Spring Has Sprung! 7 Tips to Avoid Aches and Pains While Gardening

Spring Has Sprung! 7 Tips to Avoid Aches and Pains While Gardening

7 Tips to Avoid Aches and Pains While Gardening

Common gardening activities, such as digging, planting, weeding, mulching, and raking can cause stress and strain on muscles and joints.

The following tips can help minimize aches and pains:

1. Get moving before you garden.

A 10 minute brisk walk and stretches for the spine and limbs are good ways to warm up.

2. Change positions frequently to avoid stiffness or cramping.

Be aware of how your body feels as you work in your garden. If a part of your body starts to ache, take a break, stretch that body part in the opposite direction it was in, or switch to a different gardening activity. For example, if you've been leaning forward for more than a few minutes, and your back starts to ache, slowly stand up, and gently lean backwards a few times.

3. Use a garden cart or wheelbarrow to move heavy planting materials or tools.

Lift with your knees and use good posture while moving a cart or wheelbarrow.

4. Give your knees a break.

Use knee pads or a gardening pad. If kneeling or leaning down to the ground causes significant pain in your back or knees, consider using elevated planters to do your gardening. If kneeling on both knees causes discomfort in your back, try kneeling on one and keep the other foot on the ground.

5. Maintain good posture.

Use good body mechanics when you pick something up or pull on something, such as a weed. Bend your knees, tighten your abdominals, and keep your back straight as you lift or pull things. Avoid twisting your spine or knees when moving things to the side; instead, move your feet or pivot on your toes to turn your full body as one unit.

6. Take breaks.

If you haven't done gardening or other yard work in a while, plan to work in short stints, building in time for breaks before you start feeling aches and pains.

7. Keep moving after you garden.

End your gardening session with some gentle backward bending of your low back, a short walk and light stretching, similar to stretches done before starting.

Gardening Aches & Pain Back Pain Lumbar Cervical Neck Scoliosis Arthritis Bone Spurs Tendinitis

Author: Andrea Avruskin PT, DPT
from: https://www.moveforwardpt.com/Resources/Detail/gardening

See A Physical Therapist FIRST For Your Back Pain!

See A Physical Therapist FIRST For Your Back Pain!

See A Physical Therapist FIRST For Your Back Pain! 

Back pain is the number one cause for work-related disability and the number one reason for work absences.  In fact, 80% of people will experience back pain at some point in their lives.  Acute low back pain is defined as pain that lasts a few days to a few weeks.  People do not often seek input from a healthcare professional with this type of back pain.  If symptoms persist for greater than 12 weeks, then it is classified as chronic. 20% of people who experience acute low back pain will continue to have symptoms at 12 weeks and as much as up to  1 year.  See a physical therapist first!

With Direct Access laws now in place in New Jersey, you can start physical therapy right away, without a prescription or referral from your doctor!

A physical therapist can be your first line of defense when you experience low back pain and can help to ensure your problem does not turn chronic.  At physical therapy, you will receive a thorough evaluation and individualized treatment which will help you to manage your symptoms and decrease the amount of time spent out of work.  Research supports the use of physical therapy for treatment of low back pain including but not limited to spinal stenosis and degenerative disc disease. In many cases physical therapy is more effective and less costly than other treatments such as surgery.  

If you are experiencing any discomfort in your low back, give us a call at MANA PHYSICAL THERAPY (732-390-8100) and schedule an evaluation to see how we can help you! 

 Back Pain Injury Facts Injuries physical therapy causes rehab lumbar

Ankle Sprains: Not Just A “Walk-It-Off” Injury

Ankle Sprains: Not Just A “Walk-It-Off” Injury

Ankle Sprains: Not Just A “Walk-It-Off” Injury

If you roll your ankle while walking, running or playing a sport you probably don’t seek treatment.  In fact, most of us will probably continue the activity and at the very most wear an ankle brace.  An ankle sprain can create poor balance and effect the way the body moves.  This occurs because the proprioception at the ankle has been damaged.  Proprioception is the brain’s way of knowing where your body is in space and being able to safely negotiate within your environment.  It is what allows us to close our eyes and touch our finger to our nose or walk on grassy, uneven ground without falling.  The brain receives this information from receptors in the muscles, tendons and ligaments throughout the body.  When you “roll” your ankle, then these structures can become damaged and result in poor balance.  Without proper retraining to regain this function at the ankle, you are at increased risk for future and possible more serious ankle injuries. Just one ankle sprain can increase your chances for recurrent ankle sprains by as much as 70%.  AND about 50% of recurrent ankle sprains end up with chronic pain or instability.   

