Get to Know Your PT: Kate LaPak, Therapydia Kona Physical Therapist

Kate LaPak physical therapist Kona Hawaii Therapydia

Therapydia Kona physical therapist Kate LaPak takes some time to talk adaptability, Frank Sinatra, and her dog, Dino.

“It’s all about balance and moderation. Balance between muscles, between work and play, between everything.”

When did you first know that you wanted to be a physical therapist?

I was a bit of a late bloomer. I have always had an interest in health and fitness but wasn’t sure where I would fit in. I did an internship through NYU shadowing physical therapists in Bellevue Medical Center for one summer during my junior year of undergrad and fell in love with physical therapy.

What is the biggest challenge involved in being a PT?

Keeping up with the paperwork. It takes more time than I’d like to admit. I’d much rather spend my time reading into the newest and latest physical therapy research for my patients.

How do you like to stay active?

I love doing just about anything with my dog. Walking, running, hiking… I also like to lift weights and practice yoga.

What’s your favorite song to get you motivated?

“1985 (Intro to “The Fall Off”)” by J. Cole. It’s all about not getting ahead of yourself or being overconfident when you are new to the game.

What surprised you the most about the physical therapy profession?

The wide variety of conditions that we are able to treat or specialize in. Before physical therapy school, I always thought of physical therapists as people you go to after a major surgery. PTs are qualified to treat not only musculoskeletal conditions but neurologic, pediatric and women’s health conditions as well.

Are you currently pursuing any further education/certifications?

I am getting my level 1 SFMA certification at the end of the month with my coworker Stephanie. I am also aiming to get my OCS (Orthopedic Clinical Specialist Certification).

What do you wish everyone knew about physical therapy?

You don’t need to be in pain to come see us! We offer wellness screens to help you move better and feel better in your everyday life.

What’s your go-to breakfast?

Grain-free granola and vanilla greek yogurt. Although every now and then I opt for a cinnamon roll 🙂

What is the most important personality trait that a PT must have?

Adaptability. You should be able to adapt to each of your patient’s needs and treat accordingly.

What do you do to de-stress/unwind?

I enjoy cooking, yoga and meditation. There’s nothing better than cooking dinner with a glass of wine and Frank Sinatra playing in the background.

Finish this sentence: On Saturday mornings, you can usually find me…

At the dog part with my dog Dino!

What is your favorite piece of wellness advice to offer?

It’s all about balance and moderation. Balance between muscles, between work and play, between everything.

Click here to learn more about Kate and the other physical therapists at Therapydia Kona.

Get to Know Your PT: Stephanie Colasanti, Therapydia Kona Physical Therapist

physical therapist kona hawaii

Therapydia Kona Physical Therapist Stephanie Colasanti, PT, DPT, takes some time to talk about staying motivated, the difficulty of turning off her PT brain when she’s not at work, and sunny-side up eggs.

“Don’t stop moving! Get off the couch and go outside to release some endorphins and feel motivated about life.”

When did you know that you wanted to be a physical therapist?

I knew I wanted to be a PT when I was an undergraduate studying exercise science and getting observation hours through various PT settings. Seeing the positive influence that PTs were able to provide through delivering personalized treatments and building caring relationships with patients motivated me to pursue the profession.

What is the biggest challenge involved in being a physical therapist?

Turning off my PT brain when I’m not at work. It is hard to go out in public and avoid observing people’s gait, posture, and overall movement patterns and not want to start giving PT advice.

How do you like to stay active?

I enjoy going to group workout classes like CrossFit. Working out with friends in a group environment is generally more motivating than trying to work out by myself. I also try to stay active by getting in the ocean and surfing or stand-up paddleboarding.

What’s your favorite song to get you motivated?

“What Do I Know?” by Ed Sheeran. It’s all about not taking life too seriously and when it comes down to it, love is all that matters.

What surprised you the most about the physical therapist profession?

I would say the most suprising thing about the profession is the lack of public awareness of the level of education physcial therapists have. It seems like most people are unaware of how equipped PTs are in diagnosing and treating most musculoskeletal conditions.

Have you learned anything new about PT recently that surprised/interested you?

