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Greetings to you all! I wish each and every one of you a beautiful and peaceful holiday season. In reflecting this month, I thought about my journey to become a physical therapist. I reflected about my time in physical therapy school where I had to learn every area of my field. I had to study and pass the boards in Pediatrics, Geriatrics, Orthopedics, wound care, amputations and what we now call respiratory therapy. After working a few years, my heart pulled me toward the area of orthopedics. I chose to develop my skills and specialize in this area. Some may think orthopedics is a broad area, but it is small compared to all the areas physical therapists must learn to pass their boards.
Why am I bringing this up? Because I feel strongly in educating our patients and continually reminding them to take control of their healthcare! It is the responsibility of each one of us to listen, learn, and make our most knowledgeable decision when deciding on our medical care. It is the responsibility for each of us to find the best medical provider in their field and to understand that each provider has their strengths, but they are not experts in all areas. This is why we call certain medical providers specialists!
A particular case comes to mind regarding a patient who had an amputation of his leg. His physician called me and wanted me to evaluate and treat this patient. I informed the physician that I had not seen a patient with any kind of amputation in 35 years, therefore, acknowledging I wasn't the best provider for this patient. I wasn't the expert. I did say, however, I would find the best physical therapist in our area for this patient, and the patient ended up very appreciative and did extremely well. My point is, even though I am a physical therapist and my specialty is orthopedics, I was not this patient's best option.
Now let's look at one of my most recent patients, whose case, I hope to use to open your minds regarding your overall understanding of physical therapy care. My patient was an orthopedic surgeon who had arthroscopic knee surgery for a torn meniscus. He came in for his physical therapy and honestly, had no idea what he needed to do to regain his full motion, strength and function.  Most people might be surprised by that statement, however, upon further review, it makes complete sense. You might be thinking, "Doesn't this orthopedist know everything about physical therapy"?  After all, the orthopedic surgeon tells physical therapists how to rehabilitate their patients. How could he have no clue?"
Answering this question, may at first glance, surprise most of you. However, if you think about it logically it shouldn't. Orthopedic surgeons study for years to excel in their area of expertise, which is surgery. There are so many surgical techniques for every joint. Trying to keep up on every joint and every new kind of surgical procedure is challenging enough for anyone. As a result, orthopedic surgeons rarely, if ever, have seen any of their patients experience what it takes to recover in physical therapy. They actually have little clue about the complexities and challenges patients experience during their rehabilitation. And, frankly, that is to be expected. You want your orthopedic surgeon continually learning his/her craft, so they can repair any major injuries that require their expertise. On the flip side you would NOT want me to do your hip or knee replacement surgery!!
Physical therapists, like every kind of medical caregiver, are studying continually to develop their specialty.  Physical therapists, like orthopedic surgeons, can be generalists or specialists. It is the patient's duty to find out, before having a surgery or going to physical therapy, what areas of expertise each one of your healthcare provider has. By researching, you have a much better chance of having a successful outcome, which means a more active and joyful life!
I have been in the Michiana area for close to 29 years. In that time, I have seen orthopedic care become more specialized. A good friend of mine, who was a generalist, (29 years ago) had an extremely high success rate in all the joints he surgically repaired. In the last 10 years he has chosen to specialize. He did so, because over the years he had earned his reputation for excellence in all he did and decided it was time to get even more specialized for even a higher rate of success. His results, as would be expected, were even better than before. 
I hope,after reading this letter, you find it in your best interest to find the specialists in the area you are most in need of. You, the patient are the controller of your destiny. Find the best healthcare specialists, listen to their advice and after researching their successes, make your decision. In becoming a more active participant of your care, you will have much more success with your overall health and life!

