ActiveRx in the Community

Tickling is good for Low Back Health!

As part of our rapidly expanding Community Outreach Program we have set up a series of  wellness-oriented talks and seminars  in the communities surrounding each of our clinics. Over the last couple of months we have presented on half a dozen occasions  at  senior centers, retirement communities and Recreation Departments. This is the latest in a series of posts describing some of  those presentations.

City of Surprise Senior Center: Through the good offices of Leslie Rudder, the Center manager we have established a strong  connection with the Surprise Senior Center and presented two very successful talks in February.

Successful Aging – what is it and how can we experience it? February 11th  was our first visit to the Senior Center and we were immediately impressed at how much was going on there – the place was buzzing and, it seems, this is what it was like most days! We set up in the cafeteria and went on just after lunch. The audience was very receptive and there were a lot of great questions both during and after the talk. Coincidentally, the topic Leslie had requested was one of the articles in our inaugural newsletter “The Second Fifty” (Same name as this blog!), which turned out to be a valuable and informative hand out, not only for the Successful Aging topic, but for several other relevant wellness issues.

Balance, Stability & Low Back Health: On Feb 25th we were back at the Center for the second of the topics Leslie had requested. This again was something of great interest to seniors – who among us, after all, has not suffered low back pain at some time? At ActiveRx we incorporate cutting edge practical research into our practice and including techniques for maintaining and improving low back health and stability. This session was designed to be more interactive since many of these techniques are easy to learn. We were able to bring several people up from the audience to demonstrate and also involve the whole ‘crowd’ in one of the techniques. This is a quote from Bill Rowen, one of the Center staff and ‘official photographer’ of the session.

“The talk around the center after was very positive and appreciative of the knowledge and types of exercises you demonstrated to our members.”

One of Bill’s pictures is displayed above. It shows Dr. Phillips working with a volunteer from the audience on one of the simple back protective techniques he talked about. As you can see – fun was had by all! Thank you Leslie!

We are looking forward to our next ‘gig’ at the Center – watch this space!

Being responsible, Jointly

Dancing with 'DemBones'

You know the old song: ”The hip bone connected to the thigh bone, the thigh bone connected to the knee bone, the knee bone connected to the leg bone, and so on down the length of the body! Even if I didn’t get all the words correct, the song – actually a spiritual whose lyrics were taken from a chapter in the Bible (Ezekiel 37) – perfectly describes the function of joints. Whatever and wherever their type or location, joints all do the same thing – they connect and help to move ‘Dem Bones’

Joints are always ‘switched on’, always active and always an essential part of daily living. Perhaps in part because of this nonstop motion, joint (or ‘musculo-skeletal’) pain accounts for up to a third of all physician visits. We don’t leave home without them, and if our joints are not in good shape – we sometimes don’t leave home at all! Generally joint pain is the result of osteoarthritis, can affect anyone and typically starts as our bodies begin to show the effects of aging. Incidentally this effect is all the more noticeable with ‘Usual’ aging (which has and will continue to be discussed in this blog many times!)

The good news is that joint pain is not inevitable with aging and there are a number of things you can do to encourage and maintain joint health which are described below.

But first – a quick ‘Cliffs Notes’ overview of joints and their major components, because being jointly responsible also involves learning more about something that can impact your health, wellness and physical function.

Joint Moves

Every joint has the same make up – only the way they operate may differ. For example shoulders and hips work more like a ball-and-socket, while knees work more like a hinge. All joints have the same basic function: They connect one bone to another and give us the ability to bend, twist, and wave our hands (or anything else) in the air

Without going into too much detail, the main components of joints are

1. Connective Tissue – AKA Ligaments and Muscles. The ligaments provide an extremely strong ‘connection’ between one bone and the next. The muscles also ‘connect’ bones but also provide the means for movement. Essentially the ligaments provide joint stability and the muscles provide the joint movement.
2. Cartilage - AKA ‘The Smooth Cushioner’. Cartilage is a tough, fibrous disc-shaped piece of tissue that acts as a cushion between joints. Because it is also somewhat elastic it acts as a shock absorber to prevent bones from grinding against each other. Osteoarthritis appears when we start to lose that cushioning, and a number of things can contribute to the loss, often all at the same time. Here’s a list of the ‘usual suspects’

