Goalposts

#1 - You don’t have to live with the pain

If you’ve had physical therapy in the past and your injury or condition has started to bother you again, don’t get discouraged, but DO seize the day. Here’s a helpful perspective from my colleague Jerod Carter:

If symptoms return after treatment has concluded, it doesn’t mean that you have had a big setback. Moreover, it doesn’t mean that PT wasn’t the full answer to the problem. If you achieved pain-free status in PT before, it can be done again!

Please give my office a call if your injury has started to hurt again. I can get you back to doing the things you love.

#2 - Put exercise to work for you

I know our lives and the times we live in aren’t getting any less stressful, and this time of year can be especially difficult. But physical activity DOES help and is far from being just one more “to-do.” According to the Mayo Clinic, getting moving has immediate physiological benefits:

It bumps up your endorphins (your brain produces more feel-good neurotransmitters).

It lets your body systems safely practice working together through the effects of stress, providing protection for your cardiovascular, digestive, and immune systems.

It reduces anxiety and mimics the benefits of meditation. Focusing on your body’s movements can generate energy and help you feel more calm, clear, and focused.

Perhaps you know you need to exercise but have trouble making that happen either due to physical limitations or a lack of motivation. A physical therapist can provide excellent support in both of those areas. If you’re just starting out, I can address any pain you’re experiencing and design a gentle yet effective workout. If you already exercise, a consultation with me can change up your routine and provide accountability. I specialize in helping clients set and attain goals and I’d love to help you create a plan to manage stress and enhance your day to day life.

#3 - Get guidance on getting healthy

If you have a health-related “reset” in mind for after the holidays, you’re probably considering the many diet and exercise options out there – and there are too many to count! Why not make it more simple for yourself and talk it over with an expert? My practice has the tools you need to lose weight and improve your nutrition. 

For years, I’ve partnered with IDLife to offer my clients realistic, effective solutions that work because, like personalized PT treatment plans for my patients, this wellness approach is not cookie-cutter. IDLife is about as customized as you can get. A thorough assessment for every client ensures the regimen is completely suited to your needs and lifestyle, and we even offer DNA testing to analyze your body’s unique makeup and zero in on the fitness and weight loss strategies that will be most successful for you. No need to wait until the new year – come in today to understand your options and be ready to hit the ground running in January!

I’m thrilled to be embarking on this next chapter in a new facility, and I commit to maintaining the 100% personal, flexible, targeted, and efficient care that my valued patients expect and deserve. I truly look forward to seeing you soon!

Address: 3000 Cabot Blvd West, Suite 200, Langhorne PA 19047 

Hours: Monday through Friday, 8:30am to 5:00pm

Phone: (215) 968-0156

Be well,

The “why” behind hydration

About 60% of your body is made up of water. You continually lose water by breathing, talking, and perspiring; to keep your body in working condition you must replenish lost fluids. Drinking adequate fluids prompts better physical performance, energy levels, and organ function. It can also treat and prevent headaches, constipation, and kidney stones, and aid weight loss.

Besides being an important part of the fluids in your body (like blood, digestive juices, and the lymph fluid of the immune system), water is needed by each cell to work, including those in your brain. Most of us don’t realize that our brains are strongly influenced by hydration -- it impacts your mood, concentration, working memory, anxiety, and motivation.

A variety of ways to hydrate

Getting more water into your day can be as simple as making a few changes. Here are some of my favorites:

Power up your water. Almost any fluid will add value to our bodies, but water is the best choice, plus it has zero calories, can help suppress your appetite, and aids in digestion. To supercharge your water and add low-cal flavor, I love the taste and convenience of Hydrate packets from IDLife, a clean electrolyte replenisher that provides antioxidants and essential nutrients without added sugar. I just pour a packet into my water bottle, shake it, and go. (Read on for more about electrolytes and their important role.)

Snack on fruits and veggies. Cucumbers, leafy greens, radishes, celery, zucchini and tomatoes are vegetables with high-water content. Water-rich fruits include watermelon, strawberries, cantaloupe, peaches and pineapples. 

Have some oatmeal. Believe it or not, oatmeal is very hydrating - oats expand and absorb the water or milk they’re cooked or soaked in. Enjoy your oatmeal warm, or try overnight oats with this recipe from Feel Good Foodie, which includes an added boost with chia seeds that soak up 10 times their weight in extra liquid and keep you full.

Try various herbal teas, served hot or iced. Herbal teas like peppermint, lemon, chamomile, and ginger are a great source of hydration and contain no caffeine or calories (unless sugar or sweetener are added).

Find a healthier swap for dry, heavy carbs. Instead of bread, wrap your lunchmeat in lettuce, which is about 95% water. Or opt for zucchini noodles instead of spaghetti with your favorite tomato sauce.

Freeze your fruit. Homemade popsicles are a delicious way to rehydrate. Blend a hydrating ingredient like watermelon, fill your popsicle molds, and freeze for at least an hour.

