Working Toward a Healthier Community

My Involvement With the Madeline Fiadini LoRe Foundation

This month, I’m eager to talk about the Madeline Fiadini LoRe Foundation for Cancer Prevention, a nonprofit organization that focuses on preventing cancer through community awareness and early detection.

I currently serve on the board of trustees. I first got involved with the organization a couple years ago, after my dad recovered from a narrow scrape with cancer. He was one of the lucky ones. They didn’t expect him to live long, but now he’s doing well, alive and better than anyone could have predicted. As you can imagine, the goals of the foundation are near and dear to my heart.

The organization meets regularly, working on consistent policy to aid the cause, as well as planning events to raise money for the foundation. Our primary mission is to make cancer prevention programs available to the community, granting access to the necessary tests and screenings to those individuals who might otherwise be denied. It shouldn’t be the case that those who are unable to pay the frankly exorbitant cost of cancer screenings should be at higher risk. We seek to close that gap and help the people of our community live longer, healthier, richer lives. It’s truly heartening to be a part of a group of people so dedicated to literally saving lives.

Just a couple weeks ago, we held our annual Brunch to Crunch Cancer. It’s always a nice event. We bring in as many local vendors as possible, who then sell their goods and services, donating a portion of every purchase to the foundation. At the same time, we have a tasty brunch prepared for every ticket holder. We always have a speaker as well. Whether it’s a doctor or a cancer survivor, it’s amazing to hear the stories of people working to help others. The brunch was a hit. I’m not sure of the exact number yet, but we definitely raised a substantial sum, almost all of which will go toward cancer prevention.

Community involvement has always been central to my life and work. My dad was mayor when I was young, and I like to tell people that the city was our extended family. He spent nearly all his time working to improve the lives of his constituents. The amount of time he gave was just astronomical. He may be living a slower life these days, but both my mother and father instilled a keen commitment to community and aiding others that’s stuck with me.

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Beat Your Fast Metabolism

People with naturally fast metabolisms often struggle with gaining muscle. Their bodies use calories so efficiently that fueling muscle growth becomes challenging. Here are tips to overcome this challenge:

Consume More Calories
You can have the best workout regimen in the world, but if you don’t eat enough, you won’t gain muscle. To calculate the number of calories your body expends, multiply your current weight by 18.

Gradually increase this number every two weeks by consuming your current weight multiplied by 20 — then, your current weight by 22. Evaluate the effectiveness of each incremental increase and increase your caloric intake in a similar manner until you are gaining weight.Nutrition

Eat High-Quality Foods
Eat calorie-dense foods such as whole grains, nuts, dehydrated fruits, and nut butters. Incorporating these foods into your diet is easier than simply eating more food. Try to avoid foods that are low in nutrients. These don’t support muscle growth.

Getting enough protein and complex carbohydrates is key. Try incorporating more lean beef, chicken, cottage cheese, eggs, fish, oatmeal, whole grains, and healthy fats into your diet.

Focus on Heavy Compound Lifts
According to, lower reps with heavier weight are most effective. Compound movements like barbell squats force you to challenge multiple muscle groups simultaneously. This stimulates a number of muscle fbers to respond by adding mass. Weightlifting every other day will allow stubborn muscles to recover between heavy workouts.

Engage in Cardiovascular Exercise
Exercises like jogging and swimming strengthen your cardiovascular system, which is important even if you are trying to put on muscle. While it shouldn’t be a main focus, it’s important not to cut out cardiovascular exercise completely because cardiovascular exercise delivers nutrients to your muscles.

Learn about our New Jersey Institute of Balance’s Nutrition and Weight Loss Management Services.

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Are You or Your Employees Suffering From an Injury? Let Us Help!

Injured Man Seeking TreatmentAn injury suffered at work can be a heavy burden on your life. After an incident, you may be unable to perform your work effectively — or at all. Yard work, walking the dog, and other everyday tasks can feel difficult or impossible. Maybe you’re even banned from certain activities to avoid risking your workers’ compensation benefits or further injury.

