Your Prescription for Better HealthJulyAugust 2011

Your Back to School Health Checklist

How to Treat a Blister

Importance of Balance in Older Adults

Precautions to Help Prevent Lower Back Injuries

Most Common Types of Skin

Cancer

The Biggest Risk of Injury in Swimmers is to

the Shoulder

The Five Different Forms

of Lightening Strikes

coordinatedhealthcom2 JulyAugust 2011

Letter From The Editor

Dear Patients

It seems like just yesterday we were ushering in summer and now itrsquos drawing to a close That can only mean one thing- the back to school season is upon us Most schools have already begun sports camps to prepare their athletes for the upcoming season but remember even though fall is right around the corner wersquore still dealing with the summer temperatures which can certainly take a toll on athletes practicing outside

Make sure to talk to your child about the importance of keeping hydrated Many young athletes may lean towards performance drinks like Gatorade or sugar filled drinks like Kool-Aid when choosing their beverage Therersquos nothing better than water when it comes to staying hydrated but if your child absolutely insists on a flavored beverage try flavored water There are a variety of flavors available and most of the drinks contain no sugar or caffeine

Itrsquos also important to remember basic sun safety When your child is exercising outside they will most likely be wearing shorts and tank tops which will leave their face arms and legs exposed to harmful rays Remind them the importance of wearing sun screen and reapplying it throughout the day If possible they can also wear a hat which will keep the sun off of their face

You can find more information about summer safety and back to school in our JulyAugust issue of Coordinated Health magazine Discover what your child needs to ensure a healthy school year Also learn the warning signs of skin cancer and when you should visit your doctor We also have some important tips on how you can protect yourself from lightening if you get caught in an unpredictable summer storm These are just a few of the great articles we have for you in this issue We hope that the articles will allow you to enjoy the rest of your summer and remain safe and healthy

Amanda Boyce

coordinatedhealthcom2 JulyAugust 2011

Letter From The Editor

Dear Patients

It seems like just yesterday we were ushering in summer and now itrsquos drawing to a close That can only mean one thing- the back to school season is upon us Most schools have already begun sports camps to prepare their athletes for the upcoming season but remember even though fall is right around the corner wersquore still dealing with the summer temperatures which can certainly take a toll on athletes practicing outside

Make sure to talk to your child about the importance of keeping hydrated Many young athletes may lean towards performance drinks like Gatorade or sugar filled drinks like Kool-Aid when choosing their beverage Therersquos nothing better than water when it comes to staying hydrated but if your child absolutely insists on a flavored beverage try flavored water There are a variety of flavors available and most of the drinks contain no sugar or caffeine

Itrsquos also important to remember basic sun safety When your child is exercising outside they will most likely be wearing shorts and tank tops which will leave their face arms and legs exposed to harmful rays Remind them the importance of wearing sun screen and reapplying it throughout the day If possible they can also wear a hat which will keep the sun off of their face

You can find more information about summer safety and back to school in our JulyAugust issue of Coordinated Health magazine Discover what your child needs to ensure a healthy school year Also learn the warning signs of skin cancer and when you should visit your doctor We also have some important tips on how you can protect yourself from lightening if you get caught in an unpredictable summer storm These are just a few of the great articles we have for you in this issue We hope that the articles will allow you to enjoy the rest of your summer and remain safe and healthy

Amanda Boyce

coordinatedhealthcom JulyAugust 2011 3

2 Editorrsquos Letter

5 Contributing Team

14 What our patients are saying

34 Coordinated Health Locations

6 How to Treat a Blister

8 Your Back to School Health Checklist

16 Importance of Balance in Older Adults

Features

Issue

6JulyAugust

2011

coordinatedhealthcom

20 Precautions to Help Prevent Lower Back Injuries

24 The Most Common Types of Skin Cancer

26 The Biggest Risk of Injury to Swimmers is to the Shoulder

30 The Five Different Types of Lightening Strikes

Features

4 JulyAugust 2011

coordinatedhealthcom

Our Contributing Team

Jeanette Richards RN CRNP Registered Nurse

Certified Registered Nurse Practitioner

Sara Yodlosky PAC Physician Assistant

Mark Salamon PT Physical Therapist

Mike Price PT Physical Therapist

Jeff Kroboth CSCS Certified Strength and Conditioning Specialist

Marc Gallagher ATC Certified Athletic Trainer

Suzanne Westock ATC

Certified Athletic Trainer

Hannah RoppWriter

Rick Woods Design amp Layout

Cover Photo by Barbara Talijan Courtesy of lehighvalleylive com

Amanda BoyceEditor

JulyAugust 2011 5

coordinatedhealthcom6 JulyAugust 2011

Steps to Treat a Blister1 Do not pop the blister with your hands If it is preventing you from taking part in normal activity use a sterilized instrument Touching it with your hands may lead to infection or further irritation

2 Clean the area with soap and water to prevent infection If popping is necessary clean your instrument (needle scalpel) with alcohol Make an incision or hole at the base of the blister and gently squeeze the fluid out of the blister until it is flat

3 Use an antibiotic cream or ointment to keep the area clean and sterile Cover with a sterile dressing and change dressing every day to keep it clean At night take dressing off to allow airflow

4 Keep clean by washing with soap and warm water You may also soak it in a Betadine solution This will soften the skin and reduce irritation This will allow the skin to heal itself

5 When pain lessens do not cover the blister anymore Allow it to dry out By this time most of the healing has occurred so risk of infection has lessened significantly Generally if it doesnrsquot hurt it is healed

How to Treat a BlisterMarc Gallagher ATC

coordinatedhealthcom JulyAugust 2011 7

coordinatedhealthcom6 JulyAugust 2011

Steps to Treat a Blister1 Do not pop the blister with your hands If it is preventing you from taking part in normal activity use a sterilized instrument Touching it with your hands may lead to infection or further irritation

2 Clean the area with soap and water to prevent infection If popping is necessary clean your instrument (needle scalpel) with alcohol Make an incision or hole at the base of the blister and gently squeeze the fluid out of the blister until it is flat

3 Use an antibiotic cream or ointment to keep the area clean and sterile Cover with a sterile dressing and change dressing every day to keep it clean At night take dressing off to allow airflow

4 Keep clean by washing with soap and warm water You may also soak it in a Betadine solution This will soften the skin and reduce irritation This will allow the skin to heal itself

5 When pain lessens do not cover the blister anymore Allow it to dry out By this time most of the healing has occurred so risk of infection has lessened significantly Generally if it doesnrsquot hurt it is healed

How to Treat a BlisterMarc Gallagher ATC

coordinatedhealthcom JulyAugust 2011 7

coordinatedhealthcom JulyAugust 2011 7

coordinatedhealthcom8 JulyAugust 2011

Summer is just about over and everywhere you look yoursquoll find reminders that school will soon be in session Just walk into any superstore or look at the Sunday circulars and yoursquoll immediately feel the pressure to

get ready for school There are supplies and clothing to be bought anxieties to be calmed and young adults who need to get everything packed up for college But in all the chaos one thing you may forget is

that a great start to the school year also means a healthy start Here are a few health related tips to keep in mind

Your Back-to-School Health ChecklistJeanette Richards RN MSN CRNP ANP-BC

One thing you may forget is that a great start to the school year

also means a healthy start

coordinatedhealthcom JulyAugust 2011 9

1 Immunizations While immunization laws school requirements and permitted exemptions can vary from state to state The American Academy of Pediatrics (AAP) recommends that all children entering public school have their immunizations up to date A list of immunization requirements organized by state can be found on the American Academy of Pediatrics website Parents generally must provide up-to-date immunization records to the school upon enrollment

2 Hearing and vision tests Some states include hearing and vision testing as a public service for all children as part of a standardized pre-K childhood screening In other states these tests are recommended but not required Regardless of whether

the tests are required they

may be a good idea

for any child whose

parent has concerns about

these areas Impaired vision or

hearing can adversely affect learning and

young children often donrsquot know how to articulate that they canrsquot see or hear properly Some school districts also require a basic physical exam before entering school

If you get a note from your childrsquos school nurse stating that they failed their vision or hearing exams take it seriously If you are concerned about how to follow up the school nurse can provide you with a list of community resources where you can get assistance

coordinatedhealthcom

3 Special Health Concerns If your child has any special medical needs these also need to be addressed with the school Some things to remember if your child has special needs are If your child is on medications does he or she need them at school Do you have a request from your physician to provide these medications during school hours What information and forms do you have to provide to the school Is the medication in a clearly labeled bottle How will the medications be handled when your child goes on a field trip If your child needs an emergency care plan at school this should be in place before the school year begins Feel free to call your school district and meet with someone before

the school year starts This will assure a smooth transition

4 Sleep For most kids going back to school means getting up earlier this also means earlier bedtimes Sleep is critical for optimal health and learning as well as the regulation of mood and attention Kids tend to be energized and nervous about going back to school so getting enough sleep is critical Make this transition easier by gradually easing into an earlier bed time and an earlier wake-up time Even having kids go to bed 5-10 minutes earlier each night a few weeks before school starts will help

10 JulyAugust 2011

coordinatedhealthcom

5 Nutrition A healthy breakfast is an important way to start the day but especially a school day Keep quick and healthy options on hand so you can avoid the morning rush and the ldquoI donrsquot have timerdquo excuse Whole-grain breads and cold cereals quick oatmeal and hot cereals yogurt cottage cheese fruit etc will ensure breakfast goes smoothly At lunch try easy-to-carry veggies fruits dairy products lean meats whole grains and wholesome snacks that keep your childrsquos energy and attention levels high throughout the afternoon

6 Weigh the backpack Experts recommend that a childrsquos backpack weigh no more than 10-15 of his or her body weight in order to reduce the chance of back pain or injury Kidsrsquo backpacks can cause back shoulder and neck pain when theyrsquore too heavy and worn for numerous hours throughout the day Choose a lightweight or rolling backpack that has two wide padded shoulder straps and a padded back as well as a waist strap

JulyAugust 2011 11

coordinatedhealthcom12 JulyAugust 2011

7 Reduce anxiety Many kids especially those entering school for the first time or going off to college experience some anxiety Parents can help ease this by talking about what to expect and preparing for the transition together Being prepared will definitely help everyone adjust more easily

Parents should also make sure that emergency phone numbers on file at school are up-to-date and that the school nurse or your childrsquos teacher has the necessary instructions for any condition that your child might need special care for (asthma allergies etc) These forms seem cumbersome when they are sent home at

the beginning of the year but they are so very necessary and important in emergency situations For older students be sure they are equipped with their health insurance card in the event they need to seek medical care Having them submit all necessary information the college or university Health Center asks for is imperative for them to receive care when they are sick or have a medical emergency

For older students be sure they are equipped with their health insurance card in the event they

need to seek medical care

coordinatedhealthcom JulyAugust 2011 13

JOINCoordinated Healthrsquos

Free VIP ProgramRegister now to receive

Subscription to Coordinated Healthrsquos new online Magazine - we make it easy to understand your medical injuries conditions and treatment options

All-access pass to Coordinated Health TV - be a part of our growing online community as we educate and inform on the medical topics that interest you

The latest Coordinated Health news - be the first to know the latest healthcare news and how it affects your care

Priority access to our educational seminars and events - yoursquoll be first in line to register for all our special events

Updates from your physicians on the services and treatments that matter most to you and your family

TO REGISTER NOW CLICK HERE

Coordinated Healthrsquos VIP Program is a Spam Free Zone Your email will NEVER be made available to anyone for any reason

coordinatedhealthcom JulyAugust 2011 9

1 Immunizations While immunization laws school requirements and permitted exemptions can vary from state to state The American Academy of Pediatrics (AAP) recommends that all children entering public school have their immunizations up to date A list of immunization requirements organized by state can be found on the American Academy of Pediatrics website Parents generally must provide up-to-date immunization records to the school upon enrollment

2 Hearing and vision tests Some states include hearing and vision testing as a public service for all children as part of a standardized pre-K childhood screening In other states these tests are recommended but not required Regardless of whether

the tests are required they

may be a good idea

for any child whose

parent has concerns about

these areas Impaired vision or

hearing can adversely affect learning and

young children often donrsquot know how to articulate that they canrsquot see or hear properly Some school districts also require a basic physical exam before entering school

If you get a note from your childrsquos school nurse stating that they failed their vision or hearing exams take it seriously If you are concerned about how to follow up the school nurse can provide you with a list of community resources where you can get assistance

coordinatedhealthcom

3 Special Health Concerns If your child has any special medical needs these also need to be addressed with the school Some things to remember if your child has special needs are If your child is on medications does he or she need them at school Do you have a request from your physician to provide these medications during school hours What information and forms do you have to provide to the school Is the medication in a clearly labeled bottle How will the medications be handled when your child goes on a field trip If your child needs an emergency care plan at school this should be in place before the school year begins Feel free to call your school district and meet with someone before

the school year starts This will assure a smooth transition

4 Sleep For most kids going back to school means getting up earlier this also means earlier bedtimes Sleep is critical for optimal health and learning as well as the regulation of mood and attention Kids tend to be energized and nervous about going back to school so getting enough sleep is critical Make this transition easier by gradually easing into an earlier bed time and an earlier wake-up time Even having kids go to bed 5-10 minutes earlier each night a few weeks before school starts will help

10 JulyAugust 2011

coordinatedhealthcom

5 Nutrition A healthy breakfast is an important way to start the day but especially a school day Keep quick and healthy options on hand so you can avoid the morning rush and the ldquoI donrsquot have timerdquo excuse Whole-grain breads and cold cereals quick oatmeal and hot cereals yogurt cottage cheese fruit etc will ensure breakfast goes smoothly At lunch try easy-to-carry veggies fruits dairy products lean meats whole grains and wholesome snacks that keep your childrsquos energy and attention levels high throughout the afternoon

6 Weigh the backpack Experts recommend that a childrsquos backpack weigh no more than 10-15 of his or her body weight in order to reduce the chance of back pain or injury Kidsrsquo backpacks can cause back shoulder and neck pain when theyrsquore too heavy and worn for numerous hours throughout the day Choose a lightweight or rolling backpack that has two wide padded shoulder straps and a padded back as well as a waist strap

JulyAugust 2011 11

coordinatedhealthcom12 JulyAugust 2011

7 Reduce anxiety Many kids especially those entering school for the first time or going off to college experience some anxiety Parents can help ease this by talking about what to expect and preparing for the transition together Being prepared will definitely help everyone adjust more easily

Parents should also make sure that emergency phone numbers on file at school are up-to-date and that the school nurse or your childrsquos teacher has the necessary instructions for any condition that your child might need special care for (asthma allergies etc) These forms seem cumbersome when they are sent home at

the beginning of the year but they are so very necessary and important in emergency situations For older students be sure they are equipped with their health insurance card in the event they need to seek medical care Having them submit all necessary information the college or university Health Center asks for is imperative for them to receive care when they are sick or have a medical emergency

For older students be sure they are equipped with their health insurance card in the event they

need to seek medical care

coordinatedhealthcom JulyAugust 2011 13

JOINCoordinated Healthrsquos

Free VIP ProgramRegister now to receive

Subscription to Coordinated Healthrsquos new online Magazine - we make it easy to understand your medical injuries conditions and treatment options

All-access pass to Coordinated Health TV - be a part of our growing online community as we educate and inform on the medical topics that interest you

The latest Coordinated Health news - be the first to know the latest healthcare news and how it affects your care

Priority access to our educational seminars and events - yoursquoll be first in line to register for all our special events

Updates from your physicians on the services and treatments that matter most to you and your family

TO REGISTER NOW CLICK HERE

Coordinated Healthrsquos VIP Program is a Spam Free Zone Your email will NEVER be made available to anyone for any reason

coordinatedhealthcom

3 Special Health Concerns If your child has any special medical needs these also need to be addressed with the school Some things to remember if your child has special needs are If your child is on medications does he or she need them at school Do you have a request from your physician to provide these medications during school hours What information and forms do you have to provide to the school Is the medication in a clearly labeled bottle How will the medications be handled when your child goes on a field trip If your child needs an emergency care plan at school this should be in place before the school year begins Feel free to call your school district and meet with someone before

the school year starts This will assure a smooth transition

4 Sleep For most kids going back to school means getting up earlier this also means earlier bedtimes Sleep is critical for optimal health and learning as well as the regulation of mood and attention Kids tend to be energized and nervous about going back to school so getting enough sleep is critical Make this transition easier by gradually easing into an earlier bed time and an earlier wake-up time Even having kids go to bed 5-10 minutes earlier each night a few weeks before school starts will help

10 JulyAugust 2011

coordinatedhealthcom

5 Nutrition A healthy breakfast is an important way to start the day but especially a school day Keep quick and healthy options on hand so you can avoid the morning rush and the ldquoI donrsquot have timerdquo excuse Whole-grain breads and cold cereals quick oatmeal and hot cereals yogurt cottage cheese fruit etc will ensure breakfast goes smoothly At lunch try easy-to-carry veggies fruits dairy products lean meats whole grains and wholesome snacks that keep your childrsquos energy and attention levels high throughout the afternoon

6 Weigh the backpack Experts recommend that a childrsquos backpack weigh no more than 10-15 of his or her body weight in order to reduce the chance of back pain or injury Kidsrsquo backpacks can cause back shoulder and neck pain when theyrsquore too heavy and worn for numerous hours throughout the day Choose a lightweight or rolling backpack that has two wide padded shoulder straps and a padded back as well as a waist strap

JulyAugust 2011 11

coordinatedhealthcom12 JulyAugust 2011

7 Reduce anxiety Many kids especially those entering school for the first time or going off to college experience some anxiety Parents can help ease this by talking about what to expect and preparing for the transition together Being prepared will definitely help everyone adjust more easily

