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Bon Secours In Motion Physical Therapy, foot and ankle injury rehabilitation, balance and fall prevention, sports injury rehab, sports performance specialists, physical therapist clinic, Hampton RoadsBefore you reach for a cozy pair of slippers to keep your feet warm this fall, you may want to try going barefoot around the house to strengthen what some call the “foot core.”

Not only can barefoot activities improve a person’s balance and posture, but they can also help prevent shin splits, plantar fasciitis, stress fractures, bursitis and tendonitis in the Achilles tendon, according to a news release from Ithaca College.

Patrick McKeon, a professor who works in the college’s School of Health Sciences and Human Performance, says people often overlook the muscles in their feet, which play a vital role in movement and stability. Like the core muscles in the abdomen, the “foot core” plays a similar role.

Pilates, yoga and martial arts classes can help strengthen the small muscles of the foot because participants do them barefoot. Anything that has to deal with changing postures and using the forces that derive from the interaction with the body and the ground can help develop foot care strength, McKeon said.

The easiest strategy may be to go barefoot around the house.

“The more people can go barefoot, such as at home or at the office, is a really good thing,” McKeon said.

When people go barefoot, there’s a feedback cycle between the larger “extrinsic” muscles of the foot and leg, the smaller “intrinsic” muscles of the foot and the neural connections that send information from those muscle sets to the brain.

“Those interactions become a powerful tool for us,” he said.

But when that feedback loop is broken – which happens out of the necessity to wear shoes – it can lead to overuse injuries, such as stress fractures.

“Without the nuanced information provided by the small muscles of the foot, the larger muscles over-compensate and over-exert past the point of exhaustion and the natural ability to repair,” the news release states. “When the extrinsic muscles are no longer able to absorb the forces of activity, those forces are instead transferred to the bones, tendons, and ligaments, which leads to overuse injuries.”

Aside from going barefoot, McKeon suggests people perform what’s called the short-foot exercise, which targets the small muscles by squeezing the ball of the foot back toward the heel. A subtle motion that should not involve curling the toes, the exercise can help people who have shin splits, plantar fasciitis and ankle sprain, McKeon said.

It’s also helpful, he added, to work with an athletic trainer or physical therapist to learn how to do the exercise correctly.

Source: Ithaca College news release

+ Learn about the foot and ankle physical therapy program at Bon Secours In Motion. Our physical therapists develop a customized treatment program for each patient based on a comprehensive evaluation. We help clients restore motion and strength, improve balance, decrease pain and soft tissue restriction, improve ambulation and prevent re-injury to their foot or ankle.

physical therapy, Bon Secours In Motion Physical Therapy and Sports PerformanceWhen it comes to exercise, most people think about burning calories and building muscle. Just as important, however, are flexibility exercises.

Not only do flexibility exercises help the body recover from aerobic activity, but they also help lower a person’s risk for injury while improving sports performance. In fact, flexibility exercises, which benefit bones and joints, should be a part of everyone’s daily workout, according to the American Academy of Orthopedic Surgeons.

“Increasing your flexibility improves your ability to move easily,” said orthopaedic surgeon and AAOS spokesman Raymond Rocco Monto, MD, in a news release. “Some joints lose up to 50 percent of motion as we age. There are many ways to improve your joint flexibility including controlled stretches held for 10 to 30 seconds, stretches that rely on reflexes to produce deeper flexibility, as well as yoga and pilates.”

Consider these five health benefits to adding flexibility exercises to workout regimen:

  • Less back and joint pain: A 2011 study in the Archives of Internal Medicine found that regular stretching was effective in relieving chronic back pain. Research also shows that stretching the quadriceps can help decrease knee pain.
  • Better circulation: A 2009 study in the American Journal of Physiology showed that torso stretches can decrease stiffness and improve blood flow. Practicing regular bedtime hamstring and calf stretches may help decrease the intensity and nighttime leg cramps and how often they occur.
  • Improved joint function: As flexibility naturally decreases with age, stretching can help restore lost joint motion and improve function.
  • Improved athletic performance: Muscles and tendons generate more force under tension when they are supple and compliant, which can be influenced by regular stretching.
  • Improved muscle health: Mobility exercises can increase the amount of stress muscles can handle in high tension activities that involve jumping and cutting movements.

