Coordinated Health Magazine July/August 2011

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Your Prescription for Better Health July/August 2011 Your Back to School Health Checklist How to Treat a Blister Importance of Balance in Older Adults Precautions to Help Prevent Lower Back Injuries

Most Common Types of Skin Cancer The Biggest Risk of Injury in Swimmers is to the Shoulder The Five Different Forms of Lightening Strikes


Letter From The Editor Dear Patients, It seems like just yesterday we were ushering in summer and now it’s drawing to a close. That can only mean one thing- the back to school season is upon us. Most schools have already begun sports camps to prepare their athletes for the upcoming season, but remember, even though fall is right around the corner, we’re still dealing with the summer temperatures, which can certainly take a toll on athletes practicing outside. Make sure to talk to your child about the importance of keeping hydrated. Many young athletes may lean towards performance drinks like Gatorade or sugar filled drinks like Kool-Aid when choosing their beverage. There’s nothing better than water when it comes to staying hydrated, but if your child absolutely insists on a flavored beverage, try flavored water. There are a variety of flavors available and most of the drinks contain no sugar or caffeine. It’s also important to remember basic sun safety. When your child is exercising outside, they will most likely be wearing shorts and tank tops, which will leave their face, arms and legs exposed to harmful rays. Remind them the importance of wearing sun screen and reapplying it throughout the day. If possible, they can also wear a hat, which will keep the sun off of their face. You can find more information about summer safety and back to school in our July/August issue of Coordinated Health magazine. Discover what your child needs to ensure a healthy school year. Also, learn the warning signs of skin cancer and when you should visit your doctor. We also have some important tips on how you can protect yourself from lightening if you get caught in an unpredictable summer storm. These are just a few of the great articles we have for you in this issue. We hope that the articles will allow you to enjoy the rest of your summer and remain safe and healthy!

Amanda Boyce

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Features 6 How to Treat a Blister

2 Editor’s Letter

5 Contributing Team

14 What our patients are saying

8 Your Back to School Health Checklist

34 Coordinated Health Locations

Issue

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16 Importance of Balance in Older Adults

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Features 20 Precautions to Help Prevent Lower Back Injuries

24 The Most Common Types of Skin Cancer

26 The Biggest Risk of Injury to Swimmers is to the Shoulder

30 The Five Different Types of Lightening Strikes

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Our Contributing Team Amanda Boyce Editor

Hannah Ropp Writer

Rick Woods Design & Layout

Mike Price, PT Jeanette Richards, RN, CRNP

Registered Nurse, Certified Registered Nurse Practitioner

Sara Yodlosky, PAC Physician Assistant

Physical Therapist

Jeff Kroboth, CSCS Certified Strength and Conditioning Specialist

Marc Gallagher, ATC Certified Athletic Trainer

Mark Salamon, PT Physical Therapist

Suzanne Westock ATC Certified Athletic Trainer

Cover Photo by Barbara Talijan Courtesy of lehighvalleylive .com coordinatedhealth.com

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How to Treat a Blister Marc Gallagher, ATC

Steps to Treat a Blister: 1. Do not pop the blister with your hands. If it is preventing you from taking part in normal activity, use a sterilized instrument. Touching it with your hands may lead to infection or further irritation.

2. Clean the area with soap and water to prevent infection. If popping is necessary,

clean your instrument (needle, scalpel) with alcohol. Make an incision or hole at the base of the blister and gently squeeze the fluid out of the blister until it is flat.

3.

Use an antibiotic cream or ointment to keep the area clean and sterile. Cover with a sterile dressing and change dressing every day to keep it clean. At night, take dressing off to allow airflow.

4. Keep clean by washing with

soap and warm water. You may also soak it in a Betadine solution. This will soften the skin and reduce irritation. This will allow the skin to heal itself.

5. When pain lessens, do not

cover the blister anymore. Allow it to dry out. By this time, most of the healing has occurred, so risk of infection has lessened significantly. Generally, if it doesn’t hurt, it is healed.

