The single best thing you can do for your long term health is move your body! Below are some articles to help you get motivated. Click below to read articles to educate, motivate and inspire you!

Therapeutic exercise can be divided into four types:

1) Strength	3) Flexibility
2) Endurance/Cardiovascular fitness	4) Relaxation/well-being.

When you think of exercise, it may conjure ideas of over exertion, sore muscles, or just plain discomfort. This is a mythical concept and is never the desired outcome at Healing Bridge Physical Therapy. Physical therapy exercise is utilized to address issues of pain, restrictions, or functional limitations. We call it Therapeutic Exercise. Through the evaluation process, your therapist helps you identify any impairments or pain patterns associated with your diagnosis. Therapeutic Exercise can be implemented to address any issues or impairments of strength, balance, endurance, mobility, posture, movement, pain, performance, inefficiency, in stability, or breathing patterns.

Exercise for strengthening purposes may include an individualize home exercise program, weight resistive exercise with such equipment as Theraband, Free weights, a pulley system or a more sophisticated system call the Total gym. Also, the well-known Gym ball or therapy ball offers many ways to accomplish strengthening. Endurance/Cardiovascular exercise is not only beneficial to the heart but also to the injuries of soft tissue and joints because of the increased blood flow to these areas. Typically, an upright bike, recumbent bike or treadmill works well. Flexibility can be restored and maintained with appropriate stretching exercises and instruction in proper techniques. Relaxation and well-being can be a result of exercise. Exercise is known to reduce stress, increase ability to relax and improve sleep.

At Healing Bridge, we work with you to identify and prioritize your physical therapy goals. Your exercise program is designed with you to help reduce your pain and/or impairment and to enhance your daily function. Your program will be appropriate and relevant to your goals and your daily life. We are committed to offering the most appropriate exercise program for you that prioritizes any functional problems and best conforms to your lifestyle.

We offer only one on one exercise instruction and tailor it to best meet your learning style and life style. We want to provide a clear and concise program that will offer optimal functional outcome for you. We want you to understand the process and be able to comfortably participate. Your independence and self-management of your program is the ultimate goal. You will be given a written home program to help you with this. WE will offer training and/or education to family members or friends to provide support appropriate to assist you. We will monitor and modify your therapeutic exercise program as you progress.

We can progress you to community-based programs and resources that can meet as you become independent with you program and no longer require specific physical therapy services.

Our goal with therapeutic exercise as an intervention and prevention is to implement and utilize exercise as a means to reduce your discomfort and optimize your mobility. It is always tailored to you individually and designed to promote your compliance and participation for the very best outcome for you. Return to top of page.

From the Healing Bridge Physical Therapy
Summer 2001 Newsletter
by Annette Cyr, PTA

Our primary goal is not just to help you return to the activities you love, but to provide adjustments and education, teaching you how to use your body, so you “Feel Better Than Before!”

1. Increases blood circulation, promoting faster healing of injured tissue.
2. Stimulates joints to improve balance and body awareness.
3. Encourages gentle mobility of pelvic/hip region.
4. Greater awareness of better posture and use of good technique.
5. Stabilizes torso for good posture and body mechanics.
6. Strengthens limbs.
7. Improves or maintains overall physical condition.
8. Improves endurance both aerobically and muscularly.
9. Fatiguing/using muscles can decrease pain/spasm.
10. Enjoy a faster return to full function & fun!

Remember, especially following an injury, it is important to consult your physician to determine if your exercise program should be designed and supervised by your licensed physical therapist. Return to top of page.

From the Healing Bridge Physical Therapy
Fall 2001 Newsletter
by Annette Cyr, PTA

There’s a lot of evidence supporting exercise as both preventative and therapeutic. Benefits include:

•	Decreased potential for heart disease by increasing coronary blood flow, promoting better circulation and decreasing blood pressure.
•	Increased total blood volume, viscosity and improved blood chemistry balance.
•	Decreasing the concentration of fats in the blood. Cholesterol and triglyceride levels are a predisposing factor to heart disease.
•	Increased overall relaxation and decreased anxiety and tension.
•	Improved lung volume (static and residual), vital capacity and increased strength and endurance of respiratory muscles.
•	Positive effects on bones, joints and connective tissue. Loading of the bones is necessary for bone metabolism and density, and for strength of the ligament and muscle tissue.
•	Improved mood and a more positive attitude and emotional outlook are additional benefits of regular exercise.

When done wisely, with good supervision and pacing, exercise in any form will add value to the quality of your life both physically and emotionally. Return to top of page.

From the Healing Bridge Physical Therapy
Fall 2001 Newsletter
by Nancy Hartung, PTA

Walking is probably the easiest, most natural movement pattern that our body knows. It is, after all, our primary means of self locomotion after age one or two. Most of us can successfully begin and continue a walking program with relative ease. Additionally, it does not require expensive equipment or a membership. One does not even have to drive anywhere to “get there.” It offers an outdoor experience that can delight our eyes and ears as well as our bodies. Walking provides a gentle rhythm and a change of scenery that can ease the mind and even become meditative. It provides an escape from our daily stresses.