To get the most out of flexibility, the AAOS recommends these simple, yet important guidelines. Make sure to warm up before stretching because stretching cold muscles can cause injury. Stretch slowly and gently. By breathing into the stretch, you can avoid muscle tension. Try to relax and hold each stretch for 10 to 30 seconds.

Bouncing stretches – ballistic stretching – should be avoided because it can cause injury, according to the AAOS. And lastly, stretching should not hurt. If you feel pain, take the stretch easier, breathe deeply and relax into it.

Source: AAOS news release

+ Learn about the Active Isolated Stretching method, which provides effective, facilitated stretching of major muscle groups and physiological restoration of superficial and deep fascial planes.

+ Read about the Myofascial Release physical therapy program at Bon Secours In Motion. Myofascial release is a therapeutic massage that gently manipulates the fascia – the tough, connective tissue that covers the body like a web stretching from head to toe.


diabetes counseling, Bon Secours In Motion, exercisePeople who have type 2 diabetes and want to improve their blood sugar levels and cholesterol through exercise may want to try short bursts of high-intensity workouts. New research shows that this type of exercise regimen appears to have better results than working out at a lower intensity for a longer period of time.

Researchers say patients in their study who exercised at a high intensity three times a day for 10 minutes had significantly better results for improving their blood sugar levels and reducing their body mass index – a measurement of height versus weight – compared to people who did some type of sustained, lower-intensity exercise for 30 minutes, five times a week.

After three months, patients who had been following the vigorous exercise regimen had an average 0.82 percent decrease in their blood sugar patterns. Those who worked out at a lower intensity had an average 0.25 percent drop.

The research was recently presented at the American Heart Association’s Scientific Sessions. With further study, the findings could eventually change exercise recommendations for people with type 2 diabetes, researchers said. Historically, diabetes management programs have focused on low-intensity workouts. Exercise is know to help reduce cholesterol and weight, in addition to managing type 2 diabetes, all of which are risk factors for heart disease, according to a news release from the American Heart Association.

Currently, federal health authorities recommend 30 minutes of moderate-intensity physical activity for at least five days a week. Activities like walking briskly, dancing, bicycling are suggested as ways to work large muscles and increase heart rate.

In the study of intense exercise, patients achieved a higher maximum heart rate during these short bursts of vigorous exercise, said lead study author Avinash Pandey, an undergraduate student at the University of Western Ontario in London, Ontario, Canada. They worked out at 85 percent of their target heart rate. Those in the lower intensity study group reached 65 percent of their target heart rate.

“We also found that these 10 minute intervals may be easier to fit into busy schedules, since people randomized to that regimen were more consistent with exercise and ended up doing more exercise per week,” Pandey said.

Not only did the patients have greater improvements to their cholesterol levels, they also experienced a 2.3-fold greater improvement in HbA1c levels and and a three-fold reduction in BMI.

It may be possible that higher intensity exercise is more helpful than sustained, lower intensity exercise because it uses energy in a different way, Pandey said.

Sources: American Heart Association, Centers for Disease Control and Prevention

+ Have you been recently diagnosed with type 2 diabetes or are at risk for this chronic health condition? Try Individual or Group Counseling at Bon Secours In Motion to learn how healthy strategies can help people living with diabetes.

+ Learn how to choose healthier foods for better nutrition and weight loss through the Nutritional Analysis program at Bon Secours In Motion.

youth fitness, healthy, muscleStress can lead to weight gain. For parents who are stressed, it may also cause their children to gain weight, a new study suggests.

Indeed, Latino children whose parents feel high levels of stress are twice as likely to be obese, according to new research recently presented at the Obesity Society’s annual meeting.

