Activities of Daily Living Archives - MelioGuide

Stair Negotiation Exercises

Margaret Martin — Mon, 19 May 2025 15:50:29 +0000

May 19, 2025

Do you find yourself dreading stairs, even fearful of them? Do you wish you could comfortably negotiate stairs like you used to rather than just relying on your strongest leg? This post presents stair negotiation exercises – both for going up stairs as well as going down stairs. These exercises will improve your stair negotiation ability – at home, while shopping or visiting family. You will feel safer in your own home and everywhere you travel.

Over my forty years of work as a Physical Therapist, I have helped hundreds of individuals recover from surgery, car accidents, and de-conditioning. The key is to rebuild their strength and confidence. It can take a little training, breaking old habits, learning new ones but everyone succeeds and you will too!

Stair Negotiation Exercises

A lot of my clients have either moved into single level bungalows or retirement homes with elevators. They might have to step up onto a sidewalk or the entrance into their homes, but rarely encounter a set of stairs.

As a result, they haven’t negotiated stairs in a long time. When they visit families in multi-story homes, attend appointments in buildings with stairs, they are surprised by the challenge of climbing or descending a set of stairs.

These are big issues for them. They haven’t done an eight inch step in a while and they soon experience knee and hip pain. They are often fearful of losing their balance and falling.

Today I will show you how to get back to doing steps, feel safe and strong enough to negotiate stairs, and regain your confidence.

Exercise to Easily Negotiate Going Down Stairs

Going down stairs, as you know, can be difficult and scary. Stair negotiation is more challenging going down stairs than going up stairs.

Why is that?

Going down stairs requires your legs muscles to control the lowering of each leg. This is an eccentric contraction, the most demanding type of muscle contraction. Going up stairs is a concentric contraction and is much easier and less demanding on the leg muscles.

To master going DOWN stairs, you will build up to doing this controlled lowering, eventually on just one leg. I show you a step wise progression in the video below.

Start With 50% Of Your Weight On Each Leg

Start with fifty percent of your weight evenly distributed on each leg. Follow these steps as demonstrated in the video:

Stand tall with your feet hip width apart.
Use a stool, a stacked pillow on your sofa, or a tall bed to practice from.
Take a relaxed breath in.
Exhale and slowly lower yourself into the chair. Keep your knees over your feet.
Exhale through the move. It will help give you more core stability and balance and help reduce the fear or anxiety your body may be feeling. No need to go very deep.

The range you need for stairs is about half of what you need when sitting on a chair.

Start with three to five repetitions.
Build an extra repetition every other day until you can comfortably do ten repetitions.

The goal is to build your strength gradually so as not to flare up any joints and to allow all the muscles around your hips and knees to strengthen.

Gradually Increase The Amount of Your Weight You Support on One Leg

Work towards being able to hold all your weight on one leg. It may take a few weeks to build the strength, but you will get stronger and the stairs will get easier to negotiate.

Place a sturdy chair in front of the surface you have been working from, then stagger your feet so that you can feel 60% of your weight going through the back foot and 40% on the front.

In the video, I place a second chair in front of me. Behind me is the other chair. This position is secure so I am now able to stagger my stance and distribute my weight. I start with a 60/40 weight distribution and build from there.

Do five on each leg.
Gradually build to ten on each leg.
Some of you may be able to add more weight faster than others. You are all unique and will progress at the pace that you can.
When it starts to feel easier, place seventy percent of your weight on your back leg.
Every other day gradually add a little more weight onto your back leg.
Slowly over time build to ten repetitions on each leg.

Using the railing will allow you to take up the weight that you are not able to control on one leg. As you get stronger and able to control more of your weight through your knees, you will be able to rely less on the railing.

Exercise Recommendations for Osteoporosis

Exercise is an essential ingredient to bone health. If you have osteoporosis, therapeutic exercise needs to be part of your osteoporosis treatment program.

But what exercises should you do and which ones should you avoid? What exercises build bone and which ones reduce your chance of a fracture? Is Yoga good for your bones? Who should you trust when it comes to exercises for osteoporosis?

A great resource on exercise and osteoporosis is my free, seven day email course called Exercise Recommendations for Osteoporosis. After you provide your email address, you will receive seven consecutive online educational videos on bone health — one lesson each day. You can look at the videos at anytime and as often as you like.

I cover important topics related to osteoporosis exercise including:

Can exercise reverse osteoporosis?
Stop the stoop — how to avoid kyphosis and rounded shoulders.
Key components of an osteoporosis exercise program.
Key principles of bone building.
Exercises you should avoid if you have osteoporosis.
Yoga and osteoporosis — should you practice yoga if you have osteoporosis?
Core strength and osteoporosis — why is core strength important if you have osteoporosis?

Enter your email address and I will start you on this free course. I do not SPAM or share your email address (or any information) with third parties. You can unsubscribe from my mail list at any time.

Five Simple Tips to Easily Negotiate Going Up Stairs

If you have knee pain, feel unstable, or feel winded by the time you reach the top of the stairs, the following five tips will help you with all of these. I cover these in my video below:

Follow these steps:

Start with a smaller step height to practice the new technique and gain confidence.
When possible, place your whole foot on the step.
Keep your knee over your foot and not in front of it, nor to the side of it.
Bring your butt back and bend from your hips. This sets up your strongest leg muscle, your buttocks, to do more of the work. Take a breath in …
Exhale through pursed lips as you PUSH the STEP away from you, bringing your hips forward. Feel the tightening in your butt muscles.

Breath Control and Stair Negotiation

The exhalation with the effort will help you recruit your core muscles and make you more stable.

Coordinating your breath will also ensure you’re not holding your breath. You will not be out of breath by the time you reach the top. Your body will interpret your breathing and know that you are in control!!

Practice this with the support you need to feel safe and secure as you regain confidence in your legs. Once you have mastered a three to four inch step, you are ready to go to a full sized step.

Stair Negotiation: Strengthen Your Lower Body

Stronger legs (and lower body) will make stair negotiation much easier. You can supplement the two routines above with some simple leg strengthening exercises. The video below includes three leg strengthening exercises for beginners.

My strength training guide is an excellent resource as well.

Stair Negotiation: Improve Your Balance

Good balance and stability will increase your safety and help you go up and down stairs with more confidence. The two balance exercises in this video are designed to help you improve your balance.

My balance and fall prevention guide is an excellent resource as well.

Stair Negotiation: Posture

Posture influences everything – your balance, your strength, flexibility, and agility. As a result, postural alignment has a significant effect on stair negotiation. Here are two posture exercise videos you can use to improve your posture. My Posture Guide is another great resource.

Stair Negotiation Exercises in the Pool

Some of my clients are lucky enough to live in condominiums where there’s a pool. The pool will have stairs going down into the water.

If you start on the stairs that are in the water, the buoyancy of the water will help lift up your body weight and will help you do the steps. This technique allows you to start right away with a six inch step or seven inch step.

Start with the water at chest height and then progress to a higher step so that the water is eventually at hip height. The water buoyancy will gradually support more of your body weight on the step.

Osteoporosis Exercises

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Extra Safety Tips

Here are a few tips that will make your stair negotiations much safer:

Use handrails to provide support and stability.
Wear footwear that is stable and provides good traction.

Poor control with stairs is often an indicator of overall de-conditioning. Follow a safe and progressive exercise program that helps you regain your strength.

Conclusion

Physical therapy exercises for stair negotiation can transform your relationship with stairs from one of anxiety to confidence. By following the progressive stair negotiation exercises outlined in this post—practicing controlled lowering for descending stairs, mastering the five tips for ascending stairs, and even utilizing pool exercises when available—you can rebuild the strength and technique needed for safe stair negotiation.

Remember that everyone progresses at their own pace. What matters most is consistency and gradually building strength without flaring up your joints. With practice, you’ll find yourself relying less on handrails and feeling more secure in your movements.

