Achy Knees? Joint Pain? What You Need To Know About Arthritis

 

Maybe it starts with stiffness in the morning when you wake up, or you notice your hands are aching as the weather turns colder. Knees giving you some trouble, or your shoulder hurting when you lift heavy bags or objects? Age catches up to all of us eventually, but if you’re experiencing stiffness or swelling in your hands and joints, and a decreased range of motion you may be suffering from common arthritis symptoms.

If so, you’re in good company: More than 50 million adults and 300,000 children have some type of arthritis. It is most common among women and occurs more frequently as people get older.

Common arthritis joint symptoms can come and go. They can be mild, moderate, or severe. They may stay about the same for years, or may progress or get worse over time. Severe arthritis can result in chronic pain, inability to do daily activities, and make it difficult to walk or climb stairs. Arthritis also can cause permanent joint changes. These changes may be visible, such as knobby finger joints, but often the damage can only be seen on X-rays. Some types of arthritis also affect the heart, eyes, lungs, kidneys, and skin as well as the joints.

Arthritis is not a single disease — it is an informal way of referring to joint pain or joint disease. There are more than 100 different types of arthritis and related conditions. People of all ages, sexes and races can and do have arthritis, and it is the leading cause of disability in America.

Every year, arthritis and related conditions account for:

  • More than $156 billion annually in lost wages and medical expenses
  • More than 100 million outpatient visits
  • An estimated 6.7 million hospitalizations

There are different types of arthritis. Osteoarthritis is the most common type of arthritis. When cartilage – the slick, cushioning surface on the ends of bones – wears away, bone rubs against bone, causing pain, swelling, and stiffness.  Over time, joints can lose strength and pain may become chronic. Risk factors include excess weight, family history, age, and previous injury.

Arthritis can also be degenerative. A healthy immune system helps protect us. It generates internal inflammation to get rid of infection and prevent disease. But the immune system can mistakenly attack the joints with uncontrolled inflammation, potentially causing joint erosion, and may damage internal organs, eyes, and other parts of the body. Rheumatoid arthritis and psoriatic arthritis are examples of inflammatory arthritis. Researchers believe that a combination of genetics and environmental factors can trigger autoimmunity. Smoking is an example of an environmental risk factor that can trigger rheumatoid arthritis in people with certain genes.

With autoimmune and inflammatory types of arthritis, early diagnosis and aggressive treatment is critical. Slowing disease activity can help minimize or even prevent permanent joint damage. Remission is the goal and may be achieved through the use of one or more medications known as disease-modifying antirheumatic drugs (DMARDs). The goal of treatment is to reduce pain, improve function, and prevent further joint damage.

Other types of arthritis include infectious and metabolic. A bacterium, virus, or fungus can enter the joint and trigger inflammation. Examples of organisms that can infect joints are salmonella and shigella (food poisoning or contamination), chlamydia and gonorrhea (sexually transmitted diseases) and hepatitis C (a blood-to-blood infection, often through shared needles or transfusions). In many cases, timely treatment with antibiotics may clear the joint infection, but sometimes the arthritis becomes chronic.

With metabolic arthritis, uric acid is formed as the body breaks down purines, a substance found in human cells and in many foods. Some people have high levels of uric acid because they naturally produce more than is needed or the body can’t get rid of the uric acid quickly enough. In some people, the uric acid builds up and forms needle-like crystals in the joint, resulting in sudden spikes of extreme joint pain, or a gout attack. Gout can come and go in episodes or, if uric acid levels aren’t reduced, it can become chronic, causing ongoing pain and disability.

Diagnosing and controlling arthritis

Arthritis diagnosis often begins with a primary care physician, who performs a physical exam and may do blood tests and imaging scans to help determine the type of arthritis. An arthritis specialist, or rheumatologist, should be involved if the diagnosis is uncertain or if the arthritis may be inflammatory. Rheumatologists typically manage ongoing treatment for inflammatory arthritis, gout, and other complicated cases. Orthopaedic surgeons do joint surgery, including joint replacements. When the arthritis affects other body systems or parts, other specialists, such as ophthalmologists, dermatologists or dentists, may also be included in the health care team.

When the joint symptoms of osteoarthritis are mild or moderate, they can be managed by:

  • Balancing activity with rest
  • Using hot and cold therapies
  • Regular physical activity
  • Maintaining a healthy weight
  • Strengthening the muscles around the joint for added support
  • Using assistive devices
  • Taking over-the-counter (OTC) pain relievers or anti-inflammatory medicines
  • Avoiding excessive repetitive movements

If joint symptoms are severe, causing limited mobility and affecting quality of life, management strategies may be helpful, but joint replacement may be necessary. Osteoarthritis that isn’t genetic may be reduced or prevented by staying active, maintaining a healthy weight, and avoiding injury and repetitive movements. As a general prescription, focusing on healthy eating and exercise remains the best course for limiting the onset of arthritis and for helping you control symptoms now or down the road.


Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Sleep – Who Needs It?!

