Wintertime Fall Prevention

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With the build-up of snow and ice on the roads and sidewalks, slipping and falling becomes a real concern for many people during the winter. Although we haven’t had much snow yet, it’s always a good idea to be prepared. Here are some ideas to get you thinking about fall prevention before the snow flies.

Walking Outdoors

  • If you go for walks outside, consider using equipment such as ski poles for better balance. You may also try crampons, metal spikes that can be attached to shoes/boots for better traction.
  • Expect the unexpected. Although the sidewalk may look clear, there could be black ice. Take small steps to keep your body weight balanced over your feet.
  • Have someone drop you off close to building entrances so you don’t have to walk across slippery parking lots.
  • Avoid walking outdoors at night if possible. It’s harder to see hazards in the dark!
  • Walk with someone else. In addition to the good company, you have someone to lean on if necessary.
  • Take your cell phone with you. If you do fall and injure yourself while out walking, then you will be able to call for help.

Walking With Pets

Taking your dog for a walk poses its own challenges during the winter. It’s important to understand your pet’s temperament and make accommodations. If you have an animal that likes to pull on the leash, then you need to be extra cautious when out walking.

  • Consider using a harness, gentle leader, or other equipment to help reign-in your dog’s energy.
  • Walk at a slower pace and take shorter steps to improve balance.
  • Know your pet’s triggers. If your dog is skittish around traffic, then walk in quieter areas and stay away from busy streets. If other dogs are problematic, try to modify your route to avoid walking past homes/yards with aggressive dogs.
  • Walk during the warmest part of the day when sidewalks are less likely to be icy.
  • Have a friend or family member take over the dog walking duties if you are concerned about falling.


Staying Active This Winter

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As the days get shorter and the weather gets colder it’s normal to fall into hibernation mode. Many of us struggle to remain active during the winter months. Colder temperatures along with snow and ice can make outdoor exercise a dangerous undertaking. Still, we know that it is important to maintain physical fitness through all seasons of the year. Here are a few suggestions to help you stay active this winter.

Join a Gym

Purchasing a gym membership is one way to stay fit. Some gyms allow you to pay one month at a time. This is a good option if you want a convenient way to exercise in the winter, but then plan to get outside again in the spring when the weather improves. Gyms offer group classes, individual sessions with personal trainers, and a wide assortment of exercise machines. If you are not the “gym type” or a gym membership is not in your budget, then there are other options.

Go For a Walk Indoors

When the weather is bad and you can’t walk outside, try walking inside. Large stores can easily be used as an indoor track. Try walking up and down the aisles, or around the perimeter of the store. If you need to make a purchase, all the better. If you don’t have anything on your shopping list, then you can appear to be browsing for something and then leave without buying anything. Another option is walking inside a mall, recreation center, or school.

Exercise at Home

If you can’t leave the house, then there are plenty of things you can do at home without any special equipment. Consider some of the following exercises:

  • Walk laps around the house
  • Climb up and down the stairs (if available)
  • Step up and down on a step stool (if able to perform safely)
  • Do standing leg exercises such as leg raises, calf raises, or mini squats
  • Do arm exercises such as wall push-up

Every Little Bit Counts

The US Department of Health and Human Services recently revised their Physical Activity Guidelines for Americans.  In the past, they encouraged people to perform exercise in 10 minute intervals. However, this may not be possible for all people, especially those who are deconditioned or have chronic illnesses that makes exercise difficult. The new recommendations encourage everyone to sit less and move more. Adults should try to accumulate 150 minutes per week of moderate-to-vigorous physical activity in any increments, large or small. Doing exercise in any amount counts; it all adds up!


Foothills Orthopedic & Sport Therapy is here to help you with your fitness goals this winter. If you have specific concerns, or you would like to schedule an appointment to develop a personalized home-based program, we are here for you! Give us a call.

Ski Season in the Rockies

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It’s time to get your skis, snowboards, boots and bindings tuned up! Dig out your favorite jacket and gloves because ski season is almost here! Your gear may be ready for the slopes, but what about you? Are YOU ready for the slopes? Are you having any issues with your knees, hips, feet, shoulders or spine? Pain in any of these areas could slow you down on the slopes this season.

Tips for Preventing Injuries on the Slopes

A few simple changes to your routine and some common sense go a long way toward preventing injuries.

  • Perform a warm-up program before getting on the ski lift.
  • Start with a few easier runs to get your body moving and to make sure your equipment is in good working order.
  • Stick to marked trails. Skiing and snowboarding in out-of-bounds areas poses additional risks that can increase the potential for injury.
  • Maintain your skill level and use proper technique. Most people take lessons when they are new to the sport, but lessons can also be helpful for proficient skiers who want to advance their skills to the next level.