Health Information

Ten ways to skip your workout
but still exercise during the holidays  

Think you have no time for fitness during the holiday rush? Even if you can't fit in your regular workout routine, it's possible to squeeze in a few moments of exercise to keep yourself on track. Personal trainer Kathleen Trotter shares tips on how to stay healthy without missing out on any of the holiday action.
Kids' play
Train your core as you play on the floor with your kids or grandkids. Start in a V hold position. Lean back 10 degrees. Back straight, core engaged. Rotate right to pick up a toy. Then place it to your left. Repeat in opposite direction. Or, try the transfer in a plank. Start in a plank from your knees or toes, leaning on your forearms. Keep your pelvis stable as you pick your right arm up off of the floor to pick up the toy. Transfer the toy to the left hand. Then pick up your left arm and put the toy down to the left of your body. Keep your core engaged.Then place the toy next to your left elbow. Switch direction.
The home circuit
Can't get to the gym? No problem, strength train at home. You can get a full-body workout with only your own body weight. Try the following circuit: Do 15 step-ups on a kitchen chair, 15 push-ups, 15 squats, 15 lunges and a front plank. Or invest in a resistance band and a door-frame attachment for about $20. The attachment allows you to anchor the band to a door to simulate the exercises you would do with a cable machine.
Just 10 minutes
When you don't want to exercise use the "10-minute rule." I love this rule. I use it almost daily. Tell yourself that you have to do something for a minimum of 10 minutes but that if you want to stop after 10 minutes, you can. Go for a 10-minute walk or jog, do the first 10 minutes of a fitness podcast, or do some body-weight exercises in your living room. Ten minutes of exercise is better than nothing, and usually once you've done 10 minutes you'll continue and finish the workout.
Cardio at home
Who needs a treadmill or Stairmaster? Get your cardio in by running or walking outside. Or run up and down the stairs in your building. After a gentle five-minute warm-up, try this pyramid set of jumping jacks and stair running: do five jumping jacks, run up and down the stairs once, do 10 jumping jacks, run the stairs twice, do 15 jumping jacks, run the stairs three times. Repeat the cycle for 10 to 20 minutes then cool down for five minutes.
Fartlek intervals
Strengthen your heart and burn calories without ever setting foot in a gym. Get your cardio workout in with fartlek intervals. Fartlek intervals are challenging but unstructured, so you can fit in a great interval workout anywhere without fancy equipment. Warm up for five minutes. Then pick a random landmark - such as a 
stop sign - and speed up until you get there. If you are walking in regular attire, just speed walk towards the landmark. If you are out jogging or out with your dog, run or sprint toward it. Walk or jog to recover. Repeat until it is time to go home or you get to your destination.
The water bottle cure
Uncomfortable party shoes and endless errands can leave feet feeling tired and achy. Use a frozen water bottle to breathe new life into your feet. Place a water bottle in your freezer. Whenever you are cooking, cleaning or even waiting for the kettle to boil, grab the water bottle and use it to "roll" out your feet. In only your socks, place the bottle between your foot and the floor. Put weight on the bottle as you roll the bottle up and down your foot.
Door-frame stretch
Grab the edge of a door frame with one hand. Arm at chest height, almost straight, turn your body gently away from the hand. Feel a slight stretch in your chest and 
shoulders. Turn your head with your body. Repeat on the opposite arm. Then, reach both arms up toward the top of the door frame. Imagine your entire body is being stretched from head to toes. If you can't touch the frame, just reach up and imagine hanging from the frame.
Work your core
Do this at the office, in front of the TV or even at the breakfast table. Sit on the edge of your chair or sofa. Lean back roughly 10 degrees, back straight. Hold for 10 seconds. If this is easy, try one of these variations. Backstroke: Maintain the above position as you alternate "swimming" your arms backward. Tucks: Keep your upper back straight as you tuck your hip bones to your ribs so your lower spine tucks. Use your lower abdominals to do the tuck.
W to Y
Sit tall in your chair, core engaged. Form a W with your arms in the air. Keep your arms as close to the back of your chair as you can as you straighten them until they form a Y with your body. Make sure your spine stays neutral. It shouldn't arch as  you move your arms, even if that means the back of your arms move away from the chair. Return your arms back to the W position and repeat five to 10 times.
Strengthen your glutes
Do this as you wait in line, on an escalator, or as you wait for the microwave to beep. Stand on one leg. Engage your bum muscles of the leg you are standing on. Make sure the weight in your support foot is even. Don't lean. Stay straight as your other leg kicks out to the side 10 times. Then try kicking on a diagonal. Finally try kicking backward 10 times. If you want a challenge stand on an unstable surface like a pillow. If you feel silly exercising in line, ask yourself, "What's better, having tighter glutes or caring what the other people in the store think?" Everyone is probably wishing that they had the self-confidence to exercise while shopping.
* article by Kathleen Trotter, The Globe and Mail

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