrestling) may increase the risk for knee osteoarthritis progression

If you have knee osteoarthritis and are interested in becoming more physically active, our physical therapists can help by setting you up with a personalized exercise program that carefully considers your physical limitations.

There are few musculoskeletal conditions that can compete with back pain when it comes to sheer numbers. As one of the most common reasons for visiting a doctor, about 25% of Americans have dealt with back pain in just the past three months, and up to 80% of the population will encounter it at least once in their lives. Unfortunately, this means that if you’ve never dealt with back pain, there’s a strong chance that you will at some point in the future.

One of the more common causes of back pain is a herniated disc, which involves the intervertebral discs that lie between each vertebra of the spine. These discs consist of a tough exterior and are filled with a jelly‐like substance, and their purpose it to absorb shock and prevent the bones of the spine (vertebrae) from rubbing against one another. But when the softer jelly‐like substance of the disc pushes out through a crack in the tough exterior ring, it’s called a herniated disc, which can lead to pain, numbness, and weakness.

Herniated discs can develop anywhere in the spine, but they are most likely to occur in the lower back. Although herniated discs are common, they don’t always cause pain, and for patients that have low back pain, the herniated disc may not actually be the cause. In addition, most herniated discs eventually regress—or heal—on their own without surgery. Therefore, patients with low back pain from a herniated disc should be treated with nonsurgical interventions like physical therapy and avoid surgery unless it’s deemed necessary. However, not all patients experience a positive outcome with nonsurgical interventions, and the reasons why are not yet clear.

Study finds that male gender and use of opioids are associated with treatment failure

With this in mind, a study was conducted to compare the characteristics of patients with herniated disc‐related low back pain who were managed successfully with nonsurgical treatments versus those who failed conservative treatment and underwent surgery. To conduct the study, researchers reviewed the records of patients with a herniated disc in the lower back who were treated over a 10‐year period. These patients were divided into two groups: those who were successfully treated with nonsurgical treatments and those that failed nonsurgical treatments and opted to instead have surgery.

A total of 277,941 patients were included from this review. Of these patients, 97% were successfully managed with nonsurgical treatments, which included opioid medications, steroid injections, physical therapy, and occupational therapy. Only 3% of patients failed nonsurgical treatment and underwent surgery. Further analysis revealed that male gender and the general use of opioid medications were both predicting factors associated with higher rates of nonsurgical treatment failure. Patients who failed nonsurgical treatment also billed for nearly twice as much as patients who were successfully managed, and the greatest contributors to these costs were imaging tests, steroid injections, and opioid medications. Finally, patients who failed nonsurgical treatment only attended an average of 1.6 visits with an occupational or physical therapist, which is much lower than a typical treatment plan.

These findings show that the vast majority of patients with low back pain from a herniated disc were successfully treated through conservative interventions like physical therapy. For those that did not experience positive outcomes, other factors may have been at work, such as the use of opioids or not undergoing enough physical or occupational therapy sessions. We therefore continue to encourage patients with low back pain to see a physical therapist first and complete the recommended course of treatment before considering surgery.

With New Year’s Eve just right around the corner, we thought now would be a great time to talk about resolutions. Many people see the new year as a clean slate and a fresh opportunity to start the year off on the right foot—and stay on it—over the proceeding 12 months with one or more resolutions. Setting a new year’s resolution is noble and can absolutely pay off in major ways, but as we all know, setting a resolution isn’t the hard part. It’s keeping the resolution for the whole year.

It should come as no surprise that success rates for keeping a resolution start off high in the first few weeks of the new year, then drop gradually as the year continues. Statistics vary on how many people do stick with their resolution for the entire year, but some studies have found that it can be as low as 9% or as high as 55% of individuals. However, one thing is clear: those who set a resolution are significantly more likely to change their behavior than those who don’t make these yearly goals. Therefore, it’s better to focus on the potential benefits of setting resolutions than the discouraging odds sticking to them. It also helps to have a strategy to help you keep your resolutions for as long as possible, and that’s what we’re here for.

Why don’t most resolutions stick?

New year’s resolutions vary widely across the board, but there are some popular ones that stand out. Among the most common resolutions are exercising more and improving one’s fitness, losing weight, saving money, and improving one’s diet. Some studies have also reported that more than half of people keep the same resolutions as the previous year, suggesting a desire to overcome initial failures with these resolutions.

