Guidelines to Prevent Injury While Shoveling Snow

It’s that time of year again when you may have to deal with the snow.  Many people injure themselves when shoveling snow.  Therefore,  here are some tips you can use to avoid a shoveling injury this year.

Guidelines to Prevent Injury While Shoveling Snow

  1. Prior to shoveling, you should warm your body up.  This can be done by taking a 5 minute walk and moving your arms in a circular motion.  This causes increase blood flow to the areas of your body you will be using to shovel snow to prevent injury.
  2. Use an ergonomic snow shovel. One with a curved handle to keep your back straight while shoveling.
  3. Push the snow if possible. Pushing the snow away is better than lifting the snow. It you have to lift it, make sure to squat with feet shoulder width apart, and bend your knees and tighten your abdominals. Don’t bend over at the waist rounding your back. You want your legs to do the work, not your back.
  4. Scoop small amounts of snow at a time.
  5. Use a shovel with a plastic blade rather than metal because it is lighter.
  6. Keep the shovel close to your body and dump the snow in front of you or pivot your feet to turn and dump the snow to the side (never twist your body).  The worst position you can be in while shoveling snow is bent over at the waist, scooping and then twisting to throw the snow.  That position puts a great deal of pressure on the discs in your spine.
  7. Use boots with good traction and once you have cleared an area, put sand or salt down to help with your traction, while continuing to shovel.
  8. Also, make sure you take breaks. Drink lots of water and avoid caffeine or smoking before you shovel.  Caffeine can cause an increase in your heart rate and constrict your blood vessels. If you experience any chest pain, make sure you call for help.

Shoveling with Good Biomechanics

How to Prevent Back Injury with Lifting and Household Chores

Many of us have gone to pick something up from the floor or move a piece of furniture and felt some type of back discomfort.  Good body mechanics during lifting or moving objects can prevent back injury by putting less strain on your back muscles.  Listed below are guidelines to prevent back injury with lifting and household chores.

Guidelines to prevent back injury with lifting

  1. When lifting an object, stand with your feet shoulder width apart or 1 foot in front of the other.
  2. When picking something up off the ground, bend with your knees and hinge at your hips keeping the normal curves in your back.  Do not slouch forward.
  3. Also, tighten your lower abdominal muscles (refer to blog topic- Can back pain be prevented?) and maintain the contraction throughout the lift. Your abdominal muscles and your back muscles work together to give support to your spine.
  4. When lifting, keep the object close to your body.
  5. Use your legs and buttocks to straighten back up, not your back.
  6. Carry things at waist level.
  7. If you must reach for the object, stand on a chair or stool.  Do not arch your back.
  8. PUSH, do not pull when you are moving an object.

Guidelines to prevent back injury with household chores.

  1. Washing dishes– to decrease back strain at the sink, open the base cabinet and put your foot up on the ledge to become closer to the sink.
  2. Vacuuming– Walk with the vacuum or lunge forward onto one foot keeping your back straight, rather than bending forward with each push of the vacuum.
  3. Making the bed– Put one knee down on the bed when fastening a sheet to the corner of the mattress or squat to fasten it.
  4. Grooming– Put one hand down on the counter in the bathroom while using the other to brush your teeth or shave. Also, you can put a foot up onto the ledge of the base cabinet as in the kitchen.

Bending at knees for objectLifting objectLifting object

Healthy Holiday Eating Tips- Part 2

Menu Planning Tips: Modify your traditional holiday menus and recipes to reduce fat, cholesterol, and calories.

Original Menu
3 ½ ounces roast duck
½ cup stuffing
½ cup broccoli with hollandaise
½ cup jellied cranberry sauce
1 medium crescent roll
1 slice pecan pie
TOTAL FAT = 55 grams
Leaner Menu
3 ½ ounces roast turkey breast
½ cup rice pilaf
½ cup broccoli with lemon juice
½ cup fresh cranberry relish
1 fresh roll
1 slice pumpkin pie
TOTAL FAT = 21 gra

A typical holiday menu:

  • 3 ½ ounces roast duck
  • ½ cup stuffing
  • ½ cup broccoli with hollandaise sauce
  • ½ cup jellied cranberry sauce
  • 1 medium crescent roll
  • 1 slice pecan pie
  • TOTAL FAT = 55 grams

A leaner holiday menu:

  • 3 ½ ounces roast turkey breast
  • ½ cup rice pilaf
  • ½ cup broccoli with lemon juice
  • ½ cup fresh cranberry relish
  • 1 fresh roll
  • 1 slice pumpkin pie
  • TOTAL FAT = 21 grams

Remember to go easy on the following foods:

