What is PRP therapy for knee pain?

By  siteadmin  published  September 4, 2020

Patients are often looking for options to avoid a knee replacement surgery. While surgery is recommended only when other treatment options have failed, some patients can still benefit from knee injections.

One such knee injection treatment option is Platelet-Rich Plasma (PRP) injections.

Platelet-Rich Plasma Knee Injections

Platelets are one of the first natural repair agents to reach an injury. They begin by sealing the injury with a clot. During the clot formation, they release proteins, including growth factors for repair and “signaling” factors that bring in the patient’s own stem cells to aid in the repair process.

During the PRP therapy, the patient’s own blood is obtained from a peripheral arm vein. It is then centrifuged to separate the various blood components. Red blood cells are removed. That leaves a concentration of platelets in the remaining plasma. This is why the term platelet-rich plasma, or PRP is used for this treatment.

The PRP is then administered, in the same manner as other knee injections, after a local anesthetic has been injected.

While experienced surgeons can accurately administer PRP knee injections, you can ask for ultrasound guided injections. This non-invasive technique allows the surgeon to precisely visualize the injection needle within the knee joint. Sometimes, your surgeon may also recommend hyaluronic acid injections to aid lubrication in the knee joint and allow smoother movement.  Consult your orthopedic surgeon whether you are a good candidate for PRP injections for knee pain.

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Hip Dislocation

By  aenriquez  published  August 18, 2020

A dislocated hip can be a very painful experience that requires medical intervention as soon as possible. The hip joint is located where the femoral end of the thighbone is joined to the hipbone socket. When the bone is dislocated it is pushed or forced out of the socket, most often the result of a collision between the knee and something hard – the ground, a wall, the helmet of another football player, and any number of other situations. A dislocation is also common after a car crash, as the knee is pushed fast at the dashboard, pushing the thighbone out of place.

Except for a bone fracture of some kind, however, any joint dislocation, from a medical point of view, is focused on ligaments, tendons, and other soft tissue that is damaged when the bone is dislocated. Flexible soft tissue, such as a ligament, can be overstretched and tear when a joint is pushed out of place.

Symptoms

  • Groin pain
  • Leg pain or numbness
  • Overheated skin (from swelling underneath)
  • Numbness in the feet

What to do …

Your physician at FXRX will first order X-rays or use another imaging machine to get a look at your hip socket. After that, you may be mildly sedated while the physician manipulates the thighbone back into place. One that is done – that step is called a reduction – the main concern will be healing the soft tissue that held the joint together in the first place.

The aim, of course, is to have the healing take place without long-term damage. This may take some time, as ligaments can be slow to heal. Part of the reason for the slow healing is the point that you will likely be moving your hip as soon as possible.

Talk to a physician at FXRX to find the right hip brace mean to immobilize a hip joint while it heals. It is unlikely you will re-injure the hip in the same manner, but in the early stages of healing your soft tissue will not be as strong as before, leaving you vulnerable to a repeated incident, although certainly, your doctor is trying to reduce the odds on that as much as possible.

If X-rays reveal considerable damage to ligaments in the area, your physician might suggest an arthroscopy procedure. This is considered a minimally invasive operation that requires a very small incision and insertion of very small equipment that can allow the physician to see your soft tissue structure and how much damage has been done.

 During an arthroscopy procedure, the physician can also insert medical devices that manipulate ligaments directly to repair the damage done.

Healing from a hip dislocation can take several months with movement range growing slowly but surely. You can work with a physical therapist to learn how to get around despite this injury. A brace may be recommended and a physical therapist can help you learn how to put one on and make use of it.

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Shoulder Arthritis Treatments

By  siteadmin  published  August 4, 2020

Experiencing shoulder pain when performing daily tasks, such as while brushing your hair or putting on your coat, can be a sign that you need to see an orthopedic specialist. Arthritis in the shoulder is a common cause if shoulder pain and it can lead to stiffness, pain, swelling, and poor quality of life.

Shoulder Arthritis

Arthritis refers to the degeneration of joint cartilage. As the cartilage wears out, it can cause pain, limit your range of motion, and prevent you from carrying out your daily activities, such as household chores. The damaged cartilage makes the bones grind against each other, leading to pain and other symptoms.

Treatment Options for Shoulder Arthritis

Should arthritis treatment include both conservative and invasive options.