Aging: Cartilage thins as we age and over time the surface of cartilage can change from smooth to irregular and rough. That’s when you start to notice …. those things that you used to take for granted like getting out of the chair or getting up the stairs etc. It used to be done without much thought … but now …. ?

Previous injuries: Even if you didn’t think much of them at the time, seemingly minor joint injuries when you were younger can sometimes prompt joint pain in later life. They can cause microscopic injuries to muscles and ligaments (known as ‘microtraumas’) which can produce joint pain ‘down the line’.

Inflammation: Small injuries (microtraumas) can upset the biomechanics of your joints. That, in turn, changes the internal make up of the cartilage. These microtraumas can cause low levels of inflammation which then releases chemicals that are damaging to joints over time.

Muscle loss: Muscles help to support joints.  The more muscle you have – the more potential muscle strength you have – and the more you will be able to absorb the impacts and ‘poundings’ of daily living. This produces less stress on the joints. Less joint stress = more joint health!

Excess weight: More weight = more work for the joint = more damage (and more microtraumas) in the long run. This is especially true for knees, which have to support your body weight.

Ok so now you know the issues – here are some options for doing something about (most of) them. Our highly skilled staff can work with you on all of these:

Healthy Joints for Healthy living.

Stay at a healthy weight. This is probably your best option for joint health. Staying at a healthy weight will help reduce the microtraumas that damage cartilage. Research reports that a weight loss of as little as 11 pounds can reduce arthritis pain by 50 percent for many women. Weight loss (if you are already overweight) may also help slow the progression of osteoarthritis over time.

Stay active. Physical activity helps reduce stiffness in the joints. Low- or no-impact aerobic exercises like swimming, walking, or cycling twice a week or so is ideal. Strength exercises too are particularly effective for reducing symptoms of osteoarthritis (see below). When mixed with stretching and relaxation exercises, these make a highly pro-active approach for keeping joints working at optimal efficiency.

Stay strong. Weight training strengthens the muscles and ligaments that surround joints. Strong supporting muscles protect joints from damage. Our STRIVE program (Seniors Strength Training for Independence, Vitality and Energy) has been very successful in this respect.

Stay cool. Some people experience pain, swelling or discomfort after exercise. If this applies to you, icing your joints for 10 minutes or so after the activity can help. When you exercise, a lubricant called synovial fluid is drawn into your joints. However, if the fluid sticks around too long after exercise, it can cause cracks in the cartilage. Ice helps to move the fluid out of the joint and into the lymphatic system, the garbage disposal of the body.

Stay with a good diet. Studies show the omega-3 fatty acids found in fish can help to reduce symptoms of joint pain and also change the levels of inflammation that may be causing some of the pain. Fish oil appears to slow the production of inflammation-signaling cells. The best sources are fish such as salmon and tuna. Research shows that 400 to 800 International Units (IUs) of daily vitamin D may also help protect your joints, via an anti-inflammatory effect. As a comparison, one cup of milk contains 100 IUs, and three ounces of salmon has 300-650 IUs. Look out for more posts on diet and nutrition in the future.

At ActiveRx we can help by being ‘jointly responsible’ for your pro-active approach to smooth, pain-free motion.

ActiveRx in the Community

Vista de la Montana

As part of our rapidly expanding Community Outreach Program we have set up a series of  wellness-oriented talks and seminars in the communities surrounding each of our clinics. Over the last couple of months we have presented on half a dozen occasions at  senior centers, retirement communities and Recreation Departments. This is the first in a series of posts describing some of those presentations.

