Baby boomers and Gen X’ers may not realize how out of condition they have become.  Every winter people see physical therapists for injuries caused by shoveling snow.  It’s well known to all of us who clear our walks and driveways that snow shoveling can be a repetitive activity that causes muscle strain to the lower back and shoulders.  The following are some guidelines that we recommend to keep you healthy and pain-free during the winter weather.

Snow Shoveling Guidelines for Safety

Before shoveling, consider:

• Avoid shoveling snow if you are not in good health.  If you have a heart condition, speak with your doctor before attempting to shovel snow.
• Make sure you drink plenty of water and are fully hydrated.
• Use a shovel with a shaft that lets you keep your back straight while lifting. A short shaft will cause you to bend more to lift the load. Using a shovel that’s too long makes the weight at the end heavier. Step in the direction in which you are throwing the snow to prevent the low back from twisting.
• Dress warmly and in layers. Cover your hands, ears, neck, and head.
• The American Heart Association regards shoveling snow as an aerobic exercise.  Prior to shoveling snow, consider performing warm-up stretches or exercises.

While shoveling, consider:

• Shovel early and often.
• Try to push the snow in front of you.  If you have to lift the snow, do so in small amounts.  Bend your knees and lift snow with your legs – not your back.
• Do not toss snow over your shoulder or to the side.
• Take frequent rest breaks – stand up straight and walk around periodically to extend the lower back.
• Avoid excessive twisting and forward bending, because the spine cannot tolerate twisting as well as it can other movements.
• Standing extension exercises will help reverse the excessive forward bending of shoveling: stand straight and tall, place your hands toward the back of your hips, and bend backwards slightly for several seconds.
• Use salt or de-icing compounds to remove ice from steps, sidewalks, etc
• If you or anyone you know is experiencing back pain, consult your physician or a physical therapist.

Sources:

The American Heart Association (www.americanheart.org)
The American Physical Therapy Association (www.APTA.org)

Karen Stengle, DPT is a physical therapist at BodyWise Physical Therapy in Columbia, MD. She can be reached at 240-841-2639 or Karen at BWtherapy dot com

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By Arianna Berkowitz

Multiple sclerosis (MS) is an autoimmune disease of the central nervous system which manifests as lesions and scarring in the brain and spinal cord. These lesions are caused by damage to the protective myelin sheath that surrounds nerve fibers, causing interruption and slowing of nerve signals sent from the brain and spinal cord to the body.

Common symptoms of MS include extreme fatigue or lassitude; spasticity resulting in muscle spasms, stiffness and decreased joint mobility; muscle weakness; tremors; decreased balance; depression; anxiety; insomnia and tiredness; impaired concentration and memory; bladder spasms; constipation; dizziness and/or vertigo; visual impairment; heat sensitivity; and pain.

Exercising Control

The majority of persons with MS have what is known as the relaxing and remitting type of MS, which means that there are periods of time in which symptoms worsen or exacerbate and there are periods of remission. These remission periods reflect when the myelin sheath around the nerves has healed (with some residual scarring), causing symptoms to diminish.

Understanding this pattern and knowing how and when to manage the symptoms without exacerbating the condition is an important part of any conditioning and wellness program. It is in this respect that the guidance of an experienced physical therapist can be very helpful.

Traditionally, physical therapists focus on treating the symptoms an individual presents with at any given time. This would include a gradual strengthening and conditioning program appropriate to the limitations and capabilities of each individual, stretching of tight muscles, mobilization of restricted joints and soft tissue, balance training and compensatory strategies for gait and mobility. Pain management through the use of skilled manual techniques and modalities such as electrical stimulation and ultrasound are also an integral part of many physical therapy treatments.

One of the most important aspects of wellness for persons with MS is aerobic exercise, which is often overlooked or underutilized because of the extreme fatigue and weakness that individuals with MS often feel. Many think that exercise will just make their symptoms worse, when, actually, an appropriately paced conditioning program can significantly improve these symptoms and overall quality of life.

Manual Therapy

It is absolutely crucial that the physical therapist has a good understanding and respect for an individual’s symptom fluctuations and personal levels of tolerance. Otherwise, the client can be pushed to failure which leads to a worsened condition accompanied by frustration, depression and lack of motivation. Although primary loss of strength is permanent due to scarring of the nerves, weakness caused by a lack of conditioning is reversible and can be helped by physical therapy.

Along with exercise, skilled manual therapy is very important for managing the symptoms of pain and mobility. One manual technique which has shown to decrease muscle spasticity, tremors, pain and stiffness is a technique called Bowenwork.

This manual therapy stimulates the body’s own mechanism for healing by resetting muscle tension through gentle rolling and bending movements applied to the muscles and tendons throughout the body. Each move sends an energetic vibration through the body, which helps it to come into a more relaxed state. Tremors often will subside almost instantaneously with this procedure and can last for days or weeks, depending on the condition of the client.

Pain caused by muscle tension and spasm can dramatically decrease, which in effect helps improve one’s emotional well-being, also. For these reasons, Bowenwork is hugely beneficial when incorporated into a physical therapy program, especially during periods of exacerbation when traditional exercise and modalities are less tolerated.

A Point in Favor

If one adds acupuncture to this mix, the results often go from good to great. Acupuncture uses extremely fine, solid, sterile needles (not much thicker than a strand of hair), to move Qi (our vital life force), which circulates through channels or meridians throughout the body.

In this construct of medicine, when Qi is flowing smoothly and is of sufficient quantity, we are well and flourishing, living life with ease and joy. When our Qi is deficient and not flowing smoothly, it manifests as pain and “dis-ease” in the body, mind and spirit.

Individuals with MS suffering from fatigue, pain, disturbed sleep, depression and mental confusion often experience considerable relief of these and other symptoms with acupuncture, especially if it is received on a regular basis. As our bodies come more into balance, our immune systems get stronger, and we find that we make healthier lifestyle choices which contribute to our overall well-being.

When our Qi is in abundance and flowing smoothly, we have a clearer and broader perspective and can be more awake and alive to what is possible. So although acupuncture can significantly help a person with MS feel better on a physical level, it is the emotional and spiritual changes that are the greatest benefit, for when we are high on life, we tend not to notice our aches and pains as much and the brightness that is within each of us can shine through.

(the article can be found here)