Show Up Prepared for the Slopes

Make sure your body and your equipment are ready for the season. Prepare your body by participating in at least a few weeks of pre-season regular exercise including:

  • Aerobic conditioning such as cycling, running, rowing, swimming, or using an elliptical machine
  • Core strengthening such as planks
  • Leg strengthening such as squats or lunges

Remember to pack all important equipment.

  • Helmet
  • Wrist guards–recommended for snowboarding
  • Appropriately sized skis for your height, weight, skill level, and terrain

Pace yourself on the slopes.

  • Consider skiing a half-day on your first day out, or take rest breaks when needed. You are more likely to get injured when you are fatigued.
  • Don’t ski multiple days in a row for the first time out this season.
  • Limit alcohol consumption. Being active at high elevations leads to relative dehydration. Alcohol magnifies this dehydration which can increase the potential for injury. Who doesn’t love a mug of hot chocolate at the ski lodge? Just say no to the Bailey’s Irish Cream!

Pre-Season Physical Therapy

If you have any questions regarding your physical readiness to start skiing, or any other sport, please contact us at Foothills Orthopedic & Sport Therapy for a free consultation. We would be glad to assess your readiness to participate and provide guidance on appropriate exercises, as well as any treatment that might be needed to get you on the ski lift and ready to carve some powder!



National Physical Therapy Month

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October is National Physical Therapy Month

“My knee hurts when I go down stairs.” “I can’t reach behind my back without my shoulder hurting.” “I have constant back pain.” Do any of these statements apply to you? These are common problems that cause people to seek medical treatment. Pain can be debilitating and can cause people to turn to prescription pain medication. This October, the American Physical Therapy Association ( is raising awareness of physical therapy as a safe and effective alternative to opioids for treating chronic pain.


The Facts About Opioids

  • Opioid medications are prescribed at alarming rates.
    While there has been a decrease in opioid prescription in recent years, they are still prescribed at alarming rates. According to the CDC, in 2016 health care providers wrote 214 million prescriptions for opioids.
  • The risk for misusing prescription opioids is real.
    According to the CDC, every day over 1,000 people are treated in emergency departments for misusing prescription pain medications.
  • The risk for addiction is real.
    According to the CDC, as many as 1 in 4 people who receive prescription opioids struggles with addiction.
  • The risk for heroin use is real.
    According to the CDC, among new heroin users, about 3 out of 4 report abusing prescription pain medications before using heroin.
  • Physical therapy is a safe and effective alternative to opioids for long-term pain management.
    In March 2016 the CDC released guidelines urging non-opioid approaches for managing chronic pain. Physical therapy is a safe and effective non-opioid alternative.
  • There are some situations in which opioid therapy is appropriate.
    Opioids may be appropriate for cancer treatment, palliative care, end-of-life care, and certain acute situations. Still, the CDC guidelines suggest pairing drug therapy with non-drug therapy. In fact, the prescriber checklist recommends trying non-drug therapy first.
  • Patients have a choice about the kind of treatment they receive.
    Before accepting a prescription for opioids, patients should talk to their health care providers about related risks and safer alternatives.

The Facts About Physical Therapy

  • Physical therapy is not always prescribed. A study published in Spine found that between 1997 and 2010 only about 10% of doctor visits for low back pain resulted in a referral to a physical therapist. If your doctor doesn’t give you a referral to see a physical therapist, ask for one!
  • A wide range of conditions respond to physical therapy. Physical therapists are trained to work with conditions that affect all joints, muscles, tendons, and ligaments of the body. Some physical therapists have additional training in specific areas such as hand therapy or women’s health. There is likely a therapist out there with the skills to help your specific problem.






National Balance Awareness Month

By the Numbers

September is National Balance Awareness Month. Every year millions of older adults fall. In fact, more than one in four people over age 65 will fall every year. Less than 50% of those people will report falling to their doctors. Falls have a significant impact on the individual, their families and the entire community.

It’s Not Just Falling

Another important thing to remember is that not everyone who has difficulty with balance will actually fall. Some people describe tripping, stumbling, feeling dizzy, swaying, falling into objects, difficulty walking in a straight line or simply feeling “off”. You may feel like your balance is fine when you are standing still, but you may have more difficulty when waking and trying to do multiple things at the same time.

Balance relies on your vision, your inner ear, your muscular system, and your proprioception (your body’s ability to tell where it is in space). If one of these systems is not working correctly, it will result in difficulty with your balance.