Whether you’re visiting family in multi-story homes or navigating public buildings, the exercises and techniques shared here will help you move with greater ease and confidence. As I’ve seen with hundreds of clients over my forty years as a Physical Therapist, everyone can succeed with the right training—and you will too!

Don’t let fear of stairs limit your independence or quality of life. Start with these exercises today, be patient with yourself, and soon you’ll be negotiating stairs safely wherever life takes you.

Margaret Martin

Margaret Martin is a Physical Therapist with 40 years of clinical experience. Her expertise is in the treatment and prevention of osteoporosis through exercise, safe movement and fall prevention. For the last 20 years, she has concentrated on bone health and has treated thousands of patients for their osteoporosis, osteopenia and low bone density.

How to Get up From a Fall

Margaret Martin — Mon, 04 Nov 2019 20:50:31 +0000

One of the things I check with both new and existing patients is if they know how to get up from a fall. I ask them when was the last time that they practiced lowering themselves to the floor and then getting back up. Getting on and off the floor is an important part of an overall fall prevention assessment. I am not surprised when clients hesitate to tell me that it has been a long time since they practiced how to get up after a fall.

I have a large, dense one-inch foam mat that we use to explore best options for getting down and back up. We practice the two technique I present in the video below and describe in this blog.

If you are someone who does not have a strategy for getting up from the floor, I encourage you to watch this video and read this blog. Having a strategy is good, but practicing your strategy on a regular basis allows it to become instinctive. Knowing that you are able to get up from the floor removes some of the fear of falling.

I hope that you use and practice one of these techniques. Please do not practice these alone if you are not certain that you can get up and down successfully. Wait until you have a family member with you or you book time to work with a Physical Therapist who can assist you to in finding the best strategy for you.

How to Get Up After a Fall • A Case Study

If you are a regular reader of this blog, you may recall my client, Babs, who is featured in earlier blog posts on balance. One of her weekly exercises was to get down to the floor, practice a few feet of crawling forwards, get down onto her tummy, do a few knee bends or some other exercise, press back to her hands and knees and crawl backwards to get up again.

On days that she did not have the energy or we ran out of time, we simply practiced crawling forwards and backwards from the foot of her bed. Crawling on her knuckles to make it easier on her wrists.

Shortly after her 96th birthday, I showed up for one of her weekly therapy sessions. I asked her if she had had a good night of sleep. She told me she had fallen during the night while returning from the bathroom but that she remembered our practice sessions and had crawled back into bed. She was proud that she had not spent the night on a cold floor. All her practice on how to get up after a fall had payed off.

Time flies and so be sure to include getting down and up from the floor on a regular basis. You want your technique to become so instinctive that you can just get on with life the way Babs did.

Balance and Fall Prevention

You are all aware, have read and heard numerous times that you will reduce your risk of falling if you improve your balance and are aware of fall prevention strategies.

However, falls do happen. The World Health Organization (WHO) estimates that 646,000 individuals worldwide die each year from falls and that falls are the second leading cause of accidental injury deaths. (1)

Like Babs getting up at night with the lights low is a common cause of falling. Other common causes of falls include catching your toe on a curb, missing a step, slipping on ice, or losing your footing.

Hopefully, you have practiced and you know how to get up from a fall. Even if you have not injured yourself physically, falling can injure your self-esteem and your pride. Being able to get up from a fall restores your pride. Not knowing how to get up can cause panic to set in and make matters worse.

Here are two different strategies you can practice at home. The detailed steps for each strategy that can help you get up after a fall are outlined below.

How to Get up From a Fall Using an Elevated Surface for Support

Roll onto your uninjured side after the fall.

If you have not injured your upper body choose the stronger arm or uninjured leg side. Alternatively, if you are able to get onto your hands and knees, crawl to a sturdy elevated surface such as a bed or chair.

Elevate yourself onto one forearm by pushing up with the arm on the top side and use the bottom arm to support you, once you have lifted your torso.

Move Towards a Chair (or Other Sturdy Elevated Surface)

At this point, drag your body across the floor on one forearm. This requires some strength. As a result, I encourage you to build your strength with side planks from a lying position. You could practice this press action on the floor or on a firm bed.
Take a moment to look around and choose the closest sturdy surface.
Drag yourself by alternating between pulling your knees then your forearm towards your destination.
To move forward, bring your knees up.
Use the strength of your legs to push or pull yourself along the floor as you make your way.
When you get to your destination (a bed or chair, for example), rest your head, catch your breath and gather your energy for the next part.
Get in close to the chair.
Use your arm to lift your torso up so that you can rest your arm on the chair.
Take as many pauses as you need.

From this position, you have two options.

Option 1 • How to Get Up From a Fall

In the first option, put most of the weight on your unaffected side, or the happier side, and lift yourself so that both arms and your upper body are resting on the chair. At this point do the following:

Use your good (pain free) side as your power side for arm support.
Use the leg on the opposite side as your power leg.
I suggest you transfer some of the weight forward. Push up through your arm and push down through your foot.
As soon as you can clear the chair, pivot over into the chair.
In the video, I cleared it a lot more than you actually would need to.

Option 2 • How to Get Up From a Fall

Consider option two on how to get up from a fall if you make it to the chair and you know you do not have have the strength in the supporting knee and one shoulder to execute the lift and pivot. In this instance follow these steps

Face the chair, rest both forearms on the chair.
Transfer weight into your forearms or onto your hands (if you have not injured your wrist).
Press firmly into the chair or bed.
Bring one foot back and then the other foot back. Keep your feet hip width apart for more stability.
Walk around far enough that you can then pivot your butt onto the chair.
Alternatively, you can bring your hands to your thighs and walk your hands up your thighs until you come to standing.

Exercise Recommendations for Osteoporosis

Exercise is an essential ingredient to bone health. If you have osteoporosis, therapeutic exercise needs to be part of your osteoporosis treatment program.

I cover important topics related to osteoporosis exercise including:

Can exercise reverse osteoporosis?
Stop the stoop — how to avoid kyphosis and rounded shoulders.
Key components of an osteoporosis exercise program.
Key principles of bone building.
Exercises you should avoid if you have osteoporosis.
Yoga and osteoporosis — should you practice yoga if you have osteoporosis?
Core strength and osteoporosis — why is core strength important if you have osteoporosis?

How to Get up From a Fall With No Elevated Surface For Support

I frequently teach my clients this second technique on how to get up from a fall. Clients that regularly exercise on the ground find it easy to do on a day-to-day basis.

Test Your Flexibility

You need to be somewhat flexible to do this technique. Here is how to test if you are flexible enough.

Lie on your back.
Lift your leg up.
If you are able to comfortably lift both legs close to 90 degrees, say between 75 and 90 degrees, then this technique is a real viable option for you to use.

How to Get Up From a Fall Technique

Go flat on your hands or your knuckles — whichever is more comfortable for you.
If you have fallen and landed on your shoulder, roll onto your stomach.
From here, tighten up your tummy muscles and push back.
Get your butt up in the air behind you.
Push back through your forearms with your butt up.
At this point, widen the space between your knees and keep the feet the same width as your knees.
Push up onto your knuckles or onto flat hands — depending on your wrists and your hands.
Your toes will have to tuck under.
Press and walk your hands back towards your feet.
As soon as you can get your forearms onto your thighs do so and rest for a moment.
Bring your hands to your thighs and rest for a moment (it will look like you are in a baseball shortstop posture).
Finally, walk your hands up your thighs until you come to standing.

If you found that this technique worked well for you, practice it every day. Come down into the shortstop position and then come down onto the ground. From here, come straight down onto your tummy, keep your tummy muscles nice and tight as you do so.

This is certainly a great and a safe alternative to get up from a fall.