Parents should also make sure that emergency phone numbers on file at school are up-to-date and that the school nurse or your childrsquos teacher has the necessary instructions for any condition that your child might need special care for (asthma allergies etc) These forms seem cumbersome when they are sent home at

the beginning of the year but they are so very necessary and important in emergency situations For older students be sure they are equipped with their health insurance card in the event they need to seek medical care Having them submit all necessary information the college or university Health Center asks for is imperative for them to receive care when they are sick or have a medical emergency

For older students be sure they are equipped with their health insurance card in the event they

need to seek medical care

coordinatedhealthcom JulyAugust 2011 13

JOINCoordinated Healthrsquos

Free VIP ProgramRegister now to receive

Subscription to Coordinated Healthrsquos new online Magazine - we make it easy to understand your medical injuries conditions and treatment options

All-access pass to Coordinated Health TV - be a part of our growing online community as we educate and inform on the medical topics that interest you

The latest Coordinated Health news - be the first to know the latest healthcare news and how it affects your care

Priority access to our educational seminars and events - yoursquoll be first in line to register for all our special events

Updates from your physicians on the services and treatments that matter most to you and your family

TO REGISTER NOW CLICK HERE

Coordinated Healthrsquos VIP Program is a Spam Free Zone Your email will NEVER be made available to anyone for any reason

coordinatedhealthcom

5 Nutrition A healthy breakfast is an important way to start the day but especially a school day Keep quick and healthy options on hand so you can avoid the morning rush and the ldquoI donrsquot have timerdquo excuse Whole-grain breads and cold cereals quick oatmeal and hot cereals yogurt cottage cheese fruit etc will ensure breakfast goes smoothly At lunch try easy-to-carry veggies fruits dairy products lean meats whole grains and wholesome snacks that keep your childrsquos energy and attention levels high throughout the afternoon

6 Weigh the backpack Experts recommend that a childrsquos backpack weigh no more than 10-15 of his or her body weight in order to reduce the chance of back pain or injury Kidsrsquo backpacks can cause back shoulder and neck pain when theyrsquore too heavy and worn for numerous hours throughout the day Choose a lightweight or rolling backpack that has two wide padded shoulder straps and a padded back as well as a waist strap

JulyAugust 2011 11

coordinatedhealthcom12 JulyAugust 2011

7 Reduce anxiety Many kids especially those entering school for the first time or going off to college experience some anxiety Parents can help ease this by talking about what to expect and preparing for the transition together Being prepared will definitely help everyone adjust more easily

Parents should also make sure that emergency phone numbers on file at school are up-to-date and that the school nurse or your childrsquos teacher has the necessary instructions for any condition that your child might need special care for (asthma allergies etc) These forms seem cumbersome when they are sent home at

the beginning of the year but they are so very necessary and important in emergency situations For older students be sure they are equipped with their health insurance card in the event they need to seek medical care Having them submit all necessary information the college or university Health Center asks for is imperative for them to receive care when they are sick or have a medical emergency

For older students be sure they are equipped with their health insurance card in the event they

need to seek medical care

coordinatedhealthcom JulyAugust 2011 13

JOINCoordinated Healthrsquos

Free VIP ProgramRegister now to receive

Subscription to Coordinated Healthrsquos new online Magazine - we make it easy to understand your medical injuries conditions and treatment options

All-access pass to Coordinated Health TV - be a part of our growing online community as we educate and inform on the medical topics that interest you

The latest Coordinated Health news - be the first to know the latest healthcare news and how it affects your care

Priority access to our educational seminars and events - yoursquoll be first in line to register for all our special events

Updates from your physicians on the services and treatments that matter most to you and your family

TO REGISTER NOW CLICK HERE

Coordinated Healthrsquos VIP Program is a Spam Free Zone Your email will NEVER be made available to anyone for any reason

coordinatedhealthcom12 JulyAugust 2011

7 Reduce anxiety Many kids especially those entering school for the first time or going off to college experience some anxiety Parents can help ease this by talking about what to expect and preparing for the transition together Being prepared will definitely help everyone adjust more easily

Parents should also make sure that emergency phone numbers on file at school are up-to-date and that the school nurse or your childrsquos teacher has the necessary instructions for any condition that your child might need special care for (asthma allergies etc) These forms seem cumbersome when they are sent home at

the beginning of the year but they are so very necessary and important in emergency situations For older students be sure they are equipped with their health insurance card in the event they need to seek medical care Having them submit all necessary information the college or university Health Center asks for is imperative for them to receive care when they are sick or have a medical emergency

For older students be sure they are equipped with their health insurance card in the event they

need to seek medical care

coordinatedhealthcom JulyAugust 2011 13

JOINCoordinated Healthrsquos

Free VIP ProgramRegister now to receive

Subscription to Coordinated Healthrsquos new online Magazine - we make it easy to understand your medical injuries conditions and treatment options

All-access pass to Coordinated Health TV - be a part of our growing online community as we educate and inform on the medical topics that interest you

The latest Coordinated Health news - be the first to know the latest healthcare news and how it affects your care

Priority access to our educational seminars and events - yoursquoll be first in line to register for all our special events

Updates from your physicians on the services and treatments that matter most to you and your family

TO REGISTER NOW CLICK HERE

Coordinated Healthrsquos VIP Program is a Spam Free Zone Your email will NEVER be made available to anyone for any reason

coordinatedhealthcom JulyAugust 2011 13

JOINCoordinated Healthrsquos

Free VIP ProgramRegister now to receive

Subscription to Coordinated Healthrsquos new online Magazine - we make it easy to understand your medical injuries conditions and treatment options

All-access pass to Coordinated Health TV - be a part of our growing online community as we educate and inform on the medical topics that interest you

The latest Coordinated Health news - be the first to know the latest healthcare news and how it affects your care

Priority access to our educational seminars and events - yoursquoll be first in line to register for all our special events

Updates from your physicians on the services and treatments that matter most to you and your family

TO REGISTER NOW CLICK HERE

Coordinated Healthrsquos VIP Program is a Spam Free Zone Your email will NEVER be made available to anyone for any reason

coordinatedhealthcom

What ou r pat ients a re say i ng abo ut o u r phys ic ia ns

Dr Jaeger has sucessfully

taken care of both my

shoulders carpal tunnel

and kneee problems

His bedside manner is

excellent and is very

good at explaining what he is doing William B

14 JulyAugust 2011

Dr Bridgido was the first doctor my daughter had seen in 5 years that knew what her condition was he was very upbeat and enthusiastic helped her through her pain encouraged her the entire time she was his patient and took the extra steps necessary to ensure that her ankle healed and she is now pain free after 5 long years of pain Sue C

Dr James Reid is

competent frien

dly

thorough and at

tentive He

treats you as pa

rtner in your he

alth

care planning an

d always explain

s things

so you can make

informed decisio

ns The

staff in his off

ices share his a

ttitude and

professionalism

and make it a ve

ry positive

experience when

you visit

Bruce H

Dr DiIorio has been my doctor for quite a few years Always makes the patient special will always answer your questions and always trys to help you I took his advice and had both knees replaced best thing I ever did He always explains everything he does and why and never tells you it will be easy You have to do the therapy and be patient It takes time to recover He never thinks questions are too dumb or silly to answer His hospital makes surgery a lot easier Great man and GREAT DOCTOR Gail G

Dr Scarpino is the best by far He has

been treating me for many years and I

am so glad he is close by I have every

confidence in him and his staff They are

wonderful Denise L

coordinatedhealthcom

I like Dr Mazza and Dr Wagner equally because they both helped me through a very painful time in February

2010 I have been back to my usual self for awhile now Actually I tested for

my 2nd degree black belt in

Taekwondo this past Friday Stacey C

Dr Goldberg

is very kind and is

willing to try diffrent

ideas He makes you think

that you are very important

when he is listening to you I

have recommend him and other

doctors I have seen to my

friends and family

Joyce S

What ou r pat ients a re say i ng about ou r phys ic ia ns

Dr Jaeger has sucessfully

taken care of both my

shoulders carpal tunnel

and kneee problems

His bedside manner is

excellent and is very

good at explaining what he is doing William B

JulyAugust 2011 15

Dr Bridgido was the first doctor my daughter had seen in 5 years that knew what her condition was he was very upbeat and enthusiastic helped her through her pain encouraged her the entire time she was his patient and took the extra steps necessary to ensure that her ankle healed and she is now pain free after 5 long years of pain Sue C

Dr McCarroll has always been helpful easy-going and listens to me when I see him Hersquos the only doctor Irsquove needed to see there (Irsquove been lucky in the fact that I havenrsquot injured myself in any other way and hope it remains that way) Maria S

I have only seen Dr Kooch and I like the fact that he takes my input regarding what kind of treatment plan I am most comfortable with ie medications physical therapy etc He was not quick to jump to aggressive treatment right away which is good for me since I do not like to take pharmacological substances if it can be avoided Julia K

Dr Abrams is a wonderful doctor

He is a very knowledgeable and

compassionate person He is very

helpful when you have a problem He

keeps my Rheumatoid Arthritis in control

and that is very important to me

Margaret G

Dr Meade is a thorough professional doctor He strives to do the best for all his patients He has performed surgery on both my children Stephanie B

To share thoughts about your favorite Coordinated Health physician

CLICK HEREWersquod love to hear from you

coordinatedhealthcom16 JulyAugust 2011

Balance is an important part of everyday life but itrsquos one that many people overlook when it comes to exercise Balance falls into the same category as flexibility core strength and mobility These are all things our body needs to function efficiently but many of us donrsquot actually do exercises to improve them If you exercise regularly you already work on your balance however just because you exercise doesnrsquot mean there isnrsquot room for improvement

Balance is a complicated process that involves the eyes the inner ear sensors in joints

The Importance of Balance in Older AdultsBy Jeff Kroboth CSCS

coordinatedhealthcom JulyAugust 2011 17

(proprioceptors) tendons muscles and skin These sensors relay information on your body position to the brain to process Decreased balance can be attributed to a number of issues including age reduced central processing of sensory information and slowed motor responses Muscle strength can also be attributed to loss of balance As you age

muscles will shrink unless you make a concentrated effort to keep them strong The muscles then weaken and are unable to hold the body in balance There are also some medications that can result in loss of balance

The key to balance training is to start slowly Itrsquos easy to hurt yourself if you donrsquot take your time and allow your body to get used to being in an unstable environment

The key to balance training is to start slowly Itrsquos easy

to hurt yourself if you donrsquot take your time and

allow your body to get used to being in an unstable

environment

coordinatedhealthcom

Research has shown that participation in either resistance or flexibility activities prior to balance exercise can negatively impact performance so balance training should precede both resistance and flexibility activities Aerobic resistance flexibility and balance training are each important to your overall health functional capacity and quality of life as you get older However to fulfill the minimum frequency requirements of each form of activity you need to perform at least two (or more) activities on the same day and most likely within the same exercise session

Since poor balance can lead to an increased risk of falls and may limit daily activities or participation in leisure-time activities it is essential that balance exercises be incorporated into your physical activity programs especially as you get older

Here are a few balance exercises that can be incorporated into your daily routine

Step up to Balance Use an Aerobic step box Make sure the height of the box is at a comfortable level A box that is too high can cause knee and back pain

Directions 1 Stand in front of your step up box keeping your toes about 6 inches away from the box

2 Step up with your right leg making sure to place your right foot flat and firmly on the box Your left leg should follow like you are walking up a flight of stairs

18 JulyAugust 2011

coordinatedhealthcom JulyAugust 2011 19

The left leg should stop when the knee is at a 90 degree angle with the left foot flat or slightly pointed upward

3 Step down with the left leg and return the right leg to the starting position

4 Repeat this action for 10 to 12 repetitions then switch to your left leg Do 2 sets of 10 to 12 repetitions

Balance Clock Matrix

Directions 1 Stand with your feet together on the ground Slightly raise your right foot in the air approximately 2 inches above the ground If you are unable to balance on one leg use a pole to assist you

2 While keeping your leg straight extend your foot forward towards where the 12 on a clock would be

3 Return your right leg back to the starting position being sure to not touch your foot down at the starting point

4 Extend your foot out to where 1 orsquoclock would be and return then to 2 orsquoclock and so on and so on until you have gone around the numbers on the clock

5 This matrix should be done at a slower pace to begin then quicker as you become more advanced Repeat the Balance Clock Matrix twice on each leg

coordinatedhealthcom

If yoursquore not careful gardening golf and other back-busting activities can put a real cramp in your summer plans In order to protect your summer plans and your spine itrsquos important to take

certain precautions when participating in some activities

Back injuries are among the most complex to evaluate and treat This is because your spine is full of different structures that can be worn out or injured all packed into a small area that is also full of nerves You probably know what it feels like when you hit your funny bone and that is only one nerve The low back has a whole network of nerves that exit the spine at each level and branch out to cover the entire lower half of your body These nerves are packed into a small area along with discs joints ligaments tendons and muscles If any of these structures are torn swollen inflamed or in spasm they can press or squeeze the nerves Even a relatively minor muscle strain can put pressure on a nerve causing pain to radiate into areas where there is no injury

Low Back InjuriesBy Mark Salamon PT

20 JulyAugust 2011

coordinatedhealthcom

Even when your nerves are not being squeezed an injury to any of the structures of your spine can cause a reactive muscle spasm Your bodyrsquos nervous system has many mechanisms that sense if something is wrong Even a minor injury to your back can send a signal to the nervous system which sends a signal back to the muscles that surround your spine telling it to contract in order to protect the spine and prevent further injury This constant muscle contraction can cause more pain than the injury itself And since it is a protective reflex you canrsquot just relax the muscles by thinking about it Imagine making a fist as hard as you can and holding it all day long Think about how sore your hand would get That is what the muscles around your spine are doing

With any low back injury it is very important to be evaluated by a physician Diagnostic tests may be necessary to determine if it is a relatively minor injury or a dangerous situation Your physician will determine if physical therapy is appropriate

If you are referred to physical therapy your therapist will perform a thorough evaluation to determine your course of treatment This involves observing how your pain responds to different motions measuring flexibility of your back and lower extremities and testing the strength of your lower extremities and ldquocorerdquo muscles The core is a term for the group of muscles that surround and protect your spine They include not only the muscles of the low back but the stomach hip and buttock muscles All of these muscles ldquowrap aroundrdquo the whole area and if they are working properly they absorb the force of your body

JulyAugust 2011 21

coordinatedhealthcom22 JulyAugust 2011

weight If any of these muscles become weak then more of your body weight is going directly to the spine causing more wear and tear on the discs and joints and making it more difficult for any injury to heal

Leg flexibility is also very important for your lower back Your leg muscles attach to the pelvis and the pelvis is attached to the lower spine If your leg muscles are tight particularly the hamstrings in the back of your thigh then these tight muscles are constantly pulling down on your pelvis and in turn on your lower back This tension on your lower back can cause pain even if there is no injury and makes any injury more difficult to heal

Even after your injury has healed it is very important to continue the exercise program that your therapist has given you By maintaining strong core muscles and flexible legs you are decreasing the forces on your spine and decreasing the ldquowear and tearrdquo that comes with the normal aging process You are also decreasing the chance of further injury Statistically ninety percent of all people will have some type of low back injury at some point in their life Virtually all of us need to take steps to decrease the chance of injury We canrsquot make you eighteen again but we can help you enjoy a longer active life

coordinatedhealthcom JulyAugust 2011 23

presents Overuse Injuries in Youth Athletes

helliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip Youth athletes on all levels are constantly pushing themselves

to reach new heights What happens when you push too hard Overuse or repetitive injuries are on the rise

Join our live interactive audience as Sports Medicine Physician Dr Todd Melegari explains the causes prevention and treatment of common over-use injuries in sports and fitness

Discover the importance of pre-stretching before any physical exercise by Frank Lupin Pulse Performance Specialist

Dr Todd Melegari Frank Lupin

helliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip when Tuesday August 16 2011 600pmwhere 2300 Highland Ave Bethlehem 2nd Floor to register Call 610-861-8080 ext 8276 Register now space is limited helliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip

Free Flexibility Screenings Free Refreshments amp Raffle Prizes

FREE

Flexibility

Screening

wwwcoordinatedhealthcom

coordinatedhealthcom24 JulyAugust 2011

13

Ski n Ca ncerSara Yodlosky PAC

As the weather gets warmer amp you are outside more often you must be aware of the potential hazards of sun exposure Exposure to ultraviolet rays is a risk factor for developing skin cancer

Skin cancer is the most common form of cancer with the number of cases growing each year There are 3 main types of skin cancer basal cell squamous cell amp melanoma

Basal cell is the most common form of skin cancer accounting for about 90 of cases The majority of these do not spread or become malignant They are usually found on the face Having a fair complexion amp a history of severe sunburn as a child are two risk factors Basal cell cancers usually appear as dome-shaped pinkish colored bump

Squamous cell cancer occurs about a frac14 as frequently as basal cell cancers They also affect fair skinned individuals amp are found on sun exposed areas Squamous cell cancers start as precancerous growths called actinic keratoses They can appear as small raised rough patches that are red or pink with a white or yellowish scale

coordinatedhealthcom JulyAugust 2011 25

Melanoma accounts for only a small percent of skin cancer but it is by far the most serious amp potentially deadly When evaluation skin lesions it is important to remember your ABCrsquos

Asymmetry ndash Does one frac12 match the other

Border ndash Is it smooth or irregular ragged or blurred

Color ndash Is it the same throughout

Diameter ndash Is it bigger then an eraser (6mm)

