Link to my article about the connection between nutrition and health and recovery of the musculoskeletal system, posted at Physio Network.
Nutrients are substances (fat, protein, carbohydrate, vitamin, minerals) that we absorb from our food. They are the building blocks that our bodies are made of and the helper molecules that make all our bodily processes work. They are what we consist of and what keeps us not only alive, but healthy, happy, and thriving. It is easy to understand that the lack of nutrients can cause poor health and loss of mojo or worse, and that getting the nutrients we need is of utmost importance for anyone wishing to live well and for a long time.
Most people have neither the time nor interest to obtain an in-depth understanding of nutrition, and most of the articles aimed at the general public are written more with what- gets-people-to-click-on-the-link in mind than a comprehensive analysis of facts. This makes it easy for misunderstandings and myths to creep in and distort our sense of what we need from food and how to get it.
Here are 10 common myths related to food and nutrition it is time to let go of:
1) You can get all the nutrients you need from a balanced diet
Our farming practices have actually led to depletion of the soil in which our produce is grown. A Kushi Institute analysis of nutrient data from 1975 to 1997 found that average calcium levels in 12 fresh vegetables dropped 27 percent; iron levels 37 percent; vitamin A levels 21 percent, and vitamin C levels 30 percent. Many common nutritional deficiencies, such as Magnesium deficiency, are not detected in routine lab tests and since the potential symptoms are so many, non-specific and varied (for magnesium deficiency symptoms may include fatigue, high blood pressure, anxiety, trouble sleeping, osteoporosis, muscle cramps, headaches, constipation, etc.) people are rarely aware of them. Since we have changed our dietary practices so much over the past generation or two what might be perceived as a “balanced diet” today is very different from what is was for your grandmother. Highly nutritious foods such as organ meats and collagenous cuts of meat have recently fallen out of favor, while a whole host of non-food food-like substances have crept into our food supply. Cheese-like spread, anyone?
Nutrient deficiencies are actually quite common, and thirty-one percent of the U.S. population is at risk of at least one vitamin deficiency or anemia.
2) Our food is more nutritious than it used to be, so we don’t have to worry about nutrition
While it’s true that we are luckier than some of our forebears in terms our access to fresh and nutritious food, there have also been many detrimental changes to our food supply. We are exposed to large amounts of low-nutrient foods that have been engineered to be enticing, rather than healthy. Our produce is harvested long before it ripens and travels long distances, and our food is prepared and packaged (heated, exposed to light, soaked, mixed with preservatives, etc.) in ways that lead to a loss of nutrients. One change that is likely to have far-reaching consequences is the processing of food, and the change in our eating habits that leaves us with less fiber.
The loss of fiber and other pre-biotics, together with the many additives to our food (preservatives, artificial sweeteners, antibiotics, and more) starves our gut microbiome. This is significant because the health of the gut microbiome has been correlated with virtually every aspect of our health and well-being, affecting mood, skin, digestion and colon health, brain health, cardiovascular function and more. A recent study found that even fibromyalgia, or widespread pain in the body without an apparent physical cause, may be rooted in an altered gut microbiome affecting pain sensitivity and processing.
Understanding that the changes to our food supply have been both good and bad, and that these changes have occurred so gradually that we may not even be aware of them at all, is important for anyone interested in obtaining optimal nutrition from food.
3) You can be equally well-nourished on different diets. It’s literally just a matter of taste
It’s hard to deny that we are living in the age of food fads. We have gone from "All Fat is Bad" to Atkins to Low-Carb/High Fat (LCHF) to Paleo to Vegetarian to Vegan to the Ketogenic diet, and predictably the next fad is just around the corner. Adherents of all popular fads tend to be equally enthusiastic, and reading an account of the wonders of any particular diet can make the most equanimous among us feel worried that we might be missing out on something important.
These food fads create confusion among the general public and a reluctance to listen to any dietary advice. They obscure the fact that there is real and ongoing research in the field of nutrition that is quite different from the breathless headlines about the latest “news” about the supposed danger of eggs (spoiler alert: eggs are really good for you). The truth is that following any diet that is defined by an exclusion of certain food groups leads to a real risk of dietary deficiencies. As an example, the vegan diet excludes all animal products, and because of this vegans tend to be deficient in vitamin D, B12, zinc, iron, calcium and the important fatty acids EPA and DHA.
4) Carbs/eggs/red/meat/fat/ (did miss something?) are bad
Most people get their nutrition-related information through articles they happen to come across online or while waiting for their dental or hair appointment. Usually these types of articles are sensationalistic (and highly unscientific) click-bait reporting based on an isolated study, and only serve to confuse and frustrate the reader. Scientific consensus, on the other hand, is built slowly but surely, based on accumulated scientific findings (the results of many studies, replicated over many years).
Food should not be thought of as either “good” or “bad”, but as a
source of nutrition to be used appropriately.
Are you sedentary? Eat fewer carbohydrates, as these are mainly needed as a source of energy. Are you bicycling hundreds of miles per week? Eat many more carbs. In both cases, eat mainly unprocessed carbs that come with the free bonus of fiber and plant nutrients, and are absorbed more gradually in the body.
