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<p>As self-insured employers and health plans consider implementing musculoskeletal (MSK) solutions to benefit their employees and members, it's crucial to understand the effectiveness of these programs. Many competing MSK solutions in the market claim to reduce surgeries and opioid use, basing their impact on patient-reported surgical intent, also sometimes crafted as “Avoided Surgeries.“ There is insufficient evidence from peer-reviewed studies to support the use of this metric in measuring surgery reduction. Additionally, it may not provide an accurate reflection of the actual cost savings from a program. In this blog post, we'll explore why SimpleTherapy chooses not to rely on surgical intent to measure the impact of our virtual physical therapy program and what alternative evidence-based measures should be considered.</p><p>With the rise of virtual physical therapy programs, employers and health plans are often faced with the challenge of choosing the right solution for their members. Amidst the noise and competing claims in the market, one metric that has garnered attention is the reduction of surgical intent as a measure of program success. In this blog post, we discuss the reliability of this metric and provide insights from orthopedic surgeons on the importance of objective data in measuring the impact of virtual physical therapy programs.</p><h3 class="wp-block-heading" id="h-the-flaws-of-surgical-intent-metric">The Flaws of Surgical Intent Metric</h3><p>Using surgical intent as a measure of program impact involves asking members about their likelihood of having surgery in the next 12 months. Although some MSK solutions guarantee returns by calculating savings using surgical intent reduction, there is no proof that reducing surgical intent actually leads to reduced costs in claims. Furthermore, there are no peer-reviewed studies supporting the reliability of this metric for measuring surgery reduction.</p><p>Surgical intent is a subjective measure that can be influenced by various factors, such as the patient's perception of their condition, personal beliefs about surgery, and their understanding of alternative treatments. While it has been used as one of the outcome measures in some clinical studies, often in conjunction with other clinical, functional, and quality-of-life measures, these studies typically assess the effectiveness of interventions in reducing the patient's intention to undergo surgery. They do not provide direct evidence to support surgical intent as a reliable, independent metric for evaluating the true impact on surgical claims and further overestimate the impact of virtual physical therapy or MSK programs in terms of cost.</p><p>Moreover, relying on surgical intent to calculate cost savings assumes a direct correlation between reduced surgical intent and actual cost savings in medical claims. However, there is no proof that reducing surgical intent leads to reduced healthcare costs.</p><h3 class="wp-block-heading" id="h-the-orthopedic-surgeon-s-perspective">The Orthopedic Surgeon's Perspective</h3><figure class="wp-block-image aligncenter size-full is-resized is-style-rounded"><img src="/uploads/2018/09/tae-512.png" alt="Dr. Tae Won Kim" class="wp-image-2415" width="128" height="128"/></figure><blockquote class="wp-block-quote has-text-align-right is-style-large has-text-color has-small-font-size" style="color:#044f6b;font-style:normal;font-weight:300"><p class="has-text-align-center has-text-color" style="color:#1ea5de;font-size:18px">"As a surgeon, my primary focus is on the best course of treatment for my patients, taking into account their unique circumstances and medical history. Relying on a patient-reported measure of surgical intent, a patient's subjective opinion, especially within a short time frame of 6-8 weeks, may not accurately capture the true impact of a physical therapy program. Objective data, such as claims-based cost savings and measurable clinical improvements, are far more reliable indicators of a program's effectiveness"</p><cite><strong>— Tae Won Kim, M.D</strong> <br>Program Director, Orthopaedic Surgery Residency Program<br>Director, Orthopaedic Oncology Center <br>Cooper University  Heath Care</cite></blockquote><p>Orthopedic surgeons also acknowledge the limitations of relying on patient-reported measures like surgical intent. It's difficult to depend on a measure taken just 6-8 weeks after starting a program when the true impact of the program may require a much longer timeframe to become evident. Moreover, it's crucial to consider factors such as the severity of the patient's condition, the patient's overall health, and the potential risks and benefits of surgery, which cannot be captured by simply asking about surgical intent.</p><p>An orthopedic surgeon would likely perceive the patient-reported outcome measure of the likelihood of surgery with skepticism. Surgeons base their decisions on a comprehensive assessment of the patient's condition, medical history, and the severity of their symptoms. They take into account various diagnostic tests, clinical guidelines, and their expertise to determine the most appropriate course of action for the patient.</p><p>A patient-reported measure of the likelihood of surgery, while potentially informative, is subjective and may not accurately reflect the clinical need for surgery. Patients might overestimate or underestimate their need for surgery based on personal beliefs, fear, or lack of understanding of alternative treatment options. As a result, orthopedic surgeons might not rely solely on a patient-reported measure of surgical intent when making a decision about the best course of treatment.</p><p>Orthopedic surgeons may also consider factors such as the patient's functional limitations, pain levels, and response to conservative treatments like physical therapy or medications. They would likely view a combination of these objective measures as a more accurate and reliable way to determine the need for surgery and the potential benefits of non-surgical interventions.</p><h3 class="wp-block-heading" id="h-a-physical-therapists-perspective">A Physical Therapists perspective</h3><p>The time it takes for physical therapy (PT) to reduce the chances of surgery can vary significantly depending on several factors, such as the type and severity of the condition, the patient's overall health, and their adherence to the prescribed PT program.</p><p>In some cases, patients may experience significant improvements in their symptoms within a few weeks or months, while others may require a longer period of consistent physical therapy to achieve noticeable progress. It is essential for patients to follow their PT program diligently and maintain open communication with their healthcare providers to monitor their progress and adjust the treatment plan as needed.</p><figure class="wp-block-image aligncenter size-full is-resized is-style-rounded"><img src="/uploads/2023/06/Kelly_McLaughlin.webp" alt="" class="wp-image-5526" width="138" height="138"/></figure><blockquote class="wp-block-quote has-text-align-right is-style-large has-text-color" style="color:#044f6b"><p class="has-text-align-center has-text-color" style="color:#1ea5de;font-size:18px">"Ultimately, the decision to pursue surgery should be based on a comprehensive evaluation of the patient's condition, response to conservative treatments like PT, and consultation with their healthcare providers. It is important to remember that individual experiences may vary, and there is no one-size-fits-all timeline for the effects of PT in reducing the chances of surgery."</p><cite>— <em>Kelly McLaughlin, DPT, ATC Cert MDT</em></cite></blockquote><h3 class="wp-block-heading" id="h-alternative-measures-for-evaluating-msk-program-impact">Alternative Measures for Evaluating MSK Program Impact</h3><p>It's essential to rely on objective, evidence-based measures when evaluating the effectiveness of a physical therapy or MSK program. This can include functional outcomes, pain reduction, quality of life improvements, and actual healthcare cost savings resulting from reduced surgical procedures, hospitalizations, and medication use.</p><p>SimpleTherapy focuses on such cost savings and is willing to put money at RISK. By using cohort-matched studies and reviewing claims data, we demonstrate the real-world impact of our MSK program on healthcare costs and patient outcomes. This approach demonstrates actual cost savings and reflects the true effectiveness of our virtual physical therapy program. By focusing on real savings, SimpleTherapy is confident in our program's ability to make a difference, and we're willing to put our money at risk to prove it.</p><h3 class="wp-block-heading" id="h-the-simpletherapy-difference-focusing-on-transparency-and-true-cost-savings">The SimpleTherapy Difference: Focusing on Transparency and True Cost Savings</h3><p>At SimpleTherapy, we recognize the need for objective data and transparency in evaluating the impact of our virtual physical therapy program. Our Advanced Claims Analytics Engine (ACE) is designed to help employers gain insights into the true cost savings achieved through our program by analyzing medical claims data and providing accurate, reliable metrics identified in these studies.</p><p>By focusing on cohort-matched studies that review claims data, we can demonstrate the real-world cost savings associated with our program. This approach aligns with the opinions of orthopedic surgeons who emphasize the importance of objective data in measuring program success, as opposed to relying on subjective measures like surgical intent.</p><p>We are confident in our ability to deliver true cost savings and are willing to put our money at RISK. SimpleTherapy is dedicated to providing high-quality, accessible virtual physical therapy services that lead to real, measurable improvements in our users' health and well-being.</p><p>Check-out some of our case studies that showcase the claims-based analysis conducted for our clients.</p><h3 class="wp-block-heading" id="h-conclusion">Conclusion</h3><p>As healthcare decision-makers, it is crucial to be critical of the metrics used to evaluate the effectiveness of MSK solutions. Patient-reported surgical intent is not a reliable, standalone measure for determining the impact of a virtual physical therapy program. Instead, consider evidence-based measures, such as functional outcomes, pain reduction, quality of life improvements, and actual healthcare cost savings. By focusing on these more meaningful metrics, SimpleTherapy aims to provide an effective and accessible solution for musculoskeletal pain management while promoting health equity and diversity.</p>

