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There are two directions we can go with our attention, inward or outward. Both can be powerful. Say you’re on your hike. Going inward with our attention, or introverting, can have truly positive effects. If we are performing creative problem solving on the aspects of our life, it’s a true de-stressor, because it relieves anxiety. But what if going inward results in the opposite? Just a never ending circuit of ruminating about all the things that are not going right in our lives... By the time you get to the end of your hike, you might find yourself even more stressed because of where we put our attention. You may not even have seen a thing that you walked by!
But there is a solution: The other direction. Move your attention outward. Look around you as you walk or hike. Consciously acknowledge what you see, what you hear, what you feel. It could be new flowers you see sprouting, the gurgle of the of a spring that is running, the breeze on your skin. You are where you are.
Case in point, my daughter just interrupted my writing period with a facetime call. She was out on a walk, mulling over exciting vacation plans, and she wanted to show me the bright, sunny day, the snowcovered mountains, and her neighborhood street. We moved our focus from the tasks at hand to appreciate the life around us in that moment. That is a really healthy walk. And I feel energized and thankful that she shared it with me.
This newsletter contains more stories of folks redirecting their attention with the ultimate result of bettering their health, as well as information on other fundamentals of making your hike or walk the most satisfying and healthy experience. Please enjoy, be well, and happy hiking!
“[After taking part in the Cioffredi Golf Fitness Class with Neil MacKenzie PT, DPT, OCS], I had opportunity to play six 18-hole rounds of golf and my swing consistency, distance, and scoring showed dramatic improvement in all six rounds.”
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Hobby homesteader, Marc Aquila first came in to Cioffredi & Associates after injuring his hip. The pain was interfering with all the random hundred things he wanted to do: skiing, skating, chopping down trees, building a bridge, carrying bags of feed to his pigs and chickens... After making steady progress working with Megan Osanitsch, PT to resolve the pain, he transitioned from Rehab to a Performance PT program so he could focus on maintaining his active lifestyle with intermittent tune-ups.
The power to take control of your health and go beyond insurance limitations.
“My work here [with the Performance PT program] is preventative for sure, but there’s also this strength training piece. Look, I'm not trying to win a bodybuilding competition. I don't even like going to the gym. I just want to keep being able to carry 50 pound bags of feed without worrying about it... and if I need to spend a day chain sawing, not worry about it. I could do that when I was 20, but now I’m 47. I’ll get injured doing something stupid like dragging logs. Working with Meg makes it easier with less pain.”
“Now I get up most days and spend like 5 or 10 minutes doing my exercises... But life happens and some days, or weeks, are better than others. So I have my appointments with Meg scheduled out on my calendar as a sort of catch all. See, this isn't a gym. I like to say that Megan’s my trainer that knows I’m fragile!”
Treat what YOU want, when you want it with care that fits your unique goals and lifestyle. View rates and learn more at cioffredi.com/perform
“I come in and wherever I’m at, whatever I need, we do... And that’s why I’m here. I just want to do these things as long as I can.”
“[My shoulder] was painful just sitting still, and when I tried to do anything shoulder height or over my head, Forget it! Howard [Badillo, PT, DPT] diagnosed my [rotator cuff] pain in the first visit... After Therapy, resting pain was completely gone. I can now do all the things I could not do before. Howard listens, provides excellent care while there and gives exercises for home work that do not overwhelm. Give therapy a try, before surgery. You won’t be disappointed!!” -Lorinda
Poirier“Joe [Soojian, PT, DPT, OCS], was not only very knowledgeable, he also treated me like a partner in the treatment process. He patiently answered my questions, listened to me, tailored my exercises to my busy schedule, and changed tactics when necessary. He made sure that I never felt discouraged. I recommend them to everyone and would definitely return should I need physical therapy again. ” -Lisa Byrne Miller
In the Fall, Nick Lima made a big jump, recording a 2:33:45 finish in the Chicago Marathon. He was excited to build on his PR and keep it going, but when he started training for the Boston Marathon, he couldn’t run. His pain in the achilles region kept flaring up, but it wasn’t tendonitis. Even when he took time off, his nagging pain just got worse.