Think about young children out at a restaurant with their family way after their normal bedtime.  Maybe they’re on vacation or have been going all day, had to wait in line and, your luck, got the booth next to yours. They may be short tempered, ill-mannered, and obstinate – not the best dinner companions. But here’s the thing:  It’s probably not their fault. If they haven’t gotten enough sleep, they are tired and cranky. Lack of sleep throws off our chemical balance and deprives us of much-needed rest that allows us to cope, concentrate, solve problems, and function more effectively in interactive situations–like while playing, in school, and at work.

In March, we turn the clocks ahead an hour and look forward to enjoying the lengthening days and milder temperatures. If you have a dog or cat, you know they’re not happy about the time change – they expect breakfast and dinner on the schedule they’re used to. But besides upsetting our animals, the time change and loss of an hour adds to any sleep deprivation we may already be suffering and wreaks havoc with our internal clocks.

When we’re tired, we become irritable. Productivity, service, creativity, and quality of work often suffer. Being fatigued tests the patience of everyone around us, increases chances of accidents or mistakes, and aggravates chronic health conditions. It also reduces our natural immune system, making us more susceptible to illness.

Humans have a 24-hour internal clock called circadian rhythm that controls our eating and sleeping patterns, internal bodily functions and the timing of hormone secretions. We might have trouble falling asleep at night or waking up in the morning if our internal clock gets out of sync with the external day-night cycle. This happens with multi-time-zone travel and is the basis for jet lag. With the daylight savings time shift, the external time has shifted while the internal clock has not, and even though it’s been weeks, there’s still a lag.

The more stable and consistent our circadian rhythm, the better our sleep. This cycle also may be altered by the timing of various factors including naps, bedtime, exercise, diet, and especially exposure to light.

Aging also plays a role in sleep and sleep hygiene. After the age of 40, our sleep patterns change and we have many more nocturnal awakenings than in our younger years. These not only directly affect the quality of our sleep, but they also interact with any other condition that may cause arousals or awakenings, functioning like the withdrawal syndrome that occurs after drinking alcohol close to bedtime. Chronic illness, changes of medications, and injuries also affect restlessness. But whatever the causes, the more times we awake at night, the more likely we will not feel refreshed and restored in the morning.

Additionally, psychological stressors like deadlines, exams, arguments, and job crises may prevent us from falling asleep or wake us from sleep throughout the night. It takes time to “turn off” all the noise from the day. If you work right up to the time you turn out the lights, are watching television, or are on your phone or laptop, you simply can’t just “flip a switch” and drop off to a blissful night’s sleep.

Steps for sleeping more peacefully

Millions of Americans suffer from fatigue caused by poor sleep habits. And while chemical imbalances and chronic conditions such as sleep apnea—where the body doesn’t get enough oxygen during sleep—can be affecting you, there are many simple solutions you can try before turning to medications or speaking with your doctor about a sleep study.

The most important sleep hygiene measure is to maintain a regular sleep and wake pattern seven days a week. It’s also important to spend an appropriate amount of time in bed—not too little, or too much. This may vary by individual. For example, if someone has a problem with daytime sleepiness, they should spend a minimum of eight hours in bed, but if they have difficulty sleeping at night, they should limit themselves to seven hours in bed in order to keep the sleep pattern consolidated.

Here are 10 good sleep hygiene practices to consider:

  • Avoid napping during the day. It can disturb the normal pattern of sleep and wakefulness.
  • Avoid stimulants such as caffeine, nicotine, and alcohol too close to bedtime. While alcohol is well known to speed the onset of sleep, it disrupts sleep in the second half of your sleep cycle as the body begins to metabolize the alcohol, causing arousal.
  • Exercise can promote good sleep. Vigorous exercise should be practiced in the morning or late afternoon. A relaxing exercise, like yoga, can be done before bed to help initiate a restful night’s sleep; but avoid exercise close to bedtime.
  • Food can be disruptive right before sleep. Stay away from large meals, spicy foods which increase metabolism, sweets, or unhealthy snacking. And, remember, chocolate contains caffeine, though it has many helpful properties, as well.
  • Ensure adequate exposure to natural light. This is particularly important for older people who may not venture outside as frequently as children and adults. Light exposure helps maintain a healthy sleep-wake cycle, though try to avoid too much light exposure in the evening if you’ve been having trouble sleeping.
  • Establish a regular, relaxing bedtime routine and try to wake up at the same time every day.
  • Limit stimulating activities, electronic games, social networking, and TV shows before trying to go to sleep.
  • Don’t dwell on or bring your problems to bed, and try to avoid emotionally upsetting conversations when it’s time to relax.
  • Associate your bed with sleep. It’s not a good idea to use your bed to watch TV, listen to the radio, or work.
  • Make sure that the sleep environment is pleasant and relaxing. The bed should be comfortable, and the room should not be too hot or cold, or too bright.

It’s easy to put off sleep, figuring we can catch up when there’s more time. But like taking our medications, eating nutritional meals and exercising regularly, getting the rest we need is important for our overall health and wellness and should be treated as a necessity, not a commodity.

Get Active, Outdoors!

It’s time to pack away the guilt about how much we ate and how little we’ve exercised since November and get ourselves motivated to stay active this winter. Exercise and play are important for our physical and our mental health. Even though it’s colder and it still gets dark early, getting outdoors after work or school and on the weekends should be part of our wellness strategy. The fresh air is good for our lungs, the sun is good for our bodies (when we protect ourselves), and there are many interesting and healthy pursuits waiting outside our doors.