Additionally, the more stress parents experience, the more likely their children are to become obese. Researchers examined data from the Study of Latino Youth, which was funded by the National Heart, Lung and Blood Institute of National Institutes of Health to determine the relationship between parental stress and children’s weight status in the Latino population.

Previous research has shown that stress is associated with obesity in adults. Now, data suggests that stress may affect other people in the family, too.

“This study is among the first of its kind to show that parental stress is a risk factor for childhood obesity among Latinos, and adds to the understanding of family influences on child weight status,” study leader Carmen Isasi, MD, PhD, from Albert Einstein College of Medicine in New York, in a news release. The research is considered preliminary because the findings have not been published in a peer-reviewed journal.

While obesity is a health issue nationwide, racial and ethnic disparities in obesity exist, according to data published by The State of Obesity – a project of the Trust for American’s Health and the Robert Wood Johnson Foundation. Obesity rates were highest among black adults (47.8 percent), followed by Latino (42.5 percent) and white (32.6 percent) adults in 2011-12, according to recent statistics. Obesity was lowest among Asian-American adults (10.8 percent).

The inequities persist among children, too. Latino children had the highest rates of obesity with 22.5 percent. About 20 percent of black children, 14 percent of white children and 7 percent of Asian-American children were considered obese in 2011-2012.

Some of the stress factors for parents in the study included having problems at work or trouble in a relationship. The likelihood of a child becoming obese increased with the number of stress-related issues that parents experienced. Parents who had three or more chronic stressors were twice as likely to have children with obesity than parents who experienced no stress.

“Obesity and chronic stress were both prevalent among this Latino population, with more than one-quarter (28 percent) of children ages 8 to 16 with obesity, and nearly one-third (29 percent) of their parents reporting high levels of stress,” Dr. Isasi said. The families in the study lived in New York City, Chicago, Miami and San Diego.

Researchers called for medical professionals to consider high stress levels in their patients as a warning sign that not only could an adult develop obesity from stress, but other people in that patient’s family are at risk, too.

“…Special attention should be paid to adult patients who report experiencing high stress levels in this population, and providers are encouraged to consider behavioral counseling as one measure for obesity prevention and treatments,” said Margarita Teran-Garcia, a member of The Obesity Society in the news release.

Researchers said more study is needed to examine the causes and possible preventive strategies as well as whether parental stress affects children’s obesity in other populations.

Sources: The State of Obesity, The Obesity Society news release

+ Does a child in your life need help losing weight? Read about the youth fitness program at Bon Secours In Motion, which includes nutrition education.

+ Learn about the individualized weight loss programs at Bon Secours Weight Loss Institute. Take an online quiz to determine your body mass index and find the right program for your weight loss goals.

There can be many varied reasons as to why one may have leg pain, particularly when walking. In regards to Peripheral Vascular Disease, one of the most common symptoms is lower leg cramps occurring with activity that stops with rest (intermittent claudication). These symptoms may occur in one or both legs. The symptoms of PVD may look like other conditions, so be sure to see your health care provider for a diagnosis.

As with most medical diagnoses, conservative management is the primary treatment of choice recommended for patients with intermittent claudication. Part of this treatment typically involves lifestyle modifications (such as smoking cessation and nutrition/diet modifications). Under the supervision of a physical therapist, the patient is encouraged to participate in an individualized exercise training program based on that person’s motor skills and functional abilities. The person’s cardiac efficiency is improved, improving blood flow and peripheral utilization of oxygen. As a result of this and several other metabolic improvements, walking distance and uninterrupted standing is improved.

While exercise is the most conservative method, medication and surgery are also options that may be explored. Again, please consult your physician regarding the most appropriate management of your condition.

-Dave Aznar, DPT, Cert. MDT, Cert DN

Bon_Secours_Hampton_Roads_In_Motion_Physical_Therapy_Sports_Performance_Run_Walk_ExercisePeople who exercise enjoy many health benefits including a lower risk for heart failure. But for those who want to significantly lower that risk, they will need to increase their physical activity beyond regular health guidelines.