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Your Back-to-School Health Checklist Jeanette Richards RN MSN, CRNP ANP-BC

Summer is just about over and everywhere

get ready for school. There are supplies

you look you’ll find reminders that school

and clothing to be bought, anxieties to be

will soon be in session. Just walk into any

calmed, and young adults who need to get

superstore or look at the Sunday circulars

everything packed up for college. But, in

and you’ll immediately feel the pressure to

all the chaos, one thing you may forget is that a great start

One thing you may forget is that a great start to the school year also means a healthy start! 8

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to the school year also means a healthy start! Here are a few health related tips to keep in mind:


1. Immunizations: While immunization laws, school requirements and permitted exemptions can vary from state to state, The American Academy of Pediatrics (AAP) recommends that all children entering public school have their immunizations up to date. A list of immunization requirements organized by state can be found on the American Academy of Pediatrics website. Parents generally must provide up-to-date immunization records to the school upon enrollment.

2. Hearing and vision tests: Some states include hearing and vision testing as a public service for all children as part of a standardized pre-K childhood screening. In other states, these tests are recommended, but not required. Regardless of whether the tests are required, they may be a good idea

young children often don’t know how to articulate that they can’t see or hear properly. Some school districts also require a basic physical exam before entering school.

for any child whose

If you get a note from your child’s school

parent has

nurse stating that they failed their vision

concerns about

or hearing exams, take it seriously. If you

these areas. Impaired vision or

are concerned about how to follow up, the school nurse can provide you with a list of

hearing can adversely community resources where you can get affect learning, and assistance. coordinatedhealth.com

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3. Special Health Concerns: If your child has any special medical needs, these

the school year starts. This will assure a smooth transition.

also need to be addressed with the school. Some things to remember if your child has special needs are: If your child is on medications, does he or she need them at

4. Sleep: For most kids, going back to

school? Do you have a request from your

school means getting up earlier, this also

physician to provide these medications

means earlier bedtimes. Sleep is critical for

during school hours? What information and

optimal health and learning, as well as the

forms do you have to provide to the school? regulation of mood and attention. Kids tend Is the medication in a clearly labeled bottle? to be energized and nervous about going How will the medications be handled when

back to school so getting enough sleep

your child goes on a field trip? If your child

is critical. Make this transition easier by

needs an emergency care plan at school,

gradually easing into an earlier bed time, and

this should be in place before the school

an earlier wake-up time. Even having kids go

year begins. Feel free to call your school

to bed 5-10 minutes earlier each night, a few

district and meet with someone before

weeks before school starts will help.

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5. Nutrition: A healthy breakfast is

6. Weigh the backpack:

an important way to start the day, but

Experts recommend that a

especially a school day. Keep quick and

child’s backpack

healthy options on hand so you can avoid

weigh no more

the morning rush and the “I don’t have

than 10-15%

time” excuse. Whole-grain breads and cold

of his or her

cereals, quick oatmeal and hot cereals,

body weight, in

yogurt, cottage cheese, fruit etc. will ensure

order to reduce

breakfast goes smoothly. At lunch, try easy-

the chance of back

to-carry veggies, fruits, dairy products, lean

pain or injury. Kids’

meats, whole grains and wholesome snacks

backpacks can cause back, shoulder, and

that keep your child’s energy and attention

neck pain when they’re too heavy and worn

levels high throughout the afternoon.

for numerous hours throughout the day. Choose a lightweight or rolling backpack that has two wide, padded shoulder straps and a padded back, as well as a waist strap.

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7. Reduce anxiety: Many kids, especially the beginning of the year, but they are so those entering school for the first time or going off to college, experience some anxiety. Parents can help ease this by talking about what to expect, and preparing for the transition together. Being prepared, will definitely help everyone adjust more easily.

very necessary and important in emergency situations. For older students, be sure they are equipped with their health insurance card in the event they need to seek medical care. Having them submit all necessary information the college or university Health Center asks for is imperative for them to receive care when they are sick or have a medical emergency.

Parents should also make sure that emergency phone numbers on file at school are up-to-date, and that the school nurse or your child’s teacher has the necessary instructions for any condition that your child might need special care for (asthma, allergies, etc.). These forms seem cumbersome when they are sent home at 12

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For older students, be sure they are equipped with their health insurance card in the event they need to seek medical care.

