6 Tips for Reversing Your Shoulder Pain

December 31, 2017/in Pain Management, Shoulder and Elbow /by Christopher Holman

Shoulder pain—for many of us it’s just a fact of life. But when it’s keeping you from enjoying your daily activities, it may be time to try some useful remedies.

Try out some of these options for reversing shoulder pain.

Stretch

If you have soreness in your shoulder that you suspect was brought on from exercise or physical activity, an inflammation or swelling may have occurred. One way to reduce mild, exercise-related shoulder pain is through stretches. These may include chest expansions by meeting your hands behind your back or across-the-chest stretches, bringing your arm across your chest and pulling your elbow toward it with your spare hand. These are exercises that should be recommended by someone who specializes in functional assessment, such as a physical therapist or athletic trainer.

Sleep Differently

One common cause of shoulder pain, particularly when it’s experienced first thing in the morning, is sleeping habits. A potential way to reduce this pain is to try out a new sleeping position. If you favor one side over the other, it might be an indication of where your pain is coming from. Use pillows or remove pillows to determine the best amount of cushion to avoid pain if you favor sleeping on your back or stomach. According to our experts, it’s best to sleep on your back with your hands below chest height. AVOID SLEEPING ON YOUR STOMACH. This can cause even more shoulder pain when you wake up.

Diversify Your Exercises

Another frequent reason for shoulder pain is found in athletes or otherwise physically fit people—especially when they tend to exercise or engage in sports with highly repetitive shoulder movements. The best way to combat this is to keep your regimen diverse. Select a variety of exercises that don’t put undue strain on your shoulders as compared to the workout your other joints are receiving.

Try Massage

Massage therapy can very often be beneficial for shoulder pain, because it can release muscle tension and increase range of motion in the joint – which in turn can improve function and help reduce pain. Best of all, you can give yourself a neck and shoulder massage almost anywhere and at anytime for temporary relief. If you still feel stiff and sore, talk to your doctor about other therapy options.

Apply Heat or Cold

Just like when you’re nursing an injury, applying heat or cold can go a long way toward reversing your shoulder pain. Use heat to soothe stiff joints and relax muscles after a strain or when recovering from an injury. Ice packs are typically used to numb sharp pain and reduce inflammation immediately following an injury. Whichever option you need, remember to protect your skin – and only apply the hot or cold therapy as directed.

Obtain Physical Therapy

There’s perhaps no better way to reverse your shoulder pain, particularly when it’s ongoing or chronic, than being seen by a physical therapist or orthopedic physician. It’s the best way to determine if your condition is diagnosable and how best to treat it. Contacting Orthopedic Institute for an appointment is a good place to start.

4 Everyday Tips for Fighting Off Foot & Ankle Pain

December 29, 2017/in Foot and Ankle, Pain Management, Physical Therapy /by Christopher Holman

Are your “dogs” barking? You’re not alone! Every day, we take thousands of steps. So it’s no surprise that foot and ankle pain can occasionally be part of our days, too – especially as we age. See your doctor for serious pain that interferes with daily life. But when it comes to occasional foot pain or discomfort, there are a few simple steps you can take for quick relief.

Here are 4 tips to give foot and ankle pain the boot.

1. Wear the Right Shoes

One of the best things you can do to relieve foot and ankle pain today – and prevent it from happening tomorrow – is to wear properly fitted, well-cushioned shoes. Have your feet measured at a shoe store at least once a year to make sure you’re wearing the correct size and width, and replace older shoes that no longer fit. This doesn’t mean you can’t be stylish, it just means you need to know what to look for when buying new footwear.

2. Support Your Arches

Arch support isn’t just for people with flat feet – it’s important for all of us! If you’ve been experiencing foot and ankle pain, especially from wearing flat-soled shoes, try adding Powerstep inserts to your shoes. Our pedorthist, Reid Herrboldt, swears by them. They can be tough to find, but good news … we carry multiple sizes! Stop by OI to pick up a pair. Or better yet, make an appointment with Reid for a professional fitting. Your legs and feet will feel better, because proper arch support helps reduce weakness and soreness all day long.