Conservative treatments include –

  • activity modification to reduce stress on the shoulder by reducing movements that cause pain
  • heat and ice to relieve pain and inflammation

In severe cases, invasive or surgical treatment may be necessary to relieve pain and improve functional movement. These may include –

  • Arthroscopy – Arthroscopic surgery involves inserting a small camera inside the shoulder joint to look at and repair the shoulder tissue. Only two small incisions are needed. Removal of loose cartilage and bone can help in reducing shoulder pain and irritation.
  • Cartilage Transplant – The cartilage around the joint can be replaced with healthy cartilage from a healthy joint or a non-articulating joint, or a donor. This is done to stimulate growth of new cartilage.
  • Microfracture – Microfracture treatment involves removing the damaged cartilage and drilling holes into the bone marrow. This can activate stem cells to stimulate growth of new cartilage.
  • Joint Replacement – Joint replacement surgery is done to replace the head of the humerus and the shoulder socket with an implant to reduce pain and inflammation.
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Blood Clots – No Concern Or Scary?

By  aenriquez  published  July 23, 2020

Blood clots, which are diagnosed as Deep Vein Thrombosis (DVT) or Pulmonary Embolism (PE) are a very dangerous condition that can lead to heart attack, stroke, and damage to the lungs. If large enough, the PE type of blood clot can block blood from getting to your lunges, which causes your lungs to fail, which is quickly fatal.

The more optimistic news from a medical point of view is that DVT blood clots can be treated if caught in time, as doctors can prescribe medication that lowers blood viscosity, which can help dissolve the blood clot. Secondly, there are a variety of steps you can take to reduce the chances of developing a blood clot. And, more good news, you can discuss with your physician the option of having surgery to remove the blood clot.

DVT types of blood clots usually occur in deep veins in the legs, the pelvis, and sometimes in the arm. The danger of clots is that they can starve tissues of blood flow, which provide oxygen, nutrients, and other necessities to various parts of the body. A large clot that reaches blocks off blood flow to your lungs can result in long-term damage to your lungs or it can be quickly fatal if blood flow comes to a halt.

That said, while chances of survival have improved with modern medicines and techniques, between 33 percent and 50 percent of persons who develop a DVT are expected to develop complications from the DVT event. These complications include damage to the veins – most critically to valves in the vein – that creates a condition called post-thrombotic syndrome. This condition can include painful swelling, water retention, pain, and discoloration.  It can also create changes in your skin, most often with dry scaly skin, and with internal ulcers.

Risk factors

Besides the other complications that come with a DVT event, there is the bad news that a DVT event also puts you at higher risk for future DVT incidents. Other risk factors include”

A physical injury to a vein precipitated by a bone fracture, a muscle injury, surgery and other events that cause internal scarring

Slow blood flow precipitated by long episodes of staying in bed (while healing from various ailments or other reasons) limited movement caused by having to wear a cast, for example, and paralysis. Also, sitting for long periods with your legs crossed can increase your risks.

Various chemotherapy treatments for cancer

  • High levels of estrogen over long periods (often by taking birth control pills)
  • Heart disease
  • Lung diseases, such as emphysema
  • Lower bowel diseases (such as Crohn’s disease)
  • Family with a history of DVT
  • Obesity
  • A sedentary lifestyle
  • Age (the older you become, the higher your risk
  • Use of prostheses, such as a stent for your heart or a catheter place close to a deep vein

Lowering Your Risk of A DVT

Let’s see if we can balance out the risk factors with a list of risk reducers. Some lifestyle changes help lower your risk of DVT. Here are a few. Ask your doctor for other recommendations.

After confinement either sitting or lying for long periods, while recovering from surgery, for example, get up and move around as soon as you can. Get that blood flowing as they say – only now it’s for real. Get that blood flowing!

Wear what is called a graduated compression stocking that promotes better blood flow

Exercise, especially after an extended period sitting (in your car, for example). It is recommended that you take a break every two hours and stimulate blood flow with a vigorous walk for ten minutes or so. If that’s too stringent, walk for five minutes … or walk every three hours. You get the idea.

  • Loose weight
  • Stop smoking
  • Cut back to safe levels of alcohol intake

Find exercises you can do while sitting at a computer or watching television. For example, do 20 toe lifts followed by 20 heel lifts. Repeat that often. Sitting still promotes DVT events, while movement reduces your risk.

