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Snowshoeing is an excellent winter workout that can help burn calories, strengthen muscles and boost cardiovascular health. Explore the top 8 snowshoeing spots and experience this ultimate workout adventure! Significant Health Benefits: Exceptional cardiovascular workout – burn up to 1,000 calories per hour! Low-impact muscle building Endurance building Balance strengthening and agility Improves your sense of well-being by connecting to nature Prepping for Your Adventure There are some crucial details to think about when it comes to snowshoeing, especially if you are a beginner. Make sure to pick the right kind of footwear to go on top of your snowshoes; a pair of comfortable waterproof boots are a great choice and remember to wear lots of layers. Several local places rent snowshoes if you aren’t sure about spending money on a pair. Check out Bobos Ski and Board Patio or our local REI Co-Op. Check out REI’s Beginner’s Guide to Snowshoeing for reference. 8 Cool Snowshoeing Spots 1. Galena Creek Park Close to Reno, this beautiful, low-altitude park offers several trails. You’ll find various creeks and streams under cover of pristine ponderosa pines. From beginner to advanced, the differing trail systems provide a challenge for everyone! Head west on State Route 431 (Mt. Rose Highway) for about seven miles until you see the park sign on the right side of the highway. 2. Tahoe Meadows – Chickadee Ridge This local favorite not only gives fantastic views of Lake Tahoe but the best part? – friendly little chickadees will eat seeds right out of your hand! Be sure to pack plenty of sunflower birdseed, as that seems to be their favorite. From the trailhead parking lot, head southeast into the open meadow. Then follow the ridgeline to your right (southwest). Continue southwest up toward the top of the ridgeline to the west, and you’ll get to Chickadee Ridge in just under two miles. 3. Spooner Lake Trail The easy 2.5-mile loop around Spooner Lake is excellent for all skill levels. This alpine lake is surrounded by aspen trees which house varied bird species, so bring your binoculars! Dogs are allowed on a leash, and all-day parking is $10. 4. Kirkwood Ski Resort You’ll need a trail pass, but this South Lake Tahoe resort has various routes from beginner to advanced, with roughly 50 miles of terrain. Nighttime snowshoe treks during the full moon are also available throughout the winter. Kirkwood is located on Highway 88, close to Carson Pass. 5. Camp Richardson Heading north, you can find this well-established and favorite local snowshoeing spot. If you’re up for an adventure, you can trek up to Fallen Leaf Lake. It’s located off Highway 89 and near Fallen Leaf Road. 6. Dry Pond Loop This moderate, 6.5-mile loop near Washoe Valley has impressive views of Carson Valley, Washoe Lake, and the Mt. Rose Wilderness. If you like the sound of rushing water, most of the trail meanders along White’s Creek. This area is dog-friendly and kid-friendly, which makes it a family favorite. 7. Royal Gorge Soda Springs is home to this resort, which is well known for its cross-country skiing trails. Enjoy extensive trails leading deep into the trees with spectacular views. Find Royal Gorge from the Soda Springs exit on West Interstate 80. 8. Ash Canyon Creek Tucked away in the Carson Valley, these trails are filled with mountain bikes in the spring and provide excellent snowshoeing trails in the winter. Find it from Interstate 580 by taking the Highway 395 Business exit to Winnie Lane.

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Injuries happen to everyone. They are caused by participating in sports, recreational activities like hiking, and even by accidentally stepping off a curb wrong. If you experience a sprain or strain, the first few days are often the most painful. Renown Sports Medicine physicians Luis Palacio, MD and Brandon Hockenberry, MD walked us through what to do after an injury.  Listen to Your Body See a medical professional right away if: You know or suspect that a bone is broken You are having difficulties putting full weight on a joint of the leg Pain or swelling is severe There is a sign of an infection, such as redness and warmth in the joint  The First 24-72 Hours Joint sprains tend to swell more than muscle strains. You can use ice as needed for comfort and to relieve any pain, but do not use ice for more than 15-20 minutes at a time. Ice and NSAIDs (such as ibuprofen) can help prevent excessive swelling and mask the pain, but they do not speed recovery. Some research shows that overuse of ice actually delays recovery.    During the first 24-72 hours, your injury will go through an inflammation phase. Inflammation is your body’s natural way to dispose of dead tissue cells, build new healthy structures, and hopefully heal even stronger than before.