I recently learned there is a new technique being studied to reverse the effects of various types of foot and hand neuropathy (pain, numbness, and tingling occurring from nerve damage). I have seen a lot of patients who could benefit from this.

Are you currently pursuing any further education/certifications?

Not currently, however I am looking into getting SFMA (Selective Functional Movement Assessment) certified and possibly eventually doing a yoga certification for health professionals.

What do you wish everyone knew about physical therapy?

I wish everyone knew that PT should be the first line of action to take prior to surgery or medications when it comes to pain, with the exception of some very serious issues and acute fractures that require emergency surgery. PT will get you back to doing what you love sooner and with less risk than other non-conservative methods of pain relief.

What’s your go-to breakfast?

Sunny-side up eggs.

What is the most important personality trait that a PT must have?

I think being personable and having good listening skills is absolutely crucial. It makes the experience much more comfortable and allows the patient to trust you.

How do you unwind/de-stress?

Surfing, working out, hanging out with friends, reading, cleaning, yard work.

What is your favorite piece of wellness advice to offer?

Don’t stop moving! Get off the couch and go outside to release some endorphins and feel motivated about life.

Click here to learn more about Stephanie and the other physical therapists at Therapydia Kona.

Get to Know Your PT: Tyler Patrick, Therapydia Kona Clinic Director

Therapydia Kona Clinic Director Tyler Patrick, PT, DPT, OCS, ATC, CSCS, takes some time out of his busy schedule to talk about how PT is perceived by the general public, what keeps him motivated, and his dog, Rufio.

“At our clinic, we get to know the person who has the injury which allows us to treat them, and not just their injury.”

When did you know that you wanted to be a physical therapist?

My interest in medicine as a career started when I tore my ACL, MCL, and meniscus while playing football in high school. I decided to pursue Athletic Training for my undergraduate degree as it combined my interest in sports and medicine. Through clinical experiences with the different sports teams at Ohio State and professionally with the Baltimore Ravens, I realized I enjoyed rehabilitating the athletes the most, therefore I decided to become a PT.

What is the biggest challenge involved in being a physical therapist?

We are a medical provider that asks a lot of the patient. We don’t perform a lot of passive treatments, which requires the patients to take an active role in their recovery with home exercises performed daily or even multiple times a day. Once people start to take that ownership and realize that they have some control in their recovery, it is very rewarding to experience.

How do you like to stay active?

I have an exercise program that I follow 3x a week and I also run 3x a week with my dog. Then try to hike, bike, swim, and surf as much as possible.

What’s your favorite song to get you motivated?

Honestly it depends on my mood, but I have been listening to a lot of Nahko and Medicine for the People and Childish Gambino recently.

What surprised you the most about the physical therapist profession?

Since we are a young profession, compared to nursing or physicians, many people still do not truly know what physical therapists actually do until they experience it for themselves.

Are you currently pursuing any further education/certifications?

Recently I have taken a deep dive into golf rehabilitation with the Titleist Performance Institute and it has not only helped me treat the golfers on the island, but improve their golf game as well! Additionally, I have plans to take some Pelvic Restoration Institute courses to incorporate more diaphragm and breathing into my treatments.

What do you wish everyone knew about physical therapy?

I think this one ties back into my surprise as to people not fully understanding what we do. As a profession, we are trying to educate people on how we treat injuries and pain, as well as the amount of training/education that goes into becoming a PT. It takes 7 years to become a Doctor of Physical Therapy.

What’s your go-to breakfast?

I hate to admit this but I usually don’t eat breakfast, but when I do it usually is anything fast.

What is the most important personality trait that a physical therapist must have?

At our clinic, we spend an hour with new patients and 45 minutes with follow up appointments, so being able to communicate is probably the most important trait. We get to know the person who has the injury, which allows us to treat them and not just their injury.

What do you to unwind/de-stress?

I meditate, spend time with my pup Rufio, play bike polo, surf, workout, watch a movie or show, and read to name a few.

What is your favorite piece of wellness advice to offer?

I have a lot, but one that I was given recently is to imagine the person you want to be and then ask yourself, what would that person do in this situation? When it comes to fitness though my soap box topic is always to train movement, not muscles.

Click here to learn more about Tyler and the other physical therapists at Therapydia Kona.