Luckily, work-related injuries are not the end, and they don’t have to be a costly drain on an employer’s resources. Let New Jersey Institute of Balance help, with one of our robust, comprehensive industrial rehabilitation programs.

Through each plan, you will work with our team of adept physical therapists to treat or prevent workplace-related injuries. We focus on creating industrial partners, working closely with employers to get their workers back on the job in an efficient, safe manner.

To accomplish this, our physical therapists provide hands-on, evidence-based treatment to our patients, and facilitate communication between the physician, employer, patient, and payer. When all parties are striving for a patient’s recovery, the patient’s time spent out of work can be drastically minimized.

Our post-injury programs include physical and hand therapy, work conditioning, functional capacity evaluations (or FCE’s), and functional progress notes (or functional discharge summaries) through the OccuPro system. For injury prevention within the workplace, we offer work site evaluations, online education and training, pre-placement/post-offer screening, and job demands analyses.

Our services are indispensable to both workers susceptible to or suffering from an injury and their employers. So come in to New Jersey Institute of Balance today, and see what our industrial rehabilitation program can do for you!

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Successful Treatments for Cervical and Shoulder Pain

Cervical and Shoulder PainPhysical Therapy Offers Relief

A common problem treated in Physical Therapy clinics is cervical pain combined with shoulder pain.  The patient may experience radiculopathy into either upper extremity, or pain radiating proximally into the suboccipital region or distally into the spine.  As with all effective treatment, addressing the cause of the problem leads to fast, effective relief for our patients.

A primary cause of cervical and shoulder pain is poor posture.  Many patients we treat work at a desk or computer terminal for eight or more hours a day, or 2,000 hours per year.  With time his or her posture will break down resulting in a forward head, rounded shoulders, and increased thoracic kyphosis.  If this process is not addressed, the patient may eventually experience degenerative cervical changes, cervical apophyseal disease, tightening of the anterior cervical musculature, rhomboid and upper trapezius muscle spasms and other permanent postural changes.

Poor Posture Causes Other Problems

Poor postural habits change the angle of the resting scapula on the thoracic cage.  This leads to impingement of the rotator cuff muscles (especially the supraspinatus) with shoulder elevation.

Try this yourself:

  1. Sit with good posture.  Shoulder blades are pulled back and down.  Low back is slightly arched into lordosis.  Eyes are looking forward and level.  Chin is up.  Raise your arms as high as you can.  This typically is close to 160 degrees or near vertical.
  2. Now sit with poor posture typical of patients we see in our treatment or exam rooms.  Slouch your low back.  Round your shoulders forward.  Let your chin and eyes drop forward.  Now try and raise your arms overhead.  Most people will experience a 60 degree decrease in range of motion or more.

Thoracic Outlet Syndrome is the peripheral entrapment of the brachial plexus producing symptoms often mistake for shoulder tendonitis, elbow tendonitis, nerve root pain or musculoskeletal pain of the neck and shoulder.

The Journal of Shoulder and Elbow Surgery (1995:4: 113-117) and JAMA (2004;196: 109-111) reported Thoracic Outlet Syndrome is suspected in cases of a patient history involving upper extremity heaviness or numbness with prolonged postures such as sitting and when laying on the involved side.

If you experience these symptoms, contact New Jersey Institute of Balance to make an appointment.


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Revealed: How a Slipped Disc… or Herniated Disc Causes Lower Back Pain and Sciatica

Lower Back PainThe Top 3 Causes of Lower Back Pain are:

  1. Arthritis, Stenosis, Disc Degeneration
  2. Herniated Disc
  3. Pelvis

Here, we’re going to focus on a Herniated Disc…

Herniated Disc

The progression of a disc problem from good to bad is as follows:

  • Healthy disc
  • Bulging disc
  • Herniated disc
  • Ruptured disc

So What is it?

As a disc bulges, herniates and ruptures, it puts an increasing amount of pressure on the nerves in the spine. This leads to pain and can eventually cause numbness, tingling and pain down into the legs. This is commonly called “SCIATICA” (pronounced SI-ATTIC-A) or a pinched nerve.