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Over the past couple of years, pickleball has become the fastest-growing sport among people of all ages.  It’s a combination of tennis, ping-pong and badminton that originated in 1965. This sport can be played indoors or outdoors on a pickleball court where two players (singles) or four (doubles) hit a perforated hollow plastic ball over a 36-inch-high net using solid-faced paddles. A pickleball court is the same size as a double’s badminton court and measures 20×44 feet.  Pickleball is a fun, low-impact game that keeps people healthy and active. Kaitlyn Jacobson, Physician Assistant at Renown Urgent Care – Ryland, plays pickleball herself and is a big fan of the sport. Here she shares the top five health benefits of playing pickleball.

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Tendonitis occurs when a tendon in your body is inflamed or irritated. This painful condition can impact your day-to-day activities, but can be managed and prevented. Luis Palacio, MD, shared some insights into how to manage tendonitis. Overuse and Repetitive Motion Tendons are complex tissues in our body that connect muscles to bones, allowing us to move. Unfortunately, sometimes these tendons become inflamed, worn down or injured, a condition called tendonitis. Symptoms of tendonitis include pain or dull ache, tenderness and mild swelling at the site. While tendonitis can be caused by a sudden injury, it is more commonly seen in frequent motions, including: Repetitive motions in exercise, work or other physical activities. Awkward positions in a movement, including poor posture. Forced movements that strain your body. Sudden increase in frequency of movement or level of difficulty, including little to no recover time between new activity. Shoes without proper support or hard surfaces, such as concrete floors. Evaluation is Key If you suspect that you have tendonitis and it does not resolve on its own after a few days, you should get it evaluated by a primary care or sports medicine doctor. They can make recommendations to aid your recovery and refer you to the right sub-specialist if needed. With some intentional actions, you can help reduce the risk of tendonitis with the following suggestions: Add variety: Mixing up the type of exercise you do will help prevent repetitive motions that can result in overuse. Stretch and condition: Make sure the keep up with proper stretching and muscle strengthening to support your physical activities. Do it right: Make sure that the way you are completing exercise or work-related physical activities is correct. Seek out a professional for lessons or guidance if you are unsure.

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Concussions are an unfortunate occurrence in youth sports and other physical activities. Learning the signs now will help you respond if you suspect that someone near you has suffered a concussion. A concussion is a mild type of traumatic brain injury (TBI) that can occur after any injury to the head/neck area. It’s important to seek the appropriate level of care if they occur. Brandon Hockenberry, MD with Renown Sports Medicine shares tips on concussion signs to look for and what to do next. Look for these Dangerous Signs First Call 911 or visit an ER right away if you notice one of the following in the person who suffered a blow to the head or body: One pupil is larger than the other Severe or worsening headaches Drowsiness or inability to wake up, including any period of unconsciousness Slurred speech, weakness, numbness or decreased coordination Multiple episodes of vomiting Convulsions, shaking or twitching Monitor for Concussion Signs and Symptoms If someone suffers a bump, blow or other jolt, it’s important to look out for changing symptoms. Symptoms can continue to evolve for up to 24 hours after the injury. Seek care from your primary care provider, an urgent care or a sports medicine provider if you notice any of the following: Cannot recall events prior to or after the incident Appears confused or disoriented Clumsy movements Slow reaction, including movements and speech Changes to normal behavior or mood You should also question the person about how they are feeling. If they report any of the following symptoms, seek care: Headache or feelings of pressure in their head Nausea or vomiting Dizziness or balance issues Problems with eyesight, such as blurriness or double vision Increase sensitivity to light or sound Sluggishness, or feelings described as “hazy” or “foggy” Struggles with remembering or concentration Just “not feeling right”