“I started limping, even while walking, and it was super unpleasant all the time. And that’s when I came in to see Neil [Mackenzie, PT]. I swear, I was able to start noticing a difference in a week or two - and it’s now been 3 or 4 weeks and I’m running with no pain! It’s been such a positive experience.”
Neil used a multi-point approach to help Nick turn his condition around. He identified and corrected issues with footwear, provided manual therapy mobilizations, and developed a comprehensive exercise treatment plan that precisely targeted weaknesses that were contributing to his pain. Now Nick is back to running with a greater understanding and appreciation for his body, a new awareness of how it energizes the rest of his life, and big goals for the future.
“The big thing I learned here with Neil and this injury: I’m not invincible. I think a lot of the battle, a lot of the game, is being in tune with your body and following the general knowledge and rules of how to do a build and how to train for these events. Having a schedule. Having patience... I didn’t really do it as smart as I could have. But now I’m planning to gradually up my pace again, increase mileage, and probably run an October marathon. Maybe this summer I’ll even try to get back to some speed things, you know, try some 5K races again!”
Neil MacKenzie, PT presents Strength Training for Endurance Runners at the recent Running Performance Seminar at Cioffredi & Associates.
“Running helps balance me out. Mentally, it revamps me and refuels me to go back to studying and the other things I’m doing.”
Nick Lima, Geisel Med Student
Set realistic gardening goals now, planning time for recovery, rest, and stretching - so you can stay outside and active all summer long!
When we do more than our body is prepared for (which is easy to do early in the season!), there is potential for increased soreness and even pain due to tissue irritation. Be mindful of both your total number of working hours in a day and the number of days in a row you garden. Scheduling in periods to break things up with rest and hydration can make all the difference for your body’s health.
Gardening involves sustained postures and repetitive movements. While using our body is healthy, there are active things we can do during our ‘rest periods’ that can make all the difference in our comfort at the end of the day and in preventing a persistent pain problem from developing. Self massage and active stretching exercises can enhance circulation, increasing oxygenation and nutrition to tissues while moving out waste products. Try these!
Wear properly fitting gloves with enhanced grip that don’t impede your dexterity. Invest in ergonomically designed tools that reduce stress on muscles and joints.
“Within a week I was already starting to notice improvements. Not having a free weight gym at my home Marsha was able to give me some examples of products within my home that I could use for substitutes such as a soup can for strengthening my wrist, rubber bands for finger strengthening and such. These wrist exercises were easy to do anytime of the day… It brought hope back very very quickly.” -D.B.
BOTTOM LINE: Be mindful of what your body is telling you and address minor aches and pains before they develop into something worse. If pain and problems persist, don’t hesitate to get help! Painful gardening conditions can often be reversed with the help of a skilled physical therapist, especially when addressed early. Happy gardening!
Hiking is famously beneficial for practically everything: Heart, muscles, bones, blood pressure, mental health... the list goes on. But pain and injury can detract from your enjoyment and well-being. So in order to get the most out of your adventure, it’s important to consider your equipment and prepare your body for the experience. Get started with this guide including frequently asked questions and tips for your next hike.
A healthy walk starts from a solid
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Proper footwear protects your feet and provides appropriate stability, support, and comfort for your desired terrain and activity level. One shoe isn’t necessarily optimal for all levels of activity though. Here’s a quick reference guide to help find the perfect fit:
A classic running shoe or walking shoes is fine for even terrain; They just need to fit your foot and consider your body weight.
Do
As the terrain becomes less even, you will want to look for more rigid support like a low-cut hiking shoe or trail running shoe. The soles are built more firmly and with more traction than a standard running shoe, yet remain light and have a low profile.
If you are going to be hiking for a few hours on some rugged terrain, a true hiking boot that at least covers your ankles will be a worthwhile investment. These have appropriately rigid soles and stiffer material that support the foot and ankle joint.
Orthotics provide additional support for your foot in your shoe.
