With school back in session, it's likely you're repeatedly moving your child's backpack after he or she drops it at the door.  If that's the case, does it feel like it contains 40 pounds of rocks?  Maybe you've noticed your child struggling to put it on, bending forward while carrying it, or complaining of tingling or numbness.  If you've been concerned about the effects that extra weight might have on your child's still-growing body, your instincts are spot on.

When a heavy backpack is incorrectly placed on the shoulders, the weight's force can pull a child backward and, to compensate, the child might bend forward at the hips or arch the back. This can make the spine compress unnaturally, leading to shoulder, neck, and back pain.  Additionally, kids who wear their backpacks over just one shoulder may end up leaning to one side to offset the extra weight. They might develop lower and upper back pain and strain their shoulders and neck.

While we wait for solutions like digital textbooks to become widespread, here are several things you can do to lighten your child's load:

• Less weight is always better.  Use the bathroom scale to check that a pack isn't over 10% to 15% of your child's body weight (for example, the backpack of a child who weighs 80 pounds shouldn't weigh more than 8 to 12 pounds).  
• Make sure kids use both shoulder straps and tighten the straps enough for the backpack to fit closely to the body. The pack should rest evenly in the middle of the back and not sag down to the buttocks. 
• Encourage kids to use their locker or desk often throughout the day instead of carrying the entire day's worth of books in the backpack.  Make sure kids don't tote unnecessary items — laptops, cellphones, and video games can add extra pounds to a pack.  
• Encourage kids to bring home only the books needed for homework or studying each night.
• Picking up the backpack the right way can help kids avoid back injuries. As with any heavy weight, they should bend at the knees and grab the pack with both hands when lifting a backpack to the shoulders.
• Use all of the backpack's compartments, putting heavier items, such as textbooks, closest to the center of the back.

When selecting a backpack, look for:

• a lightweight pack: get one that doesn't add a lot of weight to your child's load; for example, leather packs look cool, but they weigh more than canvas backpacks
• the correct size: never wider or longer than your child's torso and never hanging more than 4 inches below the waist
• two wide, padded shoulder straps: straps that are too narrow can dig into shoulders
• a padded back: it not only provides increased comfort, but also protects kids from being poked by sharp objects or edges (pencils, rulers, notebooks, etc.) inside the pack
• a waist belt: this helps to distribute the weight more evenly across the body
• multiple compartments: to help distribute the weight throughout the pack.

What About Backpacks on Wheels?  They are so common these days, they're almost cool. But, the ACA is not giving them a strong endorsement.  Rolling backpacks should be used "cautiously and on a limited basis by only those students who are not physically able to carry a backpack," the ACA website reads. Why? They clutter school corridors, replacing a potential back injury hazard with a tripping hazard.

Despite their potential problems, backpacks are great when used properly.  Just remember: a roomy backpack may seem like a good idea, but the more space there is to fill, the more likely your child will fill it.  Help your child determine what is absolutely necessary to carry. If it's not essential, leave it at home.  Also, make sure your child uses both straps when carrying the backpack. Most importantly, If your child has back pain or numbness or weakness in the arms or legs, please don't ignore the symptoms.  Call us today...as always, we are here to help!

Did you know that one out of three seniors will fall this year, but fewer than half of them will talk with their doctors about it? Falls are also the No. 1 cause of injuries in seniors, resulting in hip fractures, cuts, and even serious head and brain injuries that can be fatal. And even when there’s no serious injury, a fall can still be so frightening that seniors may avoid certain activities because they’re afraid they’ll fall again.

The first step in fall prevention is preparedness. By putting some safe guards in place, you are less likely to becoming a victim of a fall. Here are several suggestions to get you started:
Make an appointment with your doctor. Be prepared to answer questions such as:

• What medications are you taking? 
• Have you fallen before? 
• Could your health conditions cause a fall? 