How It Works.

There is a space between the bones in your back. In this space there is a disc. The disc acts as a shock absorber to help with forces in your spine.

The disc is surrounded by a gel like substance. This is held together by a wall of fibers. Sometimes the fibers can break down and allow some of the disc and gel to push out and put pressure on the nerves in the lower back.

Common Symptoms.

Most people suffering from lower back pain and sciatica from a herniated disc have pain bending forward, lifting, coughing, twisting and sitting. The pain is usually relieved with bending backwards or standing.

Can you heal a herniated disc?

MRIs. If you took an MRI of 100 people without pain, how many would have a herniated disc or other disc problem? The answer may surprise you…it’s 80.

From research and personal experience, I have worked with people who were suffering from severe back pain and sciatica AND had a positive MRI for a herniated disc. Several were experiencing weakness in their legs.

One specific instance involved a man in his thirties who had foot drop (he could not pull his foot up). He had a herniated disc on an MRI. After 4 weeks of PT, he regained the strength in his leg and was able to run 3 miles without problems.

Did he go back and get another MRI to see if the disc had healed? Of course not! I doubt the insurance companies want to pay for an MRI on a person who is now healthy and healed.

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Physical Therapy Transforms: Over 1,000 Bring the Message to Capitol Hill

Sure, it was a little rainy. Sure, it was a bit cool for June in Washington, DC. But that didn’t stop more than 1,100 physical therapists (PTs), physical therapist assistants (PTAs), and students of physical therapy from across the United States from converging on Capitol Hill to remind lawmakers of the importance of the profession.

Galvanized by Congress’s recent decision not to include a permanent repeal of the Medicare therapy cap with legislation that eliminated the flawed sustainable growth rate formula, supporters of physical therapy showed up in record numbers on June 4 for PT Day on Capitol Hill (Hill Day), an event that began with an 8:00 am rally before participants fanned out across the halls of Congress for scheduled 440 visits to house and senate offices to discuss issues affecting the physical therapy profession and the patients and clients it serves.

In a video dispatch from the event (below), Monica Massaro, APTA congressional affairs manager, described the event as the second-largest PT advocacy event in APTA history.



While a permanent repeal of the therapy cap remains a priority for the association, Hill Day participants also discussed several other key APTA legislative priorities, including legislation that would allow PTs to participate in the National Health Services Corps, and another bill that would permit PTs to bring in another qualified PT to cover for them during temporary absences such as illness, pregnancy, and vacation. Also discussed: legislation that would recognize PTs as health care professionals qualified to make return-to-participation decisions for youth sports participants who have experienced a concussion.

PTs also participated in a health and fitness clinic for legislators and their staffs. Assessments included grip strength, balance, blood pressure, and a golf swing analysis.

Highlights from PT Day on Capitol Hill


Every year, APTA hosts an advocacy event to educate policymakers about a physical therapist’s role in improving and restoring mobility in individuals’ lives. This year’s event coincided with the association’s NEXT Conference & Exposition in National Harbor, Maryland, June 3-6.

Want to make your voice heard even though you couldn’t attend PT Day? Check out APTA’s legislative action center and download templates that make it easy to write your legislators.


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Hospital-Based Physical Therapy Reduces Readmission Rates for Older Adults With Pneumonia

Hospital-based physical therapy for older adults isn’t just beneficial to recovery from events such as stroke and hip fracture: a new study supports the idea that it can also lead to better outcomes for patients with acute illnesses such as pneumonia—especially when it comes to decreasing the chances of hospital readmission.

For the study, published in the June issue of Aging and Disease (.pdf), researchers tracked function and 30-day readmission rates for 1,058 adults 65 and older diagnosed with community-acquired pneumonia and admitted to an Ohio hospital between 2007 and 2009. Patients were administered the Katz Activities of Daily Living assessment at admission and after 48 hours in the hospital; patients whose score dropped from 6 (highest independence score possible) to 5 during that 48-hour period were targeted for the study.

About half of the patients (524) received an average of 30 minutes or more of physical therapy during their stay; the control group received usual care and no physical therapy. Researchers administered the Katz assessment again at discharge, and tracked 30-day readmission rates for all participants. The modalities of physical therapy used were not tracked.

Although researchers found no significant differences in Katz scores among the patients at the time of discharge, they did see a marked drop in 30-day readmission rates for the physical therapy group, which had an 11.2% readmission rate. The control group’s readmission rate was 16.3%.

Though Katz scores were not tracked after discharge, authors of the study believe that the readmission rates point to better functional outcomes.

“Our study contributes to the literature by providing evidence that [physical therapy—identified as “PT” throughout the article] reduces progressive functional decline, even in common acute illness (pneumonia),” authors write. “The progression of functional decline during or after hospitalization is subject to ‘traction effects’ because there are multiple contributing factors that are difficult to disentangle.” They describe physical therapy as a “buffer or breaker pedal” for these effects.

“Additional effects of hospital-based PT might include ‘delayed and spillover effects,'” they continue. “Hospital-based [physical therapy] reduces vulnerability to other episodes of acute illnesses, and consequently reduces the early hospital readmission rate.”

Authors believe that hospitals should pay attention to the findings, particularly in light of Medicare’s use of 30-day readmission rates as a performance indicator, and warn that other studies that question the benefits of hospital-based physical therapy may be questionable simply because patients didn’t receive enough treatment.

“The little or no functional benefits of hospital-based PT could be explained by premature length of hospital-based PT,” authors write. “The length of exposure to hospital-based PT could be too short to present the functional benefits by hospital-based PT. Important next steps will be to determine how to optimize the PT outcomes such as extension to home-based PT after hospital discharge and dose-response relationship between the intensity of PT and functional outcomes.”

A recorded course on the role of physical therapy in reducing hospital readmissions is available through the APTA Learning Center.

Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association’s PTNow website.


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Experts Recommend 2-4 Hours of Standing During Workday

That old REM song was right: you should stand in the place where you work. And now, according to some researchers, you can tack on “for about 2 to 4 hours a day” to the lyrics.

A new consensus statement from an international expert panel has established that workers whose jobs are “predominantly desk-based” should stand at least 2 hours per workday and move toward the goal of 4 hours of standing for optimum health. The recommendations were developed in response to multiple studies that have established the negative health effects of prolonged sitting, and media coverage that dubbed sitting as “the new smoking.”

The consensus statement was published in a recent issue of BMJ (.pdf).

According to statement authors, the conclusions are based on “the totality of the current evidence, including long-term epidemiological studies and interventional studies of getting workers to stand and/or move more frequently.”

Authors are careful to point out that they’re not simply talking about sitting all day vs standing all day, and they offer recommendations on how light physical activity should be incorporated into the workday. Those recommendations include advice to work up to the 4-hour-per-day standing goal, to regularly break up seated and standing work, and to pay attention to “musculoskeletal sensations.” Those sensations, they write, may be a normal part of the adaptive process, but they could also mean that the worker should rest for a time or see a health care provider if the sensations persist.

Workers should also remember that it’s not an all-or-nothing proposition, authors write. “Similar to the risks of prolonged, static, seated positions, so too should prolonged, static, standing postures be avoided; movement does need to be checked and corrected on a regular basis especially in the presence of any musculoskeletal sensations.”

While authors recommend the use of adjustable sit-stand desks and say that further study may galvanize the need for more changes to the actual workplace, they warn that sedentary work habits probably won’t be altered by new furniture alone—an opinion echoed in a recent Cochrane review of standing desk use.

“There are … strong indications that simply changing the office environment might not be enough to invoke long-term change in behavior,” authors write. “Strategies and programs for implementing change will need careful organizational and behavioral support and public education to prevent current interests in active office environments from simply being a passing fad.”

APTA offers information that physical therapists and physical therapist assistants can share with patients and clients on the negative impacts too much sedentary time at the APTA MoveForward webpage on sitting.

Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association’s PTNow website.

Posted by News Now Staff at 12:37 PM

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