Symptoms

A PE event (pulmonary embolism) can hit quick and creates a very critical medical emergency. Like having a stroke or a heart attack (both of which can be brought on by a blood clot) a PE event is one of the top causes of sudden death.

While the symptoms are also critical, being aware of the symptoms might help you remember to get medical attention as quickly as possible. The symptoms to look for include:

  • Shortness of breath
  • Chest pain
  • Swelling
  • Redness of the skin

A fast or irregular heartbeat (as your heart struggles to get enough oxygen for itself and other tissues.

For top injury care in the Tempe, Arizona, area, call the FXRX clinic for an appointment. Dial 480-449-FXRX.

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Treating Shoulder Injuries with Arthroscopic Surgery

By  siteadmin  published  July 13, 2020

The shoulder is the most mobile joint in the body and that leaves it vulnerable to injuries. While conservative, non-surgical treatment options, such as rest, anti-inflammatory medications, and physical therapy are able to treat a number of shoulder injuries, serious shoulder injuries may require surgery, especially if they do not respond to nonsurgical treatment options.

Arthroscopic shoulder surgery is an advanced and effective surgical procedure that causes less post-operative pain and allows a quicker recovery. This is different from earlier surgeries that were performed using a large open incision.

Shoulder arthroscopic procedures can treat a large number of shoulder conditions and injuries. Here are 2 common injuries that can benefit from shoulder arthroscopic surgery.

Rotator Cuff Repair

The rotator cuff is a group of four muscles and tendons that attach to the top of the shoulder. The rotator cuff is an important structure because it allows you to raise, rotate and keep your shoulder stable.

A partial or complete rotator cuff tear is a severe injury that requires urgent medical attention. Your orthopedic surgeon can diagnose a rotator cuff tear and prescribe a treatment plan.

Most rotator cuff repairs can be performed arthroscopically. The procedure involves –

  • A few, tiny incisions are made
  • The damage is visualized with the help of a tiny, arthroscopic camera inserted through an incision
  • Tiny instruments and sutures anchors are used to repair the tear and attach the tendon to the bone
  • The incisions are closed and dressed
  • The shoulder is placed in a sling

Total procedure time usually takes an hour. Physical therapy after surgery is a critical part of recovery because it helps the patient regain shoulder strength and flexibility.

Labrum Repair

The labrum is a ring of soft tissue on the outer edge of the glenoid cavity. It holds the head of the humerus (upper arm bone) in the glenoid cavity and stabilizes the shoulder. A torn labrum is a serious injury because it may cause shoulder instability and even shoulder subluxations or dislocations.

A torn labrum may have to be arthroscopically surgically repaired, which involves –

  • 2-3 tiny shoulder incisions
  • An arthroscopic camera is inserted into the joint to visualizethe torn labrum
  • Through the other incisions, tiny instruments and sutures are inserted to repair the damage and attach the labrum to the glenoid cavity
  • Incisions are closed and dressed and the shoulder is placed in a sling

The total surgery time is aboutan hour, depending on the severity of the tear. Physical therapy after surgery is critical because it helps to stretch the shoulder muscles, ligaments and tendons.

The signs of rotator cuff tears and labrum tears include –

  • Difficulty lifting or raising the arm
  • Instability
  • Pain
  • Subluxation/Dislocation
  • Stiffness
  • Swelling
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Concussions Hit Hard – Take Precautions

By  aenriquez  published  July 2, 2020

Concussions sustained while participating in sports, especially in contact sports, has been a frequent topic for news media outlets in recent years. This occurred after it was discovered that many former professional football players were suffering from devastating effects of chronic traumatic encephalopathy, which occurs after repeated concussions inflicted. 

 

Thankfully, many coaches and medical assistants associated with sports teams have been trained to recognize symptoms of a mild concussion. New rules are also in place in sports leagues open to younger players to prevent repeated head injuries. Many sports organizations that have oversight over various sports have issued rules that say no athlete who suffers a concussion can be allowed back onto the field of play unless first cleared by a qualified neurologist or physician.

