Stay Safe Snow Shoveling this Season!

By Kateri Kane PT, DPT

Well folks, winter is upon us.  If you live in the northern states, winter means snow (most years).  Winter means having to get up early on those cold December mornings and shovel your driveway before you head off to work.  For many people, shoveling the driveway then means back pain for the rest of the day or week or more.  So, how do you avoid becoming one of these unfortunate people?

For starters, the curves of your spine are structured to support your body while it is upright, not hunched over or bent.  Yes, your spine is able to bend forward, backward, side to side, and rotate; but excessive amounts of these motions in any one direction for a long period of time can create back problems, especially when lifting a heavy load.  One of the most harmful motions for your back is twisting with a large weight.  Perhaps you can see, now, why shoveling causes so many problems with back pain.  The most damaging mechanics for your back are staying hunched over for a prolonged period of time while repeatedly shoveling large amounts of snow and twisting as you toss the snow you have shoveled onto a pile.  These mechanics may result in a simple back strain or something more severe like a disc herniation.

The American Physical Therapy Association (APTA) released some helpful tips for proper body mechanics while shoveling snow.  They are as follows:

  • Lift smaller loads of snow, rather than heavy shovelfuls. Take care to bend your knees and lift with your legs rather than with your back.
  • Use a shovel with a handle that lets you keep your back straight while lifting. A short handle will cause you to bend more to lift the load. Using a shovel that's too long makes the weight at the end heavier.
  • Because the spine cannot tolerate twisting as well as it can other movements, it is important to avoid this movement as much as possible. Step in the direction in which you are throwing the snow to prevent the low back from twisting. This will help avoid the "next-day back fatigue" experienced by people who shovel snow.
  • Take frequent breaks when shoveling. Stand up straight and walk around periodically to extend the lower back.
  • Standing backward-bending exercises will help reverse the excessive forward bending that occurs while shoveling: stand straight and tall, place your hands toward the back of your hips, and bend backward slightly for several seconds.

This video provides a visual explanation of everything listed above.

Unfortunately, we can’t avoid certain circumstances of winter like snowfall on our driveways, and not everyone has a snow blower to help them avoid bending and shoveling.  Instead, many of us have to do our part to protect our backs while we dig out our cars and shovel a path toward the road.  We hope that these tips give you the information you need to avoid injuring yourself during these next few winter months.  Feel free to leave any comments or suggestions regarding snow removal or any other topic in which you are interested.  Thank you for reading and stay active.



Move Forward PT

Stressed Out This Holiday Season?

By Kateri Kane PT, DPT

Stress can be a real killer during the holidays, both literally and figuratively.  It has been referred to as “the silent killer.”  Stress can lead to negative effects on your BODY, MOOD, and BEHAVIOR including: headache, muscle tension or pain, chest pain, fatigue, change in sex drive, stomach upset, sleep problems, anxiety, restlessness, lack of motivation or focus, irritability or anger, sadness or depression, overeating or undereating, angry outbursts, drug or alcohol abuse, tobacco use, and social withdrawal.  It can also contribute to problems like high blood pressure, heart disease, obesity, and diabetes.

Now, stress is something we face on a daily basis and is a NORMAL aspect of everyday life.  So why is it that some people always get incredibly stressed out over the holidays and others do not?  It’s not necessarily a matter of one person having more stressful circumstances than the other.  The key difference lies in how you manage your stress.

Your body naturally responds to stress with a “fight or flight” response.  This response is created by your autonomic nervous system which means that it is a completely automatic reaction.  Due to this response, heart rate and blood pressure increases, the pupils dilate to take in as much light as possible, the veins in the skin constrict to send more blood to major muscle groups, the blood-glucose level increases, muscles tense up, smooth muscle relaxes in order to allow more oxygen into the lungs, nonessential systems (like digestive and immune systems) shut down to allow more energy for emergency functions, and the brain has trouble focusing on small tasks.  So what steps can you take to relieve stress and control this automatic reaction?  A few strategies include physical activity, relaxation techniques, meditation, yoga, and Tai Chi.  In an article by Dr. Martin V. Cohen, he describes a multitude of steps an individual can take in order to properly respond to a stressful situation.  These steps to controlling stress can be viewed here.