The same is true for other oft’ maligned foods. Eggs are great , especially if you choose pastured eggs; red meat is great if you choose grass-fed, organic meat, in appropriate amounts for age and activity level. Avoid less healthy fats such as heated vegetable seed oils (yes, as in fast food fries) and fats become your friend, too, helping you absorb fat soluble vitamins, build cell membranes, and more.
5) Nutritious food is less tasty than junk food
Our taste buds have evolved in order for us to be able to tell a nutrient form a toxin, and our preferences for taste and texture have evolved to guide us to the nutrients we need from food. But manufacturers of modern-day food products employ food scientists to manipulate the taste and texture of processed foods to make them more appealing to consumers, in essence to trick our tastebuds into finding very low nutrient density foods appealing (think: Doritos or fast food, for example).
That does not, however, mean that nutritious food is low in flavor. On the contrary, we can still use our tastebuds to guide us. We simply need to use our logical understanding of the nature of processed foods to motivate us to avoid them, and then use our sense of taste and smell to help us find the best and most nutritious real, unprocessed or minimally processed food. Italians, for example, are famously picky about the quality and freshness of their food, simply because high-quality food tastes better. (Perhaps unsurprisingly, they are also long-lived.) But the reason high quality food tastes better to us is that our tastebuds are still able to detect nutrients as an appealing flavor, texture and smell.
Our taste preferences also change with exposure. Eating a lot of sugar gets our tastebuds used to the taste of increasingly sweet foods, and exposing them to bitter tastes more often “programs” them to enjoy bitter foods. In other words, your current preferences say more about what you have been eating than what foods objectively taste like.
6) If you’re recovering from an injury or surgery and being less active, you should eat less
It may perhaps sound a bit counter-intuitive, but during recovery from injuries and surgeries your protein need is actually increased, and intakes of 2–2.5 g/kg/day are recommended during immobilization, up from the RDA of the modest 0.8 grams of protein per kilogram of body weight. You'll find a helpful online RDA calculator here. Physical activity actually stimulates muscle building in such a way that the body uses the protein it's given more effectively.
7) Senior citizens need much less food than younger people
As people get older they often choose to or think they ought to be less physically active. When this is the case, they of course need fever calories. Therefore, as the amount of food decreases it becomes increasingly important to pay attention to food quality, especially since the same population also, for a number of reasons, tends to absorb nutrients less efficiently. As we get older we also become less sensitive to the muscle-building effect of protein in our diet, and actually need to increase our protein intake after the age of 65.
8) If a diet is helpful for sick people, it’s proof that it’s the best diet for all.
The Ketogenic diet is a low carb/high fat diet. It has historically been used as a non-pharmacological treatment of childhood epilepsy and has more recently gone mainstream and is being studied as an intervention for other neurological diseases such as Alzheimer’s and Parkinson’s disease, as well as diabetes and obesity with varied success.
Does the fact that a friend lost 20 pounds on the Ketogenic diet mean that this diet is superior to others and that everyone should be on it? As mentioned above, following any diet that is defined by an exclusion of certain food groups leads to a real risk of dietary deficiencies. The Ketogenic diet can be low in fiber and certain nutrients, and has to be followed with careful attention to food choice and supplementation. The diet can be directly harmful and be contraindicated for many people, including those who are pregnant, stressed, have a genetic predisposition for high cholesterol, or have low thyroid hormone levels.
The most direct route to health, with the fewest potential pitfalls, continues to be a varied diet, ideally including foods and food preparation methods that maximize nutrient density (think organ meats, soaking legumes prior to cooking, sprouting, sourdough, etc.) that is based on high-quality food with as few harmful substances (antibiotics, pesticides, products from inproperly fed animals) as possible. In other words, a truly healthy diet is based on inclusion of nutritious food through an understanding of what humans need for optimal health, and not solely on the exclusion of certain foods.
If you’re recovering from an injury or surgery and being less active, you should eat less
It may perhaps sound a bit counter-intuitive, but during recovery from injuries and surgeries your protein need is actually increased, and intakes of 2–2.5 g/kg/day are recommended during immobilization, up from the RDA of the modest 0.8 grams of protein per kilogram of body weight. You'll find a helpful online RDA calculator here. Physical activity actually stimulates muscle building in such a way that the body uses the protein it's given more effectively.
6) OK, got it. So I’ll take a multivitamin, that will cover all the bases.
Not so fast! While taking a high quality multivitamin can be better than nothing for some people some times, multi-vitamin preparations are often of low quality, (for example containing synthetic versions of nutrients instead of the form found in food) and may even pose an added disease risk for certain people. The greatest risk multivitamins pose may be a false sense of reassurance, a belief that one has covered all the bases. Unfortunately, there are many potential problems with relying on a multivitamin. One of them is that minerals are way too bulky to fit into one. You can never get all the potassium, magnesium, or calcium you need from a multivitamin pill. Another potential problem is that they do not exclusively contain vitamins or minerals that many people are deficient in, but also those that most people are able to get in sufficient amounts from quality food. Genetic variations, health status, activity level and age are all factors that may affect both the need for and absorption of nutrients, and a one-size-fits-all multi can’t stretch to fit these varying needs.