Conclusion

We all have very unique bodies and medical histories including numerous aches and pains, arthritic joints and joint replacements. If neither of these strategies on how to get up after a fall worked for you, I encourage you to find a physical therapist near you who can help you work through your unique challenges.

Build your confidence getting up and down from the floor. This will help you feel you know how to get up after a fall and, in turn, reduce your fear of falling.

References

Falls. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/falls

Balance Exercises for Seniors Guidelines

For more information, check out my Balance Exercises for Seniors guidelines.

The post How to Get up From a Fall appeared first on MelioGuide.

How to Lift a Turkey In and Out of the Oven

Margaret Martin — Tue, 29 Oct 2019 19:36:36 +0000

Many of my clients entertain family and friends over the holiday season and meal preparation often falls on their shoulders. Turkey, roast beef, casseroles are popular servings this time of year. Each of these food servings can be very heavy and difficult to handle. Are there precautions you should take when you lift heavy food items, such as a roast turkey, in and out of the oven? What steps can you take to avoid a compression fracture, or back or shoulder pain? In this article (and companion video) I show exactly what you should do to prevent an unfortunate event and instead focus on enjoying the holiday season.

My First Suggestion

My first suggestion is to have another family member, not at risk of a compression fracture or back or shoulder pain, do the heavy lifting for you. However, if that is not possible here are several helpful tips to keep your spine, back, and shoulders safe this holiday season.

How to Safely Lift a Turkey, Roast or Casserole into the Oven

In the video, I placed a 21 pound weight in the roasting dish. Everything else in the video is authentic, other than the heat of the oven. I did not turn on the heat but I exercise the same level of caution as though the heat was on.

In one of my gardening blog posts, I describe how to safely move a heavy object. You might want to look at that blog post, as well. However, keep in mind two important differences:

It easier to lift, handle, move and place a cold object compared to a hot, unstable roasting pan.
The process of placing the large and heavy roasting pan in a narrow space adds an additional degree of complexity to the lift.

Let’s start with how you should place a cold turkey, roast or casserole in the oven to start the cooking process.

The first step is to get the heavy roasting dish right up against your body.
Then lower it down using a wide squat. I suggest a week or two or, even, three or months before the holiday season that you practice your squats. Over time, progress to the weight of the cooking item you want to lift.
Next pull the tray out as much as you safely can.
Test the stability of the rack by putting weight on it. Verify that the rack is able to handle the weight of the pan.
Come back up and get the roasting pan close to your body. It should touch you the whole time.
Now, place the roasting pan into the oven.

Hopefully by the time it is cooked and ready to come out, someone else is there to help you. If not, let’s move onto part two.

Tips on Squats

Squats are one of the most functional exercises you can do. You cannot get on and off a chair without going into a squat. Make the squat exercise a regular part of your exercise program. It will help you when you move heavy objects and in many regular day-to-day activities. The squat has many significant benefits including strengthening your hip and spinal muscles and bones. It should become a regular exercise for any one concerned about the bone density in their femoral neck.

There are several types of squat exercises to choose from. Listed below are four squat exercises in order of challenge as they are presented in the Exercise for Better Bones program. Find one that feels comfortable for you and over time progress to a more challenging level.

Exercise Recommendations for Osteoporosis

Exercise is an essential ingredient to bone health. If you have osteoporosis, therapeutic exercise needs to be part of your osteoporosis treatment program.

I cover important topics related to osteoporosis exercise including:

Can exercise reverse osteoporosis?
Stop the stoop — how to avoid kyphosis and rounded shoulders.
Key components of an osteoporosis exercise program.
Key principles of bone building.
Exercises you should avoid if you have osteoporosis.
Yoga and osteoporosis — should you practice yoga if you have osteoporosis?
Core strength and osteoporosis — why is core strength important if you have osteoporosis?

How to Safely Lift a Turkey, Roast or Casserole Out of the Oven

Several hours of cook time has passed and now the turkey, casserole or roast is ready to come out.

If you have not been able to recruit a young and strong volunteer to lift the roasting pan out of the oven, go back into the squat position that I demonstrated earlier.

It is a good idea to put on a protective chef apron. This will make it more comfortable as you bring the hot pan towards your body.

Place your elbows to your side.
Next, slide the pan as much as you can with your elbows in close.
Have the oven rack take the pan weight as much as possible. This will allow you to tuck the weight of the pan in against your body and avoid placing stress on your back as you squat down.

There are two additional steps:

Come in close again, elbows right by your side.
Use your legs to lift up, get in as close to the roast as you comfortably can, and push it back up.

Alternative Strategy for People Who Cannot Squat

Here is another option for those of you who feel that you don’t have the knees to come out of the squat. This technique can be used when you put the roasting pan in the oven and take it out.

The first step is to lower yourself into a single leg kneeling position on a padded surface at the front of the oven.
You can fold up a carpet at the base of the oven. Several folds are all you need to support your knee.
Open up the oven door.
Remember that the roasting pan is likely very hot.
Use your protective oven mitts to pull it out.
Limit the rotation of your torso as much as possible. Pivot around on your knee until you are in a comfortable position. The roasting pan should face your belly button.
Slide the roasting pan along the chair as much as you can.

One of your challenges will be to keep the roasting pan as close to your body as you can and still withstand the heat.

The movement to get the roasting pan into the oven is a very quick transition.

Lean forward, hinge from the hips, stay long through the body, and maintain perfect posture as you push the pan inside the oven.
Do a very similar movement when you take the turkey back out from the oven.
Get into a kneeling or half kneeling position. Come down.
Pull the tray as close as you can.
Slide the turkey as close as you can along the tray.
Position elbows along and close to your body. Have at least one elbow close and at the side, if you can’t get both to your side.
The long oven mitts help protect your hands and lower arms as you hold the hot roasting pan.
Lift and pivot back. Close the oven door.

Conclusion

I encourage you to use these tips and make your holiday season safe and joyful.

Thank you for tuning in. I’m Margaret for MelioGuide.

Activities of Daily Living

Visit my page dedicated to Activities of Daily Living.

The post How to Lift a Turkey In and Out of the Oven appeared first on MelioGuide.

Safety Tips on Cutting Grass

Margaret Martin — Thu, 12 Apr 2018 12:54:43 +0000

Individuals with osteoporosis or low back pain and people recovering from either a hip replacement or knee replacement need to pay special attention to their movements when mowing the lawn. I cover these safety tips and more in this blog post on cutting grass.

Safety Tips for Cutting Grass

Those of you with low bone density, osteopenia, or osteoporosis need to pay special attention to how you cut your grass.

Individuals who have not followed a regular conditioning program need to be careful not to cause back, shoulder or neck problems.

If you have osteoporosis, osteopenia, or low back pain, you should follow these six safety tips on cutting grass:

Establish a power position behind the lawnmower.
Push with your legs, with both hands placed shoulder-width apart on the mower handle.
Make sure the height of your lawnmower is adjusted to your height.
Look back before you start moving backwards.
Use a double-arm pull-back technique rather than a single arm.
Trim low-hanging branches before you cut grass to avoid bending under the branches.

Later in the post, I provide guidance for people who are recovering from either a hip replacement or knee replacement and want to get back to mowing their lawns.

Lawn Mower Position When Cutting Grass

It is important that you establish a power position behind the lawnmower. This will allow you to push through with your legs and torso and not rely exclusively on your arms and back while cutting grass.

Mid waist is an ideal power position.

Get your elbows in and push the lawn mower from the legs.

In the power position, the handle should be sitting above the height of your hips and below the height of your chest. Somewhere mid-waist is a really good power position.

The power position is especially important when you’re initiating the push of the mower. For example, if you start from a standstill position or if you encounter an uphill grade with long grass, you need to get more power behind the mower.

Make Sure the Height of Your Lawn Mower is Correct

Before you start cutting grass make sure that the lawn mower height is correct for you. Someone may have used the lawnmower before you and the height could be too high or too low.