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W h at o u r pat ie nts a re s ay

s a h e H . r fa y b t s e b e h t s i o n i I p r d a n c a s S r . a r e y y D n a m r o f e m been treating e is close by. I have every re a h y d e a h l g T o . s f f a t m a ss i h d n a m i h n i e c n e d i f n o c wonderful!! . L e s i n e D

Dr. Bridg first doctor mido was the had seen in y daughter knew what h5 years that was, he waser condition and enthusiavery upbeat her through stic, helped her pain, e ncouraged he Dr. DiIorio r the entire has been m doctor fo t i m y e s he was his p r quite a f ew years. A makes the atient, l ways a patient spe n d t o o k c ia t l h , e extra steps will alway answer you s r question n e c e s s and alwa sary to ensu help you. I ys trys to took his ad re that h e vice and h r a knees repl n k l e a d both healed and s aced, best thing I eve he i always exp s now pain fre r d id. He lains every thing he d e after 5 why and n oes and l o n g ever tells y e a rs of pain!! you it will You have to b e e !! a s y S . do the the ue C . rapy and b It takes tim e patie

e to recov nt. er. He neve questions r thinks are too du m b o r His hospita silly to an swer. l makes su r g ery a lot e Great man asier. and GREA T DOCTOR! Gail G. Reid is ly, s e m a J nd Dr t, frie tentive. He n th e t e p m at co ur heal hings o d y n a n i , h t r thoroug ou as partne ays explains y . The w treats nning and al med decisions tude and a i r care pl an make info share his att positive c ffices ke it a very so you o s i h n ma staff i onalism and i isit. profess e when you v nc experie . Bruce H 14

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Dr. J tak aeger h en c are as suce sho of ul ss and ders, ca both m fully kne rpa y e e pr l tun His nel, oble bed s m id exc elle e man s. goo nt, an ner is d is d at wha expla very inin t he g i Wil s liam doing . B.


i n g a b o u t o u r p h ys i c i a n s doctor. l u f r e d n s is a wo m a I have only seen Dr. Koo r b e and A l b a Dr. e g ch d e l w o n k y y an r r d e I e v lik v e the fact that he He is a n. He is o s r e p e takes my input regardin sionat lem. He b o g what r p a compas e v a l h o ki u nd r t o of n treatment plan I am hen y itis in co r h t r helpful w A most comfortable with. eumatoid h i.e. R . y e m m o t t n m keeps e a di t ca tions, physical therapy ry impor e v is t a etc. He was not quick to and th jump . G t to e ag r gr es a si ve treatment right away Marg w hi ch is good for me since I do not like Dr McCarroll has always to ta ke ph ar macological substances been helpful, easy-going if it can be avoided. and listens to me when Dr. Mea d e is Julia K. I see him. He’s the only a thorou g h doctor I’ve needed to see pro f essional there. (I’ve been lucky doctor. H e strives I like in the fact that I haven’t Dr. M t o do the b azza injured myself in any est for Wag n and D a l l e r equ his patie r. other way and hope it nts. a l l y b oth h b e c au He has p remains that way!!). e lpe d se t he erforme m d y e v s t h ro u urgery o er y p Maria S. n both m g a h i nf ul t a y 20 children. i me i n 10. I Fe b r u h ave ar y S t e b p e h g m a r e nie B. e n b ac y us u b d l o k to a l se l Dr, G ind and is f f o n r aw h o w. A k i le c t ua l is very o try diffrent ink l y I m te s te Tae k w y 2n d t h d f or o ndo d e willing e makes you t tant g r e t e h b i S s p as r l ac k b t ac e y t Fr id e l t in C. ideas. H are very impo you. I ay ! u

that yo is listening to d other n e when h ommend him a y m c have re have seen to I doctors nd family. a friends . Joyce S

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The Importance of Balance in Older Adults By: Jeff Kroboth CSCS

Balance is an important part of everyday life, but, it’s one that many people overlook when it comes to exercise. Balance falls into the same category as flexibility, core strength, and mobility. These are all things our body needs to function efficiently, but many of us don’t actually do exercises to improve them. If you exercise regularly, you already work on your balance, however, just because you exercise doesn’t mean there isn’t room for improvement.

