Healthy Holidays

Maintain Your Exercise Routine and Reduce Stress
The holiday season is a busy and exciting time of year, but it can also be quite stressful. Between shopping, parties, traveling, and visiting family, it’s easy for your regular exercise routine to fall by the wayside. Research has shown that physical activity levels tend to decrease the most after holidays.
That’s why it’s so important to make your health a priority this time of year. Regular exercise can actually help reduce holiday stress and keep you feeling your best.


Here are some of the key benefits of maintaining your fitness routine:


Stress Management
The holidays bring a lot of added demands on your time and energy. Exercise is a proven way to manage stress and improve your mood. When you work out, your body releases endorphins that can lift your spirits and help you better cope with the pressures of the season. Making time to be active, even just a little big each day, can go a long way in keeping you calm and centered.


Immune System Support
Cold and flu season tends to ramp up during the winter months. Staying active can help support your immune system and reduce your risk of getting sick. Keeping up with your workouts makes you less susceptible to holiday illnesses that could derail your plans.


Weight Management
The holidays are full of rich, indulgent foods that can pack on extra pounds if you’re not careful. Regular physical activity helps you maintain a healthy weight by burning calories and boosting your metabolism. It also gives you an outlet for all the extra energy you may have from eating richer foods.


If you’re having trouble sticking to your exercise routine, consider talking to your physical therapist. They can create a customized fitness plan to help you stay on track, even with a busy holiday schedule. Physical therapists can teach you exercises you can do at home and provide tips for fitting activity into your day.


Here are a few quick tips to help you stay active this holiday season:


● Schedule your workouts like any other important appointment and don’t cancel them.
● Find ways to be active with friends and family, like going for a walk after a meal.
● Keep home exercise equipment (like weights or a yoga mat) accessible and ready to use.
● Park further away from stores and buildings to get in extra steps.
Don’t let the hustle and bustle of the holidays derail your health and fitness goals. With a little planning and creativity, you can maintain your exercise routine and enjoy a happier, healthier holiday season.

What’s Physical Therapy Have to Do With Your Sleep?

Sleep is essential for our health and well-being.
It helps our bodies recover, boosts our mood, and improves our ability to think clearly. Unfortunately, many people struggle with getting enough good-quality sleep. 62% of all Americans experience a sleep problem several nights a week—and it’s likely those numbers are low, sleep problems often go under-reported.
Physical therapists often see how physical health can impact sleep. Here’s how your PT can help you sleep better, along with some tips for improving your sleep habits.


Why Sleep Matters


Good sleep is crucial for several reasons:

1. Physical Health: Sleep helps your body heal and repair itself. It supports your immune system, making you less likely to get sick.
2. Mental Clarity: Lack of sleep can lead to trouble concentrating and making decisions. A good night’s sleep helps your brain function at its best.
3. Emotional Well-Being: Sleep affects your mood. Poor sleep can lead to irritability and increased stress, while good sleep promotes a positive outlook.


How Physical Therapists Can Help

Physical therapists can play a key role in improving your sleep through various strategies:
1. Assessing Physical Pain
Many people have trouble sleeping because of pain or discomfort. A PT can help identify the source of your pain, whether it’s from an injury, chronic condition, or poor posture. By developing a plan to address these issues, we can help reduce pain, making it easier for you to sleep. This one also works both ways – not sleeping enough has been shown to make you more sensitive to pain.
2. Promoting Relaxation Techniques
Physical therapists can teach you relaxation techniques, like deep breathing, gentle stretching, or progressive muscle relaxation. These methods can help calm your mind and body, making it easier to fall asleep.
3. Creating a Personalized Exercise Plan
Regular physical activity can improve sleep quality. A PT can create a tailored exercise program that suits your needs and lifestyle. Gentle exercises, especially those done in the evening, can help you unwind and prepare for sleep.
4. Improving Sleep Environment
Your PT can also offer advice on creating a better sleep environment. This includes tips on your mattress, pillows, and bedroom setup to ensure you have a comfortable place to sleep.


