Exercise Ball (aka Balance Ball, Stability Ball, Swiss Ball)

There are several benefits for using an exercise ball as a chair for sitting exercises for the elderly.  Below is a video explaining the reasons and demonstrating how I use the exercise ball in the home to do sitting exercises!  You just can’t beat the benefits of an exercise ball as a chair for sitting exercises and other uses!  I encourage you to watch the video and continue to read.

 

 

 

For additional information about Exercise Ball Benefits, Please continue to read.

Benefits

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Improved posture

Unlike sitting on a chair or any other flat surface, the ball’s shape encourages proper sitting posture and body alignment (shoulders above the hips).  If the shoulders are shifted any direction, the redistribution of weight challenges overall balance, and the ball shifts in response to the altered postural alignment.  Consequently, the abdominal, back and leg muscles engage and AUTOMATICALLY respond to correct the alignment, control the loss of balance, and restore sitting stability.

Sitting exercises on a flat surface (chair, bed, gym/rehab table) do NOT challenge posture to improve postural control (keeping the shoulders over the hips when the legs are moving).

QUESTION:  Is it possible to slump/slouch down sitting on a chair/bed and still be able to raise a knee up?

ANSWER: Yes, it is possible.  In fact, I challenge you to sit down and slump over (round the shoulders forward over your legs and then raise one knee up and down.  Now sit with your hips toward the edge of the chair with your shoulders behind you (BE CAREFUL not to sit too close to the edge of the chair because you can slip out of the chair when you move your shoulders backward) and do a knee raise.

Sitting on a flat, firm surface does not challenge or improve posture.  So why worry about poor posture in your loved one?  If sitting posture is bad, standing posture will be worse and walking is both more DIFFICULT and DANGEROUS.  Furthermore, breathing is more difficult.

TRY THIS: round your shoulders forward again (slump over in sitting or standing) and now try and take a deep breath!  Now, sit or stand up with your shoulders over your hips and take a deep breath.  Subsequently, if you add any breathing problems your loved one might already have (asthma, COPD, Emphysema, Pneumonia) to poor posture–no wonder he/she is short of breath, easily fatigued, and weak with very light activities.

 

Improved Balance

 

Being able to move either in sitting or standing without staggering, stumbling, or falling takes good balance, reaction time, and coordination.  Balance is time-sensitive.  In other words, slow reaction times combined with weak muscles or poor balance strategies will increase your loved one’s fall risk.  If you want to improve balance, you have to challenge your balance.  

For example, when learning to ride a bike, you have to learn how to BALANCE on two wheels that are in alignment.  At first, you lose your balance side-to-side, start out really slow, and have to put your foot down quickly to prevent falling.  Eventually, you learn how to balance and ride in a straight line but turning is more difficult and requires a slightly different balance strategy.  If you persevere, you can successfully keep your balance while turning both directions.  Later, you challenge your balance more by increasing the speed, jumping ramps/inclines, or even riding WITHOUT any hands!  In summary, first you lose your balance, then you challenge/strengthen your balance strategies, and eventually you can do more without falling.

 

Now let’s compare balance sitting on a flat surface (bed, chair) to sitting on an exercise ball.  

 

QUESTION: What is providing the balance/stability in each situation?  

ANSWER:  The flat surface is providing all the balance/stability when you exercise on a chair or bed.  Your legs, abdominal muscles, and core are providing the balance/stability because the ball DOES NOT and WILL NOT balance you.  TRY or THINK ABOUT THIS:  Can you sit on a chair with one foot off the ground and still be able to kick the other foot out in front of you or raise the other knee up and down? Now, can you sit on a ball with one foot completely off the ground and still move the other leg (kick or march the knee up and down)?  You can move your leg when the other is completely off the ground while sitting on a chair/bed because the CHAIR/BED is supplying all the balance you need.  However, when sitting on a ball, your BODY must react with the ground for you to keep your balance because the BALL does not provide ANY external balance.

 

Improved Strength

 

WARNING:  THE FOLLOWING STATEMENTS ARE MY OPINIONS BASED ON MY EXPERIENCES!!!

 

 

If my patients demonstrated improved functional independence during standing, walking, transferring, and bed mobility doing sitting exercises on a chair/bed with therabands, ankle weights, or a floor bike, then I would have them do these tasks until the cows come home.  HOWEVER, I have not observed any significant or pronounced functional outcome with standing, walking or transferring doing these TYPICAL exercises on a chair/bed; therefore, I DO NOT use these techniques while treating my patients.  If my patients do ANY sitting exercises, they do them while sitting on an exercise ball!

 

 

What is one of the requirements for building strength?  Resistance!  Our bodies respond to the forces we put on them.  When someone goes to the gym with the purpose of their workout focused on improving his/her overall strength, they utilize resistance either with weights, exercise equipment, or moving their own body weight against gravity to build muscle strength.  Furthermore, combining muscle groups and movements is more effective than isolating specific muscles when building strength.

 

 

Sitting on a ball allows a wide variety of movements and when someone is extremely weak–like my patients that are technically/literally unable to physically leave their home due to their pronounced weakness/fatigue–moving their own body weight against the force of gravity to stand up, transfer, get in/out of bed, sit without back support or walk short distances is extraordinarily difficult.  Therefore, in the home setting, I focus my strengthening exercises around my patient being successful, efficient and safe moving their body weight against gravity and combining different movements simultaneously.

