Many hands make light work

This past weekend we had a major work day at my lake house. I was so impressed at how we pulled together as a community  and made heavy and hard work seem like fun. We worked from 8 am to 4 pm splitting wood and stacking it. This was from 4 pretty big trees.

Holy 5 cords of wood Batman!

We broke for about an hour for lunch which we all shared in the process of making. As we sat and pondered whether we should finish the big pile of wood that awaited us we laughed together and all took a collective sigh. I am one who doesn't do well with pausing and then resuming  work. I was all for stopping work for the day so that we could go and relax in the sunshine. Luckily I was overruled.

I was so impressed by my fellow community members who rallied and got us all going again. Although I was frustrated at first, when the work was done, and I realized we don't have to schedule another day to finish it, I felt a big sense of relief. I am so glad we finished the work on the one day vs slacking off and playing.

Throughout the course of the day, some of us were in charge of splitting, others of us were in charge of distributing and stacking, while others did the clean up work of the debris we made. Those of us stacking formed a line to make the task easier and continued on with our laughter and conversation as we plugged away at the (what seemed like) never ending piles of wood. Ever the physical therapist, I was quick to remind everyone to change direction and position frequently, to hydrate, and to remember to stretch a bit when we were done. I was completely exhausted after a full day of movement that I am not used to, but it was a really good accomplished exhaustion.

I still think it's good to spread work out on occasion. I can't say this epiphany will change how I manage my own work/life balance. It did give me a different perspective to think about though and I realized once again just how grateful I am to be a part of this community. I learned the value of completing a daunting task in one moment and the satisfaction of seeing the work done.

I'm not afraid of granny gear

 I am training  to ride in the Tim Johnson's Wachusett Fondo hosted by the Minuteman Road Club on July 28, 2018. My husband, Bill just told me that my ride would be 40 miles. I had a moment of panic. Per usual, I did some thinking again on my ride today. As I started out I chose the harder route (for me) and went up hill vs down hill. A friend who lives on that hill joked about another woman who pedaled extremely slow up the hill in the little ring. As I did the same past his house today I got anxious feeling like I needed to be faster and have improved cadence and not feel so winded.

My parents are now showing signs of slowing down. They struggle with mobility issues as many do when they get older. I realized on this ride how proud I am of both of them. They are work daily on challenging their comfort zones. They push them selves to move and continue to maintain their independence. Sometimes it's not pretty, but they do it and are better for it. I am truly blessed to have them as role models.

I can't say that I will ever stop wanting to do what I did--or even didn't do-- in my younger years. I hope I will always find the inspiration to continue to move and practice moving in way that challenge me. What I do know is that I am quite ok with needing to ride in granny gear up those hills. At least I'm doing it, and I am appreciating the view, experiencing life, and finding an inner calm at the same time.

 

Jimminy Cricket! is that a crick in my neck?!

I love being at the lake. At night the sounds of the crickets totally lull me to sleep. As a physical therapist, I see a fair amount of people who have complaints of a crick in their neck. This is usually described as a 'catch or a kink'. A lot of people will move their neck or roll their shoulders and ask me if I hear the noise. These noises will sometimes keep you awake, and are not nearly as soothing as the sounds of crickets at night.

In my experience, the noise that people describe as 'crunchy' comes from the upper trapezius and/or the levator scapula muscles. Sometimes it's a 'grinding' which can also originate from the spine and is thought to be due to arthritic changes.

Image from Google search upper trapezius and levator scapula

I have frequently heard from patients that they woke up with a crick in their neck. I think this generally occurs from sleeping in an awkward position.

Neck is forward, tipped to the left and turned to the right..ouch!

Sleeping with your head and neck in a somewhat neutral position can help to alleviate this. Neutral means with your ears in the same plane as your shoulders, and not tipped or turned to either side. Most of the time, these creaks, cracks and crickets are nothing to worry about. They sound worse than they are. If they cause pain, what motions can you do without pain? If they don't cause pain, can you adjust your posture and movement of your neck or shoulders to decrease the noise? For instance, if you roll your shoulders back and do the same motion, does it create the same noise?

These movements may help to decrease some stiffness throughout your neck muscles. They'll definitely create a more natural amount of movement in your spine and related musculature. None of them should hurt. They should be done slowly and thoughtfully. When done consistently, they will likely help to improve your overall posture and therefore ability to move in a pain free range of motion. Of course, if it's concerning or the pain is not manageable, please seek an assessment from your movement specialist to find out the root cause.

When in doubt, be like the Girafflamingo with your chin tucked, your neck long and find a better pair of earings than your shoulders.