The correct height should align with your power position.

Get your elbows in and really push from the legs.

For a tall or short individual, move the handle bar setting so that the whole handle gets moved up and allows your hand position to be in a much safer and better position for your height.

Walking Forwards and Backwards When Cutting Grass

If you want to reduce the strain on your back, you should use a double hand pull back instead of a single hand while cutting grass.

Also, make a point of looking behind you before moving backwards. You could easily trip on something and cause a fracture.

Low Hanging Limbs and Cutting Grass

Consider trimming low hanging limbs before you cut the grass. Many people have the habit of bending down and going under low hanging tree branches to access parts of the lawn below the branch.

Put your spine health ahead of your tree health.

Instead of continuously ducking underneath the low-hanging limbs, save yourself a lot of grief and save stress on your back by eliminating the low hanging branches.

Exercise Recommendations for Osteoporosis

Exercise is an essential ingredient to bone health. If you have osteoporosis, therapeutic exercise needs to be part of your osteoporosis treatment program.

I cover important topics related to osteoporosis exercise including:

Can exercise reverse osteoporosis?
Stop the stoop — how to avoid kyphosis and rounded shoulders.
Key components of an osteoporosis exercise program.
Key principles of bone building.
Exercises you should avoid if you have osteoporosis.
Yoga and osteoporosis — should you practice yoga if you have osteoporosis?
Core strength and osteoporosis — why is core strength important if you have osteoporosis?

Mowing the Lawn After Hip Replacement Surgery

I often work with patients after their hip replacement surgery. Many are anxious to return to an active lifestyle that includes garden work, mowing the lawn, cutting grass, and house work. Here are a few things to consider before mowing the lawns after hip replacement surgery.

Anterior or Posterior Hip Replacement Surgery

Pay special attention to whether you have had an anterior or a posterior hip replacement surgery. The type of contraindications during the six week period after hip replacement surgery are determined by the type of surgery.

Here are the two type of hip replacement surgeries:

Anterior approach involves an incision in the front of your hip. Your buttock muscles are unaffected.
Posterior approach involves an incision through through your buttock muscles and occurs behind your hips. Your buttock muscles are affected.

If you have had a posterior hip replacement surgery, your list of activities to avoid may include the following:

Bending your hip further than 90 degrees.
Crossing your legs.
Lifting your leg to put on socks.

It is important that you follow the guidelines given to you by your surgeon and rehabilitation team in order to protect the new hip from dislocation.

I believe that mowing your lawn after hip replacement surgery is not important enough that you join the 3% to 4% of people with hip replacement that have a hip dislocation. (1)

When Can You Mow the Lawn After Hip Replacement?

Eight to twelve weeks after a successful hip replacement, you should be able to safely mow your lawn. This assumes that you:

Can walk without any external support.
Have been diligent and done your prescribed therapeutic exercises. Your hip muscle strength and balance should be good enough that you can push a lawn mower on level ground with little resistance — as shown in the video.

I recommend you avoid pushing the lawn mower on steep inclines — at least until you have fully your strength, balance and mobility.

If you had complications from your surgery, are still challenged walking without support, or have poor balance I recommend you to seek further advice from a Physiotherapist on how to improve your strength, balance and gait before you mow your lawn.

Cutting Grass with Riding Mowers

The physical and cognitive demands of operating a riding mower are much greater than driving a car. Avoid operating a riding mower until at least two weeks after the period when your surgeon or rehabilitation team gives you the green light to drive a car.

On another note, riding a mower has more contraindications to a posterior approach than pushing your mower on level ground.

If you had a posterior hip replacement surgery, be aware of your seat position. Seat position affects the position of your hips relative to your knees. You should speak to your surgeon or Physiotherapist before jumping on your riding mower.

Also, be aware of the effect that pain and pain medication can have on your ability to safely drive.

Cutting Grass with Gas Mowers

To fuel the gas mower you need to knee down on the ground. I recommend that you not do this after either hip or knee replacement surgery. This might be a good time to consider an electric mower for both you and the environment.

Mowing the Lawn After Knee Replacement Surgery

Like hip replacement surgery, it is important that you follow the post-operative guidance given to you by your surgeon. If you can walk without any external support, you have been working on your hip and knee muscle strength, and your balance is good you should be able to safely push a mower on level ground with little resistance — as shown in the video.

Once you have mastered mowing your lawn on level ground, you can graduate to low inclines. It is wise to avoid pushing a lawn mower on steep inclines until you have regained your full strength, balance and mobility.

It is common for individuals to have a partial or medial compartment knee replacement rather than a complete knee replacement. Generally the recovery is much faster. In addition, the return to household and garden chores, such as cutting your grass, occurs with more ease.

Conclusion

I am confident that these six lawn-mowing tips will help you to avoid undue stress on your back and reduce your risk of a compression fracture. I encourage you to consider your posture and body mechanics throughout your work and play life.

Individuals recuperating from hip or knee surgery need to be especially attentive before mowing their lawn or doing other garden work.

Exercise Recommendations for Osteoporosis

Exercise is an essential ingredient to bone health. If you have osteoporosis, therapeutic exercise needs to be part of your osteoporosis treatment program.

I cover important topics related to osteoporosis exercise including:

Can exercise reverse osteoporosis?
Stop the stoop — how to avoid kyphosis and rounded shoulders.
Key components of an osteoporosis exercise program.
Key principles of bone building.
Exercises you should avoid if you have osteoporosis.
Yoga and osteoporosis — should you practice yoga if you have osteoporosis?
Core strength and osteoporosis — why is core strength important if you have osteoporosis?

References

Blom AW, Rogers M, Taylor AH, Pattison G, Whitehouse S, Bannister GC. Dislocation following total hip replacement: the Avon Orthopaedic Centre experience. Ann R Coll Surg Engl. 2008 Nov;90(8):658-62. Epub 2008 Sep 30. PubMed PMID: 18828962; PubMed Central PMCID: PMC2727808

Activities of Daily Living

Visit my page dedicated to Activities of Daily Living to learn about other activities of daily living

The post Safety Tips on Cutting Grass appeared first on MelioGuide.

Weeding the Garden Safety Tips

Margaret Martin — Wed, 11 Apr 2018 20:15:28 +0000

I encourage my clients to follow these safety tips for weeding the garden. They are especially appropriate for those individuals with osteoporosis, osteopenia, and low bone density because these individuals are at risk of fracture risk of a compression fracture. These guidelines are also applicable to individuals with low back pain, shoulder or neck pain, or knee arthritis.

Your weeds did not appear overnight and they do not need to disappear in one day. I recommend you do not do all of your weeding in one day. Break it up into smaller, more manageable periods and spread the effort (and strain) across multiple sessions — I recommend no more than 15 to 20 minutes of weeding during each individual session.

Weeding the Garden: Recommended Tools

Besides your weeding tools, I recommend that you have the following items when you weed your garden:

A foam pad for kneeling and
A sturdy stick (like a walking stick) to support you when you do the “gardener’s lift” (explained later).

Alternatively, you may want to consider a garden stool such as the one shown here.

Four Weeding Techniques

Here are four techniques to remove weeds safely and not compromise your back, your knees or your bones. Keep in mind that keeping your posture in good form is very important. Make a point of not losing all of the good progress you have been making with your osteoporosis exercise program.

Shortstop Squat/Hold — This position is ideal for weeding when you do not have a very strong root system.
Power Squat — You will need to do this for more demanding, deeper root system in your garden.
Gardener’s Lift — Based on the golfer’s lift, this one is appreciated by clients with knee problems.
Kneeling — Very effective when you plan on spending a longer period in one patch. A foam pad to support your knees or a gardener’s bench is welcomed.

Distribute your workout on both sides of your body so that you do not stress one part of your body.

Once you are done the weeds, make sure you sit back and enjoy your garden!