 

 

For example, on the exercise ball, I have my patients bounce up and down while simultaneously shifting their weight all directions in a circular pattern, OR I have them complete sit to stand transfers combined with different foot positions and/or using one hand to no hands while standing up.  The resistance created from my patient’s body weight reacting to the shift and dynamic movements of the ball simultaneously improve the FUNCTIONAL strength of various muscle, the balance strategies of the hip/ankles, the postural alignment and control of the core, and general coordination between numerous joints and muscle groups.

 

When compared to sitting on a flat, firm, static (immobile) surface such as a chair or bed, leg strength generally does not improve–especially in the muscles required for maintaining balance, postural alignment, coordination and endurance for standing up, walking, transferring, and bed mobility.  

 

Improved Coordination

 

Robots move in one or maybe 2 dimensions.  Physical therapists battle choppy, robotic movements especially when patients are turning in a circle while standing up, walking with a cane or walker, and transitioning from side lying to sitting or sitting to standing.  Every movement we make requires a symphony of coordinated movements, muscles, joints and systems (nerves, heart, lungs, senses, etc…).  Sitting and exercising on an exercise ball improves coordination through multidimensional movements (up, down, side-to-side, forward and backward).  It is easier to have robotic, isolated movements while exercising and sitting down on a chair/bed.  Doing the exact same exercises on a ball (sitting on air) will produce smoother, more controlled and coordinated movements due to the shape/surface of the ball and how your body reacts to the movements of the ball. 

 

 

 

Decreased Effort/Reps without Sacrificing Results

 

Typically, patients get frustrated and bored with repeating more than 10 repetitions of the same exercise over a short period of time.  Everyone likes knowing they are working SMARTER and not HARDER!  I can have my patients complete decreased repetitions of different exercises (movement patterns) on the exercise ball because every movement on the ball incorporates posture, balance, muscle strength, and coordination.  In other words, one leg cannot be on vacation while the other leg is moving, core strength is engaged,  proper postural alignment is active/reactive, breathing and balance are improved, and overall coordination is challenged.  Unlike exercising on a chair/bed, the ball is similar to in-home circuit or interval training so doing fewer reps/exercises yields greater results.

 

Here are products and links to purchase your own exercise ball!

RELATED PRODUCTS

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Below I have listed the 5 exercises I use with most of my patients to warm them up before I customize the rest of their treatment to meet his/her specific needs and goals.   Please, leave me a comment or ask me a question if you are interested in learning more about home-based exercises on an exercise ball for knee replacements, hip replacements, and other diagnoses.

 

General Exercises Appropriate for Several Disorders & Deficits

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Bouncing

Weight Shifts all directions (rocking forward/backward & Side-to-Side shifts, circles clockwise/counter-clockwise)

Knee Raises (Marches)

Kicks

Sit-to-Stand from the ball

 

Other Uses for an Exercise Ball

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Swelling Control – I place the ball under the ankles to elevate the feet above the level of the heart for swelling control.  I can place the ball on the footrest of a recliner, on the bed, or even on the couch for effective swelling management.

 

Pressure Relief – If my patients have a pressure sore (decubitus ulcer) on the heel, I can relieve the pressure and manage any swelling due to the curve of the ball.

  

Alternative Sitting – The ball is an excellent chair!  My daughters use an exercise ball at their computer desks.  The ball promotes posture, improved level of alertness, and helps my daughters get through their homework with decreased mental fatigue after school. My daughters stay awake even after a long day at school through bouncing!  Their posture, like my patients, is improved and they stay focused until their homework is complete.  I have recently read blogs where office personnel use balance balls at their desks and have noticed decreased back pain with improved posture and productivity!  An exercise ball is inexpensive and very versatile not only in the home but in the office as well.

WARNING:  If there are children present in the home, the ball will most likely be confiscated for their fun and entertainment–this is a common occurrence when I am treating a patient, using the ball, and children are in the home.

 

If you have an exercise ball or want to share your story, I would love to hear from you!  If you have any questions, please leave me a comment below and I will get back to you withing 48 hours.

 

I hope you enjoyed and learned something new, and I look forward to hearing from you!

Best Regards,

 

Shawna PT, MPT

Welcome,

Home Health supplies for the elderly can be confusing especially when learning how to adjust and use mobility aids for the disabled. Here is a video reviewing, explaining, and showing the proper use of a walker and how to use a walking cane. Please, watch the video and continue reading for a summary of the information covered in the video as well as an opportunity to ask any questions!

 

 

Rolling Walkers

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There are several very common walking aids used to help with balance problems, pain, and/or an inability to tolerate bearing weight on a leg due to an injury, surgical procedure, or decline in health (stroke, Parkinson’s Disease, etc…).   Rolling walkers are one of the many assistive devices commonly used in a variety of settings (home, hospital, inpatient rehab) to decrease the effort and fall risk during walking and standing activities.

 

Did you know rolling walkers have 2-wheels on the front and the wheels come in different sizes?  The larger the wheels (5 inches or larger), the better the walker will roll on rough terrain such as asphalt parking lots, dirt roads, grass, and sidewalks with large cracks. Smaller front wheels require increased effort and do not roll easily on plush carpet, sidewalks, wooden ramps, or any type of textured surface.

 

Using a rolling walker is not difficult if the walker is properly adjusted to the person’s height.  Rolling walkers, canes, and even the hand grips on crutches are easily adjusted to the appropriate height if the hand grip is even with the bend of the person’s wrist.

 

The walker and the person using the walker should make a box!  In other words, your loved one should be instructed to “walk inside the walker,” so the walker remains close to him/her, and their body completes the back of the box.

 

PROBLEM:  Walker Does Not Fit Through The Door

SOLUTION:  I highly recommend re-positioning the front wheels to the inside of the walker.  Moving the wheels from the outside of the walker will NOT change the stability of the walker.  Subsequently, if the back of the walker fits through a narrow doorway but the front of the walker does not fit because of the additional width of the front wheels, then moving the wheels to the inside of the walker will solve the problem!

