Exercise (over 65 years of age)

Older adults should do some type of physical activity every day. The more you exercise the better. Avoid injuries.

Adults aged 65 and over should:

Aim to be physically active every day.

Do activities which improve strength, balance and flexibility at least two days a week.

Perform 150 minutes of moderate intensity exercise a week or 75 minutes of vigorous intensity exercise per week.

Reduce time sitting or lying. Stay active throughout the day.

If you've fallen or are worried about falling, doing exercises to improve your strength, balance and flexibility will help make you stronger and feel more confident on your feet.  Please talk to your healthcare provider before starting any exercise routine.

What counts as light activity?

Light activity is moving rather than sitting or lying down.

Examples of light activity include:

Getting up to make a cup of tea.

Walking at a slow pace.

Cleaning and dusting

Vacuuming

Making your bed.

Standing up and moving around

What counts as moderate exercise?

Moderate exercise will raise your heart rate, and make you breathe faster and feel warmer. While performing moderate exercise, you can still talk but not sing.

Examples of moderate intensity activities are:

Brisk walking

Water aerobics

Riding a bike.

Dancing

Playing doubles tennis

Pushing a lawnmower.

Hiking

What counts as vigorous intensity exercise?

Vigorous intensity activity makes you breathe hard and fast. If you're working at this level, you will not be able to say more than a few words without pausing for breath.

Examples of vigorous activities are:

Jogging or running.

Aerobics

Swimming fast.

Riding a bike on hills

Hiking uphill

Singles tennis

Football

Energetic dancing.

Martial arts

 

What are muscle strengthening activities?

To get health benefits from strength exercises, you should do them to the point where you need a short rest before repeating the activity.

Examples of muscle-strengthening activities are:

Carrying heavy objects 

Yoga

Pilates

Tai chi

Lifting weights.

Working with resistance bands.

Using your own body weight for exercise. Like push-ups, situps

Heavy gardening like digging, shoveling

 

You can try other exercise routines like sitting exercises, strength exercises, flexibility exercises, balance exercises with the help of a trainer.

You can do activities that strengthen your muscles on the same or different days as your aerobic activity – whatever's best for you.

Muscle-strengthening exercises are not always an aerobic activity, so you'll need to do them in addition to your 150 minutes of aerobic activity.

Exercise (19-64 years of age)

Physical activity is good for you.

Adults between 19-64 years of age should:

Aim to be physically active every day.

Perform strengthening exercises that work big muscles of the legs, hips, back, abdomen, chest, shoulders, arms at least two days a week.

Perform 150 minutes of moderate intensity exercise per week, or 75 minutes of vigorous intensity exercise per week.

Decrease the amount of time sitting or lying down. Move around throughout the day as much as possible.

You can also get your weekly activity target with:

Multiple small sections of very vigorous intensity exercises.

A mix of moderate, vigorous and very vigorous intensity exercises.

You can do your weekly target of physical activity on a single day or over 2 or more days. Spreading the physical activity over multiple days will prevent exercise related injuries.

Make sure the type and intensity of your activity is appropriate for your level of fitness. Vigorous activity is not recommended for previously inactive patients.

You can start with light intensity exercises, and increase to moderate intensity exercises.

What is moderate aerobic exercises?

Moderate activity will raise your heart rate, and make you breathe faster and feel warmer. One way to tell if you're working at a moderate intensity level is if you can still talk in short sentences, but not sing.

Examples of moderate intensity activities:

Brisk walking

Water aerobics

Riding a bike.

Dancing

Playing doubles tennis.

Pushing a lawnmower.

Hiking

Rollerblading

What is vigorous exercise?

Vigorous intensity activity makes you breathe hard and fast. If you're working at this level, you will not be able to say more than a few words without pausing for breath.

Most moderate activities can become vigorous if you increase your effort.

Examples of vigorous exercises are

Jogging or running.

Swimming fast.

Riding a bike uphill

Walking up the stairs.

Sports like football, hockey

Jumping rope

Gymnastics

Martial arts

Aerobics

What counts as very Rigorous exercise?

Very vigorous activities are exercises performed in short bursts of maximum effort broken up with rest.

This type of exercise is also known as High Intensity Interval Training (HIIT).

Examples of very vigorous activities are

Lifting heavy weights.

Circuit training

Sprinting uphill

Interval running.

Running upstairs

Spinning classes

Which activities strengthen muscles?

To get health benefits from strength exercises, you should do them to the point where you need a short rest before repeating the activity.

Examples of muscles strengthening exercises are

Yoga

Pilates

Tai chi

Lifting weights

Working with resistance bands.

Using your body weight for exercise like push-ups, situps

Heavy gardening like digging, shoveling

Wheeling a wheelchair.

Lifting and carrying objects, children without injuring yourself

 

Muscle strengthening exercises are not always an aerobic activity, so you'll need them in addition to 150 minutes of aerobic activity.

 

Insomnia

What is insomnia?

Insomnia means you have difficulty sleeping on a regular basis. It usually gets better by changing your sleeping habits.

What are the symptoms of insomnia?

Find it hard to go to sleep.

Waking up multiple times at night.

Lying awake at night

Waking up early and cannot fall asleep again.

