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Massage Therapy: It’s Not Just for Rest and Relaxation!

Massage Therapy: It’s Not Just for Rest and Relaxation!

What do you think about when you hear the word “massage”? If you’re like many people, you associate massage with a day of pampering at an exclusive resort spa in the mountains or at the beach. But if that’s the first picture that comes to mind, you might be missing something very, very important. That something is the therapeutic value of massage—the ways that massage can actually improve your health and well-being.

While it is certainly true that many types of massage do help with relaxation, therapeutic massage also has a variety of important health benefits. For instance, therapeutic massage:

  • Accelerates healing by improving the circulation of blood and lymph to injured areas
  • Promotes flexibility by stretching and loosening muscles and connective tissue
  • Improves muscle tone and helps prevent or delay muscle atrophy cause by prolonged periods of forced inactivity
  • Relieves pain in joints by reducing inflammation and swelling in joints
  • Increases the effectiveness of chiropractic adjustments

Practitioners and patients alike have discussed these types of benefits for many years, but researchers have recently made a great deal of progress collecting and analyzing clinical data to understand the effects of therapeutic massage. Here are some “headlines” from their work as well as a few “notable quotes” from their study findings.

Improved Circulation and Post-Exercise Pain Relief

Investigators at the University of Illinois at Chicago recently conducted a study to determine whether or not massage improves general circulation and relieves soreness after exercise.

  • “Our study validates the value of massage in exercise and injury, which has been previously recognized but based on minimal data,” said Nina Cherie Franklin, UIC postdoctoral fellow in physical therapy and first author of the study. “It also suggests the value of massage outside of the context of exercise.”
  • “We believe that massage is really changing physiology in a positive way,” said Franklin. “This is not just blood flow speeds—this is actually a vascular response.”
  • Because vascular function was changed at a distance from both the site of injury and the massage, the finding suggests a “systemic rather than just a local response,” she said.

Reduced Chronic Low Back Pain and Improved Mobility

There are more than 100 million massage therapy visits in the U.S. each year, and lower back pain accounts for more than one-third of them. Why?  Because massage works!

A study in the Annals of Internal Medicine found that patients receiving massage (whether “structural” massage or “relaxation” massage) had better outcomes than those receiving typical medical care without massage. Measured after 10 weeks and again after 26 weeks, patients who received massage had less pain and better mobility than the control group. At 52 weeks, the results were less clear.

A review in Harvard Health Publications contained some very positive words about the study, which was funded by the National Institutes of Health’s National Center for Complementary and Alternative Medicine:

  • “My interpretation of this well-designed study is that massage appears to be at least as effective as standard treatments for chronic low back pain.  It might even be better.  And it’s likely safer than medicine.  Depending on actual costs and insurance coverage, massage may even cost less than usual care.”
  • “In my opinion, it’s time massage became a more standard option for the treatment of chronic low back pain.”

The Chiropractic Care – Massage Therapy Connection

Massage is often recommended as an integral part of a broader chiropractic treatment plan, either in the form of massage to loosen muscle tightness before an adjustment, or after an adjustment to help the muscles adapt to the newly-repaired spinal structures. Many patients report that the combination of these two therapies works better than either therapy alone. In our experience, this is most noticeable with conditions that cause chronic pain—chiropractic manipulation or mobilization techniques work to relieve the structural problems and therapeutic massage works to resolve the soft tissue problems. This is why many chiropractors work closely with massage therapists to find the most effective treatment regimen for each patient—the one that returns them to a feeling of health and well-being as quickly as possible. In our Grand Avenue office, here in Billings, Dr. Oblander often works hand in hand with our massage therapists to work with patients who have been in car accidents, are worker’s compensation patients, or who have other issues which our experience tells us would be addressed by combining massage therapy with chiropractic care

If you’re interested in learning more about what massage and chiropractic care can do for you, please give Oblander Chiropractic a call at 406-652-3553! We’ll be happy to discuss your situation with you and to explain our approach. We’re here to help!