Basic Steps for Dance Injury Recovery and Enhancement

As a dancer, the summer is the perfect time to plan and prepare for the upcoming dance season. Since dancing is such a highly strenuous physical activity, it is crucial to ensure that your body is in peak condition for performance and injury prevention. While getting injured is never part of the plan, it is an unfortunate reality of such a demanding sport. Overuse injuries like plantar fasciitis, achilles tendinitis, patellofemoral pain syndrome, hip strains/sprains, and many other injuries of the lower extremity/back are common for dancers. Many dancers expect aches and pains to be a part of dancing but this is actually not the case. The discomfort you feel is your body telling you that something needs to change. Luckily, physical therapy can offer the needed edge to ward off these aches and pains, while preventing future injuries and even strengthening and refining your current skills.

Springing Back From Injury

After so much training, preparation, and effort, the last thing a dancer wants to hear is “you’re going to need to stop dancing.” Fortunately, our physical therapists can help you get back to dancing as quickly as possible while increasing body control and restoring strength. This means less pain and more dancing! Your physical therapist will also work to incorporate dancing into your recovery program, making it so time away from the dance floor is optimized to improve your abilities.

While other pain relief solutions may offer a temporary fix, working with a physical therapist can enhance your body’s functions with the long-term in mind. Mixing exercises with an increased knowledge of your body can help you strengthen your skills, ensure that you’re moving properly, and most importantly, get you back to the activity you love doing.

Elevating Your Performance

Whether you’re seeking out ways to recover from an injury or just looking to refine your athletic prowess and become a stronger dancer, utilizing physical therapy to counteract injury will improve your body’s function in a way that is everlasting. Curious what’s involved in a Dancer Wellness Consultation?

When you first meet with a physical therapist, you’ll be taken through a dance-specific physical screening that allows for dynamic and static movement testing. Your physical therapist will evaluate flexibility, strength, body control, and observe technique to design a plan of care that is unique to your body and personal goals. They may evaluate control through:

1. Bridge Exercise Progression: To determine if you can disassociate hip movement from pelvic and low back and to find out which muscles you use to extend your hip. (By the way, you should be using one of the biggest muscles in your body to do this, your gluteus maximus!) This exercise will progress to a squat pattern and can help reduce knee, hip, and back pain, while improving posture and strengthening your core.

2. Plank Variations: To ensure that you organize your core correctly and to assess endurance.

3. Foot Exercises and Challenges: These exercises seem weird at first, but many of us spend so much time in foot coffins (shoes) that we lose the natural abilities our feet possess. Our feet are capable of so much more than we realize. Just think of what people can do with their feet if they have no hands: play instruments, brush their teeth, make meals, and pick up objects! Although many of us do not use our feet to their full potential, a physical therapist can retrain them to be the springs that they were meant to be.

Knowledge in these areas can help when it comes to early detection of bone-stress symptoms, as well as overuse injuries. The supervision and input of a highly-trained dance medicine specialist can provide education and a deeper understanding of your body, giving you the tools necessary to be stronger and move better. To learn more about the Dancer Wellness Consultation, give Therapydia Kona a call at (808) 498 4144.

Faulty Breathing Pattern Can Cause Neck Pain

neck pain treatment

Blog post by Lev Borukhov, PT, DPT

One of the most common causes on neck pain and thoracic spine discomfort is ineffective breathing patterns. To understand the reasoning behind this, we have to take a look at how your body uses muscles and skeletal structures to breath. First lets look at the diaphragm, the primary muscle of respiration.

The Diaphragm shown in the picture below is a parachute shaped muscle that attaches to the inside of your chest bone (sternum) and it goes all the way around your ribcage on both sides. As you inhale the diaphragm expands the chest, and pushes the organs that lie below it down into your belly. Exhalation happens passively as the muscle ascends back into the rib cage.


For one reason or another, a faulty breathing pattern can emerge. A faulty breathing patterns is when you’re not using your diaphragm as efficiently as you can to inhale. Many times your body will recruit the Sternocleidomastoid, Scalenes, Levator Scapulae, Pectoralis minor and major, Trapezius, and Rhoboid Major muscles to assist in expanding the rib cage. When we look at common neck pain patterns, we often see these muscles are tight, overly stretched, or painful. These are the same muscles that turn on when you’re working out or running and need to get more air in.


