Whether it’s a sore knee after a long day of walking, a back injury from lifting something heavy or recovery from a knee or hip replacement, injuries can throw off our normal routines.

The good news? Getting moving again may be an important part of the recovery process.

“Most people would be surprised,” says Crystal Whitmarsh, a physical therapist with OSF HealthCare. “We used to tell them to rest, ice, compress and elevate. But now we're finding that it's important to get moving sooner.”

That doesn’t mean jumping right back into your normal workout. Instead, Whitmarsh recommends a gradual return to activity. “Obviously, you don't want to jump into it too quickly, so you want to slowly transition back,” she says. “But early motion is really proving to be helpful in recovering faster.”

Start slow

When returning to exercise after an injury or surgery, start with low-impact activities such as walking, biking or swimming.

Whitmarsh recommends beginning with early motion, or mobilization, and then gradually increasing activity. “You don't want to go in and progress intensity, resistance and repetitions all at once,” she says. “Pick one thing and see how you respond. And then if that goes well the next day, then you might progress a little further.”

For example, you might start at about 50% of your usual workout. If that goes well, increase the next workout to 60% and continue working your way up.

How you move is just as important as how much you move. Proper form can help ensure you’re using the right muscles and protecting your joints. But poor form can increase the risk of another injury.

“We want accurate muscle use and accurate timing of muscle use, and that helps to watch your form,” Whitmarsh says. “We're not asking for perfection. That's impossible, but just making sure that you're protecting your joints as you move through the motion.”

The difference between discomfort and pain

Some discomfort can be expected when you’re getting back to exercise. But Whitmarsh says it’s important to pay attention to what your body is telling you.

“On that pain scale of zero to 10, I tell people if you're in the two to three range, I'm okay with that,” she says. “If you start getting up to six, seven or eight, now that's our red stoplight.”

Many people can gradually return to activity on their own. But there are times when working with a physical therapist can help, particularly after a serious injury or surgery.

Whitmarsh says physical therapy can be beneficial if you’re trying to return to a higher level of activity but aren’t sure how to get there. It can also help if you’ve tried to rehab on your own but need additional guidance. A physical therapist can help develop a plan that is suited for your injury, goals and activity level.

Recovery means more than recovery

Exercise is only one part of the recovery process. Getting enough sleep, eating a nutritious diet and staying hydrated are also important.

Protein can help support tissue healing. Ice may help with pain and swelling, while heat may be helpful in certain situations.

And if you overdo it during a workout, that doesn’t necessarily mean you need to stop exercising altogether. “Just listen to your body,” Whitmarsh says. “If you overdid it one day, now you're a little more swollen, maybe a little more pain. Back off, do an active rest day, and then move back into it the next day once things improve.”

Whether the injury is big or small, setbacks can happen. The key, Whitmarsh says, is to recognize them, adjust and keep moving forward.

For more information on rehabilitation services, visit OSF HealthCare.

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Chronic illness often doesn’t announce itself with a dramatic symptom or a trip to the emergency room. Instead, it can develop gradually, quietly affecting the way a person moves through everyday life.

Syed Zaidi, MD, a family medicine provider with OSF HealthCare, sees chronic illness every day in his practice. He says changes in everyday functions can sometimes be early signs that something is happening with your health.

When something is no longer easy to do, such as the way you move, eat, sleep, even the way you urinate or move your bowels, those can be signs that something is changing, Dr. Zaidi says.

In medicine, the term “silent decline” refers to the gradual progression of a long-term health problem. The body can quietly worsen over months or years before noticeable warning signs appear. Examples can include high blood pressure, diabetes and even heart failure.

You don't feel unwell until you feel unwell, and so the silent part occurs where the functional components aren't loud enough yet, Dr. Zaidi says.

Chronic illness usually doesn’t happen overnight. For example, it can take years for plaque to build up in your arteries. It can also take years for an enlarged prostate to begin significantly affecting a man’s quality of life.

“Subtle cues in terms of, let's say, cognitive decline or memory starts with, you know, a lapse here or a lapse there, but it doesn't impact your quality of life,” Dr. Zaidi says. “It goes under the radar. So, under that radar is what I would call silent.”

Prevention starts with awareness

Dr. Zaidi says it’s important to understand your health history and risk factors so you can prepare for potential chronic health problems.

Ask yourself some key questions: Am I a smoker? Do I drink alcohol? Am I sleeping or moving as well as I should?

Once you start looking honestly at those questions, you can identify areas where you can make changes.

“You don't want to reverse 30 years in 30 days, right?” Dr. Zaidi says. “So, you want to be able to be proactive as well. And I think when we talk about chronic disease, we also have to spend a lot of time talking about prevention as well.”

Chronic illness can worsen over time. That progression might happen in three months or over 10 years. It depends on the individual and the illness itself.

According to Dr. Zaidi, one important factor is functionality — how well you’re able to move through your daily life.

He gives the example of arthritis in the knees. Years of working as a laborer or participating in sports can take a toll on the knees.

“They may hurt, but the next thing you know, three months later, you're not cycling as much,” he says. “Three months later, you're probably not as active or efficient at work on those cement floors as much. Next thing you know, down the road, five years later, you're sitting on a couch.”

Small changes can make a difference

Talk to any health care provider, and they’ll likely give you plenty of ways to take better care of yourself. One of the most important places to start is with sleep. Dr. Zaidi recommends aiming for about eight hours of good-quality sleep when possible.

Other important steps include staying well hydrated, limiting ultra-processed foods and cutting back on sugary drinks.

Movement is another key component. That doesn’t necessarily mean starting an intense exercise program. Begin with something manageable, such as a brisk 15-minute walk or simple chair exercises and go from there.

But it all starts with finding a health care provider you feel comfortable with who can help guide your health journey.

“You need a primary care provider, someone who's going to help you, coach you,” says Dr. Zaidi. “And not just come to you for reactive care or provide reactive care but is going to help partner with you in that proactive approach to ensure that you're screened properly for things that are appropriate for age and risk factors.”

We all know someone who has neglected their health for years. For those people, Dr. Zaidi has a simple message: It’s never too late to make positive changes.

“There's a cost to everything,” he says. “The greatest cost we have is time, and time often becomes the reason why we didn't do the things we were supposed to do. Then you realize you don't have the time to do what you should now be doing to reverse what you should have been doing.”

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After months of winter, the urge to get outside is hard to ignore, and for many people, that starts with a simple walk.

That includes Paige Linstead, a physician assistant with OSF HealthCare. “A lot of patients have sedentary jobs, as do I,” Linstead says. “So, I try to walk on my lunch, walk my dogs when I get home. I really focus on the calorie aspect of it too, and try to increase the walking speed, the distance that you can cover.”

For years, the targeted goal was 10,000 steps, which originated in the 1960s from a marketing campaign to promote the Tokyo Olympics. While the American Heart Association still recommends 10,000 steps a day, the organization says that just a mile of walking can also provide health benefits.

But now, the prevailing thought is that 7,000 steps a day will still do the trick. Walking improves your cardiac health, lowers your risk for diabetes, improves your circulation, can help improve sleep, decreases appetite and helps with weight management. It’s also enough steps to reduce the risk of dementia, cancer and depression.

“So, 10,000 was the gold standard. It's an easy number for people to say they're going to reach,” says Linstead. “But 7,000 is sufficient for most adults. It's a good goal to help minimize health risks and improve your health.”

It’s especially good for older adults.

Walking is good for heart health

According to a study published in the journal Circulation, older adults who walk three to four miles a day - 6,000 to 9,000 steps - are 40% to 50% less likely to suffer a heart attack or stroke than those who walk a mile (2,000 steps) a day.

This study focused on cardiovascular disease (CVD) risk and the findings were the result of eight studies using data from 20,000 people in the United States and 42 other countries. Their average age was 63 with 52% being women.

“It can improve your cardiovascular health, decrease your risk for diabetes or diabetes progression, help with stability, mobility,” Linstead adds. “It can help with mental health, getting a little bit vitamin D with the sun. Just set small goals for yourself and keep increasing as you can until you can get to that goal of 7,000 steps in a day.”

But if that still seems like a lot, don’t worry. Linstead says the important thing is to get started and work your way up gradually. Start by walking around your block or maybe visiting the local shopping mall.

“Absolutely, any movement is good movement,” she says. “Instead of having a sedentary lifestyle, if you can only get a couple thousand steps in a day, that can help elderly with mobility, stability, mental health, too.”

The Centers for Disease Control encourages people to get in 150 minutes of moderate to vigorous exercise each week. But Linstead says don’t try to squeeze in all 30 minutes at once, at least to start. She recommends breaking up the time into different parts of your day – for example, 10 minutes in the morning, 10 at lunch and another 10 minutes at night might just be the best route to take.

“I think that would be good motivation for people if they had a partner or a group to walk with,” Linstead says. “And you can walk at whatever speed you're comfortable with, the distance that you're comfortable with, but knowing that you have a support system in place.”

Before starting any type of walking program, however, make sure to consult with your medical provider first.


 

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We’ve all been there. That uncomfortable feeling in your gut. The annoying stomach pain. The bloating and the difficulty of having a complete bowel movement. No matter what you do or what you try, you just can’t go.

You might be constipated.

Many times, it’s a temporary setback. Maybe it was that late night pizza or one too many hot dogs that has you backed up. But for others, it can be a chronic problem due to diet, medication, lack of exercise or dehydration. Sometimes, constipation can be a sign of something more serious.

Constipation usually means three or fewer bowel movements a week, says Breanne Gendron, a nurse practitioner with OSF HealthCare.

“Constipation is usually defined by discomfort in their abdomen because they haven't been going to the bathroom and having bowel movements as often as they should,” she says. “Some people have bowel movements every day. Some people have bowel movements every third day, and that's their normal.” 

There are plenty of reasons why people get plugged up from time to time. Certain medications can play a role in constipation. Pain medications, calcium supplements and some antidepressants have an influence.

Opioids bind to receptors in the intestines, which slows down the movement of food and waste (stool) through the colon. Additionally, opioids also increase water absorption in the intestines, making the stool harder and more difficult to pass.

There are other factors that can impact bowel movements such as travel, stress, a lack of activity or anything that interferes with your normal routine.

“The most common cause of constipation is dehydration, lack of activity and not enough fiber in your diet,” says Gendron, who adds that fiber provides bulk to stools, making them easier to pass. “It’s easy to add fiber powder to your coffee in the morning. But when you have fiber without hydration that can cause issues; so, it's about making sure that you're getting 40 to 60 ounces of water every day.” 

There are also non-diet and exercise-related causes of constipation. Structural changes such as a tumor or hemorrhoids can cause constipation and so can stress and anxiety.

Constipation can frustrate anyone, from young children to older people. Children between the ages of 5 to 12 will complain to their parents of stomach pain due to a lack of regularity. As for older adults, the digestive track tends to slow down as we age.

“I can say 30 to 40% of people over the age of 65 have constipation issues,” Gendron says. “So, it is a common thing that older people deal with. As we age, we have to have a plan. That means getting more active, drinking more water, eating fiber or adding a fiber supplement to their life.” 

Making changes 

Becoming regular again usually boils down to dietary and lifestyle changes. Gendron says the fiber goal should be 25 to 30 grams each day. Some of the best foods that help with fiber intake include beans, leafy vegetables, oatmeal, nuts, berries and apples.

Take time for at least 30 minutes of exercise a day. Walking is great way to kickstart your bowels. And establish a routine. Get in the habit of going to the bathroom at the same time each day. And never put off the urge to go.

If you’ve tried all these things and still feel stuck, talk to your medical provider, who might order an x-ray for a closer look.

“I usually recommend some combination of over-the-counter options,” says Gendron. “MiraLAX® is safe because it's not absorbed systemically. It just pulls fluid into your bowels and helps things move along.” 

Constipation is considered chronic when the problem lasts three weeks or longer. Gendron says that many people end up in the emergency department with constipation due to the length of time and discomfort they experience.

So, if your constipation does not go away through diet, hydration and exercise, or your symptoms become worse, such as blood in your stool, fever or vomiting, it’s time for medical intervention.

For more information on constipation and other gastrointestinal issues, visit the OSF HealthCare website.

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Terminology

David Rzepczynski, MD, an OSF HealthCare gastroenterologist, says it’s important to first lay out some similar sounding terminology.

• Diverticulum (singular) or diverticula (plural): These are the bulges that form when an inner part of the colon sticks out through a weak spot in the colon wall.
   
• Diverticulosis: This is the name of the condition when the bulges occur.
   
• Diverticulitis: This describes when the bulges become inflamed.

Causes, symptoms and diagnosis

Dr. Rzepczynski says diverticulosis occurs when your colon is trying to push stool forward, and the organ is not as bulky as it should be. The diverticula bulges then form.

The condition has been more common in people over 60, but Dr. Rzepczynski says health care providers are seeing a rise in cases in people in their 40s and 50s.

Diverticulosis can run in families. It’s also tied to your lifestyle.

“A diet that has more red meat, less grain and less fiber might put you at a higher risk,” Dr. Rzepczynski says.

Smoking, excess alcohol and obesity are also risk factors.

Symptoms of diverticulosis include abdominal pain or constipation. But it often comes with no symptoms and is found during a colonoscopy.

Treatment

Dr. Rzepczynski says in mild cases, a provider may tell you to change your lifestyle, such as getting more fiber in your diet. This makes bowel movements smoother.

“Often, people will look to use fiber supplements,” Dr. Rzepczynski says. “The amount of fiber intake from supplements pales in comparison to what you can get from your diet.”

Also, eat a healthier diet overall. Dr. Rzepczynski says there used to be a myth that nuts, popcorn and seeds would get lodged in the colon bulges. He says studies have shown those foods are not a risk factor.

Other lifestyle tips: exercise and cut out tobacco and alcohol.

Dr. Rzepczynski says more serious cases of diverticulosis can come with two complications. One is bleeding.

“You could have a blood vessel on the outside of the diverticulum. If it ruptures into the diverticulum, it could cause sudden bleeding from the rectum,” Dr. Rzepczynski says.

Dr. Rzepczynski says bleeding from diverticulosis is not common. He ballparks it at around one in 2,000 cases. People on blood thinning medication who develop diverticulosis have a higher risk of bleeding.

While unpleasant, Dr. Rzepczynski says most bleeding cases resolve on their own.

The second, more serious complication is diverticulitis, or when the diverticula bulges become inflamed. This happens when there is a tear in the diverticulum, and bacteria from stool leaks. And it can lead to a host of other problems: pockets of pus known as abscesses, issues passing stool and a urinary tract infection.

Symptoms of diverticulitis include pain in the lower left abdominal area, abnormal bowel movements, nausea and vomiting. If you have these symptoms, it’s important to been seen by a health care provider quickly. A doctor may order a computed tomography scan (commonly called a CT scan) to diagnose diverticulitis.

Dr. Rzepczynski says it’s not common for diverticulosis to progress to diverticulitis, and most cases of diverticulitis can be treated at home with oral medication. But, he says 12 to 15% of diverticulitis patients spend time at the hospital. Treatments there include antibiotic medication through intravenous therapy (IV) and surgery. If surgery is necessary, a doctor will drain any abscesses then remove the inflamed area of the colon.

“They’ll try to reconnect the colon at that time,” Dr. Rzepczynski explains. “But if the surgery is done on an emergency basis, sometimes the person may have a colostomy where part of the colon is coming out through the skin. That’s a temporary measure.”

A colostomy comes with a bag on the outside of your body that collects the waste that would normally leave your body via a bowel movement.

Dr. Rzepczynski warns that surgery isn’t a permanent fix. He says around 15% of diverticulitis patients who have surgery end up with another bout. It reinforces the importance of lifestyle changes. You should also get on a colonoscopy schedule as advised by your health care provider.

Learn more

Read more about how to avoid diverticulosis on the OSF HealthCare website.

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