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To Stay Healthy this Fall and Winter? Wash Your Hands! The Simplest Way

To Stay Healthy this Fall and Winter? Wash Your Hands! The Simplest Way

As summer turns to fall, lots of people (children and adults alike) will be spending more time inside and in closer proximity to one-another. Washing your hands is something simple we can all do to keep our schools, workplaces and homes just a little bit healthier. In fact, it’s actually been identified by the US Centers for Disease Control and Prevention (CDC) as the single most effective way to prevent the spread of communicable diseases.

But researchers at Michigan State University recently found that only about 1 person in 20 actually washes his or her hands properly in even the most obvious hand washing scenario—after using a public restroom. According to a summary by writer Lindsay Abrams of the Atlantic:

“Of 3,749 people observed leaving the bathrooms, 66.9 percent used soap, while 10.3 percent didn’t wash their hands at all. The other 23 percent of people stopped at wetting their hands, in what the researchers, for some reason, call “attempted washing” (as if maybe those people just weren’t sure how to follow through). Although the researchers generously counted the combined time spent washing, rubbing, and rinsing, only 5.3 percent of people spent 15 seconds or longer doing so, thus fulfilling the requirements of proper handwashing. They average time spent was 6 seconds.

Why Hand Washing?

Bacterial and viral infections can be spread when the hands come into contact with infectious respiratory secretions and carry them elsewhere. This happens most often as a result of someone coughing, sneezing, shaking hands, or touching an object that has been in the proximity of a sick person and then touching the face—particularly the nose, mouth or eyes. This is one of the primary ways of transmitting the virus that causes the common cold.

Washing your hands after using the toilet or changing a diaper is of utmost importance, as the ingestion of even the smallest amount of fecal matter can cause serious illness from deadly pathogens such as E. coli, salmonella, giardiasis and hepatitis A, among others. You should also be particularly careful about washing your hands after touching garbage, handling animals or animal waste, visiting or caring for an ill person, or if your hands show visible dirt.

Those who handle food should routinely wash their hands, not only after using the toilet, but also after touching raw meat, fish or poultry, since the microbes present on uncooked food can cause gastrointestinal infections ranging from mild to severe or even life-threatening.

Perhaps those with the greatest need to wash their hands on a regular basis are healthcare workers. Because they’re constantly exposed to sick patients and patients with weakened immune systems, and since they frequently come into contact with contaminated surfaces, these professionals have a special responsibility. Before the importance of hand washing was widely understood within the healthcare community, millions of people became sick or died from infections passed along on the hands of their caregivers. During the 19th century, up to 25% of women died in childbirth from childbed fever (puerperal sepsis), a disease subsequently found to be caused by the bacteria Streptococcus pyogenes. After hand washing was introduced as a standard practice in the delivery room, the rate of death dropped to less than 1%.

It All Begins With Hand Awareness

Here are the “4 Principles of Hand Awareness”:

  1. Wash your hands when they are dirty and BEFORE eating
  2. DO NOT cough into your hands
  3. DO NOT sneeze into your hands
  4. Above all, DO NOT put your fingers into your eyes, nose or mouth

How to Wash Your Hands the Right Way

To wash your hands properly, you need only two things: soap and clean, running water. If these two things are not available, you can use an alcohol-based hand sanitizer that has a minimum 60% alcohol content.

Before washing your hands, remove all rings and other jewelry. Using running water, wet your hands thoroughly, then apply enough soap to work up a nice lather. Keeping your hands out of the water, rub them together, being sure to scrub both the front and backs of your hands, including your wrists, and also washing between the fingers and under the nails. Do this for 20 seconds, then rinse completely under the running water. Be sure to turn off the taps with a paper towel rather than your bare hand. According to the CDC, the whole process should take about as much time as singing “Happy Birthday” twice.

But What About Drying?

The Mayo Clinic recently published its own comprehensive review and analysis of every known hand washing-related study produced since 1970. Interestingly, their researchers found that drying hands was a key part of preventing the spread of bacteria. They also concluded that paper towels are better than blowers for this purpose. Here’s some of their reasoning:

  • Most people prefer paper towels to blowers, so they’re more likely to use them.
  • Blowers take too long, encouraging people to wipe their newly-cleaned hands on dirty pants or to skip the step altogether.
  • It takes less energy to manufacture a paper towel than it does to dry hands with a blower.
  • Blowers dry out the skin on your hands.
  • Blowers scatter bacteria three to six feet from the device.