Balance is a complicated process that involves the eyes, the inner ear, sensors in joints

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(proprioceptors), tendons, muscles, and skin. These sensors relay information on your body position to the brain to process. Decreased balance can be attributed to a number of issues, including, age, reduced central processing of sensory information, and slowed motor responses. Muscle strength can also be attributed to loss of balance. As you age, muscles will shrink unless you make

The key to balance training is to start slowly. It’s easy to hurt yourself if you don’t take your time and allow your body to get used to being in an unstable environment.

a concentrated effort to keep them strong. The muscles then weaken and are unable to hold the body in balance. There are also some medications that can result in loss of balance.

The key to balance training is to start slowly. It’s easy to hurt yourself if you don’t take your time and allow your body to get used to being in an unstable environment.

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Research has shown that participation in either resistance or flexibility activities prior to balance exercise can negatively impact performance, so balance training should precede both resistance and flexibility activities. Aerobic, resistance, flexibility and balance training are each important to your overall health, functional capacity and quality of life as you get older. However, to fulfill the minimum frequency requirements of each form of activity, you need to perform at least two (or more) activities on the same day and most likely within the same exercise session.

Since poor balance can lead to an increased risk of falls and may limit daily activities or participation in leisure-time activities it is essential that balance exercises be incorporated into your physical activity programs, especially as you get older.

Here are a few balance exercises that can be incorporated into your daily routine:

Step up to Balance: Use an Aerobic step box. Make sure the height of the box is at a comfortable level. A box that is too high can cause knee and back pain.

Directions:

1. Stand in front of your

step up box keeping your toes about 6 inches away from the box.

2. Step up with your right

leg, making sure to place your right foot flat and firmly on the box. Your left leg should follow like you are walking up a flight of stairs. 18

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The left leg should stop when the knee is at a 90 degree angle with the left foot flat or slightly pointed upward.

3. Step down with the left leg and return the right leg to the starting position.

4. Repeat this action for 10 to 12 repetitions then switch to your left leg. Do 2 sets of 10 to 12 repetitions.

Balance Clock Matrix: Directions: 1. Stand with your feet together

on the ground. Slightly raise your right foot in the air, approximately 2 inches above the ground. If you are unable to balance on one leg use a pole to assist you.

2. While keeping your leg

straight, extend your foot forward towards where the 12 on a clock would be.

3. Return your right leg back to the starting position, being sure to not touch your foot down at the starting point.

4. Extend your foot out to where 1 o’clock would be and return, then to 2 o’clock, and so on and so on until you have gone around the numbers on the clock.

5. This matrix should be done at a slower pace to begin then quicker as you become more advanced. Repeat the Balance Clock Matrix twice on each leg. coordinatedhealth.com

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Low Back Injuries By Mark Salamon, PT

If you’re not careful, gardening, golf, and other back-busting activities can put a real cramp in your summer plans. In order to protect your summer plans and your spine, it’s important to take certain precautions when participating in some activities. Back injuries are among the most complex to evaluate and treat. This is because your spine is full of different structures that can be worn out or injured, all packed into a small area that is also full of nerves. You probably know what it feels like when you hit your funny bone, and that is only one nerve. The low back has a whole network of nerves that exit the spine at each level and branch out to cover the entire lower half of your body. These nerves are packed into a small area along with discs, joints, ligaments, tendons, and muscles. If any of these structures are torn, swollen, inflamed, or in spasm, they can press or squeeze the nerves. Even a relatively minor muscle strain can put pressure on a nerve, causing pain to radiate into areas where there is no injury. 20

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Even when your nerves are not being squeezed, an injury to any of the structures of your spine can cause a reactive muscle spasm. Your body’s nervous system has many mechanisms that sense if something is wrong. Even a minor injury to your back can send a signal to the nervous system, which sends a signal back to the muscles that surround your spine, telling it to contract in order to protect the spine and prevent further injury. This constant muscle contraction can cause more pain than the injury itself. And since it is a protective reflex, you can’t just relax the muscles by thinking about it. Imagine making a fist as hard as you can, and holding it all day long. Think about how sore your hand would get. That is what the muscles around your spine are doing.

