Elevate Summer 2016

Living at the height of wellness summer 2016 | Volume 4, Issue 3

safe play

Safeguarding your young athlete from overuse injuries Page 3

New: Nitrous Now available for laboring moms

Reasons for Rest Page 2

Banish the Bellyaches Page 4

Rooting Out Back Pain Page 10

Page 8

REST Weighing in on sleep You’ve probably heard that not getting enough rest may be linked to an expanding waistline. But, how strong is the connection, really?

Strong enough that health experts have begun to consider insufficient sleep a “top 3” obesity risk factor, along with overeating and inactivity.

Around 40 million Americans suffer from more than 70 different types of sleep disorders. If you think you might be one of them, contact the Sleep Disorder Center at Castle Rock Adventist Hospital at 720-455-3740 to learn more or to schedule a sleep study, available for children ages 5 and up as well as teens and adults.

Find Your Balance If you experience an injury while training, it’s even more important to balance rest and recovery. Physical therapy can help you determine which activities should be eliminated and which can simply be modified as you recover. Call 720-455-3700 to learn more or make an appointment with a physical therapist at Castle Rock Adventist Hospital.

Time for a

S

refresh

ummertime and a little R&R go hand in hand. And putting your feet up doesn’t just feel good, it’s good for us. Rest helps us regroup and replenish our energy stores so we can function at our best. Rest is one of eight focus areas that are part of CREATION Health, a scientifically proven approach to wellness used by Castle Rock Adventist Hospital.

But how should you approach rest when it comes to something like athletic performance? Because when you’re dedicated to your sport, taking time off — even for an injury — can feel like slacking off.

There is a smart way to do it, and (surprise) it’s all about striking the right balance and having an active recovery. Scott Bartel, DPT, SCS, director of physical medicine and rehabilitation at Castle Rock Adventist Hospital, offers this example.

“Balancing high-intensity activity with active recovery is critical to your training regimen. An active recovery period could simply be a lower intensity of your exercise of choice (like jogging at an easy pace for a shorter distance versus a long, fast run) or an alternative exercise (such as cycling on an off day instead of running),” Bartel says. “An alternative exercise is especially helpful to increase blood flow to muscles that have suffered microtrauma from those higherintensity days.”

To learn more about CREATION Health, go to castlerockhospital.org/creation-health.

Give your brain a beneficial break Mental rest is just as important as physical relaxation, and research shows that prayer is a great way to give your brain some downtime. But beyond its calming effects, prayer offers a wealth of other health benefits, from slowing your heart rate and lowering your blood pressure to actually helping you recover faster from heart surgery or avoid asthma attacks.

Make your vacations count Research has shown that taking vacations can have real health as well as productivity benefits. But a recent study found that not all vacations are created equal. If your getaway is stressful or poorly planned, the restful benefits of downtime get canceled out. To make the most of your summer vacation, shore up details like transportation and reservations in advance, and connect with a local expert to show you the ropes during your stay.

ELEVATE is published four times annually by Castle Rock Adventist Hospital — Portercare Adventist Health System. Executive editor is Christine Alexander. As part of Centura Health, our mission is to nurture the health of the people in our community. The information herein is meant to complement and not replace advice provided by a licensed health care professional. For comments or to unsubscribe to this publication, please email us at elevate@centura.org. ELEVATE is produced by Clementine Health Marketing.

2350 Meadows Boulevard | Castle Rock, CO 80109

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CREATION Health is a wellness program designed to support whole-person health.

Helping young athletes

avoid injury

The epidemic of overuse injuries

Kids’ bodies are resilient.

He loves to play!

If she wants a scholarship, she needs to play year-round.

We tell ourselves a lot of things when we push our kids — or allow them to push themselves — in sports. “There’s such a drive among young athletes to be the best in their sport. They play on multiple teams year-round to perfect their skills in a single Dr. Mark Christensen sport,” says Heidi Christensen, MD, a primary care sports medicine physician at Ridgeline Family Medicine at Castle Pines. “But it’s doing more harm than anyone expected.”

“The biggest long-term risk is damage to a child’s growth plate,” explains Mark Christensen, MD, also a primary care sports medicine physician who practices with his wife at Ridgeline. “The growth plate is an issue with any kid who’s not done growing.” That’s because the growth plate is particularly vulnerable, and serious damage could affect the bones’ ability to grow.