Tips for Better Sleep

In addition to working with your PT, here are a few steps you can take to improve your sleep:
● Stick to a Schedule: Go to bed and wake up at the same time every day, even on weekends.
● Limit Screen Time: Reduce exposure to screens at least an hour before bed. The blue light from screens can interfere with your ability to fall asleep.
● Create a Bedtime Routine: Establish a calming routine before bed, such as reading or taking a warm bath.
● Watch Your Diet: Avoid large meals, caffeine, and alcohol close to bedtime. These can disrupt your sleep.
● Keep Your Bedroom Dark and Cool: A dark, cool room can help signal to your body that it’s time to sleep.


Conclusion
Sleep is vital for our overall health, and physical therapists can help you achieve better sleep through pain management, relaxation techniques, and personalized exercise plans. By combining our expertise with your commitment to good sleep habits, you can enjoy the restful nights you deserve. Remember, a good day starts with a good night’s sleep!


References
Research:
1) Catherine F. Siengsukon, Mayis Al-dughmi, Suzanne Stevens, Sleep Health Promotion: Practical Information for Physical Therapists, Physical Therapy, Volume 97, Issue 8, August 2017, Pages 826–836
a) https://doi.org/10.1093/ptj/pzx057
2) Jo Nijs, Olivier Mairesse, Daniel Neu, Laurence Leysen, Lieven Danneels, Barbara Cagnie, Mira Meeus, Maarten Moens, Kelly Ickmans, Dorien Goubert, Sleep Disturbances in Chronic Pain: Neurobiology, Assessment, and Treatment in Physical Therapist Practice, Physical Therapy, Volume 98, Issue 5, May 2018, Pages 325–335
a) https://doi.org/10.1093/ptj/pzy020
3) A Survey of Physical Therapists’ Perception and Attitude About Sleep
a) https://www.ingentaconnect.com/content/asahp/jah/2015/00000044/00000001/art00008
4) Catherine F Siengsukon, Lara A Boyd, Does Sleep Promote Motor Learning? Implications for Physical Rehabilitation, Physical Therapy, Volume 89, Issue 4, 1 April 2009, Pages 370–383
a) https://doi.org/10.2522/ptj.20080310
Articles/Content:
1) PT’s Role in Sleep Education
a) https://www.apta.org/news/2017/08/08/from-ptj-pts-should-wake-up-to-their-role-in-promoting-sleep-health
2) Can PT Help You Sleep Better
a) https://www.ptprogress.com/sleep-physical-therapy/
a)

Getting Kids Moving: Pediatric Physical Therapy

Physical therapists don’t just help adults recover from injuries. Pediatric physical therapists are
specially trained to help children of all ages overcome challenges and reach their full potential.
Whether your child has a developmental delay, a sports injury, or a chronic condition, a PT can
create a fun and effective program to get them moving.


How PT for Kids Works
Unlike a typical doctor’s visit, pediatric PT sessions are all about play! Therapists use games,
activities, and exercises tailored to your child’s needs and interests. This might involve:


Building Strength and Coordination: Using fun exercises and activities like animal walks,
obstacle courses, and games, PTs help children improve their balance, agility, and muscle
control. This can be essential for everything from playing on the playground to keeping up
with friends.


Addressing Developmental Delays: Physical therapy can be a game-changer for children
who are experiencing delays in reaching milestones like rolling over, crawling, or walking.
Your PT will assess your child to identify the areas holding them back, and create a fun
program to help them develop the skills they need to progress.


Recovering from Injuries: Did your little athlete take a tumble? PTs can help kids heal from
sports injuries and surgeries. A PT will help your child restore strength and flexibility so they
can safely get back to their favorite activities.


Managing Chronic Conditions: Children with conditions like cerebral palsy or muscular
dystrophy can benefit from physical therapy to help manage their symptoms and improve
their overall function and well-being. A PT will assess your child to identify areas of strength
and areas that need improvement. They will then develop a program to help your child
maximize their strength, range of motion, coordination, and endurance. They’ll educate you
and your child on things you can work on at home. They can also help get your child any
needed equipment like wheelchairs, braces, or walkers.