Image from:

https://www.google.com/search?q=giraffe+flamingo&tbm=isch&source=iu&ictx=1&fir=FDGeoSUcJjGIvM%253A%252CUyozP3u2fnFk0M%252C_&usg=__0WHbhoe8IawDwjJgF1r77jySIhk%3D&sa=X&ved=0ahUKEwiemauFt7jbAhVD5oMKHeXWBAsQ9QEILTAB#imgrc=FDGeoSUcJjGIvM:

Just say no! To diet and exercise...

Diet and Exercise are two words that I believe should be eliminated from our vocabulary. (So is should, but that's a topic for a different blog).

We spend our lives stressing about our weight and appearance.  I admit it. I am intrigued by certain diets. I still may try to see what this Ketogenic diet is all about. I do think some people feel better if they eat a certain way, but I don't think that one way is the only way. We have become a society that strives to look like a starving supermodel. Don't get me wrong. I think some supermodels are the most beautiful people in the world,  but sometimes they look emaciated and really sad and I can't help but wonder, "what did they actually eat today and did they enjoy the activity they had to do for that shoot?"

Over the last 50 years (pretty much my entire life!) we have gone through a ridiculous amount  of fad diets and exercises. We spend a bazillion dollars on product that will make us look better and thus feel better about ourselves vs on how we actually feel on the inside. On a whole, we continue to have a rise in heart disease, diabetes, cancer, depression and osteoporotic fractures.

I propose a change! Ok...it's not an original idea, I just finished reading How to Make Disease Disappear, by Dr. Chattergee, but I absolutely resonate with the content.  It's really causing me to examine my thoughts around food and movement.

What I would like to see is how we actually view food and movement. Both are incredibly important to our survival. Too much or too little of either have been linked to disease. The quality of both can contribute to good or poor health and inflammatory processes. To live a long and happy life, I believe we need to change our perception of both food and movement. Besides, the word diet itself implies a start and end time and I'm pretty sure we want to consider food (and movement) for our entire lives.

Instead, I would like to see a change in our view of food to be an amazing fuel source. We have so many quality foods that fuel to choose from. What would happen if we actually took our time to enjoy the fuel we need? If we put in high octane, super quality fuel and we mix it up so that we get all the different true nutrients that are available to us, our engine will run better. Our bodies need a variety of fresh fruits and vegetables especially those that are not treated with pesticides and are grown locally. It grows strong with quality sources of protein such as lean meats, fish (salmon and anchovies seem to have the best Omega 3's), nuts and nut butters. Our brains function better when we include good fats like avocados and olive oil. Add in a variety of spices and we can savor what we are eating and actually enjoy food again. Limiting processed foods and sugars will decrease our risk of rusting and rotting from the inside out.

"Taste the rainbow" with colorful and flavorful foods

Taking our time to prepare a meal, sit and taste the food, share our day with our family puts more enjoyment in the process and may slow us down while we eat. This allows for a better digestive process and feeling full sooner which inevitably will decrease our overall consumption and lead to a healthier weight, blood pressure, blood sugars and cholesterol. **Note, this is not to imply that ALL these symptoms will go away. There are some other causes that we cannot control. I'm just suggesting we work to control what we can.

As I noted above, movement, not exercise is one other key to good health. I think people cringe at the idea of exercise. Not all of course. I actually enjoy working out in gym as do many of my peers and colleagues. But one hour a day in the gym doesn't correct what I do the other 23 hours a day. When i work with people, I try to give a home program that is more of a 'do thru the day' routine than an 'exercise' routine. This is because I believe you can achieve your goals by moving thru the day more than a 30 minute home program. There are so many ways to include movement in your day, it all depends on what you want to achieve. I think there are 3 components of quality movement: mobility, strength, and both intermittent, high intensity and a good, steady low intensity heart pumping.

Today I went for my first bike ride of the season. (This is where I always come up for ideas for blogs lol) As I pedaled along the lake, I took in the sights. I smelled the fresh air. I experienced the breeze on my skin. To me, that hour and a half of (mostly) steady, low intensity work, was not exercise. It was pure enjoyment.

Bike, kayak, lake..is there anything better?

I do believe we need to get our heart rate up a few times per week, to keep the blood moving well. I know it's super important to lift up some heavy things a few times per week to prevent bone loss and fractures while keeping our posture upright. I absolutely understand that if we don't work on improving our 3 dimensional mobility, we set ourselves up for risk of falling and possible pain points. Including these 3 aspects of movement in our everyday lives will truly allow us to see the world from an upright and energetic way that we are meant to.

