Category Archives: Blog

Does Your Bike Fit?

March 21, 2017 Teresa Stockton - Blog, Sports and Fitness

There is a misconception that only competitive cyclists benefit from bike fittings. The truth is that anyone that rides a bike on a consistent basis should ride a bike that fits them properly. Granted, competitive cyclists are looking for every advantage with respect to power and performance. However, fitness and recreational riders can gain the same benefits while also improving comfort and reducing the risk of on-the-bike injuries. Often, a few basic changes to a bike can make a significant difference with respect to comfort, power, endurance and overall performance. In this blog we briefly examine some of the key areas that must be considered to ensure a proper bike fit.

THINGS TO LOOK FOR

Frame Size
Obviously, not all frames are created equal. Frame geometry can vary dramatically depending on material, the manufacturer and overall design. Head tube angles, seat tube angles, top tube length, wheel base, etc. are all factors which contribute to how a bike handles and rides. This is where test riding a bike will pay dividends. For example, having a steep head angle may sound like a good idea to achieve a responsive ride. However, you may find it a bit unnerving on a steep, fast descent or even when you try to take your hands off the bar to eat or drink. With regard to mountain bikes, different suspension and wheel size options also affect the way a bike handles and rides. All are personal preferences that should match your intended use.

For general fit, most manufacturers will have measurements that you can take on yourself to help you decide which frame size will likely be best for you. However, you may also fall within the acceptable range for two different frame sizes. In that case, there is no substitute for going to a shop that carries the bikes and riding them both. In all likelihood, you will quickly feel the difference and easily decide which will work best for you. If you are leaning toward the larger of the two sizes, make sure to check the stand over height before laying your cash on the counter. Keep in mind that your primary concern with respect to frame size is the fit from the waist down. Reach is obviously important as well. However, most upper body adjustment can be achieved by varying bars or stem length/angle assuming the length of the top tube is appropriate.

Crank Arm Length
This is one area where people seem to be content to accept a length simply because that particular crank arm is what they have been told is standard or best. The truth is that many bikes come equipped with crank arms that are too long for the prospective rider. Even when told they should have a shorter crank arm, some feel that if they can push it, they will be a stronger, more powerful rider. This can be a foolish mindset as this can result in knee and/or back problems. Of course, there are also occasions where the crank arms may not be long enough. In this instance, the rider is likely giving away potential power and performance. When deciding on an appropriate crank arm length, we are usually talking about millimeters of difference. However, there are specifications for crank arm length typically based on inseam length and/or seat height.

Cleat Alignment
Pedal choice as well as cleat adjustment are vital components of bike fit. Proper cleat alignment is the starting point for overall fit and essentially aligns the position of the foot in relation to the spindle of the pedal and the crank arm. It can also be one of the most difficult aspects of fit to get accurately established. This is true primarily because it is hard to align your cleat when it is mounted to your shoe which is on your foot and clipped into the pedal. Furthermore, most modern pedal/cleat combinations allow for considerable adjustment with respect to float, rotation, fore and aft, and side-to-side. Equally important is the shoe. People often buy soft cycling shoes that are comfortable on and off the bike. Although these shoes may be more comfortable for walking, you are giving up considerable force production and performance on the bike. Furthermore, on long bike rides, these softer shoes can result in “hot spots” and foot fatigue. Cycling shoes don’t need to be uncomfortable. However, when you are riding a bike, wear the shoe that is made for the job.

Seat Adjustment
This is another area that results in much debate. Do you go higher for better force generation or lower for better control on descents? Once again, improper seat height can result in pain or injury. It can also significantly limit your performance. For most riders, seat height and saddle setback (fore/aft positioning) is crucial for comfort and performance. This is the area where the biggest abuse of the law of averages has befallen bike fit. Seat adjustment is often based on averages and equations. Unfortunately, this is rarely the correct position. Much better than averages are measured angles with the rider on the bike which results in a more exacting fit.

Stem Length/Bar Height
Fitting stem length and bar height should be based on alignment, posture, comfort and performance. These factors can have a great effect on your back, neck, shoulders and wrists.