Beyond the positive and immediate mental/emotional benefits, walking does much for the body. Quite simply, walking is wellness and health. It gently increases our heart rate to improve cardiovascular fitness and endurance. It improves circulation to all body parts; organs, joints, muscles and brain. It therefore improves nutrition to the body’s structures, speeding healing and decreasing risk of malfunction.

Increased heart rate for a sustained period (20 minutes or more) can enhance the body’s chemical production that provides for pain relief and a sense of well being. Walking feels good because it actually stimulates production of the “feel good” chemicals in our bodies.

If the physical and mental attributes are not enough, there’s more! Walking with a partner or group provides a window of social time in our busy lives. What better way to visit a friend and gain fitness all at one time? It’s good for everybody. You may just walk and talk your way into feeling great!

Begin your walking in a way that feels good to you. Start at 10 to 15 minutes if you are a beginner. Work up to 20 minutes after two weeks and then gradually up to 30 minutes. A walking program 4-5 days a week is ideal, but even 3 days a week provides great benefits.

Wear appropriate clothing to be as comfortable as possible. Take a jacket or sweater you can tie around your waist after you warm up. Shoes are very important. They should be lace up, supportive walking shoes that fit comfortably and provide good cushioning. If you walk a lot, you’ll want to get new shoes every so often as the “cushioning” begins to wear out or flatten.

Walk where it feels good; around the neighborhood, on the canal road, on the school track or on a hike. Be sensible about your tolerance to uneven terrain or cement. You may need to start on a cushiony track at one of the schools and assess how it feels. In the winter, the malls are available and are an excellent way to avoid the weather and maintain great health.

Why walk? It feels great and does great things for mind, body, spirit and friendships. Return to top of page.

From the Healing Bridge Physical Therapy
Spring 2002 Newsletter
by Annette Cyr, PTA

Stretch muscles, especially the lower back, buttocks and legs. As with any activity, your muscles will tolerate strain more easily when they are not tight.
Use stabilization exercises to keep your abdominal and lower back muscles toned. The muscles help to protect your spine and pelvis from injury.

Watch your body mechanics. Bending over at the waist is hard on the low back. Use your legs to get up and down from the ground.

Maintain neutral spine as well as possible in all positions. Change positions frequently to give joints and muscles a break. Positions may vary from sitting with legs crossed, kneeling, sitting with hips to one side and legs to the other and on hands and knees.

Rome wasn’t built in a day, and those weeds aren’t going anywhere either. Start with gardening 20-30 minutes, 2-3 times a day and increase this if your body is tolerating the current effort.

Take breaks!! After 20-30 minutes, try standing up and extending your spine gently a few times, do not continue if this causes pain.

If you have back pain, avoid early morning gardening. Why? 1) Usually our muscles are tighter in the morning, and 2) After a nights sleep, the discs in our spine are very hydrated, increasing disc volume. This increases vulnerability to injury with flexion activities.

Raise planting beds. The closer they are to you, the easier for your back. You can try raised beds on the ground or build platforms to make them waist high. Return to top of page.

From the Healing Bridge Physical Therapy
Spring 2002 Newsletter
by Heather Webster, MPT

Brief periods of warmer temperatures trick us into thinking that Spring is here, and then the 20 degree nights hit, reminding us that winter is not quite finished. As these chilly months drag on, it is easy to slip into the prolonged winter blues. But don’t despair! Here are some easy tips to putting a spring into your step and keep you sunny and warm:

1) EXERCISE!
Yes, that dreaded word. The good news is that you don’t have to run a marathon to get benefits from exercising. If you simply walk 20-30 minutes 3-5 times per week, you will notice a difference in your health. Exercise helps to promote blood flow, “oil the joints” (the WD-40 for the human body), increases your overall energy level, helps you to sleep better, and generally, will pick up your mood and sense of well-being. So, go take a walk through Drake Park, up Pilot Butte, or along the Deschutes River trail and remind yourself why we live in this beautiful area. Or, put on your snow shoes, skis, and go out and play in the snow while it lasts!

2) NURTURE YOURSELF!
Treat yourself to a massage or a hot bubble bath to relax your muscles and reduce the built up winter tension of bracing against the cold. Bodywork and spas are wonderful for rejuvenation and relaxation. Take the time to nurture yourself; when we are feeling well ourselves, we have much more to give to others.

3) CHANGE YOUR “MENTAL LATITUDE”:
Often we can get stuck in negative or depressive thinking. And the weather can contribute to these cycles. Meditation, the Feldenkrais Method of Somatic Education, Yoga, Tai Chi, are all ways to ways to help change our “mental latitude.” So, try something new! HBPT offers lots of class options (please see our programs list).

4) PUT THE BEST-BURNING FUEL IN YOUR TANK:
What we eat affects our energy level. Take a look at your winter diet…often people consume more carbohydrates and starches during the winter months. Are you? Nutrition is often overlooked or underplayed in our culture; yet the importance of how we “fuel” ourselves cannot be overstated. We each have an unique system and there may be certain foods you should avoid or nutrients you need more of. Consult a Naturopath or a Nutritionist if you want some guidance.