Feeling tired after waking up

Difficulty napping during the day even when you try

Feeling tired and irritable

Difficulty with concentration because you're tired.

How much sleep does one need?

Adults on an average require about 7-9 hours.

Children 9-15 hours.

Toddlers and babies 12-17 hours.

What are the common reasons for insomnia?

Uncontrolled stress, anxiety or depression.

Noise

Room that is too hot or too cold.

Uncomfortable bed, pillow.

Alcohol, caffeine, nicotine, recreational drugs.

Jet lag

Irregular sleep schedule like shiftwork, graveyard shift

Self-help for insomnia?

Go to bed and wake up the same time every day[Even during holidays, vacation, weekends]. Go to bed only when you feel tired. 

Start relaxing, winding down one hour before going to bed. You can take a relaxing bath, or read a paper book.

Make sure your bedroom is comfortable. It should be dark and quiet. You can use eye masks, ear plugs. Do not keep TV in the bedroom. Put your cell phone on silent mode.

30 minutes of moderate intensity exercise during the day. Avoid strenuous exercise before going to bed.

Make sure your mattress, pillow, covers, night dress are comfortable.

What are the things I should NOT do?

Do not use stimulants like tea, coffee and tea six hours before going to bed. Avoid alcohol six hours before going to bed.

Do not need a big meal at night.

Did not perform strenuous exercises at least four hours before bed.

Do not watch television, or use any devices with bright green like Cell phone, iPad, laptops, computer etc, one hour before going to bed.

Avoid napping over 30 minutes during the day.

Do not drive when you're sleepy.

Do not sleep in after a bad night sleep, or weekends. Stick to your regular sleeping hours all the time.

See your Healthcare provider if you continue to notice insomnia.

How can the healthcare provider help me?

Your healthcare provider can talk to you more about sleep hygiene.

They can prescribe medicines to help you with insomnia or conditions causing insomnia.

 Complications of insomnia.

Image result for insomnia

Shoulder pain

What are the symptoms of shoulder problems?

Pain and stiffness that does not go way over months or years.

Pain that's worse after using your arm or shoulder.

Tingling, numbness, week feeling like it's clicking on locking

Sudden bad pain where you cannot move your arm, or it changes shape.

Pain on the top of the shoulder.

Acute severe discomfort in the shoulder, preventing regular activities.

What should I do if I have shoulder problem?

Consult your healthcare provider.

You should see your healthcare provider right away if you have

Pain is sudden or very bad.

You are unable to move your arm.

Shoulder or arm has changed shape or severe swelling.

Pins and needles that do not go way.

No feeling in the arm or shoulder.

Arm or shoulder is hot or cold to touch.

Unable to move shoulder after trauma [ Falls, car accidents]

How can my healthcare provider help me?

Your healthcare provider will talk to you about the injury, perform a physical exam.

If it is determined necessary, your healthcare provider will order imaging tests. [X-ray, CT scan, MRI] 

They will prescribe medicines, exercises to relieve discomfort.

Self-help?

Consult your healthcare provider if there is any concern at any time.

Self-help is recommended only for mild symptoms.

Stay active and gently move the affected shoulder.

Try exercises recommended by your healthcare provider.

Stand up straight to your shoulders gently back.

Sit with a cushion behind the lower back.

Rest your arm on a cushion in your lap.

Use medicines prescribed by your healthcare provider for pain relief. You can use ice packs, heating pad. Avoid ice/heat burn injury to the skin.

Do NOT do the following.

Do not stop using your shoulder completely.

Do not do activities that make the symptoms worse.

Do not make up your own strenuous exercises, or use heavy gym equipment.

Do not slouch was sitting. 

Breathing exercise for stress

This calming breathing technique for stress, anxiety and panic takes just a few minutes and can be done anywhere.

You will get the most benefit if you perform these exercises for 5-10 minutes twice a day on a daily basis even when you are feeling well.

You can do it standing up, sitting in a chair that supports your back, or lying on a bed or yoga mat on the floor. 

Find a quiet room with comfortable temperature.

Make yourself as comfortable as you can. If you can, loosen any clothes that restrict your breathing.

If you're lying down, place your arms a little bit away from your sides, with the palms up. Let your legs be straight, or bend your knees so your feet are flat on the floor.

If you're sitting, place your arms on the chair arms.

If you're sitting or standing, place both feet flat on the ground. Whatever position you're in, place your feet roughly hip-width apart.

Take a slow deep breath from your nose, and let it flow deep into your belly without forcing it.

Breathe out slowly through your mouth.

Breathe in and out very slowly. You can count steadily from 1 to 5 in your head when you taking a deep breath in.

You can count 1 to 5 steadily as you are breathing out.

Keep taking deep, slow breaths in and out for 10 minutes. 

Information

At the time of office visit, please present your insurance card.  We bill your visit to the insurance card you present. 

In the event of an error in your insurance, please let our front office staff know.

We are in network with most insurances. However individual plans may vary and not known till a claim is adjudicated.

We are a smoke free facility.

We need every patient to finish all the forms online and check in online if possible. 

Most visits start on time, so please plan to be at the office, fifteen minutes before your appointment.

Habitual no show patients are terminated from the patient panel.

We charge a no show fee.

If you are not able make the commute, or take time off for commute , explore tele medicine available now.