 

Chronic traumatic encephalopathy is a degenerative disorder that develops from repeated concussions. It is caused by Tau protein clumps that form in the brain and spread over time, killing brain cells as it spreads. As such, parents or guardians, coaches, and medical staff should be on the lookout for symptoms of concussions, mild, modest, or severe.

 

Primary symptoms

 

The primary symptoms of a concussion include headache, dizziness, changes in vision, sensitivity to light, slow reaction times with any mental activity (including counting, holding a conversation, and anything that involves memory).

In addition, concussions can show up as confusion or disorientation, slurred speech and nausea or vomiting. Ringing in the ears is common and, among children, uncharacteristic crying and mood swings can occur. Fatigue is also a potential symptom. 

 

Public Awareness

 

Public awareness concerning chronic traumatic encephalopathy has risen in recent years starting, tragically with numerous suicides and cognitive disorders among retired professional football players. However important such awareness is, the public is often fed erroneous information about concussions through popular entertainment. Adventure movies are filled with fights that end with someone (or many people) “knocked out.” Yet there is no follow-through that warns the public that being “knocked out,” in a movie fistfight has zero accountability. Knocking someone out in the movies is considered normal, common, and unimportant. This should not be the case in real life. 

 

Treatment

 

Severe or repeated concussions can cause permanent brain damage, which is why even mild concussions must be taken very seriously. Multiple concussions can result in a chronic problem.

For mild to moderate concussions, the symptoms will likely fade away in seven to 10 days. In the meantime, the counter anti-inflammatory, such as ibuprofen and naproxen can help. Anyone recovering from a concussion should also reduce the time spent watching television, video games, or computer screens and get plenty of rest.

The most important tip involving concussions, however, is to avoid strenuous activities, especially one that could result in another blow to the head. Never participate in sports until the concussion has fully healed and the return to sports is cleared by your doctor.

 

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You Love to Bike – Stay Safe

By  aenriquez  published  June 24, 2020

Riding a bicycle is one of the most pleasant and appealing global pastimes. In the minds of many, bicycling ranks right up there with taking a nap and hiking in the woods among the most pleasant activities.

A pedal bicycle is quiet, gets you where you want to go, and is a terrific exercise for staying in shape and getting in those cardio minutes that your doctor recommends.

But bicycling does involve serious risks for mishaps and injuries based on overuse of a particular muscle group. As far as mishaps go, sadly, the American Family Physicians organization notes that bicycling is second in a list of most dangerous activities, following No. 1, which is riding animals as a sport. Bicycling accounts for approximately 900 deaths per year in the United States and accounts for 23,000 hospital admissions, 580,00 emergency room visits, and 1.2 million appointments with family physicians each year.

Yes, this is the activity that brings to mind bucolic scenes of bicycle riders in the 1800(s) and reminds of us of that playfully romantic song, “A Bicycle Built for Two.”

There are risks in any sport, but bicycling has numerous risk factors, some of which are behavioral and some of which are circumstantial. That said, you can change your behavior by wearing a helmet. But most of us do not change genders and males are more likely to have a bicycle accident than females. Here is a list of risk factors. Pay special attention to the risk factors you can change:

Circumstantial Risk Factors

  • Men are more likely than females to get into a bicycle accident
  • Cyclists are between the ages of 9 to 14 have a higher risk
  • Riding over unsafe ground, such as riding on ice or mountain biking
  • An automobile is involved
  • Cyclist has a pre-existing condition
  • Bicyclist is from an unstable family life

In contrast, here are some behaviors that you can change to reduce your risk of getting into an accident or sustaining a dangerous injury:

  • Wearing a helmet, which is required by law in some places
  • Riding while intoxicated
  • Bicycling in early mornings or late evenings – essentially, this refers to bicycling when sunlight is apt to be glaring or dim
  • Riding without reflective warning lights on a bicycle
  • Bicycling when tired
  • Bicycling when under the influence of medicinal or non-medicinal drugs.
  • Riding at high speeds downhill or otherwise
  • Trying to perform trick while riding

Common Injuries

Of course, there are specific injuries involving bicycles, which include strained muscles and sprained tendons. The most common areas for inflammation to build up from overuse injuries are in the lower back and the knee. Neck strains are also common due to holding your head up while leaning forward for long periods.

Minor injuries include chafing, sore muscles, and sunburn.