How much is enough?

A common rule of thumb is to drink 64 ounces (8 cups) of water daily. There’s no scientific rationale to this adage, but it’s an appropriate starting point. According to the Mayo Clinic, adequate daily fluid intake is:

About 15.5 cups (124 ounces) of fluids a day for men

About 11.5 cups (92 ounces) of fluids a day for women

(These recommendations cover fluids from water, other beverages, and food. About 20% of daily fluid consumption usually comes from food and the rest from drinks.)

There’s no one formula -- the amount of water each individual requires will vary based on climate and altitude, general health, medications, and alcohol consumption. And, other factors like age and exercise can even affect the degree to which you experience thirst.

What about electrolytes?

If water is the gasoline that fuels your body, then electrolytes (minerals like sodium, chloride, potassium, magnesium, and calcium that maintain your body’s ionic balance) are the motor oil that keeps everything running. When you’re working out for longer than an hour or sweating a lot on a hot day, you might need to replenish your body’s electrolytes in addition to staying hydrated. 

Sports drinks (like Gatorade and Powerade) are well-known electrolyte boosters, but use caution: a 20-ounce sports drink can contain as much sugar as a regular-size Snickers bar or two servings of ice cream! Even low-sugar/low-cal sport drink varieties aren’t without drawbacks; most substitute acesulfame and sucralose for sugar and may contain food dyes, such as Red No. 40, Blue No. 1, and Yellow No. 5. These artificial dyes are derived from petroleum and may increase the risk of hyperactivity in children. They’ve also been linked to cancer.

To replenish electrolytes without added sugar or artificial ingredients, check out natural alternatives (another reason I love IDLife Hydrate) or consider making a healthier sports drink at home with this recipe.

A few final tips

Keep in mind that the body hides mild dehydration very well, so it can take hours before you realize that you’re dehydrated. That’s why an important strategy is to prevent dehydration by hydrating frequently. 

As with any new habit, consider starting with a smaller target for a week or two to establish the routine, then increase your goal from there. For more about forming healthy habits, visit my blog.

The bottom line? Even mild dehydration can affect you mentally and physically. Make sure that you get enough water each day, whether your personal goal is 64 ounces or a different amount. It’s an essential building block for your overall health.

Be well,

Brian

Mobility and flexibility are essential to your golf swing and your grip. In fact, your swing involves muscles in nearly every area of your body - back, shoulders, and arms, of course, but also hips, calves, knees, even ankles and core. Each golfer has a unique swing, so specific muscle use varies. 

You’ve probably noticed that your body is more flexible in some areas than others. Because flexibility varies from muscle to muscle, your body takes action to adapt and modify. In other words, when you lack mobility in one area, you make up for it in some other way (for example, shifting between more hip and knee motion or more shoulder and upper body motion, depending on your trouble spots). Our bodies are amazing at compensating. Whether you modify the mechanics of your swing intentionally or it’s happening unconsciously, stretching your muscles will help your body perform helpful compensations rather than overtaxing weaker or lesser used muscles.

When should you stretch?

Stretching before your outing is important to help you limber up. Periodic stretching throughout your game can help you feel even better. You don’t have to stretch at every hole, just choose a couple of stretches about every third or fourth hole. Otherwise, as the day goes on, your fatigued muscles will tighten up again and affect your comfort and your game by the time you reach the later holes.

How long should you stretch?

You’ll get the most out of these stretches if you hold each position for a slow and steady count of 15 to 30 seconds.. Repeat each motion five to ten times.

How should you stretch?

Here’s an easy to follow routine:

Stand up straight. Hold a golf club with your hands shoulder-width apart. Reach up and extend your arms overhead. The club will be parallel to the ground.

First, bend side to side. Remember to hold the stretch for 15-30 seconds on each side.

Next, holding the club over your head, twist at the waist to rotate from side to side. This stretches your sides and back to help with your followthrough.

Then, carefully lower the club so it rests behind your neck, across your shoulders. Again, twist gently from side to side and hold 15-30 seconds at each side.

Now, extend the club back up over your head. With your arms overhead, bend forward at the waist so you’re looking at the ground and the club is out in front of you. Hold for 15-30 seconds, then slowly come back to standing upright. You’ll feel this stretch in your upper back, shoulders, and lower back.

Finally, stand straight, lower your arms to chest level and extend them in front of you. With the club at chest level, twist gently from side to side and hold for 15-30 seconds on each side.

These are stretches that are generally safe for most players. It’s a good idea to take them slowly and stop if you feel pain. A physical therapist can prescribe a stretching regimen personalized to any difficulty you experience. 