5) LAUGHTER IS THE BEST MEDICINE:
Go see a funny movie, or hang out with some friends and laugh, laugh, laugh!! The healing affects of laughter are well documented, and we can feel it without needing scientific proof. Laughter reminds us not to take ourselves or our lives too seriously. And, it’s contagious…so, spread it around! Return to top of page.

From the Healing Bridge Physical Therapy
Spring 2002 Newsletter

It’s another beautiful Central Oregon day, and there are trails to be hiked, annuals to be planted, golf to be played. You’re ready to tackle any number of Spring outdoor pursuits, but are your feet ready?

Most mammals distribute body weight among four feet, but our two feet must bear it all and be flexible enough to perform the finely coordinated actions for movement. You owe it to the 26 bones, 31 joints and 20 intrinsic muscles in your feet to minimize unnecessary stresses by wearing the appropriate footwear. Yet, shoe stores offer a sometimes almost overwhelming selection, for every activity you can think of. Here’s how to find shoes that fit your feet!

The basic components common to all types of shoe include the upper, sole, heel, reinforcements and the last. Each part serves a different function, and how they come together is what determines how right the shoe is to your foot and its designated function.

The Upper: This two-portioned part covers the top of your foot. The vamp covers your forefoot and toes. Pick a shoe with a vamp that is high enough to accommodate your arch height. The quarter part of the upper contains the lace stays, and typically comes in one of two styles: Blucher or Balmoral. A Blucher is open at the bottom, so the material above the toes flows continuously up to create the tongue. This style allows for the greatest amount of volume adjustment, so it should be considered if you wear inserts or orthotics. Hiking boots or other shoes worn when the volume of the foot changes due to normal swelling may benefit from this style. The Balmoral style has a quarter that creates a closed piece at its lower end. Think of an old fashioned pair of saddle shoes. This is the Balmoral style, and it’s sturdy but does not adjust as much as the Blucher.
The Sole: Plastic and rubber offer variations in grippiness and shock absorption, while leather soles don’t have any intrinsic shock reducing qualities, and provide minimal traction. In inclement weather and for people with poor balance, a better gripping synthetic would be a safer choice.

The Heel: Available in every conceivable shape and size, or not there at all (sneakers don’t have a built-up heel). In general, less is better. A broad, low heel provides the most stability and distribution of force. A one inch heel height may help with certain aspects of gait, and doesn’t significantly affect hip and knee positions. Higher heels force the lower leg forward, leading to bent knees and hips, increased backward knee pressures and curvature in the spine (lumbar lordosis). If you’re looking for a shoe with a heel, start by eliminating any higher than one inch.

Reinforcements: preserve the shape of the shoe, such as a toe box. Often, reinforcements aren’t visible, so it’s a good idea to ask about them (i.e. work boots may have a steel toe box). If you find it’s easy to roll your ankles, look for a shoe with a firm heel counter. Squeeze the sides of the heel together to get a sense of the shoe’s heel counter.

The Last: This is the mold used to build the shoe. They vary by manufacturer, and are why shoe sizes aren’t universal. All of the many wonderful anatomical variations in foot size and shape can be matched by a properly fitted shoe, so utilize your salesperson’s experience to get the best match possible.
Finally, try on many different styles. Do your shopping between midday and evening hours. Always try the shoes on (it sounds funny to say that, but you’d be amazed how many people don’t), and don’t be afraid to keep looking to find the best fitting, nice looking shoe. Fit should never come second to fashion.
If you have special footwear needs or want more information including where to go for specialized foot care, just ask your physical therapist. Return to top of page.

From the Healing Bridge Physical Therapy
Winter 2003 Newsletter
by Annette Cyr, PTA

•	Stay well. Take good care of yourself in the winter months. Adequate sleep, nutritious foods, vitamins and rest can keep you healthy so you can work and play.
•	Stretch your muscles to reduce chance of injury. Muscles take longer to warm up in cold weather because it takes longer to for blood to circulate to the extremities.
•	Walking on ice... local sporting stores sell “crampons” or “spikes” that fit onto shoes. They make walking safer, which gives you more confidence and enjoyment.
•	Strengthen! Whether an at-home program for your back or a general program at the gym, this will help to keep you fit and enable you to enjoy winter outings.
•	Make plans with friends. It can be more motivating to get out when others are involved, as well as safer.
•	Layer clothing and remove a layer if you get too warm.
•	Sign up for a class through C.O.C.C., Parks and Rec., or other community resources. They offer many outdoor programs with instruction, equipment and transportation. You are sure to make new friends.
•	Cold, dry air increases dehydration! Drink plenty of water when exercising, even though you may not be as thirsty as in the warmer months.
•	Protect your skin with sunscreen. The high desert sun is very intense, especially in the snow. Sunglasses and a cap are also helpful.
•	If you can’t get outside, use exercise equipment at the gym or at home. This is a great way to get aerobic exercise and may even save you time.
•	Mall walking is a great way to keep warm and dry while the roads are icy.

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