Try this test: Most all athletic footwear have an inner footbed that is removable. Take the foot bed out and try to flatten it to the floor. If it flattens like a pancake, you can enhance the quality of the shoe by purchasing an off the shelf, generic orthotic. Note that a small percentage of people will benefit from a custom fabricated orthotic. Cioffredi & Associates has over three decades of experience providing custom orthotics for the Upper Valley
"I initially saw two specialists and had imaging done and a clear reason for my knee/leg pain was not identified. I decided try PT and Marsha's assessment not only identified the issue; she was also able to suggest exercises to help with some ongoing lower back pain I'd been living with for a while too. Marsha was wonderful to work with. She explained everything in a way that was easy to understand, used multiple modalities to reduce symptoms, and built an exercise plan that I was able to reference and follow along with in an app at home to make sure I didn't miss any of my daily exercises or stretches. After 2 months, I'm pain free most of the time, continuing to strengthen my trouble areas, and ramping up my training for a summer out on the trails. By far, this was the best practice I've received physical therapy services from and I highly recommend this team." -S.G.
The basic pros and cons: You burn some extra energy in exchange for improved balance. The amount may not be large but advantages in unweighting our joints and supporting our muscles may be greater or lesser for each individual situation and needs. The drawback is that there is increased strain on the upper extremity joints and muscles. Think about what your strengths and needs are when making this decision.
Hydration helps regulate temperature, increases energy, promotes recovery, and boosts physical and mental performance.
1. The rule of thumb with hydration is drinking one liter of water for every two hours of hiking. Err on the safe side and consider the weather as hydration needs will vary depending on the temperature.
2. Start even before you start your hike to prime your body to perform and sip the fluid as you go, as opposed to long periods between stopping to take long large drinks. Your body can only store so much water and, if you drink too much at once, the excess is expelled.
3. Dress (In Layers) For Success. Most hikers know to dress in layers to account for any changes in weather, but it also has the added benefit of helping to control the amount of fluid you lose through perspiration.
To get the most enjoyment out of walking and hiking and reduce the chance of injury, prepare your body for the season or planned trip. Our tissues adapt to stressing them and get stronger if we approach it gradually. Many times, we end up treating people who have just returned from a walking or trekking vacation for new pains and injuries. Situations like this, with days of long walks or hikes without sufficient recovery creates too steep a gradient and our tissues begin to break down. So think ahead! Arthritic joints and limited balance can improve substantially with appropriate exercise. Create an exercise plan to build you up and plan in recovery time as needed. You can start with a sample of fundamental exercises on our website, and we can also provide our clients with customized programs for their specific needs.
“[Howard Badillo, PT] somehow made the pain go away... I have now reached my goal of having no pain and being able to go for walks again.” -Judy Ribeiro
So get out there and explore... From all of us, we hope you have a fantastic and enriching summer season!
“This past July, I was rushed to the hospital with what I learned had been a stroke... A stroke demands lifetime changes in physical, mental, emotional, daily living challenges to develop a ‘New Normal.’ For me vision and balance were substantial issues.”
And so Sharon began working with Taylor Daley, PT at Cioffredi & Associates where they developed a comprehensive course of treatment to improve her balance, strength, and eye coordination.
“Little did I know at that time, I would receive a perfect match for my needs, interests, and personality. Taylor has met and exceeded all I could dream of... As with any recovery, there are ups and downs – celebrations and challenges. I can’t say the challenges are any greater than any other recovery but they were entirely new for me – any other medical challenges I had ever dealt with had been minimal and/or known to be short-lived.”
Despite the long road and great adversity along the way, Sharon persevered and made steady progress towards her goals.
On the Maine coast “Thinking about and looking for brighter days ahead.”
“As I faced additional family and business challenges/ disappointments (including the sudden death of a nephew), Taylor was right there listening to the emotional impact and encouraging: ‘Take the time you need but don’t forget taking care of yourself.’ This rehab program became one of continued education and motivation that has truly exceeded my expectations, I believe because Taylor has so actively encouraged my desire to learn/ understand and be involved in why we are doing these exercises. I am back at work and most other activities on a limited basis including planning for interim follow-up meetings with Taylor to help keep me on track in my ‘New Normal.’”
-Sharon Guardaldi