Factors Affecting Balance

There are many different factors that can cause difficulty with your balance including:

  • Muscle weakness
  • Joint stiffness
  • Inner ear problems
  • Medications
  • Decreased activity levels
  • Some medical conditions
  • Fear of falling

Prevention is Key

Taking steps to prevent falls and improve your balance is essential to your health and wellness. Look around your house and make sure that you have proper lighting and clear pathways. Avoid excessive clutter. Visit your eye doctor regularly. Maintain your strength, balance, and endurance. If you have had a fall or you are having difficulty with balance, we would love to help. Contact our office today to schedule a balance assessment.

Common Jaw Exercises in the Treatment of TMJ Dysfunction

What is TMJ Dysfunction?

The temporomandibular joint, or TMJ, is formed by your jaw bone (mandible) and skull (temporal bone). Dysfunction of this joint is common and results in a variety of symptoms. People with TMJ dysfunction may experience: headaches, jaw pain, neck pain, earaches and/or ringing, and at times difficulty opening the mouth. Joint noise such as “clicking or grinding” may also occur.


The causes of TMJ dysfunction vary. Common factors include localized arthritis, injury, occlusal (bite) imbalance, and stress in the form of clenching and/or grinding. Exercises relax the jaw muscles, reduce strain to the TMJ, decrease clenching/grinding, restore normal motion, and increase joint stability (strength).

Specific Exercises for the TMJ


  1. Normal resting tongue position – Place your tongue against the roof of the mouth as if making a “clucking/clicking” sound. Ideally the front 1/3 of the tongue should rest upwards, just behind the front teeth. This is considered to be the best position for your tongue to help keep the jaw muscles more relaxed.


  1. Controlled Opening – Place your tongue towards the roof of the mouth (exercise #1 above). Open comfortably without pulling the tongue away from its upward position. This is intended to limit jaw movement and minimize excessive strain to the ligaments and muscles that support the TMJ. This also often helps to decrease joint noise.


  1. Mandibular Isometrics – This exercise has also been called rhythmic stabilization. The goal is to increase muscular control or strength by a series of contractions. Place the jaw in rest position with slight opening and then lightly push against the lower jaw in six different directions: open, close, right, left, backward, forward – without letting the lower jaw move. Keep the amount of resistance very light.


  1. Axial Extension of the Cervical Spine – This exercise is used to improve the relationship of the head to cervical spine (neck). It helps to decrease postural stress that could influence the jaw muscles. Tilt the head (eyes) down slightly, complete a gentle chin tuck, then finish with a tiny “nod” of the head without losing the chin tuck position.

If you are experiencing any symptoms associated with TMJ dysfunction, we may be able to help. Contact our clinic today to be evaluated by a TMJ specialist.

Ask a Physical Therapist To “Screen” Your Movements This Summer


It’s A Process

Let’s talk about the last time you interviewed for a new job. Chances are the first step was a phone screen. When you passed that portion of the process, you were then invited for an in-person interview. At that stage, the employer probably asked you to demonstrate your skills through a test or two. The process is set up in a way that narrows down the options until the most suitable candidate is found. Makes sense, right?

Just as job recruiters screen applicants to understand their abilities, PTs screen your movements to understand your body mechanics. These movement screens are just one tool in identifying the most appropriate treatment program for you. But unlike a job interview, the screen is not testing your skills or abilities. It’s simply identifying how your body functions during a variety of movements.

When to Have a Movement Screen

Summer is the perfect time to make an appointment with your physical therapist for a movement screen. The warmer weather means more time spent outdoors participating in activities that may be physically demanding. A PT checkup will ensure that you’re physically able to engage in popular summer adventures.

Physical therapists perform movement screens for a variety of reasons, including:
• Identifying areas of strength and weakness
• Uncovering issues or rule them out
• Determining readiness to begin a safe exercise program
• Improving sport performance (for both novice and elite athletes)

A movement screen can be done whether you have a nagging injury or you are simply ready to kickstart your activity level after a long hiatus. Gaining an understanding of how your body performs during basic exercises helps your PT ensure that you can safely jump on a bike or into a pool this summer. A movement screen can help you develop a lasting relationship with the activities you enjoy most.

Common Bicycling Injuries

When you hear the phrase “bicycling injuries” what comes to mind for you?  Skinned knees and elbows? Bruised arms and legs? Car versus bicycle encounters that result in the rider becoming airborne? Although these types of overt injuries can happen, especially when riders are males traveling at faster speeds, non-traumatic bicycle injuries are more common and account for up to 85% of all cycling-related injuries.