Currently, federal health guidelines recommend at least 150 minutes of moderate intensity physical activity every week. That may change since new research shows that people who are much more active have better success at lowering their risk of heart failure.

In fact, doubling or quadrupling the minimum suggested levels of physical activity may lower the risk of heart failure by as much as 35 percent, according to research published in the American Heart Association’s journal Circulation.

Walking 30 minutes a day as recommending in the U.S. physical activity guidelines, may not be good enough – significantly more physical activity may be necessary to reduce the risk of heart failure,” said Jarett D. Berry, M.D., senior author of the study and an associate professor of internal medicine and clinical sciences at the University of Texas Southwestern Medical School in Dallas.

Heart failure affects millions of people in the United States.

More than 5 million people in the United States have heart failure – when the heart muscle is so weak it cannot pump enough blood into the aorta. Roughly half of the people who develop heart failure die within five years of being dianosed, according to the federal Centers for Disease Control and Prevention.

Heart failure happens when the heart is not able to supply adequate amounts of blood to the rest of the body and is characterized by shortness of breast and a reduced ability to exercise, a news release from the AHA states.

“If you look at the general population,” Berry said, “we’ve had tremendous success in reducing coronary heart disease over the last 30 years. But heart failure rates have not declined enough. The findings from the present study suggest that higher levels of physical activity may help combat this growing burden of heart failure.”

After analyzing data from 12 studies conducted in the U.S. and Europe, researchers were able to determine that people who exercised 150 minutes weekly only had a modest reduction in heart failure risk. However, those who reported twice that amount of activity enjoyed a 20 percent reduction in heart failure risk. Putting four times the recommended amount of time into exercise gave people a 35 percent reduction.

“Future physical activity guidelines should take these findings into consideration, and potentially provide stronger recommendations regarding the value of higher amounts of physical activity for the prevention of heart failure,” said Ambarish Pandey, M.D., lead author of the study and a cardiology fellow at University of Texas Southwestern Medical School in Dallas.

Source: American Heart Association news release, Centers for Disease Control and Prevention statistics

+ Learn how to choose healthier foods for better nutrition and weight loss through the Nutritional Analysis program at Bon Secours In Motion and Sports Performance.

+ Do you need help losing weight? Find the right weight loss program for you at Bon Secours Weight Loss Institute.

youth fitness program, childhood obesity, nutritional education, Registered Dietitian, weight loss, child, weightParents who struggle to get their children to eat more fruits may want to try offering more apples.

This simple fruit, which comes in a variety of flavors and colors, was by far the most favorite fruit of more than 3,100 children ages 2 to 19 surveyed for a study recently published in the journal Pediatrics.

The study also found that most children are not eating nearly enough fruit in their diet. Only four in 10 children under the age of 18 ate the recommended one to two cups of fruit every day, according to the study. Furthermore, one-third of what counts as fruit came from drinking 100 percent fruit juices.

Drinking juice might not be as unhealthy as drinking soda, but too much juice can cause children to easily gain weight because it’s packed with sugar and calories. Consistently drinking juice can also hinder efforts for many children trying to lose weight. Although many parents are well aware of childhood obesity,  more than one-third of children and adolescents continue to be overweight or obese, according to the federal Centers for Disease Control and Prevention.

The findings highlight an important challenge for parents. Not only are fruits an important source of nutrients for children that promote health and protect against chronic disease, but they also are associated with a decreased risk of diabetes, stroke, cancers and other deadly conditions, according to the American Academy of Pediatrics.

Researchers discovered that over half – 53 percent – of fruit consumption came in the form of whole fruits, which have the greatest health benefits. Apples, apple juice, citrus juice and bananas were responsible for almost half of total fruit consumption, according to the study.

Apples comprised about 20 percent of fruits consumed while apple juice accounted for 10 percent.

