The days are shorter, the weather colder and the holidays are quickly approaching. Neighbors are stringing up their lights. Christmas music is playing on the radio to help get us in the holiday spirit. Children are thumbing through toy catalogs making out their wish lists. So, why aren't we happy?

Why do we always feel anxious and a bit nervous as the end of the year holidays arrive? Here are the reasons and some steps to help combat this holiday stress from Debbie Mandel, an author and stress-reduction specialist.

1. Seasonal Affective Disorder: Summer is gone and daylight is decreased. Some of us are prone to SAD - Seasonal Affective Disorder. Getting out into natural light each day, even for a short time, will help counteract depressed feelings.

2. Unrealistic Expectations: Many people spend too much time trying to make the holidays perfect. Whether it is planning a traditional family dinner, buying the perfect gift or trying too hard to make everything magical, stress sets in if things don't go as planned. Learn to appreciate the little things. All that matters for us is the moment, living in the present is our greatest present. Doing these things will change our perception, which is the key to peace and happiness.

3. Materialism: The economics of the holidays can overwhelm us, especially in today's times. Spending money sometimes gets confused as an expression of love. Buy or create a beautiful card with an individualized message and give a special coupon as a gift. Have fun brainstorming for heartfelt gifts as opposed to spending extravagantly. After all, it is the thought that counts.

4. Deficient Diet and Lack of Exercise: To combat holiday stress, eat healthy and exercise. Holiday treats will cause your body to cycle up and down as well as deplete your immune system. Bolster your energy levels by eating a balanced diet, drinking plenty of water and reducing caffeine and alcohol intake. Then, make sure to do some physical exercise everyday.

5. Time Pressures: Don't surrender to the last second shopping stampede. Give yourself plenty of time to reflect, shop and run errands. When we set deadlines, we increase the pressure and decrease the joy. When we are having fun, we lose track of time. When we are miserable, time seems an eternal sentence. Not setting deadlines and planning ahead will help shed the stress of the holiday countdown. Enjoy the journey!

Falls in the elderly population are prevalent, dangerous and costly. About one in three seniors above age 65, and nearly one in two seniors over age 80 will fall at least once each year, many times with disastrous consequences. As our nation's population ages, the rate of falls is rising. Yet, falling and fear of falling may be reduced by physical therapist intervention, says the American Physical Therapy Association (APTA).

"Falling and fear of falling among seniors is a public health problem and should not be accepted simply as a normal condition of aging," says physical therapist Leslie Allison, PT, PhD, Assistant Professor in the Department of Physical Therapy, College of Health Sciences, at East Carolina University in Greenville, NC.

Allison notes that there are several risk factors associated with falls, including; being older; being female; impairment of balance or walking; poor vision; leg or trunk weakness; reduced cognitive status (dementia); pre-existing medical conditions, such as Parkinson's Disease, stroke or diabetes; being on more than four medications simultaneously; use of an assistive walking device; and a past history of falls.

There are evidence-based interventions that can help reduce the risk of falling and reduce falls-related injuries. A comprehensive examination that includes a balance assessment performed by a physical therapist can be effective in determining the factors that are contributing to an individual's loss of mobility, risk for falls and/or decreased confidence. Once this information has been gathered, the physical therapist can then determine which type of muscle strengthening and balance retraining program would be most beneficial to reduce the individual's risk of falling.

In addition to adhering to a program designed specifically by a physical therapist, older adults should:

• Ask health care providers to review their medications to reduce side effects and interactions.
• Have their eyes checked by an eye doctor at least once a year.
• Reduce hazards and improve the lighting in their homes.
• Have a proper assessment of cane or walking aid use to avoid fall-related injuries.

If you or someone you know is having difficulty walking or maintaining balance, then you need to ask your doctor for a referral to Premiere Physical Therapy so we can help. Our therapists help people improve balance and their ability to walk every day in all three of our locations.

As always, our therapists will give you one on one attention with one goal, when we're done, "LIFE FEELS BETTER."

The American Academy of Pediatrics recommends looking for these features when shopping for your child's backpack:

1. Wide, padded shoulder straps - Narrow straps can dig into shoulders. This can cause pain and restrict circulation.

2. Two shoulder straps - Backpacks with one shoulder strap that runs across the body do not distribute weight evenly.

3. Padded back - Extra padding protects against sharp edges on objects inside the pack and increases comfort.

4. Waist strap - A waist strap can distribute the weight of a heavy load more evenly.

5. LIghtweight backpack - The backpack itself should not add much weight to the load.

6. Rolling backpack - This type of backpack may be a good choice for students who must tote a heavy load.

The American Academy of Pediatrics recommends these tips to help prevent injury from an overloaded school backpack.