Debunking the Surgical Intent Metric and Focusing on Real Cost Savings

<p>At SimpleTherapy, we prioritize providing evidence-based, clinically proven methods to help our users manage and reduce pain. While some digital health solutions rely on motion-tracking devices and sensors, SimpleTherapy's approach is grounded in research that supports the efficacy of virtual therapy without the need for additional hardware. In this post, we'll explore the lack of clinical evidence for motion-tracking devices, discuss a recent clinical study conducted with Mount Sinai, and explain how SimpleTherapy effectively delivers appropriate care without these devices.</p><h3 class="wp-block-heading" id="The-Lack-of-Clinical-Evidence-for-Motion-Tracking-Devices:">The Lack of Clinical Evidence for Motion Tracking Devices:</h3><p>Motion tracking devices, such as wearable sensors, are often touted as the future of rehabilitation, but the scientific evidence supporting their use remains limited. According to a systematic review published in the Journal of Medical Internet Research (JMIR), there is a lack of high-quality studies evaluating the effectiveness of sensor-based interventions for musculoskeletal (MSK) disorders<sup>(1)</sup>. The review concludes that more rigorous, controlled trials are needed to establish the validity of these devices in clinical practice.</p><hr class="wp-block-separator has-alpha-channel-opacity"/><figure class="wp-block-image aligncenter size-full"><a href="/uploads/2023/06/Kelly_McLaughlin.webp"><img src="/uploads/2023/06/Kelly_McLaughlin.webp" alt="" class="wp-image-5526"/></a></figure><figure class="wp-block-pullquote has-white-color has-text-color has-background has-small-font-size" style="border-width:40px;border-radius:55px;background:linear-gradient(135deg,rgb(30,165,222) 1%,rgb(46,182,149) 100%);font-style:normal;font-weight:400"><blockquote><p><strong><em>“Clinical decision-making revolves around pain and the mechanical responses to movements. Therefore, it is not necessary to use sensors that only record movement, but rather, it is more clinically relevant to obtain subjective and mechanical response to those particular movements to prescribe the best care for the patient.”</em></strong></p><cite>- Kelly McLaughlin, DPT, ATC Cert MDT <br>Director of MSK Programs | SimpleTherapy Inc.</cite></blockquote></figure><hr class="wp-block-separator has-alpha-channel-opacity"/><h3 class="wp-block-heading" id="SimpleTherapy's-Clinical-Study-with-Mount-Sinai:">SimpleTherapy's Clinical Study with Mount Sinai</h3><p>SimpleTherapy recently conducted a clinical study with The&nbsp;Department of Rehabilitation and Human Performance at the Icahn School of Medicine at Mount Sinai in NYC to further investigate the effectiveness of our virtual physical therapy platform without the use of motion-tracking devices. The study conducted by SimpleTherapy and Mt. Sinai involved a retrospective analysis of data from 3109 users with multiple types of chronic musculoskeletal pain. The findings showed that engaging with the SimpleTherapy program was associated with a significant decrease in pain intensity and significant improvements in self-reported quality of life and work life. These outcomes are comparable to traditional physical therapy results without requiring any additional equipment like motion tracking devices.</p><h3 class="wp-block-heading" id="The-study's-key-findings-include-the-following:">The study's key findings include the following:</h3><ol><li><strong>A significant decrease in pain intensity:</strong> Users reported a clinically significant decrease in pain intensity of 2.09-point points on a pain Visual Analogue Scale by the 11th session.</li><li><strong>Significant improvements in quality of life and work life: </strong>The study found that using the SimpleTherapy program was associated with significant improvements in self-reported percent improvement in participants' quality of life and work life.</li><li><strong>High levels of engagement: </strong>46% of participants were performing more than one session per day, 70% were doing two sessions within two days of onboarding, and 88% were engaging within a week of onboarding.</li><li><strong>Scalability and wide-ranging disease applicability: </strong>The study included a large number of participants and multiple pain sites, demonstrating the potential for the SimpleTherapy program to be applied across various conditions without the need for sensors or motion-tracking devices. Users with pain in various body parts, such as the lower back, upper back, neck, ankle, foot, wrist, hand, hip, and knee, experienced benefits without the need for motion-tracking devices or computer vision technology.