Tips for Shoveling Snow

Let it snow! Let it snow! Let it snow! Although the snow may be delightful to watch coming down, the shoveling that is most likely to follow may be somewhat frightful. That’s because this is an activity that can cause back pain flare-ups or create new, onset back pain. This can be especially true for individuals who may not be used to a lot of physical exertion or those who, due to COVID-19, have dramatically decreased their activity level and are not as physically able to exert themselves as they once were.  

It is always a good idea to try to maintain strong muscles and healthy joints by performing regular physical activity long before the snow starts to fall to help prevent injury when it does come time to start shoveling. Here are some other useful tips you may want to consider in keeping yourself free from excessive pain or injury:

  1.  Warm up your muscles before heading out. Shoveling can be a high intensity exercise for some, so it is appropriate to perform some light stretches, especially to your back, legs and shoulders, before beginning. It is also a good idea to stretch when you are finished. 
  2. Find the right type of shovel. There are a lot of options out there, and some are better than others. A plastic shovel will be lighter than a metal one. One with a smaller blade may be better as you will not be able to load it as much, which puts less strain on your back. You may have to make more trips, but it will be worth it. There are shovels made purely for pushing snow, which is less strenuous than lifting the snow. See what is available at your local hardware store.
  3. Try to maintain a good, solid foundation. Keep your feet wide for balance. Wear boots that have good traction or put on snow cleats to help you keep your footing. If necessary, throw some sand or salt on areas that are very icy before you start shoveling. When you do have to lift the snow, engage your core muscles and try to throw it straight in front of you, instead of twisting to the side. 
  4. Start shoveling early and pace yourself. It’s better to remove small amounts of snow more often than to wait until it is very deep and compacted, making it significantly heavier. If it is very deep, try removing it in layers. Shoveling a strip down the middle of the driveway and then removing each side is better than trying to clear the entire width of the driveway. If you feel yourself becoming winded, sore or overworked, take breaks as needed.  

Despite following all of these tips you may still find yourself with some general pain and stiffness in various muscles, especially in your lower back. This is fairly normal and should not be cause for great concern. Your muscles are just letting you know they got a workout that they may not be used to. If this occurs, some gentle stretching, walking around the house or some ice/heat may be used to help lessen the soreness. Try to avoid going straight to the recliner and staying there the rest of the day. This will only allow your muscles to become stiffer due to lack of blood flow from not moving. If your pain does not subside after a couple of days or a few weeks, becomes progressively worse or intolerable or starts shooting down your legs, you may benefit from seeing a physical therapist to help treat your pain.  Happy shoveling, and stay safe!

Innovate Physical Therapy Assessments Help Prevent Falls, Ensure Quality of Life

Many older American’s fear falling, and there’s good reason for this. According to the National Institute on Aging, more than one in three people 65 years or older fall each year, with the risk of falling — and fall-related problems — rising with age. However, many Americans don’t necessarily know what puts them at risk of falling. Predicting and preventing falls is one of the key areas physical therapists consider when they perform annual physical therapy assessment, says physical therapist and geriatric certified specialist Paul Gardner, Administrator of Innovate Physical Therapy, serving the greater Omaha area.

“We generally serve the senior population at our facilities,” Gardner said. “We realized that we often see patients after an episode, such as a fall, for the first time. We wondered how to move that conversation to identifying how to predict and prevent the most common reasons, like falls, for an older person to begin to decline and experience an episode.”

That’s the goal behind Innovate Physical Therapy’s new Annual Physical Therapy assessment program. Launched in August, the assessments are based on a Moving Target Screen developed by Dr. Carole Lewis, a national leader in physical therapy and gerontology. The goals are to establish a baseline for fitness, spot problems as they emerge and suggest exercise programs to address the problem areas. The assessment features tests in five core areas: balance, posture, strength, flexibility and endurance. For example, one test measures velocity, which is a key predictor of fall risk. If a person is walking at a slower speed, he or she is moving less efficiently and taking shorter steps. Shorter steps translate into the risk of stumbling, stumbling leads to a falls, and falls lead to fractures, which, in turn, often lead to hospitalization. Once an older person is hospitalized, the onset of decline happens more quickly and more severely. “A person will start limiting their movement, have trouble managing their environment and withdraw from their communities,” Gardner said. “It’s a cycle that leads to weakening and being at even higher risk. So if we know someone is a fall risk, we can help mitigate that.”