I also believe we can include movement without having to be at the gym. Why not play with your kids, or nieces and nephews, on the swing set? Or throw a football around? Or play tag? How about throwing on some fun and upbeat music and dance with your family while everyone helps to create a fun new meal? Take a walk and admire the flowers. Grab a float and kick around a pool. Strap on a pair of water or snow skis and rip it up. Get up and down from the floor a few times in a row...now THAT will get your heart rate up, improve your mobility AND build some strength!

Picture from Google images-Pinterest

The possibilities of good food and movement are endless. Find what you enjoy doing and eating. Take your time in the process and tune in to how you feel during and after. Perhaps you too will drop the words of diet and exercise from your vocabulary and just enjoy life again.


To learn more about Dr Chattergee's book, check here. **Note, if you order from this site, I will receive money from Amazon.

Run for your life..but what are the consequences?

Photo by Gabriel Matula on Unsplash

Photo by Aditya Wardhana

Lately, I have been reading about the side effects of stress on our body functions. Not only will constant stress increase our resting heart rate, stop us from getting a good night sleep and leave us angry at the little things, but a chronic state of stress leads to weight gain, muscle pains and general malaise.  This can make us feel like we are at the end of our rope.






Our stress response is stimulated by the sympathetic nervous system which is part of the autonomic nervous system. This is responsible for our fight or flight response. This is what diverts blood flow to our extremities and allows us to make those life or death situations when we don't want to think, but we just need to act. The parasympathetic system counterbalances the sympathetic with the rest and relax states. This is when digestion occurs, and what allows our heart rate and respiratory rate to return to a normal level after all that life or death stuff.

Cortisol is the hormone that regulates how our body reacts. When the brain senses a need to alarm the body, it sends out signals to the adrenal glands which in turn release cortisol and then activate the sympathetic nervous system. If our body never recognizes that the threat is gone, the cortisol remains high, and leads to all of those chronic stress problems.

There is growing research that ongoing stress in the body may contribute chronic pain. It may have to do with the increased tension we feel, or the inflammatory response that is created when cortisol is released.

Photo by Jesper Aggergaard

In our current world, we are always on the go. We are connected to the world 24/7 via internet and phone. We don't leave our jobs at the office anymore. We rarely sit down to dinner to have a relaxing meal and make connections with our family. We push ourselves to do better, do more and just do. I think it's even more important these days to schedule time to shut down and encourage our parasympathetic nervous system to be more active. We need to retrain our sympathetic nervous system to quiet down and allow a balance between the two systems.

I know first hand that removing some of our daily tasks is not possible. So I recommend trying to add. That's right...add activities that may promote paraspympathetic activity. Just fit them in during your day while you're driving,  getting gas or mowing the lawn. What are these crazy things that can help you find some de-stress time thru your day?  My top 5 suggestions are:

• Breathe! Work on increasing the length of your exhale
• Remember what makes you happy and visualize it
• Sing and dance while listening to your favorite song, or listen to something funny and laugh
• Walk away from your work/computer for 15 minutes and take a walk while enjoying the views
• Eat a meal at the table without electronics and share your day

If you have time, start to meditate and learn to quiet your brain. My current favorite app is Insight Timer. I like it because I can set however long I have, I can follow a guided meditation or I can just sit and it will tell me when time is up.

If you've been struggling with managing pain, have had a change in weight and energy levels or generally don't feel well and your MD has not provided a diagnosis (even if you have a diagnosis that can lead to these), I encourage you to add some relaxation and play into your life. It can have profound effects when you let some air out and just exhale.

Many thanks for the inspiration for this post and for more reading about how stress, food, mobility and rest can impact your life, and suggestions for how to make a change,  check out the book "How to Make Disease Disappear" by Dr. Rangan Chatterjee. (Publisher  HarperOne; 1 edition (May 1, 2018) ) 

Runners and back pain

I commonly see runners who have low back pain, so the research roundup article in PT in Motion this month came as no surprise. In it they suggest that if the intrinsic core is weak, the superficial back muscle will compensate. This will lead to abnormal shear and compression forces on the back. Overtime this can create pain and dysfunction.

Learning how to correct the imbalance will help to decrease fatigue or injury. By identifying which muscle is over working vs under working, and progressing the core exercise gradually, you can build better mobility and allow the joints and muscles to move more efficiently.

Picture from Google Images Core Muscles 

You don't have to be in pain when you run. You only have to do the work to prevent the pain.

See here for the full abstract of the original article.

Photo by Zoltan Tasi on Unsplash

Sugar, sugar...oh honey honey....

I have never been super strict with my diet. I grew up with a mother who used nutrition to manage her Multiple Sclerosis (and she did a damn good job at it!). My philosophy has always been moderation vs elimination. So one might ask why am I now looking at doing a sugar detox. The answer there is I have noted multiple aches and pains, have been feeling sluggish, and just not so happy with how my body is working lately. According to Healthline.com, sugar has been linked not only to inflammation, which will contribute to those aches and pains, but also to insulin resistance and obesity. I generally can resist cookies and candy, so I figure this would be the best place to pay attention to my diet and to make a change.