The remaining top choices for fruit included:

  • citrus juices
  • bananas
  • melons
  • berries
  • citrus fruit
  • fruit salads
  • grapes
  • peaches
  • nectarines

Source: American Academy of Pediatrics

+ Does your child need help losing weight or understanding the importance of good nutrition? At Bon Secours In Motion, we provide children with the opportunity to learn how to have a healthy lifestyle through our Youth Fitness program, which promotes physical fitness and nutritional education in a safe and fun environment.

Pregnancy, Weight Gain, Childhood, Obesity, Risk, PreventionPregnant women experiencing back pain may find some relief through exercise.

In fact, physical exercises before and during pregnancy can be effective in preventing and reducing low back and pelvic pain, according to a news release from the American Academy of Orthopaedic Surgeons.

Hormonal changes during pregnancy can affect a woman’s muscles, ligaments, bones, and joints that make up the musculoskeletal system.

According to a new literature review in the September issue of the Journal of the American Academy of Orthopaedic Surgeons, these hormonal changes during pregnancy can cause many joints to flex beyond normal limits due to ligament laxity, weight gain, and a shift in the body’s center of gravity.

Indeed, the impact on the spine can accentuate low back curvature and thrust and tilt the pelvis forward, causing pain.

Low back pain is a common medical condition associated with pregnancy; nearly half of pregnant women experience it. As ligaments which connect bones to each other stretch and the uterus expands as the baby grows, they put excessive stress on the spine and pelvis.

This can lead to low back pain, pelvic girdle pain, or both, said study author Zbigniew Gugala, MD, PhD, in a news release.

“Low back/pelvic girdle pain is especially common in pregnant women who are older, overweight, or have a history of back pain during a previous pregnancy,” Gugala said. “Women who already have joint hypermobility or are bearing more than one child at a time are also at higher risk.”

However, so far, the correlation between lumbopelvic pain and maternal weight gain during pregnancy or birth height or weight of the newborn has not been established. While pain typically begins at the 18th week of pregnancy and ends between the 24th and 36th weeks of pregnancy, many women, continue to have back pain after delivery.

“About half of women with low back pain during pregnancy continue to experience pain after delivery, sometimes for up to a year,” Gugala said. Pain management during pregnancy is usually focused on conservative treatments.

“Physical exercises before and during pregnancy can be effective in preventing or reducing low back and pelvic pain. But before beginning any exercise regimen, the expectant mother should check with her doctor,” Gugala said.

To help reduce the risk of low back pain and pelvic girdle pains during pregnancy, women should ask their doctor about correct posture, relaxation techniques and how to avoid sudden movements that could lead to extreme joint stretching in the spine and pelvis.

Exercise can also be helpful. Pregnant women should remain active by continuing normal daily activities and work, if possible. Daily routines should incorporate supervised flexibility, stretching, and muscle-strengthening exercises.

Source: AAOS news release

+ Learn about the physical therapy program at Bon Secours In Motion specifically tailored for pregnant women experiencing pain.

This blog was written by dietitian Judy Mitnick, MS, RD, CDE, CSSD.

Let’s face it: we live in a fast-paced, stressed-out world.  Some stress is vital to being a productive member of society.  We all need goals and deadlines, but excessive stress over time leads to anxiety, illness and hurts us in our efforts to improve our health.

In fact, overeating and/or eating unhealthy foods are two of the top reported habits Americans note as a result of stress. All of these extra calories are sure to lead to weight gain.  Additionally, the stress itself produces changes in the body’s hormonal balance, leading to hormone-induced cravings for high-fat, high-sugar foods (comfort foods) and the storage of fat, particularly abdominal fat. It can become a viscous cycle!

While we can’t eliminate all of the stress that faces us every day, we can plan ahead to address many of the stressors that can literally make us sick and tired.  Experts talk about the four A’s of stress management:  Avoid, Alter, Adapt, or Accept. Every situation may warrant a different management strategy (one of the “A’s”).