With any low back injury, it is very important to be evaluated by a physician. Diagnostic tests may be necessary to determine if it is a relatively minor injury, or a dangerous situation. Your physician will determine if physical therapy is appropriate.

If you are referred to physical therapy, your therapist will perform a thorough evaluation to determine your course of treatment. This involves observing how your pain responds to different motions, measuring flexibility of your back and lower extremities, and testing the strength of your lower extremities and “core” muscles. The core is a term for the group of muscles that surround and protect your spine. They include not only the muscles of the low back, but the stomach, hip, and buttock muscles. All of these muscles “wrap around” the whole area, and if they are working properly they absorb the force of your body coordinatedhealth.com

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weight. If any of these muscles become weak, then more of your body weight is going directly to the spine, causing more wear and tear on the discs and joints, and making it more difficult for any injury to heal. Leg flexibility is also very important for your lower back. Your leg muscles attach to the pelvis, and the pelvis is attached to the lower spine. If your leg muscles are tight, particularly the hamstrings in the back of your thigh, then these tight muscles are constantly pulling down on your pelvis, and in turn on your lower back. This tension on your lower back can cause pain even if there is no injury, and makes any injury more difficult to heal. Even after your injury has healed, it is very important to continue the exercise program that your therapist has given you. By maintaining strong core muscles and flexible legs, you are decreasing the forces on your spine, and decreasing the “wear and tear” that comes with the normal aging process. You are also decreasing the chance of further injury. Statistically, ninety percent of all people will have some type of low back injury at some point in their life. Virtually all of us need to take steps to decrease the chance of injury. We can’t make you eighteen again, but we can help you enjoy a longer, active life.

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presents

EE y R F it ibil g x Fle enin re Sc

Overuse Injuries in Youth Athletes

…………………………………………………………………………………… Youth athletes on all levels are constantly pushing themselves to reach new heights. What happens when you push too hard? Overuse or repetitive injuries, are on the rise.

Dr. Todd Melegari

Frank Lupin

Join our live, interactive audience as Sports Medicine Physician, Dr. Todd Melegari explains the causes, prevention and treatment of common overuse injuries in sports and fitness. Discover the importance of pre-stretching before any physical exercise by Frank Lupin, Pulse Performance Specialist.

…………………………………………………………………………………… when where to register

Tuesday, August 16, 2011 6:00pm 2300 Highland Ave., Bethlehem, 2nd Floor Call 610-861-8080 ext. 8276 Register now, space is limited

…………………………………………………………………………………… Free Flexibility Screenings Free Refreshments & Raffle Prizes! www.coordinatedhealth.com

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Skin Cancer Sara Yodlosky, PAC

As the weather gets warmer & you are outside more often you must be aware of the potential hazards of sun exposure. Exposure to ultraviolet rays is a risk factor for developing skin cancer.

Skin cancer is the most common form of cancer, with the number of cases growing each year. There are 3 main types of skin cancer: basal cell, squamous cell & melanoma. Â

Basal cell is the most common form of skin

cancer accounting for about 90% of cases. The majority of these do not spread or become malignant. They are usually found on the face. Having a fair complexion & a history of severe sunburn as a child are two risk factors. Basal cell cancers usually appear as dome-shaped pinkish colored bump. Squamous cell cancer occurs about a Âź as frequently as basal cell cancers. They also affect fair skinned individuals & are found on sun exposed areas. Squamous cell cancers start as precancerous growths called actinic keratoses. They can appear as small, raised, rough patches that are red or pink with a white or yellowish scale.

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Melanoma accounts for only a small percent of skin cancer but it is by far the most serious & potentially deadly. When evaluation skin lesions it is important to remember your ABC’s.