PTs are also qualified to help you safely resume golf if you’ve missed out on it for a time due to pain, surgery, or injury. I recently worked with a patient whose goal was to get back to golfing after being out of the game because of back pain. My guidance helped him to realize that a slow and steady approach was going to be the safest way to get him back into the hobby he loves. While he wouldn’t be ready to play a full round right away, going to the driving range or playing nine holes were attainable goals that kept him motivated. He worked diligently with me to attain the mobility and strength he’d lacked. There’s no doubt that coming off injuries, surgeries, or pain in the back or extremities can make it really challenging to get back to the sport you love. Don’t get discouraged if 18 holes is not the first thing you do, but be encouraged to get back to swinging the club and slowly making your way back to the green. 

If you have a few minutes and are interested in learning more, check out my brief video here to see these and other stretches in action and also learn the safest way to pick up your ball from the cup after you sink those putts. I think you’ll find that getting into the habit of stretching will feel great, helping you maintain your game and enjoy the course. 

Be well,

Brian

I love my profession because I find it so rewarding to help people to overcome challenges and difficulties, regain their function, and improve their life. What’s more, every single day is unique. I love the challenge that comes with figuring out what’s causing an issue and finding creative ways to meet a patient's goals.

Before starting my practice, I spent many years in inpatient rehab, various outpatient settings, home care, and nursing homes. That wide variety of PT environments definitely helped mold me into the PT I am today. I learned a great deal.

When I took the leap start my business 15 years ago, I did it because I believed so strongly in providing the best comprehensive care for patients. 

I knew that there were (and are) plenty of options out there for PT. Many are good; some are not. I’d always taken pride in my field and held myself to a high standard of being a professional who always does the very best I can. I’d managed my career that way, now I wanted to bring that commitment to an entire practice. I wanted to create a culture of excellence and a 100% patient-focused approach that would consistently deliver the highest level of care for patients. I believed in this idea so firmly that I wanted to put my name, my time, and all of my resources behind it.

That’s how Mulligan PT came to be, and it was one of the best decisions I’ve ever made. I love being an entrepreneur because it lets me bring these key values to my work with patients:

Freedom - Managing my own schedule means I can spend the right amount of time with each patient and see them at the right intervals for optimum results.

Versatility - I adapt to the needs of my patients and provide individual care and treatment. I’m passionate about helping people with all aspects of health and wellness and have partnered with IDLife, a customized health and nutrition company, to address patients’ whole health. 

Relationship - I’m humbled by the challenges my patients overcome and their willingness to entrust me with their health and return to me for care over the years. I treasure the relationships that are built by being able to really engage with my patients, treat them like family, and take an interest in their lives. 

Being a business owner has its challenges, but I love it. I know I wouldn’t have as much freedom to treat and operate this way if I was working for someone else or for a large entity. Looking ahead, I’m thrilled to explore the endless possibilities for growing my practice in different areas while still maintaining a personal, caring, individualized approach to my patients. I look forward to the next 15 years and beyond to see where God is leading me and my practice to help those in this community with the best possible physical therapy services, treatment, and outcomes.

A huge and heartfelt thank you to all my patients for keeping me going, and to the family and friends who’ve supported me for the last 15 years! You are simply the best!

Be well,

Nutrigenomics (also known as nutritional genomics) is basically the relationship between nutrients, diet, and genes. It’s a relatively new scientific field that wasn’t even possible until the mapping of human DNA sequencing began in the 1990s. Today, it forms the foundation for truly personalized nutrition tailored to individuals. Getting your genetic blueprint can help you figure out exactly what your body needs to be at its best.

Here’s how it works. By analyzing a DNA sample, scientists can spot biomarkers (genes) that impact how your body processes certain nutrients. Interpreting those results could reveal that your lifestyle is actually working against your genetics. For instance, a marker in your FTO gene signaling that you could actually gain weight from endurance workouts, other genes indicating extreme sensitivity to the macronutrients in certain diet plans, or a vitamin B 12 deficiency that creates fatigue and weakness, even with a multivitamin. These are just a few of the many possibilities. 

Here’s what happened for one of my clients, Fran:

I had no idea that there are certain elements of my DNA and health that were important for me to be aware of in order to maximize my goals. I had been doing “the usual,” cutting out the carbs so I could lose weight. Only I wasn’t losing even though I was doing everything you were supposed to. What I found out from my DNA test was that my body actually required more carbs in my daily intake and that by cutting them out, I was being counter productive to my weight loss journey. Once I made that adjustment and followed the recommendations, I began to take off those last pounds that otherwise would’ve most likely continued to be a losing battle without having that crucial information.

I really enjoy helping clients like Fran. The nutritional analysis tool I use with my clients is IDLife DNA. IDLife DNA connects the dots from your genetic makeup, diet, and lifestyle to create a truly personalized nutrition and fitness. 

Getting started is easy. After talking with me and enrolling, you’ll register your kit online. Next, swab a sample of cheek cells and send it off to our HIPAA compliant lab. In 3 to 4 weeks, you'll receive your personalized id life DNA report. Check out a sample report here.