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Health systems across the country recently celebrated Patient Access Week from April 2-8. Join us in recognizing our Patient Access team at Renown!  Fighting the Good Fight starts the moment a patient steps onto the grounds of our health system. When patients visit Renown on their healthcare journey, they look to the experts to not only help them navigate through the complexities of the process but also ensure their experience with us starts off on the right foot.  Renown Health’s Patient Access Representatives (also referred to as “PARs”) are the faces of this entire process. As the key links between patients, providers and insurers, they strive to create a welcoming and respectful environment for everyone. PARs are committed to providing all of Renown’s patients access to the quality care when needed. After all, it’s in their name!  A Friendly Face  PARs are the front faces of almost all clinical areas at Renown. As the starting point for much of the patient experience, the day-in-the-life of PARs can vary. Checking patients in and out, getting demographic information, verifying insurance, answering phone calls, fostering communication between patients and their care teams, scheduling patients for follow-ups, explaining financial responsibilities and our financial aid programs, creating an overall positive experience and environment, the list goes on – but they all remain united under one goal: setting patients off on the right foot as they access care through our health system.  “Each day, PARs are met with new patients who are seeking solutions to different concerns,” said Macy Betts, PAR for Renown Women’s Health. “We are the front doors to this department. We are not just checking patients in and out; we are the first step to the patients receiving the care they deserve.”  “We take pride in our work,” added Tanya Quintanilla, Shari Longley and Nancy Arroyo Garcia, PARs for Renown Pediatrics. “Usually, we are the first point of contact within Renown, so we don’t take our role lightly. For example, when we see a newborn, we must ensure the registration has been verified, which consists of patient demographics, patient preferences and insurance verification. We need to be consistent and thorough because what we do affects every point of contact a patient may have within Renown.”  “As my team’s senior PAR, my day begins with gathering the outpatient therapy work queue numbers and assigning the team to work them,” added Logan Johnson, Senior PAR in Pre-Registration at Renown. “Our goal is to contact and schedule patients for physical, occupational and/or speech therapy as soon as possible so that they have the maximum benefit and can get back to a normal life as quickly as possible. Our encounters can make or break the entire experience.”  PARs never underestimate the power of good communication and compassion. Even during the busiest of times, our PARs work diligently to ensure all patients and their care teams fully understand the administrative side of whichever part of their journey they are about to embark on, lending a helping hand and a smile.  “Whether you’re communicating with patients, leaders or coworkers, communication is key,” said Jonathan Figueroa, PAR for the Renown Institute for Heart & Vascular Health (IHVH). “We try and make sure that we do everything possible to make their visit go as smoothly as possible.”  “Communication makes the world go round,” added Keith Madrona, Sherry Riley, Erika Rios and Andie Kilpatrick, PARs at Renown Urgent Care – Ryland. “Having a friendly attitude and demeanor is very important.  “The PARs in Labor & Delivery do so much more than just registering patients – from escorting expectant parents to their rooms, welcoming newborn babies, processing pre-estimates and more – and the patience and excellent communication I receive from other teams is what keeps me going,” added Nanci Barash-Vietti, PAR for Renown Labor & Delivery (L&D). “This is critical to the success and effectiveness of the PARs in our department.”  Shift changes for PARs mimic other teams at Renown, leveraging technology and both written and spoken communication to ensure the next shift begins successfully.  "When I come in, the night shift will give me a report on what is going on and what the schedule looks like during the day; then I log in to my computer and get everything that I will need for that day up on the screen,” said Allie Boracchia, PAR for Renown L&D. “Usually around this time we have a 7-8 a.m. induction scheduled for the first patient, so I will grab the pre-made packet that the night shift put together, the unit clerk will call the nurse to get a room number, and I take the patient to the room and have them sign all the forms. After the patient has the baby, then we admit them and finish registration. This is continuous all day long.”  Our PARs all agree that regardless of the setting, whether it be emergent or routine, every patient is looking for that advocate from the moment they enter through our doors.  “Being friendly, patient and understanding is a must,” said Sheryl Lundgren, PAR for the William N. Pennington Institute for Cancer. “It is so nice being able to brighten the days of patients who are living with a cancer diagnosis.”  “In the urgent care setting, a lot of the patients we see are not feeling their best, so it is important that we show them we care and are here to help make check in go smoothly,” added Sam Deithrich, PAR at the Renown Urgent Care – Los Altos.   “Patients are relieved that they are speaking to a real person that will help set up appointments,” added Rick Jordan and Celeste Landry, PARs in Lab Services at Renown South Meadows.   PARs embrace lifelong learning at Renown, especially as their roles differ day-to-day. They are always ready to jump in and assist on tasks that might be new for them, growing their skills on the job and never hesitating to say, “How can I help?”  “As a PAR, you are always learning new things, even when it seems like you know just about everything,” said Liz Cardenas-Ramos, PAR for Renown Endocrinology. “It’s been such a positive experience.”  “Giving yourself grace to learn and grow in Patient Access is the key,” said Maggie Savoie, PAR for Renown Primary Care – Fernley. “I find myself learning every day at Renown, and if you’re learning, you’re growing. Being able to take a breath and say, ‘this is a learning opportunity for me, and tomorrow I will be better a better PAR because I’ve gained this knowledge’ is an amazing way to stay positive in the position.”  “In L&D, we are all multi-tasking, and every day I am learning something new about my department and patients, as well as how to excel in my position,” added Nanci Barash-Vietti.  Renown PARs are the front lines to health care access, and they wear that badge with pride. Jeanette Flores, PAR in the Emergency Department at Renown South Meadows, sums up the role of Patient Access well: “Talk about first impressions!”  “I am proud of our team and the excellent care we give our patients,” said Dawn Linker, PAR for the Renown IHVH. “We want them to have a good experience.”  Impactful Accomplishments  The role of our Patient Access team members goes beyond the desk. A patient’s healthcare journey begins, and sometimes even ends, with the helping hands of our PARs, leaving a lasting positive impression of Renown.  "Our interactions with the patients make a difference before they see the provider, so we always demonstrate a welcoming and helpful atmosphere for the patients to feel like their needs are being met,” said Mary Dettling, PAR for Renown Endocrinology.  “I love seeing the difference we make in peoples’ lives,” added Shannon Leone, PAR for the Stacie Mathewson Behavioral Health & Addiction Institute. “We can get patients at their toughest and worst times. Watching them overcome their fears, traumas and addictions has been very rewarding.”  Our PARs don’t just make goals for themselves – time and time again, they surpass them, all in the name of patient experience and excellence.  “We have not only met our monthly point-of-sale scores, but we also have exceeded our stretch goal for the last eight months and our scores have been in the 50th percentile or higher,” said Jeanette Flores.  “Along with being the top point-of-sale collectors, we have also been known to be some of the sweetest and most helpful staff at South Meadows,” said Katie Morrill, PAR in the Emergency Department at Renown South Meadows.  As their teams grow, so does their impact on our patients. PARs are dedicated to providing the best customer service possible, and with their expanding teams, that service goes even further, even throughout the pandemic.  “A year ago, we only had one PAR; now, we have a full and amazing team,” said Alex Bucholz, PAR for Renown Advanced Wound Care. “We have come so far in a short amount of time.”  "During the pandemic, we have maintained a core group of individuals who come in every day and help keep this office and all its parts moving smoothly,” added Shannon Leone. “We have maintained a full patient load the last three years and never had to close our office for any reason. We have even had the opportunity to start our Medicated Assisted Treatment and Transcranial Magnetic Stimulation programs.”  "We successfully operated and maintained our pediatric COVID clinic, which is the only one within our five clinics,” added Tanya Quintanilla, Shari Longley and Nancy Arroyo Garcia. “We feel proud knowing our tiny humans are protected with the COVID vaccine.”  Like many other teams at Renown, our PARs are masters at teamwork. Despite any obstacles that may happen along the way, they are always there for each other to ensure every patient gets the care and attention they deserve.  “We call ourselves the ‘A-Team’ here in Pulmonary,” said Shannon Birnberg, PAR for Renown Pulmonary & Sleep Medicine. “We have persevered through changes, additions and departures. We are most proud of bringing different personalities to the team and being super strong and effective.”  “I have noticed the team always steps up whenever needed,” added Brittany Hughes, PAR for the Renown IHVH. “Everyone has a great attitude and is very positive!”  “While our team is fairly new, we are growing together, learning our strengths and weaknesses and always pushing for stronger unity,” added Angel Freer, PAR in the Emergency Department at Renown Regional.  When our PARs find ways to simplify a process or make a workflow run more efficiently, they don’t waste any time in making that happen. They take any opportunity to enhance patient experience.  “Our team came up with a solution on how to get patients registered faster,” said Jess Castillo-Marquez, PAR in Lab Services at Renown Regional. “We came up with modalities which assign each PAR their own procedure in which they will be registering for during their scheduled shift. It has been a great success, helping our productivity and keeping our patients satisfied with our service.”  “We are proud of our successful implementation of our new therapy workflow,” added Logan Johnson. “Patients are now waiting much less to be contacted about their care.”  Our PARs know that teamwork makes the dream work, and their commitment to the patients they serve – and the goals they continue to blow out of the water – continue to inspire them daily.   “You are only as strong as your team,” said Aundie Yonker, PAR in the Emergency Department at Renown Regional.

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Senior Care Plus is pleased to announce we are now a proud sponsor of Jam On It Pickleball, open to the community seven days a week at the Reno Sparks Convention Center. We’re excited to help promote this fun activity to our members, employees and the public. Pickleball has many wonderful health benefits – particularly for seniors. It’s a low-impact game that raises the heart rate, improves hand-eye coordination and increases mobility. In addition to the obvious physical benefits, pickleball is a great social activity. Getting out of the house and playing a fun, easy-to-learn game with others is a great way to make new friends while improving your physical and mental health!   Ralph Barbato, a Senior Care Plus member from Reno, is a huge fan of pickleball and all it has to offer. “Pickleball has made such a positive impact on my life. I love the physical and mental health benefits along with the social aspect – it’s a great way to meet new people and I’m excited to have it in our community,” said Ralph.

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While the appearance of a winter wonderland in your yard can be a welcome one, an accompanying aspect is not: the idea of clearing your driveway and sidewalks. The sometimes-daunting task of snow shoveling is a repetitive activity that can cause muscle strain to the lower back and shoulders. However, by following the tips below, you will spend more time appreciating your winter wonderland -- when your sidewalk and driveway are all clear, that is. But, we all know that injuries happen, and if you do find yourself with back pain that does not resolve in a few days, contact your primary healthcare provider, or visit a Renown Urgent Care. Another way to avoid injury during strenuous activity, or help heal an injury that won't go away, is to work with a physical therapist who can offer at-home exercises to keep your body strong. 6 Tips for Safe Snow Shoveling Following these tips from the American Physical Therapy Association can help you avoid injuries: Lift smaller loads of snow, rather than heavy shovelfuls. Be sure to bend your knees and lift with your legs, rather than your back. Use a shovel with a shaft that lets you keep your back straight while lifting. A short shaft will cause you to bend more to lift the load. Using a shovel that’s too long makes the weight at the end heavier. Step in the direction where you are throwing the snow to prevent the low back from twisting to help prevent “next-day back fatigue.”  Avoid excessive twisting because the spine cannot tolerate this motion. Bend your knees and keep your back as straight as possible so that you are lifting with your legs. Take frequent breaks when shoveling. Stand up straight and walk around periodically to extend the lower back. Backward bending exercises while standing will help reverse the excessive forward bending of shoveling. Stand straight and tall, place your hands toward the back of your hips and bend slightly backward for several seconds. When in doubt, ask for help. The Reno community is a generous one and you can typically find snow shovelers for hire on local message boards like Nextdoor and Facebook. Or, if you have a kid in your neighborhood, they might be looking to make some extra money on a snow day.