  • Nuts
  • Chips
  • Crackers
  • Dips
  • Olives
  • Eggnog
  • Stuffing
  • Gravy
  • Fatty deli meats
  • Candy, cakes, pies, cookies
  • Alcohol

Celebration Strategies:

  • Be realistic. Trying to lose weight during the holidays may be a self-defeating goal. Striving to maintain your weight, however, is a reasonable expectation.
  • Forget the “all or nothing” mindset. Depriving yourself of special holiday foods or feeling guilty over a particular food choice are not part of a holiday eating strategy – and certainly not part of the holiday spirit!
  • Have fun! Sharing food is an important way to spread holiday cheer. Enjoying a traditional meal or celebrating with family and friends need not destroy the healthy food habits you have nurtured all year.
  • Get enough rest.
  • Drink lots of water.
  • Get at least 30 minutes of brisk exercise every day to reduce stress and burn calories (try it before breakfast).
  • Don’t skip meals, especially breakfast.
  • Eat slowly – put your fork down between bites.
  • Chew gum while preparing food and cleaning up to curb tasting and snacking.
  • Keep a daily food/calorie diary – enter every taste and snack you take.
  • Resist the urge to bake as gifts, instead make jellies, barbecue sauces, etc.

Snacking During the Busy Holiday Season:

With all the preparations and celebrations, you might be too busy to eat regular meals. Take some time to learn how tasty, convenient snacks and appetizers can fill hunger gaps, contribute important nutrients, and add enjoyment to your holiday eating.

  • Try these portable snacks when you travel:
    • Make a trail mix of nuts, raisins, and pretzel chips
    • Tote some of your favorite ready-to-eat cereal in a plastic bag
    • Stow a couple of breadsticks and a crisp apple
    • Pack a handful of graham crackers and small can of fruit juice
    • Wrap up a mini-bagel spread with peanut butter
  • For home, try stocking up on these snacks:
    • Raw broccoli florets
    • Red and green pepper strips
    • Zucchini circles
    • Cucumber wedges
    • Carrot and celery sticks
    • Low-fat, low-sodium cheeses
    • Lean, low-sodium deli meats
    • Fruit
    • Yogurt
    • Juices
    • Assorted bread, crackers, graham crackers, pretzels, and breadsticks
    • Cook a large batch of chili and freeze individual portions, reheat as needed
  • Snack ideas for company
    • Top reduced-fat crackers with your favorite hors d’oeuvre combinations
    • Serve hummus with pita wedges
    • Make fruit kabobs with pineapple chunks, melon balls, and ripe strawberries
    • Arrange colorful vegetables on a platter with a tangy yogurt dip
    • Place bowls of homemade snack mix on convenient tables
    • Create a cheese board with some new lower-fat varieties and an assortment of crackers and breadsticks
  • For a sweet treat:
    • Slices of angel food cake drizzled with raspberry sauce
    • Non-fat and lower-fat cookies
    • Dried fruit and nuts arrangement
    • Serve small portions of special holiday sweets

Written by Julie Katz, Registered Dietitian- Baltimore, MD

Healthy Holiday Eating Tips- Part 1

Food is an integral part of holiday festivities with many of the traditional treats being high in calories and fat. You may be asking yourself, “How can I enjoy the holidays and still manage to maintain a healthful diet?”  The secret is moderation and balance so that you may fit in some of your holiday favorites.

Party Tips: It may be difficult to juggle drinks, plates, and conversation during these stand-up events, but try to still pay attention to the foods you are eating.

  • Eat small, lower-calorie meals during the day so you can enjoy a special treat later. Eat a healthy snack right before the party – a hungry stomach can sabotage even the strongest will-power.  Try a smoothie of skim milk and fruit to take the edge off your appetite.
  • When you arrive at the party, don’t rush to the food. Greet people you know, get a low-cal beverage, and settle in.
  • Make only one trip to the buffet and be selective. Choose only the foods you really want to eat. Keep portions small. Often, a taste is all you will need to satisfy a craving or your curiosity.
  • Skip the fried food and eat the crackers, bread, and fruit. If you want to nibble on cheese, take only one or two pieces.
  • Fresh vegetables are always great. Have a small dollop of dip, just enough to coat the end of the carrot stick, or broccoli floret.
  • Boiled shrimp or scallops are a good choice. Choose cocktail sauce or lemon and horseradish as a condiment.

Dinner Party Tips: With a meal already planned and out of your hands, you may not have a menu choice.