Learning how to breath better may take some of your neck pain away and even solve them for good. So how do you start?

1) Lay on your back. Make sure that your pelvis, rib cage and head are on the surface you’re laying on with only 1 pillow under your head. Put your feet on the wall or a stool so that your knees and hips are flexed 90 degrees.

2) Take a deep breath in through your nose, keep your mouth closed. As you inhale you want your belly, and ribcage to expand in 360 degrees. Meaning you should feel your rib cage pushing into what you’re laying on.

3) Exhale all the way through your mouth only. Say “Haaaaaaaaa” as you exhale and don’t purse your lips. Make sure your exhale time is at least double the inhale time. You should also feel your obliques contract, if you didn’t that means you have more air in there that you should exhale.

Improve The Timing Of Foot Pronation To Eliminate Plantar Fasciitis

Blog post by: Dr. Lev Borukhov, PT, DPT

Plantar fasciitis can be a painful and limiting injury. It often affects the bottom of your foot between the heel and arch. Plantar fasciitis is usually described as a sharp pain in the morning as soon as you get out of bed. Most people will modify their gait ( the way they walk) by walking on the outside edge of their foot to decrease pain. Over time that compensation my result as a heel spur. Plantar fasciitis is thought of as an overuse injury but the cause is unknown.

Plantar fasciitis symptoms include:
• Pain with walking especially in morning
• Pain with walking after sitting

Physical therapist treatments for people with plantar fasciitis should be custom tailored to their specific functional limitations. At Therapydia we use an individualized approach to every patient. One of my favorite approaches to treat plantar fasciitis is to look at the timing of the foot when it pronates and supinates. I commonly find a discrepancy between what should happen and what is happening.

Your foot begins to enter pronation when your big toe lands on the ground after you heel strike. If your foot doesn’t get to pronate then the shock absorbing properties that are innate to the foot structure don’t get a chance to take place which may lead to plantar fasciitis-like pain.

plantar fasciitis pronation kona

The foot enters supination to give itself rigidity for a stable platform to push off from. If the foot doesn’t supinate properly or in time it may mean that you are pushing off a pronated foot which could cause some pain in the plantar fascia area.

plantar fasciitis supination kona

So speed up or slow down these steps I like to use little foam wedges. In this video we are using wedges to speed up pronation.

In this video we are using wedges to speed up supination of the foot.

Pronation is a normal foot motion and helps to absorb shock on the foot, knee, hip and back. However, over pronation stretches the plantar fascia leading to plantar fasciitis. By improving the timing and positioning on each step, you can eliminate plantar fasciitis pain. There are many other treatment modalities that physical therapists utilize to treat patients with plantar fasciitis. Most treatment plans are tailored to the patient and their specific functional deficits. Give us a call if you’re experiencing heel-related pain and we’ll work with you to create a custom treatment plan for your needs.

3 Cross Training Exercises For Runners

If you’re a runner training for a big, or little, race, cross training is important to keep you injury free. If you just started to run and are going from couch to 5k, or a general training plan to run your first half marathon or marathon, you might want to swap out a running day with a cross training day to make sure that you don’t get an overuse injury.

Single Leg Deadlift with a Row

single leg deadlift runner
• Feet hip width apart knees should be soft, hold the kettle bell handle in your hand.
• Hinge your hips as you lower the bell
• When you’re as parallel to the floor as you can be, bring your elbow up to your side.
• Lower the bell and use your hips/ gluts to bring your self vertical again. your focus should be on balancing on the foot thats on the ground.

Walking Lunges with Medicine Ball

walking lunges with a medicine ball

• Hold the medicine ball close to your torso
• Take a lunge forward with your left leg and rotate the ball over the leg.
• In one movement bring the ball back to center and bring your right knee in the air to get into position to lunge over your right leg.

1.5 Kettle Bell Swings

1.5 kettle bell swings
• Stand with one leg in front of the other with enough space between your legs to swing the Kettlebell.
• Your back heel should be off the floor
• Swing the bell back towards your butt and use your hip to thrust it forward around mid chest level.
• Remember to switch to do the other side.

Try these to weed out those weak links so that you can be a bulletproof runner.

Running With A Physical Therapist

running form kona physical terapy

Written by: Stephanie Colasanti, DPT & Tyler Patrick, DPT, OCS, ATC, CSCS

An estimated 10 million in the US run and it is fast becoming the most popular form of exercise. From the cardiovascular improvements to stress relief to losing weight, it’s no surprise that many people pick up running for its health benefits. With the popularity of running increasing, so has the rates of injuries from running. In fact, a whopping 82% of runners will get injured at some point. This could range from relatively minor symptoms to major game changers that  can cause you to halt all of your running goals. Although it may seem like the repetitive nature of running would lead to injury, there is no evidence that running is actually bad for you. Now this comes with a disclaimer….with the right type of training and form, your body should be able to withstand the forces in running and get stronger from them, injury free!

That’s where we come in. As physical therapists, we generally see people after they get hurt, which is extremely frustrating for us. With the right guidance, runners of all ages and skill level could benefit from a screening and assessment to PREVENT injury or even unlock performance potential.

What Happens During a Run Analysis

To decrease run-related injuries and improve your run times, a physical therapist will examine the following:

• Muscle strength (muscles provide the force to allow movement)
• Muscle length (allows your joints to move through their full range of motion)
• Joint mobility (joints create movement between bones)
• Ligament integrity (ligaments help keep joints together)
• Running form/movement

Problems with one or multiple of these could lead to excessive wear and tear and possible injury. A physical therapist will examine all of these bones, joints, muscles, as well as how they interact with each other during movement. From your spine, all the way down to your big toe, we will make sure that everything is working the way it should in order to keep you out of that 82% or help manage that nagging injury that prevents you from unlocking your full running potential. By assessing your musculoskeletal makeup and movement patterns, you and your PT will have information on your unique biomechanics and develop a custom treatment program based on those findings.

For a little bit of insight and to get you started at home, here is one of the things we would take a look in a running assessment: hip flexor flexibility.

Hip Flexor Assessment For Runners

Hip flexor tone/tightness is a common issue that we find in people because we have made a life that allows us to sit for everything. Sitting causes your hip flexors to be in a shortened position and leaves your hips and legs tight and your glutes inactive. Why does this matter for running? Tight hip flexors limit the ability of your leg to go behind you (hip extension). Running requires a great deal of hip extension to generate the force to propel you forward. Tight hip flexors can also cause your back or knee to take more stress than it should. If you have less than 10-20 degrees of hip extension (or hip flexor flexibility), the range of motion required for normal walking/running, you will increase your chances of injury due to stresses placed on your low back and knees.

To assess your own hip flexor tightness, lay down on the edge of a bed, then bring both of your hips up towards your chest:

assess hip flexor tightness physical therapy

Allow one leg to fall down with your knee bent slowly. You have iliopsoas (hip flexor) tightness if your thigh is not parallel to the table/bed:

hip flexor runners

You have rectus femoris (hip flexor/knee extensor) tightness if your lower leg is not straight up and down:

hip flexor tightness assessment

If you find that you have some tightness, here are a few stretches that will get you started on improving your flexibility.

2 Stretches For Tight Hip Flexors

Lunge Hip Flexor Stretch

couch stretch runners

Couch Stretch
lunge hip flexor stretch runners
Perform each stretch for at least 30 seconds, but preferably 1 minute. Do this about 3 times on each side daily. Contract your butt muscles on the leg where the knee that is down to prevent your pelvis from tilting forward. Also, work on your breathing to sink into the stretch during the exhale.

Get started on your flexibility and come see one of us down at Therapydia for a running assessment, as well as an individualized program that will prepare your body to handle the impact of running.

Stay tuned for the remainder of our running series! We will be discussing shoes, as well as some tests and corrective exercises that should help you unlock your full potential!

How To Properly Warm-up Before Your Workout

side lunge warm up stretch

By Jaime Granchelli, PT, DPT

Yes, it matters. It’s actually kind of a big deal. If you’re not physically warm before you hit your workout, you’re not ready. Muscles don’t like to be asked to move and do work under load and tension when they are cold. Cold muscles also have a higher chance of being strained or even torn.

Why Stretching Isn’t Enough

What muscles prefer is to be warmed up gradually from smaller to bigger range. Kicking your foot up on a bench and hanging in a passive hamstring stretch for a few minutes isn’t going to cut it. Sure, this will help lengthen the muscle but simply gaining more range from sitting in a stretch doesn’t mean that muscle is geared and ready for dynamic movement. In order to achieve more range, your muscle has to relax itself and is technically shutting down. When you hold a stretch for a period of time without involving movement, you’re actually shutting your muscle down even more and goes against exactly what you’re trying to accomplish.

Furthermore, this relaxation of the muscle is shutting down it’s natural responses that are necessary for power and force generation. A 2014 Journal of Strength & Conditioning Research study found that 60 seconds of four different static stretches resulted in substantial decreases in jump height and power compared to not stretching at all. In another 2014 study by the Journal of Sports Medicine found that an upper body static stretching protocol negatively affected peak jump force. With all that said, sitting in a passive stretch after your workout is a great addition to your cool down routine since you will be done putting those muscles under load and going into “shut down mode”, so to speak, and it won’t be detrimental to performance and/or health of the muscle.

Customize a Warm Up Routine For Each Activity

So, how should I warm up for my walking program?… my triathlon training?… surfing? Does it matter?

Warming up doesn’t have to be fancy, but it should be deliberate. Start by easy walking, jogging, biking, or swimming. Then, gradually start to open up your stride or pick up the pace as you feel your body warming up and engaging. Once you’re warm, play around with all those bounty drills we did in P.E. class or high school or college sports: lunges, side lunges, squats, jumping jacks, fire hydrants, regular or knee push ups, soldier kicks, high knee jog, inch worms. These can and should cater to what exercise you’re about to perform, as well as, where you tend to be tight. If you know you are about to do a shoulder intensive workout, the shoulder and arm take priority over hip and leg drills. If you feel you have tight hips, make sure to do some drills that loosen them up. Lastly, depending on what sport you’re warming up for and what skill demands you may require, start honing into more sport/skill specific movements. Tap into muscle memory and get them activated.

Below is a lower body warm-up routine you can do before your next workout!


low body warm up exercise routine


2 rounds of:

  1. 10 Squats
  2. 10 Lunges (5 each leg)
  3. 10 Side lunges (5 each leg)
  4. 10 Fire hydrants (5 each leg)
  5. 20m High knees Jog

Change The Way You Move At Work

Therapydia Work Injury Treatment

Developing an ergonomic and workplace injury doesn’t just have to do with heavy lifting or bad posture at a desk. Even if you’re moving around on your feet all day, you may still be at risk for developing some repetitive movement injuries. If you work in the service industry, you may feel like there’s no way to avoid certain tasks that may be contributing to daily aches and pains. We usually move without thinking—which may not be the best thing if we’re moving in a way that strains our bodies. Our bodies tend to do better with more neutral movements. Unnatural movements like constantly lifting, reaching, or holding objects on a daily basis may overexert your muscles and lead to injuries you probably didn’t even know you were developing. A lot of employees within the hospitality and service industries are at risk for sprains and strains, simply from moving the wrong way. Even quick breaks to stretch and walk around can make a huge difference. Beyond that, you can be at top level performance at work without having to worry about those constant aches in your neck, shoulders, arms, and back.

If You’re At The Front Desk

If you usually work at a workstation or behind a desk, keep to general ergonomic tips about adjusting your desk space. Keeping your body as relaxed as possible is critical for this type of environment. Unnatural positioning when using your mouse and keyboard can potentially cause carpal tunnel in your wrists. It also puts you at risk for tennis elbow, which causes the muscles and tendons around the elbow to become inflamed. Just moving your mouse and typing on your keyboard the right way makes a huge difference.

Tips For Your Mouse, Keyboard, & Computer:

• Place pressure on the palm of your hand, don’t hold mouse too tightly
• Keep mouse and keyboard at elbow height
• Type with straight wrists
• Keep your computer screen at eye level

Tips For Your Chair:

• Keep thighs horizontal with room for knees under desk
• Keep neck and shoulders relaxed
• Don’t stoop forward, keep to good posture

Taking the time to relieve neck and shoulder tension could prevent any postural misalignments that could occur in your upper spine. One way to release tension throughout your entire spine and chest area and also improve posture is to stretch backwards. Counter a long day of hunching forward and flexing your spine with a quick break.

Quick Stretch Break:

• Get to a comfortable standing position
• Keep your feet hips-width apart
• Bring your hands up over your head with palms facing forward and thumbs hooked
• Begin to bend gently backwards
• Remember to breathe deeply as you do so

After sitting for a long time, this could be a good way to extend your posture. If you have back pain related to stenosis, remember that you should avoid bending backwards altogether.

Serving Is More Strain Than You Think

A lot of service industry jobs involve being in strenuous positions for most of the day. If you think about it on an ergonomic level, there’s a lot you personally can do to minimize the amount of stress you’re putting on your muscles and joints. Our bodies move and function the best way in natural positions. Carrying trays, plates, or bottles of beverages aren’t exactly the most natural ways for your body to hold weight. Waiters and waitresses have to contend with carrying a lot of weight balanced on one arm, which has the potential for injury.

How To Hold A Tray:

• Keep your position as neutral as possible
• Keep hand firm but relaxed on bottom of tray, don’t tense your fingers
• Keep your wrists straight and upper arm vertical
• Hold the tray as close to your body as possible
• Balance the tray on both your arm and hand
• Alternate which arm you use so you don’t overuse one arm
• Carry fewer plates at a time, ask other servers to help with larger orders

Pain because of these repeat movements might be felt in the the wrists, elbows, or shoulders. This might eventually put a server at risk for developing an overuse injury such as carpal tunnel, bursitis, or tendinitis around a joint. Servers are at risk for carpal tunnel symptoms progressing to the elbows as well as the wrists because of the way they hold heavy trays. Doing some wrist stretches during breaks can help relieve built-up tension in your wrists, your elbow, and general forearm musculature.

Quick Stretch Break:

• Extend your arm forward, hold your hand straight out, palm down
• Use the opposite hand to grab the back of the hand and the fingertips
• Pull the hand towards your trunk
• To stretch other side, flip your palm over and repeat the movement
• Hold for 10 seconds on each side

Pouring & Shaking

For servers or bartenders who work with heavy jugs, coffee pots, or bottles of beverage—keep to general tips about how to hold weight.

How To Pour:

• Hold jugs, pots, or bottles close to your body when carrying them
• When pouring, move the glass or cup as close to you as possible
• Don’t overreach with a full jug

For bartenders, they also have to worry about reaching for heavy bottles of premium liquor and constantly shaking drinks filled with heavier ice (which is similar to the motion of a baseball pitch). With all that shaking, they’re at risk for tendinitis in the elbow or the shoulder. If you’re a bartender, thinking about the way you shake is critical. You need to get the maximum impact from the way you’re shaking, but don’t let it impact your body as well.

How To Shake:

• Keep your shoulders and wrists as flexible as possible
• Stretch when you can
• Focus on which muscles you’re putting the most force on
• If you feel more pressure or force in one area, direct the pressure away
• Switch hands when shaking, vary your shaking routine

A common injury bartenders are prone to is shoulder tendonitis. Doing some external shoulder rotations to strengthen the muscles of the rotator cuff around the shoulder will help strengthen and stabilize your shoulder joint.

Quick Workout Break:

• Lay on your side with the knees bent and a dumbbell in the upper hand
• Start small with the weight if you’re just starting out
• Bend the elbow to a right angle
• Keep the upper arm supported on your side with the dumbbell hovering in front
• Rotate the shoulder to pull the lower arm and dumbbell up
• Pull so the they are level with the top side of your body
• Slowly return down to the starting position

Keep Moving, Stretching, and Walking

Remember to take as many breaks as you can. If you’re on your feet all day, invest in good shoes that have some arch support and aren’t too pointed at the tip. Most servers or front desk workers have to stoop forward to speak with customers all day, which puts strain on their lower back. Comfortable shoes can go a long way in helping decrease lower limb and lower back pain. Get up, move around, throw something away, go to the bathroom, take a quick walk around your office space—whatever you can do. If you’re working the front desk, make sure you take the time to relax your hands. Be mindful of which positions feel awkward or uncomfortable when going through your work day, chances are, there’s a way to correct your movement to make it more natural. That way, you can avoid the aches and pains that come along with your specific job duties.