Evolving ndash Has it changed in any way

The best ways to prevent skin cancer are to avoid prolonged sun exposure and to practice sun safety Here are a few tips

bull Avoid the sun during 10AM amp 4PM

bull Wear sunscreen with SPF of 15 or higher and donrsquot forget to reapply

bull Wear protective clothing ndash hats sunglasses amp cover-ups

13

coordinatedhealthcom26 JulyAugust 2011

All sports come with injury risks Swimming is often thought of as a sport that is safe with little to no risk If swimming is a sport you are interested in picking up for exercise by far the biggest risk of injury in swimming is in your shoulder Many people watch competitive swimming and draw an interest in the sport from watching When you watch swimming you are only seeing what goes on above the water but preventing injury comes with understanding what should be done under the water

I swam competitively from age 6 to 20 I was at an elite level by the age of 14 I qualified for nationals at that age and was on nationally ranked teams throughout high school I was riding high because of my success but then my yardage (distance I was swimming) bumped up and I became

more knowledgeable of the demands of the sport on the shoulder then I wanted to be I ended up missing the majority of my sophomore and junior seasons in high school due to shoulder injuries on both sides I rehabbed and became aware of

a lot of things I did wrong in and out of the water Luckily from that point on I had no more shoulder issues and that experience led me to a career in rehabilitation

When talking to people about swimming I try to relate it back

to mainstream sports You are probably aware that baseball is very hard on the shoulders and most pitchers are placed on a pitch count They may throw 120 pitches and that is the end of their game They may throw bullpen sessions on their off days but they will not throw 120 pitches again for 4-5 days Swimmers take approximately 15-20 strokes per lap and swim in the range of

Swimmers and ShouldersBy Mike Price PT

If swimming is a sport you are interested in

picking up for exercise by far the biggest risk of injury in swimming

is in your shoulder

coordinatedhealthcom JulyAugust 2011 27

10000 yards a practice (400 laps) so they may take 6000-8000 strokes in a practice They will then get in the water the next day and do it all over again I am not comparing throwing to swimming but you can see where the overuse of the shoulder comes in for swimmers Even a new swimmer may only swim 500 yards (20 laps) but in that time they are likely to do 300-400 overhead repetitions in the water

The most common shoulder pathologies in swimmers are rotator cuff tendonitis and impingement syndrome These diagnoses are characterized by loss of motion mostly overhead and into internal rotation loss of strength throughout the shoulder and pain There are a few things that can go wrong in and out of the water that can make swimmers more prone to these diagnoses In the water you can have issues of technique including arm placement under water limited trunk rotation in the water asymmetrical breathing patterns and hand placement in the water Out of the water poor posture which will lead to

poor posture in the water can also lead to injuries

Under the water if a swimmer does not bend their elbows they make their

shoulder muscles take more of a load to move them forward in the water instead of allowing other arm muscles and chest muscles to assist in forward movement

Having a symmetrical trunk rotation and learning how to breathe to both sides also will help you avoid injuries The less your trunk is rotating while you swim the flatter you are in the water The lesser rotation of your trunk the more internal rotation will be required at your shoulders and being in internally rotated positions increases the likelihood of impingement

Proper elbow bending under water to lessen stress on shoulder

coordinatedhealthcom28 JulyAugust 2011

Hand placement into the water can also increase the tendency of shoulder impingement Many swimmers try to enter thumb first but by doing so you are again demanding more internal rotation of the shoulder which can lead to injury When swimming you should try to enter the water with more of a flat hand Lastly poor posture can cause you to crossover the midline under the water which also puts you in a position where there is more stress on the rotator cuff

Swimming is a great cardiovascular exercise and can really condition your entire body However it can be stressful on your shoulders If swimming is a sport you

really want to try I strongly recommend you get formal instruction from someone that has a background in swimming or at the very least watch an underwater video of proper swimming technique It is also useful for you to meet with a physical therapist or performance specialist that can assess you to make sure your shoulders are flexible enough and strong enough to make a smooth transition to the sport

Poor posture making swimmer cross the midline with stroke

Example of correct flat hand entry into water

coordinatedhealthcom JulyAugust 2011 29

1 in PatientSatisfaction

Based on Medicare Data 2009-2011Visit hospitalcompare hhs gov

coordinatedhealthcom

ALLENTOWN BETHLEHEM EASTON HAZLETON PHILLIPSBURGBRODHEADSVILLE E STROUDSBURG LEHIGHTON

coordinatedhealthcom JulyAugust 2011 17

(proprioceptors) tendons muscles and skin These sensors relay information on your body position to the brain to process Decreased balance can be attributed to a number of issues including age reduced central processing of sensory information and slowed motor responses Muscle strength can also be attributed to loss of balance As you age

muscles will shrink unless you make a concentrated effort to keep them strong The muscles then weaken and are unable to hold the body in balance There are also some medications that can result in loss of balance

The key to balance training is to start slowly Itrsquos easy to hurt yourself if you donrsquot take your time and allow your body to get used to being in an unstable environment

The key to balance training is to start slowly Itrsquos easy

to hurt yourself if you donrsquot take your time and

allow your body to get used to being in an unstable

environment

coordinatedhealthcom

Research has shown that participation in either resistance or flexibility activities prior to balance exercise can negatively impact performance so balance training should precede both resistance and flexibility activities Aerobic resistance flexibility and balance training are each important to your overall health functional capacity and quality of life as you get older However to fulfill the minimum frequency requirements of each form of activity you need to perform at least two (or more) activities on the same day and most likely within the same exercise session

Since poor balance can lead to an increased risk of falls and may limit daily activities or participation in leisure-time activities it is essential that balance exercises be incorporated into your physical activity programs especially as you get older

Here are a few balance exercises that can be incorporated into your daily routine

Step up to Balance Use an Aerobic step box Make sure the height of the box is at a comfortable level A box that is too high can cause knee and back pain

Directions 1 Stand in front of your step up box keeping your toes about 6 inches away from the box

2 Step up with your right leg making sure to place your right foot flat and firmly on the box Your left leg should follow like you are walking up a flight of stairs

18 JulyAugust 2011

coordinatedhealthcom JulyAugust 2011 19

The left leg should stop when the knee is at a 90 degree angle with the left foot flat or slightly pointed upward

3 Step down with the left leg and return the right leg to the starting position

4 Repeat this action for 10 to 12 repetitions then switch to your left leg Do 2 sets of 10 to 12 repetitions

Balance Clock Matrix

Directions 1 Stand with your feet together on the ground Slightly raise your right foot in the air approximately 2 inches above the ground If you are unable to balance on one leg use a pole to assist you

2 While keeping your leg straight extend your foot forward towards where the 12 on a clock would be

3 Return your right leg back to the starting position being sure to not touch your foot down at the starting point

4 Extend your foot out to where 1 orsquoclock would be and return then to 2 orsquoclock and so on and so on until you have gone around the numbers on the clock

5 This matrix should be done at a slower pace to begin then quicker as you become more advanced Repeat the Balance Clock Matrix twice on each leg

coordinatedhealthcom

If yoursquore not careful gardening golf and other back-busting activities can put a real cramp in your summer plans In order to protect your summer plans and your spine itrsquos important to take

certain precautions when participating in some activities

Back injuries are among the most complex to evaluate and treat This is because your spine is full of different structures that can be worn out or injured all packed into a small area that is also full of nerves You probably know what it feels like when you hit your funny bone and that is only one nerve The low back has a whole network of nerves that exit the spine at each level and branch out to cover the entire lower half of your body These nerves are packed into a small area along with discs joints ligaments tendons and muscles If any of these structures are torn swollen inflamed or in spasm they can press or squeeze the nerves Even a relatively minor muscle strain can put pressure on a nerve causing pain to radiate into areas where there is no injury

Low Back InjuriesBy Mark Salamon PT

20 JulyAugust 2011

coordinatedhealthcom

Even when your nerves are not being squeezed an injury to any of the structures of your spine can cause a reactive muscle spasm Your bodyrsquos nervous system has many mechanisms that sense if something is wrong Even a minor injury to your back can send a signal to the nervous system which sends a signal back to the muscles that surround your spine telling it to contract in order to protect the spine and prevent further injury This constant muscle contraction can cause more pain than the injury itself And since it is a protective reflex you canrsquot just relax the muscles by thinking about it Imagine making a fist as hard as you can and holding it all day long Think about how sore your hand would get That is what the muscles around your spine are doing

With any low back injury it is very important to be evaluated by a physician Diagnostic tests may be necessary to determine if it is a relatively minor injury or a dangerous situation Your physician will determine if physical therapy is appropriate

If you are referred to physical therapy your therapist will perform a thorough evaluation to determine your course of treatment This involves observing how your pain responds to different motions measuring flexibility of your back and lower extremities and testing the strength of your lower extremities and ldquocorerdquo muscles The core is a term for the group of muscles that surround and protect your spine They include not only the muscles of the low back but the stomach hip and buttock muscles All of these muscles ldquowrap aroundrdquo the whole area and if they are working properly they absorb the force of your body

JulyAugust 2011 21

coordinatedhealthcom22 JulyAugust 2011

weight If any of these muscles become weak then more of your body weight is going directly to the spine causing more wear and tear on the discs and joints and making it more difficult for any injury to heal

Leg flexibility is also very important for your lower back Your leg muscles attach to the pelvis and the pelvis is attached to the lower spine If your leg muscles are tight particularly the hamstrings in the back of your thigh then these tight muscles are constantly pulling down on your pelvis and in turn on your lower back This tension on your lower back can cause pain even if there is no injury and makes any injury more difficult to heal

Even after your injury has healed it is very important to continue the exercise program that your therapist has given you By maintaining strong core muscles and flexible legs you are decreasing the forces on your spine and decreasing the ldquowear and tearrdquo that comes with the normal aging process You are also decreasing the chance of further injury Statistically ninety percent of all people will have some type of low back injury at some point in their life Virtually all of us need to take steps to decrease the chance of injury We canrsquot make you eighteen again but we can help you enjoy a longer active life

coordinatedhealthcom JulyAugust 2011 23

presents Overuse Injuries in Youth Athletes

helliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip Youth athletes on all levels are constantly pushing themselves

to reach new heights What happens when you push too hard Overuse or repetitive injuries are on the rise

Join our live interactive audience as Sports Medicine Physician Dr Todd Melegari explains the causes prevention and treatment of common over-use injuries in sports and fitness

Discover the importance of pre-stretching before any physical exercise by Frank Lupin Pulse Performance Specialist

Dr Todd Melegari Frank Lupin

helliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip when Tuesday August 16 2011 600pmwhere 2300 Highland Ave Bethlehem 2nd Floor to register Call 610-861-8080 ext 8276 Register now space is limited helliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip

Free Flexibility Screenings Free Refreshments amp Raffle Prizes

FREE

Flexibility

Screening

wwwcoordinatedhealthcom

coordinatedhealthcom24 JulyAugust 2011

13

Ski n Ca ncerSara Yodlosky PAC

As the weather gets warmer amp you are outside more often you must be aware of the potential hazards of sun exposure Exposure to ultraviolet rays is a risk factor for developing skin cancer

Skin cancer is the most common form of cancer with the number of cases growing each year There are 3 main types of skin cancer basal cell squamous cell amp melanoma

Basal cell is the most common form of skin cancer accounting for about 90 of cases The majority of these do not spread or become malignant They are usually found on the face Having a fair complexion amp a history of severe sunburn as a child are two risk factors Basal cell cancers usually appear as dome-shaped pinkish colored bump

Squamous cell cancer occurs about a frac14 as frequently as basal cell cancers They also affect fair skinned individuals amp are found on sun exposed areas Squamous cell cancers start as precancerous growths called actinic keratoses They can appear as small raised rough patches that are red or pink with a white or yellowish scale

coordinatedhealthcom JulyAugust 2011 25

Melanoma accounts for only a small percent of skin cancer but it is by far the most serious amp potentially deadly When evaluation skin lesions it is important to remember your ABCrsquos

Asymmetry ndash Does one frac12 match the other

Border ndash Is it smooth or irregular ragged or blurred

Color ndash Is it the same throughout

Diameter ndash Is it bigger then an eraser (6mm)

Evolving ndash Has it changed in any way

The best ways to prevent skin cancer are to avoid prolonged sun exposure and to practice sun safety Here are a few tips

bull Avoid the sun during 10AM amp 4PM

bull Wear sunscreen with SPF of 15 or higher and donrsquot forget to reapply

bull Wear protective clothing ndash hats sunglasses amp cover-ups

13

coordinatedhealthcom26 JulyAugust 2011

All sports come with injury risks Swimming is often thought of as a sport that is safe with little to no risk If swimming is a sport you are interested in picking up for exercise by far the biggest risk of injury in swimming is in your shoulder Many people watch competitive swimming and draw an interest in the sport from watching When you watch swimming you are only seeing what goes on above the water but preventing injury comes with understanding what should be done under the water

I swam competitively from age 6 to 20 I was at an elite level by the age of 14 I qualified for nationals at that age and was on nationally ranked teams throughout high school I was riding high because of my success but then my yardage (distance I was swimming) bumped up and I became

more knowledgeable of the demands of the sport on the shoulder then I wanted to be I ended up missing the majority of my sophomore and junior seasons in high school due to shoulder injuries on both sides I rehabbed and became aware of

a lot of things I did wrong in and out of the water Luckily from that point on I had no more shoulder issues and that experience led me to a career in rehabilitation

When talking to people about swimming I try to relate it back

to mainstream sports You are probably aware that baseball is very hard on the shoulders and most pitchers are placed on a pitch count They may throw 120 pitches and that is the end of their game They may throw bullpen sessions on their off days but they will not throw 120 pitches again for 4-5 days Swimmers take approximately 15-20 strokes per lap and swim in the range of

Swimmers and ShouldersBy Mike Price PT

If swimming is a sport you are interested in

picking up for exercise by far the biggest risk of injury in swimming

is in your shoulder

coordinatedhealthcom JulyAugust 2011 27

10000 yards a practice (400 laps) so they may take 6000-8000 strokes in a practice They will then get in the water the next day and do it all over again I am not comparing throwing to swimming but you can see where the overuse of the shoulder comes in for swimmers Even a new swimmer may only swim 500 yards (20 laps) but in that time they are likely to do 300-400 overhead repetitions in the water

The most common shoulder pathologies in swimmers are rotator cuff tendonitis and impingement syndrome These diagnoses are characterized by loss of motion mostly overhead and into internal rotation loss of strength throughout the shoulder and pain There are a few things that can go wrong in and out of the water that can make swimmers more prone to these diagnoses In the water you can have issues of technique including arm placement under water limited trunk rotation in the water asymmetrical breathing patterns and hand placement in the water Out of the water poor posture which will lead to

poor posture in the water can also lead to injuries

Under the water if a swimmer does not bend their elbows they make their

shoulder muscles take more of a load to move them forward in the water instead of allowing other arm muscles and chest muscles to assist in forward movement

Having a symmetrical trunk rotation and learning how to breathe to both sides also will help you avoid injuries The less your trunk is rotating while you swim the flatter you are in the water The lesser rotation of your trunk the more internal rotation will be required at your shoulders and being in internally rotated positions increases the likelihood of impingement

Proper elbow bending under water to lessen stress on shoulder

coordinatedhealthcom28 JulyAugust 2011

Hand placement into the water can also increase the tendency of shoulder impingement Many swimmers try to enter thumb first but by doing so you are again demanding more internal rotation of the shoulder which can lead to injury When swimming you should try to enter the water with more of a flat hand Lastly poor posture can cause you to crossover the midline under the water which also puts you in a position where there is more stress on the rotator cuff

Swimming is a great cardiovascular exercise and can really condition your entire body However it can be stressful on your shoulders If swimming is a sport you

really want to try I strongly recommend you get formal instruction from someone that has a background in swimming or at the very least watch an underwater video of proper swimming technique It is also useful for you to meet with a physical therapist or performance specialist that can assess you to make sure your shoulders are flexible enough and strong enough to make a smooth transition to the sport

Poor posture making swimmer cross the midline with stroke

Example of correct flat hand entry into water

coordinatedhealthcom JulyAugust 2011 29

1 in PatientSatisfaction

Based on Medicare Data 2009-2011Visit hospitalcompare hhs gov

coordinatedhealthcom

ALLENTOWN BETHLEHEM EASTON HAZLETON PHILLIPSBURGBRODHEADSVILLE E STROUDSBURG LEHIGHTON

coordinatedhealthcom

Research has shown that participation in either resistance or flexibility activities prior to balance exercise can negatively impact performance so balance training should precede both resistance and flexibility activities Aerobic resistance flexibility and balance training are each important to your overall health functional capacity and quality of life as you get older However to fulfill the minimum frequency requirements of each form of activity you need to perform at least two (or more) activities on the same day and most likely within the same exercise session

Since poor balance can lead to an increased risk of falls and may limit daily activities or participation in leisure-time activities it is essential that balance exercises be incorporated into your physical activity programs especially as you get older

Here are a few balance exercises that can be incorporated into your daily routine

Step up to Balance Use an Aerobic step box Make sure the height of the box is at a comfortable level A box that is too high can cause knee and back pain

Directions 1 Stand in front of your step up box keeping your toes about 6 inches away from the box

2 Step up with your right leg making sure to place your right foot flat and firmly on the box Your left leg should follow like you are walking up a flight of stairs

18 JulyAugust 2011

coordinatedhealthcom JulyAugust 2011 19

The left leg should stop when the knee is at a 90 degree angle with the left foot flat or slightly pointed upward

3 Step down with the left leg and return the right leg to the starting position

4 Repeat this action for 10 to 12 repetitions then switch to your left leg Do 2 sets of 10 to 12 repetitions

Balance Clock Matrix

Directions 1 Stand with your feet together on the ground Slightly raise your right foot in the air approximately 2 inches above the ground If you are unable to balance on one leg use a pole to assist you