Blood glucose is normal in our body and is what gives us energy. If there is too much blood glucose in your body, and it can't be broken down by the insulin, it stays in your body and cannot be used for energy. This is what happens with Diabetes. Over time this can lead to a whole lot of health issues. Calgary Avansino sheds some good insight of how sugar, and not just added sugar, can affect our health.

As I go forward with this detox challenge on Facebook, with some cool people by my side, I thought I'd make a list of foods I eat and the sugar content. This should help me plan where I can drop food, but also to find a better substitute that I can add in so that I don't feel deprived.

Let's start with the one I think will be the hardest to avoid: wine! Shape reports only about .7 grams in my favorite reds, and whites are pretty close to that as well. This surprises me because I expected a lot of sugar. Unfortunately, alcohol does limit the liver's ability to convert carbohydrates to glucose which can lead to a drop in blood sugars similar to what happens in diabetes. For this detox, I'll be including wine from my list.

Peanut butter, which I can eat by the tablespoon right out of the jar you would not expect to have sugar.  Natural peanut butter has 1 gram but some peanut butters have 3 grams, 2 of which are added sugar.

I love to add Craisins to my salads...at a whopping 26 grams per serving, I will definitely be cutting these out. Toppings for my salads can add a crazy amount of hidden sugars too

Typical salad dressing (photo from Google images 'salad dressing' )

Balsamic Vinegar (Image from Google images)

White wine vinegar (image from Google images)

I think the key as I move forward removing sugar this week will be to really read the labels and to keep track of how much sugar I am consuming. For a 2,000 calorie diet (which is really high for an average, moderately active adult), the recommended amount of sugar is 25 grams or about 5-7 teaspoons.  Perhaps this challenge might actually be more challenging than I thought. If those aches and pains go away, if I have more natural energy, and if my body does what I expect it to do....the challenge will be worth it. 

For the next week, and beyond, The Archies might be the best added sugar, sugar in my life 😂😜😜

Give it a try and let me know how it goes.

Travelling tips down memory lane

I love to travel! I really don't go away as often I would like to, but each trip seems like a true adventure in life. Today I am off to San Jose and then Santa Cruz in California, to further my studies on movement via  Anatomy in Motion (AiM). 

As I started my trek across the country today, I realized how blessed I am to have such amazing siblings. My husband is travelling back to MA himself, so my brother drove me to the train station and I met my sister at work so she can drop me at the airport. Today's journey really is like the very funny movie Planes, Trains and Automobiles...and maybe a little walk down memory lane.

My sister, Jenn, is an advisor at Northeastern University (NU). Being a double Husky I always get nostalgic and love coming back to campus. I forget at times how easy it is to get into Boston, and the really cool city that we called home for a big part of our lives.

NU Quad outside Dodge

Since I knew that I would be sitting a LOT on my flight to CA, I decided to walk from Back Bay to NU. It's not that far, but it did prove to be a good little workout as I had to dodge cars and snow banks while dragging my over filled suitcase behind me. I found that I had to frequently change arms to pull the suitcase, and it helped to turn my palm forward or back as I got tired. I noted after the 20 minute walk that my neck was getting tired too from the weight of my back pack and pocketbook. In this video, I talk more about ways to manage your luggage while travelling. Luckily, I was able to put my bags down in Jenn's office and do some mobility work to reset my joints. I know I'll be happy about that when I am mid flight.

As I embark to learn AiM, I am reminded of the importance of embracing movement when you can. Taking a walk thru my favorite campus, and the city I love, brought back so many memories and made that challenging walk so worth it.

St Botolph Street 

I encourage you to walk and explore when you can. Catch the fresh air. Check out the sights. Enjoy the mobility and celebrate your memories as you go.

And because this weekend continues the Hockey East championship games: Let's Go Huskies!

What inspires you?

Today I was inspired at the gym. There was an older gentleman there who struggled doing his workout, yet he was doing exercises to help him move better and get stronger.  At the same time he was getting his heart rate up. He really inspired me to work hard at whatever level I can.

💪💓

 Then there was a relatively young kid who was cleaning the gym, organizing all the weights, cleaning off the machines, and putting the mats away. I think this is stuff we gym-goers should all do on our own throughout each workout.

Yet frequently I find the gym to be a messy and disorganized  place. He inspired me in his dedication to his work and when I thanked him for doing his job he sincerely looked surprised and grateful.