 

 

Canes

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Canes are another common walking device and canes are more mobile, lighter, and easier to use on steps compared to walkers and rollators.  There are several types of canes.

 

Single Tip – A cane with 1-point that does not stand up by itself so it propped up and can be easily forgotten–“Out of Sight, Out of Mind.”

 

Quad Cane – A cane with 4- tips/points that can stand up by itself without needing to be propped up against a wall.  Not as easily forgotten and provides more balance/stability compared to the Single-Tip cane.

 

Tri-Tip cane – A cane with 3-tips/points.

 

 

Walking Cane Tip:

 

Regardless of how many tips, all canes need to be properly adjusted for height.  If the handgrip on the cane is too high or too short, the arm cannot effectively decrease the weight, improve the balance, or manage the pain of an injured, weak, or painful leg.  Furthermore, the cane provides the optimal level of assistance and stability when used in the hand OPPOSITE of the injured, weak and/or painful leg.

 

 

How to walk with a cane….

 

 

Remember:  the cane should mirror the hurt, surgical or weaker leg.  In other words, when the hurt, surgical or weaker leg goes forward, the cane should either proceed the leg OR the cane should move with the leg simultaneously.

 

The sequence is EITHER:  Cane…..Affected Leg….Strong leg

 

 OR

 

Cane and Affected Leg at the same time….Strong leg

 

 

In the same manner,  going up and down a step has a specific sequence, regardless of the mobility device (rolling walker, crutches, cane, etc…).  The sequence for going up a step is to lead up the step with the stronger leg.  For going down a step, lead down with the weaker/hurt/surgical leg first.  An easy way to remember which leg goes up first and which leg goes down a step first is the following statement:

 

The good go up and the bad go down!

 

Below you will discover Amazon links under “Related Products.”

Take Advantage of Me and My Experience

 

When I provide images of related products, I am simply showing you some of the options available to address a particular situation.  However, if you have friend/relative give you medical equipment and you have a question about how to use, adjust, or set up the equipment, leave me a comment. I guarantee you are neither the first nor the last person to take on the responsibility of caring for someone with mobility problems that needs & would benefit from medical equipment but you’re just not sure what to get, how to set it up, or how to use it.  

In the same manner, when equipment is delivered, sometimes the representative takes very little time to explain and demonstrate all the features, uses, and adjustments before leaving you with the equipment.  To that end, I say, “There is no such thing as a stupid question especially when it is the safety and comfort of you and your loved one hanging in the balance of falls and injuries in the home.”  The only stupid question is the one not asked!

 

Like I mentioned before, these are some suggestions for mobility devices (walkers, canes, wheelchair, etc…). If you are considering a mobility device but are not confident and would like some advice on whether a 4-point cane, single-tip cane or walker would be better, then message me. I will ask you some questions and then offer my advice, tips and/or reasons for using a certain mobility device over another one.   I might even be able to make a video to help you make the BEST decision based on your loved one’s needs

 

I am here to make caregiving easier and safer , and I look forward to hearing from you.

 

 

Related Products

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I want to thank you for visiting my site and I hope you leave having learned something to make caregiving easier & safer, and a desire to return for future updates.  Please leave a comment, question, or idea so I can continue to help you with any daily caregiving issues.

Once again thank you for stopping by and I look forward to seeing you again soon! 

 

Best Regards,

Shawna PT, MPT

Welcome,

Getting Someone In and Out of Bed Safely can be difficult! Here are some bed mobility techniques to make getting in and out of bed easier.  I encourage you to watch the video and continue to read for more information as well as an opportunity to ask any questions!

Bed Mobility Training…Get Someone In & Out of Bed Easier

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It’s Too Hard…It Will Hurt…I Don’t Want To…

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Sounds like the excuses for not exercising, but these are the excuses I get from most patients when I approach them with the task of getting out of bed.  Weakness, muscle atrophy from inactivity, and other very serious problems can occur when someone stays in bed!  Bed sores, blood clots, and an increased risk for choking are just a few reasons for patients to GET OUT OF BED every day!

 

Have you ever heard of or seen a bed sore/pressure ulcer/decubitus wound?  Prolonged bed rest causes pressure to build up in specific areas of the body (shoulder blades, tailbone/coccyx, and heels).  When the pressure is not decreased or properly managed, a sore develops.  Hence, the name PRESSURE UlCER/BED SORE!

 

The problem with pressure sores is once you see the pressure sore on the surface of the skin, the damage is getting worse under the skin!  That’s right…the tissue under the skin is already degrading because pressure sores start under the skin and then work their way to the surface.  Nerves, muscles, and even bone can be involved and permanently damaged!  There are different stages of a bed/pressure sores based on the depth and degree of tissue involved.