Keep moving: Physical activity can go a long way toward fall prevention. With your doctor's OK, consider activities such as walking, water workouts or tai chi — a gentle exercise that involves slow and graceful dance-like movements. Such activities reduce the risk of falls by improving strength, balance, coordination and flexibility.
Wear sensible shoes. Consider changing your footwear as part of your fall-prevention plan. High heels, floppy slippers and shoes with slick soles can make you slip, stumble and fall. So can walking in your stocking feet. Instead, wear properly fitting, sturdy shoes with nonskid soles. Sensible shoes may also reduce joint pain. 
Remove home hazards.
Take a look around your home. Your living room, kitchen, bedroom, bathroom, hallways and stairways may be filled with hazards. To make your home safer:

• Remove boxes, newspapers, electrical cords and phone cords from walkways.
• Move coffee tables, magazine racks and plant stands from high-traffic areas.
• Secure loose rugs with double-faced tape, tacks or a slip-resistant backing — or remove loose rugs from your home.
• Repair loose, wooden floorboards and carpeting right away.
• Store clothing, dishes, food and other necessities within easy reach.
• Immediately clean spilled liquids, grease or food.
• Use nonslip mats in your bathtub or shower. Use a bath seat, which allows you to sit while showering.

Use assistive devices.
Your doctor might recommend using a cane or walker to keep you steady. Other assistive devices can help, too. Examples of assistive devices are:

• Hand rails for both sides of stairways
• Nonslip treads for bare-wood steps
• A raised toilet seat or one with armrests
• Grab bars for the shower or tub
• A sturdy plastic seat for the shower or tub — plus a hand-held shower nozzle for bathing while sitting down

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The Smith Clinic would love to help and assist you in brainstorming other fall-prevention strategies. Some solutions are easily installed and relatively inexpensive. If you're concerned about the cost, remember that an investment in fall prevention is an investment in your independence. Call us today to learn more about fall prevention, as well as other topics to keep you safe and healthy in the months and years to come!

Summer is winding down, and the start of a new school year can only mean one thing: fall sports season is here!  Whether it’s football, soccer, cheerleading or cross-country, sports are wonderful for children’s health and wellness, keeping them both physically active and involved with their peers.
The National Institute of Arthritis and Musculoskeletal and Skin Diseases reports that more than 2.6 million children are treated in emergency rooms every year for sports-related injuries. Considering there are more than 38 million children participating in organized sports, the overwhelming majority of children play fall sports without being harmed, but the risks are there.  The good news, however, is there are several things you can do to help your child stay safe and avoid accidents on the playing field.  

Here are some tips to help keep your athletes healthy so they can enjoy the benefits of sports participation for years to come:

Be Prepared
Before playing organized sports, make sure your child receives a physical performed by a physician or nurse practitioner under the supervision of a physician.  In addition, meet with the coaches before the first practice to inform them of history with asthma or other medical conditions that require special attention.  If you are accompanying your kid to practice or a sporting event, be sure that you are ready for an emergency by keeping a small first aid kit in the car and knowing where the nearest hospital is. 

Warm Up and Stretch 
Make sure to set aside time before every practice and game to warm up properly. Stretching before practice and games is equally as important, as it can release muscle tension and help prevent sports-related injuries.

Hydrate!  Hydrate!  Hydrate!
Be sure to send your athlete(s) to practice and games with a water bottle and encourage to drink plenty of water before, during and after play. Educate yourself on the signs and symptoms of dehydration and other forms of heat illness.  If you’re a coach, establish mandatory water breaks throughout practice and games – don’t wait for your athletes to tell you they’re thirsty.

Gear Up
It does not matter the age, wearing the proper gear is essential to participating in sports.  Be sure to use appropriate and properly-fitted sports gear to prevent or reduce the severity of injuries. Additionally, make sure athletes use the correct equipment in order to participate in both practices and games. This may include helmets, shin guards, mouth guards, ankle braces, shoes with rubber cleats and sunscreen. 

Follow a good diet
To offset the calories burned during your sport, be sure you're getting a well-balanced, nutritional diet that gives you enough energy. Avoid supplements, which aren't always guaranteed to be safe.

Play head-smart, not head-strong
Athletes and parents should be well educated on the risks and warning signs of concussion. If you suspect a concussion, seek medical assistance immediately. And, when in doubt, sit it out—one game or play isn’t worth a lifetime of concussion-related health issues.