And then there was this 20-ish-year-old kid who was doing a dynamic warm-up which included foam rolling, stretching, and activation exercises prior to his lifting. This is everything that I preach and yet rarely see in basic gyms. I liked his functional approach. Now I am hopeful that we are really making a change in how we approach fitness and exercise. (If you're not familiar with a functional, dynamic warm up check out this one by Mike Boyle Strength and Conditioning )

At the end of my workout, when I didn't want to even think about doing one more set of my Turkish get up, the older gentleman I first spoke about unplugged his head set and played his iPod out loud. The song was Under Pressure by David Bowie and Queen, I am always inspired by this song. It reminds me to always to remember love. That song help me find inner strength and finish that one more set. Now I feel very accomplished and extremely grateful for all 3 of these fellow gym-goers
What inspires you?

**Images from Google clip art

**Video MSBC In place warmup

Dizzy? How is your ankle mobility?

Last week I didn't feel so hot. Whenever I turned my head left I got dizzy and I'd feel sick to my stomach. The day before my workout consisted of heavy Turkish Get Ups, Windmills and single arm kettle bell swings.  I noted that my neck felt a bit tight, but I didn't really associate the dizziness with lifting and just thought I didn't feel well. It didn't make for a very good day of trying to make others feel better. All I wanted to do was sleep. 😪😪

The next day my husband gently nudged me out the door to go for a walk, thinking the fresh air would help. As I started on my walk I noticed my upper and lower back felt stiff. I noticed I wasn't really rotating my trunk to the right as I stepped, which in turn limited my neck rotation to the left. I started to work my way down the body chain to my feet and could feel that my right foot wasn't moving very much and my big toe felt jammed. Suddenly it dawned on my that the lack rotation in my foot was connected with a lack of rotation in my hips, my trunk and my neck. 

In putting my attention to how I was walking, I could actually feel how the foot bone was connected to the head bone. This is just one example of how foot mobility can influence core stability and why I encourage working up to barefoot training. Increasing the time out of your shoes can help you be more aware of just how your whole body is moving. It needs to happen gradually, though, so that you don't over stress the tissues that have been stuffed into your shoes. 

                                                         Photo by Jordan Whitt on Unsplash

There are multiple exercises to condition your feet. The book What The Foot? by Gary Ward is a great starting point to learn more about connecting your feet and creating mobility.

As I walked, I started putting my focus on improving my rotation. If I took a bigger step with my left foot and pushed off more with my right foot, my toe hurt more. So I decided to start from the trunk down. With each step of my right foot I encouraged more rotation to the right. This helped minimally, so I switched it up and over exaggerated rotation to the left. I looked a bit like John Travolta  in Saturday Night Fever but I just didn't care.  By the time I was 1/2 way through my walk, my back pain went away, my foot felt less stiff and the best part...no more dizziness.

Sometimes when we don't feel good we do need to lay low and rest, and sometimes the nudge out the door to get some fresh air is what we need. Whenever you can, tune into how your body is moving. Everything is connected. When one movement feels stuck, try the other way. If starting at the point of stiffness doesn't feel right, perhaps pick the opposite.

Many times our ailments can be resolved by actually listening to our body and getting a feel for what is missing. If you try something and it doesn't work, check in with your movement professional and fine tune where the stuck is. This can be the very thing you need to get back to your favorite activities, like putting up your feet and listening to the crashing waves of the ocean.

                                           Photo by pan xiaozhen on Unsplash

To gym or not to gym..that is the question

I was asked today whether I thought a patient should join a gym. My thoughts are fluid and ever changing on this topic. He specifically asked me if joining a gym would make him worse or better. My answer was, as always, "it depends".

I would generally describe myself as a gym rat, but lately I think maybe we don't NEED to be at a gym to get strong. I think moving your body through all planes of motion on a regular basis is important to your health. I also think having the ability to pick up heavy things is important in life. Have you ever carried a 5 gallon Poland Springs bottle upstairs? Even just a gallon can be work. If you don't have the physical strength to do that, you do need to do some focused strength and mobility work. Does this mean you have to sit in the gym to do it?

I work with people who sit, drive and do minimal activity thru the day. If this is you, the gym may be a good place to help you to get some mobility in your life. It also can be detrimental if you jump into it too fast or get sloppy with your technique. Working with a good personal trainer can help you to stay injury free. Working with someone who's motto is to get you to puke, pee your pants, or faint is not going to help you stay injury free--in my opinion.

I also work with people who are active moving wood, hiking, climbing multiple flights of stairs, get up and down from the floor while keeping up with their kids. It's possible that adding a gym workout may be too much and overkill. Or it may give them a way to build the mobility and stability they need to keep going with those things as they get older. Resistance training and impact activities are known to prevent things like falls and osteoporosis.