Assessments also include discussions about ways to manage environments to prevent falls (i.e., remove rugs or install handrails), or to encourage the use of devices (i.e., a cane or walker) to help a person steady themselves. At the same time, the physical therapist will recommend exercises that will help patients address their bodies’ weakness and better incorporate fitness into their routine. Following an annual physical therapy assessment, all patients will walk away with a general idea of their physical fitness, specific exercises to strengthen areas of weakness based on their assessment results and (if needed) recommendation to work with a physical therapist, physician or specialist in order to maintain an optimal quality of life. Perhaps the most important takeaway, says Gardner, is the understanding that as people age, the things they take for granted – things like balance, posture, strength, flexibility and endurance – often weaken. “Being aware means being prepared to take steps to prevent accidents like a fall,” he said.

Learn more about the value of an annual physical therapy assessment and how it can help you live your best life by calling the Innovate Physical Therapy team at (402) 682-4210.

*Information provided in Innovate’s Therapy Thoughts newsletter and online blog posts is for educational purposes only and is not intended to replace advice, treatment or a diagnosis from a certified medical professional. Please consult your health care provider with any health related issues.

Otago Exercise Program – Key to Preventing Falls for Older Nebraskans

According to the World Health Organization (WHO), falls are the second-leading cause of accidental or unintentional injury deaths worldwide.

With fall-related injuries being treated in U.S. emergency rooms every 11 seconds, falls are a leading cause of disability among older adults, costing Americans about $50 billion in medical costs, says Omaha area physical therapist and certified geriatric specialist Paul Gardner.

Such realities are why Gardner and the therapy team at Innovate Physical Therapy in Bellevue actively work to prevent falls among seniors in the greater Omaha area through an evidence-base regimen called the Otago Exercise Program.

“The Otago Exercise Program is an evidence-based program that encourages people to own their health care, fitness and outcomes,” said Gardner, Administrator of Innovate Physical Therapy. “It focuses on building strength and balance as key preventions to a fall. And, it has proven to work.”

According to Gardner, studies show the Otago Exercise Program can reduce the incidence of falls in older individuals by 35 to 40 percent.

A formal program that originated in New Zealand, the Otago Exercise Program outlines a series of exercises designed to address the areas of strength and balance through low-stress, low-impact movements performed 30 minutes a day, three days each week.

The exercises are assigned based on each individual’s specific needs, which are determined after an initial assessment. The exercises are relatively simple and mimic activities of daily living – movements such as walking up and down stairs using a handrail.

“Frailer adults tend to avoid stairs whenever possible,” Gardner said. “With guidance from a physical therapist, people gain confidence as well as balance and strength.”

According to Gardner, patients have shown a high level of motivation in sticking to their individual Otago Exercise Programs.

“Patients can clearly see that they are gradually gaining strength and balance, and their satisfaction is enormous,” he said. “Also, [the physical therapists] love seeing their patients get stronger and thrive. They love seeing their patients able to stay in their homes, and they love making a difference.”

To learn more about the Otago Exercise Program offered at Innovate Physical Therapy – how it can improve strength and balance in older adults, helping prevent falls – call (402) 682-4210.

*Information provided in Innovate’s Therapy Thoughts newsletter and online blog posts is for educational purposes only and is not intended to replace advice, treatment or a diagnosis from a certified medical professional. Please consult your health care provider with any health related issues.

Don’t Let Debilitating Hand Pain Affect Your Independence

How many times a day does the average person use their hands? From hitting the snooze button in the morning to setting the alarm at night, hands rarely remain still, constantly moving through both simple and complex motions as part of daily living.

Any kind of deficiency, caused by an injury, surgery or neurological event, such as a stroke, can significantly affect one’s daily function, explained Kathy Ramaekers, an occupational therapist and certified hand therapist with Innovate Physical Therapy in Bellevue.

Such is why Ramaekers wishes more physicians would refer patients to physical or occupational therapy when patients first complain about pain and/or movement limitations with their hands.