 

 

Stages of Pressure Sores	Signs & Degree of Tissue Involvment	Pain	Likely Permanent Damage
Stage 1	Redness that does not go away when you touch the red area, Warm to the Touch-like the skin has a fever, No broken skin or open wound visible Tissues Involved: Skin Only	Can be VERY painful from the nerves involved inside the layers of skin	No
Stage 2	Open wound is visible or skin is broken. Can have a blister-like appearance. Tissues Involved: Skin + Possible Fatty Layer just under the skin	Mild to Moderately Painful from nerve endings in the skin	Yes
Stage 3	Visible crater/Open Wound. Tissues Involved: Skin + Fat layer under the skin	Possibly Painful–depends on severity of nerve/tissue damage(debrided)	Yes
Stage 4	Open Wound very visible. Tissue Involved: Skin + Fat+ Muscle + Bone	Pain Possible but not likely due to severe tissue/nerve damage	Yes
Deep Tissue Injury	No OPEN WOUND but the underlying Tissue is Damaged. The depth of tissue involvement is difficult to assess because there is no open wound. The skin is Purple or Dark Red, Soft (Squishy) to the touch, and is either warmer or colder to the touch compared to the surrounding skin.	Painful & Tender to the Touch	Yes
Undetermined/Unstagable	Open Wound very visible. Wound bed–what is visible–is covered by a layer of tissue that can be black, gray, brown, have yellow/greenish-yellow puss, and the wound does not fit into the other categories because the depth of the tissue involvement is not clear due to abnormal/discolored layer of tissue masking the base of the wound	Pain Possible but not likely due to severe tissue/nerve damage	Yes

 

*Pictures provided by Wikimedia Commons
**Permanent tissue damage can occur with Stage 2, 3, & 4
***Bone infections (osteomyelitis) or sepsis can occur with Stage 4 leading to increased risk of amputation/death

 

PREVENTION & TREATMENT:  Pressure Sores

Below you can view and even purchase heel protectors/pressure sore prevention boots wheelchair cushions for tailbone pressure relief, and bed mobility aids.

You can prevent and treat pressure sores with frequent pressure RELIEF techniques.  In bed, turning and using different positions (lying on one side, on the back, and then lying on the other side) every 1.5 to 2 hours with an emphasis on relieving pressure on the bony areas of the shoulder, shoulder blades, hip, coccyx (tailbone), ischial tuberosities (the bony areas just below the cheeks of the glutes/buttocks), and the heels of the feet.  When someone sits in a wheelchair, sitting on a BOPPY PILLOW (see picture below) is more comfortable and easily positioned in a wheelchair if a wheelchair cushion is not already in use.

 

 

Believe me, the DONUT pillow for coccyx pressure relief is not COMFORTABLE.  A BOPPY PILLOW is larger so the surface area is larger resulting in increased distribution of pressure in sitting and overall improved comfort.  In the same manner, the BEST position for pressure relief in sitting is leaning forward like you are tying your shoes or positioning the wheelchair in front of the edge of a bed, couch, or recliner, and leaning over the bed, couch, or recliner until the pressure is relieved from the coccyx (tailbone).  When decreasing pressure, I recommend leaning forward a minimum of 5 minutes and several times a day if your loved one is sitting in a wheelchair all day.

 

 

 

Go With The Flow…It Does the Body Good

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If bed sores are not enough reason to GET OUT of BED, then consider something else that is potentially lethal–BLOOD CLOTS (Deep Vein Thrombosis/DVT).  Blood clots can develop when circulation slows down or stops! The veins in our bodies are like a river.  When a river is moving fast, it moves debris forcefully downstream.  However, if the river flow slows down, the force of water does not clear debris downstream, and debris can build up along the edges.  Eventually, the buildup of debris can either stay lodged on the edge of the river (slowing down the flow more) or some of the debris can dislodge along the edges, travel downstream, and make a dam downstream.  Either way, the debris disrupts the flow of water!  In our blood stream, the debris (aka thrombosis) can be molecules of fat, blood cells, or even air molecules.  If the thrombosis dislodges, it can travel (embolize/move) to the heart, lungs, or the brain.  When an embolus reaches the heart, lungs or brain, the end result can be sudden DEATH!

 

 

Use It or Lose It…Risking Your Secondary Pump

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We all agree our heart is a pump–with every contraction-relaxation, blood is pumped/moved throughout the body.  In the same manner, the large muscles of the legs are a secondary pump to help the heart move blood from the toes all the way back up to the heart and lungs because the toes are a very long distance from our heart and lungs compared to the head, abdomen, and hands.  However, the only way our legs can work as an effective pump is through ACTIVE muscle contraction-relaxation during walking, standing up, transferring, etc…  Subsequently, when the legs get weak due to inactivity, increased bed rest, and/or circulation problems (diabetes, cellulitis, congestive heart failure, surgery, etc…), the risk of developing a blood clot increases exponentially!  Keeping the legs ACTIVE and STRONG decreases the risk of developing a blood clot because the secondary pump effectively moves blood–inhibiting debris buildup.

So what are the signs of a potential blood clot?

♦  Redness – generally on the back (posterior) side of the leg, soft area behind the knee, or in the calf area

♦  Warmth (fever) – the red area feels warmer than the surrounding skin

♦  Pain/Tenderness – if the clot is in the calf, pain/tenderness occurs with toe raises (the clot is squeezed when the muscle contracts around it).

♦  Swelling/Edema – the leg, ankle, and foot swell due to impeded circulation

♦  Positive Doppler Test – an ultrasound test that assesses the flow of blood for any abnormal flow caused by a clot.

 

 

Choking & Aspiration…Not Appropriate Bed Activities

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Choking…when food or an object completely blocks the windpipe (trachea) effectively stopping all breathing.  What do you do when someone is choking–you administer the Heimlich Maneuver!  Okay, now consider trying to successfully administer the Heimlich Maneuver on someone choking IN A BED!  Precious seconds are lost as you try to set up yourself and the choking victim in a position for effective delivery of forceful abdominal thrusts.

Aspiration…when food or an object goes down the wrong way–it goes down the windpipe into the lungs instead of down the esophagus into the stomach.  Eating while reclined in bed increases both the risk of choking and of aspirating.  Both situations can be LIFE THREATENING!