Weeding the Garden Demonstration Video

Exercise Recommendations for Osteoporosis

Exercise is an essential ingredient to bone health. If you have osteoporosis, therapeutic exercise needs to be part of your osteoporosis treatment program.

I cover important topics related to osteoporosis exercise including:

Can exercise reverse osteoporosis?
Stop the stoop — how to avoid kyphosis and rounded shoulders.
Key components of an osteoporosis exercise program.
Key principles of bone building.
Exercises you should avoid if you have osteoporosis.
Yoga and osteoporosis — should you practice yoga if you have osteoporosis?
Core strength and osteoporosis — why is core strength important if you have osteoporosis?

Safely Weeding the Garden

I recommend you break your weeding up into tangible bits. Maybe 20 minutes to half an hour of weeding at a time.

Other than your weeding tools, I recommend that you have a pad that you can kneel on and a strong and sturdy stick that you can use as a support.

Squats and Happy Knees

If you are happy with your squats and have happy knees, then by all means squat and save your back. You can also support your back by bringing your forearm down onto your thigh — like the short stop position.

From this position you can do some weeding that’s not aggressive or that is not too demanding.

If you need to tackle a deeper root system, then you are going to have to get two legs behind the item, get in close and use much more of the power pushing up with your legs.

Use a Stick for Support

Consider hinging from your hip, and avoid getting down into deep squats. This is important for people with arthritis in the knees.

Use the stick in the opposite side from the leg that you’re going to be leveraging off of. Hold the stick far enough apart that you feel stable, so that when you go up, you can continually just offset the bend and use the weight from the opposite hand.

If you’re doing this and you’re moving along the garden and you’re coming down and working through different areas, I would encourage you to do half of it with the leverage off of the right foot, and then certainly switch part way through, and do half of it with the leverage off of the left foot.

Keep Your Balance

Good balance is important through your weeding session.

Consider Sitting

Instead of getting on your knees, consider sitting on a low stool. That allows you to spend time in through this whole area, or your whole area of garden that you have to work through.

This well covers whether you’re doing a short stop hold, the hip hinge or golfer’s lift, or coming down and working in a better ergonomic position.

Keep in mind to save your back that you can balance the weeding from the right arm and left arm. This provides an even workout through your body.

Finally, remember to break it up even through the day or even better through the week.

The Spinal Stretch Exercise

For those of you who have had posterior disc bulge or wish to avoid one, forward work should be sandwiched in between back extensions. A gentle back extension is a spinal stretch:

Activities of Daily Living

Visit my page dedicated to Activities of Daily Living to learn about other activities of daily living.

Images

Folding Kneeler Stool image source: Lee Valley Tool.

The post Weeding the Garden Safety Tips appeared first on MelioGuide.

Eight Shoveling Safety Tips

Margaret Martin — Wed, 11 Apr 2018 20:06:34 +0000

Shoveling is an essential part of the gardening experience. However, poor shoveling technique can lead to back, shoulder and neck pain. For those individuals with osteoporosis, it can cause compression fractures. To avoid these outcomes, I provide eight shoveling safety tips I encourage my patients to follow — especially those with osteoporosis, osteopenia, or low back pain.

Wear sturdy shoes that keep you grounded and that allow you to transfer your force into the ground.
Use a sharp shovel that can penetrate the soil in your garden.
Use a shovel that is the right length for you.
The shovel handle should be between your shoulder and your hip. That is your power zone.
Take the earth or gravel out of the hole with your legs and not your back.
Leverage (or offset) the load onto your leg.
Keep the load close to your body as you move the shovel.
When moving in another direction, move with your feet and do not rotate.

Shoveling Safety Tips Video Demonstration

Eight Shoveling Safety Tips

Follow these shoveling safety tips when you move plants, re-establish gardens, or replant things. This is the advice that I give to many of my clients.

Wear Sturdy Shoes

Wear sturdy shoes that allow you to transfer your force into the ground.

Choose the Right Shovel

Use a sharp shovel that is the right height for you.
At just under five-two, a short-handled shovel is perfect for me.
For my taller clients, I would recommend that they use a longer handled shovel so that they can get up and behind the shovel.
Because I’m not that tall, I use a short shovel.
Anybody over five-seven using a short shovel will end up in a position where the shovel is below the height of their hip.
You do not want to be in this position because you can’t get your body weight over the shovel.
The handle of the shovel should be below your shoulder and above your hip. That is in your power zone.

Establish Your Power Zone for Shoveling

Remove the earth or gravel with your legs and less so with your back and your arms.
If you lift with your back and arms your legs would be straight, forcing you to bend from the back and use your arms.
You might not experience the detrimental effects of this within a day, but eventually you pay the consequences with your bones or discs.
Use your legs to lift.
If it’s a really heavy load, offset some of the weight onto your thigh as you’re coming up.
Then keep that load as close as possible as you move your load.
If you are moving the load in another direction, always move your feet in the direction that you are going to drop the load, as opposed to just taking it and rotating from the body. That movement is to be a lot more harmful on your back.

That covers shoveling safety tips for your garden.

Exercise Recommendations for Osteoporosis

Exercise is an essential ingredient to bone health. If you have osteoporosis, therapeutic exercise needs to be part of your osteoporosis treatment program.

I cover important topics related to osteoporosis exercise including:

Can exercise reverse osteoporosis?
Stop the stoop — how to avoid kyphosis and rounded shoulders.
Key components of an osteoporosis exercise program.
Key principles of bone building.
Exercises you should avoid if you have osteoporosis.
Yoga and osteoporosis — should you practice yoga if you have osteoporosis?
Core strength and osteoporosis — why is core strength important if you have osteoporosis?

Activities of Daily Living

Visit my page dedicated to Activities of Daily Living to learn about other activities of daily living.

The post Eight Shoveling Safety Tips appeared first on MelioGuide.

12 Tips on Raking Leaves

Margaret Martin — Wed, 11 Apr 2018 15:53:23 +0000

Here are twelve safety tips for raking leaves. When fall arrives and the leaves accumulate in the yard, I encourage my patients to follow these tips — especially those with osteoporosis, osteopenia, or low back pain.

Twelve Safety tips for Raking Leaves

Face your leaves while you rake.
Make a point of knowing where you are and what is around you so that you can walk backwards safely without tripping and falling.
Always rake the leaves towards you.
Keep your upper arms close to your body.
Pull the rake using movement from your legs (not just your arms) and step back as you rake.
Halfway through your job you should shift your raking activity to your other side. In other words, if you start raking from your left side then you should shift the raking effort to the right side as you cross the halfway mark of your job. This distributes the workload across your body avoiding fatigue or strain on one side of your body.
Avoid movements that involve flexion of the spine and adjust (or avoid) movements that involve extreme rotation.
Rotation of the body, while raking, can aggravate the back or bring on low back pain. I suggest you avoid this movement while raking.
Reaching out to rake leaves and extending your body places stress on your spine. Instead, move closer to the leaves.
In the video you will see that I am using a rake with a wide fan. You will also notice that I have a lot of leaves to gather and hence the need for the large fan. The challenge for many people who use large fans is that it requires a fair amount of strength.
If you do not regularly include strength training in your exercise program you would be safer to use a rake with a smaller fan.
It is best to rake when the leaves are dry (and light) and not when they are wet and heavy.

Benefits of Raking Leaves Safety Tips

Follow these twelve raking leaves safety tips and you will:

Reduce your risk of a compression fracture.
Avoid aggravating your back or neck pain raking your garden.

Exercise Recommendations for Osteoporosis

Exercise is an essential ingredient to bone health. If you have osteoporosis, therapeutic exercise needs to be part of your osteoporosis treatment program.

