1. Use a supportive chair when sitting for an extended period of time. Sit with your back firmly against the chair
2. If reading from a textbook on a table, it’s helpful to have it propped up. Prop it on another book, so that the neck doesn’t have to bend as much
3. Take frequent breaks. Even the most ideal position should be changed periodically. This is especially important when using the computer (desk top or laptop) or mobile device.
4. When using tablet for prolonged periods, try to have it supported on something, for instance a tablet stand. If using it away from desk and seated, use some cushions on your lap to support your arms.
5. Stretch muscles that are getting sore or cramped from prolonged positions or repetitive computer work. Take a few deep breaths and then try the following stretches:

• Roll shoulders forward and back;
• Turn neck from side to side;
• Bend and straighten wrist; open and close the hand.

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Facial exercises in front of a mirror can help patients with Bell palsy who suffer from persistent weakness.

Exercise physiotherapy is recommended for Bell palsy patients with persistent weakness, according to clinical practice guidelines published in the September 2014 Canadian Medical Association Journal.  A multidisciplinary panel that included Dr. Joseph Chen from Sunnybrook Department of Otolaryngology and myself developed the guidelines.

Bell palsy is a weakness or paralysis of the facial muscles, thought to be due a virus affecting the facial nerve. Most patients will have complete recovery, usually within 3 to 6 months. But about 20 per cent of patients will have persistent weakness. These people report problems with eating, drinking and speaking, as well as with facial expressions such as smiling. The psychological effects are significant.

At the time of onset, patients should seek medical attention to ensure appropriate diagnosis and medical management (like medication and proper eye care). Facial exercises are inappropriate at first, as the facial nerve needs time to heal. Forceful facial movements have little effect other than to exercise the uninvolved side. Later, they may be harmful as they can reinforce improper movement.

If there is persistent facial weakness after 3 to 6 months, an appointment with a facial physiotherapist may be helpful. The physiotherapist evaluates the patient’s recovery and works with the patient to develop an individualized treatment plan. Treatment may include facial muscle relaxation techniques, as well as retraining exercises in front of a mirror. Even patients with longstanding facial weakness may benefit from treatment.

You can read the full guidelines here.

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You’ve probably noticed your child’s backpack is starting to get heavier now that they are in full learning mode, which typically means increasing workloads and homework. Too often, heavier backpacks = potential back pain.

While many factors can contribute to back pain — like poor posture and prolonged inactivity — a heavy backpack can make things worse — worsen posture and increase muscle soreness, shoulder pain, numbness and tingling.

Here are some things to keep in mind for safe backpack use:

• A backpack that is too heavy or worn incorrectly (over one shoulder only) can strain muscles and joints and cause pain.
• When full, your child’s backpack should not weigh more than 10-15% of their body weight. (To figure out this range, take your child’s weight, ie. 60 lbs, and multiply it by 0.15. So, 60 x 0.15 = 9 lbs. Your child’s bag shouldn’t be more than 9 lbs.)
• Encourage your child to wear both shoulder straps of the backpack. Wide, padded straps are preferable to reduce pressure and distribute the load.
• Backpacks with a waist strap can help to distribute the load better.
• Adjust the straps so that the pack lies high on the back and is not hanging down or sagging.
• Keep the load balanced by placing heavier items in the large compartment closer to the body.

Remember, good posture can also help prevent aches and strains in our muscles and joints.

• Sit or stand to your full height, bringing shoulders gently back, belly slightly in without holding your breath and chin lightly in. We can’t stay this way all of the time but it’s important to keep retuning to our full posture throughout the day.
• When seated for prolonged periods, it is important to use a supportive chair. Make sure to sit with your back firmly against the seat back, getting the chair to do some of the work for you.
• Even the most ideal posture needs to be changed periodically as that can cause muscles to cramp and joints to be strained. Avoid prolonged positions by taking breaks, doing some stretches or switching up tasks every so often.

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