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So far Tony Grabiec has created 6 blog entries.

Fall clean up

Fall clean up  is upon us.  For most this includes: Lifting and moving patio furniture, organizing garages, raking and dragging leaves. All these activities can bring on injury, especially in the low back. Proper identification and preparation can prevent injury and optimize time spent performing these chores.

Identification – Can I lift and carry this item without sustaining an injury?

When preparing to perform lifting tasks it is always important to size up the item that is to be lifted. Items that are too large or awkward may require assistance, and proper technique is always needed to avoid injury, even with a 2+ person lift.

Preparation – Have I properly loosened up to lift this object?

It may seem silly to think that you should need to provide time to warm up prior to performing lifting tasks, but for lifters who are advanced in age or have had prior injury, it can be essential to avoid reinjury. Warm ups consisting of use of heat or stretching techniques can significantly decrease risk of injury/reinjury. For persons who have forgotten or have not been educated in such techniques, resources such as the internet or your physical therapist can be utilized.

Technique – Am I lifting this object correctly?

Even smaller, lighter objects can cause injury with repetition or incorrect posture. It is important to assess posture when performing these lifting tasks. Straight back, use of legs, item held close to the body are some of the finer points of lifting that cannot be ignored. Also, with regards to multiple person lifts, teamwork is vital for injury prevention. Having a team leader to count “1,2,3,lift.” Can be important to insure proper technique.

Pacing – Have I done too much, too quickly?

In the race to finish, sometimes the lifter can perform these tasks too quickly or sloppily but if they continue over a longer period of time that may worsen the injury/reinjury. Knowing “When to say when” is also important for injury prevention. Taking frequent breaks every 30 to 60 minutes (dependent on personal ability and tolerance) can help to prevent injury as well.

In summary, injury caused by repetitive fall cleaning activities can be lessened or avoided by these simple points of emphasis. As always, if you do sustain an injury, you should consult your physician and come and see your friends at Wilton PT.

Staying motivated

Staying motivated

Regular physical activity can increase hormones that can make you feel happier, sleep better and improve your skin’s appearance.  In addition regular exercise can help you lose weight, decrease your risk of chronic disease and improve your sex life.  Most health benefits occur with at least 150 minutes of moderate aerobic exercise per week and at least two days a week of high intensity aerobic exercise and resistance training for muscle development.  Participating in a regular exercise program takes time, discipline and motivation.  We all deal with the stress of work and busy families.   Life throws many distractions at us which can make it hard to stay motivated! Here are some suggestions to stay on track.

Activity choice

Whether it is running, cycling or kayaking if you enjoy doing the activity you will be less likely to skip workouts.  Consistency is the key to exercise and finding the right activity will keep you on the path.  

Make it social 

Finding a partner or a group is a great way to motivate you! Knowing you are meeting a group or a friend for a workout will make you accountable. Also working out with others can push you to new limits and drive your competitive spirit. 

Challenge yourself

There are a lot of athletic events to choose from.  Signing up for a triathlon or running race will give you something to train for.  Following a training plan and completing an event will give you a sense of accomplishment and can motivate you to sign up for more challenging events.  

Use technology

There are many apps out there that can help you stay motivated.  Peleton, Fitbit and my favorite, Strava are a just a few.  Strava is an app for runners/cylcists.  The app records users routes and various metrics such as distance and pace. The app also provides features for users to create weekly goals or participate in monthly challenges within the Strava community.   The ability to monitor progress and compete with others is a great way to keep you motivated.   “That which is measured improves.” Thomas S. Monson

Staying motivated can sometimes be a challenge but if you enjoy the activity, team up with others and challenge yourself it becomes easier to maintain a healthy lifestyle!



How to safely start an exercise program

How to safely start an exercise program

In the “new normal” many of us have more free time and started to exercise. Whether you are new to exercise or just getting back into it. There are a few things to be aware of to make your transition into the exercise realm safer. Here are some basic guidelines so you can make the most of working out and avoiding injury.

Choosing an activity

There are many exercise activities you can engage in but which is best? The best activity is the one you are interested in! This sounds pretty basic but if you enjoy an activity this will make it easier to be consistent and stay compliant.

Create a realistic schedule

Once you have decided on an activity you now have to fit it into your schedule. A lot of people set high expectations for themselves. “I am going to start going to the gym 5-6 times a week.” This is very ambitious and you may achieve this but for those just starting out this is unrealistic. A lot of people do not take into consideration all the time that goes into exercising. What you think may only take an hour may take 90 minutes because you forgot about packing your gym bag, driving or logistics of the equipment. All these things add up so it is best to take the first couple weeks to determine how much time the activity will take and then create your exercise. schedule. It is best to start with realistic attainable goals and then build as you feel more comfortable.

Injury prevention

Injuries often occur by increasing either volume or intensity of an activity in a small time frame. Just because you could bench 250lbs in college does not mean you can do it as a 40 something. The first 6-8 weeks of any exercise program should focus on achieving a base layer of fitness. Whether it is resistance or cardiovascular training you should do lower intensity and volume at first to give your body a solid base fitness level. After this base period you can start adding more volume and varying levels of intensities to achieve your desired neuromuscular adaptation. An example of neuromuscular adaptation would be a runner that wants to become faster. To become faster the runner would need to apply intensities that stimulate speed. This would include doing intervals or tempo runs above their normal pace.