3. Stretch Often

Muscles can become stiff and painful whether you’re standing and walking all day, or simply sitting at a desk or table. Every hour or so, remind yourself to stretch, relax and lengthen the muscles in your feet and ankles. Start by pointing your toes down to stretch the top of the foot and ankle. Then, roll your feet in circles (clockwise and counter-clockwise) to loosen up your ankle. Finally, point your toes straight up to stretch the back of your calf. Our physicians and therapists like these six stretches from Prevention Magazine.

4. Baby Your Feet

You can help your feet recover from carrying you around all day with simple foot care techniques. Do the bottoms of your feet hurt? Try rolling them from heel to toe over a frozen water bottle, tennis ball or baseball. The gentle massage stretches muscles and helps your feet recover from the day. Pain on the top of your foot can be an indication of arthritis. Most people with plantar fascitis have very tight calf muscles. You can use the six stretches noted above for relief.

If your foot and ankle pain persists, it’s time to see a specialist at Orthopedic Institute.

5 Key Symptoms of a Neck Injury

December 7, 2017/in Fractures and Trauma, Neck and Spine /by Christopher Holman

Neck pain is a common problem that about two-thirds of the population experience at some point. After all, your cervical spine and supporting muscles and ligaments support a head that weighs approximately 15 pounds. Due to the flexible but complex structure of your neck, it’s quite vulnerable to injury, both serious and minor. Tracking down the source of neck pain and whether injury is present, though, can be difficult.

To help you out, here are several symptoms that can stem from a neck injury.

General Stiffness

Stiffness is a symptom of many neck injuries. Whether it’s whiplash or a minor strain, your neck may experience some level of stiffness. This symptom alone, though, isn’t reason to worry about neck injury. The remedy could be as simple as icing your neck or doing some stretches. You might also be experiencing symptoms of arthritis.

To help ease neck stiffness, try doing 10-15 reps of these stretches:

Tilting your head to each shoulder
Rolling your shoulders backward
Pressing your shoulder blades together

Want more at-home pain relief ideas? Download our free book: Home Remedies for Back and Neck Pain.

Decreased Range of Motion

Neck injuries can also result in less range of motion – which is often related to general stiffness symptoms above.

If you can’t quite tilt your head all the way in a certain direction—as much as you could before the pain began—you’ve lost range of motion. This can occur after strains and sprains but isn’t cause for alarm if the symptom recedes after a few days. If your range of motion doesn’t return after weeks or you can’t move your head at all, then it’s time to consider a visit to the doctor’s office.

Headaches and Dizziness

When your head is abruptly snapped backward and/or forward with quick force, it can cause what’s known as whiplash. When you experience whiplash, muscles and ligaments stretch beyond their typical ranges of motion. In technical terms, you experience a hyperextension when your neck extends backward beyond its normal limits and hyperflexion when it does so in a forward motion.

Whiplash can result in headaches at the base of the skull, dizziness and blurred vision. Aching and stiffness can also occur. It’s not unusual for symptoms to disappear and then reappear within a few days of the injury.

Sprains and Strains

A sudden jolt to your neck from a hard fall or serious collision, such as a car accident, can result in stretched ligaments and muscles in your neck. Any pain in the back of the neck that worsens with movement or muscle spasms near the upper shoulder can be indicators of a neck sprain or strain, especially if it peaks about a day after the injury occurred. A headache toward the back of the head and decreased range of motion are also signs of a neck sprain or strain.

Tingling and Numbness

One of the more concerning possible symptoms of neck injuries is tingling and numbness in limbs. If you start to feel a numbing sensation or that “pins and needles” feeling in your arms or legs after a neck injury, then it’s best to consult a doctor. Most neck injuries have the potential to produce this symptom but typically only in more severe instances. Usually these symptoms will resolve with non-surgical treatments.

Sources: OrthoInfo, Healthline, Spine Universe

4 Ways a Certified Hand Therapist Can Benefit Your Life

4 Ways a Hand Therapist Can Benefit Your Life

November 20, 2017/in Hand and Wrist, Pain Management /by Christopher Holman

A crucial part of recovery from a physical ailment lies in occupational therapy. Thankfully, highly specialized therapists exist to guide people through the treatment and recovery process. One such expert is a hand therapist, whose specialty is worth exploring.

A certified hand therapist can use his or her practice to bring the many benefits of occupational therapy to your life.