Final Words

At the start of the biking season, many people try to bike more miles than they are used to. Remember to start slow and work up your stamina from there. Consult your doctor on what your limitations might be. Then get out there and stay safe and have fun.

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Stretching Tips To Help Prevent Injury

By  aenriquez  published  June 19, 2020

It is safe to say that stretching before you exercise is one of the most under-appreciated health tips. Yes, it’s popular to establish a cardio-style exercise regime. Yes, it’s helpful to improve muscle tone by lifting or with other isometric practices. But stretching? Who has time for that?

The fact is, that athletic-looking man or woman in the parking lot who is walking on crutches or that great tennis player you watched at the courts with two knee braces to keep him going is often someone who did not stretch before going full force in their chosen sport. In addition, many people who stretch will tell you they do so because they suffered a ligament tear in high school or the doctor warned them their knee would “blow out” again if they didn’t take proper care of themselves.

Of course, you can stretch properly and still get hurt. You can ignore stretching and get lucky, working out hard without injury. But you are still raising risks by not stretching before your workout. Here’s why.

BENEFITS OF STRETCHING

Makes tasks easier

Increased flexibility simply makes it easier to perform in any sport. Furthermore, going hard in any sport can make muscles and ligaments tighten, rather than gain flexibility, according to the Mayo Clinic. So, why risk injury or a compromised performance? 

Improves range of motion

An approved range of motion is also why some tasks are easier when you stretch first. You can reach further, run easier, and extend yourself a bit more when you stretch regularly. Have you ever noticed how you can climb a set of stairs much easier after you stretch?

Better posture

Having good posture can be compared to the balance you need to ride a bicycle. When you are in balance, the bike seems to have no weight. When you are off-balance, then you realize how much the bicycle weighs.

The same can be said for better posture. You can run faster and react quickly when you have the correct posture. Also, the correct posture will translate to less wear and tear progression on your joints.

Better circulation

Your cardio-vascular system pumps oxygen to the many parts of your body. Oxygen is transferred from the atmosphere to your blood supply by your lungs. You also need to exhale carbon dioxide.

Needless to say, your cardio-vascular system is critical for all human movement and survival. When you exercise, of course, you breathe harder, because your body needs more oxygen when you work out. Stretching helps by getting your heart pumping at a higher rate before you start running hard.

Some Tips On Stretching

There are two basic styles of stretching. One is called “dynamic” stretching. This involves stretching in a more aggressive style – stretching by exercising lightly or “bouncing” as you stretch.

The other style of stretching is called “static ” stretching. This style involves no bouncing, only pulling gently on muscles and ligaments. With static stretching, you stretch in one direction gently and keep up the pressure for a moment or two.

Leg stretches while sitting with your legs stretched out in front of you and bending forward is a form of static stretching, while running in place would be seen as dynamic stretching.

Thirty Seconds

Stretching a muscle group gently but firmly is recommended for static stretching, widely viewed as the correct style for most of us. It is also recommended that you hold each stretch for 30 seconds, then relax and repeat the stretch several times.

Pain-free

If the stretching causes you pain, you have gone too far. Ease back and aim for pain-free stretching. If the pain persists or reduces your functioning significantly, discuss the matter with your physician.

For top sports injury care in the Tempe, Arizona, area, call the FXRX clinic for an appointment. Dial 480-449-FXRX.

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Symphysis Pubis Dysfunction Affects Mostly Women, But Men Too

By  aenriquez  published  June 11, 2020

It has been postulated, casually and clinically, that there will be a sudden rise in childbirths nine months after the initial COVID-19 lockdown date in each country. If this is true, congratulations are in order. However, one study has shown that 37.1 percent of pregnant women experience some degree of discomfort from symphysis pubis dysfunction, an ailment that also affects men and non-pregnant women.

Symphysis pubis discomfort is the name given to a condition marked by pain in the symphysis pubis joint, which is where the two pelvis bones meet in the front of the pelvis. This joint is held together by a dense pattern of ligaments, which can become stretched and strained. When this occurs, the discomfort can be anywhere from mild to severe.