As chiropractic physicians, we have a special interest in helping our patients (and non-patients, for that matter) avoid illness and injury. This means helping them develop healthy lifestyle habits—like regular hand washing—that prevent disease. We also work closely with them in areas like diet, exercise, sleep and stress management. If you’d like to learn more about what we can do to help you stay healthy and live your life to its fullest, please call or visit our office today!

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The Most Dangerous Jobs: A Chiropractic Perspective

The Most Dangerous Jobs: A Chiropractic Perspective

It’s no secret that some jobs are just more physically demanding and more dangerous than others. Some of the most challenging ones are obvious—combat roles in the military, fire and rescue, heavy construction and deep sea fishing are just a few that come to mind. However, when it comes to non-fatal musculoskeletal injuries, the statistics tell a very different story about occupational health and safety and about who’s most likely to get hurt on the job.

Because chiropractic physicians are experts in treating conditions that involve the musculoskeletal and nervous systems (including many common workplace injuries), we have a unique perspective on why they happen, how they can  be prevented and the best ways to treat them.

Musculoskeletal Disorders by the Numbers

Let’s start with a long-term trend that’s good news for the nation’s workers but that doesn’t get much media attention. The number of reportable occupational injuries and illnesses has declined steadily across the past decade from 50 cases per 1,000 full-time workers in 2003 to 33 cases in 2013. So progress is clearly being made, even if it doesn’t grab the headlines.

That said, musculoskeletal injuries continue to be among the most common on-the-job injuries, and they can require significant recuperation time. The Bureau of Labor Statistics (BLS) says that musculoskeletal disorders (MSD) “are injuries or illnesses affecting the connective tissues of the body such as muscles, nerves, tendons, joints, cartilage, or spinal disks.”

A very high percentage—about one-third—of 2013 workplace injury and illness cases that required days off from work involved the musculoskeletal system.  Plus, workers who sustained musculoskeletal injuries required more time to recover before returning to work—a median of 11 days to recuperate compared with 8 days for all types of workplace injury and illness cases. In 2011:

  • The back was the primary site of MSD injuries in 42% of all cases across all occupations, requiring a median time off of 7 days to recuperate.
  • Although it accounts for only 13% of all MSDs, the shoulder was the area with the most severe injuries, requiring a median of 21 days off of work to recuperate.
  • Injuries and illnesses due to repetitive motion involving “micro-tasks” (such as typing) accounted for only 3% of all occupational injury and illness cases. However, those workers with this kind of injury required nearly 3 times as many days away from work to recover as those with all other types of injuries and illnesses—a median of 23 days.

 

As we mentioned earlier, though, MSDs are not distributed evenly across all industries and occupations.

  • In 2013, the highest MSD incident rates were found in transportation and warehousing (80.3 cases per 10,000 full-time workers), healthcare and social assistance (50.2 cases per 10,000 full-time workers), arts, entertainment and recreation (46.5 cases per 10,000 full-time workers) and construction (41.9 cases per 10,000 full-time workers).
  • In 2011, six occupations accounted for 26% of all MSD cases: nursing assistants, laborers, janitors and cleaners, heavy and tractor-trailer truck drivers, registered nurses and stock clerks.
  • In 2011, those with the greatest number of median days spent off from work in order to recuperate from an MSD were heavy and tractor-trailer truck drivers (21 days).

So it’s clear from the numbers that the dangerous jobs featured on reality TV shows (think about Deadliest Catch and Ice Road Truckers) aren’t necessarily the ones that result in the most MSD-related visits to the chiropractor or general practitioner.

The Role of Chiropractic Care in Prevention and Treatment

Over the past several years, companies of all sizes have become increasingly interested in occupational health and wellness programs. Chiropractic physicians have a special interest in working with employees and business managers alike to help prevent job-related injuries and to encourage a healthy, productive work environment. If you’d like to learn more, we encourage you to call or visit our office today.