Vista de la Montana Retirement Residence is part of the Holiday Touch Network and is a really lovely facility set in some beautiful well kept gardens at 18510 N. Parkview Place in Surprise (Check out the picture above!). Our presentation was entitled “Catching some zzzz’s – Good Habits for Good Sleep” (See our post http://secondfifty.wordpress.com/2010/02/07/catching-some-zzz’s-good-habits-for-good-sleep/ for more details on this topic) – and was organized by Joyce Sprengel the Activities Director. About 15 people attended and there were lots of great questions and feedback – many of our audience already had a very positive approach to wellness and in some cases had worked out a great sleep routine of their own! The session produced a very interesting and lively/humorous discussion, which occasionally drifted outside the topic at hand, but was always very wellness oriented.

After the ‘official’ presentation a number of people stayed behind to chat and ask more questions and we discovered that 4 of the ladies in our group were (actively) approaching their “Third Fifty Years”! So we would like to congratulate Hattie (99 years), Grace (96 years), Vera (96 years) and Rosie, 90 (years) for so impressively showing us all what Successful Aging can look like!

Thank you Joyce for being such a great host. We look forward to our next presentation in March!

Catching some zzz’s! Good Habits for Good Sleep

Catching a couple of zzz's

#1 Good Habit: Be active on a regular basis!

We believe that being active is the primary foundation of good sleep! Because of this we want you to be sure that the exercise program you follow is appropriate for you and for your lifestyle.The wrong kind of exercise, too much exercise, or exercising too late in the day can disrupt your sleep and leave you feeling fatigued and listless. The other thing to consider is that doing any kind of physical activity/exercise when you have some underlying functional issue with your muscles or joints can worsen this condition and also disrupt your sleep quality. Those aches and pains you have been experiencing may well be an ‘early warning signal’ for future, more serious and debilitating, conditions. The earlier these signals are identified the easier they are to deal with, and the less your sleep will suffer.  Take a pro-active attitude to your ‘sleep hygiene’ and schedule a Wellness evaluation with one of our highly qualified professionals. This will enable us to identify the best program for your needs and so prevent these functional problems before they start. As a basic guide you should exercise on a regular basis at a moderate level, and finish your session at least 3 hours before bedtime. Late afternoon is the perfect time for exercise that will help you sleep. At ActiveRx we can help you find the optimal program – and one that will also be covered by your insurance.

Other sleep inducing habits include …

• Avoid arousing activities before bedtime like working, paying bills, engaging in competitive games or family problem-solving.
• Avoid exposure to bright lights before bedtime because they send ‘wake up’ signals to the body at exactly the wrong time!
• Make sure you have ‘sleep-friendly’ surroundings – cool, quiet, dark, comfortable and free of interruptions.
• Make sure your mattress is comfortable and supportive. Most good quality mattresses last about 9 or 10 years. Don’t forget comfortable pillows!
• Finish eating at least 2-3 hours before your regular bedtime. This will make you more comfortable when settling down for bed.
• Establish a regular bed and wake time schedule including weekends. The more of a routine you develop the better the sleep pattern.
• Avoid caffeine, nicotine and alcohol products close to bedtime. They all contain stimulants that can keep you awake.
• Avoid long naps during the day. Although a ‘power nap” can be very effective for energy replacement, long daytime naps can disrupt your sleep pattern.

Finally, if after all this, you still have problems with sleeping – or with staying awake/alert during the day, you should also consult your physician. Be sure to tell him/her if you have already tried these tips and for how long.

Based on information from the National Sleep Foundation

Tips for staying ‘Topside’!

Staying 'Topside"- one leg at a time!

Prevent Falls, and Increase Function, Independence and Quality of Life!

What’s up with falling down?

At first glance, the statistics on Falls seems to be full of nothing but ‘bad news’!