How They Treat

Certified hand therapists have no shortage of expertise—to achieve their certification they must have worked in the field for a minimum of five years, had 4,000 + hours in the area of practice and passed a difficult exam that traditionally has only a 40 percent pass rate. Across the globe, there are only 5,300 certified hand therapists—and two of those are in Sioux Falls at Orthopedic Institute (OI). Hand therapists work alongside occupational therapists, physical therapists and orthopedic surgeons to help bring new vigor not only to hands but also wrists, elbows and shoulders affected by any of the following:

Rheumatoid and osteo arthritis
Congenital deformities
Traumatic amputations or injuries
Wounds and infections
Joint replacement
Carpal tunnel syndrome
Stroke-related contractures
Postoperative rehabilitation
Chronic pain/ Work-related injuries

Restored Function

One of the most satisfying parts of hand therapy is the feeling of restored function. The whole arm is vital to pivotal tasks. Experiencing pain or loss of function would be hard on anyone. Many of the listed conditions take a toll on people in one way or another. More often than not, conditions such as arthritis diminish the enjoyment people receive from beloved hobbies or fulfilling jobs. Due to the complex nature of the hand, they can require surgery and weeks to months of therapy, but the end result can greatly impact a person’s life for the better.

Renewed Confidence

With restored function also comes renewed confidence. When people lose the ability to partake in the hobbies they love or experience pain performing basic tasks, it increases feelings of vulnerability and dependence on others. When a hand therapist expertly walks people through the process of restoring function to their hands and upper limbs, it also gives them back the strength to live as they did before the onset of a painful injury or condition.

Gained Knowledge

Getting through the rehabilitation process with a therapist is learning experience for both parties. As the therapist comes to understand the patient, the patient also learns about his or her injury and the healing process. This experience helps patients understand the importance of hand therapy and the effort needed by everyone involved. Learning about the injury, how it affects the body and what has to happen for healing to occur will better prepare people for the process, should another injury arise.

Reduced Stress

Pain in your shoulders, wrists, elbows and hands doesn’t just cause inconvenience, but it can also lead to stress, decreased coping abilities, and trouble sleeping. A hand therapist understands this as much as any other occupational therapist and will carefully work with you to relieve pain and/or assist with appropriate modification techniques. Once the building blocks of hand therapy and healing are underway, the ability to function should significantly improve.

4 Surefire Signs of a Top-Notch Carpal Tunnel Surgeon

November 17, 2017/in Hand and Wrist /by Christopher Holman

If you’ve been diagnosed with carpal tunnel syndrome, you know all about pain, numbness, and tingling in your hand and arm. It’s a common condition that occurs when one of the major nerves to the hand from your wrist becomes squeezed or compressed, and it can get worse over time. Surgery may be recommended to relieve the pressure on the nerve.

That’s when you’ll need to know these 4 Surefire Signs of a Top-Notch Carpal Tunnel Surgeon.

1. They’re a board-certified specialist.

When it comes to your hands, not just any doctor will do. A top-notch carpal surgeon should be board-certified in orthopedic surgery AND specialize in hand surgery. The more experience a doctor has with carpal tunnel surgery , the better your results are likely to be. At Orthopedic Institute, our board-certified hand specialists are Dr. Blake Curd and Dr. David Jones.

2. They won’t recommend surgery first.

Carpal tunnel syndrome can often be treated without surgery – through the use of braces, corticosteroids and changes to your daily routine. If you’ve been experiencing symptoms for a long period of time with no relief, or if your symptoms have begun dramatically interfering with your daily life, surgery may be right for you. The important thing is to arrive at that decision WITH your doctor during the course of treatment. If they recommend surgery the first time they meet you, it’s time to look for a second opinion.

3. They have excellent satisfaction ratings.

Do your homework! A quick search of any potential surgeon’s name online can give you a wealth of information – including whether or not they are in good standing with state and federal agencies, or have a history of malpractice claims. We’re proud of how the Orthopedic Institute team rates on Healthgrades.com.

4. They take time to talk with you.

Once you’ve narrowed down your list based on certification, experience and track record – it’s time to consider one final criteria: communication. Will your surgeon take the time to sit down with you, explain his or her process and what you can expect? Or will you only be meeting with them on the day of your surgery? (Hint: don’t settle for that last one.) Ask for a consultation appointment where you can meet and interview your surgeon.

Ready to take the next step? Make an appointment today or visit one of our walk-in clinics.