Cycling by its very nature is a repetitive activity. During a recreational ride of 30 minutes, you will likely complete between 1,800-2,400 pedaling cycles depending on your revolutions per minute. Riding a bike also involves holding a relatively static posture over a prolonged period of time. The combination of these two factors can result in several common overuse injuries including:

  • Iliotibial band irritation
  • Patellofemoral pain (pain in the front of the knee)
  • Back and neck pain
  • Saddle soreness/compression neuropathy
  • Wrist/hand pain

So, how can you prevent yourself from developing an overuse injury? First, consider having a physical therapist perform a medical bicycle fitting to ensure proper alignment while you are riding. Even minor positional faults can lead to serious problems over time. Next, be sure you have adequate flexibility and strength in order to ride your bike with good posture. Again, a physical therapist can assess your joint mobility and strength and help you develop a home exercise program to meet your goals. Lastly, your training schedule is important. If you’re just dusting off the bike for the first time this season, then it’s probably not a good idea to ride 50 miles the first time. As we physical therapists like to say, “Start low and go slow.” Progress your mileage slowly and incorporate regular stretching and rest days.

If you are having pain while riding your bike, then you might be suffering from an overuse injury. Call our clinic today to schedule an appointment with one of our bike fit therapists. We want to help you stay pain-free and in the saddle!

Bicycling for Fitness and Fun

It’s springtime in the Front Range which means beautiful sunny days (most of the time) and mild temperatures (except for those crazy spring snow storms) that are perfect for bike riding. Whether you ride a road bike, mountain bike, tandem, recumbent or other style of bike, there are many benefits to this activity, not only for your health and well being, but for that of the environment as well.

Bicycling is a great form of low-impact aerobic activity, exercise that puts less stress on our joints and gets our heart and lungs working. This is an especially important type of exercise as we get older, as many adults develop arthritis in their weight-bearing hip and knee joints.  Riding a bike decreases the impact on knees and hips and allows us to exercise more comfortably. Additionally, bicycling helps to maintain muscular strength and endurance.

The Physical Activity Guidelines for Americans (available at outlines key recommendations for aerobic activity. Specifically, the average adult should aim for 150 minutes of moderate intensity aerobic exercise per week. This could be easily accomplished with several bike rides throughout the week at a moderate speed (less than 10 miles per hour).

When increasing your level of activity it is important to progress gradually in order to allow your body tissues to adapt and get stronger. Progressing too quickly could result in tissue irritation and the development of overuse injuries. Bicycle riding should be a fun and pain-free activity.

If you are experiencing pain while riding, then your bike may not be fitted properly resulting in increased strain on your body. This is an area where a physical therapist can help assess you and your bike, and make adjustments in order to improve your comfort and performance in the saddle. Several of our therapists are trained in bicycle fitting and are available to perform a comprehensive assessment and bike fitting. Call us today so we can help you get back on the bike!

In the next posting, I’ll discuss some common bicycle-related injuries and ways to avoid them.

Your Smart Phone Could Be Rapidly Aging Your Spine

Chances are that you probably haven’t given much thought to how your neck and back are faring in the era of the smart phone, but studies show that you most certainly should. It’s practically a reflex these days to pull out our smart phones when we’re standing in line, sitting at the airport or riding the subway. And while it’s great that we rarely need to venture beyond our pockets for entertainment, our bodies are beginning to retaliate—and mourn the pre-texting days. So, what exactly are these contemporary conveniences doing to our bodies? A surgeon-led study that published in Surgical Technology International assessed what impact surgeons’ head and neck posture during surgery—a posture similar to that of smart-phone texters—has on their cervical spines. With each degree that our heads flex forward (as we stare at a screen below eye level), the strain on our spines dramatically increases. When an adult head (that weighs 10 to 12 pounds in the neutral position) tilts forward at 30 degrees, the weight seen by the spine climbs to a staggering 40 pounds, according to the study.

How pervasive of a problem is this? According to the study, the average person spends 14 to 28 hours each week with their heads tilted over a laptop, smart phone or similar device. Over the course of a year, that adds up to 700 to 1400 hours of strain and stress on our spines. As a result, the number of people dealing with headaches, achy necks and shoulders and other associated pain has skyrocketed. Trained to address postural changes and functional declines, physical therapists are well-versed in treating this modern-day phenomenon, widely known as “text neck.”

Over time, this type of poor posture can have a cumulative effect, leading to spine degeneration, pinched nerves and muscle strains. Scheduling an appointment with a physical therapist can help people learn how to interact with their devices without harming their spines. The PT will prescribe an at-home program that includes strategies and exercises that focus on preserving the spine and preventing long-term damage.

Exercise is an important part of taking care of our spines as we age, but what we do when we’re not in motion matters, too. So next time you pick up your smart phone or curl up with your e-reader, do a quick check of your head and neck posture. Your body will thank you for years to come.