1. Always use both shoulder straps.

2. TIghten the straps so that the pack is close to the body.

3. Pack heavier items closer to the center of the pack.

4. Bend using both knees to pick up the backpack.

5. Learn back-strengthening exercises.

6. Stop often at school lockers, if possible. Do not carry every book all day long.

7. Pack light. The backpack should never weigh more than 10-20% of the student's body weight.

8. Backpack should not be wider or taller than the child's shoulders when sitting.

Back strengthening exercises are taught by all of our therapists at Premiere Physical Therapy through our "Spine Rehabilitation Program." If your child starts to suffer from any type of back, neck or shoulder pain during this school year, then ask your doctor for a referral to Premiere Physical Therapy so that they don't have to suffer too long. After all, it is your choice where you want to go for treatment. Our therapists will give you one on one attention with one goal, when we're done, "LIFE FEELS BETTER!"

As another school year starts, kids are eager to get back to class. There are many great things about the start of school. There is the excitement about a new teacher, learning new things, seeing old friends and meeting new classmates. By now, most parents have finished back to school shopping and purchased all the necessary supplies. There are #2 pencils, ink pens, lined notebook paper and pocket folders, but the most important decision of the year is buying the proper backpack for your young students. Let's see if your purchase makes the grade!

Backpacks come in all sizes, colors, fabrics and shapes and help kids of all ages express their own personal sense of style. Many packs feature multiple compartments that help students stay organized while they tote their books and papers from home to school and back again. Almost every child seems to carry one in some form or another.

While backpacks are one of the most convenient ways to carry books and school supplies, an overloaded and/or improperly worn backpack gets a failing grade, according to the American Physical Therapy Association (APTA). Recent studies have reported that up to 64% of school aged children suffer from back pain. Although many factors can lead to back pain, some kids have backaches because they are lugging around their entire locker's worth of books, school supplies and assorted personal items all day long.

To help understand how heavy backpacks can affect a child's body, it helps to understand how the back works. The spine is made up of 33 bones called vertebrae, and between the vertebrae are discs that act as natural shock absorbers. When a heavy weight, such as a backpack filled with books, is incorrectly placed on the shoulders, the weight's force can pull a child backward. To compensate, a child may bend forward at the hips or arch the back, which can cause the spine to compress unnaturally. The heavy weight causes a lot of children to develop shoulder, neck and back pain.

"The extra stress placed on the spine and shoulders from heavy loads is causing children to develop adult-like back problems," said Dr. Christine Ho, a pediatric orthopedic specialist at Children's Medical Center and assistant professor of Orthopedic Surgery at UT Southwestern Medical Center. "The most common injuries are muscle strains and, in extreme cases, slipped discs. Some injuries could lead to long term conditions if not avoided."

There have been increasing reports of childhood back pain for the last several years. The Consumer Product Commission has found that every year, more than 10,000 children ages 5 to 14 see their doctors with backpack-related complaints. By the end of their teen years, more than 50% of youths experience at least one low back pain episode, and research indicates that this increase may be due to improper backpack use.

While these numbers may be alarming, what matters most is that your child may be one suffering from pain caused by improper backpack use. Premiere Physical Therapy can help your child feel better through our "Spine Rehabilitation Program." Ask their doctor for a referral to Premiere Physical Therapy. It is your choice where you want to go for treatment! As always, our therapists will give you one on one attention with one goal, when we're done, "LIFE FEELS BETTER!"

Next week we will give you some useful tips on how to keep your child safe while using a backpack...

Most people have experienced back pain at one time or another. The causes of back pain are numerous; some are self-inflicted due to a lifetime of bad habits. Other back pain causes include accidents, muscle strains and sports injuries. Although the causes may be different, most often they share the same symptoms. The most common symptoms for back pain are:

1. Persistent aching or stiffness anywhere along your spine.

2. Sharp, localized pain in the neck, upper back or lower back.

3. Chronic ache in the middle back, especially after sitting or standing for long periods.

4. Back pain that shoots from your low back to the buttock and down your leg to your foot.

5. Inability to stand straight without having severe muscle spasms in the low back.

If you have any or all of these symptoms, then you need to see your physician. In most cases, it is best to see your primary care physician first. Often, he or she will suggest physical therapy for your back pain, especially if you have any of these additional symptoms:

1. Numbness, tingling or loss of control in your arms or legs.

2. Pain that extends down the back of your leg.

3. Your pain increases when you cough or bend forward at the waist.

4. You have dull pain in one area of your spine when lying in or getting out of bed.

About 80% of Americans, or four out of five people, experience back or neck pain at some point in their lives. Many of these people with chronic low back pain are working age and for them, back pain is the most frequent cause of lost productivity.