We will focus on one particular stress reliever that can be extremely effective: EXERCISE!  Exercise increases the production of endorphins which are the “good feeling” neurotransmitters in your body.  If you’ve ever heard of the “runner’s high,” endorphins are what produce this uplifting feeling after activity.  Increased activity can help to distract you from your current stressors and help you remain calm and clear after the activity has ended.  Overall, exercise can improve your mood by increasing self-confidence and decreasing symptoms of mild depression and anxiety.  By controlling anxiety, sleep patterns can be improved which ultimately recharges your system and increases your sense of well-being.

There is not one particular form of exercise that works exclusively for stress relief.  Any form of activity, from resistance training to yoga, can positively benefit your response to stress.  Yoga and Tai Chi incorporate a certain degree of meditation which can be particularly helpful, but the exercise benefits previously described can result from all different forms of exercise.  At minimum, however, a 30 minute daily walking or other exercise program is recommended for stress management.

We hope that this gives you the tools you need to help control your stress levels this holiday season.  Feel free to leave any comments or suggestions regarding stress management or any other topic in which you are interested.  Our next blog will discuss appropriate body mechanics for snow removal.  Thank you for reading and stay active.



The Scoop on “COLD” Laser

By Kateri Kane PT, DPT

Have you ever experienced a chronic neck or back issue that nothing seems to fix, or been in acute pain after a recent injury?  These are just a couple of conditions that “cold” or low level laser therapy (LLLT) claims to help.  So, are the claims valid? Does LLLT truly work?

According to The Department of Labor and Industries’ technology assessment in 2004, low level laser therapy is defined as follows: “a light source treatment that generates light of a single wavelength.  LLLT emits no heat, sound, or vibration.  Instead of producing a thermal effect, LLLT may act via nonthermal or photochemical reactions in the cells, also referred to as photobiology or biostimulation.”  It benefits the tissues by altering cell and tissue function, stimulating collagen production, altering DNA synthesis, and improving function in damaged nerve tissue.  Several theories exist as to cold laser’s underlying mechanism for healing and these can be reviewed here.

Unlike corticosteroids and other medications that may be used to relieve symptoms of pain, LLLT has NO known side effects.  It is only contraindicated for direct usage over the eyes, pregnant uterus, carcinomas, the thyroid gland, and hemorrhages.  It also should not be used for patients who are taking immune suppressant drugs and over the sympathetic ganglia, vagus nerves, and the cardiac region in patients with heart disease.

Several studies have been performed to test the effectiveness of LLLT.  In the past 3 years, six different systematic reviews (highly reliable research) found evidence in favor of LLLT for conditions including frozen shoulder, myofascial pain, tennis elbow, Achilles’ tendonitis, and neck pain.  Unfortunately, despite the number of studies that have shown positive responses, insurance companies do not typically reimburse for this form of treatment.  It is deemed to be investigative because there is not enough overwhelming evidence in favor of the benefits of LLLT.  One possible explanation for the mixed evidence found in the literature is the need for very specific parameters when treating certain conditions with LLLT.  Any study that does not utilize the appropriate parameters will not conclude in positive results.

Due to the lack of reimbursement, many providers have been forced to charge through self-pay routes in order to receive payment for the laser therapy services provided.  Treatment costs average between $50 and $150 per visit and treatment lasts about 10-15 sessions.  LLLT may not be right for everyone, but there have been positive findings for certain specific conditions.  Advanced Physical Therapy and Fitness is proud to announce that we are currently in possession of a Thor Laser and have begun using this treatment on a self-pay basis.  If you believe LLLT may benefit you, contact us to find answers to your specific questions or are curious about costs.

So do you feel like you have a better understanding of laser?  Feel free to leave any comments or suggestions regarding laser or any other topic in which you are interested.  Our next blog will discuss stress management and how exercise can help.  Thank you for reading and stay active.


WA Gov




The Lancet

Spine Journal


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  Disclaimer:  The information in this medical library is intended for informational and educational purposes only and in no way should be taken to be the provision or practice of physical therapy, medical, or professional healthcare advice or services. The information should not be considered complete or exhaustive and should not be used for diagnostic or treatment purposes without first consulting with your physical therapist, physician or other healthcare provider. The owners of this website accept no responsibility for the misuse of information contained within this website.