A systematic review of 2 RCTs with 703 and 1057 patients determined that completing a supervised rehabilitation program focusing on balance and coordination for a minimum of 6 weeks after an acute ankle injury substantially reduced the risk of recurrent ankle sprains for as long as a year.

See a Physical Therapist.  A physical therapist has the tools necessary to ensure your symptoms improve and there are no long-term deficits as a result of your ankle injury.  They will perform a thorough evaluation of your ankle movement, strength, balance/proprioception and develop a plan of care tailored to your needs in order to avoid ankle sprains in the future.   


Patrick OM, Hertel J. Systematic review of postural control and lateral ankle instability, part II: is balance training clinically effective? J Athletic Trng. 2008;43:305-315.
Hubbard, Tricia J. and Wikstrom, Erik A.  Ankle sprain: pathophysiology, predisposing factors, and management strategies.  J Sports Med. 2010; 1: 115–122.

Posture Is Important, BUT WHY?

Posture Is Important, BUT WHY?

Posture Is Important, BUT WHY?

We’ve all been told since we were children “sit up straight, don’t slouch”. To which we would roll
our eyes and swear our parents didn’t know anything. And I don’t think I need to tell you that
our parents were right.

I’d like to say that over the course of time we are becoming more aware of our posture, but it
seems the opposite is happening. With technology at the forefront of our lives, society has
become dependent on tablets, smartphones and computers.
And what does this mean for our posture? It means there’s no hope for any of us to sit up
straight and not slouch.

If you’re reading this blog post, you’re most likely sitting at a computer or on your phone and I’ll
bet you just adjusted your posture...There’s been an epidemic taking over our nation…”Text
neck”. This is the term used to describe an increased forward head position or looking down
which is largely due to the increased use of smart devices.

This increase of forward head position increases the amount of weight on the cervical spine. In
a neutral position, the head weighs about 12 pounds, if you tilt your head forward just 15 degs,
the amount of pressure through the neck more than doubles to 27lbs. And if you bend your
head forward 60 degs (which is probably the most common position for using our phones) the
amount of pressure through your neck increases to 60lbs.

So I know this might be hard for you to imagine...but 60lbs is 5x the amount our cervical spine is
designed for...that’s equivalent to about 4 average bowling balls or half an octopus...did that

What does this mean and why should we care? With our heads in this position we are
essentially reversing the normal curve of our spines leading to increased neck pain, HA, upper
back pain and can even affect our lower back.

 Posture Correction Scoliosis Rehab Physical Therapy correct slouching

What can we do?
Hold our phone/tablets at eye level: tuck your elbows in to your sides like so and keep the
screen at an angle in which you can see it without having to bend your head
GET UP! Don’t sit for more than 20-30 mins, even you if you just stand to stretch or take a lap
around your office, when you sit back down you will be more mindful of your posture
Come visit Mana Physical Therapy. Physical therapy can help you to improve your posture by
working to improve ROM, joint mobility and alleviate pain. Additionally we can help to
strengthen the postural muscles which help to support the head and neck. Our bodies are great
compensators and will take the path of least resistance, retraining your posture is not easy and can often times feel uncomfortable, but in the long run you’re protecting your muscles, joints and
improving your overall health.

If you have any further questions regarding posture or any other aches and pains please call to schedule your appointment with Danielle at MANA PHYSICAL THERAPY (732) 390-8100.

Running season is finally here! Don't Let runner's knee hold you back!

Running season is finally here! Don't Let runner's knee hold you back!