Asymmetry Border Color Diameter Evolving

– Does one ½ match the other

– Is it smooth or irregular, ragged, or blurred

– Is it the same throughout – Is it bigger then an eraser (6mm)

– Has it changed in any way

The best ways to prevent skin cancer are to avoid prolonged sun exposure and to practice sun safety. Here are a few tips: •

Avoid the sun during 10AM & 4PM

Wear sunscreen with SPF of 15 or higher and don’t forget to reapply

Wear protective clothing – hats, sunglasses, & cover-ups

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Swimmers and Shoulders By: Mike Price, PT

All sports come with injury risks. Swimming

more knowledgeable of the demands of

is often thought of as a sport that is safe

the sport on the shoulder then I wanted

with little to no risk. If swimming is a

to be. I ended up missing the majority of

sport you are interested in picking up for

my sophomore and junior seasons in high

exercise, by far the biggest risk of injury in

school due to shoulder injuries on both

swimming is in your shoulder. Many people

sides. I rehabbed and became aware of

watch competitive swimming and draw an interest in the sport from watching. When you watch swimming you are only seeing what goes on above the water, but preventing injury comes with understanding what

a lot of things I did

If swimming is a sport you are interested in picking up for exercise, by far the biggest risk of injury in swimming is in your shoulder.

wrong in and out of the water. Luckily from that point on, I had no more shoulder issues and that experience led me to a career in rehabilitation.

When talking to people about swimming I

should be done under

try to relate it back

the water.

to mainstream sports. You are probably aware that baseball is very hard on the

I swam competitively from age 6 to 20. I

shoulders and most pitchers are placed on

was at an elite level by the age of 14. I

a pitch count. They may throw 120 pitches

qualified for nationals at that age and was

and that is the end of their game. They may

on nationally ranked teams throughout high

throw bullpen sessions on their off days but

school. I was riding high because of my

they will not throw 120 pitches again for 4-5

success, but then my yardage (distance I

days. Swimmers take approximately 15-20

was swimming) bumped up and I became

strokes per lap and swim in the range of

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10,000 yards a practice (400 laps) so they

poor posture in the water can also lead to

may take 6000-8000 strokes in a practice.

injuries.

They will then get in the water the next day and do it all over again. I am not comparing throwing to swimming but you can see where

Under the water if a swimmer does not bend their elbows, they make their shoulder muscles

the overuse of the

take more of a

shoulder comes

load to move

in for swimmers.

them forward in

Even a new

the water instead

swimmer may

of allowing other

only swim 500

arm muscles and

yards (20 laps) but in that time they are likely

Proper elbow bending under water to lessen stress on shoulder

chest muscles to assist in forward movement.

to do 300-400

Having a symmetrical trunk rotation and

overhead repetitions in the water.

learning how to breathe to both sides also will help you avoid injuries. The less your

The most common shoulder pathologies

trunk is rotating while you swim, the flatter

in swimmers are rotator cuff tendonitis and

you are in the water. The lesser rotation

impingement syndrome. These diagnoses of your trunk, the more internal rotation will are characterized by loss of motion, mostly be required at your shoulders and being in overhead and into internal rotation, loss of

internally rotated positions increases the

strength throughout the shoulder and pain.

likelihood of impingement.

There are a few things that can go wrong in and out of the water that can make swimmers more prone to these diagnoses. In the water you can have issues of technique including arm placement under water, limited trunk rotation in the water, asymmetrical breathing patterns and hand placement in the water. Out of the water, poor posture which will lead to coordinatedhealth.com

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Hand placement into the water can also increase the tendency of shoulder impingement. Many swimmers try to enter thumb first, but by doing so you are again demanding more internal rotation of the shoulder Example of correct flat hand entry into water

which can lead to injury. When swimming, you should try to enter the water with more of a flat hand. Lastly, poor posture can cause you to crossover the midline under the water which also puts you in a position where there is more stress on the rotator cuff.

Swimming is a great cardiovascular exercise and can Poor posture making swimmer cross the midline with stroke

really condition your entire body. However, it can be stressful on your shoulders. If swimming is a sport you

really want to try, I strongly recommend you get formal instruction from someone that has a background in swimming or at the very least watch an underwater video of proper swimming technique. It is also useful for you to meet with a physical therapist or performance specialist that can assess you to make sure your shoulders are flexible enough and strong enough to make a smooth transition to the sport.

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When Lightning Strikes By: Suzanne Westock ATC, ROT

Summer weather can be unpredictable. Sunshine and a few clouds one minute could turn into a major storm without much warning. That makes lightening a major concern when it comes to any outdoor summer sports. Field officials and umpires have guidelines to protect athletes and spectators, but unfortunately lightning still kills approximately 100 people in the United States every year.

