​Baking is comfort food, not just for the end result, but just by way of the process. The meditative work of whisking and watching ingredients combine from the ground up, to the aromatherapy of flavors swirling through the air and that final moment of pulling your baked goods from the oven, it is pure comfort.  And the good news is:  it doesn't have to be unhealthy to taste good!  

If you love to bake but try your best to eat clean, then this Chocolate Chip Banana Bread is for you!  It is the perfect combo of warm and cozy meets decadent, is delicious, and it is perfect for breakfast, as a snack or even a dessert treat.  Try it....you won't be disappointed!  

Chocolate Chip Banana Bread
Ingredients

• Dry:
• 2 c whole wheat flour
• 1 cup coconut sugar
• 1/4 tsp cinnamon, optional
• 3/4 tsp baking soda
• 1 tsp baking powder
• 3/4 tsp salt
• Wet:
• 1/3 cup + 1 Tbsp coconut oil
• 1/3 cup non-dairy milk
• 1/2 cup water
• 1 Tbsp apple cider vinegar
• 2 tsp vanilla extract
• 2 extra-ripe large bananas, mashed
• Fold in:
• 1/2 - 3/4 cup chocolate chips 

Instructions

1. Preheat oven to 415 degrees. Grease a loaf baking dish very well with any oil.
2. Add all the dry ingredients to a large mixing bowl. stir well to combine.
3. Add the water, non-dairy milk and coconut oil to a small bowl. Place it in the microwave for about thirty seconds. Remove from microwave and stir until the coconut oil is just about fully melted.
4. Pour the oil mixture into the dry bowl and whisk for a few strokes. Then add in the vinegar and vanilla. Whisk again until smooth and fluffy. Finally, add the mashed bananas and stir well. Fold in the chocolate chips.
5. Pour the batter into your loaf pan.
6. Bake at 415 for 15 minutes. Then lower the temperature to 350 and bake for another 35 minutes until cooked through. Use the toothpick test to check for doneness.
7. Cool for at least twenty minutes before removing loaf from pan and slicing to serve.

Yield: 1 loaf

Spring is (hopefully) just around the corner, and the cold will soon be on its way out!  For many people, spring is the time to get up and get outside to actively enjoy the sunshine. While an active lifestyle is encouraged, if you “spring” into activity too fast there could be some serious consequences.  With that in mind, here are some friendly reminders to play it safe:

Build Gradually
If it has been some time since participating in an activity, slowly ease back into it to reduce the risk of an injury. Light exercise, like leisurely walking, can help build stamina. Gradually increase the intensity level before you actively jump into a new activity. It is important to be comfortable with moderately intense physical activity  before participating in a vigorous activity.

Hard Day, Easy Day
Maximum gains in conditioning are best obtained when appropriate rest is allowed along with exercise.  Inadequate rest increases the probability of sustaining an injury, therefore, an intense workout should be followed by a lighter workout the next day. Always remember that your body makes gains in strength and endurance during recovery. If you don't provide time for recovery, the body can break down.

Warm Up and Stretch
Warming up and stretching go hand in hand, but it is important to remember that they are different from one another. Sports injuries are most commonly caused by improper warm ups. Warm up with a low level activity  like jump rope or jumping jacks before you stretch. Warm ups raise muscle temperatures, which prepare the whole body for physical activity, and thus reduces the risk of a sports injury. Warm up for a minimum of 5 to 10 minutes so the body can prepare for an activity.

Stretching improves blood circulation, in turn increasing flexibility, and continue to raise muscle temperatures after a warm up. When you stretch, hold each stretch for 20-30 seconds. Each stretch should only be done once. If a person stretches a muscle before a proper warm up, the muscle will still be cold, and make the person more susceptible to injury.

Use Proper Techniques
Many sports require the use of different techniques. Learn the correct technique that is associated with a sport to lessen the risk of sports-related injuries to tendons, bones, and muscles. If you are unsure of what techniques you are supposed to use, talk with your coach or ask a professional to help you.