Runner’s Knee

One of the most common injuries with running is knee pain and often times it presents itself as patellofemoral pain syndrome or Runner’s Knee.  

What is patellofemoral pain syndrome?

PFPS occurs due to improper tracking of the kneecap between the condyles of the femur (thigh bone).  As you bend and straighten your knee the kneecap should move down and up respectively. When the above does not occur it can create friction, inflammation and pain in the area.  

Why does this occur?  

Most often the kneecap does not move properly  due to muscular imbalances between the quadriceps (front of the thigh); hamstrings (back of the thigh) and gluteals (buttock).  This can be a result of increased tension in the iliotibial (IT) band, stiffness at the ankle joint, hip or back, or improper running technique.  

What can we do?

At Mana Physical Therapy we can do a thorough evaluation of your movement patterns to identify strength and flexibility deficits.  Through video analysis, we can assess your running technique and develop a plan of care tailored to your specific needs.

Call Mana Physical Therapy today to address your runners' knee or other running injuries, at (732) 390-8100.





Five Myths About Concussions

Five Myths About Concussions

Five Myths About Concussions

The CDC estimates 1.6-3.8 million sport/recreation-related concussions happen per year in the
United States. 300,000 high-school athletes experience a concussion per year. These
numbers are large. Understanding the myths associated with concussion can help you or a
someone you know seek treatment when necessary.


Most people believe that you need to lose consciousness or “black out” in order to have a
concussion, but this not true. A person may experience a concussion if they had their “bell


Concussions occur due to rapid acceleration of the brain inside the skull resulting in it hitting the
sides of the skull. One does not have to just hit their head for this to occur. A hit to the body
which accelerates the head quickly can result in a concussion. Direct contact is also not
necessary, a person involved in a motor vehicle accident who experiences whiplash may be


There is no research that supports this theory. In fact, a helmet was originally designed to
prevent skull fractures, which it does however it does not prevent or reduce the likelihood of
concussion. Similarly, mouth guards protect against dental injuries, but do not impact the
chance of concussion. TOUGHER HELMETS=HARDER HITS!

 Concussion Symptoms Rehab Recovery Rehabilitation Certified Concussion management


Concussions can occurs in any sport where rapid acceleration/deceleration occurs. Athletes
involved in sports such as soccer, lacrosse, basketball, gymnastics, and cheerleading are at risk
for concussion. In fact, the third highest occurrence of concussion occurs in Girls Soccer.


This used to be the case. However recent guideline from the Berlin Concussion Consensus
Statement states a brief rest period of 24-48hrs is recommended, but then light submaximal
activity is advised. Research supports the use of vestibular rehabilitation therapy (VRT) in order
to improve outcomes in patients.

At Mana Physical Therapy, Danielle Mendez is a certified concussion rehabilitation professional and can develop an individualized VRT program for you. Call (732) 390-8100 today for your appointment.

Laser Tracking For Training Cervical Proprioception

Laser Tracking For Training Cervical Proprioception

This video is narrated by our Therapist Danielle and being demonstrated by our aide Caity. 

This laser tracking exercise is a way to test joint position error testing in the neck. It can treat neck pain, headaches, and concussions.

For treatment or relief of these or any other symptoms, call us today at 732-390-8100 and set up your appointment with Danielle! We are conveniently located next-door to the Stop & Shop supermarket at Route 18 Southbound & Arthur Street.

Certified Concussion Management at Mana Physical Therapy

Certified Concussion Management at Mana Physical Therapy

By Danielle Mitko, PT, MSPT

Over the past weekend I participated in an Evidence-based CONCUSSION REHABILITATION Course.  The course focused on a systematic approach to evaluating and treating patients dealing with vestibular, balance, and musculoskeletal disorders which can result from a concussion. It also provided protocols which are supported by the most current and effective evidence available.  The course also highlights the importance of a multidisciplinary approach to treatment for these individuals and the need for early intervention in order to prevent long-term disability and recurrence. 

After completion of the weekend long intensive course and exam, I am a Certified Concussion Management Professional through The American Institute of Balance.  