One example:  If getting to work on time is always stressful due to traffic, altering the route or leaving earlier can reduce this stress. Similar strategies can be used to directly address the overeating that can result from stress.  Some examples include:

  • Regular eating during the day:  A stressful day followed by a traffic filled ride home is a recipe for “pigging out” as soon one walks in the door from work.  Bringing food for lunch as well as a late afternoon snack containing some protein can at least take hunger out of this equation.  Good snacks include a yogurt, a small container of Hummus and raw carrots, or a piece of fruit and a string cheese stick.
  • “Decompressing” before entering the kitchen! :  By making a habit of taking at least 15 to 20 minutes to “switch gears” from work to home mode, one is less likely to inhale food as a way to calm down.  As above, this is easier to accomplish if that snack with protein was consumed close to quitting time.  This gear switching might be accomplished by changing into comfortable clothes, taking a bath, or even going for a short walk outside.  A more relaxed (and not starving) person is much more likely to make healthier food choices and eat reasonable portions than one who is famished and fried!
  • Practicing mindful eating and adding some accountability to eating: So many of us tend to “check out” when we are eating, especially if we are eating in response to stress or after a stressful day.  Keeping a food journal or using a phone app to record what is eaten ( right as it is eaten or right after), pulls us back into the moment and refocuses us to what we are about to eat.

Stress is a part of life that isn’t likely to ever completely go away.  Managing overall stress and awareness of our eating responses to stress can help minimize the negative effects on our health and our waistlines!

Alex KThis blog was written by Alex Kenefic, Registered Dietitian, at Bon Secours In Motion Physical Therapy and Sports Performance.

You need to eat well to fuel your top performances in races. Try out these tips to do your best at any distance:

For all exercise

High intensity, short duration athletes have different nutrition needs from endurance athletes.  General healthy nutrition, however, is important for both.  You need to eat enough calories from high quality carbohydrates, proteins, and fats will ensure healthy training and top performance as well as proper repair and replenishing after exercise.

Hydration is essential to all types of exercise as well.  Dehydration decreases muscle strength, power, and endurance.  During training, weigh yourself before and after a run so you can replenish 24oz of fluid for each pound lost.  Having sips of a sports drink every 15-20 minutes during activity will also help prevent hyponatremia, or overhydration.

1 mile, 5K, and 10K

Carb loading is unnecessary for exercise less than 45 minutes.  Eating a small carbohydrate snack can help for a 45-90 minute workout and is most helpful for exercise that is 90 minutes or longer.  This snack could be fruit, a granola bar, whole wheat crackers, or dry cereal.

Half Marathon, Full Marathon, Ultra-Endurance Races

Long-race athletes have higher carbohydrate requirements before, during, and after exercise.  An average male marathoner consumes 8 grams of carbohydrates per kilogram of body weight per day. This would equal 654 grams of carbohydrate spread out during the day for a 180 pound (81 kilogram) person.

Choosing quick and easy carbohydrates will make eating this large amount more tolerable.  Choose compact, low-fiber forms particularly on race day such as pasta, white rice, sports bars/gels, and high carbohydrate drinks (juice, chocolate milk, smoothies).  Avoid high fiber foods like beans, whole grains, and produce on race day to prevent gastrointestinal problems.

Carb loading three days before a race can be an effective way to store more available energy in the form of glycogen in muscles and liver.  Glycogen is stored with water, so don’t be alarmed if you feel stiff or heavy during this time. The feeling usually goes away with exercise.

Protein needs are increased as well during high intensity and high duration training, particularly after exercise for muscle repair and growth.  Choose lean proteins such as deli chicken or turkey, Greek yogurt, tuna, eggs, or low fat cheese.

Experiment with different food combinations and timing of meals during training.  Do not try anything new on race day.  Every athlete is different; find what works or your body and your activity.

+ Get a personalized nutrition plan from one of our registered dietitians!