</li></ol><h3 class="wp-block-heading" id="Evidence-Based-Approach-without-Motion-Tracking-Devices:">Evidence-Based Approach without Motion Tracking Devices</h3><p>These findings provide foundational evidence that SimpleTherapy programs can offer similar benefits to traditional physical therapy but with the added advantages of high levels of patient compliance with prescribed care and enhanced accessibility. Our platform eliminates the need for expensive, hi-tech setups like motion sensor or computer vision technology, making it more convenient and cost-effective for users seeking pain relief and rehabilitation.</p><p>By demonstrating that motion-tracking devices aren't necessary for effective physical therapy, this study further solidifies SimpleTherapy's commitment to delivering evidence-based, virtual therapy services that are both effective and accessible.</p><p>SimpleTherapy focuses on delivering virtual therapy services that are supported by scientific research. Our platform provides personalized exercise therapy programs that have been shown to be effective in reducing pain and improving function for individuals with MSK conditions <sup>(2)</sup>. Furthermore, a study published in the Journal of Telemedicine and Telecare found that virtual rehabilitation without motion-tracking devices can lead to similar outcomes as traditional in-person therapy, including pain reduction and functional improvements <sup>(3)</sup>.</p><h3 class="wp-block-heading" id="Promoting-Health-Equity-and-Diversity:">Promoting Health Equity and Diversity:</h3><p>By eliminating the need for motion-tracking devices and providing virtual therapy services that are both effective and accessible, SimpleTherapy actively supports health equity and diversity. Without additional hardware, our platform can be accessed from any device with an internet connection, making it more convenient for users seeking pain relief and rehabilitation; and cost-effective for employers looking to bring a solution that supports health equity without breaking the bank. Our platform allows individuals from various socioeconomic backgrounds, including those with limited access to traditional physical therapy services, to receive high-quality care that can improve their lives.</p><p>SimpleTherapy's commitment to health equity and diversity extends beyond offering an accessible platform. We also prioritize hiring diverse healthcare professionals to ensure our users receive culturally sensitive care that caters to their unique needs.</p><h3 class="wp-block-heading" id="Conclusion:">Conclusion:</h3><p>SimpleTherapy is committed to delivering evidence-based, digital, and virtual therapy services that are both effective and accessible. SimpleTherapy's clinical study with Mt. Sinai provides compelling evidence that motion-tracking devices are not required for effective physical therapy. Our platform offers personalized home-based exercise therapy programs for people with chronic pain, can achieve significant pain reduction and improved quality of life without relying on additional hardware. This approach enables us to provide a more accessible, affordable, and user-friendly solution for individuals seeking pain relief and rehabilitation.</p><p>By prioritizing research-backed methods and focusing on user engagement, delivering high-quality virtual therapy, SimpleTherapy is committed to positively impacting the lives of those living with chronic pain, without the need for motion-tracking devices. By making our services accessible and affordable, we aim to improve people's lives with chronic pain through evidence-based, personalized home-based exercise therapy programs.</p><p></p><p class="has-small-font-size">References:</p><ol><li class="has-small-font-size">Lund, H., Juhl, C., Nørgaard, B., &amp; Christensen, R. (2018). Movement Sensors for Effect Estimation in Patients with Musculoskeletal Disorders: A Systematic Review of the Literature. Journal of Medical Internet Research, 20(5), e197. <a href="https://doi.org/10.2196/jmir.9973"><u>https://doi.org/10.2196/jmir.9973</u></a></li><li class="has-small-font-size">Kim T, Gay N, Khemka A, Garino J. Internet-Based Exercise Therapy Using Algorithms for Conservative Treatment of Anterior Knee Pain: A Pragmatic Randomized Controlled Trial<br>JMIR Rehabil Assist Technol 2016;3(2):e12 <a href="https://doi.org/10.2196/rehab.5148">Internet-Based Exercise Therapy Using Algorithms for Conservative Treatment of Anterior Knee Pain: A Pragmatic Randomized Controlled Trial</a></li><li class="has-small-font-size">Delgado, Andrew Dean1; Salazar, Sophia Isela1; Rozaieski, Kendal2; Putrino, David1; Tabacof, Laura1. Engagement in an mHealth guided exercise therapy program is associated with reductions in chronic musculoskeletal pain. American Journal of Physical Medicine &amp; Rehabilitation ():10.1097/PHM.0000000000002257, March 31, 2023. | DOI: 10.1097/PHM.0000000000002257</li><li class="has-small-font-size">Cottrell, M. A., Galea, O. A., O'Leary, S. P., Hill, A. J., &amp; Russell, T. G. (2017). Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review and meta-analysis. Journal of Telemedicine and Telecare, 23(5), 557-564. <a href="https://doi.org/10.1177/1357633X16649531">https://doi.org/10.1177/1357633X16649531</a></li></ol>