Gyms offer a wide variety of equipment and they may be more cost effective in the long run so you don't have to buy everything. Of course, you can get just a few kettle bells, bands and a yoga mat and you can create your own 'gym' at home with plenty of variety to be able to target all aspects of fitness.

This particular person had knee replacements years ago and he felt like his knees were getting loose. When we check his mobility, he had lost some knee flexion that he had post-operatively. He thought going to the gym just to ride a stationary bike would be the fix since that's what he did just after the surgery. Unfortunately, what was needed at the time, may not be the exact answer now. I do think cycling is good to keep some motion in the knees, but it doesn't allow for end ranges of motion nor is it addressing the feeling of looseness.

Since I enjoy working out in a gym setting, I will usually recommend gym workouts. For all of us I think fitness and mobility wellness is dependent on a variety of factors. We need some cardiovascular, some strength, and some stretching. If we over focus on one area, the other areas lack. I am learning more each day the beauty of finding balance in life. I struggle with it myself, but I do think that is the key to happy, healthy, pain free living. This includes balancing our workouts. If you can find ways to include resistance, mobility, agility and heart pumping activities in your daily life without the gym then go for it. If you need the gym for motivation, equipment, or instruction then go for it.

The answer, in my opinion, is to move well and to move often...the rest is up to you.

Why your mother always tells you to stand up straight

Posture matters.

The best posture is the one you can move in and out of freely without pain.

 At rest, we aim to keep our chin level, with the back of the neck elongated; shoulders stacked over your hips and ankles, and relaxed down; hips are even; knees straight but not hyper-extended; and 3 points of contact on your feet (first toe, 5th toe and heel sharing equal load). When we do things like walk or run, our posture should be dynamic and moving through the 3 planes of motions.

Unfortunately, because we are creatures of habit, we get 'stuck' in postures that not so awesome.

Slouched: shoulders rolled forward, neck jutting out

Hyper-lordotic: over extending at lower back

This leads to muscles not in good alignment and when we move out of that posture we risk injury.

I frequently see people in the gym who are so focused on increasing their weight for an exercise that they compromise their form. Yesterday I saw a woman killing it on the pec deck as far as weight goes, but her neck and head was down, and her shoulders were totally rolled forward like this

Chest fly castastrophe waiting to happen

What I see when I look at this is either a Rotator Cuff or Neck injury just waiting to happen.

 To decrease your risk of injury, work toward keeping your alignment when you lift. This is what I like to see when you're lifting.

A simple exercise to create better postural awareness is weight shifting on a physioball. This is a good way to change your position through the day and can help you on your journey toward better posture. 

As with any of my posts, please leave a comment or send me an email (which you can find on my websiteif you have any questions or thoughts.  :)

90 90 breathing

Everything you didn't know you'd want to know about your colonoscopy

I turned 50 this year, and with that comes a whole lot of procedures that I never knew about.

 When we are growing up we learn all about the 'facts of life' in health class. It was a long time ago, but all I remember from those classes was the reproductive facts. I was lucky enough to have very open parents who also discussed the basic facts. What no one ever talked about was the tests we need as we get older like what to expect from a mammogram or a colonoscopy. They are diagnostic exams that detect signs of cancer in your breasts and colon. The suggested age for a mammogram is 40 years old and for a colonoscopy it's 50 years. Of course, if you have a family history or signs of anything wrong it's recommended sooner.

The chance of recovery (prognosis) is greater if cancer is detected early, especially with breast and colon cancer. Having a colonoscopy can prevent further problems by detecting and removing pre-cancerous polyps.

The American Cancer Society states there are signs of potential problems that you should see your doctor and discuss a colonoscopy sooner. Some signs are:

• A change in bowel habits that lasts more than a few days
• A feeling that you need to have a bowel movement that doesn't go away after you do
• Rectal bleeding
• Dark stools
• Cramping in the abdominal area
• Weakness and fatigue
• Unintended weight loss
• Back pain that doesn't go away or change with position. (This is why it's important to get assessed by someone who gets a good history and looks at your movement patterns.)

No one likes to talk about cancer let alone a colonoscopu because they are awkward topics. My cousin passed away 11 years ago from a rare colon cancer. I would rather talk about it and be awkward than ignore the symptoms and shy away from a test that scared me. There are complications with every aspect of life. Sometimes you need to weigh the risk vs rewards. Knowing what to expect, for me at least, helps to ease some fears.

So here's some info about my colonoscopy experience that I hope help you to be less scared.

