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So far Jennifer Valerio has created 18 blog entries.

Spinal Cord Awareness Month: Insider Insight with Dr. John

2020-09-25T18:48:07+00:00

September is Spinal Cord Injury Awareness Month and at I.P. we have a unique perspective on this topic. In 2004 Dr. John suffered a spinal cord injury while playing football that resulted in severe loss of function in his entire right arm. While many people may know bits and pieces of what happened, we thought sharing his story would help shine some light on what motivated John to start Integrative Physiotherapy and help others MOVE! 

Tell us how your injury happened. 

I was playing cornerback, in a semi-pro league, on the left side when I went to strip the ball. My arm was fully extended and the safety crowned me in the elbow as the back kept running with my hand. I sustained a grade 3 brachial plexus strain with medial ulnar avulsion and a complete rupture of my tricep, UCL ligaments and 6 forearm muscles. I was writhing in pain and shaking immediately afterwards. I don’t have a sweet tooth but I have never had such a craving for sugar in my life. At the hospital they tried to yank my arm straight to get an X-ray, I kicked the tech as a response because of the pain. They sent me home with pain meds and told me that I was going to wish I broke my arm because the soft tissue damage was going to be way worse. Correct statement knowing the recovery from breaking my wrist 3 times… but that’s a different story.  I experienced chills, hot flashes, bowel and bladder symptoms, insomnia, nausea and vomiting for days and months, even the first few years after the event. 

Did you undergo surgery?

No and I should have. My tendon and ligaments needed to be fully reattached for me to have full function of my arm. I had the opportunity to have surgery at the time. I still was on my mom’s insurance for a few more months and the surgeon had told me he had only ever seen one case worse than mine and that I absolutely had to have surgery. But because I had met some mentors who had shown me how often surgery could be avoided, I challenged myself to see how much I could get done without surgery. In retrospect, it was appropriate that surgery should have been performed, but I also wouldn’t know what I know now about rehabilitation if I would have gone through the surgery. As far as function goes, the surgery was definitely necessary. That is an aspect I contemplate any time patients ask me about surgeries while there are so many variables that go into deciding to have surgery or not. I always say once the knife goes in, it can’t come out; but it may be the right course of action depending on the person and situation. That’s why it’s important to know the current science behind the efficacy of surgeries – for long term benefit and considering the dynamics surrounding each individual. A patient’s co-morbidities and lifestyle are huge indicators of whether it would be possible for someone to avoid surgery. Respecting every profession and their part of the comprehensive care process is paramount. 

What was the hardest part of your recovery process?

The mental aspect of how long it took to recover and the emotional changes that go into an altered self-identity post-injury… let alone the patience. The hardest part as an athlete with an injury that is that severe, is that you lose your ‘runner’s’ high’. You’re used to running and jumping and moving and competing. I’d been in an almost obsessive physical routine for the better part of a decade, and overnight I only had use of 3 limbs. I was injured; I wasn’t releasing my happy hormones from exercise. That emotional state really makes you question your motivations, who you are as a person, and how you decide what your new identity is going to be after experiencing something that traumatic. 

How long did it take you to regain function of your right arm for daily activities, and then also for sport/fitness?

Took about a year for functional activities and about 2.5 years for sport. At first my arm and fingers were curled in a rigid position. I could only use the very tips of my fingers for the better part of 6 months. Couldn’t eat with that arm, couldn’t brush my teeth, couldn’t do basic self-care ADLs… The first time I tried to wipe my own a** and using my left arm was very humbling to realize my body had never turned the other way. 

It was a painstakingly slow process of breaking down the whole system; the mechanical, chemical and electrical engineering. You have to take all the segments through the whole system – like trying to rewire a computer. Since the arm gets its strength from the legs, you have to take the arm all the way down the ankle. You keep going through this process..over and over again. Sometimes there are huge gains, and other times it’s the smallest little things that are battle victories. I keep working on each aspect of the journey…constantly looking for new and innovative ways to restore function. That rolls into being able to treat simple to complex cases with a lot of variability to pull from and push past plateaus. 

How do you apply your personal experience towards patient care?