“Most people just accept some pain or stiffness as a normal part of aging and wear and tear on the body,” she said. “But that isn’t necessarily true. In fact, there is a lot a hand therapist can do to alleviate pain and improve hand function.”

Each hand contains 27 major and minor bones that are wrapped together by ligaments, tendons, muscles, nerves and arteries. All work in concert to perform activities like tying a shoe, opening a jar, or putting together a model airplane, so when something limits one’s use of their hands, it can have a profound effect on her or his entire life.

“As individuals age, learning to live without functioning hands is challenging physically, mentally, emotionally and socially,” Ramaekers said. “A hand therapist works to get his or her patients back to as much normal function as possible. Hand function is key to independent living.”

Even though complaints may be localized to the hand, Ramaekers says all hand therapy treatments should be preceded by an assessment of the entire arm extremity – from the neck and shoulder down through the arm and fingers.

“I’m looking at alignment, position, strength and flexibility, range of motion and grip strength,” she said.

As the provider of choice for multiple orthopedic physicians focusing on the hand, Ramaekers recognizes such assessments would also identify inflammation, swelling or other indications of medical conditions, such as arthritis, which can be affecting the hand.

Once a cause of pain or loss of function is determined, a treatment plan is formed. In addition to exercises and therapies such as massage or ultrasound, a hand therapist can suggest compensating strategies and adaptive equipment.

Compensating strategies may include selecting shoes with Velcro or magnetic straps that don’t require knot tying, learning to do certain tasks with the other hand or choosing shirts without buttons. Adaptive equipment prescribed may include an appliance that opens jars, handles that make gripping and pulling easier (such as seat belts), or specially designed silverware or writing tools.

Hand therapists will also work with individual clients to devise strategies that help them alleviate stress on the hands, such as carrying items with the arms and not the hands.

To learn more about how a hand therapist can help improve function while alleviating discomfort, pain and inflammation in the hands and arms, call (402) 682-4210.

*Information provided in Innovate’s Therapy Thoughts newsletter and online blog posts is for educational purposes only and is not intended to replace advice, treatment or a diagnosis from a certified medical professional. Please consult your health care provider with any health related issues.

Innovate Physical Therapy Offers Back- and Joint-Friendly Gardening Tips for Seniors

After a long, cold, snowy winter many aging adults are looking forward to spring and being able to get back outside. For many individuals, tending to the garden is high on their list of priorities. Spring gardening and yardwork provides several benefits for aging adults, including connecting with the beauty of nature, physical activity and growing nutritious fruits and vegetables.

Gardening is an enjoyable activity many adults perform throughout life. However, reduced mobility, flexibility and pain caused by arthritis may make this difficult as individuals age.  According to, an estimated 54 million American adults have been diagnosed with arthritis, creating potential barriers for individuals who desire to participate in challenging outdoor activities.  This doesn’t have to be the case, says Sarah Blomenkamp, PT, of Innovate Physical Therapy in Bellevue.

A primary factor in managing arthritis is actually engaging in physical activity and exercise to help improve strength and stability. So if gardening is what you love, there are ways to help support the body while you garden.

“A lot of people stop gardening because maybe they have had some difficulty in the past,” Blomenkamp said. “If you are getting back into it, start slow and easy with just a few gardening tasks, such as potted plants for the porch.  As your body adapts and tolerates it, you can keep adding a little more.”

Enjoy all the delights of gardening this year with the following tips from Blomenkamp:

Invest in supportive tools and equipment. Gardeners with bad knees can purchase a gardening mat or pad at outlets such as Ace Hardware, Walgreens, Menards, etc. If kneeling is painful, another modification is to use a small stool and garden while seated. Blomenkamp mentions that when rising from a kneeling position, it is helpful to use a nearby shovel or stool for support. For those who have arthritis in the fingers or wrists, check out a variety of adaptive and ergonomic tools that may be easier to grip.

Take frequent breaks, and pace yourself. With the first rays of sun, it can be tempting to spend all day in the garden as the days get longer, but it’s best to start slow. Perhaps potting flowers for the porch is a great first step. As the season progresses, the body builds tolerance to do more.