2 While keeping your leg straight extend your foot forward towards where the 12 on a clock would be

3 Return your right leg back to the starting position being sure to not touch your foot down at the starting point

4 Extend your foot out to where 1 orsquoclock would be and return then to 2 orsquoclock and so on and so on until you have gone around the numbers on the clock

5 This matrix should be done at a slower pace to begin then quicker as you become more advanced Repeat the Balance Clock Matrix twice on each leg

coordinatedhealthcom

If yoursquore not careful gardening golf and other back-busting activities can put a real cramp in your summer plans In order to protect your summer plans and your spine itrsquos important to take

certain precautions when participating in some activities

Back injuries are among the most complex to evaluate and treat This is because your spine is full of different structures that can be worn out or injured all packed into a small area that is also full of nerves You probably know what it feels like when you hit your funny bone and that is only one nerve The low back has a whole network of nerves that exit the spine at each level and branch out to cover the entire lower half of your body These nerves are packed into a small area along with discs joints ligaments tendons and muscles If any of these structures are torn swollen inflamed or in spasm they can press or squeeze the nerves Even a relatively minor muscle strain can put pressure on a nerve causing pain to radiate into areas where there is no injury

Low Back InjuriesBy Mark Salamon PT

20 JulyAugust 2011

coordinatedhealthcom

Even when your nerves are not being squeezed an injury to any of the structures of your spine can cause a reactive muscle spasm Your bodyrsquos nervous system has many mechanisms that sense if something is wrong Even a minor injury to your back can send a signal to the nervous system which sends a signal back to the muscles that surround your spine telling it to contract in order to protect the spine and prevent further injury This constant muscle contraction can cause more pain than the injury itself And since it is a protective reflex you canrsquot just relax the muscles by thinking about it Imagine making a fist as hard as you can and holding it all day long Think about how sore your hand would get That is what the muscles around your spine are doing

With any low back injury it is very important to be evaluated by a physician Diagnostic tests may be necessary to determine if it is a relatively minor injury or a dangerous situation Your physician will determine if physical therapy is appropriate

If you are referred to physical therapy your therapist will perform a thorough evaluation to determine your course of treatment This involves observing how your pain responds to different motions measuring flexibility of your back and lower extremities and testing the strength of your lower extremities and ldquocorerdquo muscles The core is a term for the group of muscles that surround and protect your spine They include not only the muscles of the low back but the stomach hip and buttock muscles All of these muscles ldquowrap aroundrdquo the whole area and if they are working properly they absorb the force of your body

JulyAugust 2011 21

coordinatedhealthcom22 JulyAugust 2011

weight If any of these muscles become weak then more of your body weight is going directly to the spine causing more wear and tear on the discs and joints and making it more difficult for any injury to heal

Leg flexibility is also very important for your lower back Your leg muscles attach to the pelvis and the pelvis is attached to the lower spine If your leg muscles are tight particularly the hamstrings in the back of your thigh then these tight muscles are constantly pulling down on your pelvis and in turn on your lower back This tension on your lower back can cause pain even if there is no injury and makes any injury more difficult to heal

Even after your injury has healed it is very important to continue the exercise program that your therapist has given you By maintaining strong core muscles and flexible legs you are decreasing the forces on your spine and decreasing the ldquowear and tearrdquo that comes with the normal aging process You are also decreasing the chance of further injury Statistically ninety percent of all people will have some type of low back injury at some point in their life Virtually all of us need to take steps to decrease the chance of injury We canrsquot make you eighteen again but we can help you enjoy a longer active life

coordinatedhealthcom JulyAugust 2011 23

presents Overuse Injuries in Youth Athletes

helliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip Youth athletes on all levels are constantly pushing themselves

to reach new heights What happens when you push too hard Overuse or repetitive injuries are on the rise

Join our live interactive audience as Sports Medicine Physician Dr Todd Melegari explains the causes prevention and treatment of common over-use injuries in sports and fitness

Discover the importance of pre-stretching before any physical exercise by Frank Lupin Pulse Performance Specialist

Dr Todd Melegari Frank Lupin

helliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip when Tuesday August 16 2011 600pmwhere 2300 Highland Ave Bethlehem 2nd Floor to register Call 610-861-8080 ext 8276 Register now space is limited helliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip

Free Flexibility Screenings Free Refreshments amp Raffle Prizes

FREE

Flexibility

Screening

wwwcoordinatedhealthcom

coordinatedhealthcom24 JulyAugust 2011

13

Ski n Ca ncerSara Yodlosky PAC

As the weather gets warmer amp you are outside more often you must be aware of the potential hazards of sun exposure Exposure to ultraviolet rays is a risk factor for developing skin cancer

Skin cancer is the most common form of cancer with the number of cases growing each year There are 3 main types of skin cancer basal cell squamous cell amp melanoma

Basal cell is the most common form of skin cancer accounting for about 90 of cases The majority of these do not spread or become malignant They are usually found on the face Having a fair complexion amp a history of severe sunburn as a child are two risk factors Basal cell cancers usually appear as dome-shaped pinkish colored bump

Squamous cell cancer occurs about a frac14 as frequently as basal cell cancers They also affect fair skinned individuals amp are found on sun exposed areas Squamous cell cancers start as precancerous growths called actinic keratoses They can appear as small raised rough patches that are red or pink with a white or yellowish scale

coordinatedhealthcom JulyAugust 2011 25

Melanoma accounts for only a small percent of skin cancer but it is by far the most serious amp potentially deadly When evaluation skin lesions it is important to remember your ABCrsquos

Asymmetry ndash Does one frac12 match the other

Border ndash Is it smooth or irregular ragged or blurred

Color ndash Is it the same throughout

Diameter ndash Is it bigger then an eraser (6mm)

Evolving ndash Has it changed in any way

The best ways to prevent skin cancer are to avoid prolonged sun exposure and to practice sun safety Here are a few tips

bull Avoid the sun during 10AM amp 4PM

bull Wear sunscreen with SPF of 15 or higher and donrsquot forget to reapply

bull Wear protective clothing ndash hats sunglasses amp cover-ups

13

coordinatedhealthcom26 JulyAugust 2011

All sports come with injury risks Swimming is often thought of as a sport that is safe with little to no risk If swimming is a sport you are interested in picking up for exercise by far the biggest risk of injury in swimming is in your shoulder Many people watch competitive swimming and draw an interest in the sport from watching When you watch swimming you are only seeing what goes on above the water but preventing injury comes with understanding what should be done under the water

I swam competitively from age 6 to 20 I was at an elite level by the age of 14 I qualified for nationals at that age and was on nationally ranked teams throughout high school I was riding high because of my success but then my yardage (distance I was swimming) bumped up and I became

more knowledgeable of the demands of the sport on the shoulder then I wanted to be I ended up missing the majority of my sophomore and junior seasons in high school due to shoulder injuries on both sides I rehabbed and became aware of

a lot of things I did wrong in and out of the water Luckily from that point on I had no more shoulder issues and that experience led me to a career in rehabilitation

When talking to people about swimming I try to relate it back

to mainstream sports You are probably aware that baseball is very hard on the shoulders and most pitchers are placed on a pitch count They may throw 120 pitches and that is the end of their game They may throw bullpen sessions on their off days but they will not throw 120 pitches again for 4-5 days Swimmers take approximately 15-20 strokes per lap and swim in the range of

Swimmers and ShouldersBy Mike Price PT

If swimming is a sport you are interested in

picking up for exercise by far the biggest risk of injury in swimming

is in your shoulder

coordinatedhealthcom JulyAugust 2011 27

10000 yards a practice (400 laps) so they may take 6000-8000 strokes in a practice They will then get in the water the next day and do it all over again I am not comparing throwing to swimming but you can see where the overuse of the shoulder comes in for swimmers Even a new swimmer may only swim 500 yards (20 laps) but in that time they are likely to do 300-400 overhead repetitions in the water

The most common shoulder pathologies in swimmers are rotator cuff tendonitis and impingement syndrome These diagnoses are characterized by loss of motion mostly overhead and into internal rotation loss of strength throughout the shoulder and pain There are a few things that can go wrong in and out of the water that can make swimmers more prone to these diagnoses In the water you can have issues of technique including arm placement under water limited trunk rotation in the water asymmetrical breathing patterns and hand placement in the water Out of the water poor posture which will lead to

poor posture in the water can also lead to injuries

Under the water if a swimmer does not bend their elbows they make their

shoulder muscles take more of a load to move them forward in the water instead of allowing other arm muscles and chest muscles to assist in forward movement

Having a symmetrical trunk rotation and learning how to breathe to both sides also will help you avoid injuries The less your trunk is rotating while you swim the flatter you are in the water The lesser rotation of your trunk the more internal rotation will be required at your shoulders and being in internally rotated positions increases the likelihood of impingement

Proper elbow bending under water to lessen stress on shoulder

coordinatedhealthcom28 JulyAugust 2011

Hand placement into the water can also increase the tendency of shoulder impingement Many swimmers try to enter thumb first but by doing so you are again demanding more internal rotation of the shoulder which can lead to injury When swimming you should try to enter the water with more of a flat hand Lastly poor posture can cause you to crossover the midline under the water which also puts you in a position where there is more stress on the rotator cuff

Swimming is a great cardiovascular exercise and can really condition your entire body However it can be stressful on your shoulders If swimming is a sport you

really want to try I strongly recommend you get formal instruction from someone that has a background in swimming or at the very least watch an underwater video of proper swimming technique It is also useful for you to meet with a physical therapist or performance specialist that can assess you to make sure your shoulders are flexible enough and strong enough to make a smooth transition to the sport

Poor posture making swimmer cross the midline with stroke

Example of correct flat hand entry into water

coordinatedhealthcom JulyAugust 2011 29

1 in PatientSatisfaction

Based on Medicare Data 2009-2011Visit hospitalcompare hhs gov

coordinatedhealthcom

ALLENTOWN BETHLEHEM EASTON HAZLETON PHILLIPSBURGBRODHEADSVILLE E STROUDSBURG LEHIGHTON

coordinatedhealthcom JulyAugust 2011 19

The left leg should stop when the knee is at a 90 degree angle with the left foot flat or slightly pointed upward

3 Step down with the left leg and return the right leg to the starting position

4 Repeat this action for 10 to 12 repetitions then switch to your left leg Do 2 sets of 10 to 12 repetitions

Balance Clock Matrix

Directions 1 Stand with your feet together on the ground Slightly raise your right foot in the air approximately 2 inches above the ground If you are unable to balance on one leg use a pole to assist you

2 While keeping your leg straight extend your foot forward towards where the 12 on a clock would be

3 Return your right leg back to the starting position being sure to not touch your foot down at the starting point

4 Extend your foot out to where 1 orsquoclock would be and return then to 2 orsquoclock and so on and so on until you have gone around the numbers on the clock

5 This matrix should be done at a slower pace to begin then quicker as you become more advanced Repeat the Balance Clock Matrix twice on each leg

coordinatedhealthcom

If yoursquore not careful gardening golf and other back-busting activities can put a real cramp in your summer plans In order to protect your summer plans and your spine itrsquos important to take

certain precautions when participating in some activities

Back injuries are among the most complex to evaluate and treat This is because your spine is full of different structures that can be worn out or injured all packed into a small area that is also full of nerves You probably know what it feels like when you hit your funny bone and that is only one nerve The low back has a whole network of nerves that exit the spine at each level and branch out to cover the entire lower half of your body These nerves are packed into a small area along with discs joints ligaments tendons and muscles If any of these structures are torn swollen inflamed or in spasm they can press or squeeze the nerves Even a relatively minor muscle strain can put pressure on a nerve causing pain to radiate into areas where there is no injury

Low Back InjuriesBy Mark Salamon PT

20 JulyAugust 2011

coordinatedhealthcom

Even when your nerves are not being squeezed an injury to any of the structures of your spine can cause a reactive muscle spasm Your bodyrsquos nervous system has many mechanisms that sense if something is wrong Even a minor injury to your back can send a signal to the nervous system which sends a signal back to the muscles that surround your spine telling it to contract in order to protect the spine and prevent further injury This constant muscle contraction can cause more pain than the injury itself And since it is a protective reflex you canrsquot just relax the muscles by thinking about it Imagine making a fist as hard as you can and holding it all day long Think about how sore your hand would get That is what the muscles around your spine are doing

With any low back injury it is very important to be evaluated by a physician Diagnostic tests may be necessary to determine if it is a relatively minor injury or a dangerous situation Your physician will determine if physical therapy is appropriate

If you are referred to physical therapy your therapist will perform a thorough evaluation to determine your course of treatment This involves observing how your pain responds to different motions measuring flexibility of your back and lower extremities and testing the strength of your lower extremities and ldquocorerdquo muscles The core is a term for the group of muscles that surround and protect your spine They include not only the muscles of the low back but the stomach hip and buttock muscles All of these muscles ldquowrap aroundrdquo the whole area and if they are working properly they absorb the force of your body

JulyAugust 2011 21

coordinatedhealthcom22 JulyAugust 2011

weight If any of these muscles become weak then more of your body weight is going directly to the spine causing more wear and tear on the discs and joints and making it more difficult for any injury to heal

Leg flexibility is also very important for your lower back Your leg muscles attach to the pelvis and the pelvis is attached to the lower spine If your leg muscles are tight particularly the hamstrings in the back of your thigh then these tight muscles are constantly pulling down on your pelvis and in turn on your lower back This tension on your lower back can cause pain even if there is no injury and makes any injury more difficult to heal

Even after your injury has healed it is very important to continue the exercise program that your therapist has given you By maintaining strong core muscles and flexible legs you are decreasing the forces on your spine and decreasing the ldquowear and tearrdquo that comes with the normal aging process You are also decreasing the chance of further injury Statistically ninety percent of all people will have some type of low back injury at some point in their life Virtually all of us need to take steps to decrease the chance of injury We canrsquot make you eighteen again but we can help you enjoy a longer active life

coordinatedhealthcom JulyAugust 2011 23

presents Overuse Injuries in Youth Athletes

helliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip Youth athletes on all levels are constantly pushing themselves

to reach new heights What happens when you push too hard Overuse or repetitive injuries are on the rise

Join our live interactive audience as Sports Medicine Physician Dr Todd Melegari explains the causes prevention and treatment of common over-use injuries in sports and fitness

Discover the importance of pre-stretching before any physical exercise by Frank Lupin Pulse Performance Specialist

Dr Todd Melegari Frank Lupin

helliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip when Tuesday August 16 2011 600pmwhere 2300 Highland Ave Bethlehem 2nd Floor to register Call 610-861-8080 ext 8276 Register now space is limited helliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip

Free Flexibility Screenings Free Refreshments amp Raffle Prizes

FREE

Flexibility

Screening

wwwcoordinatedhealthcom

coordinatedhealthcom24 JulyAugust 2011

13

Ski n Ca ncerSara Yodlosky PAC

As the weather gets warmer amp you are outside more often you must be aware of the potential hazards of sun exposure Exposure to ultraviolet rays is a risk factor for developing skin cancer

Skin cancer is the most common form of cancer with the number of cases growing each year There are 3 main types of skin cancer basal cell squamous cell amp melanoma

Basal cell is the most common form of skin cancer accounting for about 90 of cases The majority of these do not spread or become malignant They are usually found on the face Having a fair complexion amp a history of severe sunburn as a child are two risk factors Basal cell cancers usually appear as dome-shaped pinkish colored bump

Squamous cell cancer occurs about a frac14 as frequently as basal cell cancers They also affect fair skinned individuals amp are found on sun exposed areas Squamous cell cancers start as precancerous growths called actinic keratoses They can appear as small raised rough patches that are red or pink with a white or yellowish scale

coordinatedhealthcom JulyAugust 2011 25

Melanoma accounts for only a small percent of skin cancer but it is by far the most serious amp potentially deadly When evaluation skin lesions it is important to remember your ABCrsquos

Asymmetry ndash Does one frac12 match the other

Border ndash Is it smooth or irregular ragged or blurred

Color ndash Is it the same throughout

Diameter ndash Is it bigger then an eraser (6mm)

Evolving ndash Has it changed in any way

The best ways to prevent skin cancer are to avoid prolonged sun exposure and to practice sun safety Here are a few tips

bull Avoid the sun during 10AM amp 4PM

bull Wear sunscreen with SPF of 15 or higher and donrsquot forget to reapply

bull Wear protective clothing ndash hats sunglasses amp cover-ups

13

coordinatedhealthcom26 JulyAugust 2011

All sports come with injury risks Swimming is often thought of as a sport that is safe with little to no risk If swimming is a sport you are interested in picking up for exercise by far the biggest risk of injury in swimming is in your shoulder Many people watch competitive swimming and draw an interest in the sport from watching When you watch swimming you are only seeing what goes on above the water but preventing injury comes with understanding what should be done under the water

I swam competitively from age 6 to 20 I was at an elite level by the age of 14 I qualified for nationals at that age and was on nationally ranked teams throughout high school I was riding high because of my success but then my yardage (distance I was swimming) bumped up and I became

more knowledgeable of the demands of the sport on the shoulder then I wanted to be I ended up missing the majority of my sophomore and junior seasons in high school due to shoulder injuries on both sides I rehabbed and became aware of

a lot of things I did wrong in and out of the water Luckily from that point on I had no more shoulder issues and that experience led me to a career in rehabilitation

When talking to people about swimming I try to relate it back

to mainstream sports You are probably aware that baseball is very hard on the shoulders and most pitchers are placed on a pitch count They may throw 120 pitches and that is the end of their game They may throw bullpen sessions on their off days but they will not throw 120 pitches again for 4-5 days Swimmers take approximately 15-20 strokes per lap and swim in the range of