I cover important topics related to osteoporosis exercise including:

Can exercise reverse osteoporosis?
Stop the stoop — how to avoid kyphosis and rounded shoulders.
Key components of an osteoporosis exercise program.
Key principles of bone building.
Exercises you should avoid if you have osteoporosis.
Yoga and osteoporosis — should you practice yoga if you have osteoporosis?
Core strength and osteoporosis — why is core strength important if you have osteoporosis?

Activities of Daily Living

Visit my page dedicated to Activities of Daily Living to learn about other activities of daily living.

The post 12 Tips on Raking Leaves appeared first on MelioGuide.

Hip Hinge Exercise and Standing Forward Bend

Margaret Martin — Sun, 12 Nov 2017 08:18:19 +0000

The forward bend position occurs when people do certain exercises, Yoga and Pilates poses, and day-to-day movements. When done incorrectly, they can cause flexion of the spin. This can be problematic. But this forward flexion does not have to happen — if you learn to move correctly. The hip hinge is a great foundation for many of the movements you use during exercise and daily activities. I encourage many of my clients to learn and practice the hip hinge.

In today’s blog post I will provide a detailed step-by-step instructions on how to do the hip hinge exercise. I cover why you should practice this exercise and show you where you can use it in your activities of daily living, your exercise program, and your yoga or Pilates practice. As a bonus, I offer a few tips on how to know you are flexing your spine when doing a forward bend. Let’s get started!

Benefits of Learning the Hip Hinge Exercise

The hip hinge exercise has many benefits. Here are several that come to mind:

Increase your body awareness and mindfulness not only within your Yoga, Pilates and exercise program but also in your day-to-day movements.
Improve your postural alignment and increase your strength in your core and back. This will increase your strength not only into your core exercise program but improve your balance and prevent falls.
Teach you how to improve your posture and reduce the risk of compression fractures caused by habitual forward flexion.

How to Do the Hip Hinge Exercise

The hip hinge exercise warm up exercise from the Exercise for Better Bone program. It is one of several warm up exercises you should do before starting the strength exercise component of the Exercise for Better Bones.

The following are the instructions for the hip hinge exercise.

I call it the Bird Nod because it reminds of those little red birds when I grew up that would nod back and forth and that’s essentially what you’re going to be doing. It’s a great warm up for your hamstrings and for balance.

With your hands centered you’re going to bend the supporting knee slightly.
Bend your supporting knee as you start to lift the unsupported leg.
For every degree that you’re lifting the leg, let your torso drop so that eventually you come into a horizontal position and back.
If you only have the stability to go to 45 degrees, go to 45 degrees until you build that stability.
Keep your pelvis level.
Visualize a ruler across your buttocks.
Keep that ruler nice and level as you come down. You don’t want this coming across.
Let’s look at this on the other side.
Take your breath.
For every degree that you lift your leg, your torso drops like a teeter totter, and back.

That’s it for the hip hinge exercise.

Hip Hinge Exercise • Professional Tip

The following are tips for health and fitness professionals for the hip hinge exercise.

Often what will happen is with your client, they don’t have an association of where their torso is for keeping it straight, so they will either drive their leg up far more than they’re dropping their torso, or vice versa, they’ll have their torso dropped before their leg comes up.

One of the ways that I encourage them to visualize that is working with the mirror to their side, is having them think about that unity between the shoulder, the hip, and the knee.

And so as they’re moving, and having them start even just with 10, 15, 20 degrees at a time, so that they’re getting this concept, this moving as a solid unit with the trunk hinging around the hip joint for the Bird Nod.

So I hope that helps you with your clients.

Standing Forward Bend

Movements, exercises and Yoga poses that involve the standing forward bend can (and should) be done without flexion of the spine. This requires that you do two things:

Bend from your hips, knees and ankles.
Actively use your postural muscles to resist gravity and keep your spine elongated.

Forward bending is a very common way to “loosen up those hamstrings” in an exercise class. But we also bend forward quite frequently to pick things up and set things down. Unfortunately, most people are bending forward with the head and shoulders forward and the spine rounded. When we bend in this way, we are improperly stretching the hamstrings and causing damage to our spine.

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How to Prevent an Unsafe Standing Forward Bend

In the photo you can see our model, Pat, warming up for her exercise program by touching her toes. She goes into a forward bend that is unsafe because she is bending from her spine.

Unfortunately, Pat might not even be aware that she is doing this movement. Are there cues that Pat can try to indicate that she is putting herself in forward flexion?

Yes, she can. Here are two I recommend to my clients.

Tips to Check if You Are in Flexion When You Forward Bend

Here are the details of the first tip:

Place one finger on your belly button and another finger at the base of your sternum at the xiphoid process.
Start to bend forward.
As soon as your fingers start to come towards one another that means that you’re flexing somewhere in your spine.
This is your stopping point in order to protect the spine.
If you want to do those toe touches or forward bends, this is as far as you go.

I often have my yoga students do this exact thing in their sun salutations. If we want to go further forward we really need to keep this nice length through the spine.

Here is a second tip that I really like to use (but never do in a public class):

Pinch the skin just above your waist on your back.
While pinching that skin and folding forward, if I go too far and cause my back to bend I’m going to feel that pinch right away.
However, if I keep my butt out and my back flat that pinch should not change at all because I’m not rounding from my spine. I’m simply hinging from my hips, bending from my knees and keeping my spine safe.

Exercises to Avoid if You Have Osteoporosis

I have a detailed blog post on exercises you should avoid if you have osteoporosis (including the one above!).

Forward Bend Movements and the Hamstring Stretch Exercise

If you have tight (or short) hamstring muscles, you will need to bend from the hip and knees until your hamstrings are more flexible. Safe hamstring stretches are highly recommended. I have a detailed blog post on safe hamstring stretches that you can follow.

Exercise Recommendations for Osteoporosis

Exercise is an essential ingredient to bone health. If you have osteoporosis, therapeutic exercise needs to be part of your osteoporosis treatment program.

I cover important topics related to osteoporosis exercise including:

Can exercise reverse osteoporosis?
Stop the stoop — how to avoid kyphosis and rounded shoulders.
Key components of an osteoporosis exercise program.
Key principles of bone building.
Exercises you should avoid if you have osteoporosis.
Yoga and osteoporosis — should you practice yoga if you have osteoporosis?
Core strength and osteoporosis — why is core strength important if you have osteoporosis?

Forward Bend, Yoga and Hip Hinge

There are a number of Yoga poses that involve a forward bend. We will cover two here in this discussion. Let’s start with the Uttanasana. Here Jan is doing an unsafe Forward Bend Yoga pose.

Unsafe Forward Bend Yoga

Uttanasana • Standing Forward Bend Pose

The Uttanasana, or Standing Forward Bend Pose in Yoga, requires modification for most students of Yoga.

In order to maintain spinal elongation, especially in the thoracic area, bring your should blades together.
Your spine should not flex forward to the point where the rib cage makes contact with the thighs.
The Standing Forward Bend Yoga Pose requires a deep bend of the hips. If you have tight hamstrings, you will also need to bend deeply at the knees. (I encourage you to practice my hamstring stretch exercise.)

Props also help but should not be treated as a replacement for engaging the postural muscles. Here is Jan doing the Forward Bend Yoga pose but this time with good alignment.

Safe Forward Bend Yoga

Sun Salutation • Surya Namaskar

The Surya Namaskar, commonly known as the Sun Salutation, involves a sequence of poses, many of which incorporate the forward bend. Like the Standing Forward Bend Pose, you need to be mindful of where you are bending when transitioning between poses.

You should not flex from the spine, and instead use a combination of the hips, knees and ankles to transition safely from pose to pose. I encourage you to learn how to do a proper hip hinge and increase the flexibility of your hamstrings. Both will improve you Sun Salutation!

If you want to learn more about how to safely practice Yoga if you have osteoporosis, osteopenia or low bone density, I encourage you to check my book Yoga for Better Bones. It describes with pictures and text what poses you need to modify and which you should probably avoid.