This season is rich in recreational opportunities that expand on the exercise and fitness we can be pursuing at the gym, in our homes, or at classes. Walking is the easiest example, whether in our neighborhood, at a local school or park. Jogging or hiking offers scenic beauty and interesting wintery landscapes as backdrop for our workout. Additionally, we live in a region that offers parks and forests for cross-country skiing, snow shoeing and snowmobiling, close-by mountains for downhill skiing, and frozen ponds or rinks for ice skating and hockey. And when the snow is abundant, so are opportunities for sledding, tubing and tobogganing, activities that are fun for the entire family and a good workout.

No matter the choice of outdoor recreational activity, it’s critical that we take appropriate measures to protect ourselves. That includes dressing for the weather, making sure we’re properly hydrated, wearing sunscreen, knowing our limitations, and always respecting Mother Nature.

Dressing in layers and wearing the right types of materials are critical for keeping warm in the cold weather. But when planning our outdoor wardrobe, moisture management is also an important consideration. To keep the body warm during high-energy activities, clothing should transport moisture away from the skin to the outer surface of the fabric where it can evaporate. Also, look for garments made from the new stretch fabrics for better fit and performance.

Cotton is a poor choice for insulation, because it absorbs moisture and loses any insulating value when it gets wet. Instead, moisture-wicking synthetics which move moisture away from the skin are the best choice for active winter sports like skiing, snowboarding, hiking or climbing. Not only do synthetic fabrics wick moisture away from the skin, they dry quickly and help keep us warm in the process.

The next layer should be a lightweight stretchy insulator, such as a breathable fleece sweater or vest. The final part of our cold-weather wear should be a lightweight and versatile shell jacket. Fabrics like three-layer Gore-Tex and Windstopper allow companies to create shells that are ultra lightweight while remaining waterproof, windproof, and breathable. For aerobic activities, a shell’s ventilating features are particularly important. Look for underarm zippers, venting pockets and back flaps.

Always bring a hat and gloves, regardless of the weather or activity. Proper foot protection is critical, as well — wear insulated and water-proof shoes or boots, and synthetic socks that won’t absorb sweat. As with the rest of our clothing, synthetic materials work best for protecting us against the extremes. Look for fleece hats made with Windstopper fabric, gloves and mittens layered with Gore-Tex and fleece, and socks made of synthetic, moisture-wicking materials.

No matter where we’re going or what we’re doing outdoors, bring plenty of water or sports drinks, and try to avoid caffeine or alcohol — both actually dry you out, instead of hydrating, and alcohol lowers our body temperature. Also, make sure to have a cell phone, that somebody knows where you are, and when you’ll be returning. And remember to apply a protective lip balm and to wear sunscreen — the sun’s ultraviolet rays remain potent, even in the winter, and hydrating our skin with a UV-protective moisturizer will help protect from wind and other elements.

Finally, though it may not be at the top of our “fun” list, when it snows most of us have to shovel. Dressing warmly and appropriately is key, and the same tips for hiking and sports apply:  Stretch before lifting, stay hydrated, and knows our limitations. Avoid alcohol, caffeine or nicotine before shoveling as these drugs place more strain on our body and on our heart. Use a shovel that isn’t too big to reduce weight, lift with our knees, not the back, and start slow and work steadily – take plenty of breaks, don’t rush and don’t try and lift too much at one time.

When it comes to winter activities in the outdoors, the best advice, overall, is to be smart and know our limitations. Many winter sports injuries happen at the end of the day, when people overexert themselves to finish that one last run or hike one more mile before the day’s end. A majority of these injuries can easily be prevented if participants prepare by keeping in good physical condition, stretch before getting started, stay alert and stop when tired or in pain. But the rewards are worth the risks – get out there, have fun, and stay healthy!


Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Talk the walk

We spend a lot of time and money staying active and fit. Between the cost of memberships, athletic equipment, and appropriate clothing, fitness is a mutli-billion-dollar business. Yet there’s one incredibly basic, common and essentially cost-free activity most of us can pursue that’s easy, rewarding, convenient and okay alone or in crowds – yup, you guessed, it is walking!

Walking at a moderate pace for 30 to 60 minutes burns stored fat, builds muscle and speeds up our metabolism. Here are some other benefits:

  • Walking can reduce our risk of heart disease, breast cancer, colon cancer, diabetes and stroke.
  • Walking is low-impact, which means it causes less stress to our joints and our body than high-impact activities such as running.
  • Walking is a weight-bearing exercise, which helps prevent the onset of osteoporosis in women.
  • Walking reduces stress, improves blood flow and circulation, aids our respiratory system and helps reduce or limit weight gain.

If there’s any downside at all to walking, it’s that people who may have strained or damaged joints (knees and hips) or bad backs may find walking more difficult or painful. Ironically, though, back pain often is the result of wearing the wrong types of shoes for the activity of choice – or the wrong shoes, in general.  In fact, more than 50 percent of working Americans suffer from back pain each year, according to the American Chiropratic Association Not only that, but back pain ranks as the number-two reason people see a doctor, overall.