Your report will reveal your unique genetic dietary needs, weight predispositions, food response, metabolism and exercise response. The report also breaks down how your body metabolizes certain nutrients, creating the perfect foundation for your one of a kind customized vitamin program, IDNutrition. We’ll meet to discuss your results and I’ll share my recommendations. By combining the guidance of your genetics report with the highest quality personalized vitamin product available, IDNutrition, you’ll finally have the complete picture of how to achieve your health and wellness goals.

I’d love to help you find out how to optimize your own unique make-up. Talk to me about IDLife DNA today and let’s come up with the right diet and lifestyle choices to create a completely personalized nutrition and fitness program designed just for YOU!

Be well,

Brian

Track 1: “I Can’t Fight This Feeling Anymore”

There’s a huge emotional component to injury, disease, and recovery. Perhaps a friend dealing with shoulder surgery isn’t just unable to use her arm as accustomed, she’s sad that she can’t lift her toddler. An aging parent with a leg fracture may be eager to walk again but struggling with fear of putting weight on the leg and learning to trust it again. Or your spouse who struggles  with chronic pain may be experiencing depression and anxiety because he wakes up feeling unwell many days and isn’t certain what he’ll manage to accomplish. 

Gently encourage your loved one to share the emotions that accompany their situation. Getting these feelings out into the open can help to relieve stress and fear and prompt a better mindset toward physical therapy. Often, a counselor or mental health therapist can be instrumental in helping patients handle difficult emotions and refocus on improving their lifestyle and function.

Track 2: “Love Hurts”

It’s hard to see someone we care about experiencing discomfort and PT can definitely be uncomfortable at times.  I think WebMD puts it very well:

[Physical therapy] will be safe. But because you'll use parts of your body that are injured or have chronic pain, physical therapy can be challenging, even hard. For example, you may feel sore after stretching or deep tissue massage.

But there’s a reason for that. Your therapist has a specific plan in mind based on your particular needs. Sometimes to get stronger, you have to do some tough training. It will push you, but it shouldn't be too much.

Each person may respond differently to therapy. Your body type, daily activities, alignment, and habits all affect your plan. Stick with it, and you'll get the benefits.

Sharing specific details when asked, “how did you feel after our last session?” can allow the physical therapist to make adjustments, incorporate more stretching or strengthening techniques, and employ heat, ice, and electrical methods to help decrease pain or swelling after a therapy session. Help your loved one bear in mind, though, that the therapist’s job isn’t to pamper them, it’s to help them overcome pain and challenges, which can mean doing the very things they may not feel like doing to attain progress. 

The patient can and should be candid, too, if tempted to skip sessions or discontinue therapy. Ask them to talk to their therapist about their reasons for missing  treatment or quitting so that these reasons can be addressed. I’m always willing to help patients modify their approach rather than stop altogether.

Track 3: “Wind Beneath My Wings”

PT is hard work and it takes discipline to see it through. Here are some simple ways to lend ongoing, practical support: 

>> Cast a vision. Find out a specific goal that the patient is working towards and frequently help him or her envision the good things that will come from achieving that milestone; for instance, “there’s a festival we should check out once you’re more comfortable walking on the grass,” or “your grandson will love it when you can sit on the floor to play with his train set.”

>> Encourage progress at home. The biggest area that I see family members making a difference is with the home exercise program (HEP), an individualized set of therapeutic exercises that’s really one of the most important aspects of physical therapy. Research shows patients who comply with an HEP are significantly more successful at achieving rehab goals and tend to experience relief from pain more quickly. For more tips on home exercises, check out my article.

>> Educate yourself. Check out sites like www.choosept.com for easy-to-understand info about PT’s effectiveness in addressing various injuries and conditions.

>> Defer to the professional. You mean well and only have your loved one’s best interests at heart, but resist the impulse to interrupt a session or naysay the therapist’s advice. PTs are licensed rehabilitation experts with years of schooling and tons of experience. If you have lingering concerns and the patient is a family member, give the practice a call and ask for some time to speak with the therapist. 

Track 4: “Nothing Compares 2 U”

Anyone can encounter a tendency to compare their progress to others, whether that means other clients at the therapy clinic or accounts heard from friends or relatives. But I’m not being trite when I say that physical therapy is unique for each and every individual. Besides a myriad of different conditions, impairments, and degrees of severity, I’ve seen firsthand that personality, lifestyle, and circumstances heavily influence a patient’s progress and outcome - as does the quality of their support system. I don’t use cookie-cutter treatment plans, and my clients don’t experience cookie-cutter outcomes. Each person is on his or her own journey with PT. With the right treatment, they’ll attain the goals most appropriate for their life in the timing that expertly blends safety and effectiveness. If you or your loved one is frustrated by the pace, instead of making comparisons and getting discouraged, revisit my earlier tip and request a time to speak with the physical therapist. 