Swimmers and ShouldersBy Mike Price PT

If swimming is a sport you are interested in

picking up for exercise by far the biggest risk of injury in swimming

is in your shoulder

coordinatedhealthcom JulyAugust 2011 27

10000 yards a practice (400 laps) so they may take 6000-8000 strokes in a practice They will then get in the water the next day and do it all over again I am not comparing throwing to swimming but you can see where the overuse of the shoulder comes in for swimmers Even a new swimmer may only swim 500 yards (20 laps) but in that time they are likely to do 300-400 overhead repetitions in the water

The most common shoulder pathologies in swimmers are rotator cuff tendonitis and impingement syndrome These diagnoses are characterized by loss of motion mostly overhead and into internal rotation loss of strength throughout the shoulder and pain There are a few things that can go wrong in and out of the water that can make swimmers more prone to these diagnoses In the water you can have issues of technique including arm placement under water limited trunk rotation in the water asymmetrical breathing patterns and hand placement in the water Out of the water poor posture which will lead to

poor posture in the water can also lead to injuries

Under the water if a swimmer does not bend their elbows they make their

shoulder muscles take more of a load to move them forward in the water instead of allowing other arm muscles and chest muscles to assist in forward movement

Having a symmetrical trunk rotation and learning how to breathe to both sides also will help you avoid injuries The less your trunk is rotating while you swim the flatter you are in the water The lesser rotation of your trunk the more internal rotation will be required at your shoulders and being in internally rotated positions increases the likelihood of impingement

Proper elbow bending under water to lessen stress on shoulder

coordinatedhealthcom28 JulyAugust 2011

Hand placement into the water can also increase the tendency of shoulder impingement Many swimmers try to enter thumb first but by doing so you are again demanding more internal rotation of the shoulder which can lead to injury When swimming you should try to enter the water with more of a flat hand Lastly poor posture can cause you to crossover the midline under the water which also puts you in a position where there is more stress on the rotator cuff

Swimming is a great cardiovascular exercise and can really condition your entire body However it can be stressful on your shoulders If swimming is a sport you

really want to try I strongly recommend you get formal instruction from someone that has a background in swimming or at the very least watch an underwater video of proper swimming technique It is also useful for you to meet with a physical therapist or performance specialist that can assess you to make sure your shoulders are flexible enough and strong enough to make a smooth transition to the sport

Poor posture making swimmer cross the midline with stroke

Example of correct flat hand entry into water

coordinatedhealthcom JulyAugust 2011 29

1 in PatientSatisfaction

Based on Medicare Data 2009-2011Visit hospitalcompare hhs gov

coordinatedhealthcom

ALLENTOWN BETHLEHEM EASTON HAZLETON PHILLIPSBURGBRODHEADSVILLE E STROUDSBURG LEHIGHTON

coordinatedhealthcom

If yoursquore not careful gardening golf and other back-busting activities can put a real cramp in your summer plans In order to protect your summer plans and your spine itrsquos important to take

certain precautions when participating in some activities

Back injuries are among the most complex to evaluate and treat This is because your spine is full of different structures that can be worn out or injured all packed into a small area that is also full of nerves You probably know what it feels like when you hit your funny bone and that is only one nerve The low back has a whole network of nerves that exit the spine at each level and branch out to cover the entire lower half of your body These nerves are packed into a small area along with discs joints ligaments tendons and muscles If any of these structures are torn swollen inflamed or in spasm they can press or squeeze the nerves Even a relatively minor muscle strain can put pressure on a nerve causing pain to radiate into areas where there is no injury

Low Back InjuriesBy Mark Salamon PT

20 JulyAugust 2011

coordinatedhealthcom

Even when your nerves are not being squeezed an injury to any of the structures of your spine can cause a reactive muscle spasm Your bodyrsquos nervous system has many mechanisms that sense if something is wrong Even a minor injury to your back can send a signal to the nervous system which sends a signal back to the muscles that surround your spine telling it to contract in order to protect the spine and prevent further injury This constant muscle contraction can cause more pain than the injury itself And since it is a protective reflex you canrsquot just relax the muscles by thinking about it Imagine making a fist as hard as you can and holding it all day long Think about how sore your hand would get That is what the muscles around your spine are doing

With any low back injury it is very important to be evaluated by a physician Diagnostic tests may be necessary to determine if it is a relatively minor injury or a dangerous situation Your physician will determine if physical therapy is appropriate

If you are referred to physical therapy your therapist will perform a thorough evaluation to determine your course of treatment This involves observing how your pain responds to different motions measuring flexibility of your back and lower extremities and testing the strength of your lower extremities and ldquocorerdquo muscles The core is a term for the group of muscles that surround and protect your spine They include not only the muscles of the low back but the stomach hip and buttock muscles All of these muscles ldquowrap aroundrdquo the whole area and if they are working properly they absorb the force of your body

JulyAugust 2011 21

coordinatedhealthcom22 JulyAugust 2011

weight If any of these muscles become weak then more of your body weight is going directly to the spine causing more wear and tear on the discs and joints and making it more difficult for any injury to heal

Leg flexibility is also very important for your lower back Your leg muscles attach to the pelvis and the pelvis is attached to the lower spine If your leg muscles are tight particularly the hamstrings in the back of your thigh then these tight muscles are constantly pulling down on your pelvis and in turn on your lower back This tension on your lower back can cause pain even if there is no injury and makes any injury more difficult to heal

Even after your injury has healed it is very important to continue the exercise program that your therapist has given you By maintaining strong core muscles and flexible legs you are decreasing the forces on your spine and decreasing the ldquowear and tearrdquo that comes with the normal aging process You are also decreasing the chance of further injury Statistically ninety percent of all people will have some type of low back injury at some point in their life Virtually all of us need to take steps to decrease the chance of injury We canrsquot make you eighteen again but we can help you enjoy a longer active life

coordinatedhealthcom JulyAugust 2011 23

presents Overuse Injuries in Youth Athletes

helliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip Youth athletes on all levels are constantly pushing themselves

to reach new heights What happens when you push too hard Overuse or repetitive injuries are on the rise

Join our live interactive audience as Sports Medicine Physician Dr Todd Melegari explains the causes prevention and treatment of common over-use injuries in sports and fitness

Discover the importance of pre-stretching before any physical exercise by Frank Lupin Pulse Performance Specialist

Dr Todd Melegari Frank Lupin

helliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip when Tuesday August 16 2011 600pmwhere 2300 Highland Ave Bethlehem 2nd Floor to register Call 610-861-8080 ext 8276 Register now space is limited helliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip

Free Flexibility Screenings Free Refreshments amp Raffle Prizes

FREE

Flexibility

Screening

wwwcoordinatedhealthcom

coordinatedhealthcom24 JulyAugust 2011

13

Ski n Ca ncerSara Yodlosky PAC

As the weather gets warmer amp you are outside more often you must be aware of the potential hazards of sun exposure Exposure to ultraviolet rays is a risk factor for developing skin cancer

Skin cancer is the most common form of cancer with the number of cases growing each year There are 3 main types of skin cancer basal cell squamous cell amp melanoma

Basal cell is the most common form of skin cancer accounting for about 90 of cases The majority of these do not spread or become malignant They are usually found on the face Having a fair complexion amp a history of severe sunburn as a child are two risk factors Basal cell cancers usually appear as dome-shaped pinkish colored bump

Squamous cell cancer occurs about a frac14 as frequently as basal cell cancers They also affect fair skinned individuals amp are found on sun exposed areas Squamous cell cancers start as precancerous growths called actinic keratoses They can appear as small raised rough patches that are red or pink with a white or yellowish scale

coordinatedhealthcom JulyAugust 2011 25

Melanoma accounts for only a small percent of skin cancer but it is by far the most serious amp potentially deadly When evaluation skin lesions it is important to remember your ABCrsquos

Asymmetry ndash Does one frac12 match the other

Border ndash Is it smooth or irregular ragged or blurred

Color ndash Is it the same throughout

Diameter ndash Is it bigger then an eraser (6mm)

Evolving ndash Has it changed in any way

The best ways to prevent skin cancer are to avoid prolonged sun exposure and to practice sun safety Here are a few tips

bull Avoid the sun during 10AM amp 4PM

bull Wear sunscreen with SPF of 15 or higher and donrsquot forget to reapply

bull Wear protective clothing ndash hats sunglasses amp cover-ups

13

coordinatedhealthcom26 JulyAugust 2011

All sports come with injury risks Swimming is often thought of as a sport that is safe with little to no risk If swimming is a sport you are interested in picking up for exercise by far the biggest risk of injury in swimming is in your shoulder Many people watch competitive swimming and draw an interest in the sport from watching When you watch swimming you are only seeing what goes on above the water but preventing injury comes with understanding what should be done under the water

I swam competitively from age 6 to 20 I was at an elite level by the age of 14 I qualified for nationals at that age and was on nationally ranked teams throughout high school I was riding high because of my success but then my yardage (distance I was swimming) bumped up and I became

more knowledgeable of the demands of the sport on the shoulder then I wanted to be I ended up missing the majority of my sophomore and junior seasons in high school due to shoulder injuries on both sides I rehabbed and became aware of

a lot of things I did wrong in and out of the water Luckily from that point on I had no more shoulder issues and that experience led me to a career in rehabilitation

When talking to people about swimming I try to relate it back

to mainstream sports You are probably aware that baseball is very hard on the shoulders and most pitchers are placed on a pitch count They may throw 120 pitches and that is the end of their game They may throw bullpen sessions on their off days but they will not throw 120 pitches again for 4-5 days Swimmers take approximately 15-20 strokes per lap and swim in the range of

Swimmers and ShouldersBy Mike Price PT

If swimming is a sport you are interested in

picking up for exercise by far the biggest risk of injury in swimming

is in your shoulder

coordinatedhealthcom JulyAugust 2011 27

10000 yards a practice (400 laps) so they may take 6000-8000 strokes in a practice They will then get in the water the next day and do it all over again I am not comparing throwing to swimming but you can see where the overuse of the shoulder comes in for swimmers Even a new swimmer may only swim 500 yards (20 laps) but in that time they are likely to do 300-400 overhead repetitions in the water

The most common shoulder pathologies in swimmers are rotator cuff tendonitis and impingement syndrome These diagnoses are characterized by loss of motion mostly overhead and into internal rotation loss of strength throughout the shoulder and pain There are a few things that can go wrong in and out of the water that can make swimmers more prone to these diagnoses In the water you can have issues of technique including arm placement under water limited trunk rotation in the water asymmetrical breathing patterns and hand placement in the water Out of the water poor posture which will lead to

poor posture in the water can also lead to injuries

Under the water if a swimmer does not bend their elbows they make their

shoulder muscles take more of a load to move them forward in the water instead of allowing other arm muscles and chest muscles to assist in forward movement

Having a symmetrical trunk rotation and learning how to breathe to both sides also will help you avoid injuries The less your trunk is rotating while you swim the flatter you are in the water The lesser rotation of your trunk the more internal rotation will be required at your shoulders and being in internally rotated positions increases the likelihood of impingement

Proper elbow bending under water to lessen stress on shoulder

coordinatedhealthcom28 JulyAugust 2011

Hand placement into the water can also increase the tendency of shoulder impingement Many swimmers try to enter thumb first but by doing so you are again demanding more internal rotation of the shoulder which can lead to injury When swimming you should try to enter the water with more of a flat hand Lastly poor posture can cause you to crossover the midline under the water which also puts you in a position where there is more stress on the rotator cuff

Swimming is a great cardiovascular exercise and can really condition your entire body However it can be stressful on your shoulders If swimming is a sport you

really want to try I strongly recommend you get formal instruction from someone that has a background in swimming or at the very least watch an underwater video of proper swimming technique It is also useful for you to meet with a physical therapist or performance specialist that can assess you to make sure your shoulders are flexible enough and strong enough to make a smooth transition to the sport

Poor posture making swimmer cross the midline with stroke

Example of correct flat hand entry into water

coordinatedhealthcom JulyAugust 2011 29

1 in PatientSatisfaction

Based on Medicare Data 2009-2011Visit hospitalcompare hhs gov

coordinatedhealthcom

ALLENTOWN BETHLEHEM EASTON HAZLETON PHILLIPSBURGBRODHEADSVILLE E STROUDSBURG LEHIGHTON

coordinatedhealthcom

Even when your nerves are not being squeezed an injury to any of the structures of your spine can cause a reactive muscle spasm Your bodyrsquos nervous system has many mechanisms that sense if something is wrong Even a minor injury to your back can send a signal to the nervous system which sends a signal back to the muscles that surround your spine telling it to contract in order to protect the spine and prevent further injury This constant muscle contraction can cause more pain than the injury itself And since it is a protective reflex you canrsquot just relax the muscles by thinking about it Imagine making a fist as hard as you can and holding it all day long Think about how sore your hand would get That is what the muscles around your spine are doing

With any low back injury it is very important to be evaluated by a physician Diagnostic tests may be necessary to determine if it is a relatively minor injury or a dangerous situation Your physician will determine if physical therapy is appropriate

If you are referred to physical therapy your therapist will perform a thorough evaluation to determine your course of treatment This involves observing how your pain responds to different motions measuring flexibility of your back and lower extremities and testing the strength of your lower extremities and ldquocorerdquo muscles The core is a term for the group of muscles that surround and protect your spine They include not only the muscles of the low back but the stomach hip and buttock muscles All of these muscles ldquowrap aroundrdquo the whole area and if they are working properly they absorb the force of your body

JulyAugust 2011 21

coordinatedhealthcom22 JulyAugust 2011

weight If any of these muscles become weak then more of your body weight is going directly to the spine causing more wear and tear on the discs and joints and making it more difficult for any injury to heal

Leg flexibility is also very important for your lower back Your leg muscles attach to the pelvis and the pelvis is attached to the lower spine If your leg muscles are tight particularly the hamstrings in the back of your thigh then these tight muscles are constantly pulling down on your pelvis and in turn on your lower back This tension on your lower back can cause pain even if there is no injury and makes any injury more difficult to heal

Even after your injury has healed it is very important to continue the exercise program that your therapist has given you By maintaining strong core muscles and flexible legs you are decreasing the forces on your spine and decreasing the ldquowear and tearrdquo that comes with the normal aging process You are also decreasing the chance of further injury Statistically ninety percent of all people will have some type of low back injury at some point in their life Virtually all of us need to take steps to decrease the chance of injury We canrsquot make you eighteen again but we can help you enjoy a longer active life

coordinatedhealthcom JulyAugust 2011 23

presents Overuse Injuries in Youth Athletes

helliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip Youth athletes on all levels are constantly pushing themselves

to reach new heights What happens when you push too hard Overuse or repetitive injuries are on the rise

Join our live interactive audience as Sports Medicine Physician Dr Todd Melegari explains the causes prevention and treatment of common over-use injuries in sports and fitness

Discover the importance of pre-stretching before any physical exercise by Frank Lupin Pulse Performance Specialist

Dr Todd Melegari Frank Lupin

helliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip when Tuesday August 16 2011 600pmwhere 2300 Highland Ave Bethlehem 2nd Floor to register Call 610-861-8080 ext 8276 Register now space is limited helliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip

Free Flexibility Screenings Free Refreshments amp Raffle Prizes

FREE

Flexibility

Screening

wwwcoordinatedhealthcom

coordinatedhealthcom24 JulyAugust 2011

13

Ski n Ca ncerSara Yodlosky PAC

As the weather gets warmer amp you are outside more often you must be aware of the potential hazards of sun exposure Exposure to ultraviolet rays is a risk factor for developing skin cancer

Skin cancer is the most common form of cancer with the number of cases growing each year There are 3 main types of skin cancer basal cell squamous cell amp melanoma

Basal cell is the most common form of skin cancer accounting for about 90 of cases The majority of these do not spread or become malignant They are usually found on the face Having a fair complexion amp a history of severe sunburn as a child are two risk factors Basal cell cancers usually appear as dome-shaped pinkish colored bump

Squamous cell cancer occurs about a frac14 as frequently as basal cell cancers They also affect fair skinned individuals amp are found on sun exposed areas Squamous cell cancers start as precancerous growths called actinic keratoses They can appear as small raised rough patches that are red or pink with a white or yellowish scale

coordinatedhealthcom JulyAugust 2011 25

Melanoma accounts for only a small percent of skin cancer but it is by far the most serious amp potentially deadly When evaluation skin lesions it is important to remember your ABCrsquos

Asymmetry ndash Does one frac12 match the other

Border ndash Is it smooth or irregular ragged or blurred

Color ndash Is it the same throughout

Diameter ndash Is it bigger then an eraser (6mm)

Evolving ndash Has it changed in any way

The best ways to prevent skin cancer are to avoid prolonged sun exposure and to practice sun safety Here are a few tips

bull Avoid the sun during 10AM amp 4PM

bull Wear sunscreen with SPF of 15 or higher and donrsquot forget to reapply

bull Wear protective clothing ndash hats sunglasses amp cover-ups

13

coordinatedhealthcom26 JulyAugust 2011

All sports come with injury risks Swimming is often thought of as a sport that is safe with little to no risk If swimming is a sport you are interested in picking up for exercise by far the biggest risk of injury in swimming is in your shoulder Many people watch competitive swimming and draw an interest in the sport from watching When you watch swimming you are only seeing what goes on above the water but preventing injury comes with understanding what should be done under the water