Chiropractic care can be one of the most effective ways to treat musculoskeletal pain and accelerate recovery.  Dr. Oblander has the training and experience necessary to successfully diagnose and treat a wide range of workplace injuries, and he’ll be happy to answer any questions you may have! So if you or someone you care about has recently been hurt on the job, please give us a call at 406-652-3553 or stop by either of our Billings chiropractic offices. We have an office located at 3307 Grand Avenue and an office at 410 Wicks Lane in the Heights  and we’re here to help!

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Being a Great Fitness Buddy

Being a Great Fitness Buddy

Studies have shown that one of the best ways to stick to your fitness regime is to have a reliable fitness partner. Being a fitness buddy means that someone else is counting on you to make them accountable for their workout, keep them inspired and ensure that they are not alone in their quest for fitness. To be a great fitness buddy you just need to keep a few basic guidelines in mind:

You should both have similar goals ­– If you are training for a place on the Olympic team and your fitness buddy just wants the occasional weekend workout, neither of you is likely to meet your goal. This does not mean that you have to share the same goal, but they should be relatively comparable. That way, you can encourage your partner to meet their goal while not losing sight of your own.

Find someone at a similar fitness level – Your fitness partner does not want to feel like they are being left behind if you are at a much higher level than they are. Similarly, choosing someone at a higher level may make them feel like they have to hold back. Having the same starting point is more motivating for you both.

Be reliable – Always show up when you say you are going to. Your fitness buddy will be more motivated knowing that he or she can count on you to be there for a scheduled workout. You should ideally have similar schedules so that your partner does not have to work around your previous commitments.

Don’t hesitate to push your partner – It’s natural to want to do as little work as possible to reach our goals. But encouraging your fitness buddy to push themselves a little farther than they might on their own can help them to reach their goals a little faster. Never push them beyond what they can safely do, but there is no harm in encouraging your partner to push beyond what they perceive are their limits, and they will be pleasantly surprised at how much they can accomplish that they never thought they could.

Keep focused – Help your partner to keep focused on his or her workout by ensuring that your mind does not wander off or become distracted by the cute guy or girl walking by in the gym.

Provide useful criticism ­– Do not hesitate to correct your workout partner if you feel he or she is using bad form or doing something unsafe. Part of the responsibility of being a great fitness buddy is ensuring that your fitness partner does not become injured during their workout and that they perform to the best of their ability.

 

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Beating the Odds: How Some People Stick with Diet and Exercise Plans

Beating the Odds: How Some People Stick with Diet and Exercise Plans

Billings Chiropractic Diet Services
balance-scales

How long did your last diet or exercise plan last? If you’re like many people, your answer is “not that long.” In fact, one UK survey found that the average length of time a person stays on a nutrition plan is 19 days. A slightly more positive poll found that women tended to quit their diets after five weeks and two days. If these statistics sound distressingly familiar, it might be time to reassess how you approach your own diet plan.

How Do People Stick with Their Diet and Exercise Plans?

If you want to make sure your diet and exercise plan doesn’t become just another statistic, a change in attitude can make all the difference. In order to create a diet plan you can stick with, it’s important to be honest with yourself about what types of changes will fit into your lifestyle. Diet plans with long lists of “bad” foods might help you cut back on calories in the short term, but do you really plan to go the rest of your life without cake? People who stick with their diet plans take a more moderate approach, making small changes that they can live with in the long term.

Exercise plans can be just as difficult to carry out. People who stick with their exercise plans view physical activity as a regular part of life, not something they do only when they have the time, energy, and motivation. Of course, sticking with physical activity is much easier when it’s enjoyable. Rather than slogging it out on the treadmill, try yoga, martial arts, or another exercise program that stimulates your mind as well as your body. And variety helps too!

You Don’t Have to Go It Alone

Whether you’re building a diet plan or an exercise program (or are making changes in both areas), the people around you can make a huge difference in your level of success. If your spouse, children, or friends tend to turn to food in celebration or out of boredom, it’s easy to forget about your diet goals. Getting enough exercise is a lot more difficult if the people around you would rather watch TV than go on a walk.

Fortunately, when it comes to sticking with your diet and exercise plan, the people around you can also be a huge help. Making dietary changes as a family can help everyone involved lose weight and improve their health, while exercising with a friend can make the time go by much more quickly and pleasantly.