You have an important role in your friend or family member’s success in PT. Whether you team up to do home exercises, ask about their progress, help them get to and from appointments, or encourage perseverance when the going gets tough, you can help the one you love stick with PT, gain confidence, and achieve their goals.

Happy Valentine’s Day!

Be well, Brian

Charles Duhigg, author of “The Power of Habit,” reveals that while goals rely on extrinsic motivation, habits are automatic. They literally rewire our brains.

Once we develop a habit, our brains actually change to make the behavior easier to complete. After about 30 days of practice, enacting a habit becomes easier than not doing so.

Our lives are structured around habits, many of them barely noticeable. According to Duhigg’s research, habits make up 40% of our waking hours.

Another speaker and author, ID Life founder/CEO Logan Stout, paraphrases an ancient precept by saying, “Thoughts lead to actions, actions lead to habits, habits lead to results.” 

So, how did your existing habits come to be embedded in your life? And how can you create a new habit or two that moves you toward your goal, a dream, or your 2021 resolutions? Here are a few points I find helpful.

Dissect your larger goal and break it into actions. This is helpful because it’s practical and specific. If you’re having trouble, try changing your mindset from a negative (stop overspending; have more energy) to a positive (save money; get more sleep), and then to an action (put $25 into a savings account every week; go to bed a half-hour early each night). Habits, not goals, make otherwise difficult things easy.

When introducing these actions as new habits, connect them to routines or habits you’ve already established so you don’t have to think about the timing. If you desire a healthier diet, eat an apple every day with lunch. If you want to be more active, take a stroll around the block each time you get the mail or take the trash cans to the curb.

Start small, and I mean really small. What makes a habit is not a degree of difficulty, but repetition that becomes ingrained. Once these become fixed, the complexity can be increased. Stanford psychologist BJ Fogg recommends “tiny habits,” such as flossing one tooth! Science shows that when you make your new habit something utterly manageable that you can and will get done, your brain experiences a “win” each time and releases positive neurochemicals, making you want to do it again and enticing you to go beyond the minimum you’ve set. 

What’s more, make a point to celebrate your small “win” each and every time you perform the new habit. It may sound (or feel) silly, but a fist-pump or a quiet “Yes!” make a difference because our brains actually form attachments to the emotions created by a habit. Taking a second to pat yourself on the back reinforces your new habit with feel-good associations that make your brain even quicker to take that action next time.

As a physical therapist, I’m a “professional habit-breaker” of sorts. While some patients see me for help recovering from an accident, health event or surgery, plenty of others are seeking help for pain or limitations have simply developed over time as a result of faulty habits (for instance, bad posture while at your desk or using your phone, sleeping in a poor position, or lifting with your back instead of your legs). Physical therapy can impart new, better habits that strengthen and support your body as you move, work, play and live your life. And, by partnering with IDLife, I help people assess and improve their nutrition, sleep and hydration. 

If you’d like to establish new habits that enhance your enjoyment of home, work, fitness, or recreational activities, call today for an appointment - I’d love to help you get on the road to good habits and better health!

Be well,

Brian

As you’d imagine, I get to know my patients really well over the course of treatment. I hear about their families and their interests, their joys and their challenges -- it’s a great part of my day and my job. But physical therapy isn’t usually a permanent intervention, and so for most patients, the time comes to say goodbye. When a client feels better and overcomes his issues, it’s time for him to be discharged from therapy and continue on his own to maintain his progress. As their treatment winds up, I ask myself, do they have all the tools they need? Will they continue to follow my instructions? Are they in a good place to be done and moving on? Just like my patients move on when it’s time, I’ve had to come to the realization as a parent that the same is true for our kids. 

My oldest son recently left our home after two years of community college to transfer to college in Virginia. That was a very difficult time as a dad -- knowing that my son who is now a young man is suddenly six hours away from home in a new place, not knowing anyone, and off to start a whole new chapter in his life and engage in new and exciting experiences all on his own. Only two weeks later, my other son, a recent high school grad, departed for Army Basic Training in South Carolina. Like his brother, he’s leaving home for the first time and entering a whole new world not knowing anyone and hardly knowing what to expect. 

I’m so proud of both of my sons and the boldness with which they step into these new chapters. I’m proud of my daughters too, and I know they’ll be taking their own new paths in the not so distant future. For now, the impact of both sons leaving our home and our family within two weeks of each other has drastically impacted the four of us remaining at home.  Simply put, we miss them terribly.