Benefits Beyond Movement
Physical therapy isn’t just about physical health. While physical therapists play an important role
in promoting physical activity and health in kids, PTs can also help children with:


Self-Confidence: As kids gain strength, coordination, and independence, their confidence
soars. This can have a positive impact on all areas of their lives.


Pain Management: PTs can teach children techniques to manage pain and discomfort,
improving their overall quality of life.


Socialization: Gross motor skills help children participate in play and games with peers,
which help children develop social skills and build friendships.
If you think your child might benefit from physical therapy, talk to your pediatrician or
give your PT a call. They can assess your child’s needs and create a personalized plan to
help them reach their goals!

Relief Through Movement


Physical Therapy for Chronic Pain


Chronic pain can be a debilitating condition, limiting your mobility and impacting your daily life. The CDC estimates that around 50 million Americans experience chronic pain, and 17 million have substantial reductions in activity because of pain. Beyond limiting activity or your ability to work, chronic pain has been linked to depression, Alzheimer’s disease, and substance abuse.


Chronic pain is complex. There’s no single intervention to treat it, but physical therapy should be part of the mix. Here’s why:


How PT Approaches Pain:
Physical therapy often provides relief that’s just as effective as medication but without the potential side effects. Here’s a breakdown of how PT tackles pain and its effectiveness:

Identify the Root Cause: PT goes a step further than medication that masks pain. Therapists assess your posture, muscle strength, flexibility, and joint mechanics to pinpoint the source of your discomfort.

Address the Underlying Issues: Based on the evaluation, PT focuses on strengthening weak muscles that support your joints, improving flexibility for a better range of motion, and correcting any imbalances or postural problems that might contribute to pain.

Use A Multi-Faceted Approach: A PT treatment plan will be customized based on the evaluation. In addition to therapeutic exercise, a PT might use various techniques. Examples include:
• Manual Therapy: PTs use massage, joint mobilization, and trigger point therapy to address muscle tension, improve circulation, and alleviate pain.
• Modalities: Techniques like ultrasound, heat therapy, or electrical stimulation can reduce inflammation, promote healing, and manage pain.
• Aquatic Therapy: A warm, therapeutic pool supports your body and joints while offering gentle resistance. This can often make it easier to start moving again after being in pain for an extended time.

Educate and Empower Patients: PTs equip you with the knowledge and tools to manage your pain independently. This might include learning a new exercise routine, how to modify activities, or how to modify your daily schedule when you’re feeling better (or worse) than normal.

It’s also becoming increasingly likely that you’ll learn how pain works. Research shows that combining pain education with physical therapy is an effective treatment.

If you’re struggling with chronic pain, call your physical therapist. They might have the key that will unlock a pain-free life.

References:
1. Chronic Pain Among Adults — United States, 2019–2021 | MMWR (cdc.gov)
2. The impact of combining pain education strategies with physical therapy interventions for patients with chronic pain: A systematic review and meta-analysis of randomized controlled trials, Physiotherapy Theory and Practice, 37:4, 461-472 DOI: 10.1080/09593985.2019.1633714
3. Preferred Communication Strategies Used by Physical Therapists in Chronic Pain Rehabilitation: A Qualitative Systematic Review and Meta-Synthesis, Physical Therapy, Volume 102, Issue 9, September 2022, pzac081 Preferred Communication Strategies Used by Physical Therapists in Chronic Pain Rehabilitation: A Qualitative Systematic Review and Meta-Synthesis – PubMed (nih.gov)
4. The Influence of Cognitive Behavioral Therapy on Pain, Quality of Life, and Depression in Patients Receiving Physical Therapy for Chronic Low Back Pain: A Systematic Review https://onlinelibrary.wiley.com/doi/abs/10.1016/j.pmrj.2018.09.029

PTs Fuel Healthy Movement With Nutrition

Physical therapy and nutrition are often seen as separate, but the truth is, they are deeply
intertwined. To get the most out of PT, especially after an injury or surgery, integrating both is
crucial. Here’s why:

Food Fuels The Body
During recovery from an injury or surgery, your body is working to heal itself. The activities and
exercises you’re doing in PT are designed to help it along. To take advantage of all the work
you and your body are putting in, proper nutrition is critical.
Protein provides the building blocks for tissue repair and muscle growth. Carbohydrates provide
energy and help support your immune system. Your body also needs healthy fats to regulate
inflammation and to build certain cells. Being short on any of these critical components will slow
your recovery down.
You also need enough micronutrients, like vitamins and minerals. For example, vitamin C is
needed to make collagen, which goes into bones, skin, and connective tissue. Vitamin D helps
your body absorb calcium, which is important for healing fractures, or surgeries involving bones.
Iron helps your blood cells carry oxygen throughout your body, which is needed for healing in
general. Again, being low on any of these micronutrients will affect your healing.

Your Weight Affects Your Health
Being overweight directly affects your health. It puts you at higher risk for cardiovascular
disease, stroke, osteoarthritis, back pain, diabetes, sleep apnea, and more. All of these are
conditions that you might see a PT directly for, or that will impact your healing. Eating a healthy
diet is the most effective way to reduce body weight. Combining a healthy diet with exercise is
even better for your health.
As an example, an 18-month study of 450 people with knee osteoarthritis showed that the group
that lost weight through a diet and exercised had less pain, better walking speed, and lower joint
forces in their knees than groups who either only lost weight, or only exercised.

How can a physical therapist help with nutrition?
While PTs are not authorized to provide individual diet plans or medical nutritional advice, they
can still help with your nutrition.


• PTs can screen for potential nutritional deficiencies or imbalances that may impact your
progress in PT or your overall health. This might involve screening for malnutrition,
sarcopenia (muscle loss), or assessing dietary habits affecting energy levels, healing, or
muscle building.
• Your PT can educate you on the importance of nutrition for various aspects of
rehabilitation and recovery. This includes explaining how specific nutrients like protein,
vitamins, and minerals contribute to tissue repair, muscle building, energy production,
and pain management.
• They can offer general guidance on healthy eating patterns, portion control, and
choosing nutrient-rich foods to support reaching your specific physical therapy goals.
• PTs recognize that overall health and well-being involve various factors, including proper
nutrition. They can encourage you to adopt healthy lifestyle habits that include a
balanced diet alongside regular exercise and proper sleep hygiene.

Finally, your PT can recognize when your nutrition needs exceed what they are able to provide.
In that case, they can refer you to and collaborate with a registered dietician or other qualified
healthcare professional for help in dealing with complex nutritional needs or recommending
specific dietary changes.

By combining the power of physical therapy and nutrition, you can achieve your
recovery goals faster and feel your best!

References:
1. Effects of Intensive Diet and Exercise on Knee Joint Loads, Inflammation, and
Clinical Outcomes Among Overweight and Obese Adults With Knee
Osteoarthritis: The IDEA Randomized Clinical Trial Effects of Intensive Diet and
Exercise on Knee Joint Loads, Inflammation, and Clinical Outcomes Among
Overweight and Obese Adults With Knee Osteoarthritis: The IDEA Randomized
Clinical Trial | Obesity | JAMA | JAMA Network
2. Ottawa Panel Evidence-Based Clinical Practice Guidelines for the Management
of Osteoarthritis in Adults Who Are Obese or Overweight Ottawa Panel
Evidence-Based Clinical Practice Guidelines for the Management of
Osteoarthritis in Adults Who Are Obese or Overweight | Physical Therapy |
Oxford Academic (oup.com)
3. Strategies for optimizing nutrition and weight reduction in physical therapy
practice: The evidence Strategies for optimizing nutrition and weight reduction in
physical therapy practice: The evidence: Physiotherapy Theory and Practice: Vol
25, No 5-6 (tandfonline.com)
4. Body mass index and risk of knee osteoarthritis: systematic review and metaanalysis of prospective studies Body mass index and risk of knee osteoarthritis:
systematic review and meta-analysis of prospective studies – PMC (nih.gov)
5. Nutrition: A Portion of PT’s Menu of Services Nutrition: A Portion of PTs’ Menu of
Services | APTA
6. Considerations for PT’s Role in Nutrition Considerations Related to the PT’s Role
in Nutrition and Diet | APTA
7. Nutrition and PT a Powerful Combination – Nutrition and Physical Therapy: A
Powerful Combination | APTA

Have You Scheduled Your 2023 PT Exam?