10) Colorful vegetables are good, white food is bad and other oversimplifications
I know, simple rules of thumb feel helpful, but “no white foods” is not a helpful one. While large amounts of rice and pasta may give you more carbohydrate and less in the way of micronutrients, potatoes are very nutritious - yet also very white.
Avoiding any food without a firm scientific reason to do so imposes unnecessary restrictions, increases the risk of nutrient deficiencies, and helps build an image of food as a dangerous enemy instead of as a source of pleasure, health, and life.
To quote Harvard professor David Sinclair, PhD once more: “Truth is, moderation is key. Don’t eat too often and too much of anything.”
Bon appetit :-) !
The good news is, there’s good news, so read on :-)
One in five Americans suffer from chronic pain and most of them believe they do so because of an injury or breakdown of their tissues. This is called the biomedical model. The biomedical model assumes that injury and pain are the same issue; therefore, an increase in pain is seen as sign of increased tissue injury. Similarly, it is believed that increased tissue injury leads to more pain. This model (called the Cartesian model of pain) is over 350 years old, and is no longer believed to be correct. While there is, in acute pain, often a correlation (although varied, and never absolute) between tissue injury and pain, in chronic pain this correlation starts to fall apart, and fails to provide a complete explanation of the issue.
One reason for this is that tissue injuries heal, and pain that persists months after an injury can logically not be due to said, one-tie, tissue injury. Sometimes there is not even a distinct injury precipitating the onset of pain, but the onset is gradual. Pain is also highly dependent on our attention, stress, emotions, learned behaviors, beliefs and expectations, including beliefs about what the pain means, whether we feel safe or not, whether we feel empowered or helpless. Psychological factors have actually been found to be more predictive of the development of chronic pain than physical ones.
Modern pain neuroscience has enhanced our understanding of pain
The fundamental thing that modern pain neuroscience research has shown is that chronic chronic pain may not correctly represent the health of the tissue, but may be due to extra-sensitive nerves and modulated by our beliefs and expectations.
You could describe the peripheral nerves leading out to our tissues as wires picking up various signals (touch, temperature, pressure etc) and our brain as the processor that interprets these signals. In a well-functioning system the signals are interpreted correctly. Touch is interpreted as touch, movement as movement etc. But this system can malfunction, and the nervous system can start to misinterpret or over-interpret these signals, so that eg stimulation of receptors in muscles and tendons that should result in a sensation of movement instead results in a sensation of pain.
Pain is created and experienced in the brain
Nociception is the word we give our ability to detect potentially harmful stimuli. It is a protective process that helps us avoid harm by either creating a reflex to pull away from the stimulus, for example a thumb tack you just stepped on, or a sensation that is so unpleasant (read:painful) that it results in behavioral strategies on our part to avoid the stimulus (to look around and step carefully in order to avoid stepping on more thumb tacks). Our “wires” lead the signal of a certain input to the brain, the “central processor”, which then makes an executive decision about whether the stimulus is worthy of our attention, and if so, how much of it. If the brain interprets the signal as a result of a potentially harmful phenomenon, it creates a sensation of pain. Worry, fear, negative beliefs and expectations, previous experiences and many other psychological factors affect the brain's decision-making process.
In some people the alarm system gets stuck at a higher level of sensitivity. With the alarm system extra sensitive and close to the “firing level,” it does not take a lot of movement, stress or activity to activate the alarm system. When this happens, it is natural to think that something must be wrong, even though there is no injury or damage to your body. This is called central sensitization. Central sensitization produces hypersensitivity to pain and other sensations by changing the sensory response elicited by normal inputs. Now even those inputs that usually evoke innocuous sensations such as touch, movement etc may be perceived as pain or other worrysome sensations.
Pain in a person with central sensitization may arise spontaneously without any sensory input such as touch, movement or pressure and it can be elicited by normally harmless stimuli such as gentle touch (this is called allodynia). It is exaggerated and prolonged in response to normally painful stimuli (hyperalgesia), and spreads beyond the original painful area (secondary hyperalgesia).(By the way, these fancy terms are just names for the phenomena we observe, not an additional diagnostic label to be worried about!)
The pain in central sensitization is in other words not proportionate to what is going on in the body.
Sometimes this heightened level of responsiveness of the nervous system is felt only in particular part of the body. Chronic episodic pain is pain that, as the name implies, occurs in episodes, instead of always feeling the same. Pain can be triggered by eg stress, and fear of pain and disability can be a powerful stressor. Individuals with chronic or recurring pain therefore have to work diligently at controlling their thoughts and emotions through education, awareness -building practices such as meditation and other means of keeping levels of stress and catastrophizing thoughts low.
Why do some people develop chronic pain?
There are genetic differences in our pain threshold (how quickly we would characterize a stimulus as painful). Hormonal levels affect our sensitivity to pain. As an example, low level of the sex hormone estrogen, as experienced during certain parts of the menstrual cycle and even more so in menopause increase pain sensitivity. Cold this be part of the reason why middle-aged women are the group most often diagnosed with fibromyalgia? More than anything, our thoughts, beliefs and expectations affect pain.