Forward Bend, Core Strengthening and Hip Hinge

The plank and side planks, in my book Strengthen Your Core, are excellent core strengthening exercises. However, you want to do this with good form, which means you do not want to flex your spine when you forward bend. In the video, below, I describe how to forward bend from the hips and not the spine, when getting into a plank position.

As the video illustrates, when you forward bend, you should do it from the hips and not the spine.

Before you go into your plank position, you want to make sure that your posture is properly aligned. There are two cues you can use to make sure that things are well aligned.

Establish the Natural Distance Between Your Sternum and Bellybutton

Flexed posture: You’ll notice that the space between our sternum and the bellybutton comes closer together.
Extended posture: The space between our sternum and the bellybutton is wide apart.
Neutral spine position: The distance between the two is neither too close or too far.

Make Sure Your Shoulder Blades are Not Too Far Apart or Too Close

When you are in a flex position, the shoulder blades come forward and come away from the spine. Even if you try to have a neutral posture but your shoulder blades are forward, it will be counterproductive for you. This is especially true when you get into a position where you’re supporting your weight on your hands.

A similar problem occurs in extension, with the shoulder blades too tucked.

How to Enter the Plank Position

Enter in with movement from the hip.

Flex from the hip and not from the spine. If you enter it with flexion of the spine, then you have to undo things before you even get into your plank position. You will have to undo the position of the shoulder blades, the position of my neck, and the roundness of the spine.

As you get into position for your plank and side plank you should do so by doing a forward bend from your hips rather than bending at the spine. This will allow you to set your position before you increase the challenge on your shoulders, hips and abdominals.

Unsafe Forward Bend

Safe Forward Bend

Forward Bend, Strength Exercises and Hip Hinge

The hip hinge allows you to maintain a proper forward bend when doing many exercises, including strength exercises. A good example is the Bent Over Row Exercise, found in the Exercise for Better Bones program.

The Bent Over Row Exercise benefits the muscles of the upper back, buttock and hamstrings. It is also beneficial for the bones in the hips, spine and wrists. In the video above, I demonstrate how to do this exercise and maintain the forward bend with good form. Note how I incorporate many of the movements from the hip hinge exercise.

Exercise Recommendations for Osteoporosis

Exercise is an essential ingredient to bone health. If you have osteoporosis, therapeutic exercise needs to be part of your osteoporosis treatment program.

I cover important topics related to osteoporosis exercise including:

Can exercise reverse osteoporosis?
Stop the stoop — how to avoid kyphosis and rounded shoulders.
Key components of an osteoporosis exercise program.
Key principles of bone building.
Exercises you should avoid if you have osteoporosis.
Yoga and osteoporosis — should you practice yoga if you have osteoporosis?
Core strength and osteoporosis — why is core strength important if you have osteoporosis?

Golfers Lift

A number of our activities of daily living involve a forward bend and as we lift an object off of the ground. Reaching down to lift or pick up an object with a forward bend from the spine puts significant pressure on the lumbar and thoracic spines. Repeated movements like this can lead to disc problems. If you have osteoporosis, these movements can cause compression fractures.

How Tight Hamstrings Can Restrict Your Forward Bend

If I try to pick something up off of the floor, I will bend at my hips with straight legs until my hamstrings say “that’s it, I can’t give you any more range.” The hamstrings are attached to the pelvis and their job is to allow this bending—or hinging—within an allowable range of motion. For me, that range of motion is a little under 90 degrees. For you, that range may be more or less.

Once I get to the “that’s it” point in my hamstrings, my option is to bend from the knees by increasing the distance between my feet and then going down into a deeper squat. In this position I can pick something up safely by using my knees and hips, while keeping that little arch in my back. However, this movement is possible for me because my hamstrings are just moderately tight. I can get there, but just barely.

If your hamstrings are tighter, bending just the knees and hips may not be enough to facilitate picking something up. So how do we get there? Typically, the rest of the bend ends up coming from your spine due to the limitations of the hamstrings. This type of bending in the spine should be avoided for multiple reasons, especially those related to osteoporosis.

Golfers Lift Technique

Like the exercises and poses described above, you need to be careful not to bend from the spine and instead bend from the hips. This is accomplished with either a hip hinge or a technique called the Golfers Lift.

The Golfers Lift is a safe way to bend over and retrieve an item without compromising your posture. In the video above I demonstrate this technique.

It is called the Golfers Lift because you sometimes see golfers use it as they retrieve their golf ball off the grass. Instead of movement coming from the spine, the movement comes from the hip. This is much safer for your spine! Your bones, your spine and your body will be much happier.

Hip Hinge Exercise Alternatives

Here is a video I did several years ago on how to bend forward safely using the mechanics of the hip hinge exercise.

Osteoporosis Exercise Plan

Visit my Osteoporosis Exercise Plan page for more information on this topic.

The post Hip Hinge Exercise and Standing Forward Bend appeared first on MelioGuide.

How to Safely Unload Your Washer and Dryer

Margaret Martin — Sat, 12 Nov 2016 16:09:20 +0000

In today’s post, I cover how to safely unload your washer and dryer if you have osteoporosis, compression fractures or weak joints. The video demonstrates how to unload your laundry from a front-loading dryer. Later in the post I provide instructions on how to unload a top-loading washer or dryer.

How to Safely Unload Your Washer or Dryer

A client recently asked me how to unload her front-loading washer and dryer while being mindful of her spine movements. She has osteoporosis and was concerned that the wrong movement could cause a compression fracture.

Arthritis in her knees limits her joint movement and mobility. Using a squat to lift a heavy load of laundry (especially a wet load from the washer) is too difficult because of the arthritis in her knees.

She needs alternative techniques to follow that are safe and friendly to her joints and spine. A number of people who read this blog have similar challenges so I thought it would be a worthwhile to share these tips.

How to Hinge From Your Hips

We need to cover how to hinge from your hips so that you avoid using your spine to lift.

There are several important issues related to proper movement, specifically shoulder blade positioning, rounded shoulders and spinal flexion.

These photos illustrate the hip hinge (the safe forward bend) and spinal flexion (an unsafe forward bend).

Safe Forward Bend

Unsafe Forward Bend

Now that we know hip hinging, let’s move onto how to safely unload a front-loading washer or dryer.

How to Safely Unload Your Front-Loading Dryer or Washer

Follow these steps to safely unload a front-loading dryer or washer.

1. Use a Low Stool or a Reacher

If you find the technique I demonstrate too difficult to do, then I suggest that you use a low stool to help you reach into the washer or dryer. If the reach causes you to go into flexion, I recommend that you use a reacher. In fact. for most people, I recommend that they use a reacher.

2. Use a Pad or Folded Carpet to Protect Your Knees

If you are able to kneel without experiencing discomfort, I recommend that you use a pad or a folded carpet to protect your knees.

3. Lift the Basket with Good Form

Once you unload the dryer or washer — whether you’re doing it on one knee or both — keep the basket close to your body, hinge from your hips (your butt should be sticking out), and place the basket onto your thigh for support.

Hug the basket close to you once it is on your thigh. The effort of holding and moving a heavy laundry basket is much easier and less demanding on your spine if you keep it close to your body.

4. Use Your Hand to Support You as You Stand Up

Position one of your your hands so that you can help yourself up. Done properly, this will take the load off your knee. Use your hand and arm strength as a leverage to lift yourself off the knee with the basket close to your body.

5. Turn Your Feet in the Direction of Your Body

At all times and with all loads, turn your feet in the direction that you point your body.

With these directions, you should be injury free when you unload laundry from a front-loading washer or dryer. In the next section, we will cover how to unload a top-loading washer or dryer.

Exercise Recommendations for Osteoporosis

Exercise is an essential ingredient to bone health. If you have osteoporosis, therapeutic exercise needs to be part of your osteoporosis treatment program.