Often, there are two primary reasons why walking can hurt our backs. The first is what we choose to wear on our feet, and the second reason is how we actually walk, relative to posture, stride and form. For example, for women who wear high heels, these fashionable but typically uncomfortable shoes can throw off the alignment of our spine, adding extra stress and strain on the lower back. At the other extreme, shoes like flip flops are so flat that the lack of support can lead to arch, heel pain, ankle or knee pain.

Athletic shoes are grouped into categories for running, training and walking. This includes shoes for hiking, jogging and exercise walking. For a walking shoe, look for a comfortable soft upper, good shock absorption, smooth tread, and a rocker sole design that encourages the natural roll of the foot during the walking motion. Joggers, on the other foot, should wear a shoe with more cushioning impact. Running shoes are designed to provide maximum overall shock absorption for the foot. Such a shoe should also have good heel control. Walking shoes have more rigidity in the front so you can roll off your toes rather than bend through them as you do with running shoes.

We do not necessarily need a different pair of shoes for every sport in which we participate. Generally, people should wear sport-specific shoes for sports played more than three times a week. If you have worked out for some time injury-free, then stick with the particular shoe you have been wearing. There is really no reason to change.

Wearing the right shoes for the job or activity is critical, but so is making sure they’re the right size. If it’s been two or more years since your feet were professionally sized, there’s a good chance your shoes aren’t fitting you properly.  Feet change shape as we age, and tight-fitting footwear can lead to heel pain, deformed toes, bunions, corns, calluses, ingrown toenails, and a host of other painful problems.

Unless you’ve been sized recently, be careful about wearing shoes purchased over the Internet. Instead, go to a store with knowledgeable salespeople and have them measure your feet. If possible, purchase athletic shoes from a specialty store. The staff will provide valuable input on the type of shoe needed for your sport as well as help with proper fitting. This may cost a little more but is worthwhile, particularly for shoes that are used often.

Proper-fitting sports shoes can enhance performance and prevent injuries. Follow these fitting facts when purchasing a new pair of athletic shoes.

  • Try on athletic shoes after a workout or run and at the end of the day. Your feet will be at their largest.
  • Wear the same type of sock that you will wear for that sport.
  • When the shoe is on your foot, you should be able to freely wiggle all of your toes.
  • Since it’s common to have feet of different sizes, be sure to have both feet measured and fit to the larger of the two.
  • The shoes should be comfortable as soon as you try them on. There is no break-in period.
  • Walk or run a few steps in your shoes. They should be comfortable.
  • Always re-lace the shoes you are trying on. You should begin at the farthest eyelets and apply even pressure as you create a crisscross lacing pattern to the top of the shoe.
  • There should be a firm grip of the shoe to your heel. Your heel should not slip as you walk or run.

The importance of posture and stride

As with any form of exercise, good form plays a vital role in keeping us fit and healthy. How we stand, and the way we walk can cause back pain and muscle stress. Here are some tips for proper walking technique:

  • Posture: Stand up straight and look ahead. Don’t look down at your feet or the pavement below since that puts excessive and unnecessary strain on our neck and back.
  • Overstriding: Walk naturally. When we walk faster, a natural inclination is to lengthen our stride in front. Don’t. We should concentrate on taking shorter, quicker steps to avoid striking the ground too hard with our feet.
  • Understriding: On the flip side, avoid taking steps that are too small. This can constrict our muscles and their elasticity. We need to listen to our bodies. If we’re not comfortable as we move, we need to change our stride.
  • Flapping feet: If our feet hit the ground with a slap we’re probably fighting stiff shoes or our shins are too weak to let us roll through the step properly. Find a good pair of walking shoes that flex at the balls of the feet, and work on strengthening the shins.
  • Arm swing: A normal walking motion uses the arms to counterbalance the leg motion. We can add power and speed by using our arms effectively. To do this, bend your arms at a 90-degree angle and swing them naturally back and forth opposite your legs. Avoid under-using your arms by not moving them enough or overusing them by moving them faster than your legs.

Finally, no matter what we wear or how we walk, if our feet, legs or back are hurting us when we’re walking or when at rest, we need to visit a general physician or orthopedist, or to see a podiatrist, a doctor who specializes in foot care. A podiatrist checks out our feet, gait, and alignment.

He or she may recommend specialized footwear that has been modified to treat our particular foot condition, most often with inserts or orthotics that provide extra support. These can lead to improvements in foot and overall alignment, which can result in more efficient muscle use. You can also get shoes custom made to address your specific foot and back issues.

It’s important that we keep walking, whether indoors at the mall, at work and school, or outdoors enjoying nature and the elements around us.  Proper shoes and a basic understanding of the physiology of walking will go a long way toward enjoyment and improved health.

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Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Getting healthier is all in the wrist

When we were kids, pedometers were pretty cool . . . right up there with Dick Tracy two-way communication wristwatches, which weren’t real, but we knew they would be, some day. That day came and went with a yawn – people (the Boomers) really didn’t care that much. But then millennials took over the world, geeky became trendy, mobile phones changed our universe irrevocably, and personal fitness took center stage. So the marketing wizards figured out how to put chic back on our wrist and in our pockets by combining technology, health and wellness, and 20-somethings’ love of gadgets.