Sometimes an acute injury leads to an adaptation to pain (think of someone with acute low back pain and how they tend to move) that includes altered movement strategies and a decreased levels of movement that in turn set the stage for chronic pain and malfunction that seems seamlessly connected to the initial injury, but actually is arising from the changes we, consciously and not, made in response to the acute pain. Now the initial injury or muscle spasm is long gone, but the patient has made permanent changes to how they view and use their bodies which create ongoing pain.
Central sensitization represents a more fundamental shift in how the nervous system perceives pain, and all of the reasons for this aren’t well understood just yet. However, we know that anxiety, stress and depression are also present in 30–45% of patients. Other factors that may contribute to symptoms include endocrine dysfunction, psychosocial distress, trauma, and disrupted sleep.
Adversity in childhood can set the stage for central sensitization, and so can traumatic events leading to PTSD.
It is as if though the brain learns that the world is a dangerous place and remains a bit more on high
alert, and over-interprets potential signals of danger.
Examples of situations where you’ll find central sensitization are whiplash that persists a long time after the original accident. Fibromyalgia is the prototypic example of central sensitization. Less often, but in a percentage of cases of low back pain, tendon problems, shoulder pain, osteoarthritis, rheumatoid arthritis, pain following cancer treatment, tennis elbow, headaches, shoulder pain, tendonitis of the elbow, knee and ankle central sensitization plays a role. Sometimes central sensitization presents as a heightened sensitivity to pain that seems to move from place to place or be felt in many body regions at the same time. Opiod use can actually lead to an increased pain sensitivity, so called Opioid-induce hyperalgesia.
It may be helpful to think about sensitization in chronic pain as existing on a spectrum, so that you don't either have it or don't have it, but may have more or less of it. All of this also means that when you experience acute pain, you can think and behave in ways that may help prevent chronic pain.
Incorrect beliefs about the nature of pain and a belief that the body is inherently fragile, and subsequent
avoidance of movement out of fear of further damaging what the patient believes is an already
damaged body, are called Fear Avoidance Beliefs and have been strongly correlated with chronic pain.
Is chronic pain always a nervous system problem?
The reason developing a better understanding of the nature of pain is helpful is that it empowers us to take the correct action. This action is not to power trough the pain, but at most to gently "nudge:" it, to move despite moderate pain, through through gritted teeth. To know when to heed it's call and when to call it's bluff.
When we approach out bodies with this enhanced understanding, we don't risk overloading tissue in conditions, such as hypermobility disorders , where there may be chronic overload on certain tissues, contributing to pain. These underlying issues have to be addressed, because, at best, they keep the flame burning under the enhanced, chronic pain.
If you have had pain for a long time and haven't been getting better, you know or suspect that central sensitization plays a role in the pain you’re feeling, or have been wondering why seemingly innocuous activities often make you hurt so much, or lead you into a spiral of pain, take heart! The reason central sensitization develops in the first place is the so called plasticity of the nervous system, in other words it’s ability to change and learn. If your nerves have learned to become too trigger-happy and your brain has learned to exaggerate signals they can also gradually learn to calm down. Working with a qualified healthcare provider and trusting that the sometimes initially counter-intuitive things you’re learning are true is key. After all, pain in central sensitization feels just the same as any other pain, and it can at first be hard for some patients to understand that it is not a discrete physical injury that is driving the pain, but rather a hypersensitivity of the nerves.
It can also be hard for patients with chronic pain to take in the fact that pain does not go away by waiting for "healing" (of tissues that aren't injured) to take place before increasing movement. That is actually placing the cart before the horse. Even acute pain heals faster and better when appropriate movement is part of the treatment plan!
Here are some key points to consider:
Learn to understand chronic pain. It is important to understand that you are not hurting simply
because of a broken body or injured body part. Understand that pain may not correctly
represent the health of the tissue, but may be due to extra-sensitive nerves or incorrect usage of
Understand that movement, properly introduced and performed, is your friend and will not
injure you. Your body is not fragile! Feeling sore after movement does not mean that you have
been injured or hurt.
Approach movement through graded exposure. Graded exposure means that you are, through
gradually increasing exposure to movement, decreasing the sensitivity of the nervous system
and correcting movement-related pain associations. Your fear of movement, pain and of
"getting hurt" will decrease slowly but surely through gradual, positive experiences .
Find the right provider. Some healthcare professionals may not be quite familiar with current
pain neuroscience. If you are only being treatment with drugs, passive treatment modalities or,
conversely being encouraged to completely disregard pain and work
harder, find a provider that can more appropriately guide you through the
process. You need to find and accept a "Goldilocks-level" of gradually increasing exposure to
Learn to not interpret initial discomfort as a sign that your body is being hurt or injured. Your
body is not fragile. Learn to not focus on sensations of discomfort, and be disciplined abut
redirecting you attention to other sensations and phenomena. What part of your body feels
good? Were you able to make some progress with your exercise program? Did you tolerate
more movement before reaching a familiar level of discomfort? A
brain that fears the sensations it experiences creates much more pain than the
brain of person that is informed and feels safe, not scared. Fear of the pain
itself also increases the intensity of pain.
Focus on progress and ability, not on pain and disability.