Having the support of a chiropractor who really understands the power (and challenges) of making healthy lifestyle changes (think nutrition, exercise, sleep and stress management, for example) is another way to help you meet your goals. The staff here in Billings at Oblander Chiropractic can work with you to make targeted, realistic adjustments that you’ll be able to stick with in the long term. Sticking with a diet and exercise program isn’t always easy, but you might be surprised by just how easy it is to make the changes you’re looking for with the right type of advice and support!

Staying Healthy at the Office

Staying Healthy at the Office

Staying Healthy at the Office
Staying Healthy at the Office

When you work in an office job—even one that’s otherwise rewarding—it’s easy to feel trapped in a day-to-day pattern that doesn’t seem to leave much room for physical exercise or healthy eating. And this is true even though more and more Americans are becoming aware that sitting for long periods of time, often without a break, is hazardous to your health.

The simple truth is that they’re right to be concerned. One study conducted in 2010 indicated that “men who reported more than 23 hours a week of sedentary activity had a 64 percent greater risk of dying from heart disease than those who reported fewer than 11 hours a week of sedentary activity.” And yet the nature of office work is essentially sedentary. So what can you do to change that fact and improve your health? This article lists a number of suggestions that may help.

  • Eat breakfast. Studies have shown that workers who eat breakfast have better concentration than those who only drink coffee in the mornings. In addition, those who eat breakfast tend to eat less during the day than those who do not, and thus more easily avoid gaining weight.
  • Bike or walk to work. If you live close to work, biking or walking can provide much of the exercise you need each week, and you can arrive at work feeling more energized after spending some time in the fresh air. If you take public transportation to work, consider getting off one or two stops earlier and walking the rest of the way.
  • Take frequent short breaks. Even if you take a longer break for lunch or to go to the gym, sitting for long, uninterrupted periods of time can still be hazardous. Studies have shown that taking micro-breaks (getting up from your desk and moving around every 15 minutes or so) can be more valuable than taking a longer break only once a day.
  • Use the stairs. Why ride in a stuffy metal box with 10 other people when you could get a little healthful exercise?
  • Drink lots of water. Experts recommend you drink 4 to 6 glasses a day to keep yourself hydrated and healthy. If you have to get up to refill your glass from the drinking fountain or the refrigerator, that’ll also provide an opportunity for another micro-break.
  • Don’t forget about fresh air. Offices can often be stuffy and under-ventilated.  If possible, open a window near your desk. If not, be sure to take occasional breaks outside the building, even if only for short periods of time.
  • Bring a healthy lunch and snacks from home. Rather than eating in the cafeteria, make a healthy lunch at home and sit outside when eating it. Instead of eating sugary snacks from vending machines, bring fruit and nuts and snack on them.
  • Think ergonomically. Adjust your chair to fit your body and sit with your feet flat on the floor. Position your computer monitor at eye level and your keyboard at elbow level, so that your wrists are straight when you type. Move your whole arm when you use the mouse, not just your wrist.
  • Stretch at your desk. You may not be able to jog or do push-ups at your desk, but you can certainly stretch and release tension from your arms, neck, shoulders, and fingers.
  • Exercise before you go home. After a long day at work, many people get home and just want to sit down on the couch and relax. If you are a member of a gym or jog regularly, doing this directly after work will improve the likelihood that you’ll actually exercise.
What is “Referred Pain”?

What is “Referred Pain”?

Billings Chiropractor“Referred pain” can be a perplexing phenomenon for anyone who experiences it. Referred pain is what happens when you feel pain in an area of your body that is not actually the original source of the pain signals. The most common example of referred pain is when pain is felt in the left arm, neck or jaw of a person suffering a heart attack, while they often have no feelings of pain in the chest area itself.

It’s important to note that referred pain is different from radiating pain, in which the pain felt in one area travels down a nerve, causing pain along the length of the nerve. This is often the case with sciatica, where pain originates in the lower back and radiates down the leg.