5 Key Symptoms of Knee Injuries

October 4, 2017/in Knee /by Christopher Holman

Your knees help you get from place to place. They help you stay active, and they help you perform daily activities at home and at work. But when unusual symptoms set in, which are serious and which are worth ignoring?

Here are five key symptoms of knee conditions that are worth keeping tabs on.

Pain When Moving

Pain—it’s an obvious warning sign that something is going on with your knees. But the specific location of the pain and when it occurs (i.e., when moving or when sitting) can help determine the underlying problem. Tendinitis, for example, is a condition where pain is caused by kneecap-to-shin tendon irritation and the onset can sometimes be slow—especially when moving or exercising. Ice is a good first course of action in this case (when there’s not an explainable incident to link the pain to), after which an orthopedic doctor should be called if pain persists.

Popping

Experience an audible “pop” or even the feeling of popping when moving your knee joint? If you’re particularly active in health and fitness you may have experienced a knee injury—namely, an ACL injury, which is a particularly common ailment for athletes. If the popping is accompanied by pain, swelling or inability to fully utilize your knee, it’s a good idea to get yourself seen by an orthopedic physician.

Heat

Is your knee emanating an unexplained warmth? Heat at the joint site—especially when caused by a fall or tumble—can be a sign of an orthopedic condition, such as bursitis. This type of ailment can lead to infection, so if the heat is accompanied by fever, swelling or unusual sensitivity, you should plan on setting an appointment to be seen by a knee or joint specialist.

Bruising

Have you had a recent impact to your knee that you may have simply ignored? If you begin to see bruising in the area, it might be more worth investigating than you might immediately suspect. Bruising from a collision or fall, particularly when it’s accompanied by difficulty walking or bending the knee joint, can be attributed to a fracture of your kneecap. Make sure to schedule a physical examination if the bruising and pain is persistent.

Locking

The feeling that your knee is locked in place—whether it’s in a bent or unbent position—can be a symptom of a variety of orthopedic conditions. One such ailment is a torn meniscus, something most commonly found in athletes who participate in physically aggressive sports and in seniors, whose knee joints have begun deteriorate with age. A locked knee is something that should be checked out by an orthopedic specialist who can determine if physical therapy or surgical treatment is necessary.

How to Detect Spinal Conditions in Your Children

September 28, 2017/in Neck and Spine /by Christopher Holman

While there’s no exact science when it comes to parental detection of spinal conditions in your children, there are some early warning signs that you can look out for. In fact, the earlier you notice changes in your child’s back, posture or gait, the easier it is to treat, oftentimes.

Here are four ways in which spinal conditions can be detected in your children.

Flexibility

It’s the classic test you likely experienced yourself at some point in school or at home—a test of your ability to bend is a great way to determine early symptoms of conditions such as scoliosis. Traditionally, this test entails standing with arms forward and hands together, bending at the waist and toe-touching. A parent or physician or nurse can then do a check to see if anything feels uneven or asymmetrical. This is a good starter test that can be performed at home to potentially detect early signals of a spinal condition.

Posture

Noticeable changes in posture can also be an early sign parents should take note of in their children. While not always indicative of a spinal condition, it can be a symptom that should be looked into by a physician or nurse. If hip or shoulder placement seems uneven, your child begins to experience a marked slouch or he or she encounters shoulder, waist or hip asymmetry, it might require an orthopedic appointment confirm the cause.

Physical Symptoms

Certain types of spinal conditions carry symptoms beyond back asymmetry. In fact, young children may experience fatigue, shooting pains, feverish conditions or trouble with walking. Pain-related sleepless nights in children younger than six can be a sign it’s time to set up an appointment. (Some degree of back pain is more common in very active teenage children—but ongoing symptoms, such as weakness or increased pain, are also a sign it’s time to take your adolescent into an orthopedic clinic.)

Lab Testing

Some of the recommended clinical tests that may be ordered for your child to detect spinal conditions could include scanning and X-rays, which can pinpoint fractures, nerve damage or more chronic conditions, and blood tests, which can help to find inflammations and infections. Labs are most widely used to assess for infection and vitamin D deficiency—another potential cause of joint or muscle pain. These tests can help to rule out or identify conditions and assist your doctor in determining a treatment plan.

Ready to see our new spinal physician Dr. Wingate?