My injury has fostered my ability to keep being innovative and creative while empathetic and sympathetic in clinic; approaching the patient as a whole person, addressing each point of that pyramid (chemical/emotional/physical). Addressing the emotional distress that comes with injuries/ailments is so important to consider in the recovery process. There’s a lot of evidence that shows if you believe you aren’t going to get better, you’re not going to get better. Addressing people as a whole by checking each point of their pyramid has enabled me to better see what they are needing at that time. Re-integrating a person back into their life, if you will. You see stories of amputees or veterans that have gone through so much and are still able to play basketball or handstand with or without the use of prosthetics or assistance. A neurologic injury makes you focus on body entities rather than muscles, requiring a restoration of a certain harmony between the systems to become your best current self. 

What symptoms do you still have to this day?

I’m still unable to fully straighten my right arm in a couple angles. I have difficulty with certain manual therapy techniques in clinic when I need to fully straighten my arm. I get occasional numbness and tingling and still have muscle atrophy from the lower motor neuron damage. There’s always something to work on, something that reminds you of what you once were, where you are, and where you are going. 

Spinal Cord Awareness Month: Insider Insight with Dr. John2020-09-25T18:48:07+00:00

Get Assessed This August

2020-08-19T23:06:04+00:00

As you might have seen in recent social media posts, we’re offering a FREE SFMA to anyone who refers a patient to IP this month!

What is the SFMA? Read below to find out! 

The SFMA is a set of seven full-body movement tests evaluated and scored in patients. This assessment examines what movement pattern is dysfunctional and non-painful first, and then is broken down in detail to determine the root of this dysfunction. The two main root problems typically stem from a lack of MOBILITY or STABILITY (motor control deficit). This dysfunction can then be treated by the clinician using targeted therapeutic exercise, manual therapy, and neuromuscular reeducation. 

Do you have pain performing normal day to day activities or carrying on your active lifestyle? For most of us, pain free functional movement with any activity is the goal. Many components comprise pain-free functional movement including adequate posture, ROM, muscle performance, motor control, and balance reactions. Impairments of each component could potentially alter functional movement resulting in or as a consequence of pain. Utilizing the SFMA, the clinician is able to identify key functional movement patterns and describe the critical points of assessment needed to efficiently restore functional movement.

During your SFMA, we will examine and assess:

  1. Cervical Flexion (looking down)
  2. Cervical Extension (looking up)
  3. Cervical Rotation (looking side to side)
  4. Upper Extremity Pattern 1 (reach behind back)
  5. Upper Extremity Pattern 2 (reach overhead)
  6. Multi-Segmental Flexion (touch toes)
  7. Multi-Segmental Extension (lean back)
  8. Multi-Segmental Rotation (twist and look behind back)
  9. Single-Leg Stance
  10. Arms Down Deep Squat

Let us know if you’ve referred a friend for the IP experience in the past month so we can schedule your SFMA today!

Get Assessed This August2020-08-19T23:06:04+00:00

Striding Through Summer

2020-07-15T22:14:01+00:00

With the wild ride that 2020 has been, we have noticed a movement trend in the clinic. What is it? Running! With everyone striving for social distancing, gym closures, wanting more time outdoors, and also wanting to stay active, we have seen a huge surge in the amount of runners entering our clinic!

With this uptick of running, we have had more patient requests for running gait analyses to correct form and prevent injuries. Your provider will have you run at your normal pace on a treadmill and record in slow-mo so that you can both take a look at your form and observe any dysfunction in your gait that may be contributing to symptoms.

Some of these dysfunctional gait patterns include:

  • Scissoring Gait: Criss-crossing your legs while running, minimal width between where your left and right foot land on the ground
  • Heel or Toe Contact: Unless sprinting, most runners should be landing on their midfoot to decrease excess load through ankles, knees, and hips
  • Shortened Stride: Expending energy to propel upwards instead of primarily forward, often due to glute weakness
  • Midfoot Position: Excess pronation or supination upon landing
  • Forward Trunk Lean: Often due to lumbar spine weakness contributing to lack of upright position

***Want to watch individual videos of these common dysfunctions? Check out our latest instagram post @IntegrativePT that displays these slow-mo running gait analyses!***

We unfortunately have also seen more running-related injuries enter the clinic. Oftentimes (there is no black and white in PT!), overuse lower extremity injuries may occur as a result of glute weakness and lack of ankle mobility. A systematic review in American Family Physician shows the most common running injuries as:

  • Knee
      • Patellar Tendinopathy: 12%
      • Iliotibial Band Syndrome: 10%
      • Patellofemoral Syndrome: 6%
  • Ankle and Foot
      • Ankle Sprain: 10%
      • Achilles Tendinopathy: 6-9%
      • Plantar Fasciitis: 5-18%
  • Hamstring 
      • Hamstring Tendinopathy: 12%
      • Hamstring Muscle Tear: 7%
  • Bone 
      • Medial Tibial Stress Syndrome: 10%
      • Tibial Stress Fracture: 4%

Have no fear, most of these are overuse injuries that can be managed with our conservative treatment and our unique IP approach utilizing kinetic chain movement patterns and tailored manual therapy treatments! Whether you are experiencing a running-related injury or would like to work on improving performance, give us a call and we can have you putting your best foot forward in no time!
 

Striding Through Summer2020-07-15T22:14:01+00:00

Slidin’ Into the Solistice

2020-06-17T20:51:43+00:00

 

“I don’t go to the gym, how do I stay active at home?”

“I’m traveling this month, what exercises will work on the road?”

“I don’t have space for a lot of equipment at home, what should I use?”

Each week, we get dozens of patients asking questions like these. Whether you are staying home to social distance, traveling for work, exercising on a budget, or prefer the minimalist home gym, we have two words for you: FURNITURE SLIDERS! Over the past few years, Dr. John has created a 25 exercise-sequence that addresses the entire body and can be personalized and modified to address your injuries, goals, and fitness levels. You I.P. team uses these slider exercises to treat diagnoses such as:

  • Disc herniations (neck and low back)
  • Sciatica
  • Shoulder impingement
  • Labral tears (hip and shoulder)
  • Muscle strains
  • Tendinopathies
  • Spinal Instabilities
  • Patellofemoral Pain Syndrome/Patellar Tracking Dysfunction
  • Post-Op for shoulder, wrist, knee, hip, ankle, and spine   

Our slider sequence helps to strengthen, restore posture, improve balance, and enhance motor control. These exercises will get you on the pathway to our “Three P’s” by helping reduce your Pain, Improve your Performance, and Prevent future injuries! 

Slidin’ Into the Solistice2020-06-17T20:51:43+00:00

Integrative Physiotherapy’s Adjustments Amidst COVID19

2020-03-18T16:25:11+00:00

I.P.’s Adjustments Amidst COVID19

We know everyone is inundated and overwhelmed with information right now, so we want to keep our updates succinct, and help contribute to keeping calm amongst the chaos.

Here’s the short of what you need to know about your sessions at Integrative Physiotherapy as we navigate this time of uncertainty: 

  • Unless otherwise enforced/announced, we are remaining cautiously open for in-person sessions at both Fort Collins and Wellington locations. See details below.
  • We have ramped up our sanitation procedures & frequency in the clinic. We also ask that if you come in for a session to please wash your hands upon entering the facility and remain 6-feet distance from other patients. More details below.
  • If you have a session and are feeling sick at all or are in contact with someone who has been sick, please stay home. We are rolling out options for tele-sessions and consults effective 3/18/2020. See details below.
  • Be proactive, wash your hands, continue to move your mind and mind your movement. Let us know how we can help!
PROCEDURE CHAGES FOR IN-PERSON APPOINTMENTS
  • There will not be more than 10 people in the clinic at once, until recommendations indicate otherwise. You are encouraged to text us to let us know you have arrived for a session and wait in your car until your therapist is ready to begin your session.
  • Stay 6 feet from others when in clinic
  • Wash hands before and after sessions
  • Wipe down any equipment used during sessions
  • WELLINGTON: You will need to be let in, even if you are a gym member. As gyms are closed to the public, your key fob will not work for entry for the next 30 days. Please text when you have arrived.
  • If you feel sick, know someone who is sick, stay home!
TELE-SESSION OPTIONS
  • We will be offering the option of live video sessions and phone consults to prevent regression while practicing social distancing. You know we’re creative so we can keep you on track in quarantine!
  • Call or email to designate an existing appointment as a video session, or to schedule a virtual session.
  • Currently, Medicare is the only insurance that is across the board not allowing physical therapy tele-sessions. You can write your congressmen here in a pre-formatted letter (you only have to enter in your name and contact info!) to request they lift the restriction.
  • For other insurance or pricing options, call or email.
  • We are able to offer virtual sessions via 
    • GoToMeeting
    • Google Duo
    • Google Meet
    • Facetime
  • We have been assured if our providers get to a place where they are conducting these sessions from a home environment, that our virtual documentation software is HIPAA compliant.
Integrative Physiotherapy’s Adjustments Amidst COVID192020-03-18T16:25:11+00:00

20 Tips for a Healthy 2020 at 2020

2020-01-01T18:10:32+00:00

As we’re setting ourselves up for a new decade at 2020, we wanted to share 20 tips to keep your ‘health vision’ 20/20!!

  1. Set realistic SMART goals 
  2. Get MOVING!
    • Most studies recommend a healthy adult gets in 150 minutes of moderate or 75 minutes of vigorous aerobic exercise per week! Spread this time out over the week and this is very easily attained!
  3. Kickstart your January with Whole30! 
    • While we don’t promote crash or fad diets, the Whole30 program can be used to discover food sensitivities you may have and get back to eating WHOLE foods!
    • This program has you eliminate processed sugars, dairy, grain, legumes, alcohol, etc. for 30 days. You then slowly introduce these foods back in to see how they affect your energy levels, digestion, and inflammation!
    • Learn more here https://whole30.com/whole30-program-rules/
  4. Consume Local Honey!
    • Honey has anti-inflammatory properties that can help your body recover.
    • Two teaspoons before bed will even out your blood sugar and help you sleep better!
  5. Get STRONG!
    • Though aerobic cardio exercise is very important, strength training is equally if not more important for your overall health! Most studies say as a general guideline all “major muscle groups” should be trained 2x week (good thing IP exercises incorporate your entire body!)
  6. Get a yearly skin check
    • With how much time we spend in the great outdoors of Colorado, it is important to get a full body skin cancer check at the dermatologist! 
  7. Stay Hydrated! 
    • The Mayo Clinic suggest men should drink between 3-4 liters/day and women 2-3. If you are very physically active, this number should increase!
  8. Read books to stimulate your mind! Some of our staff favorites are:
    • John
      • The Body Electric by Robert O. Becker
    • Jen: 
      • Bad Science by Ben Goldacre 
      • The Fourth Turning by Neil Howe and William Strauss
    • Dina: 
      • Love Letter to the Earth by Thich Nhat Hanh
    • Alex: 
      • Shantaram by Gregory David Roberts
  9. Get outside every day!
    • For your body to produce/maintain healthy levels of Vitamin D, shoot for 15-30 minutes outside during the daytime. 
  10. Limit screen time at least one hour before bed
    • The blue light emitted from electronics can delay the release of melatonin and disturb your circadian rhythm responsible for the sleep/wake cycle.
  11. Set up an in person social interaction at least 1x/week
    • Having a thriving social network can reduce depression and anxiety!
  12. Start a gratitude journal
    • As part of a quick morning or bedtime routine, jot down a few things you’re thankful for to put things into perspective!
  13. Limit caffeine intake 
    • Though this will vary person to person, most adults can tolerate up to 400mg of caffeine in a day (roughly 4 cups of coffee). In 2020, see if you can keep this under 200mg!
  14. Take a daily 30 min walk!
    • Get your heartrate up, improve your mental health, stimulate your digestive system, need we go on?
  15. Listen to a podcast!
    • Learn something new while you commute to work, clean your house, or get ready for the day!
  16. Get a yearly physical
    • Whether you have a pre-existing condition or typically are in great health, it is important to partake in preventative measures! 
  17. Go on a social media cleanse!
    • Limit your social media usage to help you boost your productivity. If you decide to “mindlessly scroll,” set a timer for 5 minutes and then close the app before 5 minutes becomes an hour!
    • Most apps will have a way to monitor how much time you spend per day scrolling. Take a look and decide if you need a break!
  18. SLEEP! 
    • Most adults should be getting 7-9 hours of sleep per night (children should be 10-12), but rarely get that much! Start prioritizing good sleep habits and your body will thank you!
  19. Try a new physical activity
    • Your body craves movement, especially new ones! Grab a friend and go to a yoga class, climbing gym, skiing, hiking, kickboxing, etc. The possibilities are endless!
  20. Schedule an appointment at IP!
    • Lingering injury? Chronic Pain? Difficulty achieving maximal performance? Schedule an evaluation and we will make sure 2020 is your best year yet!
20 Tips for a Healthy 2020 at 20202020-01-01T18:10:32+00:00

October 19: FALL Into Wellness

2019-10-02T15:43:28+00:00

October is National Physical Therapy Month and with that we want to dive into what makes this profession so special and why you should always #ChoosePT first! Read below to learn where the field of PT got its roots and some common FAQs that we get about physical therapy!

History of Physical Therapy

Modern Physical Therapy began to be recognized as a legitimate medical profession in the early 1900s, beginning with the polio outbreak in 1916. “Reconstruction aides” (later to be known as PTs) began to rehabilitate disabled children affected by this epidemic with therapeutic exercises. Following the start of World War II in 1918, reconstruction aides worked to restore function to wounded soldiers at the same time the first PT school was established at Walter Reed Army Hospital in Washington, D.C. In 1921, the mother of physical therapy, Mary McMillin established what is now known as the APTA in order to advocate for the field and encourage treatment protocol research. As awareness of PT began to spread, the field grew into what it is today with treatment taking place not only in hospital settings, but outpatient facilities, public schools, skilled nursing facilities, and rehabilitation centers towards the end of the 1950s.

Physical Therapy FAQs

How long do you have to go to school to become a PT?

 In the United States (requirements differ in each country), students are required to obtain a Doctor of Physical Therapy degree (DPT) following a 4-year bachelor degree. The APTA has changed this from the previously required Master of Physical Therapy degree in the past two decades. If you currently hold a Master’s, you may continue to practice, but are encouraged to continue your education to help broaden your knowledge of differential diagnosis, evidence based research, and systems analysis.

What types of patients do physical therapists treat?

When thinking of PT, most people expect post-op care, injured athletes, or the person making you get out of bed in the hospital with the gait-belt. In reality, physical therapists treat an enormous variety of patients! Did you know PTs could treat in all of these areas?

  • Orthopedic
  • Sports
  • Acute Care
  • Neuro Rehab
  • Cardiovascular and Pulmonary
  • Pediatrics
  • Geriatrics
  • Integumentary and Wound Care
  • Women’s Health
  • Hand Therapy
  • Pelvic Floor
  • Palliative Care
  • Oncology

Do I need a prescription from my MD to get physical therapy?

No! As of 2016, Colorado is a direct access state for physical therapy. This means you may schedule an appointment without needing a referral (unless you have Medicare). At the initial evaluation, your DPT will perform a thorough differential diagnosis and multi-systems analysis and refer you out for further medical testing, consultation, and/or imaging if it is suspected that your symptoms are not amenable to pt services.

What is the difference between physical therapists and chiropractors?

While both practitioners may co-treat the same patient, the focus of that treatment often varies. Chiropractic care often focuses on disorders of the spine and joints and achieving alignment throughout the body to alleviate pain and symptoms. Physical therapists are often thought of as the “movement specialists.” PTs evaluate, diagnose, and treat a wide range of musculoskeletal, neurological, cardiopulmonary, developmental, and integumentary conditions using manual (hands-on) treatment, therapeutic exercises, neuromuscular re-education, and various modalities. Most people don’t expect this, but PTs can perform grade V (high velocity low amplitude) joint manipulations that you would receive at a chiropractor’s office!

October 19: FALL Into Wellness2019-10-02T15:43:28+00:00

August 2019: “Posture” Your Self For A Successful School Year

2019-08-14T00:27:45+00:00

The topic of posture is something almost every patient inquires about during their PT stint. “What is good posture?” “Do I have bad posture?” “How do I build strength in my postural muscles?” While there isn’t exactly a “perfect posture” that will work for everyone, we have plenty of anecdotal and evidence-based research to safely say certain postures can contribute to pain in sitting, standing, etc. Since August is all about Back to School, we know this means back to sitting for 8 hour days for students. For many adults, sitting at work for long periods of time is inevitable. This is why addressing posture and building postural stability and strength is so important! 

Before we dive in to what good posture IS, lets first discuss what good posture ISN’T:

  • Pulling your shoulder blades back and down
    • This creates tension/strain on your brachial plexus (the nerve network that runs from your neck to your arms)
  • Standing with your butt tucked under you with posterior pelvic tilt
    • Thinking of your spine being straight will contribute to unnatural loading patterns for your vertebral column and your discs
  • Keeping your neck held “straight” with a chin tuck
    • This will lead to military neck and loss of cervical lordosis and your natural curvature

Message from all of this? KEEP YOUR CURVES! Your spine is S-shaped and maintaining this is what good posture is all about! If you have worked with us at IP, you may have heard some expressions like: keep your ears over your a$$, pull your butt up to your blades, or  _________ . We aren’t saying these expressions for a laugh, but to cue to you to keep your natural lordosis and kyphosis (spinal curves). In the picture below, you see the anatomical plumb line. If maintaining good posture, this line should cross your earlobe, outside of the shoulder, outside of your hip, outer knee, and outer ankle in standing!

Think of maintaining these curves the next time you have to stand or sit for a prolonged amount of time to begin building postural endurance and strength! If you struggle with sitting or standing for prolonged amounts of time without aches and pain, consider scheduling your PT evaluation at IP!

August 2019: “Posture” Your Self For A Successful School Year2019-08-14T00:27:45+00:00

July 2019: Maintaining INDEPENDENCE with Home Exercises While You Travel

2019-07-04T15:26:36+00:00

Happy 4th of July! Summer has finally arrived in Colorado! This means more time spent outdoors doing your favorite activities, covering up with some SPF (see the last blog…), and of course, traveling! One of the biggest questions we get from our patients during this time of year is, “What exercises can I do while I’m gone so I don’t lose progress in my rehab?” Vacation and traveling don’t have to get in the way of a steady recovery as long as you stay consistent!

There are dozens of body-weight exercises that we prescribe our patients at IP, with our favorite being the Fire Hydrants. This sequence of four exercises works on stability AND mobility for the spine, hips, shoulders, knees, and wrists, need we say more?! Check them out below and try to hold each position for up to a minute! For added resistance and a more challenging workout, throw a pair of furniture sliders and therabands in your bag and you’ll be able to enjoy your vacation with a healthy body! 

Another concern with summer traveling is the increased stiffness and pain that comes from long flights or car rides. Below we are going to show some simple, yet easy ways to stay mobile while getting to your destination!

Seated Thoracic Extension/Flexion

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Lumbar Flexion/Extension

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Seated Figure 4 Stretch (Stay active by pulling knee open and keeping foot flexed)

Seated Thoracic Rotation (push your thigh out into hand for resistance)

Hip Adduction with Hand Resistance

July 2019: Maintaining INDEPENDENCE with Home Exercises While You Travel2019-07-04T15:26:36+00:00

June 2019: Celebrating Summer Solstice & #FatherhoodFitness

2019-06-14T15:20:50+00:00

Did you know that PTs are educated on skin care and the integumentary system as part of their coursework and that many PTs specialize in skin and wound care? As the weather starts to warm up (waiting for normal weather in Fort Collins…) and everyone starts to spend more time outdoors, taking care of your largest organ, your skin, is so important! You should have a head to toe skin check yearly to screen for skin cancer by your provider, as well as perform self-checks on larger moles, freckles, etc. regularly. Early detection is key to prevent spreading of lesions and treatment with excision. You can see Dr. John getting his #FatherhoodFitness on with Malaki, enjoying sunny Colorado and practicing safe skin care! Tag us on social so we can see those dad bods moving!

 

Here is what you should look for when performing a self-check:

The ABCDE’s of Skin Cancer

Asymmetry: If you draw a line through the lesion, the halves will be uneven
Border: Edges of the lesion will be uneven, crusty, or notched
Color: Uneven coloring, especially appearance of white and/or blue
Diameter: Lesions larger than a pencil eraser in diameter
Evolving: The lesion will begin to change in size, shape, or color or begins to bleed and scab

Summer Skin Care Tips

  • Apply broad-spectrum, water-resistant sunscreen of 30 SPF minimum to all exposed areas of skin when spending time outdoors (and reapply every 2 hours!)
  • Wear lightweight protective clothing to prevent prolonged sun exposure, especially between 10am and 2pm
  • Avoid tanning beds and sunbathing
  • EXERCISE! While it won’t protect you from skin cancer, working up a regular sweat is the best way to keep your skin healthy. Exercise increases circulation, delivers nutrient-rich blood to the skin, helps to flush out damaging free-radicals, and boosts skin cell turnover!
June 2019: Celebrating Summer Solstice & #FatherhoodFitness2019-06-14T15:20:50+00:00