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Halloween is around the corner. So while you're prepping pumpkins for carving, putting together creative costumes and coordinating trick-or-treating plans, safety is one more detail to remember.   Masks, haunted houses, witches, ghosts and ghouls — it all spells Halloween, and what could be more frighteningly fun, right? For children, however, Halloween can indeed be frightening and not so fun.  According to Dr. Kristina Deeter, Physician-in-Chief of Renown Children’s Hospital and Chair of Pediatrics for the University of Nevada, Reno School of Medicine, it is common for younger children to express Halloween fears — being afraid of monsters, the dark or really anything out of the norm. “It's normal for children to struggle with separating reality from fantasy,” she explains.   For children who fall into this category, the month of October can be traumatizing. Halloween may not come until the end of the month. Still, in the weeks building up to the spookiest night of the year, little ones are bombarded on all sides with decorations — mummies, skeletons, coffins, vampires, you name it. For a child with a blossoming imagination who, as Dr. Deeter said, is still learning to differentiate real from pretend, this can cause additional fears and anxieties. In commemoration of Halloween Safety Month, Dr. Deeter shares safety tips for the spooky holiday from the American Academy of Pediatrics:  Dressing Up & Heading Out  Plan costumes that are bright and reflective. Ensure shoes fit well and that costumes are short enough to prevent tripping, tangling or coming into contact with flames.   Consider adding reflective tape or striping to costumes and trick-or-treat bags and baskets for greater visibility.  Masks can limit or block eyesight. Instead, consider non-toxic makeup and hats, which should fit properly to prevent them from sliding over the eyes. Test makeup ahead of time on a small patch of skin to test for allergies before full application.  When shopping for costumes, wigs and accessories, look for and purchase those with a label clearly indicating they are flame resistant.  If a sword, cane or stick is a part of your child's costume, make sure it is not sharp or long. A child may be easily hurt by these accessories if he stumbles or trips.  Do not use decorative contact lenses without an eye examination and a prescription from an eye care professional. While the packaging on decorative lenses will often make claims such as "one size fits all," or "no need to see an eye specialist," obtaining decorative contact lenses without a prescription is both dangerous and illegal. This can cause pain, inflammation, serious eye disorders and infections, which may lead to permanent vision loss.  Review with children how to call 9-1-1 (or their local emergency number) if they ever have an emergency or become lost.  Carving Pumpkins  Leave the carving to the grownups. Have children draw the pumpkin design with markers, but keep knives away.  Consider using a flashlight or glow stick instead of a candle to light your pumpkin. If you do use a candle, a votive candle is safest.  Candlelit pumpkins should be placed on a sturdy table, away from curtains and other flammable objects, and not on a porch or any path where visitors may pass close by. They should never be left unattended.  Prepping Your Home  Keep your entryway safe for trick-or-treaters by removing all items from the porch or front yard that a child could trip over, like garden hoses, toys, bikes and lawn decorations.  To ensure visibility, check outdoor lights and replace burned-out bulbs.  Sweep leaves (or snow) from sidewalks and steps.  If there are dogs in the home, take steps to ensure they don't jump on trick-or-treaters. Hunting for Treats  Young children should always be accompanied by a parent or responsible adult.   Give each child and adult a flashlight (with fresh batteries).  If older children are heading out to trick-or-treat alone, plan and review a route you can agree on, as well as a specific time they are supposed to return home.   Only visit homes with a lit porch light. Never enter a home or a car for a treat.  Notify law enforcement authorities of any suspicious or unlawful activity immediately.  Since pedestrian injuries are the most common injuries to children on Halloween, remind youngsters to take crosswalk safety precautions.  For more key tips regarding Halloween safety for your young trick-or-treaters, visit our partners at Safe Kids Worldwide for a variety of spooky safety resources.