If you haven't been as productive as you would like to be because of your back pain, then you need to ask your doctor for a referral into Premiere Physical Therapy's "Spine Rehabilitation Program." This program focuses on relieving your pain and teaching you how to keep it from returning.

Our therapists are experts in helping people get rid of their back pain and getting back to work! Don't suffer being less than your best any longer. Call the Premiere location nearest you today. We always give you one on one attention with one goal, when we're done, "LIFE FEELS BETTER."

With the prices at the gas pumps rising and vacation season getting under full swing, Premiere Physical Therapy would like to help you earn $50 in free gas. Here is how you can do it:

1. Suggest our facebook page (www.facebook.com/premierept) to as many of your facebook friends as possible.
2. They must be new friends to our page.
3. Instruct them to "like" or become a friend of our page and post on our wall who sent them.
4. If you can get five people to "like" our page by June 23rd, then you will be eligible for a drawing for the $50 gas card.
5. Thanks and good luck.

As the highly anticipated spring temperatures arrive, most people are more than ready to begin their outdoor activities. Whether your game is walking, running, softball, hiking or gardening you will need to gradually get back into shape to avoid injuries.

Jumping right back into strenuous exercise after a long winter of inactivity can potentially lead to a higher risk for injury. Even those who exercise regularly are at risk for injury as they take on new challenges or change their routines. The old adage "good judgement comes from experience and experience comes from bad judgement" holds true for both experienced and novice exercisers alike. Bad judgement, poor choices, and common exercise mistakes can lead to several different types of aches, pains and injuries that affect the ability to maintain a commitment to an exercise program.

The most common thype of exercise related injury is not actually a single injury like a pulled muscle or broken bone, but rather a series of injuries leading to "overuse" or "chronic" injuries. These series of injuries can be over several weeks, months or even years. These events can irritate or weaken a part of the body to the point where exercise becomes painful or even impossible.

Some common types of overuse injuries include runner's knee, tennis elbow, "little leaguer's" elbow, shin splints, plantar fascitis, low back pain, shoulder tendonitis or bursitis. Stresses that we place on our bodies too soon after starting a workout regimen can build over time causing aching kneecaps, stress fractures, back pain, shoulder pain, tender tendons or strained muscles. However, you don't have to exercise very hard or even for a long period of time to develop an overuse injury. Worn out shoes, uneven or unforgiving running surfaces, poor body alignment, and muscular imbalances can all contribute to these types of injuries.

Next week we will explain common mistakes made when getting into shape and how to avoid making them....

If you have ever experienced low back pain, then you know exactly how debilitating it can be. Approximately one quarter of Americans report feeling pain in their low backs within the past three months at any given time. Low back pain often occurs due to overuse, strain or injury. This includes too much bending, twisting, lifting and even too much sitting.

A common question that our physical therapists are asked is, "Why can't I just rest to get rid of my back pain?" In a few rare cases, low back pain is mild and will disappear on its own. However, for most people, back pain will return or persist, leading to a decrease in quality of life or even disability.

The key to recovery from low back pain is staying active and doing as much of your normal routine as possible. Bed rest for longer than a day can slow down your recovery. Research within the past 10 years has shown that inactivity weakens the muscles that support the spine and, if continued too long, can prolong recovery or even make certain conditions severe enough to require surgery.

If you have had low back pain off and on that seems to get worse or last longer each time, then it is time to "get rid of your pain" once and for all! Our physical therapists can help you "restore and improve your motion", treat your persistent or recurrent low back pain, and help you prevent and reduce future episodes. In many cases, all done while avoiding painful surgery and adverse effects of medications.

How is this done? Our physical therapists are experts at relieving low back pain through our "low back rehabilitation program." They will work one on one with you in this program to teach you how to relieve and prevent your low back pain from returning so that you can function at your very best. Our physical therapists will work with you to help you understand your body so you will achieve long term health benefits!

At your initial evaluation, a physical therapist will evaluate you and develop a plan of care using a variety of treatment techniques designed to help you move, reduce pain, restore function and prevent disability. They will help you prevent loss of mobility and motion by developing a fitness and wellness oriented program tailored to your specific needs. They do this so that you can function at your very best!

Ask your doctor for a referral to Premiere Physical Therapy so we can help you get rid of your low back pain. It is always your choice where you want to go for treatment, and we have three convenient locations from which to choose.

As always, our therapists will give you one on one attention with one goal, when we're done, your "Life Feels Better!"

Do you experience sharp pain in your shoulder when raising your arm over your head?