But as a dad, it’s more than that. I’ve been asking myself over and over, “Did I do enough? Did I teach them all I wanted to and what they need to know now that they’re on their own out in the world? Did I give them enough advice to help them handle themselves in all situations?” That and many other questions and thoughts that have run through my mind since they both left. I’ve always tried to instruct my kids and teach them to have good morals and values and valuing others more than themselves. We share a great faith and I tried to instill in them the importance of persistence, working hard and reaching for goals no matter how big or small. They are great kids and I’m sure they will be fine, but the idea that a new phase of life has begun for them and for me as their parent is a strange place to be in. I don't know if I’ll ever feel that I’ve done enough in teaching them and instructing them, but I know I did my best in guiding them to be the people they will continue to grow into, and I’m thankful that God will lead them wherever they go and will always watch over them. They’re always my kids and I’ll never stop being a dad, no matter how old they become. Being a father is a blessing and thrill that I wouldn’t trade for anything. 

Step 1 - Assess risk

During a balance and gait assessment at my practice, I discuss the patient’s history (past falls, especially in the last year, and any recent hospitalizations or other causes of weakness or lost muscle mass) and any diagnoses like osteoporosis or arthritis. I assess their strength and stride and conduct a range of tests to check their balance. 

I typically ask about the patient’s medications, too. If you take multiple medicines (prescribed or over the counter), your risk for falling is higher. Many drugs can cause you to be dizzy, lose your balance or have blurry vision. Once identified, these side effects and medications can be discussed with your doctor or pharmacist. Additionally, it helps to be aware that fall risk increases significantly in the days following a medication change (start, stop, or dose change), according to some studies.

Step 2 - Implement a personalized treatment plan

The best treatment plans combine exercises to address four key areas: strength, balance, coordination and posture. Flexibility matters too, since range of motion in the legs or spine impacts your walking and gait pattern. I utilize various tools to get baseline scores and track improvement throughout the treatment plan and sessions.

In many cases, the best way to improve balance is to challenge it. We accomplish this by combining upper body and lower body movements, working on steps and curbs, practicing standing on one leg, and navigating unsteady surfaces. All of these potentially risky actions can be practiced safely and beneficially with the help of a trained therapist.

I can also help a client prepare for how to minimize injury if a fall can’t be avoided. We practice getting up from the floor, and we evaluate safety measures like life alerts or smartphone/smartwatch apps for fall detection. 

Importantly, my patients’ treatment course extends outside the clinic to touch their daily lives. We talk about the importance of staying active to maintain strength, flexibility, coordination and balance. Staying active has the added benefit of typically reducing your fear of falling. I help my patients select activities that they can do safely - yoga, swimming, walking, or other pursuits they enjoy.

Overall, physical therapy can be extremely effective in preventing falls and building confidence, and that leads to other benefits. Recently I worked with a client who was reluctant to walk on the grass for fear of falling, and as a result he’d missed out on many backyard picnics and his grandkids’ sporting events. When I help a patient like that achieve new goals and do things they thought they couldn’t, it improves so much more than their physical function, it improves their quality of life. It’s a privilege for me to play a role in that. 

If you or a loved one needs a falls screening and guidance about reducing risk, please contact me today.

Be well,

Brian

Follow directions Do the correct number of repetitions and sets that your therapist requested and rest briefly between sets. Perform your exercises and stretches as often as your therapist instructs -- not less often, but also not more often. Your therapist knows the appropriate balance between work and rest that will most benefit your specific condition. If you’re told to rest (avoid certain exercises or activities) on certain days, please don’t assume you can accelerate your progress by doing more than you were instructed -- it’s best to follow your therapist’s advice.

Get into a routine Schedule time for yourself and do your exercises at the same time each day. Clients often ask me when is the best time to do their home exercises. Every so often, I’ll recommend a time of day or increased frequencies based on an individual condition, but in general I tell patients that the best time to exercise is the time you know you will. Some people are more motivated in the morning, others in the afternoon or evening. Whenever you’ll be the most disciplined about following through is the best time. 

Be accountable Create a program checklist of dates and exercises to keep yourself on track. Hang it on your fridge, bathroom mirror, or another eye-catching spot and mark off each day that you complete your regimen.

Share feedback with your therapist What I design for clients to do at home is intentionally based on how they perform and respond to treatment sessions. In fact, I rarely give out exercises on the first day. I want to know what’s working for patients, supervise their technique and see how they responded to it the next time I see them before sending them home to do the same. I’m constantly adjusting exercises during treatment visits based on patient feedback and my patients frequently hear me say, “if it’s causing pain, let me know and we’ll modify or switch to something else -- I have plenty of exercises that we can try.” Communication is key to successful rehabilitation. 

Last but not least, be honest with your PT if you’re not doing your exercises. Through candid exchanges with my clients, I help them find solutions to obstacles, motivate them towards persistence, and share what I’ve seen work especially well. It’s what I enjoy most about my profession -- caring about people as more than just patients, and equipping them with what they need to succeed. 

Be well,

Brian

1) Caffeine

Obviously, you’re drinking an energy drink for the caffeine, and most do fall safely within the recommended daily limit of 400mg. However, be aware of a few things:

How many do you consume per day? 

