by Jamie Miller PT, DPT, CKTP

This topic seems to be the million-dollar question that many people, including myself, feel defeated with right out of the gate. In realizing this, I first had to change my mindset. Let’s not look at the quality of our holiday season based on what we can/can’t eat, but rather on who we can enjoy, what traditions can we keep, and what is it in the activities we do that bring us holiday cheer.

Here are a few tips to help us with the parties, the leftovers, and changing our mindset to a healthier holiday season:

  • Don’t miss meals. You will likely end up eating double at the party to satiate your hunger. To help, try eating something light before leaving for a party. A piece of fruit, some veggies, or a light sandwich, so that you don’t arrive hungrily and eat more than you intended.
  • If you go to a restaurant or have catered food at the company party, choose the healthiest dishes: veggies, grilled meat, or salad. Go light with sauces or dressings (get these on the side if possible, your diet will thank you later).
  • Dessert is also ok, in smaller portions! Fruit can also be a nice choice for a sweet end to the wonderful meal.
  • Some ideas for preparing at home for the holiday events & how to organize your refrigerator:
    • Stock your fridge with healthy foods. High-fiber veggies to fill you up, and lean protein (leftover turkey breast counts!) to keep you satisfied. Fruit is also good to have on hand if you are wanting something sweet without breaking the “bank” (diet).
    • Organize your fridge strategically. Put leftovers in the fridge towards the back and keep fruit and veggies in front. This way you’ll have to work to get the good stuff, and have easy access to the healthiest foods.
  • Put food away. Those holiday cookies might look festive on the countertop, but they’re more likely to tempt you if you can see them. The more accessible food is, the harder it is to resist, says Beth Vallen, Ph.D., assistant professor of marketing at Villanova University and environmental food cues researcher. Your best bet is to keep food in the cupboard or fridge below eye level, so you don’t see treats every time you walk by the kitchen or swing open the fridge door for a snack.
  • Start the day with something light, based on vegetables, chicken or fish, and non-greasy food.
  • Use smaller plates. When given a choice at a holiday event or at home, pick a small plate to avoid overeating. Occasionally it is okay to overindulge, but day in and day out, you will see the scale creep up and wonder why your diet is failing.
  • Last but not least and quite possibly most important: fit in some form of physical activity. Whether it’s a fast walk, going up/downstairs at home, or signing up for a holiday run with family and friends, it is important to keep moving! If you haven’t been, now is the time to GET YOUR MOVE BACK. Exercise will allow you to burn those extra calories which have been proven to improve mental health & wellness. This is especially important during the hustle and bustle of the holiday season. Research shows you only need to exercise 30-60 minutes, 3-5 times per week to experience these effects of exercise. I have found it incredibly helpful to “challenge” my friends, family, and co-workers to exercise. This keeps me accountable for my personal health/wellness. It also allows you and your loved ones to become healthier!

Change your MINDSET:

Divert your attention. Don’t let food be the star of the show. Instead, focus on your social activity and the people you’re sharing the experience with, whether it’s family members, colleagues or friends. Let the experience this year be what brings you joy & true holiday cheer.

Wishing you and your families a blessed, happy and healthy holiday season from our team at Foothills Sports Medicine Physical Therapy! For more tips, tricks and information don’t hesitate to contact a clinic near you.

“iPosture” or “text neck” is a newly developed medical term physicians are using to diagnose orthopedic conditions associated with the repetitive stress and overuse of technological devices by their patients.

Do you ever look around and wonder what will come of the “electronic generation,” those burgeoning adults who constantly have their hands on technology? Have you ever wondered what impact screen-time might have on the development of your children? What affect this might have on their ability to socially interact or communicate? Or how they may look in 20 years? I hope to answer a few of your burning questions.

You can always pick out “iPosture” individuals sitting at a table in a restaurant, in their cars at red lights, waiting for the bus, walking through the mall, in line at the grocery store, and at the airport. They are everywhere, and quite possibly you!

Through anatomical goggles you can quickly identify them anxiously hunched over their device. Neck and head forward, shoulders rounded, and arms extended with wrists rotated inward as they clutch their device. They could be doing any number of things like: searching the web, watching videos, texting, playing games, or reading the news.

According to Kaiser Family Foundation, 8-18 year olds spend an average of 7.5 hours a day using “entertainment media.” Data released by the Census Bureau compared the number of text messages sent in December 2015 to the number sent in December 2016. The findings revealed 48 billion text messages were sent in 2015, and 110 billion in 2016. The prevalence of American’s on their devices is skyrocketing!

A new study released in April 2016, which will be presented at the 2016 Pediatric Academic Societies Meeting, revealed some striking findings between the use of technological devices and speech delays. The study found that the more time children between the ages of six months and two years spent using handheld screens such as smartphones, and tablets, the more likely they were to experience speech delays.

Another concern is that in people between the ages of 12 and 22 there will be an increase in back pain therapy cases, and in greater than numbers currently reported in adults. Healthcare professionals consider the following problems to be associated with iPosture or “text neck”:

  • Headaches
  • Forward head posture
  • Back and neck pain
  • Achy shoulders and arms
  • Tension/pain and tingling in the hands, elbow and wrist

By the time they are 25-35 years old, degenerative arthritis will have already started to form because alignment is not correct, which will lead to an increase of medications and surgery.