One of the oldest fitness gadgets is the pedometer. This simple device counts a person’s steps by detecting the motion of his or her hands or hips. Used originally by sports and physical fitness enthusiasts, pedometers are popular as an everyday exercise counter and motivator.

Today there are apps included on your mobile devices such as Apple Health for iOS and Google Fit for Android. And you can download even more apps to measure heart rate, track calories, set calendars, and engage step counters. There are related yoga and meditation apps, and apps for tracking where and how long you run, how many times you hydrated, calorie counters, when you should expect your period, when you took your medicine, how long you slept, and much more.

Function has replaced style for devices worn on the wrist. Devices like the Fitbit – which basically are just fancy pedometers – track steps, though the more sophisticated ones can detect things like heart rate, and sleep (how often you wake, tossing and turning, etc.). These can be synced to your phone and/or computer for tracking and analyzing data. Other popular wrist-worn devices include those from Jawbone, Garmin, Mio, and even Microsoft. The list continues to grow.

Finally, there also are “smart scales,” weight counters you step on, just like in the old days. These use WiFi and Bluetooth technology to sync weight results with your tablet, computer, phone or device. This allows you to integrate results in tracking and reporting programs. These modern scales are especially useful for helping physicians monitor weight loss or gain for chronically ill patients, shut-ins or people who can’t easily get to medical facilities. The results are sent via phone lines to a monitoring location, where technicians and nurses can identify red flags and call the patient or his or her doctor for an intervention.

The bottom line is that anything that helps you exercise more, set goals and measure your progress is good. But trends change, and people lose interest in their devices as new ones come along, and when they see it still requires work. And, sure, you could simply write down your numbers on a pad . . .  but what fun is that?

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Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Go take a hike!

Hiking in the autumn is a perfect outdoor wellness and recreation activity for individuals or the entire family. It’s not too hot, and not too cold. The fall colors are magnificent, it’s great exercise, and walking is physically and emotionally reinvigorating. Connecticut features dozens of state parks, well-kept and popular hiking trails, nature preserves and public-access reservoirs and protected green spaces – there’s no shortage of locations and great views for every skill level!

Whether you’re planning to hike for the entire day or just for a few hours, there are a number of important, simple steps you can take to better ensure your safety, comfort and enjoyment. To start, know your limitations – or those of your walking companions. Don’t be afraid to push yourself a bit, but if you’re unused to prolonged walking, pick a hike that’s not too long, not too steep and doesn’t feature physically challenging terrain. Guidebooks and websites often will provide general information such as degrees of difficulty and alternative trails – take the time to do this homework, unless you’re going somewhere familiar.

Dress for the weather and time of year, and always bring extra clothing. When you exert, you perspire, so wear synthetic, wicking clothes closest to your body to dissipate your sweat, rather than retain it. Wear or pack extra layers, as well – it’s easy to take them off as you go, or add them later. Carry an extra sweatshirt or jacket in case your clothes get wet, or you get colder than expected, especially if it’s windy or might rain. Include a hat, gloves and extra pair of dry socks.

Wear comfortable hiking shoes, boots that have been broken in, or sneakers – no sandals, flip flops, Crocs or open-toed shoes. It’s best to have shoes that protect your ankles and are waterproof or water resistant. To be safe and to protect your feet, carry powder, Band-Aids and moleskin, items you can purchase at any pharmacy. Other required “first aid” items should include anti-itching cream for bug bites, an antibiotic cream for bites or small cuts, treatments for blisters, adhesive bandages of various sizes, several gauze pads, adhesive tape, and over-the-counter pain medication. Also take sunscreen, insect repellant and lip balm.

Pack healthy food and snacks like fresh or dried fruit, nuts, energy bars and treats rich in fiber and protein. Hiking burns a lot of calories, and you’ll need to replenish as you go, so bring extra food in case it’s needed, particularly things that don’t have to be cooked. Most important, take plenty of water – at least two liters for yourself and every other person accompanying you (if you’re carrying their water – otherwise, they should bring water). Avoid sugary drinks or juices, or anything high in salt, such as soda. If you have a water-pumping system that allows you to draw and purify water from streams and brooks you may encounter, that’s always a good backup plan.

Bring waterproof matches and a lighter (or matches in a waterproof container), and a headlamp or flashlight with extra batteries, even if you’re hiking during the daytime. Weather changes quickly, nighttime descends faster than we realize, and if you or your party gets lost, lights become a critical safety and signaling tool. Cell phones are valuable too, but cell service is unreliable in some areas. Other safety items to pack include a compass and map, a knife and sunglasses. And of course, take a small garbage bag so everything you bring with you comes out with you as well.

Once you’ve assembled all your necessary gear, carry it in a daypack or other backpack that goes over your shoulders and keeps your hands free. Multiply the items you’re bringing so everyone in your group can be protected, kept warm, adequately fed and safely hydrated.

No matter where you go or who’s with you, make sure someone else not joining you knows your plans. That should include where you’re heading, and when you expect to be back. Set a check-in time so they can alert authorities if you’re long overdue.

While this may seem like a lot of preparation for a short hike or day trip, it’s all necessary, commonsense advice. Hiking, especially in less-congested or non-urban areas, is exciting, dynamic and healthy. But nature is unpredictable and terrain challenging, and both can throw many challenges your way. The Boy Scout motto is “Be Prepared,” but when it comes to hiking outdoors, that’s wise advice for everyone.