I cover important topics related to osteoporosis exercise including:

Can exercise reverse osteoporosis?
Stop the stoop — how to avoid kyphosis and rounded shoulders.
Key components of an osteoporosis exercise program.
Key principles of bone building.
Exercises you should avoid if you have osteoporosis.
Yoga and osteoporosis — should you practice yoga if you have osteoporosis?
Core strength and osteoporosis — why is core strength important if you have osteoporosis?

How to Safely Unload Your Top-Loading Dryer or Washer

Many people have top-loading washers and the directions above will not address concerns with potential fractures or injury.

The most important thing you need to do when loading or unloading a top-loading washer is to make sure you have leverage. This means that you need to lift or elevate your body so that you have a clear reach over the top part of the washer. Follow these instructions.

Stand on a very sturdy stool. The stool needs to be high enough so that the top of your pelvis is at least at the height of the washer.
Elevate your your laundry basket by placing it on a chair (or other elevated structure) beside your stool. Elevating the basket reduces the chance that you will go into flexion as you reach for the basket.
Once you open the top of the washer, place a piece of nonslip cupboard pad or a folded Yoga mat, on the edge of the washer. Most top-loading washers have a six inch space between the outer edge of the washer and the outside edge of the lid.
With a straight back, hinge forward from your hips (your back should be straight) as you reach over the washer.
Rest one forearm on the non slip mat.
Retrieve the wet clothes from the washer with your free hand and drop each item into your basket.
Try to limit the number of wet laundry items you lift with each pass.
Retrieve the basket from the chair (or support structure) using a squat technique.

Conclusion

This should adequately cover how to safely unload your washer and dryer whether it appliance is front-loading or top-loading. Always be mindful of your joints and your movements in the spine and shoulder. Learn how to hinge from the hip and not flex from the spine as you lift heavy objects such as wet laundry.

Activities of Daily Living

Read my guide to Activities of Daily Living.

The post How to Safely Unload Your Washer and Dryer appeared first on MelioGuide.

Opening Fridge Safety Tips

Margaret Martin — Tue, 23 Jun 2015 19:13:13 +0000

If you have a history of fracture from osteoporosis or weakness from events such as surgery, opening the fridge door can be a significant (and potentially dangerous) activity. In this video I share some opening fridge safety tips. This is particularly applicable for people concerned about vertebral compression fractures.

Opening Fridge Safety Tips Demonstration

A number of my clients are de-conditioned from prolonged hospital stays or other medical conditions. As a result, opening their fridge door is an exhausting task.

Recently I snapped off my fridge door handle when I opened the fridge. The handle was fairly old and I had to search out a replacement. The gentleman who sold me the handle gave me a tip to reduce the resistance from the fridge. (He explained to me that manufacturers have increased the magnet strength used inside door fridges. That had increased demand for fridge door handles lately!).

He suggested applying little bit of vegetable oil along the rubber seal where the fridge door meets the fridge. If you apply vegetable oil along the whole length of the seal, it reduces the resistance that’s required to pull open the fridge door.

I thank him for the suggestion to use vegetable oil on the inside rubber strip to create a film between the rubber and the fridge body.

Give it a try and see if this helps you open the fridge door.

This tip will save you the headache of replacing your fridge door handle, avoid any back pain and reduce your risk of a compression fracture.

That’s all for MelioGuide today, thanks for tuning in.

Step by Step Instructions

Here are several opening fridge safety tips you should follow to avoid an injury or fracture.

Apply a bit of vegetable oil along the rubber seal to reduce the force of the magnet that holds the fridge door closed.
As you stand ready to open the fridge door, get into a staggered stance (like a boxer). Do not have your feet parallel or side-by-side.
Place the front foot about twelve inches to the outside of the fridge.
Your back foot is best aligned in line with the handle.
Keep the elbow of the arm that is pulling at a 90 degree angle.
As you engage, shift weight forward to the front foot.
As you pull, shift your weight onto the back foot.
Remember to take in a breath before you start and exhale as you pull the door open.
To protect your neck, keep you tongue relaxed and placed at the roof of your mouth.

Exercise Recommendations for Osteoporosis

Exercise is an essential ingredient to bone health. If you have osteoporosis, therapeutic exercise needs to be part of your osteoporosis treatment program.

I cover important topics related to osteoporosis exercise including:

Can exercise reverse osteoporosis?
Stop the stoop — how to avoid kyphosis and rounded shoulders.
Key components of an osteoporosis exercise program.
Key principles of bone building.
Exercises you should avoid if you have osteoporosis.
Yoga and osteoporosis — should you practice yoga if you have osteoporosis?
Core strength and osteoporosis — why is core strength important if you have osteoporosis?

Conclusion

Hopefully these opening fridge safety tips will help you avoid injury such as a compression fracture or experience low back pain.

Activities of Daily Living

Visit my page dedicated to Activities of Daily Living to learn about other activities of daily living.

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Activities of Daily Living Archives - MelioGuide

Stair Negotiation Exercises

Table of Contents

Stair Negotiation Exercises

Exercise to Easily Negotiate Going Down Stairs

Start With 50% Of Your Weight On Each Leg

Gradually Increase The Amount of Your Weight You Support on One Leg

Exercise Recommendations for Osteoporosis

Five Simple Tips to Easily Negotiate Going Up Stairs

Breath Control and Stair Negotiation

Stair Negotiation: Strengthen Your Lower Body

Stair Negotiation: Improve Your Balance

Stair Negotiation: Posture

Stair Negotiation Exercises in the Pool

Osteoporosis Exercises

Extra Safety Tips

Conclusion

Margaret Martin

Further Readings

Stair Negotiation Exercises

How to Get up From a Fall

How to Lift a Turkey In and Out of the Oven

Safety Tips on Cutting Grass

Weeding the Garden Safety Tips

Eight Shoveling Safety Tips

How to Get up From a Fall

Table of Contents

How to Get Up After a Fall • A Case Study

Balance and Fall Prevention

How to Get up From a Fall Using an Elevated Surface for Support

Move Towards a Chair (or Other Sturdy Elevated Surface)

Option 1 • How to Get Up From a Fall

Option 2 • How to Get Up From a Fall

Exercise Recommendations for Osteoporosis

How to Get up From a Fall With No Elevated Surface For Support

Test Your Flexibility

How to Get Up From a Fall Technique

Conclusion

References

Balance Exercises for Seniors Guidelines

How to Lift a Turkey In and Out of the Oven

Table of Contents

My First Suggestion

How to Safely Lift a Turkey, Roast or Casserole into the Oven

Tips on Squats

Exercise Recommendations for Osteoporosis

How to Safely Lift a Turkey, Roast or Casserole Out of the Oven

Alternative Strategy for People Who Cannot Squat

Conclusion

Activities of Daily Living

Safety Tips on Cutting Grass

Table of Contents

Safety Tips for Cutting Grass

Lawn Mower Position When Cutting Grass

Make Sure the Height of Your Lawn Mower is Correct

Walking Forwards and Backwards When Cutting Grass

Low Hanging Limbs and Cutting Grass

Exercise Recommendations for Osteoporosis

Mowing the Lawn After Hip Replacement Surgery

Anterior or Posterior Hip Replacement Surgery

When Can You Mow the Lawn After Hip Replacement?

Cutting Grass with Riding Mowers

Cutting Grass with Gas Mowers

Mowing the Lawn After Knee Replacement Surgery

Conclusion

Exercise Recommendations for Osteoporosis

References

Activities of Daily Living

Weeding the Garden Safety Tips

Table of Contents

Weeding the Garden: Recommended Tools

Four Weeding Techniques

Weeding the Garden Demonstration Video

Exercise Recommendations for Osteoporosis

Safely Weeding the Garden

Squats and Happy Knees

Use a Stick for Support

Keep Your Balance

Consider Sitting

The Spinal Stretch Exercise