Researchers are still not exactly sure what causes referred pain. Some experts believe that it is due to a mix-up in nerve messaging. The central nervous system (CNS) is constantly receiving a barrage of different messages from different parts of the body. These messages may get mixed up somewhere along the path between the place where the irritated nerve is signaling and the spinal cord or brain where pain signals are processed. With an extensive network of interconnected sensory nerves that serve the same region of the body, such as the nerves of the lower back, thighs and hips, it may be more common for signals to get mixed up than you might imagine.

Although referred pain is usually felt as painful, it can also cause feelings of numbness, tingling or the sensation of pins and needles. Another example of referred pain is a tension headache, in which headache pain is due to an irritation of the nerves in the neck.

Referred pain tends not to cross sides of the body. In other words, if the pain signals are originating in the liver or gallbladder (which are on the right side of the body), you may feel pain in your right shoulder. If the signals originate in the pancreas (on the left of the body), you may feel pain in your left shoulder, etc.

Chiropractic adjustments can address the source of the referred pain, leading to long-term pain relief. Nerves in the area of the spinal cord that are irritated due to a spinal misalignment (subluxation) can be a cause of referred pain. When your chiropractor adjusts your spine, he or she removes the source of irritation, thus providing relief. Dr. Oblander is a Billings Chiropractor who is very knowledgeable about which tests can be performed to determine the underlying cause of your pain (whether direct or referred), and can treat it accordingly. If you have questions or want to seek chiropractic treatment, be sure to give us a call at Oblander Chiropractic: 406-652-3553.

Spinal Anatomy 101

Spinal Anatomy 101

vertebrae-model-200-300 “Never grow a wishbone, daughter, where you backbone ought to be.”

-Clementine Paddleford, American Writer (1898 – 1967)

It’s no accident that so many philosophers and writers have used the backbone as a metaphor for discipline, force of will or character.  Your spine (or “backbone”) is the primary physical support for your body’s entire frame.  It’s a remarkable piece of natural engineering composed of 33 separate vertebrae that act as a single unit to provide stability as well as flexibility while you’re sitting, standing or in motion.  A healthy spine is both strong and resilient.  With proper nutrition, exercise, postural habits and chiropractic care, it can allow us to lead an active lifestyle well into old age.  However, poor biomechanics, injury and disease can cause problems with the spine that result in misalignment, inflammation, pain and restricted movement.

The spine develops from infancy into adulthood, gradually evolving from a C-shape, which is suitable for crawling, to its distinctive S-shape, which is the appropriate shape for two-legged walking.  The natural curves in the spine serve to cushion impact from movement, absorb shock, preserve balance, and allow range of motion.  The three main curves in the spine are known as the cervical curve (the neck region), the thoracic curve (the upper back) and the lumbar curve (the lower back).

There are 7 cervical vertebrae, 12 thoracic, 5 lumbar, 5 sacral and 4 coccygeal vertebrae.  The sacral and coccygeal vertebrae are those located lowest in the spine, below the area of the lumbar curve.  Twenty-four of the vertebrae in your spine are moveable. They are cushioned by intervertebral discs which act like coiled springs. These discs are fluid filled and—as we age—become thinner and more brittle, often causing us to get shorter.  Over time (or as a result of excessive wear and tear or specific injury), they can degenerate, bulge or herniate, potentially causing significant pain and loss of mobility.

There are several other common spinal disorders.  Lordosis, also known as “sway back,” occurs when there is abnormal forward curvature of the lumbar spine.  Those who have abnormal curvature of the thoracic curve have kyphosis, or “hunchback.”  Scoliosis occurs when there is a side-to-side curvature in the spine. Slight curves of less than 20 degrees do not usually present health or problems and are seldom treated.  Moderate or severe curves usually require treatment because they can interfere with the functioning of internal organs and may significantly limit physical activity.

While the bones and connective tissues of the spine are very good at what they do, they cannot support the body’s weight and facilitate movement on their own.  They need the help of strong core muscles.  Good muscle tone is important to help maintain proper posture and spinal alignment.  This is why it’s so important for us to put effort into maintaining proper posture when we sit, stand, lie, walk and run.  Over time, poor posture can place unnatural stresses on the musculoskeletal system (especially the spine), limiting our range of motion and producing pain.

