Skip to content

The Importance of Good Posture!


For the past couple of week, my 24-year-old daughter, Mariella, has been complaining of some intense pain in her shoulders and back. After discussions with me (perks of a Doc-Mom) and a visit to her sports-specialist chiropractor, it became clear that Mariella’s issues were stemming from her rather poor posture. In addition to working long hours hunched over her laptop, Mariella is a professional drummer, and was taught to balance her center of gravity on her drum kit by hovering slightly forward over the instrument. It was quite a surprise for my daughter to learn that her issues were due to poor posture – and it made me consider that perhaps others could benefit from the advice Mariella has been receiving on how to improve the alignment of her spine.


Over time, our daily habits in our careers and our personal lives affect how we carry our bodies throughout the day. 80 percent of American’s experience back pain at some point in their lives, and nearly 90 percent of the population hunch their shoulders! We can attribute much of our daily backaches and pains to poor posture and weak muscles. Correcting these issues is vital to a healthy spine and a happy-looking body. Fortunately, there are many simple steps that one can take to improve posture and prevent future back problems. If this subject is new to you, I encourage you to examine the diagrams I have provided below and learn the importance of  STRAIGHTENING OUT!


Why Is It Important To Have Good Posture?

– Good posture improves muscle tone and back strength.

– A straight spine eases the task of breathing and increases blood flow in the body. 

– Poor posture is the major contributor to Dowager’s Hump, a common issue in the elderly wherein the spine is visibly hunched (not just osteoporosis!).

– Having a properly aligned spine significantly decreases your risk for back injuryand back pain.

– Sitting up straight improves our appearance! Nobody likes “a slouch!”


Are these reasons enough for you to get yourself “in-line”? If so, begin by taking a look at the article from The Huffington Post  which outlines 10 different, highly common scenarios in our daily lives that cause and exacerbate poor posture. You’ll be surprised to find that things like sitting on our wallets or washing dishes can seriously mess with our spines!!! Developing an awareness of one’s posture and the habits which worsen it is the first and most important step to improving our alignment.

Simple adjustments to our daily physical activities can make a huge difference in our posture. However, it is also important to strengthen the muscles responsible for holding us upright. To begin toning up these muscles, check out this simple FitnessBlender exercise video my daughter Mariella passed along to me for use in today’s blog. After just 2 weeks of performing the exercises outlined in the video and maintaining an awareness of her posture, Mariella’s back pain has significantly subsided. Not only is this video appropriate for all ages and equipment-free, it also provides great insight into the importance of good posture and requires no prior experience! (Don’t do any exercise that hurts, and always ask your personal physician if you have questions about any new exercise regimen.)

So check this information out and report back to me with your progress! Have a fabulous weekend!

Dr. Emily Nolfo





Resist The Resistance: How to Combat the Global Antibiotic Crisis

Image Courtesy of The Economist – “The Spread of Superbugs”

“The growth of antibiotic-resistant pathogens means that in ever more cases, standard treatments no longer work, infections are harder or impossible to control, the risk of spreading infections to others is increased, and illnesses and hospital stays are prolonged.”


Antibiotic resistance is one of the most significant public health crises this planet faces today. Every year, the human species grows increasingly resistant to antibiotic treatment, largely due to the overuse or improper application of these medications. As a primary care doctor, I am frequently asked to prescribe antibiotics for illnesses that are not caused by bacterial pathogens.

The implications of this kind of abuse of antibiotics are so extreme that recently the CDC created its own FAQ homepage dedicated to informing and educating the public on antibiotic resistance, calling this issue “one of the world’s most pressing public health problems.”

So today I would like address some of the issues surrounding antibiotics and antibiotic resistance and also explain how you, as a savvy patient, can naturally boost your body’s immunity to bacterial infections so you’ll have less need for antibiotics.

Q: What is antibiotic resistance and how can it happen to me? 

A: Antibiotic resistance occurs when harmful bacteria and other microbes learn how to work around or sabotage antibiotic medications  used by doctors, veterinarians and agricultural producers to kill them off (examples: Amoxicillin, Cipro and Zithromax). Bacteria are clever and can “learn”: the more often and longer harmful bacteria “see” antibiotics, the better chance they have to transform themselves in ways that they become resistant. This is happening more and more, principally from the improper use of such medications.

Antibiotics are ineffective in treating illnesses caused by viruses such as the common cold, the flu, and actually the majority of common coughs and other common illnesses like sore throats. Yet because members of the general public do not understand this fundamental difference, these antibiotic drugs are often prescribed for problems not associated with bacterial infections – causing long-term resistance to treatment on part of the bad bacteria while the good bacteria in our bodies gets killed off unnecessarily. (In future blogs we’ll talk more about the importance of “good” bacteria in our guts.)

Q: Why should I care about antibiotic resistance? 

A: Progressive resistance by bacteria to treatment with antibiotics is a major public health crisis happening RIGHT NOW! Scientists find that most bacteria  have become resistant to antibiotic treatment due to non-discretionary use of such treatments. Over time, this has made it increasingly more difficult to properly treat serious illnesses caused by bacteria. While this is most devastating to weak or immune-compromised individuals, everybody’s health is at risk due to this resistance, so more discretion needs to be used to avoid escalation of this public health problem.

Q: How might I be inadvertently causing resistance in my body?

A: One common dangerous mistake is when you only take part of a prescription of antibiotics you DO need before your infection is fully treated. You’ll kill the susceptible bacteria, and the resistant ones left behind will grow wild. Always complete the course of treatment.

Side effects?  Call your doc, don’t just stop early!

Q: How can I naturally boost my immunity to bacterial infections? 