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With the help of Aaron Bertalmio, MD of Renown Urgent Care, we're sharing nine essential must-have items for your hiking emergency kit. 9 Essential Items For Your Hiking Emergency Kit With more than 300 days of sunshine in Reno-Tahoe and plenty of trails to explore, you'll want to keep these essential items in your kit. 1. Water Surprisingly, this no-brainer, however, is often overlooked. Bring enough water to last for the entire adventure. This amount of water can be heavy depending on the distance, altitude or intensity. With this in mind, the next best bet is to filter or purify water from a lake or stream. Here's how: You can do this with iodine or chlorine dioxide tablets, charcoal or an ultraviolet light wand. Tip: Look for water that is moving or rushing over rocks. Having enough water or filtration cannot be underestimated. "If you become injured and need to wait for help, you can only last about three days without water," Dr. Bertalmio says. 2. Food Meals-Ready-to-Eat (MREs) or dehydrated food pouches are essential, ensuring you have plenty to eat if you're outdoors longer than expected. 3. Maps Bring a printed map, compass or GPS. You can't always rely on your smartphone, so this is the perfect backup plan. 4. First-Aid Supplies Your hiking first-aid kit should change based on the type of hiking. As a basic rule, keep the following items in your pack: Fever/pain reliever Sewing kit with safety pins Tweezers Bandages and moleskin Antibiotic ointment Duct or medical tape Whistle 5. Light Source Wear or pack a small headlamp to illuminate the way if you get caught outside after sunset or in a poorly lit area. Headlamps are also great in emergencies because they are hands-free. 6. Emergency Shelter Even if you're only going out for the day, pack a low-weight emergency blanket for the trip. In other words, if the day trip turns into an overnight adventure, the blanket will keep you warm and alive in the event of cold temperatures. 7. Fire Starter Pack small tools in your hiking emergency kit to ensure an easy fire start. Waterproof matches, a knife, a lighter, or a strike fire starter are great options. Tip: Bring a multi-tool, including a knife and scissors that can be used for first-aid. 8. Layers of Clothing Mother Nature likes to change her mind in northern Nevada, and temperatures vary significantly within 24 hours. Therefore, pack a compact, lightweight waterproof and windproof jacket. This will protect you from being uncomfortably chilly and experiencing hypothermia. "Hypothermia is when your body temperature drops to a dangerously low level. You want to avoid this completely by keeping body temperature regulated outdoors and avoiding cold water immersion," says Dr. Bertalmio. 9. Sun Protection Certainly, sun protection should be part of your daily routine and an essential in your hiking emergency kit. You'll want to bring enough sunblock to reapply in direct sunlight and layers to cover exposed skin every two hours. Dr. Bertalmio reminds everyone the sun is intense in northern Nevada. "The higher altitude means an increased risk of sun-induced skin damage," he explains. "Some trails can reach above 10,000 feet, and at that altitude, UV radiation could be 35 to 45 percent more intense than at sea level."