Once a child reaches the late stages of puberty, other types of overuse injuries are common. For example, a baseball pitcher who doesn’t get adequate rest is at risk of damaging tendons and ligaments in the shoulder and elbow. Basketball, football, and soccer players have increased risk of knee injury, while hip injuries are more common in sprinters and hurdlers.

Rest Reduces Risk The answer to overuse injuries is simple, says Dr. Heidi Christensen: rest and cross-training to reduce risk of injury and improve overall performance.

The American Academy of Pediatrics advises not playing a single sport more than five days a week — with at least one day off from any organized sport. They also advocate playing on just one team per season and taking two to three months a year off from their particular sport.

Strength training for kids

50%

A 2014 American Medical Society for Sports Medicine report noted that overuse injuries comprise half of sports injuries in teens and adolescents.

Signs of overuse injury: • Pain that typically increases with activity • Swelling • Changes in form or technique

castlerockhospital.org

3.5

million More than children ages 14 and younger get hurt annually playing sports or participating in recreational activities.

According to the American Academy of Pediatrics (AAP), kids who strength train not only get stronger, but also may see: • Improved athletic performance • Lower risk of injury • Increased bone density • Improved mental well-being The AAP advises not starting a strength program until at least age 7 or 8 — after a child’s balance and postural control skills have matured. Perhaps the most important thing is form: If a youngster can’t perform the exercise correctly using only her body weight, don’t let her add weight.

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Bellyaches andBeyond

Millions of kids have gastrointestinal issues that range from lactose intolerance and celiac disease to irritable bowel syndrome and gastroesophageal reflux disease (GERD).

Learn more about the most common causes, the symptoms to watch for, and your best course of action for getting an accurate diagnosis.

Y

ep, it’s possible that your son or daughter really could be faking tummy trouble to miss a test. But Ted Stathos, MD, a pediatric gastroenterologist at Castle Rock Adventist Hospital, is understandably skeptical.

“This idea that children complain of abdominal pain just to get out of school or chores is a misconception,” he says. “As diagnostics improve, we’re finding there’s almost always a source.”

Stathos and other pediatric gastroenterologists specialize in caring for gastrointestinal (GI) problems in children from the womb through their teens — everything from milk protein allergies to a bad reaction to high school cafeteria food.

“Children have gastrointestinal problems to almost the exact same degree their parents do; it just happens at about one-seventh of the frequency,” Stathos says. In fact, they can experience every problem or disease an adult would have, with the exception of GI cancer, which is rarely seen in children, according to Stathos.

Here, he walks us through some of the most common conditions and the signs and symptoms to watch for.

ELEVATE 4 Summer 2016

Common concerns

Signs to watch for

INFANTS

TODDLERS

SCHOOL-AGE CHILDREN TEENS & YOUNG ADULTS

• Milk protein allergy or intolerance • GERD • Constipation

• GERD • Constipation • Chronic abdominal pain (infectious)

• • • •

“These patients can be the hardest to diagnose because they can’t tell you what’s wrong,” Stathos says.

“This tends to happen when they start going to day care and have more exposure to other kids,” he says. “This tends to be one of the more infectious parts of your life. All the way through kindergarten and first grade, you’re catching lots and lots of GI bugs.”

• Blood in stool • Spitting up to the point where the infant is not gaining weight or seems in pain when it’s happening

• Vomiting • Diarrhea • Signs of dehydration, like decreased energy and urination

Contact pediatrician or family doctor immediately.

Ulcers Colitis Crohn’s disease Irritable bowel syndrome (IBS)

• Stool abnormalities: Twice a day to once every other day is considered normal; outside that, it should be discussed with their doctor • Chronic, recurrent abdominal pain, especially if it’s associated with any other symptoms, such as joint pain, a skin rash, mouth sores, headaches, or blood in their stool

All the same chronic conditions that their parents can have, from ulcers and GERD to gallstones and inflammatory bowel disease.

• Not growing/ gaining weight at an appropriate pace (either excessively or inferiorly) “Changing the trajectory of obesity early in life has dramatic and positive long-term effects,” Stathos says.