Think long-term. No matter how seductive various treatments that only temporarily relieve pain
may be, understand that they are not a way out of chronic pain, and actually
may distract you from the important work at hand. When you are
tired it may feel like you need coffee, and coffee would of course temporarily
help. But the actual problem is not that you haven’t had enough coffee, it is
that you haven’t had enough sleep, and that is the problem you actually need to
solve. If you continue to drink coffee instead of getting some sleep, you’ll
soon be in deep trouble. Remember, the problem causing the heightened I pain intensity
doesn’t primarily lie within the tissues, but in the sensitized nerves, incorrect beliefs and incorrect
You need active work more than passive, palliative treatments.
Normalize your body's function. When your body works more like a well-oiled machine than a
cart where the wheels are slowly coming off, you will be loading your bod's tissues isn a way that
strengthens them, instead of weakening and irritating them. Note: in chronic pain conditions
you need a physical therapist to guide you through this process. You already now that
simply trying to move more makes you feels worse!
Knowledge is power. When your brain understands that the
sensations you are noticing are not a sign of danger to your body, it will
actually immediately produce less pain! Remember, the type and amount of pain we
experience is very directly and strongly dependent on our beliefs about the
pain and what it means. Be your own coach and remind yourself of this every day!
A healthy body feels pain sometimes, and gets better by adapting to activity,
not by avoiding it. Waiting for pain to completely go away before returning to
activity is putting the cart before the horse, because resting makes
you weaker, not better adapted for activity. But sudden dramatic increases in
activity may be just as ill advised to the sensitized person. Start low and go
slow is a useful mantra. The body in chronic pain is like a scared cat. You can’t
force it, but you can entice it, and gradually convince it that it is safe to come
out to play.
You are not a passive recipient of pain. It may not feel like it, but pain is a process that takes
place within your own brain, and you have a lot of control over it. By educating yourself,
disciplining your thoughts, finding proper guidance for movement and lifestyle (deep sleep, a
good diet, emotional support, mindfulness and other aspects of a health-supporting lifestyle all
have immense effects on the amount of pain we feel) and trusting your body's inherent strength
and capability you can make powerful changes that help you suffer less.
Remember, the way out of chronic pain lies not in avoiding it, but in understanding it and transcending it. You transcend it by understanding its very nature, that it is not warning or guiding you, but deceiving you. It is simply a sign of a nervous system set on high alert, of having ended up in the dead end of avoiding pain instead of confronting it. The opportunity available to us is to slowly but surely reclaim our health and freedom to move and enjoy life.
Do you have questions about how to address or avoid chronic pain? Comment below!
Actionable ideas for the tired, overworked, fearful, pain-ridden, injured and concerned.
We all know there are benefits to be derived from regular exercise, but most aren’t aware of quite how great they are. In order for us to be motivated to do something we need to find our why, our motivation to devote time and energy to said enterprise.
Sooo many benefits you'll love
This study showed that with regular exercise, 70-year olds had muscle mass and strength identical to their 40-year old counterparts. The authors conclude that the loss of bone, muscle, strength and balance over time is due to increasing levels of inactivity, not age. This is great news, and completely contradicts the commonly held false belief that aging inevitably has to be a period of gradual decline.
Multiple studies and review papers such as this one show the effects of regular exercise on mood, cognition and its power in warding off dementia. As a matter of fact, the great news is that those genetically most at risk for Alzheimer’s disease (those with one or two copies of the so called ApoE4 gene) seem to reap the greatest protective effects from physical exercise! There seems to be justice in the world after all!
Add to this the fact that regular exercise helps prevent the most common diseases (75% for breast cancer, 49% for cardiovascular and heart diseases, 35% for diabetes, 22% for colorectal cancer). Imagine if there was a pill that could do that! We have such a "pill" at our disposal in the form of exercise and with only positive side-effects at that. When exercise is combined with other simple constructive behaviors such as sleeping in a pitch-black room, eating nutritious food and cultivating a peaceful mindset the effects are even more pronounced.
Given how fantastic the effects of exercise are, why aren’t we all out there, reaping the many benefits? (After all, physical exercise even gets you closer to that coveted “look better naked” status.)
But (almost) no-one spontaneously prefers exercise to a comfy seat on the couch, and in a real-world situation many obstacles seem to keep so many of us from reaping the tremendous benefits of regular exercise. To help you move from passivity to physicality I have listed some of the most common obstacles below, along with some hopefully helpful and actionable work-arounds. If you are experiencing obstacles or concerns that aren’t listed below, reach out to me in the comments section!
Time to troubleshoot!
I don’t have the time. Yes, you do. But your available time may be found in small increments during the day. Work by a desk? Type standing, stand and do toe-raises while on the phone, take 30-second breaks (which enhance creative thinking and make you more productive) to do push-ups against your desk, squats over your chair etc. And take the stairs every time. The elevator is for lazy people, and you’re not lazy, just busy. This advice applies to stay-at-home parents as well. Take advantage of the opportunities you may have been missing to strengthen arm and trunk muscles while holding a baby, or leg muscles by performing little lunges carrying groceries.
I’m too tired. If you are truly exhausted, you should not perform strenuous exercise. Yet. You need to work on your burnout and nurture yourself back to health. When tolerated, start with slow, short walks. During your recovery, perform stretching and meditation to stay in touch with your body and its intrinsic value. You know you suffer from this level of exhaustion when any exercise leaves you drained instead of invigorated.