 

Obviously, daily out of bed activity is very advantageous, but (and there always seems to be a ‘BUT’) you might be struggling with getting someone out of bed after he/she has agreed to GET OUT OF BED.  Here is a quick review of the key points covered in the video followed by links for pressure relief equipment, bed mobility aids, and wheelchair cushions.

 

TIPS for Getting OUT of bed:

 

1) Bend the knees!  A ball rolls better and easier than a board.  Bending both of the knees will make rolling easier.

2)  Roll him/her on their side and don’t leave anything behind!  Make sure he/she reaches toward the edge of the bed with his/her “free” hand and brings the shoulder close to the surface of the bed.

3)  Instruct your loved one to, “Look for, find, and keep his/her eyes on the floor.”  Usually, we are afraid of what we can’t see and the unknown.  By having your loved one keep his/her eyes on the floor, you are boosting their confidence and calming their subconscious fear of falling because they can “see where they are in relation to the floor.”

4)  Block his/her bent knees with your body.  Your loved one will automatically keep his/her shoulders on the bed; therefore, you need to control the knees so you have control over the “control panel.”  If you block the knees, he/she will not FALL OUT OF BED.

5)  Keeping the top shoulder forward will “ACTIVATE” the teeter totter–when the legs/feet lower to the ground, the head will raise up!

 

 

Tips for Getting IN Bed:

 

1) Make sure your loved one/client is sitting near the head of the bed (close to the pillow).  If he/she sits too low in the bed, they will have to exert unnecessary energy to scoot up toward the pillow once they lie down.

2)  Position him/her like they are “side sitting on a horse.”  When he/she begins to lie down, side-sitting on the edge of the bed will “ACTIVATE” the teeter totter–when the head/shoulders lower to the surface of the bed, the legs–especially the top leg–will rise up to the surface of the bed.

3)  If he/she needs help moving to the center of the bed, I recommend “PULLING” the control panel (hips) toward you with both of their knees bent.  REMEMBER: A ball rolls/moves easier than a board.  If the legs are straight, you’re trying to move a board!

 

 

  

Take Advantage of Me and My Experience

 

When I provide images of related products, I am simply showing you some of the options available to address a particular situation.  However, if you have friend/relative give you medical equipment and you have a question about how to use, adjust, or set up the equipment, please leave me a comment below and I will make every effort to answer you within 48 hours. I guarantee you are neither the first nor the last person to take on the responsibility of caring for someone that needs medical equipment and are just not sure what to get, how to set it up, or how to use it.  

In the same manner, when equipment is delivered, sometimes the representative takes very little time to explain and demonstrate all the features, uses, and adjustments before leaving you with the equipment.  To that end, I say, “There is no such thing as a stupid question especially when it is the safety and comfort of you and your loved one hanging in the balance of falls and injuries in the home.”

 

I encourage you to browse, locate and ask questions before purchasing any medical equipment for the sake of you and your loved one’s safety and sanity.

 

Related Products

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Pressure Relief & Heel Protectors

 

I want to thank you for visiting my site and I hope you leave having learned something to make caregiving easier & safer as well as a desire to return for future updates.  Please leave a comment, question, or idea so I can continue to help you with any other daily caregiving issues.
 
 
 
Once again thank you for stopping by and I look forward to seeing you again soon!

Best Regards, 

Shawna PT, MPT

Welcome,

 

 

Apple Cider Vinegar, Ice and Coconut Oil are 3 ingredients I use personally and during patient care in the home for several reasons.  Sit back and Discover 5 Reasons You Should Take Advantage of the Many Benefits of Ice, How to Use Coconut Oil and The Natural Healing Qualities of Apple Cider Vinegar.

Who said you have to spend a lot of money to look younger, cure skin problems, reduce pain instantly, heal wounds or even improve overall health . Most likely, you already have 3 very inexpensive remedies in your kitchen right now!

 

 

 

 

 

BRAGG APPLE CIDER VINEGAR BENEFITS

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There are literally hundreds of benefits to using ACV. From curing warts, sore throats, toenail fungus, wounds, and moles to improving the health of your hair.  ACV is an inexpensive and very effective MIRACLE solution. These are pictures of one of my patients that treated his foot with ACV and EPSOM salt soaks once a day for about 1 week.

Foot Wound Before ACV Treatment	Foot Wound AFTER ACV Treatment

 Have plantar’s warts? No problem. Soak a piece of a cotton ball in ACV, put it over the wart, secure it with a bandaid, and do this until the wart turns black and eventually falls apart. Generally, my daughter has to do this for 5-7 days, but the good news…the wart does not come back, there is no SPREADING or making of additional warts, AND it does not cost me $75-100 for a dermatologist to “Freeze the wart off.” Win, Win, Win in my book.

 

 

What about sinus congestion, sore throats, or that “I feel like I am coming down with something?” Yep, I treat it all with a “SHOT” of ACV. I have literally saved hundreds of dollars in trips to the “Doc-In-The-Box” clinics because when my family or I get the first signs of not feeling well, a shot (1-2 Tablespoons) of ACV for about 3 days and Ta Dah…the symptoms go away!

 

 

Ok so maybe you want to look younger, have shinier hair, whiter teeth, manage sunspots (dark pigmentation on the skin from the sun), tone the skin’s surface, or get rid of moles. I have done all of these using ACV. Literally, Apple Cider Vinegar has been an ALL NATURAL, CHEAP, and VERY VERSATILE cure for me, my family and patients for YEARS.

 

Natural Sunspot, Skin Toner Secret:  Apply ACV directly on the face at night (keep your eyes closed until the ACV dries and DO NOT rub ACV near the eyes or in the EYES) by soaking a cotton ball in ACV.