Well-prepared to help “Castle Rock Adventist Hospital has invested in the future of the children in Castle Rock, with state-of-the-art GI equipment for diagnosis and pediatric-trained staff,” Stathos says. “We can handle just about anything from the GI side, including emergency GI issues.” Common pediatric GI procedures performed include: • Endoscopies to take biopsies, diagnose illness, stop bleeding, and remove foreign objects that can cause a lifethreatening emergency, such as a swallowed button battery • Colonoscopies for diagnosis of various disease processes • Therapeutic endoscopy procedures — such as removing gallstones or intestinal polyps — and other abdominal surgeries without leaving a single scar If your child is experiencing a persistent problem that’s not getting resolved, Stathos suggests asking your pediatrician for a referral to a pediatric gastroenterologist.

Maximum Exposure The largest surface area on your body that’s exposed to the environment is not your skin; it’s your GI tract — which happens to be the size of a studio apartment! As children’s immune systems develop, they become more adept at managing this exposure. But this is why children tend to be so widely affected by GI viruses and bacteria early on.

castlerockhospital.org

The Celiac-IBS Connection A recent six-year study found that celiac disease is four times more common in children who suffer from irritable bowel syndrome than the rest of the pediatric population.

Is your child experiencing frequent stomachaches, diarrhea, constipation, or other GI problems?

Castle Rock Gastroenterology, located in the Alexander Building on the Castle Rock Adventist Hospital campus, specializes in pediatric GI issues. Call 720-455-3879 to schedule an appointment.

Good nutrition goes a long way

Pediatric gastroenterologists also help with nutritional issues, including: 1. Infant nutrition: “We know that the GI tract develops better in response to breast milk, so breast milk advocacy is a huge part of what we discuss with new moms,” Stathos says. “Not exposing infants to formula within the first several months of life has been scientifically proven to be extremely beneficial to the child in helping to prevent them from developing allergies as well as autoimmune diseases later in life.”

For mothers who cannot breastfeed their babies exclusively or are not producing enough milk, call Castle Rock Adventist Hospital’s milk depot at 720-455-0355.

2. Picky eaters: Stathos recommends taking your finicky foodie grocery shopping with you. “Have a list of nutritionally sound foods and let your child help pick from those groups,” he says. “You need fruit and vegetables, carbohydrates, fats, and proteins. You want to find healthy options within those categories that your child will eat.” And take heart: While variety is good, he recommends going with what works. If the only protein approved by your toddler’s palate is turkey, then turkey every day it is, until he or she decides it’s time to mix things up.

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Dr. Ted Stathos

Caring for every age and stage Stathos works with children of all ages — even before they’re born. (Currently, he’s treating a child who has been diagnosed in utero with liver disease to get a head start on the baby’s care.)

The problems he sees most commonly tend to vary by age group:

Head to toe, know when to go Heart attacks and strokes are not the only medical emergencies that require fast care

A

trip to the ER won’t always be triggered by severe chest pain or loss of consciousness.

Sometimes the symptoms are more subtle, but just as serious.

“Common sense can play a big role in whether or not your condition warrants a trip to the ER,” says Stefen Ammon, MD, medical director of emergency services at Castle Rock Adventist Hospital. “When in doubt, go to the ER.” Use this head-to-toe guide to assess symptoms of the most common medical emergencies.

Head

Possible indication of

Confusion, disorientation

Stroke, concussion, serious infection, cardiac arrest

Inability to be awakened

Stroke, cardiac arrest

Sudden, severe headache

Blood clot, stroke, aneurysm, hemorrhage

Drooping face

Stroke

Slurred or altered speech

Stroke

Loss of vision or blurred vision

Stroke

Neck, jaw

Unusual discomfort/pain

Heart attack

Chest

Sudden, unusual pain

Heart attack, heart failure

Lungs

Shortness of breath, difficulty breathing

Heart attack, heart failure, blood clot

Abdomen

Sudden, intense, or lingering pain that worsens over time

Appendicitis, ectopic pregnancy, hole in intestine, bowel blockage; note: Women may experience stomach pain during a heart attack

Arms

Paralysis, numbness, weakness

Stroke

Unusual discomfort/pain

Heart attack

Paralysis, numbness, weakness

Stroke

Legs

7

symptoms

signs of something more serious These symptoms also require immediate emergency attention: • Sudden, severe, unusual pain anywhere throughout your body • Uncontrollable bleeding • Persistent or severe vomiting or diarrhea • Blood in your vomit or stool • Unmanageable fever • Infectious condition with pain elsewhere in the body • Seizures with no known history of epilepsy

The Centura Health Trauma System is the region’s leading and most comprehensive network of trauma care and emergency services. It includes six emergency rooms throughout the southern Denver metro area: • Castle Rock Adventist Hospital • Littleton Adventist Hospital • Centura Health Emergency & Urgent Care (opening September 2016) • Parker Adventist Hospital • Porter Adventist Hospital • Southlands ER To find out wait times, go to southdenverhealth.org.