A: It’s easy! You can start with these simple steps:

1) Try taking an over-the-counter probiotic supplement once per day. “VSL3” is one probiotic that I particularly like, however there is a wide variety of probiotic products available at grocery stores and pharmacies which will all be helpful in aiding your immune system.

2) Taking 10 mgs of a zinc supplement daily has also been shown to be quite useful in preparing your body for a bacterial attack – it has beneficial effects on our immune cells, particularly CD3 and CD4 cells which help our bodies fight off infections. (Disclaimer: DO NOT TAKE ZINC IF YOU HAVE KIDNEY PROBLEMS!) If you prefer to get your nutrients from foods, here is a list of high-zinc foods:

3) Take 100-200 mg of Ginseng per day. Ginseng has been used for thousands of years in traditional Chinese medicine for effective immune enhancement and is another fabulous (and natural!) way to limit your need for antibiotic treatment.

4) WASH YOUR HANDS! Only plain soap and warm water are necessary. Wash your hands thoroughly for 30 seconds in the sink after potentially coming in contact with bacteria. Anti-bacterial soap is not required to make this effective, in fact the FDA has recently warned that these soaps may be posing an additional problem for bacterial resistance to antibiotics.

5) Most importantly: Talk to your primary care doctor when you are sick and work with her/him cooperatively on the best treatment. Many illnesses can be treated without antibiotic medications – and these drugs should not be used thinking they are a “fool-proof” method for becoming well every time you’re feeling under the weather.

Stay well and here’s to hoping you’ve learned something new!

Dr. Nolfo

Making 60 The New 40!


As an internist (A.K.A. adult medicine doctor, primary care provider), one of the best things about my job is variety. My youngest patient is 17; my oldest patient recently passed away peacefully at 104 and 4 months!

Two weeks ago I wrote here about helping my younger patients develop great health habits. Today, I want to focus on my patients over 35. (To my 35 and unders who are reading: share this with the ‘rents!)

I believe strongly that it’s never too late to make healthy life changes. NEVER! Using myself as an example, I was starting to get the creaks and groans of arthritis in the morning. Hours on the computer at the office were causing my shoulders to hunch forward, and I was starting to notice that I wasn’t as strong as I used to be, which is a sign of the natural loss of muscle mass that is especially bad for women as they age.

So my husband must have thought he wants me to hang around a while, because for Christmas 2013 he signed me up for some sessions with a personal trainer. THIS HAS BEEN LIFE-TRANSFORMING FOR ME! My trainer is Steve Cioppa*. Today we are going to hear from Steve in an interview with him I conducted earlier this week. But first……


While I’m well aware that all of your medical specialist should be board certified, I did not know how important a personal trainer’s certification is! Some trainers have literally only a few hours of training and do not know the physiology of the human body well enough not to seriously hurt you! 

So now that we’ve spilled some knowledge on ya about this topic , let’s spill a little more with an expert in the field!

:::: Check out this interview with CT Personal Trainer Steve Cioppa :::


Dr. Nolfo: Thanks for sitting down with me today Steve. Can you tell our readers what it means to be a certified personal trainer and why it’s so important for your clients?

Steve Cioppa: Your trainer should be certified by a nationally recognized organization such as NATIONAL STRENGTH AND CONDITIONING ASSOCIATION (NSCA) , THE AMERICAN COLLEGE OF SPORTS MEDICINE (ACSM) , THE AMERICAN COUNCIL ON EXERCISE (ACE) or THE NATIONAL ACADEMY OF SPORTS MEDICINE (NASM). A certified trainer will have rigorous training and also ongoing requirements for continuing education to maintain certification. There are many additional specialized certifications trainers can get on top of this  for example, I am certified to train with TRX  but they need the solid background.

Dr. Nolfo: Steve, what should the trainer do for you?

Steve Cioppa: As you get older, the focus should be on functional strength and fitness. Not only should your trainer be able to help you make your daily life tasks easier, you should be able to advance far beyond that and increase your ability to garden longer, shovel snow easier or improve in any sport you play. One of my 60+ year old clients was upset with me because he had to change all the clubs he used for golf after he added 20 yards to his golf swing! 

Steve Cioppa: Your trainer should have the skill simply to look at your posture and tell which of your muscles are weak and underused and prescribe corrective exercises to balance your body. This can eliminate a slew of unnecessary pains and limitations. I always recommend stretching the hip flexors and strengthening the posterior muscles.

 Here are examples of anterior pelvic tilt:

Here is an example of “upper cross syndrome”, which can cause shoulder pain and a hunched back:


Steve Cioppa: Look at the diagram of Upper Cross Syndrome. In this case, I would work on strengthening the rear shoulder muscles and stretching the chest area.

Dr. Nolfo: What would you say to those of our readers who might ask: “Isn’t it expensive to work with a certified trainer?”

Steve Cioppa: What is it worth to you to be stronger, have better balance, have more energy and have better body composition, which helps your metabolism? And those are only a tiny portion of the benefits. As Dr. Nolfo has written before, exercise, reduces risks of diabetes, cancers and Alzheimers. What is that worth? That’s everyone’s choice.”

Dr. Nolfo: Thank you so much for all the useful information! I will say, working with a personal trainer is without a doubt the best decision I’ve made in this stage of my life. Last night my daughter’s rock band played a gig and afterward we helped her bring her drums to the outside of the club. I snatched up a heavy cymbal bag and two drum stands like it nothing was nothing and I realized I could not have carried them so easily last year! It was a pretty empowering feeling. 

Steve Cioppa is a NSCA Certified personal trainer / TRX certified trainer with over 20 years of experience.  He can be reached at 203-767-5899 or

Work with a trainer? Think about it. As always, the information I have posted for you here is completely unsolicited – I have no financial ties with Steve!

Have a fabulous weekend,

Dr. Nolfo

%d bloggers like this: