March is here, which in Arizona means swimming season is right around the corner. It also happens to be National Nutrition Month®! In our profession, I hear a lot from clients about what they “used to be able to do” and “used to look like” before they got hurt. Many people undergoing physical therapy services tend to gain weight, due to their pain limiting movement and exercise, as well as the emotional tendency to eat when we are suffering. Here are a few helpful tips that may help you in your journey to look and feel better.

Cardio Versus Cutting Calories
The two most effective ways to lose weight are to add in cardiovascular exercise, such as walking, biking, or running, or to decrease your caloric intake. There are benefits to choosing one over the other. For example, if you have significant arthritis in your knees making walking painful, initially cutting calories to lose weight may be the smarter and more comfortable choice. Alternatively, if you have been dieting for a while and are already at a low caloric intake, adding in cardio may be your only option. However, both may be used in combination to meet your goal.

Fruit Intake
We need fruits and vegetables in our diet to ensure that we are getting a full dose of all the essential minerals and vitamins our bodies need to perform optimally. However, one of the biggest problems I see from patients is the excessive carbohydrate intake. When many start to diet, they first change to eating “healthy” foods and snacks. Typically, this is in the form of adding fruits to their meals. While fruits may be a better choice than potato chips, 1 small apple has 21g carbohydrates (77 calories), and 1 medium banana has 27g carbohydrates (105 calories). Adding 1 piece of fruit to each meal and snack can equate to an additional 125g of carbs, or 500 calories over the course of the day. That is the same as 8 slices of wheat bread. Remember, there is a difference between eating for your health, and eating for your physique.

Timing of Meals
One of the most common myths I hear is that you cannot eat after 8 p.m. or all the food will be stored as fat. The second most common is that you need to eat multiple small meals a day to speed up your metabolism. Both could not be further from the truth. Eating at night will only cause the scale to give you a higher number in the morning because your body was not in a fasting phase for as long as when you stop eating by 6 or 7 p.m. In fact, recent studies have shown that fat loss is achieved in caloric deficit, regardless if a majority of calories were consumed at night or spread evenly throughout the day4. When consuming the same number of calories over the course of the day, be it between two large meals or six small meals, there is no difference in metabolic rate in overweight or obese individuals1,2. Furthermore, this was also found to be true in healthy weight individuals when consuming two versus seven meals per day3. Increasing meal frequency does not affect metabolic rate when caloric consumption is the same. Eat the number of meals you need when it works for your schedule to meet your nutritional needs each day without stressing about the timing.

Alcohol Consumption
This one is short. Don’t forget that your nightcap not only has carbohydrates, but it also has alcohol. Alcohol is a toxin to the body, which means that when you consume it, your body puts all stomach contents needing to be digested on hold while it rids your body of the alcohol. Each gram of alcohol requires 9 calories of energy to break down and rid it from your body. Your “light” 3.2% beer adds nearly 80-125 calories for every 12oz, and a glass of red wine can add between 125-150 calories for a 5oz pour. Keep that in mind while going through your physical therapy services.

At Foothills, our goal is to get you back to the activities you love. If you’re looking for more tips on how to live a healthy life, contact a Foothills Sports Medicine Physical Therapy clinic near you!

  1. Taylor, M. A., & Garrow, J. S. (2001). Compared with nibbling, neither gorging nor a morning fast affect short-term energy balance in obese patients in a chamber calorimeter. International Journal of Obesity and Related Metabolic Disorders: Journal of the International Association for the Study of Obesity,25(4), 519-528.
  2. Garrow, J. S., Durrant, M., Blaza, S., Wilkins, D., Royston, P., & Sunkin, S. (1981). The effect of meal frequency and protein concentration on the composition of the weight lost by obese subjects. British Journal of Nutrition,45(01), 5-15.
  3. Verboeket-Van De Venne, W. P., Westerterp, K. R., & Kester, A. D. (1993). Effect of the pattern of food intake on human energy metabolism. British Journal of Nutrition, 70(01), 103-115.
  4. Sofer, S., et al., Greater weight loss and hormonal changes after 6 months diet with carbohydrates eaten mostly at dinner. Obesity (Silver Spring), 2011. 19(10): p. 2006-14.


Foothills Sports Medicine is a group of locally-owned Phoenix physical therapy clinics that provide hands-on, high quality services to patients all over the Valley. Our therapists offer a free assessment of your needs, which can be scheduled online here. For more information about Phoenix physical therapy, follow our blog!

Susan Williams has a doctorate in physical therapy and is a valued member of our staff at Foothills Sports Medicine. She has experience working with active people of all ages, and she also works specifically with women and pregnant mothers. Here, Susie explains how to remain active and reduce pain during a pregnancy.

In the absence of any medical complications, pregnant women are recommended to exercise moderately for 30 minutes per day. This recommendation from the American College of Obstetricians and Gynecologists is the exact same recommendation made for women who are not pregnant, and women who have had children. However, only about 11-17% of pregnant women adhere to this recommendation, and even those who were exercising prior to becoming pregnant often considerably decrease the duration and intensity of their exercise.

There are many barriers pregnant women might be facing that prevent them from exercising. Some common issues include nausea, fatigue, incontinence, breast tenderness, back pain, and constipation. However, there are also numerous benefits to exercising while pregnant. Exercise improves maternal glucose levels, well-being, self-image, self-esteem, and has even been shown to decrease labor time. It also allows mothers to maintain the ability to work and perform daily activities, and maintain a healthy weight for themselves and their babies.

Exercising can also have a positive impact on pregnancy-related complications. It has been shown to reduce the risk of the following:

  • Gestational diabetes
  • Preeclampsia
  • Preterm Birth
  • Depression/Anxiety
  • Musculoskeletal pain, including low back pain

Despite these benefits, it can often be difficult for women to exercise comfortably while pregnant. In order to help women deal with their unique needs and pregnancy’s demands on the body, some physical therapists are trained and specialized in women’s health. We have a deeper knowledge of women’s issues throughout their lives, and can help you with your specific challenges.

Up to 80% of women have low back pain or pelvic pain at some point during pregnancy, and symptoms persist in up to 65% of women for as long as 12 months after delivery. Your PT can help you become more comfortable by addressing pelvic asymmetry, correcting posture, and educating you on correct body positioning and proper movements during certain tasks, such as lifting, carrying, and caring for children. We will also teach you how to manage these issues on your own, so your body can continue to receive benefits from physical therapy far into the future.

If you have more questions related to physical therapy during your pregnancy, or for any other condition you might be experiencing, feel free to contact your local Foothills Sports Medicine Phoenix Physical Therapy clinic today!

Foothills Sports Medicine Physical Therapy is a group of locally-owned AZ physical therapy clinics dedicated to providing quality care to patients all across the Valley. We believe in an individualized, hands-on approach to therapy to ensure you get exactly what you need. To book a free appointment with one of our physical therapists, simply go online here today. For more information about AZ physical therapy, follow our blog!

Susie Williams has a doctorate in physical therapy, is a professional figure competitor, and a devoted member of the Foothills staff. In this article, she explains Achilles tendinopathy, how to treat it, and how to decide which treatment option is best for you.

You finally get back into your running and work out routine, when suddenly you experience pain extending from your calf to your heel; your Achilles tendon. Your doctor gives you a few options: you can get an injection, and/or try physical therapy. So what should you do?

Achilles tendinopathy, which includes tendinosis and tendinitis, is a type of overuse injury. It is characterized by damage to the tendon, which leads to pain, swelling, and decreased performance. It is common in runners and athletes who suddenly increase their duration, intensity, or frequency of training. It is also common in less active and older individuals who start up a new work out or walking routine.

Healing an Achilles tendon insure can be tricky. When your tendon (the connection from muscle to bone) is strained or stretched repeatedly, its ability to handle pressure and transmit the forces that allow you to move decreases, causing the process to become less efficient. The tendon becomes fatigued, and the ability of its cells to repair the damage is overwhelmed by repetitive microtrauma, which is the term for small injuries that occur, often due to the weakened state of the tendon. Most injuries of the Achilles occur in its mid-portion. This area naturally has the least amount of blood supply, which further decreases the tissue’s ability to heal.

Your doctor may recommend a corticosteroid injection. These can be very beneficial in the short term to decrease pain, however they significantly weaken the tendon for up to 14 days, and can disrupt the natural healing by leading to collagen breakdown. The injection does not address the root cause of the problem, and it tends to make the tendon weaker than it already is. It can also be dangerous because the pain is masked and you feel better, so you may start being active again, further damaging the tendon.

So what can you do?

  • Avoid icing before activity
  • Be careful of the amount of NSAIDs (such as Ibuprofen, Tylenol) you are taking. These are anti-inflammatory drugs, and your tendinopathy is often not an inflammatory issue. They might mask the pain, but could lead to further damage.
  • Be patient! The limited blood supply, low metabolic rate, and few reparative cells in the area lead to a longer recovery period. Most patients report significant pain reduction after 6 weeks of PT, however it often takes 4-6 months for full recovery and reversal of the breakdown that has occurred.
  • Seek help from your physical therapist!

What will your physical therapist do?

  • Analyze the position of your foot.
    • You may have a flattened arch in your foot when you are standing because of a joint moving too much. Tight calves can also increase the stress on the Achilles. Both of these issues can be remedied with shoe inserts, heel lifts, stretching, and strengthening exercises to improve your alignment.
  • Check your hips and knees.
    • These areas may also be affected if you’ve changed your walking because of pain, or they may be tight and therefore causing the problems at your heel.
  • Analyze and correct your gait pattern during running or walking.
    • For example, running with a forefoot strike pattern, which is when your toes are hitting the ground before your heels are, can lead to Achilles tendinopathy.
  • Perform manual therapy techniques.
    • This can include joint mobilizations to free up any joints that are stiff, and cross friction massages to break up adhesions and promote blood flow to the area.
  • Strengthen the area with eccentric exercises.
    • These exercises help improve function and decrease pain. PTs also want to address other areas of weakness, such as your glutes.

If you received a corticosteroid injection and are also doing PT, please be sure to tell your therapist. Strenuous activity of the associated muscle should be avoided for 2 weeks due to the high risk of tendon damage.

If you’re seeking physical therapy, contact your local Foothills Sports Medicine clinic today!