According to the Centers for Disease Control and Prevention …

• More than one third of adults 65 and older fall each year in the United States.
• The rates of fall-related deaths among older adults has risen significantly over the past decade.
• In 2000, direct medical costs totaled $19 billion for nonfatal fall injuries.
• Up to 30% of people who fall suffer moderate to severe injuries such as bruises, hip fractures, or head traumas. These injuries can make it hard to get around and limit independent living. They also can increase the risk of early death.
• Most fractures among older adults are caused by falls.
• Many people who fall, even those who are not injured, develop a fear of falling. This fear may cause them to limit their activities, leading to reduced mobility and physical fitness, and increasing their actual risk of falling.

However there is also GOOD NEWS…

AGING IN AND OF ITSELF IS NOT THE CAUSE OF FALLING! Research has shown that there are a number of factors well within your control that can significantly improve your mobility, balance, stability and coordination – and so dramatically reduce your chance of falling. As your partner in Successful Aging, our mission is to show you how to make these factors part of your lifestyle and ensure that you do not become just one more fall statistic.

During my time as a research scientist at Stanford University School of Medicine and a Professor at Arizona State University I was involved in designing, researching and reviewing a variety of “fall prevention programs”. These were all ‘research-based’ and included one or more of the following components: physical factors (e.g. exercise, strength and/or balance training), environmental factors (e.g. home modification, assistive aides, ‘fallproofing’), educational factors (e.g. increasing awareness and knowledge of fall risks) and medical/clinical factors (e.g. medication compliance and dosage, clinical assessment of risk and/or cause pre- and post-fall).

All these factors have been shown to help reduce falls. However, as I worked with more and more older adults I became aware of other factors that also seemed important, particularly how older adults’ lifestyle behaviors influence fall risk and frequency. We have taken the best of these ‘Best Practice’ approaches and, often in collaboration with your physician, enhanced them with what we have learned from years of hands on experience working with our patients. The end result is a comprehensive and highly effective fall prevention program that is part of your own, unique lifestyle. We call this …

The ActiveRx  ‘Action Steps’ Program

What makes Action Steps different is that it does not only address the ‘Usual Suspects’ of falling, as listed above. It digs deeper, into your behaviors, your lifestyle, your aches and pains … even your low back health. We have found all of these can play a role in preventing falls but are rarely dealt with in conventional programs.

If you are concerned about falling or know someone who is, we encourage you to schedule a fall-risk screening today with one of our experts.  Reference this blog posting and we will waive the fee for the initial screening.  We will determine your needs and how we can meet them, jointly review your results and provide this information to your doctor if you desire to begin the program. By doing this, the program will be covered by your Medicare, Medicare Replacement Plan and Supplement Insurance.  This program is brand new for 2010 and we have limited space available. If you are interested please call today so we can reserve your spot !

Be Steady, Ready … Go for 2010!

The Seven Habits of Highly Successful Agers

Successful Second Fifties!

In their landmark book “Successful Aging”, renowned aging researchers Dr’s John Rowe and Robert Kahn summarize the conclusions of the decades long MacArthur Foundation Study on Aging, which investigated the differences between those who were ‘good for their age’ (Successful Aging) and those who weren’t (Usual Aging). The authors identified 3 overarching conditions which ‘Successful Agers’ demonstrated in comparison to ‘Usual Agers’.

High mental and physical function

Low risk of disease and disease related disability

Active engagement with life

In everyday terms seniors can achieve these highly positive conditions by adopting some or all of these 7 ‘lifestyle habits’