If you or anyone you know has experienced a CONCUSSION and continues to be affected by it, call me, Danielle, at Mana Physical Therapy, I can answer any questions you have and may be able to improve your daily function.  Call (732) 390-8100 now to schedule your appointment.


Concussions can happen in the following ways:

 Concussion rehab head trauma injury physical therapy    

Debunking Four Myths About Arthritis and Exercise

Debunking Four Myths About Arthritis and Exercise

By Danielle Mitko, PT, MSPT

Myth #1: “Exercise will make my joint pain/arthritis worse”

MOTION IS LOTION! Moving our joints actually improves lubrication in the joint and can help
increase flexibility.”

Myth #2: “I have arthritis, I have not exercised in the past and should not start now”

It is never too late to start exercising. Exercise is recommended for all types of arthritis and has
actually been shown to slow the progression of arthritis.

Myth #3: “I can only do low impact activities because of my arthritis”

Research actually supports the use of high intensity training in individuals with arthritis (both hip
and knee). This means that performing activities such as squats and step ups with weight is
actually recommended. Always be sure to consult a healthcare professional before engaging in

Myth #4: “Pain is a bad thing”

Pain should always be used as a marker. People often confuse joint pain (stiffness/tightness)
with muscular fatigue/work (burning); if you are exercising and feeling a burning or strain in the
muscles, this is okay, this is a normal response to exercise. In fact you want this to occur in
order to build muscle.

If you have arthritis pain, contact us at Mana Physical Therapy! We can help alleviate the pain and educate you on proper exercise technique and prescription. Please call us at (732) 390-8100 to schedule your appointment today. 

 Arthritis join pain relief geriatric elderly injuries rehabilitation

Spring Cleaning Tips from a Physical Therapist

Spring Cleaning Tips from a Physical Therapist

Spring is here! Avoid common injuries during spring cleaning with the following tips!

  1. Protect your back! Avoid lifting heavy loads or bending/twisting a lot at the back.  This can overload the back and cause discomfort.

  2. Protect your knees! If you will be doing a lot of kneeling or work that is at the ground level, consider using a pad under your knees and adopt a half-kneeling stance.  (One knee up and one knee down on the pad) Alternate knees regularly to avoid increased strain on one leg. 

  3. Work smart! SLOW AND STEADY WINS THE RACE! Remember performing work in smaller amounts may take a longer time, but rest is important to avoid overuse of the body!

  4. Work Together! Enlist help from a spouse, partner, child, friend, neighbor, whomever.  This will help to lighten the load and you’ll be twice as efficient.


 Spring Cleaning spine lower upper back neck pain knee injury wrist   

Spring Cleaning spine lower upper back neck pain knee injury wrist


Quadruped Diagonals Resisted with Neutral Spine

Quadruped Diagonals Resisted with Neutral Spine

This exercise helps develop lumbar and core stability and strength, with simultaneous extremity movement patterns. Thank you to our aide Caity for performing the exercise in this video.

Active Release Technique at Mana Physical Therapy! Schedule a Free evaluation this week to see how ART and corrective exercise can ease pain and improve mobility!

Active Release Technique at Mana Physical Therapy! Schedule a Free evaluation this week to see how ART and corrective exercise can ease pain and improve mobility!


Hundreds of our patients have had the pleasure of experiencing the quick and permanent release of painful adhesions in as little as 3-5 sessions. We are Certified in ART at Mana Physical Therapy and have had outstanding results with this prestigious soft tissue technique. If you have been suffering with a nagging ache or pain, ART is the Gold Standard in Soft Tissue Treatment to help aide your path to mobility. 

Active Release Technique (ART)

ART is a state of the art soft tissue system/movement based massage technique that treats problems with muscles, tendons, ligaments, fascia and nerves. Headaches, back pain, carpal tunnel syndrome, shin splints, shoulder pain, sciatica, plantar fasciitis, knee problems, and tennis elbow are just a few of the many conditions that can be resolved quickly and permanently with ART. These conditions all have one important thing in common: they are often a result of overused muscles.