I swam competitively from age 6 to 20 I was at an elite level by the age of 14 I qualified for nationals at that age and was on nationally ranked teams throughout high school I was riding high because of my success but then my yardage (distance I was swimming) bumped up and I became

more knowledgeable of the demands of the sport on the shoulder then I wanted to be I ended up missing the majority of my sophomore and junior seasons in high school due to shoulder injuries on both sides I rehabbed and became aware of

a lot of things I did wrong in and out of the water Luckily from that point on I had no more shoulder issues and that experience led me to a career in rehabilitation

When talking to people about swimming I try to relate it back

to mainstream sports You are probably aware that baseball is very hard on the shoulders and most pitchers are placed on a pitch count They may throw 120 pitches and that is the end of their game They may throw bullpen sessions on their off days but they will not throw 120 pitches again for 4-5 days Swimmers take approximately 15-20 strokes per lap and swim in the range of

Swimmers and ShouldersBy Mike Price PT

If swimming is a sport you are interested in

picking up for exercise by far the biggest risk of injury in swimming

is in your shoulder

coordinatedhealthcom JulyAugust 2011 27

10000 yards a practice (400 laps) so they may take 6000-8000 strokes in a practice They will then get in the water the next day and do it all over again I am not comparing throwing to swimming but you can see where the overuse of the shoulder comes in for swimmers Even a new swimmer may only swim 500 yards (20 laps) but in that time they are likely to do 300-400 overhead repetitions in the water

The most common shoulder pathologies in swimmers are rotator cuff tendonitis and impingement syndrome These diagnoses are characterized by loss of motion mostly overhead and into internal rotation loss of strength throughout the shoulder and pain There are a few things that can go wrong in and out of the water that can make swimmers more prone to these diagnoses In the water you can have issues of technique including arm placement under water limited trunk rotation in the water asymmetrical breathing patterns and hand placement in the water Out of the water poor posture which will lead to

poor posture in the water can also lead to injuries

Under the water if a swimmer does not bend their elbows they make their

shoulder muscles take more of a load to move them forward in the water instead of allowing other arm muscles and chest muscles to assist in forward movement

Having a symmetrical trunk rotation and learning how to breathe to both sides also will help you avoid injuries The less your trunk is rotating while you swim the flatter you are in the water The lesser rotation of your trunk the more internal rotation will be required at your shoulders and being in internally rotated positions increases the likelihood of impingement

Proper elbow bending under water to lessen stress on shoulder

coordinatedhealthcom28 JulyAugust 2011

Hand placement into the water can also increase the tendency of shoulder impingement Many swimmers try to enter thumb first but by doing so you are again demanding more internal rotation of the shoulder which can lead to injury When swimming you should try to enter the water with more of a flat hand Lastly poor posture can cause you to crossover the midline under the water which also puts you in a position where there is more stress on the rotator cuff

Swimming is a great cardiovascular exercise and can really condition your entire body However it can be stressful on your shoulders If swimming is a sport you

really want to try I strongly recommend you get formal instruction from someone that has a background in swimming or at the very least watch an underwater video of proper swimming technique It is also useful for you to meet with a physical therapist or performance specialist that can assess you to make sure your shoulders are flexible enough and strong enough to make a smooth transition to the sport

Poor posture making swimmer cross the midline with stroke

Example of correct flat hand entry into water

coordinatedhealthcom JulyAugust 2011 29

1 in PatientSatisfaction

Based on Medicare Data 2009-2011Visit hospitalcompare hhs gov

coordinatedhealthcom

ALLENTOWN BETHLEHEM EASTON HAZLETON PHILLIPSBURGBRODHEADSVILLE E STROUDSBURG LEHIGHTON

coordinatedhealthcom22 JulyAugust 2011

weight If any of these muscles become weak then more of your body weight is going directly to the spine causing more wear and tear on the discs and joints and making it more difficult for any injury to heal

Leg flexibility is also very important for your lower back Your leg muscles attach to the pelvis and the pelvis is attached to the lower spine If your leg muscles are tight particularly the hamstrings in the back of your thigh then these tight muscles are constantly pulling down on your pelvis and in turn on your lower back This tension on your lower back can cause pain even if there is no injury and makes any injury more difficult to heal

Even after your injury has healed it is very important to continue the exercise program that your therapist has given you By maintaining strong core muscles and flexible legs you are decreasing the forces on your spine and decreasing the ldquowear and tearrdquo that comes with the normal aging process You are also decreasing the chance of further injury Statistically ninety percent of all people will have some type of low back injury at some point in their life Virtually all of us need to take steps to decrease the chance of injury We canrsquot make you eighteen again but we can help you enjoy a longer active life

coordinatedhealthcom JulyAugust 2011 23

presents Overuse Injuries in Youth Athletes

helliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip Youth athletes on all levels are constantly pushing themselves

to reach new heights What happens when you push too hard Overuse or repetitive injuries are on the rise

Join our live interactive audience as Sports Medicine Physician Dr Todd Melegari explains the causes prevention and treatment of common over-use injuries in sports and fitness

Discover the importance of pre-stretching before any physical exercise by Frank Lupin Pulse Performance Specialist

Dr Todd Melegari Frank Lupin

helliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip when Tuesday August 16 2011 600pmwhere 2300 Highland Ave Bethlehem 2nd Floor to register Call 610-861-8080 ext 8276 Register now space is limited helliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip

Free Flexibility Screenings Free Refreshments amp Raffle Prizes

FREE

Flexibility

Screening

wwwcoordinatedhealthcom

coordinatedhealthcom24 JulyAugust 2011

13

Ski n Ca ncerSara Yodlosky PAC

As the weather gets warmer amp you are outside more often you must be aware of the potential hazards of sun exposure Exposure to ultraviolet rays is a risk factor for developing skin cancer

Skin cancer is the most common form of cancer with the number of cases growing each year There are 3 main types of skin cancer basal cell squamous cell amp melanoma

Basal cell is the most common form of skin cancer accounting for about 90 of cases The majority of these do not spread or become malignant They are usually found on the face Having a fair complexion amp a history of severe sunburn as a child are two risk factors Basal cell cancers usually appear as dome-shaped pinkish colored bump

Squamous cell cancer occurs about a frac14 as frequently as basal cell cancers They also affect fair skinned individuals amp are found on sun exposed areas Squamous cell cancers start as precancerous growths called actinic keratoses They can appear as small raised rough patches that are red or pink with a white or yellowish scale

coordinatedhealthcom JulyAugust 2011 25

Melanoma accounts for only a small percent of skin cancer but it is by far the most serious amp potentially deadly When evaluation skin lesions it is important to remember your ABCrsquos

Asymmetry ndash Does one frac12 match the other

Border ndash Is it smooth or irregular ragged or blurred

Color ndash Is it the same throughout

Diameter ndash Is it bigger then an eraser (6mm)

Evolving ndash Has it changed in any way

The best ways to prevent skin cancer are to avoid prolonged sun exposure and to practice sun safety Here are a few tips

bull Avoid the sun during 10AM amp 4PM

bull Wear sunscreen with SPF of 15 or higher and donrsquot forget to reapply

bull Wear protective clothing ndash hats sunglasses amp cover-ups

13

coordinatedhealthcom26 JulyAugust 2011

All sports come with injury risks Swimming is often thought of as a sport that is safe with little to no risk If swimming is a sport you are interested in picking up for exercise by far the biggest risk of injury in swimming is in your shoulder Many people watch competitive swimming and draw an interest in the sport from watching When you watch swimming you are only seeing what goes on above the water but preventing injury comes with understanding what should be done under the water

I swam competitively from age 6 to 20 I was at an elite level by the age of 14 I qualified for nationals at that age and was on nationally ranked teams throughout high school I was riding high because of my success but then my yardage (distance I was swimming) bumped up and I became

more knowledgeable of the demands of the sport on the shoulder then I wanted to be I ended up missing the majority of my sophomore and junior seasons in high school due to shoulder injuries on both sides I rehabbed and became aware of

a lot of things I did wrong in and out of the water Luckily from that point on I had no more shoulder issues and that experience led me to a career in rehabilitation

When talking to people about swimming I try to relate it back

to mainstream sports You are probably aware that baseball is very hard on the shoulders and most pitchers are placed on a pitch count They may throw 120 pitches and that is the end of their game They may throw bullpen sessions on their off days but they will not throw 120 pitches again for 4-5 days Swimmers take approximately 15-20 strokes per lap and swim in the range of

Swimmers and ShouldersBy Mike Price PT

If swimming is a sport you are interested in

picking up for exercise by far the biggest risk of injury in swimming

is in your shoulder

coordinatedhealthcom JulyAugust 2011 27

10000 yards a practice (400 laps) so they may take 6000-8000 strokes in a practice They will then get in the water the next day and do it all over again I am not comparing throwing to swimming but you can see where the overuse of the shoulder comes in for swimmers Even a new swimmer may only swim 500 yards (20 laps) but in that time they are likely to do 300-400 overhead repetitions in the water

The most common shoulder pathologies in swimmers are rotator cuff tendonitis and impingement syndrome These diagnoses are characterized by loss of motion mostly overhead and into internal rotation loss of strength throughout the shoulder and pain There are a few things that can go wrong in and out of the water that can make swimmers more prone to these diagnoses In the water you can have issues of technique including arm placement under water limited trunk rotation in the water asymmetrical breathing patterns and hand placement in the water Out of the water poor posture which will lead to

poor posture in the water can also lead to injuries

Under the water if a swimmer does not bend their elbows they make their

shoulder muscles take more of a load to move them forward in the water instead of allowing other arm muscles and chest muscles to assist in forward movement

Having a symmetrical trunk rotation and learning how to breathe to both sides also will help you avoid injuries The less your trunk is rotating while you swim the flatter you are in the water The lesser rotation of your trunk the more internal rotation will be required at your shoulders and being in internally rotated positions increases the likelihood of impingement

Proper elbow bending under water to lessen stress on shoulder

coordinatedhealthcom28 JulyAugust 2011

Hand placement into the water can also increase the tendency of shoulder impingement Many swimmers try to enter thumb first but by doing so you are again demanding more internal rotation of the shoulder which can lead to injury When swimming you should try to enter the water with more of a flat hand Lastly poor posture can cause you to crossover the midline under the water which also puts you in a position where there is more stress on the rotator cuff

Swimming is a great cardiovascular exercise and can really condition your entire body However it can be stressful on your shoulders If swimming is a sport you

really want to try I strongly recommend you get formal instruction from someone that has a background in swimming or at the very least watch an underwater video of proper swimming technique It is also useful for you to meet with a physical therapist or performance specialist that can assess you to make sure your shoulders are flexible enough and strong enough to make a smooth transition to the sport

Poor posture making swimmer cross the midline with stroke

Example of correct flat hand entry into water

coordinatedhealthcom JulyAugust 2011 29

1 in PatientSatisfaction

Based on Medicare Data 2009-2011Visit hospitalcompare hhs gov

coordinatedhealthcom

ALLENTOWN BETHLEHEM EASTON HAZLETON PHILLIPSBURGBRODHEADSVILLE E STROUDSBURG LEHIGHTON

coordinatedhealthcom JulyAugust 2011 23

presents Overuse Injuries in Youth Athletes

helliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip Youth athletes on all levels are constantly pushing themselves

to reach new heights What happens when you push too hard Overuse or repetitive injuries are on the rise

Join our live interactive audience as Sports Medicine Physician Dr Todd Melegari explains the causes prevention and treatment of common over-use injuries in sports and fitness

Discover the importance of pre-stretching before any physical exercise by Frank Lupin Pulse Performance Specialist

Dr Todd Melegari Frank Lupin

helliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip when Tuesday August 16 2011 600pmwhere 2300 Highland Ave Bethlehem 2nd Floor to register Call 610-861-8080 ext 8276 Register now space is limited helliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip

Free Flexibility Screenings Free Refreshments amp Raffle Prizes

FREE

Flexibility

Screening

wwwcoordinatedhealthcom

coordinatedhealthcom24 JulyAugust 2011

13

Ski n Ca ncerSara Yodlosky PAC

As the weather gets warmer amp you are outside more often you must be aware of the potential hazards of sun exposure Exposure to ultraviolet rays is a risk factor for developing skin cancer

Skin cancer is the most common form of cancer with the number of cases growing each year There are 3 main types of skin cancer basal cell squamous cell amp melanoma

Basal cell is the most common form of skin cancer accounting for about 90 of cases The majority of these do not spread or become malignant They are usually found on the face Having a fair complexion amp a history of severe sunburn as a child are two risk factors Basal cell cancers usually appear as dome-shaped pinkish colored bump

Squamous cell cancer occurs about a frac14 as frequently as basal cell cancers They also affect fair skinned individuals amp are found on sun exposed areas Squamous cell cancers start as precancerous growths called actinic keratoses They can appear as small raised rough patches that are red or pink with a white or yellowish scale

coordinatedhealthcom JulyAugust 2011 25

Melanoma accounts for only a small percent of skin cancer but it is by far the most serious amp potentially deadly When evaluation skin lesions it is important to remember your ABCrsquos

Asymmetry ndash Does one frac12 match the other

Border ndash Is it smooth or irregular ragged or blurred

Color ndash Is it the same throughout

Diameter ndash Is it bigger then an eraser (6mm)

Evolving ndash Has it changed in any way

The best ways to prevent skin cancer are to avoid prolonged sun exposure and to practice sun safety Here are a few tips

bull Avoid the sun during 10AM amp 4PM

bull Wear sunscreen with SPF of 15 or higher and donrsquot forget to reapply

bull Wear protective clothing ndash hats sunglasses amp cover-ups

13

coordinatedhealthcom26 JulyAugust 2011

All sports come with injury risks Swimming is often thought of as a sport that is safe with little to no risk If swimming is a sport you are interested in picking up for exercise by far the biggest risk of injury in swimming is in your shoulder Many people watch competitive swimming and draw an interest in the sport from watching When you watch swimming you are only seeing what goes on above the water but preventing injury comes with understanding what should be done under the water

I swam competitively from age 6 to 20 I was at an elite level by the age of 14 I qualified for nationals at that age and was on nationally ranked teams throughout high school I was riding high because of my success but then my yardage (distance I was swimming) bumped up and I became

more knowledgeable of the demands of the sport on the shoulder then I wanted to be I ended up missing the majority of my sophomore and junior seasons in high school due to shoulder injuries on both sides I rehabbed and became aware of

a lot of things I did wrong in and out of the water Luckily from that point on I had no more shoulder issues and that experience led me to a career in rehabilitation

When talking to people about swimming I try to relate it back

to mainstream sports You are probably aware that baseball is very hard on the shoulders and most pitchers are placed on a pitch count They may throw 120 pitches and that is the end of their game They may throw bullpen sessions on their off days but they will not throw 120 pitches again for 4-5 days Swimmers take approximately 15-20 strokes per lap and swim in the range of

Swimmers and ShouldersBy Mike Price PT

If swimming is a sport you are interested in

picking up for exercise by far the biggest risk of injury in swimming

is in your shoulder

coordinatedhealthcom JulyAugust 2011 27

10000 yards a practice (400 laps) so they may take 6000-8000 strokes in a practice They will then get in the water the next day and do it all over again I am not comparing throwing to swimming but you can see where the overuse of the shoulder comes in for swimmers Even a new swimmer may only swim 500 yards (20 laps) but in that time they are likely to do 300-400 overhead repetitions in the water

The most common shoulder pathologies in swimmers are rotator cuff tendonitis and impingement syndrome These diagnoses are characterized by loss of motion mostly overhead and into internal rotation loss of strength throughout the shoulder and pain There are a few things that can go wrong in and out of the water that can make swimmers more prone to these diagnoses In the water you can have issues of technique including arm placement under water limited trunk rotation in the water asymmetrical breathing patterns and hand placement in the water Out of the water poor posture which will lead to

poor posture in the water can also lead to injuries

Under the water if a swimmer does not bend their elbows they make their

shoulder muscles take more of a load to move them forward in the water instead of allowing other arm muscles and chest muscles to assist in forward movement

Having a symmetrical trunk rotation and learning how to breathe to both sides also will help you avoid injuries The less your trunk is rotating while you swim the flatter you are in the water The lesser rotation of your trunk the more internal rotation will be required at your shoulders and being in internally rotated positions increases the likelihood of impingement

Proper elbow bending under water to lessen stress on shoulder

coordinatedhealthcom28 JulyAugust 2011

Hand placement into the water can also increase the tendency of shoulder impingement Many swimmers try to enter thumb first but by doing so you are again demanding more internal rotation of the shoulder which can lead to injury When swimming you should try to enter the water with more of a flat hand Lastly poor posture can cause you to crossover the midline under the water which also puts you in a position where there is more stress on the rotator cuff

Swimming is a great cardiovascular exercise and can really condition your entire body However it can be stressful on your shoulders If swimming is a sport you

really want to try I strongly recommend you get formal instruction from someone that has a background in swimming or at the very least watch an underwater video of proper swimming technique It is also useful for you to meet with a physical therapist or performance specialist that can assess you to make sure your shoulders are flexible enough and strong enough to make a smooth transition to the sport

Poor posture making swimmer cross the midline with stroke

Example of correct flat hand entry into water

coordinatedhealthcom JulyAugust 2011 29

1 in PatientSatisfaction

Based on Medicare Data 2009-2011Visit hospitalcompare hhs gov

coordinatedhealthcom

ALLENTOWN BETHLEHEM EASTON HAZLETON PHILLIPSBURGBRODHEADSVILLE E STROUDSBURG LEHIGHTON

coordinatedhealthcom24 JulyAugust 2011

13

Ski n Ca ncerSara Yodlosky PAC

As the weather gets warmer amp you are outside more often you must be aware of the potential hazards of sun exposure Exposure to ultraviolet rays is a risk factor for developing skin cancer