“Where the head goes, the body will follow. For every inch of FHP, it can increase the weight of the head on the spine by an additional 10-15 lbs.” (Kapandji, Physiology of Joints. Vol.3). In addition, the “Loss of cervical curve stretches the spinal cord 5-7 cm and causes disease”. (Dr. Alf Breig, Neurosurgeon & Nobel Prize Recepient). These have implications on posture, and may contribute to headaches, or complaints of neurological symptoms in the arms/hands (such as carpal tunnel, numbness, tingling and loss of strength).

What you do to prevent iPosture:

  • Bring device to eye level
  • Posture check every hour (try the app Posture Corrector)
  • Make sure your behind is back up against the chair­—“sit up straight”
  • Use both hands while texting
  • Take breaks
  • Raise your phone a few inches up your sightline—seems easy enough and it may, quite literally, help take a load off. (Hansraj K Assessment of Stresses in the cervical spine caused by posture and position of head. Surgical Technology International. 2014)

What should you do if you are experiencing problems associated with technology overload? Make an appointment with one of our physical therapists at Foothills Sports Medicine Physical Therapy to determine if you need back pain therapy.

We will perform an evaluation to determine the underlying causes of skeletal or muscle impairments (inflexibility, tightness/myofascial restrictions, trigger points, or muscle weakness) including a neurological screen in the event that you are experiencing numbness/tingling.

Most programs will start with patient education on posture correction, then target the sources by way of exercise and stretching to improve posture. Additionally, we make use of equipment and hands on techniques to address adaptive muscle tightening and restrictions. We will identify structures contributing to your symptoms and can establish a program designed specifically for you.

Toe walking is a condition where a person walks on his or her toes without putting much, or any, weight on other parts of the foot—especially the heel. This condition is composed of multiple aspects of functional development working together to create change over time. As a parent, you might identify toe walking in your toddler as they learn to navigate, explore, and manage their environment in a dynamic, upright walking position.

Parents who discover their children toe walking often wonder what caused it and how they can help. I hope to answer a few of these questions, but more importantly to explain the importance of physical therapy in recovery.

Let’s start with a few causes, looking beyond just the “muscles and bones.” Doctors have yet to identify a known cause for habitual, or idiopathic, toe walking. Biomechanical involvement due to congenital shortening of the Achilles tendon (which is often hereditary and is the result of abnormal foot structure) causes the tendon to shorten if its full length is not being used. Neurological diagnoses include muscle spasticity associated with cerebral palsy and paralytic muscle disease, or as a sign of autism. Last, but not least, there’s a sensory component that can be affected by a vestibular/visual dysfunction, a sensory processing disorder (SPD), or retained infant reflexes (ATNR/STNR) associated with development delay.

A pediatrician can advise you on further medical testing and treatment. They may prefer to wait and see if the child will “outgrow” the condition. However, other treatments include:

  • Physical therapy
  • Night splints or bracing
  • Ankle-foot orthosis (AFO) or serial casting used to promote progressive stretching of naturally shortening tissues
  • Botox therapy used to help relax the calf muscle allowing the patient or a healthcare practitioner to stretch the musculature.  The goal would be to lengthen the muscle allowing flexibility through the heel during gait.

If conservative measures fail to correct the toe walking after about 12–24 months, surgical lengthening of the tendon is an option.

Let’s talk about what you can expect from physical therapy in the treatment of toe walking.

Beyond just muscles and bones

A physical therapist can assess the “muscles and bones” of the condition: the length of the musculature, range of motion (ROM), strength, balance, palpation of the sensation and gait.

Immediate treatment focuses on improving range of motion and flexibility. The patient is asked to actively participate in stretching areas of tightness, working on imbalances of the skeletal system from right to left and front to back as part of a strengthening program. This teaches the body how to adjust to new positions and muscle lengths, changes in proprioception (the receptors that help your brain and body know where they are in space), how to adapt to balancing on different surfaces and textures, and how to re-educate their neuromuscular system.

The sensory of it all

When toe walking is related to vestibular and visual dysfunctions, the inner ear may be to blame. The vestibular system, inside the inner ear, is responsible for feeding the brain information on position and movement. This correlates eye, head and body positioning. If this information is skewed or perceived incorrectly, the brain may not be aware of how the feet are moving or if they are not functioning in the most effective way. In this case, the physical therapist works on vestibular habituation exercises, activities in which we move the eyes, head, neck and extremities separately or together, while working on balance training and coordination.

If your child is sensitive to touch and different textures or has an aversion to shoes, socks or bare feet, this may indicate a sensory processing issue, or even sensory processing disorder, for which the child may walk on their toes to avoid overstimulation. In this instance, therapy can help by implementing tactile techniques. Desensitizing the bottom of the foot is an important part of improving tolerance for walking with the whole foot, from heel to toe.

Last, but not least, Facilitate New Gait

Historically, toe walking has been treated through the instruction and repetition of stretching, followed by more stretching. Treatment of only the “muscles and bones.” However, treatment is much more effective when it focuses on providing the best conditions for the body to work how it is intended. The goal is to find the missing pieces in therapy, work on the sensory of it all, and facilitate new, fine-tuned gait patterning. Think of tweaking the old movement patterns as facilitating a new gait pattern rather than trying to actually stop the toe walking. To do so, the physical therapist is tasked with creating an environment to which the toe walkers are asked to adjust. This means investigating and adjusting the patient’s center of mass, the weight shifting and reaching out of their base of support, stability, the transition from heel strike to pushing off through the toes, quality of gait, stride length, cadence, transition from one foot to the other, and sensory systems, how the child perceives sensations and pressure.