You may be saying to yourself, “Then tell me how my bike should be set up.” The fact is that an accurate fit cannot be done without looking at the individual on their bike. Many bike fits are based on measurements such as inseam, reach, trunk length, etc. which are then plugged into a variety of equations. Adjustments to the bike are then made according to the resulting numbers. The problem is that these equations often vary and are based on averages. Most of us aren’t average. We all have differing body composition and physique. Strength, flexibility, experience and orthopedic issues all play into proper bike fit. Proper fit must be done with the rider on the bike looking at specific measures and alignments.

Ultimately, a good bike fit is well worth the money and can go a long way toward improving comfort on the bike, improving your performance, and reducing the risk of injury. There are obviously many approaches and “schools of thought” when it comes to bike fit. The point here is that the most accurate fits are accomplished by evaluating you on your bike. Remember, depending on your effort and ability, cycling can be a very intense form of exercise. However, that doesn’t mean you have to hurt. If you have pain on the bike, something is typically wrong. More often than not, the problem can be addressed by improving fit. The bottom line is that you want to be sure the bike you ride is fit specifically to you. You should never be forced to fit yourself to the bike.

Written by Michael Choate, MSPT, USA Cycling Certified Coach at North Lake Physical Therapy & Rehabilitation in Portland, Oregon.

North Lake Physical Therapy & Rehabilitation clinics use progressive techniques and technologies to stay on the forefront in their field. OTheir staff is committed to providing patients with advanced healing techniques. To learn more about them click here.

March is National Athletic Training Month

March 16, 2017 Teresa Stockton - Blog, Events, Sports and Fitness

March is National Athletic Training Month! Your protection is our top priority. Athletic trainers are health care for life and sport.

Athletic trainers specialize in patient education, injury prevention, and are an athlete’s first line of defense from the time of injury to recovery. Athletic trainers work closely with coaches and parents and may refer athletes to other health care professionals such as physicians, physical therapists and surgeons when needed.

What is an Athletic Trainer?
Athletic trainers hold at least a four year degree from a BOC (Board of Certification) accredited institution. they are licensed, certified health care professionals working with athletes on and off the field. Generally they are the first responders when injuries occur during sporting events.

Athletic trainers work closely with coaches and parents and will refer athletes to other health care professionals such as physicians, physical therapists and surgeons when needed.

Athletic trainers hours are determined by sports schedules. Typically they are available after school and stay until sporting events have concluded.

For more information about our athletic trainers, and what they do visit NATA’s websites at: www.nata.org or www.atyourownrisk.org

Guidelines to Prevent Throwing Injuries

March 14, 2017 Teresa Stockton - Arm, Blog, Shoulder, Sports and Fitness

In this monthly series, we examine the proper ways to exercise and prevent throwing injuries in baseball. If you have any sudden significant increase in pain, swelling, or discoloration while performing or following exercise, discontinue immediately and contact your primary care provider.

PUSH UPS
Start on your stomach with your hands below your shoulders. Maintain a straight line from your ankles, through your hips, to the shoulders. Extend your elbows pushing your stomach away from the floor.

BICEP CURL
Begin seated with your elbow extended and palm facing forward. Bend the elbow as far up as you can without flexing your shoulder or rotating your wrist.

TRICEP DIP
Find two even surfaces to support your upper body with your elbows bent (a chair with arm rests works well). Extend your elbows pushing your body up toward the ceiling. Lower slowly.

OVERHEAD TRICEP EXTENSION
With your shoulder in full flexion overhead, hold a weight in your hand with your elbow bent behind your head. Straighten your elbow toward the ceiling without changing the angle of your shoulder.

This information was written by Advance Rehabilitation Physical Therapy, an outpatient physical therapy group with 24 locations in Georgia and Florida. Advance Rehabilitation is a physical therapy practice that focuses on providing the highest quality rehabilitation services. We specialize in physical therapy, sports medicine, industrial rehabilitation and athletic training. Our staff includes highly-trained professionals that serve as a bridge between injury and recovery to help patients get back to pre-injury status as quickly as possible. For more information click here.

See the entire Guidelines to Prevent Throwing Injuries series here:

Lower Limb Amputations

March 9, 2017 Teresa Stockton - Blog, Foot, Leg

The goal for every patient with a lower limb amputation is to walk normally again.
A patient with a lower limb amputation faces many challenges when it comes to walking safely in a variety of walking surfaces and without exerting excessive energy. Generally, the higher the amputation level, the more we can expect to see gait deviations or difficulty walking. This is because with each segment of the anatomy is lost to amputation, more muscle, sensory receptors and leverage are also lost. A Physical Therapy treatment program can be designed to assist a patient return to a “normal” walking pattern in terms of posture, step length, stability, balance, rate of speed, and limb positioning.

GAIT TRAINING
Almost all patients with a lower limb amputation will benefit from physical therapy and gait training at some point in their recovery to help them return to a more normal walking pattern. Pre-amputation exercises will assist the patient in arm and leg strengthening to help them prepare for using a walker during gait training with their prosthesis. After amputation surgery a prosthetist will work with the patient to fabricate and align a prosthesis to assure that it will optimize the patients walking pattern.

WHAT TO EXPECT DURING PHYSICAL THERAPY

The physical therapist will typically work with the patient 3 days per week
The physical therapist and prosthetest will remain in close communication with gait training is occurring since any changes in the prosthesis will affect the gait pattern
Initially physical therapy is focused on standing and walking with enough stability to ensure safety (this initial gait training is performed in parallel bars with the assistance of the physical therapist holding the patient with a gait belt for additional safety)
Initial gait training is supplemented with strength and flexibility exercises for the legs and trunk muscles since strong trunk and leg muscles make it easier to progress the patient’s gait training
The physical therapist will also work with the patient to improve balance and coordination to help the patient develop a more normal step length and walking speed

Physical therapists use many different techniques during gait training sessions

LEARNING HOW TO WALK AGAIN
Specialized Treatment Techniques

SPLINTER SKILLS: Technique where the walking pattern is broken down into a sequence of events that are practiced individually before putting them all together to build the walking pattern
WHOLE WALKING: Technique in which the entire gait pattern is performed all at one time without thinking about the individual components of walking therefore relying on the body’s natural tendency to find the most stable and energy efficient way to walk

BUILDING CONFIDENCE
Once the patient feels confident and the physical therapist believes that it is safe, a walker can be used instead of the parallel bars. When using a walker, the focus will change to helping the patient walk on uneven surfaces such as outdoors and walking around obstacles or stepping up and down stairs.

Even patients who have walked with a prosthesis for years can benefit from gait training for a “tune up” of their walking skills or to learn a new skill such as side stepping, tandem walking or even running.

Seeing a Physical Therapist After an Accident

March 7, 2017 Teresa Stockton - Back, Blog, Neck

Anyone who has been involved in an accident and is now struggling to cope with a resulting injury should seriously consider visiting a physical therapist. The documented benefits of physical therapy are numerous, and in many cases physical therapists are able to greatly improve their patients’ quality of life. Whether you are mildly hurt or are suffering from a long-term debilitating injury, read on to learn what physical therapy is, which types of accident injuries physical therapists commonly work with, and about the numerous benefits of physical therapy

What is Physical Therapy?

Physical therapy is a type of rehabilitation aimed at bringing injured patients back up to their optimal level of health via various treatments and exercises. Physical therapists create patient specific plans designed to enable the patient to perform their daily tasks at the highest possible level of function. While a physical therapist will set different goals for different patients, common goals of therapy include:

Improving physical function and movement
Decreasing/managing the patient’s pain
Preventing re-injury
Increasing the patient’s strength, endurance, range of motion and flexibility

Wondering how physical therapy helps achieve these goals? While different therapists may approach these goals in slightly different ways, physical therapy programs rely mostly on progressive exercises and manual therapy in order to reach a patient’s goals. For example, a therapist will generally start you out with simple stretches and gradually work towards more challenging exercises tailored to suit your injury, limitations, and recovery goals. Additionally, manual therapy, such as soft tissue mobilization and joint mobilization, can help decrease a patient’s pain, reduce swelling, and restore motion.

Accident Injuries that Physical Therapists Commonly Work With

While physical therapists are well equipped to assist patients with minor as well as serious injuries, many people who visit a physical therapist in Houston do so because of a long-term debilitating injury that they suffered as a result of a boat, truck, or car accident. For example, physical therapists commonly work with patients who have been involved in an accident and are suffering from:

Back and neck pain
Arm and shoulder pain
Leg and knee pain
Foot and ankle injuries
Hand injuries
Decreased range of motion

The Benefits of Physical Therapy

Individuals who are injured in an accident often find that attending physical therapy improves their well-being in a number of different ways. While each case and each patient are different, the benefits commonly associated with physical therapy include:

Pain Management: Many people who are injured in an accident attend physical therapy primarily in order to reduce or eliminate the pain caused by whiplash, disc herniation, fractures, and other injuries. The therapeutic exercises and manual therapy techniques utilized by physical therapists are often able to help reduce a patient’s pain and allow them to rely less on pain medication.
Can Help Avoid Surgery: In some circumstances physical therapy has been known to help a patient avoid having surgery altogether. This can be beneficial as surgeries sometimes involve a lengthy recovery, not to mention the inherent risk of undergoing the surgery itself.
Quickens Recovery: Individuals who attend physical therapy after an accident often recover much faster than they otherwise would have. Additionally, these individuals also tend to ultimately achieve better range of motion and muscle strength than those with comparable injuries who did not attend rehab.
Helps Prevent Chronic Pain: People injured in car accidents often suffer from chronic pain and other symptoms long after the accident occurred. Additionally, some car accident injuries, if left untreated, will worsen over time. Fortunately, accident victims who promptly attend physical therapy tend to experience much less chronic pain than they otherwise would.

Of course, if you have been injured in a wreck due to another person’s negligence, you may wish to speak with a car accident lawyer for help. Indeed, an attorney can help advocate on your behalf to ensure you receive the compensation necessary to pay for your recovery.

Functional Capacity / Work Capacity Evaluation

March 2, 2017 Teresa Stockton - Blog, Industrial Rehab

What is FCE / WCE Testing?
A Functional Capacity / Work Capacity Evaluation evaluates an individual’s ability to perform work activities post injury or illness. It documents the patient’s current ability from physical, medical, behavioral and ergonomic perspectives. It is within the scope of practice for occupational and physical therapists to provide such testing.

What to Expect
• FCE / WCE s can be used by physicians to complete work status reports. The FCE / WCE identifies the ability of an individual to safely return to work at full, modified or transitional duty
• The patient’s strength for material handling activities are identified via Department of Labor Standards: ex.) sedentary, light, medium or heavy
• An individual’s tolerance to non material activities such as sitting, walking, bending, etc. are quantified as never, occasional, frequent or constant as per Department of Labor standards
• A FCE / WCE will identify discrepancies between symptoms and objective findings
• FCE / WCEs can identify whether further medical evaluation or intervention is appropriate
• It can determine if there is a need for therapy or change in current therapy or direction
• If the individual is not ready for return to their previous job, it can establish a baseline for a work hardening program

This information provided by Rebound Physical Therapy, an outpatient physical therapy group located throughout Bend, OR. Rebound’s Bend North location specializes in industrial rehabilitation and More information about their industrial rehab center can be found here.

Weight Loss: What Are Your Options?

February 28, 2017 Teresa Stockton - Blog, General Information

The prevalence of obesity has increased steadily in Western cultures over the past century, particularly during the last several decades. In fact, most health professionals agree that we are in the midst of an obesity epidemic in the United States.

Being overweight is closely linked to many very serious health conditions. It is a significant risk factor for coronary artery disease (CAD), stroke, high blood pressure, high cholesterol, high triglycerides, low levels of HDL (high-density lipoprotein—the “good” cholesterol), and type 2 diabetes. Fortunately, even modest reductions in weight can help reduce the risk or improve these conditions. Plus, practicing the behavioral changes of a healthier diet and regular exercise may actually reduce these risk factors whether weight loss occurs or not.

Energy Balance: The Simple Principle of Weight Loss
Scientists often explain weight loss quite simply in terms of the energy balance equation: energy in versus energy out. To lose weight, you must consume fewer calories than you burn or, in reverse, you must burn more calories than you consume.

This is, of course, easier said than done. But no matter what weight loss methods you may employ—diet, exercise, medications, supplements, surgery, therapy, group support—the principle of energy balance is unavoidable. In fact, experts from both traditional and nontraditional disciplines agree that to achieve and maintain weight loss you must make changes in your diet and activity level to favorably affect the balance of the energy equation.

Using Strategies to Get Started
Getting started is often the most difficult part of losing weight. Any changes you make in your eating and exercising behaviors must become habitual, which takes time. In addition, carrying extra weight, no matter how much, can affect how you feel about yourself psychologically, sometimes making it more difficult to take the necessary steps to begin to change.

The following 5 strategies are crucial to successful weight loss and can help to overcome some of these barriers:

• Set and commit to realistic goals and monitor your progress toward achieving these goals
• Slowly modify your eating and exercise behaviors, as well as habits influencing both
• Examine and restructure unrealistic, negative thoughts, or expectations
• Reduce stress
• Develop a network of social support and information

Looking at Weight Loss Aids
There is a great deal of interest in whether prescription medications or supplements can facilitate weight loss. Some medications suppress appetite by interfering with brain chemicals that affect mood and appetite. Others reduce fat absorption from the gut. Here are examples of medications that may be recommended for weight loss:

• Diethylpropion
• Lorcaserin
• Orlistat
• Phendimetrazine
• Phentermine—can be taken alone or in combination with another medication

Some studies have supported the use of these medications when combined with lifestyle changes. For example, as part of a review of weight loss drugs, researchers analyzed 15 trials involving almost 10,000 people who were either taking orlistat or placebo. Compared to the placebo group, those taking orlistat had a higher chance of achieving a 5% or 10% weight loss. These types of medications, though, are usually prescribed only for people who are severely obese when other methods of weight loss have not worked. Accordingly, these medications are not without side effects or potential adverse events and should only be used with careful monitoring by your doctor.

The same goes for dietary supplements. Supplements do not undergo the same rigorous approval process as drugs. That being said, certain supplements may provide weight loss benefits since they may contain similar mechanisms of action as drugs. Along the same line, some of the same risks and side effects may be present, as well, which is why you should talk to your doctor before taking any over-the-counter weight loss products.

Also, be sure you know what is in diet medications and supplements. Some medications and supplements that were used in the past have been pulled from the market as it was found that the dangers of taking them were higher than the benefits. Whenever you are considering taking a diet supplement, know exactly what is in the product and share this information with your doctor.

The question is: when should you consider taking these weight loss aids? While it depends on your overall health and medical history, the best approach may be a conservative one. For example, adopt lifestyle changes for 6-12 months before trying a drug or supplement. Your doctor can give you guidance as to which weight loss options you should try first.

by Jackie Hart, MD

RESOURCES:
National Heart, Lung, and Blood Institute
https://www.nhlbi.nih.gov

National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov

CANADIAN RESOURCES:
Dietitians of Canada
http://www.dietitians.ca

Health Canada
http://www.hc-sc.gc.ca

REFERENCES:
Choosing a safe and successful weight-loss program. National Institute of Diabetes and Digestive and Kidney Disorders. Available at: http://www.niddk.nih.gov/health-information/health-topics/weight-control/choosing-safe-successful-weight-loss-program/Pages/choosing-safe-successful-weight-loss-program.aspx. Updated December 2012. Accessed January 14, 2016.

Diets for weight loss. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 21, 2015. Accessed January 14, 2016.

Obesity in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 21, 2015. Accessed January 14, 2016.

Rucker D, Padwal R, Li SK, Curioni C, Lau DC. Long term pharmacotherapy for obesity and overweight: updated meta-analysis. BMJ. 2007;335(7631):1194-1199.

Weight loss medications for obesity in adults. Available at: http://www.ebscohost.com/dynamed. Updated October 7, 2015. Accessed January 14, 2016.

7/6/2009 DynaMed’s Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Seo DC, Sa J. A meta-analysis of psycho-behavioral obesity interventions among US multiethnic and minority adults. Prev Med. 2008;47(6):573-582.

10/15/2010 DynaMed’s Systematic Literature Surveillance http://www.ebscohost.com/dynamed: US Food and Drug Administration. Meridia (sibutramine): market withdrawal due to risk of serious cardiovascular events. US Food and Drug Administration website. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm228830.htm. Updated Sepember 9, 2013. Accessed January 14, 2016.

Last reviewed July 2016 by Michael Woods, MD Last Updated: 1/14/2016

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

Can Your Feet Cause Pain in Your Knee, Hip or Back?

February 23, 2017 Teresa Stockton - Back, Blog, Foot, Hip, Knee

Can your feet cause pain in other areas of the body? Yes it can. The foot is an arch and arches decrease compressive forces by distributing them across the span of the arch. Engineers use arches in building and bridges to hold up greater weight across longer spans. The human foot has 3 arches that all work together to distribute the forces our bodies put on it. This allows us to walk, run and jump.

We start running into problems when the arch is either too flat or too high – causing the forces put through the foot to be abnormally distributed, resulting in strain.

Flat feet limit the range of motion of our ankle, causing our hips to rotate inward and move towards the center of our body.
High arches do the opposite to our hip joints.
These changes cause strain to our ankle, knee and hip joints, and our back.

People can be unaware that their feet cause pain throughout the body because they were born with flat feet or high arches and they do not know what “normal” feels like. As physical therapists we have treated many children who didn’t realize that their feet are not supposed to be sore. But instead of seeing them for prescribed foot pain, they come for pain in their joints or back.

Orthotics were developed to correct or adapt to changes in the foot. Orthotics should be fitted by a healthcare professional trained in assessing the foot and gait. Standing on a pressure plate in the store is not good enough. Why? If your foot hurts are you going to stand on it normally? Probably not. This results in an abnormal reading.

An orthotic by itself is not the best treatment. A physical therapist will assess your function, strength, flexibility and range of motion. Patients will present with other problems as the result of abnormal arches. Treatment with orthotics combined with strengthening and stretching exercises, balance training, functional training and manual therapy is necessary to restore full function.

PT News

February 16, 2017 Teresa Stockton - Blog, PT News

This Month in PT News. Featuring articles from PTandMe partnering clinics!

2. Early Intervention is the Key to Success
Written by Ben Eggleston, PTA at the Center for Physical Rehabilitation – Grand Rapids, MI

The relationship between longevity of symptoms and healing time is of reciprocal proportion? Read more

3. Overtraining Doesn’t Help, It Hurts
Written by the Therapy Team at Momentum Physical Therapy – San Antonio, TX

Working to achieve a sports or fitness goal can drive many people to overtrain in an effort to get stronger, better, faster. Read more

Recommendations to Help Prevent High Blood Pressure

February 14, 2017 Teresa Stockton - Blog, General Information

Hypertension is abnormally high blood pressure. High blood pressure puts extra strain on the heart, lungs, brain, and kidneys. It carries with it an increased risk of death and disability from coronary artery disease (CAD), stroke, heart failure, and kidney disease.

High blood pressure is very common but can’t be seen or felt. Many people with high blood pressure don’t know they have it. The best way to know if you have high blood pressure is to keep track of your numbers. You can get your blood pressure checked at your doctor’s office, at home, or at your local pharmacy. It’s important to get your blood pressure checked regularly.

Defining High Blood Pressure
High blood pressure is defined by 2 numbers (systolic and diastolic). The systolic or top number measures the pressure in your blood vessels when your heart beats. The diastolic or bottom number measures the pressure in your blood vessels when your heart rests between beats.

The normal blood pressure varies with age, usually increasing as we get older. In general, systolic blood pressure (SBP) less than 120 mm Hg and diastolic blood pressure (DBP) less than 80 mm Hg are considered normal and prehypertension is a SBP120-139 mm Hg or DPB 80-89 mm Hg. Abnormal levels include:
• Stage 1 hypertension—SBP 140-159 mm Hg or DPB 90-99 mm Hg
• Stage 2 hypertension—SBP more than 160 mm Hg or DBP more than 100 mm Hg

In people with diabetes or kidney disease, the targets numbers are lower. Check with your doctor to see what your target range should be.

Common Risk Factors
There is no single cause for high blood pressure, but there are several factors that can increase your risk.

Some risk factors for high blood pressure include:
• Age: middle-aged or elderly—onset generally happens at 20-50 years, but likelihood increases with age
• Race: African American
• Gender: Male

Medical factors, such as:
• Diabetes
• Obesity
• Metabolic syndrome—A condition marked by elevated blood pressure, cholesterol, blood glucose, and body weight. Excess weight centered around the midsection is of particular concern.
• A family history of high blood pressure
• Sleep apnea
• Prehypertension

Lifestyle factors, such as:
• Smoking
• Being physically inactive
• Taking birth control pills
• Having diet high in red meat, salt, and saturated and trans fats
• High alcohol intake

Risk factors don’t mean you will get high blood pressure, but that you have an increased chance of developing it. Fortunately, there are also factors that can help you prevent high blood pressure or lower your blood pressure if you already have elevated blood pressure.

Lifestyle Guidelines to Prevent or Reduce High Blood Pressure
The National Heart, Lung, and Blood Institute’s recommendations to help prevent or lower high blood pressure include:
• Losing weight if you are overweight
• Increasing levels of physical activity—Aim for 30 minutes per day on most days of the week.
• Eating a diet rich in fruits, vegetables, and low-fat dairy products
• Eating a diet that is low in saturated and total fat
• Limiting consumption of sodium (salt) to less than 2,300 milligrams per day
• Drinking alcohol only in moderation—This means 1 drink or less per day for women and 2 drinks per day or less for men.

Another approach endorsed by National Heart, Lung, and Blood Institute is use of the DASH diet. This is a special low-salt diet which has been shown effective in both preventing and treating high blood pressure.

High blood pressure is a major player in heart disease and stroke. Protect yourself and know your numbers. The next time you take a trip to the pharmacy, check your blood pressure. If you do it on a regular basis and follow the lifestyle guidelines, you may be able to avoid future problems.

by Michael Jubinville, MPH

RESOURCES:
National Heart, Lung, and Blood Institute
https://www.nhlbi.nih.gov

American Heart Association
http://www.heart.org

CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca

Heart & Stroke Association
http://www.heartandstroke.ca

REFERENCES:
Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003;42(6):1206-1252.

How can high blood pressure be prevented? National Heart Lung and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/hbp/prevention. Updated September 10, 2015. Accessed August 2, 2016.

Hypertension. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 12, 2016. Accessed August 2, 2016.

Hypertension treatment in patients with diabetes. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 11, 2016. Accessed August 2, 2016.

Preventing high blood pressure: Healthy living habits. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/bloodpressure/what_you_can_do.htm. Updated July 7, 2014. Accessed August 2, 2016.

Understanding your risk for high blood pressure. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/UnderstandYourRiskforHighBloodPressure/Understand-Your-Risk-for-High-Blood-Pressure_UCM_002052_Article.jsp#.V6CgG02FPIU. Updated June 29, 2016. Accessed August 2, 2016.

Whelton PK, He J, Appel LJ, et al. Clinical and public health advisory from the National High Blood Pressure Education Program. JAMA. 2002;288(15):1882-1888.

Last reviewed July 2016 by Michael Woods, MD Last Updated: 8/2/2016