Orthopedic Spine Conditions You Should Know About

September 26, 2017/in Neck and Spine, Physical Therapy /by Christopher Holman

Back pain can be caused by a variety of conditions—while osteoporosis and arthritis are traditionally orthopedic conditions that you hear a lot about, there are other potential causes of your pain of which you should be aware.

Here are four potential orthopedic conditions that you should know about.

Sciatica

You’ve probably heard someone say something along the lines of “my sciatica is acting up” at one point or another—but what does this condition actually entail? First of all, sciatica is more of a symptom than it is an out-and-out condition. It’s often a sign of other conditions, such as the ones below. It will typically involve a consistent pain, usually at its worst when a person is sitting, in the leg and rear. That achiness or feeling of weakness can make rising from a seated position uncomfortable. Pain emanating through the sciatic nerve can cause pain from the lower back all the way down one side of your lower body to your feet.

Bonus Fact: While it’s more common among middle-aged individuals, younger people aren’t immune sciatic pain—people as young as their 20s can experience this type of nerve pain. It affects nearly half of the population at some point in their lives, according to the New England Journal of Medicine. In young people, sciatica is most commonly caused by disc herniation.

Degenerative Disc Disease

The style of the condition can vary, but generally speaking, degenerative disc disease (or “DDD”) is caused by inflammation of an aging or “degenerating” disc in the spine. Perhaps the most painful symptom of the condition is the reflex spasm that often occurs when your body is attempting to stabilize its inflamed spine. While it may not always be clear that DDD is evident right away, back or neck pain that can last several days or that becomes ongoing can be an early warning sign. Bending over and picking up objects can also spur the related pain.

Bonus Fact: This condition primarily affects people as they age (hence, “degenerative”)—according to the Chicago Institute of Neurosurgery and Neuroresearch, by 50 years old, more than 80 percent of people will start to experience DDD. (But not all will have symptoms at first or at all.)

SI Joint Dysfunction

The sacroiliac joint, or “SI joint,” is situated at the base of your lumbar—essentially in the vicinity of your tailbone. It connects your spine to your pelvis. When this joint is irritated or inflamed, it can cause pain in your lumbar and one or both of your legs. Dysfunction can set it in from several causes, but two common ones are overdoing lower back movement or lack of activity in your SI joint. Injections are often considered a good way to determine an SI joint dysfunction is present.

Bonus Fact: While SI joint dysfunction can affect anyone, it’s most common in younger to middle-aged females. This is due to pelvic size and hormonal differences between men and women and can be a condition spurred during pregnancy.

Spondylolisthesis

When young adults experience lumbar and/or leg pain, one common cause is a slippage of spinal vertebra, causing it to become uneven with the vertebra below it. This is called spondylolisthesis—it’s a condition that can have similar symptoms to other orthopedic conditions but is typically caused by an impact or injury—or spondylolysis. This type of injury can also be quite common among particularly active teenagers—especially student athletes.

Bonus Fact: According to the American Journal of Sports Medicine, spondylolysis injuries appear to be most common in athletes with lower-back-heavy movement, such as winter sports, rowing and boxing.

Physical Therapy in South Dakota: Meet Megan Cook

August 21, 2017/in Physical Therapy /by Christopher Holman

We take pride in our team of physical therapists at Orthopedic Institute (OI). This talented group of individuals can be a key asset when dealing with pain or other orthopedic conditions.

Our featured team member this time around is Megan Cook. Megan graduated from the University of Sioux Falls and earned her doctorate in physical therapy from Creighton University. She primarily specializes in outpatient rehabilitation and aquatic therapy.

Keep reading to find out more about some of Megan’s most unique experiences since joining the team, as well as what she prides herself on in her care.

How did you decide to become a PT?

I was involved in sports throughout my childhood and was interested in the field of athletic training. My senior year of high school, I tore my ACL and meniscus playing volleyball and had to undergo surgery and extensive therapy. My own rehabilitation process opened my eyes to the career of physical therapy.

What led you to join the OI team?

I spent five months with the OI sports medicine team while I was recovering from my own surgery, and they were very knowledgeable and kind. My own success story as a patient led me to believe in the work that OI is doing. After physical therapy school at Creighton University, I moved to Scottsdale, Ariz., to begin my career. When I became engaged to my husband and moved back to the Sioux Falls area, I knew that OI was the place I wanted to work.