Over-used muscles (and other soft tissues) cause painful scar tissue due to: 

1. Acute injuries such as pulls, tears, collisions 

2. Accumulation of small tears seen in many athletes 

3. Prolonged poor posture and repetitive work activities

 Active Release Technique treating East Brunswick South River Spotswood Old Bridge ART

Dear RockTape, THANK YOU for managing my chronic back pain.

Dear RockTape, THANK YOU for managing my chronic back pain.

by Olivia Barton on the RockTape blog:

 Chronic back pain relief with RockTape

I just want to say that I am SOOO glad I discovered RockTape. I am 23 years-old and I suffer from a small central disc protrusion with associated annular tear and central canal and neural foramina on my L5-S1… paired with some mild scoliosis…crazy right? I have been dealing with this issue since was about 14. I have been through a lot of trial and error trying to relieve the pain. From physical therapy twice, acupuncture and cortisone shots… Physical therapy didn’t work for me and acupuncture worked but it wouldn’t last long enough and getting an appointment on a military base (shout to our veterans and military spouses!) is about near impossible. Last year my back pain became SO severe that I couldn’t do any leg related workouts because It would feel like my back was being physically crushed; it really took a toll on my mental state and physical state. Then the best thing ever happened…. I stumbled upon RockTape. As an individual who has been through some serious pain and suffering – to the point of not being able to walk for days at a time, I’m always down to try things that might take even 20% of my pain away. So I bought some.

I first tested RockTape on my five-hour plane ride – plane rides are the worst because I usually can’t even go more than ten minutes without feeling SO uncomfortable with having to adjust my seating position or get up and walk around. I used to directions on how to apply for the lower back, two pieces vertical and one piece horizontal. IT. WAS. INSTANT. RELIEF. It was like a cortisone shot. I felt such relief in my first minutes of having RockTape on that I cried; I was pain free again – all my tightness and tension from my lower back, down to my hamstrings was gone! As for my plane ride? Awesome! I did wiggle around once, but I didn’t have to get up AT ALL and I even fell asleep because I was so comfortable. UGH it was such an awesome plane ride haha.

My next test was trying RockTape in the gym… you bet your butt it was AMAZING!! I was able to do TWENTY box jumps in a row without stopping because my back wasn’t a bother (before I could barely do six in a row without having to stop) I was also able to do my squat cleans and presses without pain (and able to go into a deeper squat). I was feeling so great, I did a banded glue workout (this usually kills my back) and was able to work through it with, you guessed it, no pain! RockTape has forever changed my life. I cannot thank the people RockTape enough for creating such an amazing product that allows sport-loving, weight lifting people like me to be able to do the things we love to do. I wish I could thank each and every one of you personally and you could see the happy tears that roll down my face. Thank you, thank you, thank you! 2017 was a horrible year and it kicked my butt. I vowed to make 2018 my year and I’m off to amazing start thanks to RockTape!!! STAY AWESOME!!!!!!!!

Sending so much love your way!!

(Video) Single Leg Squat on Bosu with RockTape RockFloss

(Video) Single Leg Squat on Bosu with RockTape RockFloss

Our aide Alison demonstrates a single leg squat on a Bosu ball. After being unable to complete the movement on her own, once RockFloss is applied, she is able to complete the squat. This improves the proprioception and tissue gliding between her fascia and muscles.

Meet Danielle Mitko, Our New Physical Therapist

 Danielle Mitko Mendez PT MSPT FMT best Physical Therapist Therapy East Brunswick

Danielle MItko earned her Master’s of Science in Physiotherapy from the CAPTE-accredited program at Robert Gordon University in Aberdeen, Scotland.  Danielle returned to the States for her last clinical placement in 2013 and received her license in early 2014.  Prior to studying abroad Danielle attended Rutgers, The State University of New Jersey where she earned her bachelor’s in biological sciences.

Danielle takes an individualized approach to management of her patients and believes the best patient care comes from tailoring treatment to the person not the diagnosis.  Danielle has taken courses such as Maitland, Mulligan and Spinal Manipulation, to progress her manual skills, as well as Functional Movement Taping, Pilates and Runner’s Rehab to further expand her skillset.  Danielle is currently preparing to become a board certified specialist in Orthopedics in early 2018.