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Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Putting our shoulder into our work

For pitchers, quarterbacks and carpenters, it can be a career-limiting — or ending — injury. Likewise, if you do manual labor or projects involving lifting, carrying or moving objects, it can sideline you for months. Even working out in the gym, swimming or playing tennis can cause this injury, but the most common catalyst, affecting millions of Americans annually, is advancing age and the normal wear and tears of life.

The culprit is a rotator cuff injury. The rotator cuff is a group of four tendons and muscles that converge around the shoulder joint at the top of the humerus, the upper arm bone above the elbow. Together, they form a ”cuff” that both holds our arm in place and allows it to move in different directions. While our shoulder is one of our most mobile joints, it’s also somewhat weak. Too much stress — or repetitive motion — can cause partial tears and swelling in the tendons of the rotator cuff. Abrupt stress may even cause one of the tendons to pull away from the bone or tear in the middle of the tendon.

Sometimes the shoulder blade is rough or abnormally shaped and rubs or scrapes the tendon. Over time, this can cause tiny tears and bleeding. When these tears heal, the scar tissue is weaker and less flexible than normal tendon, so the whole rotator cuff gets weaker. The weaker the tendon becomes, the greater its chances of tearing.

Most rotator cuff tears develop gradually. But they also can happen suddenly — you might feel a pop, intense pain, and weakness in the arm. Falls, lifting heavy luggage, even shoveling snow or working in the garden can aggravate our shoulders, especially as we age. Aging causes tendons to wear down, which can lead to a tear. Also, previous injuries and genetics may play a role in increasing susceptibility to rotator cuff injuries.

If the shoulder is very painful and motion is limited, or if you have numbness, tingling and a “pins and needles” sensation that travels down through your elbow and into your hands, you should consult your physician, orthopedist, or sport medicine specialist. Without treatment, rotator cuff disease may lead to permanent stiffness or weakness and may result in progressive degeneration of the shoulder joint.

Typical symptoms of a rotator cuff tear include:

  • Pain in the shoulder and arm, which varies depending on how serious the tear is
  • Weakness and tenderness in the shoulder
  • Difficulty moving the shoulder, especially when trying to lift our arm above our head
  • Snapping or crackling sounds when moving the shoulder
  • Inability to sleep on the shoulder

As bad as these injuries can be, the good news is that many rotator cuff tears heal on their own. They may simply require a little time and relative inactivity involving the injured shoulder. You also should:

  • Rest the joint as much as possible, and avoid any movement or activity that hurts. Some patients may require slings early in the healing process.
  • Ice the shoulder two to three times a day to reduce pain and swelling.
  • Perform range-of-motion exercises, if your doctor recommends them.
  • Consider physical therapy to strengthen the joint and to learn safe, supportive exercises.
  • Use anti-inflammatory painkillers, or NSAIDS, like Advil, Aleve, or Motrin. However, these drugs can have side effects, like an increased risk of bleeding and ulcers. They should be used only occasionally, unless your doctor specifically says otherwise.

More serious rotator cuff tears require surgery. One procedure is shoulder arthroscopy, usually an outpatient procedure. During arthroscopy, the patient is put to sleep with general anesthesia. A small camera is inserted into the shoulder to see the injury, and miniature tools are used to repair the rotator cuff tear. In some situations, an open tendon repair may be a better option. In these types of surgeries, your surgeon works through a larger incision to reattach the damaged tendon to the bone. Open tendon repairs typically have a longer recovery time than that seen with more minimally invasive procedures done arthroscopically.

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Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

If you’re going to sweat it, wet it!

Paying careful attention to proper hydration, especially in the warmer months, is critical to our health. When it’s warm, our bodies perspire more to help cool us down, draining fluids important to the flow of oxygen and red blood cells to our muscles and organs. During exercise and activity, we also lose valuable nutrients and minerals. These include sodium, magnesium and potassium, which help keep our muscles working properly, reduce fatigue and prevent dehydration.

Thirst alone shouldn’t be our barometer for measuring fluid loss. The rule of thumb is if you’re thirsty, you’re already becoming dehydrated. Drink plenty of liquids before, during and after each activity. A good guideline to use when preparing for an outdoor workout is to drink about two cups of fluid two hours before the activity. That helps make sure we are well-hydrated before we even go outdoors. Then, during the activity, we should drink four to six ounces every 15 to 20 minutes to keep our muscles well-hydrated. If planning an hour-long walk or gym workout, take a water bottle with about 16 ounces (two cups). Then, after exercise, drink again.

Fluids are vital to help our muscles function throughout our activity, but so is our blood sugar. Eat a light meal or snack of at least 100 calories about an hour or so before an activity. The nutrients from the snack will help keep hunger from interfering. The best snacks combine healthy carbohydrates, protein, and a small amount of fat. Fruit, yogurt, nuts, and granola bars are all good examples.

Water or sports drinks?

For most outdoor activities, regular tap or bottled water does the trick. If activity lasts an hour or more, either fruit juice diluted with water or a sports drink will provide carbohydrates for energy, plus minerals to replace electrolytes lost from sweating.