Describe a unique experience you’ve had working as a PT for OI.

I had the opportunity to work with the cast of the Broadway musical Matilda while they were in Sioux Falls performing at the Washington Pavilion. I was unsure of what to expect but was told that the cast members have an extremely demanding athletic component to their shows, so they often are susceptible to injury while traveling around the country. I stepped in as their “PT for the day” and treated multiple cast members in a fast-paced backstage setting, providing massage, stretching, corrective exercises and manual techniques according to their specific needs. It was fun to get to know the cast members and to be able to help them while they are away from their primary providers.

What is your favorite part of your job?

The best part of my job is forming relationships with patients and empowering them to be active in their pursuits of independence. I love it when patients stop back to report to me how well they are doing months or years after completing physical therapy.

What are the strengths of OI’s PT team?

There is a camaraderie that allows us to ask questions of each other and collectively seek answers that will benefit our patients. The staff has extensive knowledge and many years of combined experience, which makes it a great environment for learning new things on the job every day.

What is the best part about working with patients?

I love meeting a variety of personalities and seeing the hope in their eyes when they realize that “PT” doesn’t always consist of “pain and torture.”

If you could tell every patient one thing before they came in, what would it be?

Speak up, and be honest with us about your symptoms and your personal needs. If you do not like the “idea” of therapy, just come in and give us a chance. We are able to tailor a PT program specifically for your goals—you don’t have to be an athlete to participate in a PT program.

What is your career highlight?

I have had many patient-oriented highlights in my career, including seeing wheelchair-bound patients walk again and meeting patients who become life-long friends. Another highlight was helping to open OI’s first-ever outreach PT clinic located at GreatLIFE Woodlake Athletic Club. It has been a great two years of working alongside the GreatLIFE staff and offering excellent PT services, including aquatic therapy, on the southwest side of Sioux Falls.

How do you spend your time when you’re not at OI?

I can’t wait to get home to my two little girls every night. They are five and three years old, and I am constantly chasing them around the neighborhood. Time with my family and husband is important to me. If I get “spare time,” I like to run and play tennis and golf.

Get to know more about the PT team at OI here.

5 Pieces of Student Athlete Protective Gear for Outdoor Sports

August 18, 2017/in Sports Medicine /by Christopher Holman

The fall is just around the corner—the student athletes in your family might already have started practices to prep for the upcoming season. But when it comes to staying safe in outdoor practices and games, there are several ways you can outfit your athlete with the right protection.

Here are five pieces of protective gear you should keep in mind.

Eyewear

Athletic glasses aren’t merely for those students who wear contact lenses or traditional glasses in their daily lives—eye protection is a great option for vision safety in general. Ensure you’re using certified sports protective eyewear that meets the standards and rules of the sport in question. Not all sports eyewear is prescribed—you can wear this type of protection to prevent injury or impact and to block out over-exposure to UV rays.

Mouthguards

Their requirement in organized sports varies, but any contact-sport athletes should at least consider a mouthguard, whether it’s mandated or not. This level of protection can reduce your risk of tooth chips or breaks, and even cuts on the inside of your mouth. Just make sure that it’s been properly fitted to your jaw—have it fitted by a sports medicine professional for best results.

Properly-Fitted Helmet

Many sports, particularly high-impact ones, require use of a helmet for all or part of game time. But if your student athlete’s helmet isn’t properly fitted, it can’t truly do its job to the best of its potential. Make sure the pads inside the helmet, the chin strap and the face mask meet standards set by your state’s athletic board. As far as fit goes, a good rule of thumb is that it should fit relatively snugly without use of the chin strap. Make sure to check for a NOCSAE (National Operating Committee on Standards for Athletic Equipment) sticker—it’s the organization that regulates the safety of helmets.

Padding

Depending on the sport, joint protection could be critical for you student athlete. This may include the standard elbow and knee pads for resisting injury from tumbles and contact with competitors. Hip and tail pads are required for high-contact sports such as football or hockey and can provide protection from contusions.

Sun Protection

Depending on the time of year, one piece of protective gear that may be easy to count out are those that screen out sun exposure. Whether it’s visors or billed hats to keep sun out of eyes in outdoor events or proper application of sunblock, student athletes spend a great deal of time in direct sunlight in practices, games and meets. Reduce the risk of skin cancer and other related complications by planning ahead.