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body Area

PEDIATRIC EMERGENCIES Tips to help you decide when to go to the ER

You do everything you can to keep your kids safe and healthy. But sometimes the unexpected illness or injury happens. Being prepared can help, especially if your child has a chronic illness. If your child has asthma, for example, Stefen Ammon, MD, emergency department medical director at Castle Rock Adventist Hospital, recommends parents educate themselves about the warning signs of a flare-up.

Dr. Stefen Ammon And be assured that with a visit to the Castle Rock Adventist Hospital ER, your child will be in good hands. Michael Milobsky, MD, a pediatrician at Castle Rock Adventist Hospital, wants parents to know that the hospital’s ER doctors are thoroughly trained to make rapid assessments in pediatric cases, which is key with very young patients.

“With a 3-month-old with fever, you can tell quite a bit just by looking,” Milobsky says. “With a month-old baby, you need testing right away to understand what is going on.”

Here are the five most common reasons children end up in the ER, with advice from Ammon and Milobsky on how parents can decide when to go:

Asthma

triggers • • • •

Colds Allergies Pollution Exercise

when to go to the er Look for: • Nasal flaring • Chest retractions • Blue around the lips • Failure of typical medication treatment

Concussions • Vehicular accidents • Sports injuries • Falling from height greater than his/her own height

Look for: • Nausea with vomiting • Confusion • Vertigo • Headaches • May or may not lose consciousness

Abdominal pain

• • • •

Look for: • High fever and tenderness in lower right quadrant, which could be appendicitis; kids with appendicitis also won’t jump because of the associated pain • Blood in the stool • Pain or difficulty urinating

Seizures

• Epilepsy • Fever • Sleep deprivation

• • • •

Newborns may get bacterial infections right after delivery.

Fever in any infant less than 3 months old requires evaluation by a physician.

Fevers in infants under 8 weeks old

Appendicitis Viruses E. coli or salmonella Many childhood illnesses, from pneumonia to strep throat

If it’s your child’s first seizure Change in seizure pattern Failure to respond to medications For fever-induced seizures lasting less than 5 minutes, see your pediatrician ASAP to check for causes like meningitis

Other causes include: • Flu • Strep • Inner ear infections • Urinary tract infections (UTI) • Pneumonia • Minor illnesses

18%

of children under 18 have at least one ER visit per year.

Castle Rock Adventist Hospital ER has cared for more than 13,000 kids since opening — convenience that Castle Rock families trust.

CHEAT SHEET A little preparation can save a visit to the ER. For chronic conditions, like epilepsy or asthma, attach a check-off list to prescriptions and update it regularly.

• Verify Rx expiration dates • Make a note of additional medications for drug interactions • Keep one prescription at home and a duplicate at school Photo: ©Ellen Jaskol

emergency

We are part of the Centura Health Trauma System, the region’s largest and most comprehensive network of trauma care and emergency services. castlerockhospital.org

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A new (old) optio Many new moms are considering an old remedy to help ease their pain during childbirth: nitrous oxide. But is it safe and effective?

Here we take a closer look at a long-standing alternative that’s making a comeback.

Birth Concierge Jacque Northrup (center) and Sue McConaughy (right), certified nurse midwife at Castle Rock Adventist Hospital, talk through options for easing delivery, such as a birthing stool, with an expectant mom.

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Power over pain

Safety first

Epidural analgesia (anesthesia administered through a catheter to the base of your spine that blocks pain and causes numbness in the lower half of your body) is the most common method of pain relief during labor and delivery for women in the U.S. But a 2006 survey found that more American women are interested in considering less-invasive techniques. Sue McConaughy, a certified nurse midwife who practices at Castle Rock Adventist Hospital, is well-versed in the full array of pain relief options. And the thing she likes most about nitrous oxide is how it puts the power in women’s hands.