Haven’t thought about having an annual PT exam? We’re biased, but we think you should. You see your optometrist and dentist regularly because your eyes and teeth are important. You get an annual physical from your family physician. You might even be getting ready to see your accountant to get your yearly taxes done.

But what about the rest of your body? Have you lost range of motion, or strength? How’s your balance and coordination? These all affect how you move. You might not notice small changes until you have problems like trouble lifting a heavy load, joint pain, or a sprained ankle from a stumble. An annual PT exam can catch problems early, then correct them before they lead to something bigger.

What to Expect

An annual PT exam is quick and easy. Your annual visit may include:
● A history of your injuries, as well as a health history
● Assessment of your strength, balance, flexibility, etc.
● A review of your movement goals (do you want to run a marathon? Get on and off the floor easily playing with your grandkids?)
● A review and update of your exercise program

How Important Is Moving Well?

There is strong evidence suggesting that movement is a valuable predictor of future health and resilience against disease. Moving well can keep you healthier and help you live longer. Here are some examples of the power of movement when it comes to predicting future health:

Gait Velocity

Gait velocity is how fast you walk. Studies have shown that if your typical walking speed is over 1 m/s or 3.3 ft/s, you’re likely able to complete typical daily activities independently. You’re also less likely to be hospitalized and less likely to have adverse events like falls.

Get On and Off the Floor

A series of studies suggest that if you can go from standing to sitting on the floor and back to standing without using your hands, you’re a lot less likely to die than someone who can’t. It’s called the sitting-rising test. You can find the instructions and examples with a quick internet search.

Notice that both gait velocity and the sitting-rising test aren’t specific to any one thing. The risk of hospitalization in the gait velocity studies was hospitalization for any reason. Death in the sitting-rising studies was death from anything. So science says that moving well is incredibly important to your overall health. It’s also important for your quality of life. We think moving well is just as important as your teeth, eyes, and taxes. If you agree, get that annual PT exam scheduled!


References
Why provide an annual physical therapy visit – https://www.apta.org/patient-care/interventions/annual-checkup

Physical Therapists’ Role in Prevention, Wellness, Fitness, Health Promotion, and Management of Disease and Disability – https://www.apta.org/apta-and-you/leadership-and-governance/policies/pt-role-advocacy

Ability to sit and rise from the floor is closely correlated with all-cause mortality risk — ScienceDaily

Gait velocity as a single predictor of adverse events in healthy seniors aged 75 years and older – PubMed (nih.gov)

Returning to Activity After a Pandemic

During the COVID-19 pandemic, activity levels dropped for a lot of people. Between stay at home orders, gym closures and working from home, people became more sedentary. On top of that, there were shortages of equipment like dumbbells and bicycles, making staying active at home difficult even if you wanted to.

But this summer, things look different; vaccines are widely available, restrictions are loosening and people are looking to get active and enjoy the warm weather. That’s all good news, but if you had a long break from activity, your body might not be ready to jump right back in. Here are a few tips to help you get more active without getting hurt:

Start slow
● If you’re a runner, think about a walk to run program
● If you’re a weight lifter, start with lighter weights and less reps.
● Whatever your activity of choice is, start with short periods of activity and gradually work your way back up.
Warm up and cool down
Warming up gets your heart and lungs ramped up and prepares your muscles and tendons for the increase in activity about to come. Include some light cardio like jogging, calisthenics, or cycling, followed by active stretching like butt kicks, high knees, or yoga.

Cooling down transitions your body back to a lower state of stress – it brings your heart rate and breathing down, decreases blood flow to your muscles and back to places like your digestive system, and helps you relax. It’s also a great place for static stretches if you need some work on your flexibility.

