• 70% of weight loss comes from calorie reduction, 30% from adding physical activity and exercise—even if you can’t work out because of injury, you can still lose weight.

• Weight loss is not as complicated as you think.  It’s simple math: 3,500 calories = 1 pound.  To lose one pound per day, you need to cut 500 calories per day.  Tracking calories (at least initially), portion control and moderation are key. 

• Exercise, whether for weight loss or just regular health maintenance, is good for the mind, the mood, and the body.  Choose a mode of exercise that you enjoy!  Work out with a friend.  Whatever it takes, keep moving!

• Fad diets, diets that eliminate complete categories of food altogether, and “supplements” like Hydroxy-Cut and Alli may give you short term weight loss, but over the long term, a healthy change of lifestyle that can be maintained is the wiser (and usually more cost-effective) choice.

• You must continue to eat in order to lose weight.  Severe calorie restriction will put your body into starvation mode, shutting down your metabolism and slowing or completely stopping the weight loss process.

• It is important to eat a healthy breakfast which includes some protein, as well as carbohydrates (whole grain toast, fruit, etc.—not donuts!).  That will get your metabolism going so that you can burn those calories throughout the day.

• Drinking plenty of water is crucial!  64 oz. per day is the typical recommendation for a healthy diet.  Drinking a large glass of water prior to a big meal will help you decrease portion size, as you will feel fuller from the water.

• Eat slowly, savoring the flavor of the foods you enjoy.  Put your fork down between bites, chew each bite completely and swallow before taking another bite.  Subjects in studies who have done this feel fuller and eat an average of 1/3 less than subjects who eat fast.

• Regardless of how you lose weight, keeping it off is just as challenging.  The following behaviors have been identified in people who maintain their weight loss over 2-4 years:

  • They weigh themselves frequently, at least weekly, and have an upper barrier that they do not allow themselves to go over.

  • They keep track of their food intake in a calorie journal.  Online journals can be very helpful (try www.my-calorie-counter.com).

  • They eat a “controlled breakfast and/or lunch,” meaning they have the same thing each day, knowing exactly how many of their daily allotment of calories are going towards those meals.

  • They stay more active, making exercise part of their lifestyle—FOREVER.

  • They ask others to help keep them accountable.  Including friends and family in on their goals and exercise habits makes a difference.

Range-of-Motion Exercises

To help relieve pain, people with arthritis often keep their affected joints bent—especially those in the knees, hands and fingers. This may temporarily relieve discomfort, but holding a joint in the same position may potentially cause permanent loss of mobility and hinder the ability to perform daily activities.

Range-of-Motion exercises (stretching or flexibility) help maintain normal joint function by increasing and preserving joint mobility and flexibility. They consist of exercises that gently straighten and bend the joints in a controlled manner.

Strengthening Exercises
These types of exercises are important, as strong muscles help keep weak joints stable and comfortable and protect them against further damage. Isometric and isotonic exercises can maintain or increase muscle tissue to support your muscles without aggravating the joints.

Endurance Exercises
When paired with a healthy diet, endurance exercises are fundamental to controlling weight, which helps to reduce excess pressure on joints. Those affected with arthritis should begin a program at a comfortable level, avoiding overexertion. This may be achieved by carefully monitoring intensity and splitting exercise time into small time increments throughout the day.

Disclaimer: Consult your physician or physical therapist prior to beginning any exercise regimen.

Common Spinal Disorders that Attribute to Low Back Pain
There are numerous spinal conditions/diagnoses that result in low back pain. A thorough physical therapy evaluation may narrow down these diagnoses, which are often confirmed with diagnostic imaging such as an x-ray, MRI, or CT scan. The most common causes of low back pain are described below.

Spondylolisthesis: is the forward slippage of one vertebrae as compared to the vertebrae above and below that segment. This slippage is due to instability, which may be attributed to worn discs or fractures. When the vertebra slips forward, this tends to irritate nerves and may cause pain to travel down the leg. This type of spinal condition may then lead to spinal stenosis if stabilization is not accomplished through exercise or surgery.

Spinal stenosis: Spinal stenosis is described as the narrowing of the foramen (holes) that the nerves travel through by bony overgrowth. Stenosis is noticed more with trunk extension, or bending backwards, as these foramen close with this motion. As the foramen narrow even more, this may compress tnerve that travels out of that segment, he which may result in pain shooting down into the buttock, hip, or down the leg with lumbar stenosis.

Herniated disc: Herniated discs are common in the low back because of the size of the vertebrae and limited supportive structures as compared to other areas in the spine. The disc comprises the area between two vertebrae. You may think of the disc as a "jelly donut." The disc is made of a more rigid outer structure called the annulus fibrosis and an inner jelly-like fluid called the nucleus pulposus. A herniated disc is the bulging of the annulur or rigid portion of the disc either backwards, to the side, or a combination of the two. If the disc bulges backwards, which is made worse with forward bending and rotation, this can compress the nerves that travel down the leg, causing "sciatica" symptoms or radiculopathy.

Degenerative disc disease (DDD): Degenerative disc disease is the loss of disc height and shock-absorbing ability in the DDD is often a result of the aging process,which may be more advanced in some individuals at younger ages. This spinal condition may also result in low back pain or shooting pain down the legs as the nerve roots may be compressed with the loss of disc height or bone spur formation, which often occurs in patients with DDD.

Benefits of physical therapy:

• Recruit “core” muscles to stabilize the low back
• Restore spinal mobility
• Instruct in home exercises that may provide relief of symptoms
• Educate regarding proper body mechanics and positions to avoid to prevent flaring up symptoms