“Come up with a plan beforehand,” Blomenkamp said. “Say, ‘Today I’ll plant these flowers, and I’ll do these other things tomorrow.’ And write out a plan beforehand so as not to overdo. It’s more work, but it can be better on your body in the long run to plan ahead.”

Blomenkamp also suggests listening to your body and taking breaks. It can be helpful to set a timer for every 30 minutes as a reminder that it is time to stand, stretch, lie down or sit on a bench and take in the beauty of your garden.

Stretch and change positions. Gardening often involves repetitive motions, requiring you to bend over with the body in a forward flexing position. To help back and knee strain, Blomenkamp recommends stretching and extending the body before, during and after time in the garden. Stretches can include: standing tall and placing hands on the small of back for a gentle arching stretch; rotating the body to the left and right; squeezing the back shoulder blades together; circling the neck; and stretching the hamstring by sitting down and extending the leg and knee out straight.

Blomenkamp explains that it is important to be mindful of posture, use proper body mechanics when lifting or bending and to balance work with rest in order to fully enjoy your time in the garden this year.

To learn more or to schedule an appointment Innovate Physical Therapy call (402) 682-4210.

*Information provided in Innovate’s Therapy Thoughts newsletter and online blog posts is for educational purposes only and is not intended to replace advice, treatment or a diagnosis from a certified medical professional. Please consult your health care provider with any health related issues.

Improve Post-Surgery Rehab with “Prehab”

With about a million knee and hip replacements performed each year in the U.S., physical therapist Paul Gardner says that it’s more important than ever for future joint replacement patients to create the best possible outcome for themselves after surgery. They can actually do this by beginning rehabilitation before surgery.

It’s called prehabilitation – a process during which a physical therapist prepares patients for joint surgery through a strengthening or range-of-motion program that helps set the table for a quicker and more successful rehab and recovery following the procedure.

“There is research indicating that some individuals who have greater strength and better range of motion will have a better outcome after the surgery,” says Gardner, Administrator of Innovate Physical Therapy.

A typical prehabilitation program will begin 4 to 6 weeks in advance of surgery. And, the benefits of such a program are many:

Strengthening the body: Establishing and executing an exercise program developed by a physical therapist and tailored specifically for the patient can help strengthen the body and integrate neuromuscular pathways before surgery. This can result in a shortened hospitalization stay and reduced recovery duration.

“Prehabilitation prior to joint replacement surgery,” Gardner says, “can reduce post-surgery rehab time by 25 to 50 percent. Since the body is stronger before surgery, it will also be stronger after surgery.”

Calming the mind: Prehabilitation is an opportunity for a physical therapist to prepare someone mentally for surgery, so they know what to expect. This can reduce pre-surgery stress levels. Education and knowledge can decrease the amount of stress and fear leading up to the procedure.

“There is a psychological benefit of having knowledge of what an individual is going to be working with,” Gardner explains. “There is also the benefit of function and quality of life. The better I am set up for after that surgery, I am going to be able to function at a higher level, which plays out with me being more satisfied.”

Accelerating the recovery: A portion of the prehabilitation process includes practicing exercises needed post-surgery, as well as modifying the home and becoming familiar with adaptive equipment. This may include rehearsing with a walker, crutches or cane in and around your home, and making modifications such as cleaning up clutter, increasing light, reorganizing the kitchen, or modifying a shower or toilet.

The physical therapist may also discuss ways to manage pain after surgery through positioning, ice, and massage techniques. Gardner says that it’s a good idea to reach out to your support system and organize a plan for after surgery, such as how to get the groceries or transportation to rehab.

Since many aging adults undergo joint surgery, the reality is that there are other chronic conditions to consider such as diabetes, hypertension or congestive heart failure. As specialists in aging adults, Innovate Physical Therapy is able to understand the conditions that are more prevalent in older adults, and to evaluate a person’s health regardless of the perception of age.

“We can look beyond age and understand the complex care that will be involved for each individual,” Gardner said, “and the assets that this individual possesses to reach a positive rehab outcome.”

To learn more about how prehabilitation can prepare you for surgery and improve rehab after the procedure, contact Innovate Physical Therapy at (402) 682-4210.