“The biggest benefit, in my opinion, is that women can control their pain management themselves,” she says. “Nitrous is noninvasive and safe for the laboring woman and her fetus. And 45 years of labor and delivery experience has shown me that women who feel that they are in control of their labor pain management feel more satisfaction with their experience.”

One key safety factor McConaughy points to is in how nitrous is administered: by the laboring mom, via a handheld mask. Because she’s actually holding the mask herself, she would drop it before she was able to inhale too much. And while nitrous doesn’t provide the kind of complete pain relief an epidural can, it doesn’t carry its potential side effects either.

“It is free from the risks of epidural, such as the rare case of infection or residual spinal headache,” McConaughy says. “It is also free from the risk of a sedated baby at birth.”

In their position paper on nitrous, the American College of Nurse-Midwives touts its effectiveness and safety, including how easily it can be administered, as well as how quickly it can both begin working and be discontinued if desired.

They also note that nitrous doesn’t negatively affect the progress of labor, isn’t associated with an increased risk of complications for mom or baby, and doesn’t require invasive monitoring.

There are other advantages, too, including financial considerations: Nitrous oxide is much more affordable than more invasive methods like an epidural.

A more natural experience So, what about that criticism that nitrous oxide doesn’t wholly eliminate pain in the way that an epidural can? The answer goes back to the question of choice. It’s true that while many women find it does reduce their pain, nitrous isn’t designed to eradicate it. But an effect that may be seen as a detriment to some is actually an advantage for others. After all, not all women want their deliveries to be completely pain-free, or to be highly medicated throughout. They prefer to experience childbirth in a more natural physical state, and increased access to nitrous oxide (and more options like it) is another way to honor their birth wishes.

safe Breastfeeding?

Use of nitrous oxide during delivery does not affect breastfeeding.

on for labor pain Ease Into Labor Pain Relief Method

How it works

• • • •

Facilitates a more comfortable labor, potentially shortening the process

Soaking tubs Birthing balls Birth slings Birthing stools

• Aromatherapy Serves as a • Guided imagery diversion

castlerockhospital.org

Being in an upright position is more comfortable and can physiologically shorten labor by encouraging rotation and descent of the baby’s head and putting pressure on the cervix, which in turn increases the strength and frequency of contractions, McConaughy says. “It’s better for the fetus, as it increases parental blood flow.” These techniques are not for use with an epidural or IV anesthesia.

The soothing effects of aromatherapy and visualization techniques employed via guided imagery can be calming and comforting in the delivery room. “Techniques like guided imagery and aromatherapy as well as hypnobirthing and Lamaze or Bradley techniques help by distracting the laboring woman from the pain of labor,” McConaughy says.

Learn more about nitrous in our FREE prenatal classes.

Questions? Want to tour our BirthPlace? Call our birth concierge, Jacque Northrup, at 720-455-0355.

Castle Rock Adventist Hospital joins a small but prestigious list of hospitals offering nitrous oxide to laboring women. Other hospitals include Brigham and Women’s Hospital and Tufts Medical Center, both in Boston; the University of California at San Francisco; and Vanderbilt University Medical Center in Nashville.

Summer 2016

Photo: ©Ellen Jaskol

In addition to nitrous oxide,The BirthPlace at Castle Rock Adventist Hospital offers other options for laboring moms.

9 ELEVATE

Cause and effect Getting the right treatment for your back pain begins with understanding its cause

B

ack pain can be a complex thing. Finding the right culprit isn’t always easy. Even if you can point to a specific incident that triggered the pain, a doctor might still have to do some detective work to accurately diagnose the injury.

Dr. Christopher Gallus “As physicians, we ask patients a lot of questions to make sure we understand the type of pain and its exact location,” explains Christopher Gallus, DO, a spine surgeon at Castle Rock Adventist Hospital. “Those are critical clues to helping us understand the injury.”

A physical exam and sometimes imaging scans are needed, too.

Here’s why that detective work matters: “Only when we understand the injury can we make the best recommendation for treatment,” he says.

Gallus walks through some of the most common back injuries and the best treatments for each to show how the same type of pain could be caused by two wholly different problems requiring different treatments.

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Whether it’s because of overuse or a sudden awkward twist, muscle or ligament strain is the most common cause of acute back pain. People who are overweight and those who are sedentary are at the greatest risk of injury.

“Our bodies are meant to move,” Gallus says.

“Being active and staying in shape are key to preventing back pain.”