Symptoms of Symphysis Pubis Dysfunction

  • Pain in the pelvic region, which can be mild to severe. Clicking noise in the pelvis while in motion occasionally appears
  • Difficulty walking or maintaining proper posture when walking
  • Incontinence can develop.
  • Difficulty urinating can also occur.
  • Diagnosing Symphysis Pubis Dysfunction

Doctors begin diagnosing symphysis pubis dysfunction or SPD by reviewing the patient’s medical history and through a one-on-one discussion.  Frequently, ultrasounds are given to assess the problem. In addition, X-ray images can be used to diagnose SPD, but this is not recommended for pregnant women.

Symphysis Pubis Dysfunction and Pregnancy

Pregnancy can cause SPD and occurs in higher rates among pregnant women who were obese before they became pregnant. It is also prevalent in men or women who experienced lower back pain in the past.

 The health of the fetus is not affected by PSD, although it could be a factor in the decision of how to deliver the child. Women with PSD should discuss this with their obstetrician and/or their primary physician.

One option for pregnant women with PSD is to wear a supportive belt that takes some of the pressure off the woman’s pelvic bones. This can reduce discomfort if worn for the prescribed duration. Another study reported that 20 percent of those with PSD experience bouts of severe pain.

What Can You Do? Treatment Options

There are several steps you should review with your physician. These include several options you can try at home to reduce distress from PSD.

  • Chiropractic sessions help in some cases
  • Massage therapy can help in some cases

Stretching. Doctors often recommended an exercise that involves lying on your back with knees bent and feet flat on the floor. The patient then tightens the stomach muscles and the gluteal muscles in 20-second intervals. The process is repeated 10-20 times.

  • Putting a pillow between legs while asleep
  • Avoid long periods of sitting
  • Rest
  • Supportive shoes help in some cases
  • Kegel exercises
  • Keep knees together when standing from a sitting position to reduce discomfort
  • Pain medication can help in some cases

If you are experiencing Symphysis Pubis Dysfunction symptoms, call the FXRX clinic in Tempe, Arizona, for an appointment. Dial 480-449-FXRX.

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How to Fit Exercise into a Busy Life

By  aenriquez  published  June 8, 2020

The COVID-19 lockdown has reminded many of us that you don’t need New Year’s Eve to establish new priorities in your life. Many people have re-established their connections to nature, taking long walks that may have faded from memory before the crisis began. Others have dusted off their neglected home exercise equipment dedicated an hour a day to get in shape.

However, with and without lockdown measures, modern lives are busy.  We fill up the day with work, chores, projects, cooking, and time-erasing entertainment. So, how do you maintain a healthy workout routine when your life seems too busy to do so?

Here are some tips for starting an exercise routine or sneaking one in when your life seems to busy to do so.

One strategy involves becoming more efficient in your exercise style. Often recommended are styles called interval training or a similar strategy called Tabata training. There is also a popular option known as the Seven-Minute Workout.

Interval training

This style of training combines various exercises. A very common form of this is a jogging path that also includes chin-up bars, rope climbs, and other options.

Tabata training

This is similar to interval training. With this style, you combine two times of exercises, say pushups combined with jumping jacks. You do jumping jacks for 20 seconds, then take a 10-second rest and then do the pushups for 20 seconds. After a few cycles of this, you switch to two other exercises, still keeping with the 20 second/10 second routine.

Seven-Minute Workouts

This routine involves doing twelve different activities for 30 seconds then taking a 10-second break between each one. The specific exercises can vary, but one standard seven-minute routine includes jumping jacks, wall sits, push-ups, abdominal crunches, step-ups using a chair, squats, triceps dips using a chair, plank, running in place with high steps, lunges, push-ups with rotations and side planks.

Other tips:

Do what you love

If you find it difficult to even think of exercising, try getting a workout through something you love. Maybe you enjoy a game of tennis. As long as you exercise at least three times a week, you should be all right.

Take any Motivation you can find

Don’t worry about motivation. Anything that works is perfectly acceptable. Maybe you just enjoy the company you can find at the gym. If that helps get you there, don’t argue with it. Say thanks and get to the gym.

Make a Schedule

Some people need a routine they can stick to. If so, put exercise down as a priority and don’t let other distractions derail your routine.

Stairs Instead of Elevators

This idea involves more than just avoiding elevators when possible. There are many ways to include exercise in your daily life. Try parking at the farthest reaches of the parking lot rather than parking as close to the store as possible.

If you are just beginning an exercise regime and need advice, call the FXRX clinic in Tempe, Arizona, for an appointment. Dial 480-449-FXRX.

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