How quickly do you drink them? Most people sip hot coffee (80mg of caffeine) or tea (40 mg) slowly, but you may down an energy drink much more quickly, which can amplify its stimulant effects and cause unwelcome side effects like jitters and heart palpitations.

Can you clearly tell how much caffeine the drink contains? Manufacturers aren’t required to list all ingredients, and some get away with saying “energy blend” - what’s in that, and does it add caffeine? Manufacturers aren’t required to clearly state which ingredients are sources of caffeine, so it can be confusing to determine how much you’re really taking in. Too much caffeine can increase anxiety, sleep problems, dehydration and digestive issues.

Is it an energy drink or a sports drink? Energy drinks shouldn’t be confused with sports drinks such as Gatorade, which are consumed to help people stay hydrated during exercise. As described by Verywell Fit, the crucial difference is this: sports drinks provide carbohydrates in the form of sugar and electrolytes that may be lost through perspiration, but the caffeine in energy drinks acts as a diuretic and promotes dehydration, which could be dangerous during exercise.

2) B Vitamins

Many brands add B vitamins to energy drinks, making them appear healthier. But do you need them? B vitamin deficiency is uncommon, and as Men’s Health notes, even if you are deficient, drinking B vitamins won’t give you an immediate boost - it could take weeks or months for your energy levels to be restored.

What’s more, these B vitamins could potentially do more harm than good. Verywell Fit points out that these adverse effects of high doses of B vitamins have been noted:

Vitamin B3 (niacin) can cause flushing, burning, itching, redness on the face, arms, and chest, and increased heartbeat.

Vitamin B6 (pyridoxine) may increase the risk of hip fractures in older adults or cause sensory neuropathy if high dose supplements are taken for long periods of time.

Check this out: Monster energy drink contains 200% of the RDA for niacin, and 5-hour Energy delivers 8333% of the recommended daily intake of vitamin B12.

3) Sugar

Some energy drinks contain high amounts of sugar - as much as 54 to 62g. That’s the same as 13 to 15 teaspoons of sugar! The RDA for added sugar is 37.5g/day for men, and 25g/day for women. Have you ever tried an energy drink and experienced a crash a few hours later? That crash often comes from the sugar rather than the caffeine!

Some brands have improved in recent years and you may see “low sugar” and/or “low calories” on the label, but that should prompt you to consider what else is in it. The health and safety of artificial sweeteners like sucralose is debatable, so I like to look for natural sweeteners like stevia and fruit juice. Also check the amount of sodium, since when a product is low in sugar, it might have a lot of sodium to add taste. Excess sodium takes a toll on your kidneys. Is your energy drink making your body work a lot harder to get rid of the garbage just so you can feel more alert?

The bottom line

Including energy drinks as part of a healthy lifestyle really boils down to knowing what you’re drinking. Personally, my days of reaching for 5-Hour Energy are gone, but I still frequently have an energy drink and my choice for a healthy option is usually IDLife Energy (it has a time-release formula that I like so much I’d choose it even if I weren’t an IDLife distributor). For more info, check out my Facebook video detailing energy drinks or contact me. I care about all aspects of my clients’ well-being and would love to speak with you.

Be well,

Brian

1. Get into a routine

Some athletes may have kept up with drills and conditioning on their own during this time, but for many, out of sight has meant out of mind. I’ve always found that it can be much easier to get active at home when you make it part of your daily routine. There are plenty of distractions, so try to pick the same time of day each day and schedule your activity. If you don’t schedule it, you probably won’t do it. Since you may not yet be working towards an imminent game or competition, set your own goal to work towards. I also find that accountability is a big help, whether that means making a simple chart and checking off each day’s accomplishment, or choosing someone to compete against to meet a goal or achieve a certain number of workouts. And if your local reopening guidelines allow, getting together with a couple teammates can make a big difference in re-establishing commitment to the sport and starting to get reconditioned.

2. Stretch

For any workout, stretching can help prevent injuries by increasing the muscle’s range of motion. As athletes resume practice after several months of downtime, stretching becomes absolutely essential, but it can be tough for youth to know where to start. Several resources are available online, including CHOP’s “Ready, Set, Prevent”, guidelines from the American Physical Therapy Association (APTA) on preventing injuries in youth soccer players, and this helpful video about preventing overuse injuries. Keep in mind, however, that the parameters for appropriate, safe and beneficial stretching vary greatly from person to person. A few sessions with a physical therapist can pay huge dividends by developing a stretching regimen that takes into account your age, sport, conditioning, history of injuries, and other personal factors. 

Once you’ve stretched, it’s a good idea to focus on the basics. Work on the mechanics of your sport with simple drills and focus on technical aspects like footwork and body position. General conditioning and endurance exercises will always be a help no matter what sport you’re playing. 