The Science Behind SimpleTherapy: Why We Don't Use Motion Tracking Devices

<h3 data-renderer-start-pos="1"><strong data-renderer-mark="true"><u data-renderer-mark="true">SimpleTherapy Range of Motion Assessment</u></strong></h3><p data-renderer-start-pos="43"><strong data-renderer-mark="true">&nbsp;</strong></p><h4 data-renderer-start-pos="46"><strong data-renderer-mark="true">Why Do a Range of Motion Assessment?</strong></h4><p data-renderer-start-pos="87">Measuring range of motion allows you to receive a thorough assessment of the functionality and flexibility of a given joint and its surrounding muscles. Healthy joints and muscles should have no limitations in their mobility and overall movement patterns. Oftentimes, we don’t even realize our range of motion is not optimal and the assessment can allow you to recognize some potential shortcomings that you may not have realized existed prior.</p><h4 data-renderer-start-pos="536"><strong data-renderer-mark="true">What Impacts Range of Motion?</strong></h4><p data-renderer-start-pos="570">Range of motion can be impacted for a variety of reasons; some are more serious and tougher to fix than others. Common factors that might contribute to poor range of motion include:</p><p><ul></p><p> 	<li data-renderer-start-pos="753">Muscle Tightness</li></p><p> 	<li data-renderer-start-pos="753">Muscles Soreness</li></p><p> 	<li data-renderer-start-pos="753">Scar Tissue</li></p><p> 	<li data-renderer-start-pos="753">Arthritis</li></p><p> 	<li data-renderer-start-pos="753">Muscular Asymmetry</li></p><p> 	<li data-renderer-start-pos="753">Disuse syndrome</li></p><p> 	<li data-renderer-start-pos="753">Fractures</li></p><p> 	<li data-renderer-start-pos="753">Strains &amp; Sprains</li></p><p></ul></p><p><p data-renderer-start-pos="939"><strong data-renderer-mark="true">What are the Benefits of the SimpleTherapy Assessment?</strong></p></p><p><p data-renderer-start-pos="998">Although performing a self-assessed range of motion assessment lacks the pinpoint accuracy of seeing a physical therapist in person, there are still numerous benefits in the self-assessed variety.</p></p><p><ol></p><p> 	<li data-renderer-start-pos="1205"><strong data-renderer-mark="true">Visual Example</strong> - Our range of motion assessment provides a clear visual example of proper joint movement. You are able to compare your own movement patterns and range of motion to the visual example provided to you.</li></p><p> 	<li data-renderer-start-pos="1428"><strong data-renderer-mark="true">Track Your Progress </strong>- SimpleTherapy documents your range of motion scores to see if you are declining, improving, or staying neutral. These scores can be an indication of how much progress you’ve made over a period of time or if you need to start to put some more effort into seeing improvement. If we notice that your range of motion is not improving or is starting to decline, SimpleTherapy will provide you with an option to chat with a clinical team member to assess the next steps.</li></p><p> 	<li data-renderer-start-pos="1917"><strong data-renderer-mark="true">Convenience </strong>- SimpleTherapy asks you to perform a range of motion assessment(s) for your program once every three sessions. This assessment costs you nothing and does not require you to leave your house and make an appointment.</li></p><p> 	<li data-renderer-start-pos="2152"><strong data-renderer-mark="true">Build Self</strong>-<strong data-renderer-mark="true">Awareness - </strong>As noted previously, many people don’t even recognize that their joint functionality and range of motion are not optimal. Our assessment can create some much-needed awareness to encourage us to be proactive. While this limited functionality may not be causing you pain now, there is a strong likelihood it can create problems in the future. Tackling an issue like this head-on is the best and most sustainable solution long-term.</li></p><p></ol></p>