Take a day off
Rest days let your body recover and keep you from getting burned out. Not enough exercise isn’t good for you, but too much of a good thing can cause problems too.

Watch for early signs of injury
Some soreness for a few days after activity is normal, especially if you’ve had a long break. But there are a few common issues to watch out for as you return to activity:
● Swelling or bruising
● Joint pain, especially in the knees or shoulders
● Foot pain, which could be a sign of plantar fasciitis
● Muscle strains – particularly common in the hamstrings
● Sprains – most common in the ankle

Any of these issues justifies a call to your physical therapist. Getting checked out early can prevent an injury that derails your attempt to return to activity. PTs see all of the issues just mentioned on a regular basis and can help safely guide you back into a more active lifestyle.

Will COVID-19 Change the Typical PT Patient?

People usually see a physical therapist for pain or loss of function. Think of the person who has
back pain, the injured athlete or the person who’s had a stroke. They all want to improve how
they move and complete tasks. Now, there is good reason to wonder if physical therapists will
start seeing more people who are not in pain or having difficulty moving. Why would these
people come to a PT? To improve their overall health and wellness.


There is strong evidence suggesting that movement is a valuable predictor of future health
and resilience against disease. Physical therapists are movement specialists, so taking
advantage of their expertise makes sense if your goal is to become healthier and live longer.
Here are some examples of the power of movement when it comes to predicting future health:


Gait Velocity

Gait velocity is how fast you walk. Studies have shown that if your typical walking speed is over
1 m/s or 3.3 ft/s, you’re likely able to complete typical daily activities independently. You’re also
less likely to be hospitalized and less likely to have adverse events like falls.


If you’d like to test yourself, measure out a straight, flat course to walk between 10′ and 30′ long.
You’ll also need 5′ or so at the beginning and the end for acceleration and deceleration. Walk
the course at your typical speed and divide the length of the course by how long it took you to
walk it (distance/time). That’s your gait velocity.


Get On and Off the Floor

A series of studies suggest that if you can go from standing to sitting on the floor and back to
standing without using your hands, you’re a lot less likely to die than someone who can’t. It’s
called the sitting-rising test. Here’s how it works:


You start standing, and without support you sit down on the floor, then stand back up. You start
with a score of 10. Every time you put a hand, knee, forearm or the side of your leg on the floor
you lose 1 point. Putting a hand on your knee or thigh to help also costs a point. In a sample of
over 2,000 people, they found that scoring less than 8 points made you twice as likely to die in
the next 6 years when compared to people who scored higher. Score 3 or less and you’re 5
times more likely to die in the same period. Overall, each point in the test is worth a 21%
decrease in mortality from all causes.


Notice that both gait velocity and the sitting-rising test aren’t specific to any one thing. The risk
of hospitalization in the gait velocity studies was hospitalization for any reason. Death in the
sitting-rising studies was death from anything. So while we know that exercise and healthy
lifestyle reduce your risk of specific diseases like heart disease or diabetes, it appears that
being able to move may provide much more wide ranging protection than we previously thought.

Finally, Some Good News About Back Pain

Back pain is a huge problem in developed nations worldwide. It has or will affect most of us. The
current estimate is that 80% of people will experience back pain at least once. It is the single
biggest cause for disability, the third most common reason for doctor visits, and one of the most
common reasons for missing work.


It’s also expensive. Back and neck pain makes up the biggest healthcare expense in the US,
totaling $134 billion spent in 2016. The next two most expensive conditions were diabetes —
$111 billion in spending — and ischemic heart disease at $89 billion.


Diabetes and heart disease being so expensive to treat doesn’t surprise most folks – they can
both lead to other major problems, require long term medication, could require surgery, and
both can be fatal. Back pain won’t kill you, usually doesn’t require long term medication, and
usually doesn’t require surgery either. Why is it so expensive?


The first reason is that it’s so common. The second reason is that our current system isn’t very
good at treating it. Current recommendations include starting with activity modification, and
active treatments like physical therapy. Research backs this up, showing better outcomes and
lower costs with early PT. Unfortunately, only 2% of people with back pain start with PT, and
only 7% get to PT within 90 days. At the same time, a study looking at about 2.5 million people
with back pain in JAMA showed that 32.3% of these patients received imaging within 30 days of
diagnosis and 35.3% received imaging without a trial of physical therapy. Both of these things
go against current practice guidelines for treatment of back pain.