Those who feel tired and therefore unmotivated, but feel awakened and a bit better after some exercise actually need physical exercise to overcome the fatigue. The mitochondria, the little energy factories in your cells, multiply in number in response to exercise. The body rises to the challenge. They key is to re-enter the world of exercise gradually and keep your focus on your improvement, not your challenges.
I have pain. If you’re in pain from the type of acute injury that truly means you should lay off your usual exercise, such as a broken bone, exercise the part of your body that isn’t injured. Most other types of injuries respond better to activity modification, rather than cessation. In other words, lift a lighter weight fewer times, run or walk a shorter distance with a shorter stride length etc.
If you suffer from chronic pain, know that waiting for the pain to go away before starting an exercise program is putting the cart before the horse, and a mindset that will lead you deeper into pain as your body and its tissues keep getting weaker due to inactivity. Exercise decreases pain, and being decondition increases it, so pain is an added reason to exercise. Seek the advice of a physical therapist who will guide you through, and accept that there is going to be some discomfort before you feel better again. A simple rule for how much discomfort is safe is what I call the traffic light test:
Red- severe, sharp pain that takes your breath away - Stop doing what you’re doing
Yellow- Some discomfort that doesn’t seem to get worse with what you’re doing -
keep moving, with awareness
Green- movement feels great, or discomfort is decreasing - Keep right on moving cap’n!
Every time I exercise I get injured. Your amazing body adapts to what you’re using it for. Is your body adapted to sitting? Then you need to give it time to gradually adapt to movement. Want to run? Lengthen your hip flexors, strengthen your glutes, start walking and give your bones, ligaments and muscles time to gradually adapt. Want to lift weights? Work on a stable trunk
( planks, dead bug ) before you add any weight to your extremities, then strengthen buttock muscles and stretch your body to improve your joint range of motion.
And why not add some collagen to your diet (preferably before exercise and before bed and with some vitamin C) to give your body the building blocks for all the connective tissues it will be building.
Remember, an injury means that you are doing something wrong. If you can’t, despite following the above guidelines, figure out exactly what that is, consult with a physical therapist for some additional troubleshooting. Don’t give up on reaping all the benefits of regular exercise because of a few false starts!
I have special limitations. Not everyone can engage in all kinds of movement. If you have spinal stenosis, for example, you may not enjoy uphill running, but you may very well tolerate working out on an exercise bike. Learn how to get the most out of it (doing sprints on the bike, for example, adds a whole new layer of benefits) and you may over time find that other types of exercise get easier. If you can’t run, then walk, use an elliptical trainer or a bike. If you don’t have access to a gym, exercise class or a work-out buddy, use your body weight, household objects and the great outdoors for an equally beneficial experience.
If you are recovering from an injury, progress at a pace that allows all of your tissues to grow stronger. Muscles grow strong faster than ligaments, tendons and bones, so if you feel discomfort in theses tissues simply slow down the pace a bit. Older individuals and those on the hypermobility spectrum need to give their bodies more time to recover and progress.
I am just not motivated enough. Ask yourself what you are motivated to do or want to experience, and how that will play out in a gradually weakening and deteriorating body. Not so great, huh? Tough love, yes, but it is also part of a rather absolute reality that the physical body needs strain (aka exercise) in order to remain healthy.
Ask yourself what you need your body for. Is it playing with the grandkids? Travel? Long hours of work? Attracting a mate? Aging comfortably, with dignity and joy? Exercise is the key for all this, and more. See: the beginning of this post.
And lastly, the close cousin of lack of motivation:
I have to suffer in order to benefit. While vigorous exercise can certainly be a special kind of uncomfortable, it also offers immediate feelings of wellbeing of an even greater magnitude. And for a beginner, exercise does not need to be vigorous. The habit of seeing the world in black and white / can or can’t / good or bad is a counterproductive one, and prevents you from seeing the opportunities you do have. Don’t ask yourself whether you can or can’t do something, ask yourself instead how you can do it. If you are unsure about performing squats, don’t rule them out, but find a safe way to do them (over a chair? holding on to the kitchen sink?). If you have trouble running or lifting weights, don’t give up because of what you can’t do. Ask yourself, instead what can I do? Perhaps you’ll decide to start walking and doing some simple body weight exercises instead. And if you can’t walk yet, you might decide that what you can do is stand up every 15 minutes.
Remember, age is not an excuse (see above). Not having exercised before is not a reason not to start now (the body responds at any age). Injuries should end in recovery. Not possessing the know-how is no problem (make an appointment with a movement expert and learn).
Your quality of life depends on your physical health, and your body, unequivocally needs some form of movement and strain to stay healthy. Find your why and your how and the what will appear!
What would you like to be able to do?
Here’s why most people might benefit from a physical therapy checkup
If you are reading this, chances are you consider yourself at least moderately health-conscious. And why wouldn’t you? Good health is not simply the absence of illness, it’s a state of well-being and the ability to enjoy life and experience all the wonderful things a healthy body allows us to do. Health is arguably our greatest asset, and without it, not much else is much fun anymore.