1. Stay strong and physically active: Walking is currently the most frequent exercise choice for seniors who are active. However research has clearly shown that strength training (or ‘resistance training’) is essential for maintaining and improving your independence and quality of life. At ActiveRx we can significantly improve your strength in as little as 15 minutes of specially designed exercises twice per week
2. Maintain normal weight: Eat a judicious combination of physical activity, strength and a balanced diet which would include fruits and vegetables and lots of water.
3. Adopt good sleep habits: Good sleep is associated with greater attention and focus. Strength training and moderate physical activity has been shown to be improve sleep habits. See our post “Catching some zzz’s”.
4. Maintain social contacts: Keep in touch with friends and family, initiate and maintain meaningful relationships, be part of a community, own a pet, give and receive hugs!
5. Keep an alert and curious mind: Use it and improve it! Participate in classes, conversations, keep up with the news, have an opinion.
6. Be self vigilant: Regularly self check your overall condition – how do you feel? Establish a good relationship with your doctor.
7. Engage with your ‘environment’: In many ways this last habit encompasses all of the others and can provide meaning and relevance in your life. Look for ways to ‘contribute’ – volunteer in church, civic, or intergenerational groups, be part of a social or community network. Be a provider as well as a receiver of support.

At ActiveRx we partner with our patients so that they are best able to incorporate these Successful Aging habits into their lifestyle

Making the Most of Medicare

As the new Health Care Bill bounces back and forth between the conflicting claims and expectations of each political party one thing stands out  for us here at ActiveRx – the way to make the most of your Medicare is to put yourself in a position where you need to use it the least! Medicare  pays  for the ‘Medical Care’ of Seniors – so the less you need to use that ‘Medical Care’ the less you will worry about ‘coverage’ – whatever that  ends up  looking like.

If this seems like a strange attitude – read on …..

What our own research and national health reporting data has told us over the years is that many chronic diseases and conditions – the very  ones that send older adults to Medicare – are not an inevitable part of aging.

Yes – you read it right – they are NOT an inevitable part of aging!

Heart disease, diabetes, high blood pressure, low back pain, arthritis, depression or even falls, can all be prevented or improved by adopting the concept and approach of what is called ‘Successful Aging’ (vs ‘Usual Aging’). ‘Successful Agers’ use less medication, are more independent, suffer less health conditions and are more socially active and involved with their community.

Why is this?

Well, it turns out that how healthy we are and how healthy we feel is, for the great majority of people, more a result of our lifestyle habits and behaviors than anything else.

Our lifestyle IS our health!

Because of this, many of the common ‘Medicare treated’ health conditions described above are preventable and even reversible – particularly when the ‘treatment’ is combined with the kind of lifestyle oriented approaches we have implemented in our practice.

Successful Aging is an approach to life and living that is driven by making consistently wise choices related to health and active wellbeing. Our behaviorally oriented protocols emphasize the importance of such choices and how they may be incorporated into your treatment and your lifestyle.

We will be describing the major components of Successful Aging on this blog and in future issues of our newsletter. What is it, what it can do for you and how it may be incorporated into your lifestyle.

If you have any questions or comments about these issues please feel free to call, email or ask a staff member at your next visit. We welcome your input!

At ActiveRx what we want for you is to

Think more clearly and be more active!

Meet new people and make new friends!

Feel, look and be better inside and out!

Your care – and therefore your Medicare – is as much in your hands as ours!

Welcome to The Second Fifty!

Feeling Great!

Here on The Second Fifty we want to bring you relevant and important wellness information as well as the opportunity to provide feedback so that we can continuously improve the quality of our services.

This blog will enable us to learn about you and what wellness means to you. Our mission is to provide .. a different kind of wellness experience

We are the only clinic to offer a groundbreaking system specifically designed for older adults that we call “Wellness Oriented Physical Therapy”. Our system uniquely merges state of the art diagnosis and treatment protocols with evidence-based approaches to lifestyle and wellbeing.

The beauty of the ActiveRx approach is that it is equally effective for physician-referred patients with a specific diagnosis, as well as those who are ‘self referred’ and simply wish to be better informed about their current health and what they can do about it. Our unique approach is rapidly establishing a first class reputation as increasing numbers of physicians refer their patients to us. In addition our community outreach programs are connecting with more and more senior organizations and institutions who see the importance and value of our lifestyle-oriented approach.

Our newsletter – also called The Second Fifty – will be linked to this blog and will contain practical wellness information – often as a result of requests from YOU!

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