Whiter Teeth:  Use ACV as a mouth wash (swish/gargle about 2 TBSP ACV) and spit it out- I only do this once a week!

Wart Removal:  Use a STERILE straight pin and pierce the mole about 4 times (moles do not have nerve/pain receptors so this should not hurt and you ONLY are penetrating the surface of the mole–DO NOT make it bleed) on the surface. Soak a piece of a cotton ball in ACV and place the cotton ball over the mole.  Secure with a bandaid.  Repeat every day until the mole disappears.  My mole disappeared in 7 days.

Healthier/Shinier Hair:  1 tsp Vegetable Glycerin (I get this at Walmart), 2 TBSP ACV, 2 TBSP Castor Oil (I get this at Walmart), 1 Egg, and 1 TBSP Warm Honey.  Mix it all together.  Apply directly all over the hair.  Wrap hair in Saran Wrap and leave on for 1-2 hours.  Wash hair with SHAMPOO only.  I do this twice a week for a month.

 

Go on PINTEREST and search uses of ACV and you will be AMAZED!!! I only mentioned what I have PERSONALLY been successful with using ACV for, but I have never been let down by its healing, cleansing, and inexpensive solutions. I love, love, love ACV, and I know you will too.

 

If you have any questions about my personal recipes I have used to treat toenail fungus, improve the health of my hair and skin, or you have a personal story to tell me about ACV, PLEASE leave me a comment. I believe knowledge is powerful and experience combined with knowledge can be MIRACULOUS.

 

 

 

ICE, ICE BABY

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You have been told all your life, use ICE on that injury! Do you know why you should use ICE versus HEAT on a recent injury?

 

 

Without delving really far back into chemistry class, think about what happens when something gets cold versus hot. Cold temperatures SLOW down and SHRINK things. I know when I am cold I want to curl up under a blanket (get as small as I can and cover up as much of my body as I can). Snakes move slower, concrete shrinks and cold syrup pours slower than hot syrup.

 

In the same manner, when ice is applied to the skin the skin cells get smaller and circulation of fluid (blood, swelling fluids, etc…) slows down, and the blood vessels in the skin/tissue shrink down as well . Consequently, swelling, pain, and bleeding under the skin (bruising) is decreased when ice is applied rather than heat. Heat does the exact opposite–dilates (expands) cells/blood vessels and speeds up circulation–and when applied to a new wound, an already swollen and/or bruised area, it makes the bleeding, swelling, and pain worse.

 

Need pinpoint pain relief fast? Use an ice massage!

Take an ice cube or better yet, freeze water in either a paper or styrofoam cup (Sonic cup work great). If you use a cup with water frozen inside, tear the edge of the cup down (hence the reason for using paper or styrofoam) to expose about 1/2 inch of ice (See Above picture). Place a towel under the area you are going to massage with the ice to catch the melted water. Using either the ice cube or the cup of frozen water, apply the ice in circular movements over the area that is painful, swollen, and/or bruised.

NOTE: the skin will go through the following sensations before it goes numb:  feels cold, burns, and then goes numb! Stick with the ice massage until the area goes numb–this is the desired pinpoint pain relief–and the skin will be red.

TIP: When doing a massage with or without ice, always massage the area to promote drainage. In other words, start at the area where the bruise/swelling is the furthest from the heart and massage TOWARD the direction of the heart!

 

 

 

LADIES — Want to decrease fine lines, acne, and/or smooth out your foundation—THAT’S RIGHT USE ICE!!!

 

 

 

Every morning before I apply my makeup I do 2 things. First, I wash my face with a sugar scrub to clean the pores, remove dead skin cells, and even thin out those irritating fine hairs. What do I use for a sugar scrub? Simple, I use my regular liquid body wash and just add 2 Tablespoons of sugar. It’s that simple!

Second, I take 2 ice cubes and rub them all over my face until both are melted. I concentrate on the T-zone area, around my eyes and mouth. Remember, ice “shrinks cells” so by massaging my face with ice BEFORE I put on makeup I make my pores smaller which closes my pores so makeup does not clog up the pores causing acne and my makeup goes on smoother!

 

 

 

 

WHAT IS THE HEALTH BENEFITS OF COCONUT OIL

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Another tool in my arsenal is coconut oil for moisturized skin, healthier hair, and for massaging purposes on my patients when I do swelling control massages.

Coconut oil absorbs into the skin with little to no residue on clothes/linens. It instantly moisturizes the skin and hair better and cheaper than ANYTHING else I have tried (Meaningful Beauty, Avon, Sheer Cover, Beauty Control, Mary Kay). Dry, fragile, cracking, and itchy skin is instantly infused with moisture providing relief and decreasing the risk of additional skin problems associated with scratching.  I massage my patients’ skin with coconut oil because it is quickly absorbed into the skin and does not leave an oily residue on the linens.  I highly recommend coconut oil for softer, healthier, and moisture-rich skin and hair.  Here are my personal recipes:

 

Hair Care:  I apply Coconut Oil all over my hair when it is dry.  Then I braid and bun my hair with the oil in it.  I sleep in the coconut oil and wash my hair with both shampoo/conditioner the next morning.  I do this once a month–usually the 2nd week of the month because I use my ACV recipe as well.

 

Furthermore, I personally use and my patients have successfully used Coconut Oil to:

1) heal/manage surgical scars after the steri-strips are removed from the surgical incision

2) heal skin abrasions

3) manage bruises

4) resolve eczema, psoriasis, dry/cracking skin

Coconut oil is CHEAP and has worked better & faster on me and my patients compared to medicated ointments and lotions.

 

 

Did you know Coconut oil has been featured on the “Dr. Oz” and “The Doctors” to treat Diabetes?  Coconut oil is natural and can be used in Diabetic shakes, coffee, and other HEALTHY recipes. I highly recommend PINTEREST.com for recipes, but my husband was PRE-DIABETIC and has successfully controlled  his blood sugars with these recipes.  You are welcome to try one of my personal recipes below. In the same manner, if you have a recipe or have used coconut oil and would like to share your experience, please leave me a comment.

 

 

Pina Colada Shake

1/2 cup Coconut Milk (Unsweetened)
1/2 cup Coconut Water
1 Tablespoon liquid coconut oil
1/2 cup Frozen Pineapple
1/2 scoop Whey Vanilla Protein Powder

1 Teaspoon Green Tea Powder
1/2 Teaspoon Organic Honey
6 cubes of ice

Place all ingredients in a Blender (I use my Ninja Auto IQ Blender)

 

 

Mango Maniac Shake

1 cup Almond Milk (Unsweetened)
1 Teaspoon Green Tea Powder
1/2 cup Frozen Mango
1 Tablespoon Coconut Liquid Oil
1/2 of a lime squeezed for juice
1/2 Tablespoon Organic Honey
6 cubes of ice

Place all ingredients in a Blender (I use my Ninja Auto IQ Blender)

 

 

Obviously, Apple Cider Vinegar, ICE, and Coconut Oil are 3 FANTASTIC KITCHEN ingredients that I literally use or have used for several years.  I love learning natural remedies and would love to hear about some of your experiences or answer any questions about apple cider vinegar, ice and coconut oil.  Please leave a comment and share your thoughts or ideas.

 

Until we connect again,  Be Safe and Healthy,

 

 

 

 

Shawna PT, MPT

Falls….Fear of Falling….Overcoming Falls in the Elderly

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Learn Physical Therapy Techniques for getting elderly off the floor, reasons for elderly falls, and easy home-based balance exercises for the elderly.

There are several reasons for elderly falls.  However, the Balance Strategies of the ankle and hip and Elderly fear of falling are two contributing factors that are commonly overlooked!  Before we delve into elderly fear of falling and balance strategies, I would like to show you a safe wheelchair floor transfer technique!

 

 

Sometimes Falls Just Happen…How to Get Elderly Off the Floor

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Ok, so if a loved one falls, is obviously not hurt, and needs to get off the floor–what are your options?  If you have a wheelchair AND the armrests can be removed, then you can use a wheelchair transfer technique to lift your loved one off the floor (as seen in the video below).  I have also used sturdy chairs like a dining room chair to demonstrate and train the floor transfer technique featured in the video below.  REMEMBER:  Do NOT move,lift, or transfer anyone from the floor if you suspect or observe an injury as the result of a fall.  In the same manner, ask for HELP–even if the person helping you just guides/spots you during the transfer.

 

Elderly fear of falling, Basiphobia (the fear of falling), is REAL, can be a LIFE CHANGING event, and can steal a person’s QUALITY of LIFE away in the blink of an eye.  Senior citizens are more vulnerable to developing a fear of falling–generally following a substantial fall that required hospitalization, surgery, or medical treatment of a significant injury.  Typically, the fear of falling does not develop from a single fall.  The fear of falling generally develops over time through a cycle of events.

BREAKING THE CYCLE

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The cycle can be broken at any stage!  Focused management of swelling, bruising, pain, and stiffness can minimize inactivity that leads to total body weakness.  Strengthening the leg muscles and the 3-balance strategies can promote increased walking with decreased anxiety. Increased walking and activity will decrease the risk of secondary problems such as blood clots, pressure sores, pneumonia, and joint contractures.

 

Strengthening the leg muscles is not very difficult.  One the fastest, easiest and most effective lower leg exercise–besides walking–is the sit to stand!  Similar to doing a squat, the sit to stand exercise is easily modified, very versatile, and has the added benefit of strengthening the pelvic floor muscles responsible for bladder control.  Here are some tips for progressing and doing different variations of the sit-to-stand exercise:

 

Variations	Easiest	Hardest
Height of Sitting Surface	Higher/Elevated	Lower
Firmness of Sitting Surface	Very Firm/Does not move	Very Soft/Rocks and moves
Use of hands to push shoulders over the feet	Use both hands	No hands are used/the legs do all the work
Position of the feet	Shoulder-width apart or Stronger leg slightly behind	The weaker leg/foot is slightly behind
Scooting out to the EDGE	Scoot all the way to the front	Stand up without scooting forward
Number of Repetitions	Less than 5	More than 8

Combining different variations from the table above such as standing from a low/soft surface (couch) with one armrest (using one hand) and completing 3 repetitions with different foot positions (Both feet shoulder width apart, the Right foot slightly behind the Left foot, and then the Left foot slightly behind the Right foot) is another way to use the sit to stand exercise to both challenge and strengthen the lower legs.

 

Balance Strategies of the Ankle and Hip

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Have you ever heard of Balance Strategies-the techniques our bodies use to correct loss of balance and prevent falls?  There are 3 strategies for correcting different levels of loss of balance.  Here is a video explaining the 3 strategies because if you understand how balance is lost, you can relate to the exercises and understand the rationale behind specific exercises used to decrease falls associated with weakness and delayed reaction times.

If you go watch people work out in a gym or fitness facility, you typically observe people strengthening the large muscles of the legs, the abdominals for those washboard abs, and the arms.  Rarely you will see people target 1 out of 3 most important areas responsible for balance–the ankles.

 

When I work with patient’s in the home setting, I always address the ankles and the Ankle Balance Strategy.  Below are some general balance-based exercises I have my patients complete.

 

Balance Exercise Tips

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Warm up

Sit to Stand 8 to 10 repetitions
Standing Up do 8 to 10 heel raises
Standing Up do 8 to 10 toe raises
Side Step either along the edge of a couch or a bed

Walking

Walk Forward
Walk Backward
Walk in a Grapevine pattern: cross one foot over the other foot in the front of you, then cross the other foot over behind you!

Sitting Balance (You Need a Balance Ball!)

Bounce Up and Down
Shift Your Weight Side to Side
Shift Your Weight Forward and Backward
Alternate Kicking Your Legs in Front of You
Alternate Marching or Raising Your Knees Up

Ultimately, I hope your loved one does not fall and get hurt, but hopefully, you learned more about how Physical Therapists address strengthening, balance, and transfers to manage the risk of falling.

I want to thank you for visiting my site and I hope you leave with having learned something to make caregiving easier/safer and a desire to return for future updates.  Please leave a comment, question, or idea so I can continue to help you with any other daily caregiving issues.

Once again thank you for stopping by and I look forward to seeing you again soon!

 

 

Best Regards,

 

 

Shawna PT, MPT

WALKER DOES NOT FIT THROUGH BATHROOM DOOR!!!

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When nature calls, you can’t put her on hold but the walker, rollator, and wheelchair will not fit through the bathroom door!  What can you do?  I have just described what most of my patients struggle with when they need to walk into the bathroom, but their walker/rollator will not fit through the narrow bathroom door frame.  Most homes, both new and old, have 28″ to 32″ bathroom doorway openings.  Consequently, even when the front wheels of the rolling walker are repositioned to be on the inside of the walker, neither a standard rolling walker (walker with 2 front wheels) nor a rollator (walker with 4 wheels, generally a seat with a basket, and front brakes) will fit through a narrow door.   To add insult to injury, many homes with narrow doorways also have long, narrow walkways between the tub/shower and the sink with a countertop.  Furthermore, the toilet is at the very back of the bathroom (just like the bathroom in the pictures below)!

Most of us have heard the saying, “necessity (desperation) is the root of invention.”  Well, when nature calls desperation and necessity become top priority–especially when my patients DESPERATELY want/need to stop using the bedside commode because they are embarrassed by the appearance, odor, and decreased modesty/privacy associated with using a bedside commode–but narrow doorways put using the bathroom for nature’s call on HOLD!

 

THINKING OUTSIDE OF THE BOX OR THE BATHROOM = CHEAP SOLUTION!

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The pictures below illustrate how I solved 2 problems with one system–aka killing two birds with one stone!!

PROBLEM 1:  the bathroom door opening and walkway between the tub and countertop are too narrow for a walker/rollator and the toilet is at the end of the bathroom.

PROBLEM 2: no grab bar or handrail on the RIGHT side (my patient is Right-Hand Dominant) when sitting and needing to stand up from the tub/shower bench.

Materials needed:  Closet rod wall mount brackets and 1- Metal pole (Home Depot cut the pole to fit the opening of the tub)

Total Cost:  $15.23

 

 

SOLUTION 1:  As a bar to walk to the toilet	SOLUTION 2: As a handrail to stand up from shower chair/bench
Use the bar and the counter top like parallel bars to walk to the toilet	Easily lift out of the way to get in the tub
Lean the bar on the wall to get it out of the way	Use the bar to stand up
Close up picture of open end bracket mount	Close up picture of closed end bracket

 

Using the wall mounts and a closet hanging rod was a cheap but very effective solution to my patient’s problems. In addition, my patient is able to prevent water from “spraying” outside of the tub because she drapes the shower curtain over the closet rod and the bottom of the shower curtain stays inside the tub!
 
 
 
I want to thank you for visiting my site and I hope you leave with the following:  1) having learned something to make caregiving easier/safer, 2) a desire to return for future updates, and 3) having left a comment, question or idea so I can continue to help you with any daily caregiving issues.
 
 
 
Once again thank you for stopping by and I look forward to seeing you again soon!

Best Regards,

 
Shawna PT, MPT

Transferring from sit to stand on a rocking recliner can be challenging and difficult for an individual with weakness, compromised heart health, balance problems, and other impairments.  Sometimes family members will purchase a medical lift chair to decrease the effort and fall risk of a loved one that enjoys sitting in a recliner but cannot stand up from the soft, low, and rocking surface of a recliner.  However, if your loved one prefers his/her LAZY BOY recliner to a new medical lift chair, here are some tips for making recliner transfers & lifts easier:

 

 

1. Place a telephone book under the front of the recliner- this prevents the chair from rocking forward and down

2. If transferring to a wheelchair, place the wheelchair at a 45º angle from the recliner and lock the brakes

3. Remove the wheelchair armrest toward your loved one’s stronger side – the direction you want to transfer your loved one because it is easier on you and him/her to go toward the stronger leg

4. Remove both of the wheelchair’s footrests to decrease tripping/falling during the transfer

5. Have your loved one scoot to the front of the recliner

6. Use your knees to block your loved one’s weakest leg

7. Ask your loved one to reach forward and “give you a hug”

8. Spread your hands out wide over both hips to help you “scoop” up your loved one

These tips should make the transfer/lift of your loved one from a rocking recliner both easier and safer.

 

 

 

Please check my website frequently because I will be adding a video of this transfer soon.

As always,  if you have any questions or need further advice, please contact me.  I am honored to have you visit my site, and I will continue to provide tips/tricks in an effort to make daily care of a loved one easier and safer.  

Sincerely,

Shawna PT, MPT