As a health-conscious person you probably visit a dentist several times a year for a check-up and for preventive measures such as a cleaning. You know that the absence of a toothache is no guarantee that a cavity isn’t developing in some hidden nook or cranny, and therefore you use the expertise of the dentist to find problems long before they become serious and require more drastic measures, such as extractions and root canals.
This is the attitude we take to many other aspects of health, as well. We go for yearly checkups with a physician, undergo diagnostic tests and even take prescription drugs to prevent illness. But how do we relate to our musculoskeletal system, our muscles, joints, and nerves? Do we take preventive measures to benefit from the powerful existing strategies to care for the body and avoid conditions that are as common as low back pain (1, 2) or arthritis of the hip (3)? Most don’t. We wait until we feel pain, and some even wait until the pain is functionally limiting and hard to bear. Imagine taking this attitude to heart disease or dental health. It would be considered irresponsible, wouldn’t it?
There’s an easier way!
The fact of the matter is, of course, that problems tend to be much easier (and more fun!) to prevent than solve. This is definitely true for the musculoskeletal system, and we might arguably be spared a lot of pain, dysfunction and unnecessary financial strain if we took care of our muscles, joints and nerves the way we care for our teeth, blood vessels and colons. Once we are in pain, it may actually be hard to comply with both treatment and self-care, and the therapist’s hands may be somewhat tied due to the intolerance of movement and positions that the pain causes.
The preventive approach works on a large scale as well. People in countries with universal healthcare, a system that significantly lowers the threshold for seeking care and counseling long before serious illness occurs, have longer life expectancy and a longer health span. (4)
So why don’t we take steps to care for our musculoskeletal health? In a word (or three): habit, convention and lack of information. Regular physical therapy checkups and prevention just haven’t become common practices, (you know, as in something others do and you’d feel odd not doing it, too) so you simply don’t think to do it, or wouldn’t know how. So let me suggest a new approach, a new way of thinking. Let me tell you how.
Once or twice a year, whether you feel pain or not (remember how you have your teeth checked even if you don’t have a toothache?) make an appointment with a Doctor of Physical Therapy. Have the PT perform an evaluation of your musculoskeletal system. (5)
So how can I benefit from a Physical therapy check-up?
The physical therapist will evaluate important aspects of your body and its functioning and suggest simple action steps to decrease the risk of injuries, degeneration and pain before they occur. You might be taught important stretches and how to best perform them, told what muscles are under-functioning and causing strain, pain and imbalance in your body, and what to do about it. You might be taught how to hold your body and how to move it in a more natural and healthful way. If you work by a computer, you might be taught how to minimize the deleterious effects of a sedentary lifestyle. You might be given suggestions for changes or additions to your diet, supplementation regimen, posture, exercise habits, sleep and more. You might be taught an exercise regimen based on your goals and needs, making sure that you don’t waste your time performing the wrong type of exercise, or worse, harm yourself when working out. If you are an athlete, regular check-ups with your PT will help you reach and stay at the top of your performance, helping you avoid acute injuries as well as gradual breakdown from the specific strains of your sport. If you have any pre-existing problems, joints that have been replaced or segments of your body that have been immobilized through injury, underuse or surgery, you can learn important actions to take in order to prevent subsequent problems that otherwise might arise as a result of your medical history. A physical therapy screening will also uncover developing problems with your balance and may help you avoid and prevent falls. (6)
Lastly, if you have experienced gradual changes in your body and how it feels and functions and have been told (or believed) that these were happening simply because of “old age”, your physical therapist may show you that what you are experiencing is no less subject to positive changes than the ailments you may have noticed before you were old enough to blame your age.
Physical therapists are also trained to and always do screen for health problems in general, and your regular PT check-up can therefore help you uncover signs of non-musculoskeletal problems as well. Should this occur, your physical therapist will help guide you to the appropriate medical specialty.
Put simply, physical therapy helps you move, and movement is the absolute best, and often only, way to prevent joint degeneration. (7)
Do physical therapy check-ups simply mean thaat I’ll have more PT?
So does this mean that you simply need to spend more quality time with your physical therapist? Not necessarily, and it might actually mean that you’ll have less PT. A dental check-up and cleaning is faster, cheaper and less painful than a root canal and a crown. Musculoskeletal problems are no different. A regular physical therapy check-up may save you both money and time and, above all, result in a body that feels much better for much longer. Not a bad bargain, when you think about it!
Here’s to loving, respecting and taking good care of our bodies, now and for always!
The lifetime prevalence of non-specific (common) low back pain is estimated at 60% to 70% in industrialized countries
Chronic low back pain prevalence was ( …. )19.6% in those aged between 20 and 59.
Hip OA has been identified as one of the most common causes of debilitating pain in the general population, (,…)overall prevalence ranging from 0.9% to 27% with a mean of 8.0%.
Universal Health Coverage (UHC) is a comprehensive health system approach that facilitates a wide range of health services and significantly improves the life expectancy at birth and healthy life expectancy.
(5) Physical therapists are in an ideal position to promote health and wellness in their patients and clients.5 Physical therapists can reduce risk factors and prevent and treat NCDs by providing patient and client education; prescribing physical activity and exercise; and performing noninvasive, hands-on interventions consistent with a biopsychosocial paradigm. However, patients and clients often fail to recognize the role of the physical therapist in promoting health.