It’s helpful to lift with proper form — bend your knees, squat, keep your back straight. This way you use your strong leg muscles and take the load off your back.

Treatment: Muscle strains typically just need time to recover. Ice, anti-inflammatory pain relievers like ibuprofen, and topical pain relievers can help. As pain subsides, ease back into activity.

Continuing activity as your pain allows is much more beneficial than completely stopping activity. If you’re still in pain after a couple weeks, see a doctor to make sure it’s not more than a strain.

Osteoarthritis of the spine As we get older, we’re at risk for arthritis. And while we often think of hips and knees, the spine also can be affected. With osteoarthritis, the cartilage in the joints and disks breaks down and pain results.

Arthritis in the spine can lead to bone spurs, compressed nerves, and spinal stenosis — the narrowing of the spaces in the spine.

Treatment: “Maintaining a healthy weight and strong core and back musculature are helpful when it comes to back pain,” Gallus says. “For people who are overweight and suffering with osteoarthritis, I typically want them to start a simple exercise program to lose weight and increase flexibility and strength.”

Massage and acupuncture can be helpful as well.

In severe cases where spinal stenosis has caused compression of nerves, surgery may be needed.

Herniated disk In between the bones in the spine are disks, which act as shock absorbers. A sudden injury to the spine or regular wear and tear can cause a disk to be out of place, or herniated. It’s possible — ­ and common — to have a herniated disk and not experience any symptoms. But sometimes the disk can press on the nerve roots and cause pain, numbness, or weakness in the arms or legs.

Treatment: For most people, anti-inflammatory pain medications, physical therapy, and exercise — or possibly steroid injections — will help. If not, surgery is an option, Gallus says.

“I typically like to make sure a patient has tried everything else before we look at surgery,” he adds.

Typically, the surgeon removes the protruding part of the disk, which relieves pressure on the nerve, which usually gives complete relief of leg pain. In general, spine surgery is very good at relieving symptoms that arise from nerve compression.

Surgery might be needed urgently if there is severe numbness or weakness or if the disk injury has affected bladder or bowel control — indicating nerve damage.

Osteoporosis Osteoporosis causes bones to become weakened and brittle, increasing the risk of fracture. A traumatic injury or fall could lead to a broken bone, or something simple like a sneeze could cause a compression fracture. Sometimes these breaks can cause sudden, sharp pain. But other times, they go unnoticed and untreated.

Several untreated breaks over time can lead to a curve in the spine, which can vary in severity.

Treatment: If you’ve been diagnosed with osteoporosis, your doctor will likely talk to you about medications, exercise, and getting enough calcium and vitamin D. For people who’ve had several compression fractures that have led to a deformity in the spine, surgery could eventually be an option.

Compressed nerves A herniated disk is one possible cause of a compressed nerve. But even repetitive motions or holding the body in one position for long periods of time can lead to nerve compression. The type and location of the pain will depend on which nerve is compressed. A compressed nerve in one part of the spine can lead to arm pain, for example, while compression of a different nerve can lead to leg and foot pain.

Treatment: Anti-inflammatory medications and steroid injections as well as physical therapy can be helpful. For people who don’t see any relief from these conservative treatments, surgery may be needed. The goal of the surgery, Gallus says, is to remove whatever is pressing on the nerve root — that could be a disk, pieces of bone, or scar tissue.

SI joint dysfunction The sacroiliac (SI) joint is where the sacrum (five vertebrae at the base of the spine) and the iliac bones (two large bones of the pelvis) meet.

Symptoms of SI joint dysfunction often include pain on one side of the lower back, hip pain, and discomfort bending over. It can be caused by arthritis, a traumatic injury, pregnancy, having one leg longer than the other, or previous spinal fusion.

Treatment: Rest, physical therapy, medications, and joint injections commonly help. It is very important that the physician who examines you is skilled in the art of physical diagnosis so that he or she can differentiate between low back pain, SI joint pain, and other musculoskeletal disorders.

To the Core Sure, who doesn’t want washboard abs? But a strong core isn’t just about looking great at the beach. A strong core — the muscles in your torso (front, back, and sides) — can help you perform daily tasks, maintain balance and stability, improve your posture, and protect your back from injury.

Here are a few no-sweat ways to help improve your core strength: • Sit on a balance ball. It forces good posture, helping to strengthen your core.