  • If you are bringing a dish, make a lower-fat version of a family favorite.
  • If possible, choose two appetizers instead of an entrée, or share an entrée with a friend.
  • If second helpings are mandatory with your host, make your first helping small. That way, if you’re enticed to take seconds, at least the total amount of food you eat may equal a normal-sized portion.
  • Choose skinless white meat of poultry. It has fewer calories and fat than dark meat.
  • Eating a roll is fine. If it’s fresh, you may not even need butter or margarine.

Written by Julie Katz, Registered Dietitian- Baltimore, MD

Plantar Fasciitis

What is Plantar Fasciitis?

Plantar Fasciitis is an irritation of the thick ligamentous connective tissue on the bottom of the foot. This band of tissue runs from the heel to the ball of the foot providing support for the arch of the foot.  Plantar fasciitis is common in runners.

Causes of Plantar Fasciitis

1. Over pronating with walking/running– pronation is where the inside of the foot touches the ground more than the outside.

2.  Wearing old shoes– shoes lose their support after approximately 500 miles of wear.

3.  Excessive walking with improper foot support– shoes that do not provide arch support.   An orthotic might be needed to provide increase support to the arch of the foot.

4.  Tight calf muscles


Pain is felt at the bottom of the heel.  Pain is usually worse in the morning and improves throughout the day.  Pain increases with prolonged standing or sitting.


1.  Rest

2.  Ice

3.  Massage to the bottom of the foot

4.  Stretching– refer to the previous blog topic on Why does my calf cramp?  How do I relieve it?

5.  Night splinting

If the pain is still present, physical therapy can help with Plantar Faciitis.  Consult with your physician or physical therapist to determine the next step for you.    If you have any questions about Plantar Fasciitis, please contact Harbor Physical Therapy.


Cause and Treatment for Calf Cramps

Muscle cramps can occur from overexertion, dehydration, an electrolyte imbalance, and inactivity. During a muscle cramp, the muscle shortens causing sudden severe pain. Muscle cramps can develop from pointing your toes in bed.  Also, it is common in women who are pregnant.

If you experience a muscle cramp in your calf, try to walk it off.  If that does not work, massage and apply heat to your calf.  Then, stretch the calf to loosen the muscle and prevent further muscle cramping.

Calf Stretches

  1. Runner’s Stretch– Stand with your hands against the wall, with your feet staggered, lunge towards the wall. The calf you are trying to stretch should be in the back.
  2. Calf Stretch with Strap– sit with your legs in front of you and pull your toes toward your knee.
  3. Calf Stretch on Step– Stand on a step, lower the heel of the cramping leg to get a stretch.  Hold onto a railing for support.

If you are prone to calf cramps, you should stretch regularly.

Runner's Stretch
Calf Stretch with StrapCalf Stretch on Step

How to Reduce Inflammation by Changing your Diet

Swelling and inflammation are problems that can lead to the pain you are feeling.  To help decrease inflammation, and therefore pain, it is important to follow a healthy, well-balanced diet. The Food Guide Pyramid can help you to make wise choices by including a variety of whole grains, fruits and vegetables and eating sugar, sodium and fat in moderation. It is also important to choose more fresh foods and limit processed foods, as these have been known to lead to inflammation.


  • Choose whole grains like whole wheat bread, brown rice, and whole grain cereals.
  • Try to avoid processed or refined grains- meaning that they are white and the good parts (fiber and B-vitamins) have been removed.

Vegetables and Fruits:

  • All are good sources of fiber, vitamins, and minerals.
  • Make sure to get a variety of color to get all of the nutrients and aim for at least 5 servings daily.
  • Vitamin C
  • An antioxidant that fights inflammation
  • Supports healthy connective tissue
  • Involved in collagen formation
  • Sources: broccoli, melons, oranges, mango, sweet potato, spinach, collard and mustard greens, strawberries, red bell peppers, kiwi, pineapple, Brussels sprouts, tomatoes
    • Magnesium
    • Works with calcium to promote bone formation
    • Sources: seeds, nuts, legumes, unrefined cereal grains, dark green leafy vegetables
      • Antioxidants and Phytochemicals
      • Have anti-inflammatory properties
      • Choose berries and other brightly colored fruit and vegetables
        • Boron
        • Some studies have shown this trace mineral to help with osteoarthritis
        • Helps cartilage and bone to absorb calcium
        • Sources: apples, legumes, leafy vegetables, carrots, pears, grapes, grains, some drinking water

Fats and Oils:

  • Total fat 25-35% of calories
  • Choose healthy fats from unsaturated sources
    • Olive oil has been shown to reduce pain and inflammation – can be used in place of vegetable oil in baking
    • Focus on Omega-3 fatty acids
      • Powerful anti-inflammatory agent
      • Sources: cold water oily fish (salmon, tuna, mackerel, anchovies, herring, sardines, lake trout), walnuts, flaxseed, canola oil, pumpkin seeds, soybeans
      • Speak to your doctor if you are interested in adding fish oil for flax supplements
      • Limit saturated fat from animal sources to less than 7% of total calories
        • An 1800 calorie meal plan should have <60 grams total fat and <14 grams saturated fat


  • Choose low fat or fat free dairy products daily
    • Low fat calcium products have been found to promote wt loss
    • Calcium
      • Contributes to positive bone growth and maintenance of bone density
      • Sources: low fat/fat free milk, yogurt and cheese, fortified soy milk and orange juice, dark green leafy vegetables, canned sardines and salmon with bones
      • Vitamin D
        • Low levels of vitamin D can lead to more rapid progression of osteoarthritis
        • Sources: fish-liver oil, butter and cream, egg yolks, liver, fortified milk and dairy products, fortified cereals


  • Needed to build healthy tissues
  • Choose lean poultry, fish and seafood, nuts, legumes and seeds
  • Fatty red meat may trigger inflammation- choose lean cuts and limit
  • Soy proteins
    • May held reduce pain and inflammation
    • Sources: soybeans, soy nuts, tofu and soy milk
    • Try to limit processed soy foods
Foog Guide Pyramid
Food Guide Pyramid

Written by Julie Katz, Registered Dietitian- Baltimore, MD


Sitting Posture at the Computer

How to Maintain Good Sitting Posture at the Computer

We spend a lot of time sitting in front of the computer. Sitting at the computer improperly can lead to injuries at the neck, back, wrist and elbow.  Below are guidelines to help maintain good posture while sitting in front of your computer.

  • To support the low back while sitting, make sure to sit with your back touching the back of the chair and use a lumbar support.  The lumbar support should fill the space in the curve of the low back to avoid pressure on your spine and reduce muscle fatigue in the low back muscles.
  • Your feet should sit comfortably, flat on the floor.  If they don’t reach the floor, use a footstool. Your hips should be slightly higher that your knees.
  • Do not twist or reach while you are using the computer and make sure your work is in front of your body.  Your wrists should be straight and avoid using a wrist rest.  A wrist rest tends to put a strain on the neck and shoulders because it elevates the height of your wrist from the table surface.  Your keyboard should be at elbow level and you want your elbows and upper arms resting close to your body.
  • The computer monitor should be an arms length distance away from you (about 20 inches). Your eyes should be in line with a point on the screen 2-3 inches below the top of the monitor.  Research suggests that having the center of the screen 17.5 degrees below eye level is optimal for neck alignment and for reducing glare.
  • Try to take breaks from sitting because being in one position for too long can stiffen muscles.  A couple of exercises you can do during the day to prevent neck stiffness includes: rolling the shoulders forward and backward, gently rotating your head, and side bending your head to stretch the neck muscles.


Harbor Physical Therapy is offering FREE Wellness Sessions at the Merritt Athletic Club Fort Avenue on November 15th from 7AM-9AM and 2PM-6PM.  Please contact Harbor Physical Therapy 443-524-0442 or the Merritt Athletic Club 410-576-2004 with any questions. 

Merritt Athletic Club Fort Avenue
921 East Fort Avenue
Baltimore, Maryland 21230

Physical Therapist vs. Chiropractor

Many patients are curious about the difference between these two health practitioners.

Chiropractors specialize in manipulating bone structure (such as the spine) to improve the function of the joints and or nervous system.  They are very well known for manipulating the spine to help decrease low back pain.  A lot of patients frequent a chiropractor’s office several times a year for many years to manage their ailments.  A chiropractor has an aggressive approach to treatment.

Physical Therapists specialize in treating injury or dysfunction with exercises, manual techniques, neuromuscular re-education, and postural re-education to improve function throughout life.  A patient will attend a physical therapist 2-3 times a week for on average 6 weeks to improve function/decrease pain and gain education on how to further these gains with independent exercise.  Physical Therapy is a conservative treatment option and one which should be used in the first line of defense against injury.

In my professional opinion, it is in the patient’s best interest to understand the difference between these two disciplines before choosing the treatment option that is appropriate.  With acute injury, one should first go to a physical therapist.  If the patient has tried physical therapy and finds they have not met their goals, then they should look into seeking a chiropractors services.  A chiropractor offers more of an aggressive approach to treatment by using manipulations so a lot of times this is inappropriate for an acute injury, such as a car accident, ankle sprain, sport injury, etc.

If you are unsure what type of discipline best suits you, feel free to contact Harbor Physical Therapy with questions.