A new pilot program being rolled out by TRICARE, the insurance system used throughout the
US military is waiving the payment owed by the patient for up to three PT sessions in an attempt
to improve the use of what the Defense Health Agency calls “high value” treatment for low back
pain. The theory is that once a person sees some benefit from PT treatment, they’re likely to go
back for more. This is the “try it before you buy it” approach – think of the 7-day free trial Netflix
offers, free samples poured in wineries and craft breweries, or the folks you see standing
around in supermarkets with food on toothpicks. TRICARE’s data seems to indicate that it works
just as well for healthcare as it does for other businesses. In a press release they state that
once people attend one session of physical therapy, they’re likely to go back for more, no matter
what their co-pay is. But TRICARE found that higher co-pays could be a barrier to people trying
that first visit. For the group of patients with the highest co-pays in the system, only 38% of the
people prescribed PT attended the first visit. That’s about half the rate of attendance found in
the lowest co-pay group.


The fact that such a major insurer is looking into the value of PT is great news for everyone. If
TRICARE can show that lowering the cost of PT for patients can improve outcomes and save
insurance companies money, other major insurers will likely follow. This could improve the lives
of millions of people every year while reducing the huge cost of treating low back pain for the
country. That seems like a win for everyone involved.

When the Weather Gets Cold, Don’t Forget to Warm Up

Colder weather means some changes to how we exercise. Of course it’s harder to motivate
yourself to get outside for a run or bike ride when the temperature drops, and the shorter days
compress our schedules, but there are changes in your body that affect your ability to exercise
too. For many people with arthritis or other joint problems, cold weather brings more complaints
of pain. To stay warm, our bodies narrow blood vessels to reduce bloodflow to the skin, and
more superficial muscles. That means that there is an increased risk of muscle strains in the
cold. There is also an increased strain on the heart because of the narrowed blood vessels. This
isn’t to say that you shouldn’t be active outdoors in the cold, it just means you may have to
make a few changes to your routine. Here are a few to consider:

Warm up right

A good warm up is always important, but because of the tendency for joints to be stiffer, and
bloodflow to muscles to be reduced in the cold, it’s even more important that you do it right this
time of year. To start, do something to get your heart rate up a bit, maybe a brisk walk or light
jog. Follow that up with a dynamic warm up rather than static stretches. This could include
walking or jogging while pulling your knees up high to your chest. Maybe some high kicks in
front of you with straight knees to get your hamstrings loosened. A walking lunge with an upper
body twist can get your whole body moving. Cater your warm up to what you have planned in
your workout. If you’re not sure how it should look, ask your physical therapist!

Dress right

Dressing in layers allows you to adjust your insulation to your activity level. After you warm up,
you might want to take off a layer to avoid getting too hot during your main activity. You’ll have it
there later to put back on when your activity level drops and you start getting too cold.
Don’t forget about the sun either – just because it’s cold doesn’t mean the UV rays are gone.
Sunscreen and sunglasses aren’t just for the summer. A lip balm with SPF can protect you not
only from the sun but from the wind too.

Stay hydrated

Drink water before, during, and after your workout. The temperature may be down, but you’ll still
sweat and you’ll still lose water vapor in your breath. The drier air in winter lets your sweat
evaporate more quickly, so it’s easy to underestimate how much fluid you’ve lost.

Cool down

When you’re done, don’t rush to get inside and crawl under a blanket. Cool down properly. Keep
moving with a walk or another form of active recovery to let your heart rate come down. After
exercise is the right place for static stretching. You can also head inside for some foam rolling or
self massage.


The days being shorter and the temperatures being lower don’t mean you’re stuck inside for all
of your exercise. If you follow these tips, you can safely keep moving outside. If you’d like a
customized warm up or cool down, or have questions about your exercise routine, your physical
therapist is a great person to ask!