Make Rest a Priority
To help avoid injury due to overuse, athletes should take breaks during practices and games. It is also important to encourage athletes to tell coaches, parents or another adult about any pain, injury, or illness they may have during or after any practices or games.  Athletes should take at least one or two days off each week from any particular sport. 

Be a good sport
Sportsmanship is important. Play by the rules, communicate positive safety messages and serve as a model of safe behavior.

Remember, sports are fun and injuries can be prevented. Take the time to warm up properly, listen to your body and if something happens unexpectedly, seek early medical evaluation.  As always, The Smith Clinic is here to help! 

There’s nothing like enjoying homemade fruit popsicles on a hot summer day. The problem with the store-bought variety, however, is that they typically contain high fructose corn syrup and artificial flavors.  Making homemade fruit popsicles are a great alternative and an ideal way to add more nutrients into your day without using refined sugar (not to mention, a really fun way for kids and adults alike to experiment in the kitchen!). 
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So, cool off and take a "bite" out of summer by trying some of the following delicious popsicle recipes...you won't regret it!  
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Peach Strawberry Yogurt Popsicles

• 3 cups strawberries , pureed to 1 1/2 cup
• 3 cups peaches , peeled and sliced, pureed to 1 1/2 cup
• 2 tablespoons honey , divided
• 2/3 cup vanilla greek yogurt

Instructions:

1. In a blender, puree strawberries with four teaspoons honey then set aside. Clean blender, puree sliced peaches with two teaspoons, honey, set aside.
2. Layer the popsicles as follows; 2 teaspoons strawberry puree, one teaspoon yogurt, two teaspoons mango puree and repeat. Make a fruit puree your last layer.
3. Tap the mold on the counter to make sure all of the layers settle. Use a small spoon to drag vertically from the bottom to the top of the mold a few times to create a swirled pattern.
4. Gently tap the molds on the countertop to remove any air bubbles. Insert the popsicle sticks, and then freeze for at least 6 hours, or overnight.

**Recipe courtesy of https://www.jessicagavin.com.

Blackberry Lemon Popsicles

• 2/3 cup lemon juice , plus zest from lemons
• 2 1/2 cups vanilla greek yogurt
• 2 1/2 cups blackberries
• 2 1/2 cup mixed berry Greek yogurt

Instructions:

1. In a medium-sized bowl whisk together lemon juice, zest, and vanilla yogurt, set aside.
2. Puree blackberries and mixed berry yogurt, set aside.
3. Layer the popsicles as follows; 1 tablespoon lemon, 1 tablespoon blackberry, repeat. Swirl layers if desired.
4. Gently tap the molds on the countertop to remove any air bubbles. Insert the popsicle sticks, and then freeze for at least 6 hours, or overnight.

**Recipe courtesy of https://www.jessicagavin.com.

Chocolate Fudge Paletas 
1 cup light coconut milk
1/2 cup cocoa powder
3 tablespoons pure maple syrup
1 tablespoon instant espresso powder
2 avocados
Pinch of sea salt
Instructions:

1. In a small saucepan, heat the coconut milk, cocoa powder, maple syrup and instant espresso over medium heat, stirring to combine.
2. Pour this mixture into a high-speed blender, add the avocado flesh and the salt, and blend until smooth. Adjust the salt and maple syrup to taste.
3. Pour the mixture into ice pop molds, leaving about a 1/4-inch space at the top. Place the mold covering on top, and gently slide a wooden ice pop stick into each opening. Freeze overnight.
4. To serve, run the molds under hot water just enough to loosen the paletas and enjoy.

**Recipe courtesy of www.dailyburn.com.

Cherry Lime Popsicle with Honey
1 cup water
1/4 cup honey
2 cups cherries
1/3 cup lime juice
Instructions:

1. In a sauce pan, combine the water and honey. Heat on medium-high while stirring until most of the honey has disintegrated. Some foam might occur, stir and set aside.
2. Pit the cherries and juice the lime. Combine in a food processor and the water and honey mixture. Process until smooth and almost no cherry pieces remain.
3. Pour into cup or a popsicle mold and add wooden sticks. Freeze for at least 6 hours or overnight. Carefully remove from molds using hot water along the outside. Enjoy or store in freezer.

*Recipe courtesy of www.sweet-remedy.com.

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In order to help you get to know us a little better, we thought it would be fun to feature staff members from time to time. That said, please allow us to introduce you to one of our fabulous PT's: Chris Markham.

Holding a Doctorate in Physical Therapy (with concentration on Orthopedic and Manual Therapy) from the University of St. Augustine School for Health Sciences, Chris also has a Master's Degree in Exercise Science from Mississippi State University and is a member of the American Physical Therapy Association. When asked about his reason for choosing PT as a career, Chris stated, "The prospect of being able to help people get out of pain and improve their quality of life was something that really appealed to me. It was only natural that I entered the field of physical therapy. Through the use of proven, hands-on therapies and the many modalities available at The Smith Clinic, I am able to address a wide variety of conditions. I find that educating patients about their condition makes a positive impact on their recovery and can decrease their chances of re-injury.”

​Chris is truly one of kind, with the unique gifts of compassion and a gentle spirit. We are so blessed to have him as a part of The Smith Clinic family!

The "rotator cuff" is the group of 4 muscles and their tendons responsible for keeping the shoulder joint stable. Injuries to the rotator cuff are common—either from accident or trauma, or with repeated overuse of the shoulder. Risk of injury can vary, but generally increases as a person ages. Rotator cuff tears are more common later in life, but also can occur in younger people. When left untreated, a rotator cuff tear can cause severe pain and a decrease in the ability to use the arm.

A recent study in the Journal of Shoulder and Elbow Surgery looked at whether or not physical therapy can help avoid surgery on a rotator cuff tear. The MOON Shoulder Group, which is a multi-center network of research teams around the country, followed a group of 381 patients with atraumatic full-thickness tears of the rotator cuff for a minimum of two tears. The patients performed 6-12 weeks of nonoperative physical therapy focusing on basic rotator cuff strengthening, soft tissue mobilization, and joint mobilizations. At the six-week mark, patients were assessed and 9% chose to have rotator cuff repair surgery at that point. At 12-weeks, an additional 6% chose to have surgery, and, in total, 26% of patients decided to have surgery by the 2-year follow-up mark. That means nearly 75% of patients avoided rotator cuff repair surgery by performing physical therapy despite having full thickness cuff tears. 

Physical Therapy can help you reduce the worsening of the symptoms of a rotator cuff tear and even decrease your risk of worsening a tear, especially if you seek assistance at the first sign of shoulder pain or discomfort. To avoid developing a rotator cuff tear from an existing shoulder problem, it is imperative to stop performing actions that could make it worse. Your physical therapist will help you strengthen your rotator cuff muscles, train you to avoid potentially harmful positions, and determine when it is appropriate for you to return to your normal activities.

To maintain shoulder health and prevent rotator cuff tears, we recommend that you:

• Avoid repeated overhead arm positions that may cause shoulder pain. If your job requires such movements, seek out the advice of a physical therapist to learn arm positions that may be used with less risk.
• Apply rotator-cuff muscle and shoulder-blade strengthening exercises into your normal exercise routine. The strength of the rotator cuff is just as important as the strength of any other muscle group. To avoid potential harm to the rotator cuff, general strengthening and fitness programs may improve shoulder health.
• Practice good posture. A forward position of the head and shoulders has been shown to alter shoulder-blade position and create shoulder impingement syndrome.
• Avoid sleeping on your side with your arm stretched overhead, or lying on your shoulder. These positions can begin the process that causes rotator cuff damage and may be associated with increasing your pain level.
• Avoid smoking; it can decrease the blood flow to your rotator cuff.
• Consult a physical therapist at the first sign of symptoms.

Our physical therapists will work with you to restore your range of motion, muscle strength, and coordination, so that you can return to your regular activities. In some cases, you may learn to modify your physical activity so that you put less stress on your shoulder.  If you do decide to have surgery, your physical therapist can help you both before and after the procedure. Regardless of which treatment you have—physical therapy only, or surgery and physical therapy—early treatment can help you speed the healing process and avoid permanent damage.

If you are suffering from the symptoms due to a rotator cuff tear, call us today. We can get you the help and relief you need and get you back to doing the things you love without experiencing pain!