Skin cancer is the most common form of cancer with the number of cases growing each year There are 3 main types of skin cancer basal cell squamous cell amp melanoma

Basal cell is the most common form of skin cancer accounting for about 90 of cases The majority of these do not spread or become malignant They are usually found on the face Having a fair complexion amp a history of severe sunburn as a child are two risk factors Basal cell cancers usually appear as dome-shaped pinkish colored bump

Squamous cell cancer occurs about a frac14 as frequently as basal cell cancers They also affect fair skinned individuals amp are found on sun exposed areas Squamous cell cancers start as precancerous growths called actinic keratoses They can appear as small raised rough patches that are red or pink with a white or yellowish scale

coordinatedhealthcom JulyAugust 2011 25

Melanoma accounts for only a small percent of skin cancer but it is by far the most serious amp potentially deadly When evaluation skin lesions it is important to remember your ABCrsquos

Asymmetry ndash Does one frac12 match the other

Border ndash Is it smooth or irregular ragged or blurred

Color ndash Is it the same throughout

Diameter ndash Is it bigger then an eraser (6mm)

Evolving ndash Has it changed in any way

The best ways to prevent skin cancer are to avoid prolonged sun exposure and to practice sun safety Here are a few tips

bull Avoid the sun during 10AM amp 4PM

bull Wear sunscreen with SPF of 15 or higher and donrsquot forget to reapply

bull Wear protective clothing ndash hats sunglasses amp cover-ups

13

coordinatedhealthcom26 JulyAugust 2011

All sports come with injury risks Swimming is often thought of as a sport that is safe with little to no risk If swimming is a sport you are interested in picking up for exercise by far the biggest risk of injury in swimming is in your shoulder Many people watch competitive swimming and draw an interest in the sport from watching When you watch swimming you are only seeing what goes on above the water but preventing injury comes with understanding what should be done under the water

I swam competitively from age 6 to 20 I was at an elite level by the age of 14 I qualified for nationals at that age and was on nationally ranked teams throughout high school I was riding high because of my success but then my yardage (distance I was swimming) bumped up and I became

more knowledgeable of the demands of the sport on the shoulder then I wanted to be I ended up missing the majority of my sophomore and junior seasons in high school due to shoulder injuries on both sides I rehabbed and became aware of

a lot of things I did wrong in and out of the water Luckily from that point on I had no more shoulder issues and that experience led me to a career in rehabilitation

When talking to people about swimming I try to relate it back

to mainstream sports You are probably aware that baseball is very hard on the shoulders and most pitchers are placed on a pitch count They may throw 120 pitches and that is the end of their game They may throw bullpen sessions on their off days but they will not throw 120 pitches again for 4-5 days Swimmers take approximately 15-20 strokes per lap and swim in the range of

Swimmers and ShouldersBy Mike Price PT

If swimming is a sport you are interested in

picking up for exercise by far the biggest risk of injury in swimming

is in your shoulder

coordinatedhealthcom JulyAugust 2011 27

10000 yards a practice (400 laps) so they may take 6000-8000 strokes in a practice They will then get in the water the next day and do it all over again I am not comparing throwing to swimming but you can see where the overuse of the shoulder comes in for swimmers Even a new swimmer may only swim 500 yards (20 laps) but in that time they are likely to do 300-400 overhead repetitions in the water

The most common shoulder pathologies in swimmers are rotator cuff tendonitis and impingement syndrome These diagnoses are characterized by loss of motion mostly overhead and into internal rotation loss of strength throughout the shoulder and pain There are a few things that can go wrong in and out of the water that can make swimmers more prone to these diagnoses In the water you can have issues of technique including arm placement under water limited trunk rotation in the water asymmetrical breathing patterns and hand placement in the water Out of the water poor posture which will lead to

poor posture in the water can also lead to injuries

Under the water if a swimmer does not bend their elbows they make their

shoulder muscles take more of a load to move them forward in the water instead of allowing other arm muscles and chest muscles to assist in forward movement

Having a symmetrical trunk rotation and learning how to breathe to both sides also will help you avoid injuries The less your trunk is rotating while you swim the flatter you are in the water The lesser rotation of your trunk the more internal rotation will be required at your shoulders and being in internally rotated positions increases the likelihood of impingement

Proper elbow bending under water to lessen stress on shoulder

coordinatedhealthcom28 JulyAugust 2011

Hand placement into the water can also increase the tendency of shoulder impingement Many swimmers try to enter thumb first but by doing so you are again demanding more internal rotation of the shoulder which can lead to injury When swimming you should try to enter the water with more of a flat hand Lastly poor posture can cause you to crossover the midline under the water which also puts you in a position where there is more stress on the rotator cuff

Swimming is a great cardiovascular exercise and can really condition your entire body However it can be stressful on your shoulders If swimming is a sport you

really want to try I strongly recommend you get formal instruction from someone that has a background in swimming or at the very least watch an underwater video of proper swimming technique It is also useful for you to meet with a physical therapist or performance specialist that can assess you to make sure your shoulders are flexible enough and strong enough to make a smooth transition to the sport

Poor posture making swimmer cross the midline with stroke

Example of correct flat hand entry into water

coordinatedhealthcom JulyAugust 2011 29

1 in PatientSatisfaction

Based on Medicare Data 2009-2011Visit hospitalcompare hhs gov

coordinatedhealthcom

ALLENTOWN BETHLEHEM EASTON HAZLETON PHILLIPSBURGBRODHEADSVILLE E STROUDSBURG LEHIGHTON

coordinatedhealthcom JulyAugust 2011 25

Melanoma accounts for only a small percent of skin cancer but it is by far the most serious amp potentially deadly When evaluation skin lesions it is important to remember your ABCrsquos

Asymmetry ndash Does one frac12 match the other

Border ndash Is it smooth or irregular ragged or blurred

Color ndash Is it the same throughout

Diameter ndash Is it bigger then an eraser (6mm)

Evolving ndash Has it changed in any way

The best ways to prevent skin cancer are to avoid prolonged sun exposure and to practice sun safety Here are a few tips

bull Avoid the sun during 10AM amp 4PM

bull Wear sunscreen with SPF of 15 or higher and donrsquot forget to reapply

bull Wear protective clothing ndash hats sunglasses amp cover-ups

13

coordinatedhealthcom26 JulyAugust 2011

All sports come with injury risks Swimming is often thought of as a sport that is safe with little to no risk If swimming is a sport you are interested in picking up for exercise by far the biggest risk of injury in swimming is in your shoulder Many people watch competitive swimming and draw an interest in the sport from watching When you watch swimming you are only seeing what goes on above the water but preventing injury comes with understanding what should be done under the water

I swam competitively from age 6 to 20 I was at an elite level by the age of 14 I qualified for nationals at that age and was on nationally ranked teams throughout high school I was riding high because of my success but then my yardage (distance I was swimming) bumped up and I became

more knowledgeable of the demands of the sport on the shoulder then I wanted to be I ended up missing the majority of my sophomore and junior seasons in high school due to shoulder injuries on both sides I rehabbed and became aware of

a lot of things I did wrong in and out of the water Luckily from that point on I had no more shoulder issues and that experience led me to a career in rehabilitation

When talking to people about swimming I try to relate it back

to mainstream sports You are probably aware that baseball is very hard on the shoulders and most pitchers are placed on a pitch count They may throw 120 pitches and that is the end of their game They may throw bullpen sessions on their off days but they will not throw 120 pitches again for 4-5 days Swimmers take approximately 15-20 strokes per lap and swim in the range of

Swimmers and ShouldersBy Mike Price PT

If swimming is a sport you are interested in

picking up for exercise by far the biggest risk of injury in swimming

is in your shoulder

coordinatedhealthcom JulyAugust 2011 27

10000 yards a practice (400 laps) so they may take 6000-8000 strokes in a practice They will then get in the water the next day and do it all over again I am not comparing throwing to swimming but you can see where the overuse of the shoulder comes in for swimmers Even a new swimmer may only swim 500 yards (20 laps) but in that time they are likely to do 300-400 overhead repetitions in the water

The most common shoulder pathologies in swimmers are rotator cuff tendonitis and impingement syndrome These diagnoses are characterized by loss of motion mostly overhead and into internal rotation loss of strength throughout the shoulder and pain There are a few things that can go wrong in and out of the water that can make swimmers more prone to these diagnoses In the water you can have issues of technique including arm placement under water limited trunk rotation in the water asymmetrical breathing patterns and hand placement in the water Out of the water poor posture which will lead to

poor posture in the water can also lead to injuries

Under the water if a swimmer does not bend their elbows they make their

shoulder muscles take more of a load to move them forward in the water instead of allowing other arm muscles and chest muscles to assist in forward movement

Having a symmetrical trunk rotation and learning how to breathe to both sides also will help you avoid injuries The less your trunk is rotating while you swim the flatter you are in the water The lesser rotation of your trunk the more internal rotation will be required at your shoulders and being in internally rotated positions increases the likelihood of impingement

Proper elbow bending under water to lessen stress on shoulder

coordinatedhealthcom28 JulyAugust 2011

Hand placement into the water can also increase the tendency of shoulder impingement Many swimmers try to enter thumb first but by doing so you are again demanding more internal rotation of the shoulder which can lead to injury When swimming you should try to enter the water with more of a flat hand Lastly poor posture can cause you to crossover the midline under the water which also puts you in a position where there is more stress on the rotator cuff

Swimming is a great cardiovascular exercise and can really condition your entire body However it can be stressful on your shoulders If swimming is a sport you

really want to try I strongly recommend you get formal instruction from someone that has a background in swimming or at the very least watch an underwater video of proper swimming technique It is also useful for you to meet with a physical therapist or performance specialist that can assess you to make sure your shoulders are flexible enough and strong enough to make a smooth transition to the sport

Poor posture making swimmer cross the midline with stroke

Example of correct flat hand entry into water

coordinatedhealthcom JulyAugust 2011 29

1 in PatientSatisfaction

Based on Medicare Data 2009-2011Visit hospitalcompare hhs gov

coordinatedhealthcom

ALLENTOWN BETHLEHEM EASTON HAZLETON PHILLIPSBURGBRODHEADSVILLE E STROUDSBURG LEHIGHTON

coordinatedhealthcom26 JulyAugust 2011

All sports come with injury risks Swimming is often thought of as a sport that is safe with little to no risk If swimming is a sport you are interested in picking up for exercise by far the biggest risk of injury in swimming is in your shoulder Many people watch competitive swimming and draw an interest in the sport from watching When you watch swimming you are only seeing what goes on above the water but preventing injury comes with understanding what should be done under the water

I swam competitively from age 6 to 20 I was at an elite level by the age of 14 I qualified for nationals at that age and was on nationally ranked teams throughout high school I was riding high because of my success but then my yardage (distance I was swimming) bumped up and I became

more knowledgeable of the demands of the sport on the shoulder then I wanted to be I ended up missing the majority of my sophomore and junior seasons in high school due to shoulder injuries on both sides I rehabbed and became aware of

a lot of things I did wrong in and out of the water Luckily from that point on I had no more shoulder issues and that experience led me to a career in rehabilitation

When talking to people about swimming I try to relate it back

to mainstream sports You are probably aware that baseball is very hard on the shoulders and most pitchers are placed on a pitch count They may throw 120 pitches and that is the end of their game They may throw bullpen sessions on their off days but they will not throw 120 pitches again for 4-5 days Swimmers take approximately 15-20 strokes per lap and swim in the range of

Swimmers and ShouldersBy Mike Price PT

If swimming is a sport you are interested in

picking up for exercise by far the biggest risk of injury in swimming

is in your shoulder

coordinatedhealthcom JulyAugust 2011 27

10000 yards a practice (400 laps) so they may take 6000-8000 strokes in a practice They will then get in the water the next day and do it all over again I am not comparing throwing to swimming but you can see where the overuse of the shoulder comes in for swimmers Even a new swimmer may only swim 500 yards (20 laps) but in that time they are likely to do 300-400 overhead repetitions in the water

The most common shoulder pathologies in swimmers are rotator cuff tendonitis and impingement syndrome These diagnoses are characterized by loss of motion mostly overhead and into internal rotation loss of strength throughout the shoulder and pain There are a few things that can go wrong in and out of the water that can make swimmers more prone to these diagnoses In the water you can have issues of technique including arm placement under water limited trunk rotation in the water asymmetrical breathing patterns and hand placement in the water Out of the water poor posture which will lead to

poor posture in the water can also lead to injuries

Under the water if a swimmer does not bend their elbows they make their

shoulder muscles take more of a load to move them forward in the water instead of allowing other arm muscles and chest muscles to assist in forward movement

Having a symmetrical trunk rotation and learning how to breathe to both sides also will help you avoid injuries The less your trunk is rotating while you swim the flatter you are in the water The lesser rotation of your trunk the more internal rotation will be required at your shoulders and being in internally rotated positions increases the likelihood of impingement

Proper elbow bending under water to lessen stress on shoulder

coordinatedhealthcom28 JulyAugust 2011

Hand placement into the water can also increase the tendency of shoulder impingement Many swimmers try to enter thumb first but by doing so you are again demanding more internal rotation of the shoulder which can lead to injury When swimming you should try to enter the water with more of a flat hand Lastly poor posture can cause you to crossover the midline under the water which also puts you in a position where there is more stress on the rotator cuff

Swimming is a great cardiovascular exercise and can really condition your entire body However it can be stressful on your shoulders If swimming is a sport you

really want to try I strongly recommend you get formal instruction from someone that has a background in swimming or at the very least watch an underwater video of proper swimming technique It is also useful for you to meet with a physical therapist or performance specialist that can assess you to make sure your shoulders are flexible enough and strong enough to make a smooth transition to the sport

Poor posture making swimmer cross the midline with stroke

Example of correct flat hand entry into water

coordinatedhealthcom JulyAugust 2011 29

1 in PatientSatisfaction

Based on Medicare Data 2009-2011Visit hospitalcompare hhs gov

coordinatedhealthcom

ALLENTOWN BETHLEHEM EASTON HAZLETON PHILLIPSBURGBRODHEADSVILLE E STROUDSBURG LEHIGHTON

coordinatedhealthcom JulyAugust 2011 27

10000 yards a practice (400 laps) so they may take 6000-8000 strokes in a practice They will then get in the water the next day and do it all over again I am not comparing throwing to swimming but you can see where the overuse of the shoulder comes in for swimmers Even a new swimmer may only swim 500 yards (20 laps) but in that time they are likely to do 300-400 overhead repetitions in the water

The most common shoulder pathologies in swimmers are rotator cuff tendonitis and impingement syndrome These diagnoses are characterized by loss of motion mostly overhead and into internal rotation loss of strength throughout the shoulder and pain There are a few things that can go wrong in and out of the water that can make swimmers more prone to these diagnoses In the water you can have issues of technique including arm placement under water limited trunk rotation in the water asymmetrical breathing patterns and hand placement in the water Out of the water poor posture which will lead to

poor posture in the water can also lead to injuries

Under the water if a swimmer does not bend their elbows they make their

shoulder muscles take more of a load to move them forward in the water instead of allowing other arm muscles and chest muscles to assist in forward movement

Having a symmetrical trunk rotation and learning how to breathe to both sides also will help you avoid injuries The less your trunk is rotating while you swim the flatter you are in the water The lesser rotation of your trunk the more internal rotation will be required at your shoulders and being in internally rotated positions increases the likelihood of impingement

Proper elbow bending under water to lessen stress on shoulder

coordinatedhealthcom28 JulyAugust 2011

Hand placement into the water can also increase the tendency of shoulder impingement Many swimmers try to enter thumb first but by doing so you are again demanding more internal rotation of the shoulder which can lead to injury When swimming you should try to enter the water with more of a flat hand Lastly poor posture can cause you to crossover the midline under the water which also puts you in a position where there is more stress on the rotator cuff

Swimming is a great cardiovascular exercise and can really condition your entire body However it can be stressful on your shoulders If swimming is a sport you

really want to try I strongly recommend you get formal instruction from someone that has a background in swimming or at the very least watch an underwater video of proper swimming technique It is also useful for you to meet with a physical therapist or performance specialist that can assess you to make sure your shoulders are flexible enough and strong enough to make a smooth transition to the sport

Poor posture making swimmer cross the midline with stroke

Example of correct flat hand entry into water

coordinatedhealthcom JulyAugust 2011 29

1 in PatientSatisfaction

Based on Medicare Data 2009-2011Visit hospitalcompare hhs gov

coordinatedhealthcom

ALLENTOWN BETHLEHEM EASTON HAZLETON PHILLIPSBURGBRODHEADSVILLE E STROUDSBURG LEHIGHTON

coordinatedhealthcom28 JulyAugust 2011

Hand placement into the water can also increase the tendency of shoulder impingement Many swimmers try to enter thumb first but by doing so you are again demanding more internal rotation of the shoulder which can lead to injury When swimming you should try to enter the water with more of a flat hand Lastly poor posture can cause you to crossover the midline under the water which also puts you in a position where there is more stress on the rotator cuff

Swimming is a great cardiovascular exercise and can really condition your entire body However it can be stressful on your shoulders If swimming is a sport you

really want to try I strongly recommend you get formal instruction from someone that has a background in swimming or at the very least watch an underwater video of proper swimming technique It is also useful for you to meet with a physical therapist or performance specialist that can assess you to make sure your shoulders are flexible enough and strong enough to make a smooth transition to the sport

Poor posture making swimmer cross the midline with stroke

Example of correct flat hand entry into water

coordinatedhealthcom JulyAugust 2011 29

1 in PatientSatisfaction

Based on Medicare Data 2009-2011Visit hospitalcompare hhs gov

coordinatedhealthcom

ALLENTOWN BETHLEHEM EASTON HAZLETON PHILLIPSBURGBRODHEADSVILLE E STROUDSBURG LEHIGHTON

coordinatedhealthcom JulyAugust 2011 29

1 in PatientSatisfaction

Based on Medicare Data 2009-2011Visit hospitalcompare hhs gov

coordinatedhealthcom

ALLENTOWN BETHLEHEM EASTON HAZLETON PHILLIPSBURGBRODHEADSVILLE E STROUDSBURG LEHIGHTON

coordinatedhealthcom

Summer weather can be unpredictable Sunshine and a few clouds one minute could turn into a major storm without much warning That makes lightening a major concern when it comes to any outdoor summer sports Field officials and umpires have guidelines to protect athletes and spectators but unfortunately lightning still kills approximately 100 people in the United States every year

Lightningcanstrikeinfivedifferentforms

1 Direct Strike - Enters the head through the eyes ears nose and mouth and then travels through the body and into the ground

2 Contact Injury - This occurs when a person touches an object like a car or fence that is struck by lightning

30 JulyAugust 2011

When Lightning StrikesBy Suzanne Westock ATC ROT

coordinatedhealthcom JulyAugust 2011 31

3 Side Flash - This occurs when lightning strikes an object and jumps to a person standing nearby

4 Step Voltage or Ground Current - This is when the lightningrsquos electrical current travels in waves from the strike point If a person is standing with one foot closer to the site than the other the electricity will enter the body through the one leg and exit through the other The further apart the personrsquos feet are the greater the chance of injury

5 Blunt Injury - This happens when lightning currents cause a person to be thrown from the strike point resulting in non-electrical injuries

Due to the many different ways lightning can injure you and the severity of damage it can cause postponing outdoor activities can ultimately save lives Outdoor activity should be postponed when lightning is seen or even when thunder is heard since thunder cannot be created without lightning A flash to bang equation was created to detect the distance between the current location and the lightning strike

Due to the fact that light travels faster than sound the person should begin counting at the flash of lightning and should cease with the clapping sound of thunder Divide that amount by 5 to retrieve the mileage between the person and the lightning flash Everyone should be in a safe shelter before the flash to bang time is 30 seconds or 6 miles away Resumption of activity cannot begin until 30 minutes after the last lightning flash or clap of thunder The theory behind this is that after a 30 minute wait the storm (through calculations) should be between 10-12 miles away

The best area to safely wait out a storm would be an enclosed shelter with electricity

Due to the fact that light travels faster than sound the person should begin counting at the flash of

lightning and should cease with the clapping sound of

thunder Divide that amount by 5 to retrieve the mileage between the person and the

lightning flash

coordinatedhealthcom

plumbing and phone service This is an ideal location because if lightning does hit the building it is most likely to follow these pathways to get grounded The next safest structure is an enclosed vehicle with metal roof closed windows and rubber tires Though these are the safest options for shelter electrical lines plumbing phone lines and metal frame work all carry electricity Therefore to reduce risk of injury people should stay away from these areas in the shelter

If you feel your hair stand on end skin tingle or hear crackling noises you should assume the lightning safe position To get into the lightning safe position you should crouch on the ground with your feet together with all of your weight on the balls of your feet You should then lower your head and cover your ears This position puts the body at the lowest risk of electricity entering it Precautions are important to take when thunder storms are around Knowing the danger is important but following safety protocol can save lives

Check Out Coordinated HealthOn Facebook

Learn tips and tricks to treat your pain from CH physicians and therapists

Get the latest updates on whatrsquos going on at CH

Post your questions amp comments - We want to hear what you think

32 JulyAugust 2011

coordinatedhealthcom JulyAugust 2011 31

3 Side Flash - This occurs when lightning strikes an object and jumps to a person standing nearby

4 Step Voltage or Ground Current - This is when the lightningrsquos electrical current travels in waves from the strike point If a person is standing with one foot closer to the site than the other the electricity will enter the body through the one leg and exit through the other The further apart the personrsquos feet are the greater the chance of injury

5 Blunt Injury - This happens when lightning currents cause a person to be thrown from the strike point resulting in non-electrical injuries

Due to the many different ways lightning can injure you and the severity of damage it can cause postponing outdoor activities can ultimately save lives Outdoor activity should be postponed when lightning is seen or even when thunder is heard since thunder cannot be created without lightning A flash to bang equation was created to detect the distance between the current location and the lightning strike

Due to the fact that light travels faster than sound the person should begin counting at the flash of lightning and should cease with the clapping sound of thunder Divide that amount by 5 to retrieve the mileage between the person and the lightning flash Everyone should be in a safe shelter before the flash to bang time is 30 seconds or 6 miles away Resumption of activity cannot begin until 30 minutes after the last lightning flash or clap of thunder The theory behind this is that after a 30 minute wait the storm (through calculations) should be between 10-12 miles away

The best area to safely wait out a storm would be an enclosed shelter with electricity

Due to the fact that light travels faster than sound the person should begin counting at the flash of

lightning and should cease with the clapping sound of

thunder Divide that amount by 5 to retrieve the mileage between the person and the

lightning flash

coordinatedhealthcom

plumbing and phone service This is an ideal location because if lightning does hit the building it is most likely to follow these pathways to get grounded The next safest structure is an enclosed vehicle with metal roof closed windows and rubber tires Though these are the safest options for shelter electrical lines plumbing phone lines and metal frame work all carry electricity Therefore to reduce risk of injury people should stay away from these areas in the shelter

If you feel your hair stand on end skin tingle or hear crackling noises you should assume the lightning safe position To get into the lightning safe position you should crouch on the ground with your feet together with all of your weight on the balls of your feet You should then lower your head and cover your ears This position puts the body at the lowest risk of electricity entering it Precautions are important to take when thunder storms are around Knowing the danger is important but following safety protocol can save lives

Check Out Coordinated HealthOn Facebook

Learn tips and tricks to treat your pain from CH physicians and therapists

Get the latest updates on whatrsquos going on at CH

Post your questions amp comments - We want to hear what you think

32 JulyAugust 2011

coordinatedhealthcom

plumbing and phone service This is an ideal location because if lightning does hit the building it is most likely to follow these pathways to get grounded The next safest structure is an enclosed vehicle with metal roof closed windows and rubber tires Though these are the safest options for shelter electrical lines plumbing phone lines and metal frame work all carry electricity Therefore to reduce risk of injury people should stay away from these areas in the shelter

If you feel your hair stand on end skin tingle or hear crackling noises you should assume the lightning safe position To get into the lightning safe position you should crouch on the ground with your feet together with all of your weight on the balls of your feet You should then lower your head and cover your ears This position puts the body at the lowest risk of electricity entering it Precautions are important to take when thunder storms are around Knowing the danger is important but following safety protocol can save lives

Check Out Coordinated HealthOn Facebook

Learn tips and tricks to treat your pain from CH physicians and therapists

Get the latest updates on whatrsquos going on at CH

Post your questions amp comments - We want to hear what you think

32 JulyAugust 2011

coordinatedhealthcom

Whorsquos New atCoordinated Health

Michael DeRogatis PA-C

Danielle Leonz PT

Broadheadsville

Colleen BurgessRegional Manager

Easton

Patrick Kreshock District Manager East Stroudsburg

JulyAugust 2011 33

coordinatedhealthcom

Airport Bltwy

Tilghman St

Walbert Ave

Roth AveCedar Crest Blvd

Cedar Crest Blvd

Office Center Rd

Schoenersville Rd

Roseberry St

Illicks Mill Rd

Jackso

nville

Rd

Airpor

t Rd

Catasauqua Rd

Highland Ave

Brodhead Rd

Township Line Rd

17th St

Warren Hospital

Southmont Shopping Center

Crest Plaza

Easton HS

Emrick Blvd

Freemansburg Ave Freemansburg Ave

William Penn Hwy

Westgate Dr

Broad St

Brown St

Prospect St

Pocono Hospital

Route

209

Route 447

BraesideAve

Northampton St

Greenwood Ave

Greenwood Ave

248

25th St

Bankway St

N 1st St

248443

LVH Muhlenberg

Macada Rd

115715

80

81

81

80

80

22

22

78

78 78

33

33

93

378

191

611

512

PA NJ

309

78

80

476

476

309

209

HazletonCampus

Allentown HospitalAllentown Campus

Bethlehem Hospital

Bethlehem Campusat Highland Ave

Easton Campusat Emrick Boulevard

Bethlehem Campus at Schoenersville Road

East StroudsburgCampus

Brodheadsville Campus

Phillipsburg Campus

EastonCampus atGreenwood Ave

LehightonCampus

wwwcoordinatedhealthcom

happy map 2011 12511 439 PM Page 1

34 JulyAugust 2011

coordinatedhealthcom

Airport Bltwy

Tilghman St

Walbert Ave

Roth AveCedar Crest Blvd

Cedar Crest Blvd

Office Center Rd

Schoenersville Rd

Roseberry St

Illicks Mill Rd

Jackso

nville

Rd

Airpor

t Rd

Catasauqua Rd

Highland Ave

Brodhead Rd

Township Line Rd

17th St

Warren Hospital

Southmont Shopping Center

Crest Plaza

Easton HS

Emrick Blvd

Freemansburg Ave Freemansburg Ave

William Penn Hwy

Westgate Dr

Broad St

Brown St

Prospect St

Pocono Hospital

Route

209

Route 447

BraesideAve

Northampton St

Greenwood Ave

Greenwood Ave

248

25th St

Bankway St

N 1st St

248443

LVH Muhlenberg

Macada Rd

115715

80

81

81

80

80

22

22

78

78 78

33

33

93

378

191

611

512

PA NJ

309

78

80

476

476

309

209

HazletonCampus

Allentown HospitalAllentown Campus

Bethlehem Hospital

Bethlehem Campusat Highland Ave

Easton Campusat Emrick Boulevard

Bethlehem Campus at Schoenersville Road

East StroudsburgCampus

Brodheadsville Campus

Phillipsburg Campus

EastonCampus atGreenwood Ave

LehightonCampus

wwwcoordinatedhealthcom

happy map 2011 12511 439 PM Page 1

JulyAugust 2011 35

Allentown 1503 N Cedar Crest Blvd Allentown PA 18104

Bethlehem 2775 Schoenersville Rd Bethlehem PA 18017

2300 Highland Ave Bethlehem PA 18020

Easton 400 S Greenwood Ave Easton PA 18045

3101 Emrick Bivd Suite 112 Bethlehem PA 18020

Brodheadsville Rte 115 amp Switzgable Rd Brodheadsville PA 18322

East Stroudsburg 505 Independence Ave East Stroudsburg PA 18301

Hazleton 50 Moisey Dr Suite 202 Hazleton PA 18202

Lehighton 239 N First Street Lehighton PA 18235

Hospitals 503 N Cedar Crest Blvd Allentown PA 18104

2310 Highland Ave Bethlehem PA 18020

610-861-8080 877-247-8080coordinatedhealthcom

coordinatedhealthcom

Airport Bltwy

Tilghman St

Walbert Ave

Roth AveCedar Crest Blvd

Cedar Crest Blvd

Office Center Rd

Schoenersville Rd

Roseberry St

Illicks Mill Rd

Jackso

nville

Rd

Airpor

t Rd

Catasauqua Rd

Highland Ave

Brodhead Rd

Township Line Rd

17th St

Warren Hospital

Southmont Shopping Center

Crest Plaza

Easton HS

Emrick Blvd

Freemansburg Ave Freemansburg Ave

William Penn Hwy

Westgate Dr

Broad St

Brown St

Prospect St

Pocono Hospital

Route

209

Route 447

BraesideAve

Northampton St

Greenwood Ave

Greenwood Ave

248

25th St

Bankway St

N 1st St

248443

LVH Muhlenberg

Macada Rd

115715

80

81

81

80

80

22

22

78

78 78

33

33

93

378

191

611

512

PA NJ

309

78

80

476

476

309

209

HazletonCampus

Allentown HospitalAllentown Campus

Bethlehem Hospital

Bethlehem Campusat Highland Ave

Easton Campusat Emrick Boulevard

Bethlehem Campus at Schoenersville Road

East StroudsburgCampus

Brodheadsville Campus

Phillipsburg Campus

EastonCampus atGreenwood Ave

LehightonCampus

wwwcoordinatedhealthcom

happy map 2011 12511 439 PM Page 1

34 JulyAugust 2011

coordinatedhealthcom

Airport Bltwy

Tilghman St

Walbert Ave

Roth AveCedar Crest Blvd

Cedar Crest Blvd

Office Center Rd

Schoenersville Rd

Roseberry St

Illicks Mill Rd

Jackso

nville

Rd

Airpor

t Rd

Catasauqua Rd

Highland Ave

Brodhead Rd

Township Line Rd

17th St

Warren Hospital

Southmont Shopping Center

Crest Plaza

Easton HS

Emrick Blvd

Freemansburg Ave Freemansburg Ave

William Penn Hwy

Westgate Dr

Broad St

Brown St

Prospect St

Pocono Hospital

Route

209

Route 447

BraesideAve

Northampton St

Greenwood Ave

Greenwood Ave

248

25th St

Bankway St

N 1st St

248443

LVH Muhlenberg

Macada Rd

115715

80

81

81

80

80

22

22

78

78 78

33

33

93

378

191

611

512

PA NJ

309

78

80

476

476

309

209

HazletonCampus

Allentown HospitalAllentown Campus

Bethlehem Hospital

Bethlehem Campusat Highland Ave

Easton Campusat Emrick Boulevard

Bethlehem Campus at Schoenersville Road

East StroudsburgCampus

Brodheadsville Campus

Phillipsburg Campus

EastonCampus atGreenwood Ave

LehightonCampus

wwwcoordinatedhealthcom

happy map 2011 12511 439 PM Page 1

JulyAugust 2011 35

Allentown 1503 N Cedar Crest Blvd Allentown PA 18104

Bethlehem 2775 Schoenersville Rd Bethlehem PA 18017

2300 Highland Ave Bethlehem PA 18020

Easton 400 S Greenwood Ave Easton PA 18045

3101 Emrick Bivd Suite 112 Bethlehem PA 18020

Brodheadsville Rte 115 amp Switzgable Rd Brodheadsville PA 18322

East Stroudsburg 505 Independence Ave East Stroudsburg PA 18301

Hazleton 50 Moisey Dr Suite 202 Hazleton PA 18202

Lehighton 239 N First Street Lehighton PA 18235

Hospitals 503 N Cedar Crest Blvd Allentown PA 18104

2310 Highland Ave Bethlehem PA 18020

610-861-8080 877-247-8080coordinatedhealthcom

coordinatedhealthcom

Airport Bltwy

Tilghman St

Walbert Ave

Roth AveCedar Crest Blvd

Cedar Crest Blvd

Office Center Rd

Schoenersville Rd

Roseberry St

Illicks Mill Rd

Jackso

nville

Rd

Airpor

t Rd

Catasauqua Rd

Highland Ave

Brodhead Rd

Township Line Rd

17th St

Warren Hospital

Southmont Shopping Center

Crest Plaza

Easton HS

Emrick Blvd

Freemansburg Ave Freemansburg Ave

William Penn Hwy

Westgate Dr

Broad St

Brown St

Prospect St

Pocono Hospital

Route

209

Route 447

BraesideAve

Northampton St

Greenwood Ave

Greenwood Ave

248

25th St

Bankway St

N 1st St

248443

LVH Muhlenberg

Macada Rd

115715

80

81

81

80

80

22

22

78

78 78

33

33

93

378

191

611

512

PA NJ

309

78

80

476

476

309

209

HazletonCampus

Allentown HospitalAllentown Campus

Bethlehem Hospital

Bethlehem Campusat Highland Ave

Easton Campusat Emrick Boulevard

Bethlehem Campus at Schoenersville Road

East StroudsburgCampus

Brodheadsville Campus

Phillipsburg Campus

EastonCampus atGreenwood Ave

LehightonCampus

wwwcoordinatedhealthcom

happy map 2011 12511 439 PM Page 1

JulyAugust 2011 35

Allentown 1503 N Cedar Crest Blvd Allentown PA 18104

Bethlehem 2775 Schoenersville Rd Bethlehem PA 18017

2300 Highland Ave Bethlehem PA 18020

Easton 400 S Greenwood Ave Easton PA 18045

3101 Emrick Bivd Suite 112 Bethlehem PA 18020

Brodheadsville Rte 115 amp Switzgable Rd Brodheadsville PA 18322

East Stroudsburg 505 Independence Ave East Stroudsburg PA 18301

Hazleton 50 Moisey Dr Suite 202 Hazleton PA 18202

Lehighton 239 N First Street Lehighton PA 18235

Hospitals 503 N Cedar Crest Blvd Allentown PA 18104

2310 Highland Ave Bethlehem PA 18020

610-861-8080 877-247-8080coordinatedhealthcom

Allentown 1503 N Cedar Crest Blvd Allentown PA 18104

Bethlehem 2775 Schoenersville Rd Bethlehem PA 18017

2300 Highland Ave Bethlehem PA 18020

Easton 400 S Greenwood Ave Easton PA 18045

3101 Emrick Bivd Suite 112 Bethlehem PA 18020

Brodheadsville Rte 115 amp Switzgable Rd Brodheadsville PA 18322

East Stroudsburg 505 Independence Ave East Stroudsburg PA 18301

Hazleton 50 Moisey Dr Suite 202 Hazleton PA 18202

Lehighton 239 N First Street Lehighton PA 18235

Hospitals 503 N Cedar Crest Blvd Allentown PA 18104

2310 Highland Ave Bethlehem PA 18020

610-861-8080 877-247-8080coordinatedhealthcom