• The doctor will prescribe you a medicine called Suprep Bowel Prep Kit It is actually a prescription and you have to drop the script off in enough time to pick it up. I got mine the day before, but the instructions tell you to read it 2 weeks before so if you don't like to wait til the last minute, get it sooner. It costs about $110. As of today there's a coupon that will get you a discount. I ended up paying $77.
• One week before the test you have to stop eating high fiber foods like seeds, nuts, peas, corn and any supplemental fiber that you take. I'd also suggest increasing your water intake gradually at least one week out. Trust me. Water is your friend.
• The day before you have to be on a clear liquid diet. No one was amused when I asked if vodka counted😀, but along with the obvious no alcohol or food, you need to avoid anything colored red. I found chicken broth to be very soothing and easy to drink throughout the day so I didn't feel like I was starving. (Newsflash..you will not starve with one day of a liquid diet!) I stuck with plain water and coconut water beyond that. You can drink things like white grape juice, Gatorade, Vitamin Water or clear soda's too if you like. I bought all of that, but in the end water was all I wanted and now I have all these sugary drinks hanging around. I do love the taste of Dragon fruit Vitamin water though, so it gave me something to look forward to🐲🐲🐉🐉
• About 12 hours before the exam you take your first 6 oz dose of the prep. You mix it in 10 oz of water and then have to drink another 32 oz in the next hour after. 
• I used COLD water and tolerated the first dose fine. It's gross..like a mix of Robitussin, Pedi-a-lite and NyQuil...but if you drink it fast it's not terrible. Some people mix it with the other clear liquids above. 
• Someone recommended a straw. That was key! So much easier to get it down.
• Other recommendations were soft toilet paper and baby wipes. 
• You begin to experience chills right away after drinking it. Bundle up and relax. They go away after about an hour
• Your first poop will happen anywhere from 30 minutes after til 3 hours after. Some people it's urgent. I had no moments of panic, but had lots of belly gurgles throughout the whole process. 
• **Gross alert** The medicine is like a power wash for your colon. The goal is to get all the poop out. At first it will be watery and brown. As you progress thru the prep it should turn yellowish and will seem like a LOT of water. It's normal and that helps to do a good test. Credit my friend, Renee Pustizzi, for this gem of knowledge. She's a rock star GI nurse and really calmed my nerves
• Keep sipping water.
• The 2nd 6 oz happens about 6 hours later with the same process. This one hurts. I got halfway thru and nearly puked. It was not as easy to swig down. I think my body remembered the taste. Drinking plain water in between sips helped and I was never so happy to finish a drink!
• If your test is in the morning I'd recommend napping between the first and second drink. It's an interrupted night sleep either way.
• The morning of you need to show up 30-45 minutes ahead of the procedure. You need to stop any food or drink 3 hours before the test. Take a breath..the hard part is over
• You'll be a bit dehydrated so it may be tough to get the IV in. Took them 4 tries and I have some pretty bruises now, but they were gentle. Again, some deep breathing and visualization, and my veins relaxed enough to make it happen.
• They use Propofol to sedate you. It burns for about 10 seconds and then you wake up 45 minutes later in the recovery room feeling well rested. I can see how people have issues with this. That 45 minutes was the best sleep I've had in a long time. What prep was that again?

All kidding about the sleep aside, your doctor will tell you preliminary results right after. If they removed any polyps you'll get results of the biopsy in a few days. You'll need a ride home and you can't drive, workout, do housework or cook for the rest of the day. Some people have mild discomfort in their belly or bum after. Take the time to nap and enjoy the fact that you just took the first step in taking care of your colon health. 

A special shout out to all my friends and family who kept me calm throughout the whole process. Having a conversation about this stuff really does help.

What do you do when your back pain takes your breath away?

1. I can’t shave my legs

2. I can’t drive more than 10 minutes

3. I was told never to lift anything heavier than 10 pounds

4. I can’t walk the golf course or swing a club without pain

5. I was prescribed an opioid (Tramadol/Vicodin/Demerol/Percoce/Roxicet/Fentanyl) (Web MD, 2018) and am afraid I’m going to be hooked

According to the NINDS 80% of people complain of back pain at least once in their lives. (Low Back Pain Fact Sheet, 2018) It is one of the biggest reasons people miss work. (Back pain, 2018)

Some common low back pain symptoms and complaints are:
1. Spasm

2. Shooting

3. Numbness and tingling

4. Stiffness

Most pain will resolve with doing the right movement and with positional changes. You should consult an MD if: 

1. The pain is unrelenting

2. Is worse in the middle of the night

3. If you’ve had recent unexplained weight change

4. If you have weakness in both legs

In 2017 we started to move away from medication and rest as being the first line of treatment for back pain. Now the recommendations are a return to normal movement as soon as possible, manual treatment, acupuncture and yoga. It can take time, but it's been shown that most back pain will resolve over time. (KOLATA, 2017)

Starting to explore 3 directional movement and finding where you are restricted  or have pain can be helpful.  In this video, Gary Ward of Anatomy in Motion (AiM) walks us through 3D mobility and exploring where we have easy or difficult movement. (**If you're experiencing pain, I encourage you to watch this video in full and test the motions. As Gary says you can use the movements for assessment as well as working those motions to find more pain free mobility. If your symptoms persist or worsen, 1st find the pain free motion...then seek out further assessment.