Do you experience stabbing pain in your shoulder when reaching behind your back?

Does your shoulder pain limit your normal daily activities?

If you have answered yes to one or all of these questions, then you need to know what to do to alleviate your shoulder pain. Many people experience shoulder pain at some time in their lives. The most common cause of shoulder pain is impingement syndrome, or a pinching of the rotator cuff from part of the shoulder blade as the arm is lifted. The pain usually starts out mild and progressively gets worse as it is left untreated. This condition can be a result of mild trauma or suddenly appear for no reason, but it usually occurs in individuals who perform repetitive lifting or overhead activities (i.e. painters, mechanics and construction workers).

Common symptoms of shoulder impingement include:

• Minor shoulder pain present both with activity and at rest.
• Pain radiating from the front of the shoulder down to the side of the arm.
• Sudden, sharp pain with lifting or reaching overhead and out to the side.
• Inability to hold your arm overhead while working.

With warmer temperatures right around the corner, you don't want to be sidelined by your shoulder pain! You need to get out on the golf course, play softball with your friends and play in the backyard with your kids without feeling excruciating pain in your shoulder.

Premiere Physical Therapy can help you get rid of your shoulder pain! Our therapists use our "shoulder rehabilitation program" to accomplish this every day in all three of our locations.

Ask your doctor for a referral to the Premiere location nearest you so we can help you! As always, we will give you one on one attention with one goal, when we're done, "Life Feels Better."

A common question that we hear from many patients is about the initials after our names. They are:

PT– Physical Therapist: A licensed healthcare professional who works with people that have sustained disabilities, impairments, or limitations in their overall physical function. Physical therapists examine, evaluate, diagnose, develop treatment plans, and provide prognosis for each patient on an individual basis. PTs work to restore function, improve mobility, and decrease pain with the goal of re-establishing a patient's prior functional level. Over the course of the rehabilitation period, they will document progress, re-evaluate physical findings, and modify treatment strategies as appropriate. At Premiere our physical therapists may refer you to work with a physical therapist assistant (PTA) or a certified athletic trainer (ATC) depending on your diagnosis.

DPT - Doctor of Physical Therapy: A licensed healthcare professional and physical therapist who has pursued additional education and training in physical therapy. This degree reflects the growth in the body of knowledge and expected responsibilities that a professional physical therapist must master to provide best practice to the consumer.

PTA – Physical Therapist Assistant: A licensed healthcare professional that performs components of physical therapy procedures and related tasks under the direction and supervision of licensed physical therapists. They assist the PT with the development of treatment plans, documentation of patient progress and modification of specific treatments in accordance with patient status and within the scope of treatment plans developed by a physical therapist. PTAs at Premiere specialize in treating all neck and back injuries as well as geriatric patients. 

ATC – Certified Athletic Trainer:  A licensed healthcare professional that specializes in the prevention, recognition, management and rehabilitation of injuries that result from physical activity. Athletic Trainers help prevent and treat injuries for people of all ages. ATCs help prevent injuries by advising patients on the proper use of equipment and applying protective or injury-preventive devices such as tape, bandages or braces. In a clinical setting they work under the direction and supervision of licensed physical therapists progressing patients through rehabilitation programs. ATCs at Premiere specialize in treating shoulder and knee injuries as well as sports injuries.

Physical therapy is an effective solution in treating pain associated with the back, neck, shoulder, knee, hip, ankle, wrist and jaw. If you are experiencing any of the following symptoms, we can help. Consult with your physician to get a prescription for physical therapy treatment.

Back Pain Symptoms:

• Persistent aching or stiffness anywhere along your spine.
• Sharp, localized pain in the back after sitting or standing for long periods.
• Back pain that shoots from your low back to the buttocks and down your leg into your foot.
• Inability to stand straight because of severe muscle spasms in your low back.
• Numbness, tingling in your leg and foot.
• Increased pain when you cough or bend forward at the waist.

Neck Pain Symptoms:

• Persistent aching or stiffness anywhere in your neck.
• Sharp, localized pain in your neck and/or shoulders when sitting or standing for long periods.
• Neck pain that shoots into your upper back or shoulders and down your arm to your hands.
• Inability to move your head normally in any direction because of severe muscle spasms in your neck.
• Numbness, tingling in your arm and hand.

Shoulder Pain Symptoms:

• Persistent aching or stiffness in your shoulder.
• Sharp, localized pain in your shoulder and/or arm when trying to use it.
• Inability to carry objects or lift your arm overhead.
• Shoulder pain that occurs at night or while resting.
• Shoulder pain that persists beyond a few days.
• Inability to raise your arm in any direction.