Recognize the Symptoms of Overuse Injuries
Overuse injuries can be prevented if you are familiar with the progression of injury, in addition to modifying your workout prior to the onset of injury. Overuse injuries usually progress through stages, which include:

• Benevolent pain is good pain that is a normal result of overload within a conditioning program. This type of pain is present after activity, but is absent by the time of the next day's practice or is relieved by warm-up.
• Semi-harmful pain indicates that you are starting to get in trouble. Semi-harmful pain is pain that is partially relieved by warm-up.  It is present during activity but performance is not noticeably reduced. When semi-harmful pain is recognized, your conditioning program should be cut back and the treatment regimen described below should be followed. If the pain lasts more than one week, or is severe, get medical attention.
• Harmful pain indicates that you are in trouble. With this type of pain, performance is noticeably reduced and is not relieved by rest. A period of rest and medical attention will likely be required before continuing a conditioning program.

Treatment
In the unfortunate event that you do obtain an injury, we recommend using treating using RICE+AR:
Rest- Determine a level of exercise, which produces only benevolent pain, and provides relative rest. This may require complete rest from the exercise program for a few days or possibly cross training with a different sport.
Ice- Apply an ice pack several times a day for about 15 minutes at a time. This is especially important during the first 24 to 48 hours after injury.
Compression- Apply an elastic wrap with comfortably firm pressure during and after ice application. Remove the wrap during sleep.
Elevation- Elevate the injured area above the level of the heart whenever possible.  
Anti-inflammatory- Medication such as aspirin or ibuprofen can also be used to assist in the reduction of the inflammation.
Re-conditionstretching and a gradual progression to strength training and gradual return to activity. If improvement is not felt in three to five days, please contact us for an evaluation to avoid further injury.  

The most effective treatment for spring related injury is prevention. Your brain may be telling you that you’re pumped to get outside and give it all you’ve got, but your body could be telling you otherwise. Take it slow while the body adjusts, and make sure to use suitable equipment. Should you find yourself with an injury, however, don't delay in contacting us for an evaluation, so you can quickly return to your activity injury-free!

Living a healthy lifestyle doesn’t mean hours of training at the gym and eating only salad leaves. It’s about making easy-to-manage healthy choices in your day-to-day living. When it comes to adopting new healthy habits and making them stick, there are lots of little things you can do that will make a big difference in the long run (and not make you crazy in the process). So, instead of trying to upgrade your health with a huge makeover, try these nine small, practically painless moves instead for long-lasting results.

1. Eat a variety of foods!  For good health, we need more than 40 different nutrients, and it is not about a single food or meal, but a balanced food choice over time that will make a difference.  
2. Ease yourself into getting more sleep with five-minute increments.  Completely abandoning your to-do list, whether it’s business or personal, to go to sleep three hours earlier just isn't realistic. Instead, try going to bed five minutes earlier each night (or every few nights, if this is really tough for you) until you hit the seven to nine hours the National Sleep Foundation recommends for adults.
3. Replace saturated with unsaturated fat!  Fats are important for good health and proper functioning of the body. However, too much of it can negatively affect our weight and cardiovascular health. Some of these tips could help us keep the balance right:

• We should limit the consumption of total and saturated fats (often coming from foods of animal origin), and completely avoid trans fats; reading the labels helps to identify the sources.
• Eating fish 2-3 times a week, with at least one serving of oily fish, will contribute to our right intake of unsaturated fats.
• When cooking, we should boil, steam or bake, rather than frying, remove the fatty part of meat, use vegetable oils.

4. Enjoy plenty of fruits and vegetables!  Fruits and vegetables are among the most important foods for giving us enough vitamins, minerals and fibre. We should try to eat at least 5 servings a day. Perhaps an apple and a piece of watermelon as snacks, and a good portion of different vegetables at each meal.
5. Reduce salt and sugar intake!  A high salt intake can result in high blood pressure, and increase the risk of cardiovascular disease. Here are a few different ways to reduce salt in the diet:

• When shopping, choose products with lower sodium content.
• When cooking, salt can be substituted with spices, increasing the variety of flavours and tastes.
• When eating, it helps not to have salt at the table, or at least not to add salt before tasting.

As for sugar, it provides sweetness and an attractive taste, but sugary foods and drinks are rich in energy, and are best enjoyed in moderation, as an occasional treat. We could use fruits instead, even to sweeten our foods and drinks.
6. Eat regularly and control the portion size.  Eating a variety of foods, regularly, and in the right amounts is the best formula for a healthy diet.  Skipping meals, especially breakfast, can lead to out-of-control hunger, often resulting in helpless overeating. Snacking between meals can help control hunger, but snacking should not replace proper meals. For snacks, we could choose yogurt, a handful of fresh or dried fruits or vegetables (like carrot sticks), unsalted nuts, or perhaps some bread with cheese.  Paying attention to portion size will help us not to consume too much calories, and will allow us to eat all the foods we enjoy, without having to eliminate any.
7. Drink plenty of water!  Hydration is very important because, well, our bodies are made up of a whole lot of water!  Water is the best way to stay hydrated, and it's also calorie-free!  How much water is enough? According to the World Health Organization, the minimum water requirement for a 70 kg human (154 pounds) is three liters (100 ounces) per day. But, to keep things simple, we suggest aiming for eight, 12-ounce glasses of water per day (96 ounces).
8. Maintain a healthy body weight!  The right weight for each us depends on factors like our gender, height, age, and genes. Being overweight increases the risks of a wide range of diseases, including diabetes, heart diseases, and cancer.  Excess body fat comes from eating more than we need. The message is reasonably simple: if we are gaining weight, we need to eat less and be more active!
9. Get on the move, make it a habit!  Physical activity is important for people of all weight ranges and health conditions. It helps us burn off the extra calories, is good for the heart and circulatory system, maintains or increases our muscle mass, helps us focus, and improves overall health well-being. We don't have to be top athletes to get on the move.  150 minutes per week of moderate physical activity is advised, and it can easily become part of our daily routine. Suggestions include:

• use the stairs instead of the elevator,
• go for a walk during lunch breaks (and stretch in our offices in between)
• make time for a family weekend activity

Don't wait...Start now! And keep changing gradually.  Gradual changes in our lifestyle are easier to maintain than major changes introduced all at once. While maintaining a healthy lifestyle takes work, perseverance and consistency pay off and keep you from spiraling back into old, unhealthy habits.

This year, Americans will spend approximately $2 billion on candy gifts for the special Valentines in their lives. That’s good news for the chocolate industry, but not so much for the country’s collective waistline.  If you’re looking for a non-traditional gift for your special someone, we recommend giving the gift of health this Valentine's!

Staying fit and healthy with your Valentine is one of the most loving gifts you can give, as it maximizes your time spent together for years to come.  With that in mind, here are five great ways you can not only spend quality time with those you love, but also improve your health at the same time:

1. A Bike Ride for Two
Whether you have a bicycle built for two or two bicycles built for one, there really isn’t much that can compare with the feel of an early morning ride outdoors with the wind in your faces. If the weather permits, you can even bike to a scenic picnic spot and enjoy even more time outdoors together.  

2. Hit the Trails
It might seem simple, but taking your loved one on a nice hike is a great way to spend the day together! Depending on your preference, you can make this as strenuous or mild as you like. If you can, identify a trail that leads to scenic overlook or waterfall for an added dose of romance.  If weather is an issue, however, a trip to one of the various rock climbing facilities could also be just what Cupid ordered!  

3. Massage or spa treatment
A good way to help your significant other relax and achieve overall wellness is by treating him or her to a luxurious day at the spa. In fact, studies show that massages work to relieve stress and lower blood pressure! So, why not book a couple's spa treatment for you and your Valentine both to relax and reduce stress together!  

4. Personal trainer sessions
If your Valentine isn’t a serious athlete but still takes workouts seriously, a few personal training sessions can be the perfect thoughtful gift.  You don’t even need to register for a long-term commitment here. Just three to five sessions with a professional can be enough to learn some new moves and tips about how to make the most of workouts.  Now, that’s the gift that keeps on giving!

5. Cooking classes
Rather than heading to a fancy restaurant for a Valentine’s Day dinner date, why not sign up for a healthy cooking class instead? Not only will you be able to indulge in a healthier option that you don't have to regret, but it’s also something that you can continue to do after the holiday ends.  Plus, learning something new as a couple can help strengthen your relationship, and new experiences help solidify your bond as a couple!

Hopefully one of these ideas will help you celebrate a healthful Valentine’s Day. If you have more ideas on how you can celebrate a healthy Valentine’s Day, we'd love to hear your thoughts by leaving a comment below!  

​​

Ready for a change?
If getting healthier, losing weight and/or creating better habits are on your resolution list, The Smith Clinic has some great options for you to aid in your journey:

• Whole Life Challenge (Click HERE for more info!)
• Fitness Memberships (Ask our staff for more info!)

One of our top priorities at The Smith Clinic is to approach healthcare with the benefits of prevention and education. If there are ever any questions regarding fitness goals or establishing a baseline evaluation, we would be honored to have the opportunity to help you work toward a healthy and happy 2019! As always, we're here to help!

Approximately 25% of American adults have experienced knee pain at some point, affecting the function of the knee. In fact, prevalence of knee pain has increased over the past 20 years, causing many to experience difficulty performing activities such as walking, rising from a chair, climbing stairs, or playing sports.  The good news, however, is that physical therapists are specially trained to help diagnose and treat knee pain, enabling many individuals return to their normal activities without pain or limitation. 

What Type of Pain?
If you are experiencing knee pain, it is important to determine if the pain is acute, sub-acute, or chronic in nature. This can help guide proper diagnosis and treatment.  

• Acute Pain is usually the most severe and occurs 1-7 days after injury. 
• Sub-acute pain occurs from 2-6 weeks after injury.
• Chronic knee pain is pain lasting greater than 8-12 weeks. 

If you develop acute knee pain, immediately follow the R.I.C.E. principle. R.I.C.E. stands for Rest, Ice, Compression, and Elevation. After a few days of R.I.C.E., you can begin using the leg, only gently. If pain persists for more than 2-3 weeks, however, it's time to visit a doctor or physical therapist to rule out any major problem and ensure proper diagnosis and management.
Where Does It Hurt?
Knee pain can occur suddenly for no apparent reason or develop slowly as the result of repetitive trauma. Knee pain occurs in different parts of the knee, depending on what structures in the knee are involved. Below is a general breakdown of the areas in which knee pain may occur and the structures of the knee that may be involved:

• Anterior knee pain, also referred to as patellofemoral pain, is pain around the kneecap (patella) in front of the knee, caused when the kneecap shifts out of position. This condition often affects younger females, and may be due to overuse injury. Pain often occurs when performing activities like squats or stair-climbing.
• Lateral knee pain is pain that occurs on the outside of the knee. It is a type of overuse injury that commonly occurs in runners when the tendon called the iliotibial band (ITB) becomes irritated. Pain is often felt when performing activities such as climbing stairs, or when walking or running.
• Medial knee pain is pain that occurs along the inside of the knee when the MCL or the medial meniscus become irritated due to direct injury or overuse. Pain is felt when squatting, walking up or down an incline, or going down stairs.
• Pain caused by a ligament tear may result from a direct blow to the knee, or when twisting or pivoting the knee while the foot is planted on the ground. Immediate pain and swelling typically occur, and the knee may feel unstable—like it will "give out"—when an individual attempts to put weight on the involved leg.
• Pain caused by osteoarthritis may occur anywhere in the knee where cartilage has broken down. This type of knee pain may begin as mild and progressively worsen. It can become increasingly difficult to walk long distances, fully bend and straighten the knee, climb stairs, or squat to sit in a chair. The knee also may swell intermittently with increased activity.

How Can a Physical Therapist Help?
After a focused examination has been completed, your physical therapist can work with you to start the correct treatment.  Based on the findings of your evaluation, your PT will develop a customized rehabilitation program to ensure a safe return to your desired activities. Some general treatment techniques may include:

• Pain management. Your physical therapist may provide treatments using different "modalities" such as ice, heat, ultrasound, or electrical stimulation to help decrease pain and swelling.
• Manual therapy. Your therapist will apply manual (hands-on) therapy to gently guide movement of the knee area to restore joint and tissue mobility.
• Therapeutic exercises. Your physical therapist will prescribe specific strengthening, flexibility, and endurance exercises to address your specific needs and goals.
• Functional exercises. You will learn individualized exercises designed to help you return to your home, work, and sport activities. These also may include balance and coordination exercises.
• Self-care instruction. Your physical therapist will teach you ways to manage your pain at home, and design a safe and effective home-exercise program based on your specific condition, which you can continue long after your formal physical therapy sessions have ended. You also will learn how to avoid placing unnecessary forces on the knee during your daily activities for years to come.