Help prevent ongoing pain by learning to move better to avoid straining your muscles and joints:

1. Hinge at the hips with your knees bent. To practice the hip hinge put a stick against your back with your head and sacrum against the stick. Slowly bend forward from the hips keeping contact the whole time. Knees will bend as you bend forward. Stand back up

2. Push objects vs pull them.

3. Get as close as you can to the object you are moving.

4. Twist in isolation and move your feet vs twisting in combination with bending, extending or side bending

The bottom line is it is not only ok, but it is important to gradually return to normal mobility and  your usual activities, including lifting, driving, sleeping and shaving. You have options for how to manage and can be proactive in seeking help beyond rest and medication.

Back pain. (2018, January 4). Retrieved from Mayo Foundation for Medical Education and Research (MFMER): https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906

KOLATA, G. (2017, February 13). Lower Back Ache? Be Active and Wait It Out, New Guidelines Say. Retrieved from www.nytimes.com: https://www.nytimes.com/2017/02/13/health/lower-back-pain-surgery-guidelines.html

Low Back Pain Fact Sheet. (2018, January 4). Retrieved from National Institute of Neurological Disorders and Stroke: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet

Web MD. (2018, January 6). Retrieved from Opioid (Narcotic) Pain Medication: https://www.webmd.com/pain-management/guide/narcotic-pain-medications#1

2018: Harmony

In 2017 I didn't make any New Year's resolutions. I was frustrated from the previous year because I didn't meet my goal, again, of becoming a Strong First Instructor. As a result, I feel like I floundered with no real purpose for working out,

I started Move Better, LLC last year, but really started working on growing it around April. I didn't have a true goal or plan for how I intended to make the business work. I'm learning as I go. I think this led to frequently bailing on my own health and wellness and minimal growth of the company.

In mid-November, I got a wicked head cold that limited my activity. On Thanksgiving, my step-mother passed away suddenly. During that time, I lost a lot of sleep worrying for my Dad. I don't handle stress very well and it caught up with me. I ended up with symptoms of vertigo which persisted on and off through Christmas.

This year I missed a bunch of workouts because I just didn't feel good. I gained a lot of weight. My body shape changed  and since November until last week I was struggling to walk upstairs without getting short of breath. I have not felt like myself in quite sometime. All of my talk about staying on top of good movement so that we can do what we want and be healthy doing it as we age seems to be a farce in my own life, and this makes me sad on top of not feeling well.

As I reflected on the last year, I knew I needed to set some resolutions again. I felt the best when I had specific goals in sight. Even if I didn't achieve them, I had something to work toward. Also, in the past few years before 2017 I had started having a word for the year to define what I wanted to achieve. I think it helped me become motivated to do better at my job and to see some excitement in my career again.

So I have revisited my resolve for resolutions. My goal for my health is to be consistent with working out 6 hours per week. I am going to pay attention to what, when and why I'm eating. I'm adding yoga-this month I signed up for an online 31 day challenge.  I am going to meditate for at least 10 minutes daily...even if just before bed.

I am continuing to learn daily on how to build a business. I am spending time getting specific with my goals. I have a lot to learn still, but I believe now, that by setting goals I'll have a better direction to succeed. By setting goals, I help myself to resolve to take of myself in the process. (And if you know anyone in need of meeting their own movement goals thru specific physical therapy or fitness...I would love to talk with them 😁)

My word for this year is harmony. Per Dictionary.com the definition of harmony is a consistent and orderly arrangement of parts. I think this flows with setting goals and making a plan. It's synonyms are peace and understanding. This is something I have always worked to achieve in all of my relationships. If I work toward improved harmony in my life, not only will my own health and well-being be better, but I believe that all of the relationships in my life will improve.

We learn as we go. Sometimes we fail but the beauty is we always have a chance to begin again. I like looking at January to reassess where I'm going, but really we can do this every day. If I allow myself to calmly realize this, I easily achieve that harmony I seek. As a plus, in implementing my plan just today, I actually feel much better overall too.

 Whether you make resolutions or not, take some time to evaluate where you've been and where you're going. We all have room for improvement. Why not take the step and make a change toward being just 1% better every day?

Cheers and a very happy and healthy 2018 to all.