*Information provided in Innovate’s Therapy Thoughts newsletter and online blog posts is for educational purposes only and is not intended to replace advice, treatment or a diagnosis from a certified medical professional. Please consult your health care provider with any health related issues.

Innovate Physical Therapy Offers Telehealth Services

The COVID-19 pandemic has led to a lot of events being canceled, but that doesn’t mean you have to cancel your therapy appointments. With telehealth services, Innovate Physical Therapy can now bring the therapy you need to the safety of your own home. Through your smartphone, tablet or computer, your therapist can guide you through your therapy sessions through video appointments. Setting up telehealth is easy and our trained telehealth therapists are happy to help you every step of the way.

“Telehealth is a great way to provide clients with greater access to care, especially during this time when patients may not feel comfortable leaving their homes for appointments,” said Sarah Blomenkamp, PT, GCS, CEEAA, a physical therapist at Innovate Physical Therapy. “We are able to provide full treatment sessions with consistent input and coaching throughout.”

Telehealth services are more accessible than ever. The Centers for Medicare & Medicaid Services has made it easier for health care professionals to use telehealth services. Consequently, more and more insurance providers have begun covering telehealth services as the need for them has spread.

The COVID-19 pandemic has made it even more difficult to stay active. Right now, with so many places closed and fewer opportunities to stay active, it’s more important than ever to continue benefitting from physical and occupational therapy.

Don’t let COVID-19 stop you from staying active and healthy. Simply call us at (402) 682-4210 and we will help you determine if telehealth is the right step for you.

*Information provided in Innovate’s Therapy Thoughts newsletter and online blog posts is for educational purposes only and is not intended to replace advice, treatment or a diagnosis from a certified medical professional. Please consult your health care provider with any health related issues.

Strength Training at Home with Innovate Physical Therapy

As we age, we tend to lose muscle mass, so it’s important to maintain a regular exercise routine. At Innovate Physical Therapy we work on strength training with nearly everyone because it helps in a variety of ways including balance, metabolism, overall independence and physical confidence.

Because of COVID-19, more and more individuals have begun working out at home, including Innovate Physical Therapy clients. As we work with our clients through our telehealth services, there are many strength exercises that we have adapted to fit your at-home needs. 

Fancy gym equipment is unnecessary for these exercises but it is still important to have good exercise protocols and form when working out at home. As you are doing strength training, remember to do a warm-up beforehand by walking around the house a few times or marching in place. While you’re strength training, be careful and don’t overexert yourself. Control your movements and do them slowly, making sure not to use momentum to move the objects.

“Stop if it gets painful,” said Sarah Blomenkamp, PT, GCS, CEEAA, a physical therapist at Innovate Physical Therapy. “But expect some muscle-burn as your body gets stronger and more used to the exercises. For strength training we want people working with a load that they feel is ‘somewhat hard’ to ‘hard.’” Perform reps until you feel fatigue in your muscles, and if it is too easy, then next time add a little more weight if you can.”

Here some exercises that you can do at home on your own.

  1. Find a piece of furniture that is somewhat heavy but moveable and push it across the floor while making sure not to scratch your floors. This exercise works your whole body, but especially your legs.
  2. Perform push-ups on a wall, high counter or lower surface. As you get stronger, make the surface more horizontal as you are able. This exercise is great for your upper body and ab muscles.
  3. Carry loaded laundry baskets throughout the house until you get tired. This is a great endurance strength training exercise that works your upper body. Just remember to maintain a good posture so you don’t strain your back.

Through Innovate Physical Therapy’s telehealth services, we can help you continue to build up your muscle mass while keeping you active and safe. For more information about our telehealth services and the strength training we offer, visit or call (402) 682-4210.

*Information provided in Innovate’s Therapy Thoughts newsletter and online blog posts is for educational purposes only and is not intended to replace advice, treatment or a diagnosis from a certified medical professional. Please consult your health care provider with any health related issues.

Welcome to Our New Website!

Hillcrest Physical Therapy is now Innovate Physical Therapy! Same great team. Same amazing results. We’ve updated our name to highlight our focus on providing therapy for all ages and care needs. We provide physical, occupational, speech, aquatic and massage therapy. Call today for a complimentary injury screening to see if outpatient therapy could benefit you — (402) 682-4210.