• Do Pilates. This practice uses a series of exercises to improve core strength.

• Do a plank. The plank (picture the up position of a push-up), also called a hover, engages your abdominal and back muscles and your shoulders. Hold for 30 seconds and work to hold it longer. castlerockhospital.org

Summer 2016 11 ELEVATE

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Muscle strain

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Castle Rock Adventist Hospital is part of Centura Health, the region’s leading health care network. Centura Health does not discriminate against any person on the basis of race, color, national origin, disability, age, sex, religion, creed, ancestry, sexual orientation, and marital status in admission, treatment, or participation in its programs, services and activities, or in employment. For further information about this policy, contact Centura Health’s Office of the General Counsel at 303-804-8166. Copyright © Centura Health, 2016.

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Castle Rock Ridgeline Family Medicine at the Meadows 2352 Meadows Boulevard, Suite 300 Castle Rock, CO 80109 720-455-3750

Gear

Three reasons to go two-wheel cruisin’

Whether yours had handlebar streamers, a banana seat, or racing stripes, no one forgets their first set of wheels. It’s time to get that feeling back, and embrace the benefits of biking as an adult.

It may not be as fun as putting playing cards in your spokes, but riding definitely has its perks — especially when it comes to your health. Here are three big ones:

1

It boosts your health and fitness. Biking is a great aerobic workout, and it also strengthens leg muscles. It offers similar cardiovascular benefits to running, without all the pounding on your knees. Beyond keeping you fit, regular cycling also can help prevent disease. A Danish study found that individuals who cycled to work had higher levels of “good” HDL cholesterol and lower levels of “bad” LDL cholesterol and triglycerides.

2 It’s relatively low-impact. Cycling is easier on your joints than other forms of exercise, and actually works to preserve cartilage. Pro tip: To get the joint benefits, don’t choose a gear that’s too challenging, as it can put a strain on your knees.

And don’t let biking impact your head. Always wear a helmet.

Looking for a great bike trail? Check out the list of open-space parks and trails on Castle Rock’s community website at crgov.com.

Aurora CHPG Cornerstar Primary Care 15901 East Briarwood Circle, Suite 200 Aurora, CO 80016 303-269-2626 CHPG Southlands Primary Care 6069 South Southlands Parkway Aurora, CO 80016 303-928-7555 Centennial CHPG Grace Family Practice 6909 South Holly Circle Centennial, CO 80112 720-528-3559 CHPG Holly Creek 5500 East Peakview Avenue Centennial, CO 80121 303-649-3820

3 It’s versatile — and fun. If you’ve forgotten how

cool bikes can be, consider this: It’s a workout, a convenient mode of transportation, and entertainment all rolled into one. So, kick up your kickstand and let’s ride!

Ridgeline Family Medicine at Castle Pines 250 Max Drive, Suite 102 Castle Rock, CO 80108 303-649-3350

Free Wheelin’ Castle Rock FreeCycle, a partnership between Castle Rock Adventist Hospital and Castle Rock Bike & Ski, lets you rent a bike for four hours — FREE! Learn more at castlerockfreecycle.com.

CHPG Primary Care Cherry Creek 300 South Jackson Street Denver, CO 80209 303-316-0416 Greenwood Village CHPG at DTC 8200 East Belleview Avenue Greenwood Village, CO 80111 303-770-6500 Highlands Ranch Highlands Ranch Medical Associates 9135 South Ridgeline Boulevard Highlands Ranch, CO 80129 303-649-3140 Littleton Chatfield Family Medicine 10789 Bradford Road Littleton, CO 80127 303-738-2714 Clement Park Family Medicine 6901 South Pierce Street Littleton, CO 80128 303-932-2121 South Suburban Internal Medicine 7750 South Broadway Littleton, CO 80122 303-347-9897

Parker Parker Primary Care 10371 Parkglenn Way, Suite 220 Denver

Parker, CO 80138 CHPG Clermont Park 303-649-3100 2479 South Clermont Street Denver, CO 80222 Timberview Clinic at 303-649-3155 Parker 9399 Crown Crest Boulevard, CHPG Primary Care Suite 200 Highlands Parker, CO 80138 2490 West 26th Avenue, 303-269-4410 Suite A120 Denver, CO 80211 303-925-4580 CHPG Primary Care Porter 950 East Harvard Avenue Denver, CO 80210 303-649-3200