While there’s no single reason most people don’t stick with their resolutions, one common problem is starting out strong with ambitions that are too high and a regimen that’s too difficult, only to find out that maintaining it in the long term is not feasible. Many individuals also set resolutions that are far too general—like “lose weight” or “eat healthier”—which can be difficult to measure and quantify. In addition, it’s important to note that truly changing one’s habits in the long term is extremely difficult, which is why so many people eventually resort back to their old ways as time passes.

Our top 7 tips to help you beat the odds

If you’re serious about beating the odds and turning your resolution into a long-term habit, here are top 7 tips to help you make it happen:

1. When deciding on one or more new year’s resolutions, try to avoid setting the ones that you’ve failed to stick with in the past—especially from the prior year— at least temporarily
   • For example, if your resolution was to “be more productive” every year for the past 4 years, it may be time to try something else—like picking up a new hobby or eating fewer snacks—this year; you can always come back to that elusive resolution in the future
2. Start by setting a clear and concrete resolution that can be quantified and then create a plan for the year that will get you there
   • For example, lose 10 pounds, run 4 miles per week, or only eat desert on the weekends
3. Don’t expect to make big changes right out of the gates; start with small and manageable changes, then gradually work your way up as you progress
   • For example, if your goal is to run 4 miles per week and it’s your first time running regularly, start by doing a combination of running and walking over shorter distances, then increase your mileage slowly as your fitness and stamina improve
4. Try new types of exercise or different settings if your game plan in the past hasn’t been working
   • For example, if you’re not a “gym person” or find getting to the gym to be a hurdle in your fitness plan, avoid the gym altogether and try working out at home with workout videos and a few pieces of basic equipment
5. If you’re trying to learn a new skill, make it as easy as possible to practice
   • For example, if your resolution is to learn to play the guitar, leave your guitar in a visible location in your home rather than in a closet; this will reduce the amount of time needed to pick it up and start playing
6. Get support people you’re close with
   • For example, tell your friend, spouse, or family member about what resolution(s) you’ve set and ask them to check in on you periodically to see how you’re doing; it helps to have external sources of motivation
7. Reward yourself any time you accomplish something, however small it may be; on the flip side, don’t give up or get down on yourself if you failed to meet a weekly goal or slipped up in some way; change takes time and there will be bumps and roadblocks along the way

If you can make a commitment and adhere to these tips, 2023 may just be the year that you finally conquer your new year’s resolutions, which will leave you feeling awfully proud of yourself when next December rolls around.

If there’s one thing nearly everyone knows about exercise, it’s that we all need it if we want to be healthy. This association is undoubtedly common knowledge by this point, but what some may fail to fully understand is just how far these benefits go. Research continues to amount that shows how maintaining adequate physical activity levels is associated with a plethora of both physical and mental health benefits, and it can extend your expected lifespan, too.

This list is expansive and encompasses numerous fundamental areas of health, but some of the most notable benefits of exercise and physical activity include the following:

• Physical activity reduces the risk for several types of cancer, including liver, lung, breast, kidney, colon, rectal, and bladder cancer
• Regular physical activity and high fitness levels are associated with a reduced risk for premature death from any cause, particularly heart disease, in individuals with no symptoms
• Regular exercise increases strength and flexibility and lowers the risk for musculoskeletal conditions like osteoarthritis, strains and sprains, fractures, and other painful problems; it also increases stability and reduces the risk for falls in older adults
• Regular physical activity reduces the risk for developing type 2 diabetes—especially in individuals who are considered “prediabetic”—and improves outcomes in patients with diabetes

If reading these benefits motivates you to become more active, you may be wondering just how much physical activity you should be striving to get regularly. The American Heart Association, CDC, and guidelines from most other authority sources recommend that all adults aim for the following each week:

• At least 150 minutes of moderate–intensity aerobic physical activity

OR

• At least 75 minutes of vigorous–intensity aerobic physical activity

AND

• At least two sessions of muscle–strengthening exercises

Moderate–intensity aerobic physical activity

Aerobic physical activity, or “cardio,” is any activity that increases your heart rate, and intensity is how hard your body is working during a physical activity. A moderate–intensity aerobic physical activity is one that causes you to work hard enough to raise your heart rate and break a sweat. One of the easiest ways to determine if an activity is moderate intensity is that you’ll be able to talk, but not sing, the words to your favorite song. Here are a few examples of moderate–intensity physical activities:

• Brisk walking
• Water aerobics
• Riding a bike on level ground or with few hills
• Playing doubles tennis
• Mowing your lawn

Vigorous–intensity aerobic physical activity

A vigorous–intensity aerobic physical activity is one that increases your heart rate more noticeably, causing you to breathe harder and faster. The easiest way to tell if the intensity of an activity is vigorous is the talk test: if you’re unable to say more than a few words without pausing for a breath, you’re engaging in a vigorous–intensity activity. Here are a few examples:

• Running or jogging
• Swimming laps
• Riding on a bike fast or on hills
• Playing singles tennis
• Playing basketball

Strengthening exercises

Any exercise or activity that builds strength is classified as a strengthening exercise, and weights are not necessarily required. Strengthening exercises should be done in addition to aerobic activity and work all the major muscle groups of the body: legs, hips, back, chest, abs, shoulders, and arms. These exercises can be performed on the same or different days of the aerobic activity—whichever is easier for you—and should be done to a point where it’s hard for you to do another repetition without help. Try to do at least 1 set of 8–12 repetitions for each exercise, but more is always better. Here are some examples of muscle–strengthening exercises:

• Lifting weights
• Working with resistance bands
• Doing bodyweight exercises (eg, pushups and sit–ups)
• Heavy gardening (eg, digging and shoveling)
• Some forms of yoga

If you’re interested in increasing your physical activity levels but don’t know where to begin, we can help you get started on an exercise program that works for you.

Falls are the leading cause of non–fatal injuries in older adults, and the likelihood of falling increases each year as various health conditions become more common. One in three adults over the age of 65 and one in two adults over 85 will fall at least once each year, and every 11 seconds an older adult is treated in the ER for a fall. About 20–30% of falls cause moderate to severe injuries that have a significant impact on one’s functional mobility and independence, with hip fractures being the most common complication.

These facts may be daunting, but you shouldn’t allow your fear of falling to dominate your life or prevent you from getting around. Instead, you can take control of your situation by making changes in your life that will keep you strong and stable, thereby reducing your risk of falling in the process.

If you have any difficulty with movement, one positive change you can make to your daily life is to start using a walking aid like a cane or walker. Doing so will improve your mobility, balance, and confidence, which will effectively reduce your risk for falling. Walking aids are also extremely helpful for patients dealing with painful conditions like knee or hip osteoarthritis, degenerative movement disorders like Parkinson’s disease or Huntington’s disease, and those recovering a traumatic injury or surgery.

Determining whether a walker or cane is right for you

You should talk to your doctor or physical therapist about whether you need a walking aid and which type is best for you, but it’s helpful to know that walkers are the more supportive walking aid of the two options. Walkers can support up to half your bodyweight and are also helpful for preventing hip and joint pain if it occurs on both sides of the body. A front–wheeled walker, which has two wheels, is most common and best suited for those with poor balance. Three–wheeled walkers are ideal for smaller living quarters but require the user to have more balance, while four–wheeled walkers have better mobility over uneven surfaces and are recommended for those with decent balance and mobility who only need minimal assistance.

Canes are recommended for adults who only need a walking aid on one side of the body and not as much support as a walker. Canes can support up to 25% of one’s bodyweight and are ideal for when older adults first start to notice balance or mobility issues. As with walkers, there are several types of canes to choose from. A quad–based cane provides the most support and stability but is also heavier and slightly more difficult to maneuver. A standard single–base cane provides less stability but is easier to navigate and may therefore be adequate for those with only minor balance issues.

Tips on how to safely use a walker or cane

To ensure that you’re using a walker or cane as safely as possible to reap the full benefits, here are some tips for both walking aids:

Walkers

• The top of your walker should be at the level of your wrist when you’re standing with your arms relaxed at your side
• When using a front–wheeled walker, be sure to keep the front of your body in line with the back two posts of the walker; advance the walker a few inches in front of you first, and make sure all tips and wheels are touching the ground before taking a step
• When you’re ready to take a step, step forward with your bad leg first, followed by your good leg, placing it in front of your lead foot
• Don’t lift the walker off the ground while turning

Canes

• The top of your cane should also be at the level of your wrist when you’re standing with your arms relaxed at your side
• Always hold your cane with the top of the handle at your wrist in the hand opposite of the painful side
• Keep your elbow slightly bent whenever using your cane
• Move the cane forward at the same time as the leg that is painful or weak
• When walking up stairs, your good leg should go up first, followed by the weak leg and cane; when walking down stairs, the weak leg and cane should go first, followed by your good leg
  • One easy way to remember this is the phrase, “Up with the good, down with the bad”

Ensuring that you’re using safe techniques when transferring or walking with an assistive device will significantly improve your mobility and significantly mitigate your risk for falling as you go about your day. Physical therapists can also take this pra step further by training you in the proper use of these devices and designing a personalized fall–prevention program for high–risk patients. Contact us if you’re interested in learning more about walking aids.