3. Keep a good perspective

When I grapple with the many frustrations and unknowns unique to this pandemic, I remind myself about the importance of attitude and optimism. We empathize with the seniors who have missed out on their final seasons, but for the many players with remaining eligibility, the future will hold games, races, matches and tournaments. We can look forward to that with confidence! We just don’t know exactly when it will happen. And until then, exercise offers so many benefits beyond sports performance - it strengthens the immune system, is an excellent outlet for stress management, and provides restorative time to yourself. 

It’s occurred to me, too, that this hiatus may have a silver lining for today’s players. More and more research cautions that year-round sports can be detrimental. Many different studies published by the American Sports Medicine Institute consistently indicate that playing year-round (baseball, in these particular studies) results in higher injury rates. Perhaps this forced downtime offers a valuable opportunity for athletes to regenerate and heal, optimize function and build strength, and even reinvigorate their passion for playing and realize a deeper appreciation for the sport and the team they may have taken for granted.

If I can help you or an athlete in your household navigate this unique time by customizing stretches, treating a past injury, or optimizing health and strength, call my clinic today. We’re open, ready to help, following all CDC guidelines for patient and staff safety, and - like you - looking forward to getting back in the game!

Be well,

Brian 

Mental health

In addition to experiencing delirium while acutely sick, a new study published in The Lancet Psychiatry says people hospitalized for COVID-19 may present additional mental health challenges as patients could suffer from depression, anxiety, fatigue and post-traumatic stress disorder in the weeks and months after they are discharged. This has been seen in previous years with SARS and MERS. Caregivers should be alert to signs of mental health issues and ask a doctor to screen the patient regularly for symptoms.

Organ systems

Patients who’ve experienced severe forms of COVID-19 could sustain long-term effects to various organ systems, so doctors will monitor their heart, lungs and kidneys. Because the novel coronavirus is novel and much about its short- and long-term effects on the body remain unknown, experts advise even those who’ve had a mild case of COVID-19 to proceed cautiously when resuming exercise and training. According to The New York Times, sports pulmonologist Dr. James Hull recently stated in The Lancet that athletes who have tested positive for the coronavirus (or suspect they might be positive) should rest, without any exercise, for at least 10 days from the point when they first feel symptoms. Then, assuming their illness remains mild, they should continue to rest for another week, even after their symptoms resolve. 

Strength and stamina

Patients who were on a ventilator will need physical therapy to overcome lingering effects from powerful sedative medications and, at times, paralytic drugs that suppress reflexes. The vast majority of COVID patients aren’t intubated but still may struggle to return to their prior lives after weeks in bed, dealing with weakness, fatigue and loss of muscle mass. 

Working with a physical therapist can facilitate a quicker and safer return to health and prior levels of function. It’s exciting that telehealth could be especially convenient for these patients, as technology often allows for a virtual assessment of the patient’s abilities and endurance from the comfort of their home. Before scheduling physical therapy for yourself or a loved one recovering from coronavirus, do some homework to get the best possible care:

Ask questions

When considering a clinic, ask how many patients are being treated at the same time. Will your therapist be moving between patients or focused on you for an entire session? Also, some practices employ physical therapy assistants and/or have a patient see several different therapists over the course of treatment. I find that patients have the most success when paired one-on-one with a consistent therapist at every appointment, and clients with complex needs following coronavirus recovery will certainly benefit from this approach. 

Trust matters

Some patients are surprised to learn they’re not obligated to use the particular facility referred by their doctor. You have the right to choose your own physical therapist. (Of course, to minimize your financial responsibility, know your insurance policy’s requirements.) If possible, ask friends for recommendations. If you’re starting with a list of PT options from your insurance company or doctor’s office, check for feedback about the practice on Google reviews and Healthgrades. When it comes to your health and your body, proactive research is definitely worth the time. 

Be well,

Brian

Mulligan Physical Therapy is where patients receive not just treatment, but education. I love to explain how the body works, the “why” behind your treatment, and how you can fine-tune your health. Over the years, I’ve consistently found that educating my patients helps them to be more confident and have a positive attitude toward overcoming obstacles. And that’s my passion and purpose: helping people restore function and regain the abilities and activities that are meaningful to them.

The name for my blog comes from the dictionary’s definition of wellness as “the state of being in good health, especially as an actively pursued goal” - and I’d say this definition suits me to a T. As a physical therapist, setting and meeting goals is a key component of my clients’ individualized therapy. And, I go beyond exercise and movement goals to help my clients realize improvements in other important areas like sleep, hydration and nutrition. Outside the clinic, I’m equally active and goal-oriented, whether I’m running a 5K, learning a new skill, playing sports myself or getting involved in the sports and hobbies of my four kids. I’m excited to launch this blog as yet another way to share advice, new information, and tips that have worked well for me and my clients as we all progress toward our individual wellness goals. Check in often - or better yet, subscribe here on Tumblr or follow me on Facebook so you don’t miss a post. 

Thank you for visiting! I’m excited to have you here!

Be well,