In addition to its role in supporting the body’s frame and facilitating movement, the spine has another important role as well.  The spine’s bony vertebrae also encase and protect the spinal cord, which is connected directly to the brainstem.  It’s hard to exaggerate how important this protection is.  Damage to the spinal cord can cause numbness and loss of motor function.  Injury to the cervical area can cause tetraplegia (also known as quadriplegia), while injury to the thoracic or lumbar area may result in paraplegia, or loss of the use of the legs and trunk.

This article serves as a brief introduction to just one aspect of your anatomy.  If you are in the Billings area and need a Billings Chiropractor and you have any questions about your spinal health or your musculoskeletal health more generally, please don’t hesitate to call us at Oblander Chiropractic or visit our office (406-652-3553).  We’re here to help!

Tips and Precautions for Winter Exercise

Tips and Precautions for Winter Exercise

cold-weather-jogging-200-300For many people, colder temperatures outside—whether at home or while traveling over the winter holidays—can mean big changes in exercise routines. Some will move their workouts indoors or hibernate during the winter months. Others, though, will decide to work with the seasons and find ways to be active outside. If you’re one of those people, this article is for you.

While there’s certainly no rule against venturing out into the cold for a little bit of exercise, it’s important to be smart about how you do it. Remember to protect yourself from frostbite, hypothermia, and injuries that can come with freezing temperatures. To help you do that, we’ve put together a short checklist that you can use to exercise outdoors safely this winter.

Remember that Cold Weather is Often Dry Weather. Winter weather is often associated with precipitation. However, as the temperatures drop to dangerous lows—close to freezing and below—the opposite is often true regarding humidity. The air will get drier, and even if you don’t sweat as much, you can still lose valuable moisture. When exercising in the cold weather, remember to drink plenty of water, even if you don’t really feel thirsty or sweaty.

Understand the Real Temperature Where You Plan to Exercise. Look up the weather on a website or app before you head out into the cold, but understand the numbers you are looking at. The general weather conditions can differ greatly from place to place locally, even in the same region. Pay especially close attention to wind chill numbers, since the combination of wind and your own movement may lead you to experience lower temperatures. The thermometer may say it’s 35 degrees out, but the wind chill may mean it feels closer to 20 degrees in certain areas.

Dress Appropriately. It may be tempting to bundle up when going out in the cold to work out, but this comes at a cost. Thick, warm clothes will make you sweat more easily, and that sweat can leach heat from your body and allow your temperature to drop to unhealthy levels. The key, as cold weather experts know well, is to dress in layers, starting with a thin synthetic layer of wicking material, then a fleece and finally a thinner waterproof coat. The added benefit to this clothing strategy is that it’s flexible. You can always take off layers if you get too hot.

Warm Up the Extremities. When exercising in the cold weather, pay particular attention to your extremities, which are more vulnerable to frostbite. It’s especially important to cover your fingers and head. If the air is very frigid, cover up your nose and mouth, too: That cold air can damage your lungs and freeze your nose.

Fuel Up. A source of energy is vital to keeping up your metabolism and keeping you warm when out in the cold. Eat a healthy amount of complex carbs and proteins before you go out, and if you’re going to be out for a few hours, then bring a snack along, too. Stay away from sugars and other less dependable sources of energy, if possible.

Start Slow. Stretching and warming up will both make injury less likely and help your metabolism pick up until you are ready for more strenuous work. Always warm up before going out into the winter weather, particularly if you are planning on an intense session with lots of running or heavy exertion. Otherwise, joint and muscle injuries could result.

Know the Danger Signs. Hypothermia and frostbite can creep up on you if you’re not careful. You can defend against the cold better if you recognize the signs. Frostbite occurs on exposed skin like your cheeks, nose, ears, and hands, especially below 20 degrees Fahrenheit. Hypothermia occurs when shivering cannot keep up your core body temperature and your heart and brain begin to shut down. Watch for intense shivering, sudden weariness, slurred words, and trouble with coordination.

Billings and our surrounding areas have had lots of severe cold and snow thus far this winter; be sure to be smart about going outside and take care of your health!