In addition to her passion for physical therapy, Danielle has coached gymnastics for 15+ years and volunteers on the high school level from time to time.  This experience has provided her a unique insight into working with athletes, including but not limited to dancers, gymnasts, football and soccer players. 

In her free time, she enjoys working out, whether it be running, weight lifting, snowboarding or playing with her dog.  Most importantly she loves anything which involves spending time with her family. 

Winter Snow Shoveling Tips, Save Your Back!

Winter Snow Shoveling Tips, Save Your Back!

By Our Therapist, Danielle Mitko

Protect your back this winter with these tips!

  1. When shovelling snow try to lift lighter loads and choose a shovel where the handle is not too short to avoid bending too much at the back.
  2. The back does not tolerate twisting motions as well as other movements so try to avoid this by facing the direction you want to unload the snow
  3. TAKE BREAKS!  Shovelling is a heavy activity, take periodic rests and perform some back extensions (standing upright with hands on hips and bending backward) to take a break from all the forward bending during shovelling.

If you or someone you know is experiencing back pain, contact a Physical Therapist to receive treatment immediately! 


 Snow Shoveling Back Injuries Pain Winter Relief
 Proper Form Hip Shoulder Impingement Injury Pain 

SFMA Exercise Hip Hinge with Dowel

SFMA Exercise Hip Hinge with Dowel

In the following video, Dr. Nicholas Cifelli explains the SFMA exercise, Hip Hinge with Dowel, as demonstrated by our wonderful aide, Alison.

Meet Our New Acupuncturist, Kristen Giancaterino, LAc!

Meet Our New Acupuncturist, Kristen Giancaterino, LAc!


Kristen Giancaterino is a licensed, board certified, and graduate of the nation's leading Acupuncture college, the Pacific College of Oriental Medicine (PCOM) in New York City. Her training consisted of thousands of hours of Clinical experience at the college’s busy downtown community clinic. The academic program also consisted of thousands of hours of classroom, outside study, and externship time. This includes but is not limited to;  advanced needling techniques, tui na massage, five element acupuncture, cosmetic acupuncture, and the treatment of orthopedic, pediatric, and modern western diseases.

Her focus is treating chronic pain, anxiety, stress, and many other modern diseases. Kristen has had great success in treating:

  • Back Pain
  • Sciatica
  • Groin Pain
  • Tennis Elbow
  • Carpal Tunnel
  • Post surgery/Scar Tissue Pain
  • Joint Pain
  • Hip Pain
  • Knee Pain
  • Anxiety Disorders
  • Fatigue
  • Headaches
  • Insomnia
  • TMJ
  • Allergies
  • Hypertension
  • Fertility

In addition to completing the Acupuncture program, Kristen is also a certified in administering therapeutic grade essential oils and a practitioner of the Raindrop Technique.  She is licensed as Acupuncturist under the New Jersey state board of medicine.  Kristen has achieved board Certification from the NCCAOM, consisting of Acupuncture, Biomedicine, and Oriental Medicine.

Kristen developed a love for Acupuncture as college student while getting treatments for stress, back pain , and UTI’s at local acupuncture college near her home town. She discovered a drug-free solution to ailments that plagued her and was inspired. After enrolling in Pacific College’s Master’s program, Kristen participated in a externship at New York University-Hospital for Joint Diseases called Initiative for Women with Disabilities. IWD is a multi-disciplinary women’s medical center where women are treated for a wide variety of disabilities and chronic autoimmune conditions. In addition to weekly acupuncture treatments, she interacted with medical staff and social workers to plan the best course of health care for patients.

Kristen has seen & felt the benefits of Oriental Medicine and Essential Oils on one’s spiritual, mental, emotional, and physical health and wants to provide you with a worry-free, stress-free recovery from your illness or ailment.

Call Mana Physical Therapy today at 732-390-8100 to schedule your acupuncture appointments with Kristen!