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Whether it’s cross-country or downhill skiing, snowboarding or snowshoeing, your off-season preparation is vital to an injury-free and healthy experience once the snow starts to fall. We’ve got you covered with expert tips that will make you the king or queen of the hill. Millions of skiers and snowboarders hit the slopes annually. So whether you’re a weekend warrior or stay active year-round, you need to prepare your body for the demands of your favorite winter sport to avoid minor aches, pains or even severe injury. Count on two to three weeks for your body to adapt to the physical challenges ahead if you’re active. Otherwise, give yourself a minimum of six weeks to gear up for the snow. Ready to shred? Here are some conditioning tips to help put you on the path to a fun, successful winter season. 1. Start With Cardio Cardiovascular exercise increases endurance as it conditions the heart, lungs and muscles and provides a solid foundation for other forms of exercise. And when you live and play at altitude, you need even more endurance. “Research shows that our maximum heart rate, cardiac output and ability to exercise are suppressed at altitudes over 5,000 feet,” explains Daniel Staffa, PT, DPT, OCS, of Renown Rehabilitation Hospital. “In the Reno-Tahoe area, altitudes can quickly rise over 8,000 feet when we exercise in the Sierras, so it’s critical to have cardiovascular fitness to avoid associated fatigue and decreased mental alertness on the slopes.” Try this: Pick an aerobic activity you enjoy — speed walking, running, hiking, biking or a cardio machine like the elliptical trainer. Build up to a minimum of 30 minutes, three days a week. 2. Increase Your Strength Your core works overtime to stabilize the body and absorb the shock of pivots and turns and variable snow conditions. Strengthen your core, lower back, hamstrings and calves and you’ll go a long way toward guarding against ligament tears and damage to other joint structures. Stronger muscles will also allow you to relax while maintaining control and making those quick adjustments that uneven terrain demands. Try this: Squats, wall sits and lunges. Work your core and lower and upper extremities with a variation of sit-ups, crunches, back extensions and planks. 3. Integrate Plyometrics Staffa explains that if your legs aren’t used to absorbing the impact of landing, severe injuries can occur. Preempt such trauma with plyometric exercises, or “explosive movements,” that simulate the movements of your favorite sport. You’ll develop greater power in your legs when you combine plyometrics with your strength training. Try this: Incorporate multi-directional drills — such as lateral jumps and forward and backward jumps — on variable surfaces like a trampoline, solid ground, or a box or step. Here’s a challenge for the more advanced: Stand in front of a bench or box (12 inches or so). Jump up and then immediately back down. Do this 10 to 30 seconds at a time, rest and repeat. Or get old school and bust out the jump rope. 4. Improve Your flexibility Flexibility is the ability to move joints through their entire range of motion, from a flexed to an extended position. Being flexible will allow you to pivot, twist and turn and navigate varying snow conditions with ease. You can increase your flexibility while maintaining bone alignment with stretching. Don’t forget to warm up and cool down. Try taking it easy the first 15 minutes of your day on the hill; try starting with a beginner’s run or walk to warm up and prepare your body. Do the same at the end of the day or go for a brisk walk to cool down. Stretching will help return muscles to their normal length. Try this: Dynamic stretches such as leg swings, arm swings and torso twists. Target your quads, hamstrings, calves, and lower back. 5. Fuel for the Hill Staffa suggests loading up on healthy complex carbohydrates the day before you go out and bring along your favorite protein snacks. Assess the slopes before making that first run — is the snow heavy, fresh or wet — and stay mindful of your fatigue level throughout the day. Don’t forget to hydrate and re-hydrate before, during and after exercise. And most important, have fun! Visit Renown Physical Therapy and Rehab for more information. Or call 775-982-5001 to consult with our sports and orthopedic experts who can help you develop an individualized training program in preparation for the winter season, including methods for overcoming previous injuries and limitations.

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It’s true there is no cure for dementia, yet studies suggest your life choices today can reduce brain decline in the future. How important is diet to brain health? Food is the foundation of your body. Fats, carbs and protein provide the energy for your cells and metabolism. So the quality and amount of food you eat directly affects your brain. Specifically, researchers are paying special attention to the link a high sugar diet and/ or an unhealthy fat diet may have on your brain. Your brain on sugar According to the Alzheimer’s Association, when too much sugar is in the bloodstream for long periods of time, it can damage the brain cells. Many people with diabetes may develop brain abnormalities, and these changes may increase chances of dementia — research is still being done to understand this connection. Many U.S. adults have prediabetes with blood sugar higher than normal. Insulin resistance often leads to diabetes. Insulin resistance has been linked to metabolic syndrome, which is a precursor for cardiovascular and cerebrovascular disease (heart attack, stroke). Some signs of metabolic syndrome include: Large waist size (40 inches or more for men, 35 inches and up for women) Low HDL (good) cholesterol level Higher than normal blood pressure — 130/85 and above Current research suggests too much sugar in the blood causes inflammation, which can damage brain cells. High carbohydrate foods, such as sweetened beverages, chips, white rice, white potatoes, bagels, cereals and desserts, have been shown to raise blood sugar. Although anyone can get diabetes, Hispanic Americans and African Americans are at greater risk.

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