Range of Motion Assessment

<p>Many of us spend a significant amount in our cars commuting. According to the U.S. Census Bureau, it is estimated that the average time to work in the United States is slightly in excess of 25 minutes.&nbsp; Being stuck in traffic can cause significant stress and strain on the neck and cause pain and stiffness.</p><p></p><p>While we may not be able to avoid driving our cars, there are a few <a href="http://www.everydayhealth.com/neck-pain/neck-pain-prevention-driving.aspx">simple ways to minimize neck discomfort</a>.&nbsp; Maintaining good posture, good head support and proper mirror positions are easy fixes that will go a long way to make your drive more comfortable.&nbsp; Additionally, a cervical stabilization program designed to strengthen the muscles of your neck and shoulder can help too.</p><p></p><p>Here are a few tips that may ease aches while driving:</p><p></p><p><strong>Start with good driving posture</strong></p><p></p><p>Make sure your seat is adjusted to your specific height to sit comfortably and view the road clearly. The best angle for the back of your seat is at 100 degrees. Keep your hands on the 3 and 9 o'clock positions on the steering wheel</p><p></p><p><strong>Support your lower back</strong></p><p></p><p>If your car seat does not offer lumbar support, place a small pillow against the bottom part of your seat back. This maintains the right shape from your tailbone to your neck.</p><p></p><p><strong>Adjust your mirrors</strong></p><p></p><p>Move your mirrors to give yourself the widest field of vision to minimize head movement or neck strain</p><p></p><p><strong>Take a break</strong></p><p></p><p>If you start feeling aches or pains, feel free to pull off at a stop to stretch and walk off any kinks</p><p></p><p><a href="http://www.simpletherapy.com/choc">SimpleTherapy</a> provides complete exercise therapy programs for the <a href="http://www.simpletherapy.com/programs/neck-pain/">neck</a>, <a href="http://www.simpletherapy.com/programs/shoulder-pain/">shoulder</a> and <a href="http://www.simpletherapy.com/programs/upper-back-pain/">upper back</a> to minimize the stress and strain on your neck.</p><p></p><p><a href="http://onelink.to/gcr9t3">Download the SimpleTherapy app</a> to start progressing yourself today!</p>

Driving Away  Back Pain

<p><p data-renderer-start-pos="1">These 2 words are often used interchangeably. When in reality they mean two very different things. Your health care team is well versed in these differences. Hyperflexibility is referring to the amount of stretch our contractile muscles can perform, while hypermobility refers to the laxity of the ligament(s).</p></p><p><p data-renderer-start-pos="305">Hyperflexibility refers to the ability of our muscles to lengthen and reduce tension. Since they are like rubber bands, they will return to a resting position; therefore, will not increase the risk of injury to the joint due to lack of support. Often being hyperflexible does not pose a concern for injury but may indicate the need for specified strengthening.</p></p><p><p data-renderer-start-pos="669">Many people will have hypermobility in one or two joints, but only a small percentage of people have widespread laxity. A ligament does not have a contractile property, so once it is stretched/lengthened it will not return to a resting position. It will always remain lengthened. A laxed ligament will no longer support the joint which can result in pain and injury for many of those who do not know how to properly strengthen the appropriate muscles surrounding the joint. Overstretching a ligament is therefore a great big “no-no”.</p></p><p><p data-renderer-start-pos="1205">Physical Therapists, as the movement specialists of the medical community, are probably the best resource to help you understand your condition and set you up with the best exercise regimen. ST was designed by and continues to be progressed/changed and updated by physical therapists. Make sure you work within your pain tolerance while using the program and be accurate with answering the questions that may be asked before or after your sessions. This will help the system adjust to your needs. The range of motion assessments are utilized to monitor your progress and alert your healthcare team of any concerns. Remember, you can always reach out to your health coach for further advice.</p></p>

Hyper-mobility vs. Hyper-flexibility

<h3><strong>What Exactly is Stability? </strong></h3>&nbsp;Stability is our ability to remain balanced. It is critical for ensuring proper exercise execution and safe completion of daily tasks. The better your stability is, the more equipped you are to exercise safely and avoid sudden injury. Our core muscles are at the center of all stabilizing movements however local stability in joints such as the shoulders and knees can be equally as important when it comes to preserving proper movement patters and keeping the muscles and joints in the area healthy.&nbsp;<h3><strong>How Can I Improve My Stability?</strong></h3><strong>&nbsp;</strong>Exercise, mainly through strength training and flexibility training, is the best way to build a high degree of stability. While flexibility training is essential in maintaining a healthy range of motion and proper movement patterns, resistance training helps the body adapt to situations where there is imbalance. This prepares the body to react accordingly when faced with unanticipated situations like slips, trips, and falls. Stability is best utilized in the beginning of a workout. These movements are highly effective in waking up the nervous system, warming the muscles up, and allowing the body to smoothly transition into a highly active state.&nbsp;<h4><strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Methods to Consider:</strong></h4><strong>&nbsp;</strong><ul> 	<li><h5><strong>Free Weights -&nbsp;</strong></h5></li></ul>Free weights, like dumbbells and resistance bands, are great methods of building stability and strength at the same time. Dumbbells require stabilization as the exercise is being executed. Despite the weight being moved from one location to another, it is often important that most of our body remains in the same position from the beginning to the end. Machines remove the element of stability as the exercise is being performed. That is what makes exercising with free weights more of a challenge. When adding extra resistance in the form of free weights or resistance bands, it becomes easier for the body to move when no resistance is present.&nbsp;<a href="/uploads/2021/09/Stability-101-Weights-STOCK-PHOTO.webp"><img class=" wp-image-4128" src="/uploads/2021/09/Stability-101-Weights-STOCK-PHOTO.webp" alt="" width="440" height="294" /></a><ul> 	<li><h5><strong>Body Weight -</strong></h5></li></ul><strong>&nbsp;</strong>our own bodies can be our best asset when it. Bodyweight exercises allow us to focus on controlling our own body’s movement more narrowly. When we are improving how we are moving our own bodies, we are inherently building a degree of stability. Just because there is no resistance present does not mean these types of exercises cannot be challenging or less effective than exercises with weights. Yoga and dynamic warmups are some common examples of exercise modalities that improve the endurance and stability of muscles and joints.&nbsp;<a href="/uploads/2021/09/Stability-101-Body-Weight-STOCK-PHOTO.webp"><img class=" wp-image-4130" src="/uploads/2021/09/Stability-101-Body-Weight-STOCK-PHOTO.webp" alt="" width="467" height="311" /></a><ul> 	<li><h5><strong>Use Unstable Objects -&nbsp;</strong></h5></li></ul>Other items that can often be found at home or in the gym can be utilized to create instability during a particular movement. By creating instability during these exercises, you are training your joints and muscles on how to progress through a certain range of motion in an unstable environment. This also forces your muscles and joints to adapt in a different way than it would through cardio exercise and weight lifting. Examples of these objects could be a medicine ball, swiss yoga ball, Bosu ball, or TRX bands.&nbsp;<a href="/uploads/2021/09/Stability-101-Unstable-objects-STOCK-PHOTO.webp"><img class=" wp-image-4131" src="/uploads/2021/09/Stability-101-Unstable-objects-STOCK-PHOTO.webp" alt="" width="492" height="328" /></a>&nbsp;<h3><strong>Benefits of Stability </strong></h3>Adequate stability in the joints is essential for both the function and longevity of that joint and the surrounding muscles. When a joint is properly stabilized, this typically means that all the muscles responsible for movement in that joint are working harmoniously together. When muscles are out of sync, they can become weak, inflamed, shortened, or even ‘turned off’. Incorporating joint-stabilizing movements into your weekly exercise regimen can help ensure you can continue to perform all the movements and activities you need to continue to enjoy life.&nbsp;

Stability 101

<h2><strong>The Dreaded Cycle of Pain; Finding your way out</strong></h2><strong>Envision this:</strong> You are in pain and want to be active so you can increase your quality of life, but the movement seems to cause more pain at times. It seems easier to sit down and do nothing compared to the effort it takes to get moving and stretch. Inherently, you know movement is good for pain management, but it feels like a double-edged sword. Moving causes pain but a lack of movement has also led to tight hips and lower back muscles over time. Pain can feel like a never-ending cycle that we get stuck in with no apparent way out. The next thing you know, we are managing pain with “band-aids” like injections and opioids that mask the pain but never really seem to cure it. This inevitably leads to a poor quality of life and trouble performing once simple activities of daily life like tying our shoelaces or going on a walk.Don’t worry, there is a way out, though it may not be a clear-cut path! It will take some mindfulness and effort on your end!It can be very easy to look at health from a one size fits all perspective. Health is a very personal matter and very related to how you are treating your body choices that are made in your daily life. It can also be affected by the environment around you.Let’s break it down by looking at the <a href="https://wellness.huhs.harvard.edu/your-wellbeing">wellness wheel</a>&nbsp;(click link to view image) and some examples of how pain can affect the different dimensions.&nbsp;<a href="https://wellness.huhs.harvard.edu/emotional">Emotional Health</a>:<ul> 	<li>Are you getting 7-9 hours of sleep per night?<ul> 	<li>Keeping a log of your pain and how it differs based on the amount of sleep you get may be eye-opening. Our muscles rest and recover better after a good night’s rest.</li></ul></li> 	<li>Are you seeking help from a licensed counselor when you are in distress?<ul> 	<li>Stress can lead to tense muscles, especially in your neck and upper back! If you are going through a hard time, talking to a licensed counselor through your employee EAP program can make a big difference!</li></ul></li></ul>&nbsp;<a href="https://wellness.huhs.harvard.edu/intellectual">Intellectual Health:</a><ul> 	<li>Improving your intellectual health includes reading and opening your mind/challenging your beliefs. It requires lifelong work!<ul> 	<li>Pain can lead to a foggy mind, which impedes our ability to think. It can cause us to feel unfocused and distracted in life.</li></ul></li></ul>&nbsp;<a href="https://wellness.huhs.harvard.edu/physical">Physical Health:</a><ul> 	<li>Physical health is an area most are familiar with. Exercise, sleep, nutrition, substance use/abuse.<ul> 	<li>Limiting medications and alcohol dependence may help your muscles recover faster. *Always take medications as prescribed by your physician.</li> 	<li>Self-medicate by incorporating more movement into your day! Movement causes endorphins (feel-good drugs) to be released in our brains!</li> 	<li>Move regularly and walk often - Our muscles act as pumps to help blood circulate back to our hearts efficiently. Are you starting to feel jittery? This is your body signaling you that it is time to move or change positions!</li></ul></li></ul><a href="https://wellness.huhs.harvard.edu/relational">Social/Relational Health:</a><ul> 	<li>Is pain affecting your social life and/or interpersonal relationships?<ul> 	<li>Do you have social support? - If you are working to manage your pain, having a strong social circle can help lead to adherence and satisfaction.</li> 	<li>Tell your friends or someone close to you about your plan to manage your pain.</li></ul></li></ul>&nbsp;<a href="https://wellness.huhs.harvard.edu/environmental">Environmental Health:</a><ul> 	<li>This is not limited to recycling and “going green.”</li> 	<li>Is there clutter in your life that is causing you not to have time to focus on yourself?<ul> 	<li>Make a to-do list and cross things off as you complete them. This can lead to a sense of accomplishment.</li></ul></li> 	<li>Have you thought about how your actions and persona affect the environment/others around you?</li></ul>&nbsp;<a href="https://wellness.huhs.harvard.edu/financial">Financial Health:</a><ul> 	<li>Financial health is one you’ve probably heard of, setting a budget, paying off debt, preparing for retirement, and mindful spending.</li> 	<li>How does your pain affect your bottom line?<ul> 	<li>Copay’s</li> 	<li>Prescription drug costs</li> 	<li>Over-the-counter drug costs</li> 	<li>Medical tests, MRI’s, X-rays</li> 	<li>Injections</li></ul></li></ul>&nbsp;<a href="https://wellness.huhs.harvard.edu/spiritual">Spiritual Health:</a><ul> 	<li>This category is not limited to but can include faith. Think about your morals and beliefs daily. Practice self-care such as meditation and yoga. Set a good example of how to lead your life.<ul> 	<li>Think about how pain can have a negative effect on your spiritual health.</li></ul></li></ul>&nbsp;<a href="https://wellness.huhs.harvard.edu/vocational">Vocational Health:</a><ul> 	<li>Do you find joy and meaning in your work?</li> 	<li>Do you take full advantage of the resources offered to you by your employer?</li> 	<li>Does pain affect your focus at work and lead to presenteeism?</li> 	<li>Have you missed work due to pain?</li></ul>&nbsp;All of this may seem overwhelming! This is not meant to be an activity that is complete all at once. It takes constant adapting and readjusting as life events happen to all of us. Chat with your SimpleTherapy coach for support and guidance while you are on your pain journey with SimpleTherapy!

Defeat the Pain Cycle

<h2 data-renderer-start-pos="1">What Happens to Your Body When You Sit All Day?</h2><p data-renderer-start-pos="53">Pain and extended periods of sitting are closely correlated. Being in a seated position puts a tremendous amount of pressure on your spine and invites poor posture. Due to this, people who sit frequently are more prone to experiencing back pain, neck pain, and shoulder pain amongst other areas. Lack of movement also contributes to stiff joints and tight, sore muscles.</p><h4 data-renderer-start-pos="493">Immobility</h4><p data-renderer-start-pos="493">Immobility, associated with extended desk work, can contribute to muscle atrophy. Atrophy occurs when we fail to use our muscles enough resulting in loss of muscle mass and strength. This greatly increases the risk of sudden injury or chronic pain as the body is less prepared to withstand sudden movements or awkward bending and twisting.</p><h4 data-renderer-start-pos="849">Consider Your Work Environment</h4><p data-renderer-start-pos="852">Ergonomics is another important aspect to be mindful of. The relationship between your desk and chair can have a major influence on your pain. It may be inviting a slouched or hunched over the position which could increase pressure on the spine and neck. Try to prevent from having rounded shoulders, extending your head and neck forward, slouching, or crossing your legs.</p><h4 data-renderer-start-pos="1273">Move!</h4><p data-renderer-start-pos="1276">The best way to combat this? Get moving! Taking small but frequent breaks, if possible, to stretch, walk around and get some blood flow can make a big difference. This can be as simple as going to get water or coffee, just to give your body a change of pace. If you are able to incorporate any form of stretching into your work breaks, that also helps a great deal in preventing atrophy, stiffness, and soreness. It is especially important for desk workers to be physically active during off-hours. Utilize this time to stretch and exercise to ensure no muscle and joint function is lost as a result of inactivity at work.</p><p data-renderer-start-pos="1276"><strong>SimpleTherapy</strong> can provide you with personalized structured stretches and exercises to combat the negative effects associated with sitting. Stretching and exercising is extremely important in order to maintain muscle and joint function, restore mobility and ease tension.</p><p data-renderer-start-pos="1916"></p>

Can a Work Break Save You From Pain?

<p><div id="bp-page-1" class="page" data-page-number="1" data-loaded="true"></p><p><div></div></p><p><div class="textLayer">According to Oxford Dictionaries, the definition of ambivalence is the state of having mixed feelings or contradictory ideas about something or someone else. Are you still on the fence about making a change or starting something new? You are not alone. This is human nature. We tend to want things to happen simultaneously that can’t co-exist. Look at these pain predicaments:</div></p><p><div></div></p><p><ul></p><p> 	<li>Being sedentary can cause muscles to be stiff but Carl’s muscles have been stiff for so long that it hurts to move them and now he is scared to give a new flexibility program a shot.</li></p><p></ul></p><p>&nbsp;</p><p><ul></p><p> 	<li>Bob has been working on cutting empty calories out of his diet because he carries some extra weight which has led to low back pain for the past 5 years. However, his coworkers always bring in sweets and leave them out in the break room, so he has the urge to indulge.</li></p><p></ul></p><p></div></p><p><div id="bp-page-1" class="page" data-page-number="1" data-loaded="true"></p><p></p><p>&nbsp;</p><p></p><p>These feelings can bring on anxiety, cause you to freeze, and leave you not wanting to change. It can feel like a never-ending cycle of wanting to change one day and waking up the next thinking,“I’ve made it this far, why to change now?”</p><p></p><p>Does this sound familiar? If so, you may not have the right “why” for making a change. Ask yourself “why” it is that you truly want to make the change you are ambivalent about. What does the result look like? Is it internally driven or motivated by external factors?</p><h4>Internally driven goal or “why”:</h4><p>I want to manage my pain so I can live my life pain-free and enjoy an active retirement so I do not have to be wheelchair-bound and take prescription medication daily to manage my pain.</p><h4>Externally driven goal or “why”:</h4><p>My spouse wants me to manage my pain because they tell me I complain about it too much so they signed me up for this program. One of these people is more likely to accomplish their goal and want to make a lasting change for themselves. Can you guess which one it is? Hopefully, you chose the internally driven goal! If not, that’s okay and we can help!</p><p></p><p>Changing behaviors takes time and is a revolving process without a linear path. There will be good and bad days and we will all be ambivalent at some point in time. Maybe you can’t think of a good “why” or you are starting to lose faith that you can accomplish what you initially set out to do. Maybe your goal isn’t going as expected or you aren’t seeing results in the timeframe you hoped to initially. This is all completely normal and why you have a SimpleTherapy care team to support you on your journey.</p><p></p><p></div></p><p><div id="bp-page-2" class="page" data-page-number="2" data-loaded="true"></p><p><div class="ba-Layer ba-Layer--regionCreation" data-resin-fileid="861240284144" data-resin-iscurrent="true" data-resin-feature="annotations" data-testid="ba-Layer--regionCreation"></p><p><div class="ba-RegionCreation-creator ba-RegionCreator" role="presentation" data-testid="ba-RegionCreator"></div></p><p></div></p><p><div class="textLayer">If you are feeling ambivalent but are ready to make a change, schedule a call with your health coach today so you can talk through your “why.” We are here to listen!</div></p><p></div></p>

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