Sports drinks like Gatorade, Powerade, and All Sport can provide a needed energy boost during activity. They are designed to rapidly replace fluids and to increase the sugar (glucose) circulating in our blood. However, read the label to determine which sports drinks are most effective. Ideally, it will provide around 14 grams of carbohydrates, 28 mg of potassium, and 100 mg of sodium per eight-ounce serving. The drink’s carbohydrates should come from glucose, sucrose, and/or fructose, rather than from processed sugar or corn syrup. These are more easily and quickly absorbed. It shouldn’t be carbonated, as the bubbles can lead to an upset stomach.

Most sports beverages are well-diluted and contain relatively few calories. If the flavor of a sports drink helps you maintain hydration, diluting it with water or pouring it into a thermos packed with ice will cut down even more on excess calories. “Fitness waters” such as Propel are lightly flavored and have added vitamins and minerals. The additional nutrients are meant to supplement a healthy diet — not replace losses from exercise.

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Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Finding a Gym That Fits You

It’s March, a perfect time for re-tuning our 2014 personal wellness plan. Hopefully we’ve done a better job of sticking to a modified diet following holiday excesses, and recognize signs of personal dietary weakness as the cold winter days continue. But as the days get longer, and the promise of milder weather hangs in the air, continuing our commitment to physical fitness and exercise at a gym, fitness center, in our homes or even at our workplaces should be an important part of our wellness plan.

If you don’t already belong to a gym or fitness center, don’t despair – they can be intimidating and expensive, working out isn’t fun for everyone, and finding time to get there is seemingly impossible with our busy schedules and obligations. Oftentimes, it’s simply a matter of feeling like we don’t “fit” properly in a gym that is a barrier to working out. Gyms and fitness centers vary significantly when it comes to demographics such as age, goals, cost, and style. Finding the right match for your needs is a critical component if you’re going to make the leap to — or sustain — regular workouts.

Here are some tips to help you find the right workout facility to match your needs and interests, and to keep you coming back week after week.

Know your personal goals and comfort issues.  Decide what you want from exercise, and what type of exercise you want to do. Do you love to swim, prefer yoga or dance, enjoy lifting weights, running on a treadmill or cycling?  Do you want to improve cardiovascular endurance, build strength, enhance flexibility — or just make it through a workout without getting bored? If variety is your thing, you need a gym with plenty of machines and lots of classes. If you just need to get in and out and sweat for 40 minutes, then paying for access to classes is a waste of money. Consider studios instead of gyms, the size of the facility, the crowd you’re working out with, and if there are personal trainers or coaches available to you if you’re interested.

Convenience is critical. Most people fail to stick with workout regimens because the facility they choose isn’t convenient to where they live or work – or only suits one of those criteria, making it tougher to get there on weekdays or weekends. Decide when you want to work out, as well – before or after work, during lunch, at nights and on weekends, for example – and make sure the center’s hours fit your schedule. Also, if you want classes, find out when the ones you want are offered. If you want to swim or play tennis, find out when the open times are and be sure they fit your schedule.

It’s okay to find a staff and workout crowd you like.  For workouts to become a regular and welcomed part of your life, it’s good if you like the people sweating around you, and the trainers and staff you deal with each visit. It’s a good idea to talk to other members about the quality of the club you’re thinking of joining, and to find out what they like about it.

It’s also okay to ask about staff credentials, certification and experience – it’s important to have qualified staff to answer questions and to guide us on proper machine alignment and techniques, or to demonstrate proper form in a class.  If you decide to hire a trainer, look for these things: a bachelor’s degree in exercise science or a related health-science discipline, experience, and, minimally, a certification from an internationally recognized organization like the American College of Sports Medicine, the National Strength and Conditioning Association, or the American Council on Exercise.

And don’t feel funny about liking or not liking the “culture” of your workout facility. If you’re not comfortable with the people around you, the music, the size of the crowd and availability of machines when you want them, shop around for a culture that is more comfortable. Always “try before you buy” – most facilities will give you a free guess pass for a visit or a week if you ask. You don’t need extra reasons to not work out!

Cleanliness and maintenance count. When touring local facilities, take a look at the equipment. Don’t just find out if they have elliptical machines; find out how many they have, how busy the machines seem to be, and how often they’re serviced.

You don’t have to be a germaphobe to want clean workout equipment. Does it appear clean? Are there sprays or wipes that you can see throughout the gym for cleaning the equipment? How many pieces of equipment are “out of order?” Of course, make sure and check the locker rooms and showers. If they’re dirty, need maintenance or don’t appear to be well tended, go somewhere else.

Are you looking for full-service or simple workouts?  In addition to access to machines and free weights, most memberships at full-service clubs include group fitness classes, lockers and showers, towels and — depending on the size of the club — racquetball and tennis courts, and a pool. There could also be services you pay extra for, like personal training, massage, a restaurant, and child care facilities. If the club you choose offers many of these options, expect to pay more than you would to join a small fitness center with a few treadmills and free weights.

How much should you have to pay for fitness? Working out at a formal facility often is not cheap. Sticker prices can range anywhere from $10 a month for a recreation center to $150 a month or more for a posh, upper-crust club. Whether you join a studio or a full-service gym with day care, showers and a pool, you’ll be incurring a new expense. Cost is usually tied to what the gym has to offer. Don’t pay for the newest, nicest health club if you’re never going to need the showers, the lockers, child care, or the pool. If all you want is to run on a treadmill, there may be a less expensive option in your area. Instead of $150 a month, you might pay $20 a month or less.

If a spouse and children are in the picture, ask about family memberships, and before you sign a contract or agreement, read the fine print; understand their payment policies and membership cancellation fees. Also, see if there is a “reciprocity agreement” that allows you to use other clubs when you’re traveling for business or on vacation.

Whatever you do, think about how you can free up the required time for regular workouts, book it on your calendar, find a friend to join you, and set reasonable personal goals. Working out is healthy and can be a lot of fun if you do it properly and find a facility that fits you just right!

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Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Autumn Fitness Includes Walking Our Way to Better Health

Autumn in New England is, for many of us, as good as it gets — warm days, crisp evenings, the smell of wood fires, pumpkins and freshly picked apples, breathtakingly colorful, scenic panoramas in every direction…what could be bad? Well, the days are getting shorter, the evenings colder and winter isn’t far away — but let’s stay focused on the positive, okay?

This is a great time of year to be outdoors walking, riding and hiking, working in the yard and enjoying the fresh air and beautiful scenery. As the cooler weather approaches it may portend the limitation of certain outdoor activities, but as is said, “When one door closes, another opens.” In this case, it’s the opportunity to continue our commitment to improved health and fitness, and to plan activities that will prevent us from winter stagnation. That may include many kinds of indoor fitness activities such as aerobic workouts, spinning, dance, yoga, swimming, athletics and much more, but also includes outdoor recreation such as hiking, bicycling and sports that can be practiced until the big chill sets in.

Dressing properly for the cooler weather is critical, as is proper hydration. It’s also important to remember to protect ourselves from damaging ultraviolet rays. However warming and enriching, sunshine damages unprotected skin all year long, and we need to continue using sunscreen and protecting our eyes as well, even in the cooler months.

Autumn also is a good time to moderate our diets, and a chance to implement good nutritional practices that may help reduce the seasonal gluttony (and related guilt) that accompanies the rapidly approaching holidays. Taking the time now to focus on sugar, fat, salt and carbohydrate intake will leave us in far better shape come January!

Walk the walk                                                                         

One of the simplest and most beneficial outdoor wellness activities is walking. This valuable exercise is good for our hearts, breathing, blood pressure, circulation, cholesterol levels, joint health and much more. If dressed for the weather with clothes that wick or keep moisture off our skin, we can walk all-year-round. And when it comes to fitness value it doesn’t really matter where we walk, as long as it’s done regularly and for long-enough distances and time periods to make a positive health difference.

According to a recent national survey conducted in August 2013 by GfK Research on behalf of Kaiser Permanente, Americans know that walking is good for their overall health, but many are not walking enough to meet recommended guidelines for health benefits. According to the survey, 30 percent of Americans said they walk more than they did five years ago, 35 percent are walking less and 32 percent are walking about the same amount. One-third of those surveyed said they don’t walk for 10 minutes at a time over the course of a week. In addition, 31 percent of those who walk do so for less than 150 minutes per week, which is the minimal threshold for physical activity established by the Centers for Disease Control and Prevention.

Nationwide, 94 percent of those surveyed said they view walking as good for their health and 79 percent acknowledge they should walk more. At least nine in 10 respondents agreed that walking is a good way to lose weight, maintain a healthy weight and can help prevent heart disease. In addition, 73 percent said they believe their children should walk more. Respondents also view walking as a good way to reduce stress and combat depression. More than eight in 10 Americans said walking can reduce feelings of depression and 87 percent said walking helps reduce anxiety.

Survey respondents don’t necessarily view the CDC’s guidelines as difficult to meet. Half said it would not be difficult to meet the CDC’s guidelines of walking 150 minutes per week. Nearly six in 10 respondents also said they would walk more if their doctor told them to.

When asked why they don’t walk more, those surveyed cited lack of time and energy. Not living in communities where they can walk to services, shops, school and work is also a deterrent. Four in 10 describe their neighborhood as “not very” or “not at all walkable.”

So, if we know that walking is good for us, and we know we don’t do it often enough, what can we do to change this paradigm? Setting personal, achievable goals is the first priority.

Walking a minimum of 30 minutes a day, five days a week can help address chronic conditions such as heart disease, diabetes, obesity and depression that limit our quality of life and contribute to the escalating cost of healthcare. Everyone can benefit from walking, regardless of age. It can be done alone, with a partner, or in groups.  Depending on where you live, and when you go to school or work, you can establish your own walking routine any time of day or night.

Set simple goals:  Plan to walk every day, or at least five days a week, at a time that works best for you. If something interferes with your walking schedule or the weather is lousy, walk later that day or the next day when it’s more convenient. Great walking venues include parks, schools, athletic tracks, established walking trails or your own neighborhood. City streets, shopping malls and quiet, safer roads can suffice, as well. Keep a written or electronic record of your walking so you can track your progress, and reward yourself when you hit a personal milestone of your own choosing. Encourage a friend, child or work associate to join you, and see walking as a critical daily activity, not as elective.

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Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!