Warm-up/cool down

One of the best ways to decrease risk of injury is to incorporate some type of warm-up/cool down. Warming up stimulates blood flow, increases flexibility and prepares the body for the upcoming activity. Here are some examples of warming up:

*Light cardio (jog/eliptical/bike) for 10-15 minutes

*Dynamic stretching

*Foam rolling

Upon completion of most exercise activities your body is warm. This is a great time to stretch! Static stretching is most beneficial when tissues are warm and pliable. There are many theories on the durations of holding a stretch. The general consensus is between 30-60seconds holds of major muscle groups but consistency is the key! Incorporating in a 5-10 minute stretch session post workout will reap huge benefits in keeping you injury free!

Benefits of Cycling

Benefits of cycling

Most of my patients know I am an avid cyclist.  My experiences with cycling have been nothing but positive! I have seen beautiful landscapes, met wonderful people and racing has challenged myself both mentally and physically.  Personally cycling has helped me with managing stress, improving my time management and maintaining my health.  There are a lot of benefits of cycling but here are my top 5:

  1. Weight management– Cycling burns calories and builds muscle. The combination of these two characteristics helps keeping your weight down!
  2. Decrease heart and cancer risk– A research study https://www.bmj.com/content/357/bmj.j1456 from Glascow showed that cycling to work could cut a person’s risk of developing heart disease or cancer by half.
  3. Low impact– Cycling is not a full weight bearing activity which decreases overuse and injury rates.
  4. Strengthen your immune system– There is a lot of research that supports aerobic exercise such as cycling can reduce the instances of the common cold and improve upper respiratory  health.  Cycling to work also decreases exposure to confined spaces such as buses and trains where germs are prevalent.
  5. Improved mental health– Cycling releases adrenalin and endorphins, improves your sleep and helps you gain confidence from achieving goals (mileage, hills, races/charity rides).  It also allows you to see new places and meet more people!









Remember to always wear a helmet and get your bike properly fitted at a local bike shop.  Connecticut has a lot of great bike paths and scenic roads to explore.  Be safe and get out and ride!



What is telehealth?

Telehealth is a live, one-on-one video appointment with your PT. In these times of social distancing and public safety telehealth has become a viable option to treat patients. It enables patients to communicate with their physical therapist from the safety and comfort of their own home.

Benefits of telehealth:

  • Effectiveness: Studies have shown that telehealth visits are just as effective as “live” visits. Telehealth visits maintain patient consistency and compliance with their home exercise program resulting in positive outcomes.
  • Convenience: Telemedicine gives patients greater freedom to schedule appointments that meet their own specific schedules. There is no need to change your plans, reschedule work or find child care.
  • Personalized careDuring a private telehealth visit, you will work with your physical therapist in a one-on-one setting, without distractions. You also can involve family members or caregivers in your appointment, if you like.
  • SatisfactionThe majority of patients who have participated in telehealth physical therapy were satisfied with their experience and would do it again. Patients expressed feeling connected and supported by their telehealth physical therapist.
  • Transportation Telehealth visits eliminates commuting to the office, arranging rides for those who are unable to drive and decreasing driving risks when there is inclement weather.

What does a typical telehealth visit look like?

Patients will receive a link to join a HIPAA-compliant, encrypted, and secure face-to-face live audio and video connection. Once connected the visit will be conducted like a normal physical therapy evaluation or follow up appointment.

The evaluation will consist of acquiring the patient’s past medical history, subjective reports and a functional screen is performed to determine/confirm diagnosis. Patients will be given a home exercise program and review for proper form. Follow up visits will consist of monitoring the effectiveness of the home exercises and progress as indicated.

Does insurance pay for telehealth visits?

An increasing number of payers do pay for telehealth and coverage is increasing. Most recently Medicare began to cover telehealth services for physical therapists.

Plantar Fasciitis

Spring is when we start to see flowers and of course patients with plantar fasciitis! The warmer weather brings us all out of our house to clean up our yards, walk around the neighborhood and start our running season. Sometimes people are a little over ambitious with their activities which can lead to a common orthopedic issue called plantar fasciitis.

What is it?

Plantar fasciitis is an inflammation of the plantar fascia. The plantar fascia is a thick fibrous band of tissue that spans from your toes to your heel. Its main job is to give support to your arch. When you take a step the plantar fascia stretches and when you swing your leg through it returns to its resting position. This is called the “Windlass effect”. When there is an increase in standing, walking and running there is a chance the plantar fascia can become inflamed due the repetitive stretching.


Pain in the arch and heel. Pain mostly with weight bearing and especially with the first few steps in the morning.

So how can we prevent plantar fasciitis?

  1. Always wear proper footwear. If you are going on a long walk leave you flip flops in your beach bag! A good supportive walking or running shoe will be best.
  2. Monitor your volume and intensity. Whether you are a seasoned runner/power walker or someone just getting into exercise you do not want to increase either volume or intensity too quickly. Example: if you normally run/walk 3miles 3 times a week jumping to 6miles 3 times a week is a dramatic increase in volume which can lead to tissue breakdown.
  3. Watch your weight. Excess pounds puts extra stress on your plantar fascia
  4. Massage your arch. A great way to keep the plantar fascia happy is to massage it. An easy way to do this is stand on a lacrosse ball and roll your arch with some pressure for a few minutes.
  5. Stretch your calves! Tight calves can lead to decreased ankle mobility which places more strain on the plantar fascia.

A lot of the time plantar fasciitis is self limiting and should improve with modifying activities, footwear and proper stretching. If you find that you continue to have pain in your arch or heel then it is time to consult with a physical therapist. Be safe and stay active!!