Lightning can strike in five different forms: 1. Direct Strike

- Enters the head through the eyes, ears, nose, and mouth, and then travels through the body and into the ground.

2. Contact Injury - This occurs when a person touches an object, like a car or fence that is struck by lightning. 30

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3. Side Flash

- This occurs when lightning strikes an object and jumps to a person standing nearby.

4. Step Voltage or Ground Current - This is when the lightning’s

electrical current travels in waves from the strike point. If a person is standing with one foot closer to the site than the other the electricity will enter the body through the one leg and exit through the other. The further apart the person’s feet are the greater the chance of injury.

5. Blunt Injury - This happens when lightning currents cause a person to be thrown from the strike point resulting in non-electrical injuries. Due to the many different ways lightning can injure you and the severity of damage it can cause, postponing outdoor activities can ultimately save lives. Outdoor activity should be postponed when lightning is seen or even when thunder is heard, since thunder cannot be created without lightning. A flash to bang equation was created to detect the distance between the current location and the lightning strike.

Due to the fact that light travels faster

Due to the fact that light travels faster than sound, the person should begin counting at the flash of lightning, and should cease with the clapping sound of thunder. Divide that amount by 5 to retrieve the mileage between the person and the lightning flash.

than sound, the person should begin counting at the flash of lightning, and should cease with the clapping sound of thunder. Divide that amount by 5 to retrieve the mileage between the person and the lightning flash. Everyone should be in a safe shelter before the flash to bang time is 30 seconds, or 6 miles away. Resumption of activity cannot begin until 30 minutes after the last lightning flash, or clap of thunder. The theory behind this is that after a 30 minute wait, the storm (through calculations) should be between 10-12 miles away. The best area to safely wait out a storm would be an enclosed shelter with electricity, coordinatedhealth.com

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plumbing, and phone service. This is an ideal location because if lightning does hit the building, it is most likely to follow these pathways to get grounded. The next safest structure is an enclosed vehicle with metal roof, closed windows, and rubber tires. Though these are the safest options for shelter, electrical lines, plumbing, phone lines, and metal frame work all carry electricity. Therefore, to reduce risk of injury, people should stay away from these areas in the shelter. If you feel your hair stand on end, skin tingle, or hear crackling noises, you should assume the lightning safe position. To get into the lightning safe position you should crouch on the ground with your feet together, with all of your weight on the balls of your feet. You should then lower your head and cover your ears. This position puts the body at the lowest risk of electricity entering it. Precautions are important to take when thunder storms are around. Knowing the danger is important, but following safety protocol can save lives.

Check Out Coordinated Health On Facebook Learn tips and tricks to treat your pain from CH physicians and therapists Get the latest updates on what’s going on at CH Post your questions & comments We want to hear what you think! 32

July/August 2011

coordinatedhealth.com


Who’s New at Coordinated Health

Michael DeRogatis PA-C

Colleen Burgess Regional Manager Easton

Danielle Leonz PT Broadheadsville

Patrick Kreshock District Manager East Stroudsburg

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happy map 2011

1/25/11

4:39 PM

Page 1

309 Hazleton Campus

80

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115 Brodheadsville Campus

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34

July/August 2011

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Prospect St.

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610-861-8080 Allentown

coordinatedhealth.com

1503 N. Cedar Crest Blvd. Allentown, PA 18104

Brodheadsville

877-247-8080 Rte 115 & Switzgable Rd. Brodheadsville, PA 18322

Bethlehem 2775 Schoenersville Rd. Bethlehem, PA 18017

East Stroudsburg 505 Independence Ave. East Stroudsburg, PA 18301

2300 Highland Ave. Bethlehem, PA 18020

Hazleton

50 Moisey Dr., Suite 202 Hazleton, PA 18202

Easton

400 S. Greenwood Ave. Easton, PA 18045

Lehighton

239 N. First Street Lehighton, PA 18235

3101 Emrick Bivd., Suite 112 Bethlehem, PA 18020

Hospitals

503 N. Cedar Crest Blvd. Allentown, PA 18104

2310 Highland Ave. Bethlehem, PA 18020


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