There are two main types of orthotics: off-the-shelf arch supports and custom orthotics. A person is prescribed an orthotic to help normalize weight distribution with weight bearing. Some people tend to bear more weight through the inside or the outside of their foot. This in turn, can cause back, hip, knee, ankle, or foot pain. Orthotics correct imbalances, improve posture, and help to relieve pain with weight bearing activity.

Off- the- shelf orthotics (or arch supports) can be found in retail stores. They are a less rigid type of shoe insert costing approximately $30.00 to $50.00. Unless you have a severe biomechanical foot problem, initially you will be recommended to purchase an arch support.

Custom Orthotics can be created by a Podiatrist or Physical Therapist. Custom orthotics helps people that require more assistance with their foot posture. An orthotist will take a plaster cast mold of your foot to create an orthotic. This orthotic is usually the most rigid of all the orthotics. It may take several months for your foot to get used to the orthotic. Custom made orthotics are expensive. Some health insurances will cover a portion or all of the expense.

Sleeping Positions

Positions you should avoid:

1. Lying on your stomach– This position makes you maintain a position of head rotation. This causes your neck muscles to shorten and can result in pain and stiffness in the morning. Also, sleeping flat on your stomach extends your low back which causes shortening and tightening of the low back muscles.

2. Lying on your side with your arm above your head– This position can create shoulder pain. You can compress the nerves in your shoulder causing your arm to go numb. Also, you are impinging the shoulder joint. This can cause stiffness and soreness at the shoulder joint.

Ideal sleeping positions:

1. Lying on your side with your arms in front of your body and a pillow between your knees– This causes decrease strain on your shoulder and allows your back muscles to remain relaxed. The amount of pillows under your head should be determined by your neck position. Your neck position should be in a slightly flexed position compared to the rest of your body.

2. Lying on your back– In this position, you should make sure you are using the correct amount of pillows as noted above. Also, place pillows under your knees to create a position of decrease strain on your lower back.

Please note if you have current or previous injuries, the position you favor will depend upon making the area of injury as comfortable as possible. If you continue to have difficulty getting comfortable in bed, make an appointment to your local physical therapist. The therapist will determine which position will better suit you based upon your past and current medical history.

Back Pain and Pregnancy

Many pregnant women develop back pain. This is due to increased weight gain causing stress on the spine. By having increased stomach weight, one develops a increased lumbar curve putting strain on the back musculature. Many women find themselves seeking physical therapy to help to decrease their back discomfort. Physical Therapy consists of manual treatment to the back, heat, stretching, and core/pelvic floor exercises. If you are pregnant and experiencing back pain, please contact our facility for an appointment.

Morton’s Neuroma

A Morton’s neuroma is a thickening of the tissue around one of the nerves leading to your toes. Most commonly it occurs between your 3rd and 4th toes. It is also most common in middle aged women and early intervention is important.

Symptoms of a Morton’s neuroma include, tingling, numbness, burning, or pain at the ball of the foot. A common report is symptoms mimicking something stuck to the bottom of your foot.

One of the most common causes is improper footwear. Wearing shoes without much support like flip flops, high heels, and flats can cause a compression and irritation of the nerve. Other causes are previous foot problems and repetitive damage from sports.

Early treatment should include ice and changing footwear. If symptoms persist, consult with your local physical therapist. Physical Therapy would include massage to the foot, stretching, and exercises. This works to help to decrease inflammation and increase blood flow to promote healing. A physical therapist can also educate you on proper foot wear and orthotics. Injections may be needed to help decrease the inflammation. If conservative measures are not successful, surgery is performed to release pressure on the nerve.

“No Pain, No Gain” Theory

When working out, it is normal to feel fatigue and muscle burn with strength/endurance training. But you should be aware of the difference between muscle fatigue versus pain. If you experience pain while working out, you should stop the activity you are doing. Pain can develop from inflammation, bad form with exercise, and overuse of a specific muscle. Pushing yourself too far could lead to an injury that can prevent you from doing the sports or exercises you enjoy. Use ice to decrease the pain developed from the exercise. If your symptoms do not lessen with ice and rest, visit your local physician or physical therapist.

X-ray vs. MRI

An x-ray determines the alignment and condition of your bones. Examples of things x-rays can display are deformities of the spine, fractures, bone spurs, tumors, spaces between the discs of the spine, and infections.

MRI stands for magnetic resonance imaging. MRI’s will determine the condition of your muscles/ligaments and the discs in your spine.  Your doctor may not order an MRI initially. Typically no matter what is displayed on the MRI, a physician would recommend physical therapy as the first form of conservative treatment.  An MRI will help the doctor determine if surgery is required for your injury.

Food Safety in the Summer

Food can spoil easily on hot summer days; follow these tips to prevent spoiling your fun with food borne illness. 

  • Plan picnics to include foods that don’t require refrigeration: fruit salad vs. pasta salad (mayo can spoil), PB and J vs. meat sandwiches
  • If the temperature outside is above 90 degrees, food cannot stay out for longer than 1 hour

 Practice Safe Food Handling Techniques:

  • Wash hands, utensils, and food preparation surfaces – moist towelettes are a quick and easy choice for your hands when playing outdoors
  • Rinse fresh fruits and vegetables with water before packing
  • Serve safely keeping cold foods cold (<40 degrees) and hot foods hot (>140 degrees)
  • Don’t cross-contaminate: wash all surfaces very well that have touched raw meats and juices.  Keep raw meats wrapped so that juices don’t touch other foods
  • When preparing salads, chill ingredients before combining (even canned tuna should be chilled before mixing in the mayo!)

Transport Foods Safely:

  • Transport perishables as quickly as possible, and cook immediately or refrigerate
  • Keep perishables refrigerated until just before leaving
  • Consider packing beverages in a separate cooler from perishables
  • Meat, poultry, and seafood may be packed frozen so it stays colder longer
  • Plan food portions to avoid leftovers; place condiments in small containers
  • Place cold foods in an insulated cooler with ice packs and don’t pack up until you’re almost ready to leave. You can also nest perishables in bowls of ice to stay chilled
  • Carry your cooler in an air-conditioned car and place in the shade; keep the lid closed as much as possible
  • Discard leftovers if they have been out of the cooler for longer than 1 hour; if you have to question it – throw it out!

Written by Julie Katz Registered Dietitian- Baltimore, MD


If you are planning on swimming for exercise, you should warm up before you begin your workout. 

 A warm up:

            – Increases blood flow to the muscles in your body.

            – Increases your heart rate to prepare your body for exercise.

            – Decreases stiffness in your joints.

            – Increases range of motion of your shoulders and legs.

 Warm up ideas prior to swimming:

            – Jumping rope

            – Squats

            – Arm Swings

            – Lunges

After your swimming workout, you should perform stretching exercises to prevent muscles soreness.

 Important muscles to stretch for swimmers:

            – Hamstring

            – Pectoralis                                                           

            – Rhomboid

Rhomboid Stretch