The knee is a major joint in the body that is needed for most activities.  Experiencing pain can limit one or all of these activities.  By working with your physical therapist and keeping the knee joint mobile and strong, problems with knee pain may be avoided, and your mobility can be maintained.  If you are experiencing knee pain, don't wait to get the relief you need.  Call us today to get started on your journey back to health!  

As fall is (finally) in full swing, we can now sense the excitement of all that autumn brings: beautiful changing leaves, football season, hay rides, bonfires, and all things pumpkin! Even the fresh, crisp air is rejuvenating, refreshing our souls after the exhausting heat of summer.

Similarly, the autumn of life is a strange mixture of nostalgia, blessings, and potential. It yields the harvest of seeds we’ve sown throughout life and braces us for colder days to come. When life’s autumn arrives, we look back and better understand the way God led us. It’s a good transition time.

Did you know “Autumn” only occurs once in the Bible? In Jude 1:12, false teachers are compared to “autumn trees without fruit,” implying that autumn should be a fruitful season, the most abundant of the year. This bears the question: how can we take advantage of the “autumn of life”?

First, we can acknowlege the unchanging nature of God. The seasons come and go, and there's a lot of unwelcome change in our world: moral and societal change, as weak as personal change - children leaving home, the passing of dear friends, and the slow, steady decline in our vitality and health. But amid all the changes, one thing never changes—our eternal God. “LORD, You have been our dwelling place in all generations. Before the mountains were brought forth, or ever You had formed the earth and the world, even from everlasting to everlasting, You are God” (Psalm 90:1-2). The world may fade, the stars may fall, the seasons may change, and winter may come. But the God who has been our help in ages past is our hope for years to come. In Him, we have permanence, stability, joy unshakable, and life unending.

Secondly, we can rest in the divine foresight of God. We’ve all suffered setbacks along the way. BUT we still have hope, as God promised, “I will restore to you the years that the swarming locust has eaten. . . . You shall eat in plenty and be satisfied, and praise the name of the LORD your God” (Joel 2:25-26). Our omniscient Savior knows the end from the beginning, and He will bless whatever is yielded to Him. Focus on His foreknowledge, providence, and sovereignty.

Lastly, we can focus on the wonderful blessings of God: family, friends, strength, shelter, provision, opportunities to serve, more time to pray and study His Word, and eternal life still to come. It's during life’s autumn that we have a richer perspective and can count more blessings than ever before. During autumn, we all know that winter lies ahead, but we also know that, when winter comes, spring isn't far behind! ​

We hope you are able to savor all that autumn has to offer this year!!

October is finally here, bringing with it the first signs of Fall, pumpkin flavored treats, and most importantly: National Physical Therapy Month. Since its inauguration by the American Physical Therapy Association (APTA) in 1981, National PT Month has been a great opportunity to celebrate all PT professionals as well as recognize the transformative power of physical therapy. PTs and PTAs help restore and improve motion in many people’s lives. This year, APTA hopes to raise awareness about the risk of opioids and all the ways physical therapy can help with pain management. 

The theme for this year’s PT Month is #ChoosePT. This campaign hopes to let people know about the dangers of opioid use and promote PT as a safe alternative. The Centers for Disease Control and Prevention (CDC) is urging health care providers to reduce the use of opioids in in favor of safer options, like physical therapy. Some of the potential side effects to opioid use are depression, overdose, and addiction. There are also possible withdrawal symptoms when stopping use. Because of these risks the CDC guidelines state, experts agreed that opioids should not be considered first-line or routine therapy for chronic pain

How is The Smith Clinic is Celebrating Physical Therapy Month?
The Smith Clinic is celebrating PT Month by periodically featuring our amazing PTs and their teams. We are also doing a service project, so be sure check out our social media so you can participate!

For more information on National Physical Therapy Month, visit https://www.moveforwardpt.com/Default.aspx.