US Preventive Services Task Force (USPSTF) Guide to Clinical Preventive Services recommends preventive physical therapy screening for falls prevention
Regular exercise, a balanced diet, and a healthful weight can help you reduce your risk of developing osteoarthritis, especially in the hips and knees, or suffering sports injuries. Exercise helps bone density, improves muscle strength and joint flexibility, and enhances your balance.
What does your aching back or shoulder have in common with hardening of the arteries or heart disease? They are all “lifestyle diseases”, i.e. problems that arise not because of a flaw in our construction or genes, but due to a mismatch between what our bodies have evolved to require for good health, and our current lifestyle. We are experiencing what could only be called an epidemic of chronic pain, and a third (30.7%) of Americans now suffers from chronic pain. For a health professional dedicated to minimizing and eliminating pain from people’s lives, this is a shocking statistic. Prescription drug use and abuse is subsequently at an all-time high, and the federal government has been forced to start taking steps to deal with the situation.
Lifestyle disease: A disease associated with the way a person or group of people lives. and can be prevented by changes in diet, environment and lifestyle, such as heart disease, cancer, stroke, obesity etc.
But is masking pain arising from living incorrectly in our bodies a good idea? The ever rising percentage of people in chronic pain shows that it may not be. We need to understand what we are doing wrong in order to fix the problem, and since we are all doing (or not doing, as the case may be) the same thing, understanding our mistake can be hard to do. But the paradoxical nature of the pain epidemic is this; our lives are too easy. By attempting to make our lives easier, we have actually made them harder. Let's look at why that may be the case.
It may come as a surprise to you, but a certain degree of hardship is good for you! Not convinced? Imagine how much easier it would be to float around in a weightless environment than it is to carry your body weight around against the downward pull of gravity on Earth. But do you know what happens to the human body in a weightless environment? Any astronaut can tell you: osteoporosis, loss of muscles mass, loss of balance, lowered testosterone, depression and more. The fact that we evolved with the gravity of our planet also means that we require gravity in order to thrive, just like a fish that has evolved for a life in water requires its habitual environment in order to survive.
Modern life requires a minimal amount of physical activity, and the activity we have lacks variety. You may at first protest, thinking “but I’m very active, I go for walks several times a week, I’m up and down the stairs in my house all day and I love to garden”. I’m sorry to have to break it to you, but even though it may be more than what some of your peers get that is not a great deal of activity, and more importantly, not very strenuous activity. Your DNA doesn’t compare you to other relatively inactive westerners, it expects the type and degree of activity we humans have experienced during our long history on planet Earth. If you think back just a few generations, you'll realize that your great grandma and grandpa probably worked much harder simply because they had to to put food on the table than you do in your yoga class. Actually, there's really no comparison.
Modern-day westerners have gotten used to comparing activity to inactivity (sitting) which is perceived as the baseline, but that’s misleading on many levels. Sitting is not our natural state, historically speaking, low-grade activity (walking, household chores etc) interspersed by heavier activity (hunting, farming, fighting) is. Prolonged and frequent (as in sedentary work) sitting actually carries its own risks, in addition to the fact that it also means that you aren’t being active. It is now known to be an independent risk factor even if you engage in exercise activities outside of work.
Our bodies are designed for a certain degree of hardship, and this strain is actually helpful on many levels. The oft' touted anti-oxidant effects of fruits and vegetables? They are largely produced by the human body itself in an effort to defend itself against the toxic effects of plants (yes, really)! Exposure to cold, heat, sunlight and fasting have all been shown to result in beneficial changes in our bodies, even resulting in better aging, aka longer health spans. The word used to describe this is hormesis.
A short working definition of hormesis is: ‘a process in which exposure to a low dose of a chemical agent or environmental factor that is damaging at higher doses induces an adaptive beneficial effect on the cell or organism.'
Physical strain; lifting heavy objects, running fast, walking long distances, twisting, turning, pulling, pushing and carrying all have their distinct and beneficial effects on the composition and functioning of the body, and this is what is commonly missing in today’s world. A leisurely stroll with a cup of Starbucks in your hand or a weekly yoga class simply doesn’t meet the requirements for physical activity that have been shaped by our long evolution. And so, without the physical stimuli required by your DNA to produce strong, healthy tissues, your body gradually starts to malfunction and cause pain.
Adding insult to (real or metaphorical) injury, the loss of exposure to the mild to moderate discomfort regularly involved in a more active lifestyle leads to a hypersensitivity in our nervous system, resulting in even small stimuli being perceived as painful. Simply put, being inactive makes you overly sensitive, and not in a good way. It simply leads to you suffering more from anything you feel, and that fact alone should be a powerful incentive to move more.
Physical inactivity makes you much more sensitive to pain.
A more recently understood phenomenon, called Fear Avoidance Beliefs in scientific circles, has put the nail in the coffin. When our ancestors hurt, they couldn’t afford not to move, to hunt and farm, there was no sick leave or disability pay, there was no-one to sue or blame. When our modern bodies, weakened by our inactivity and thus poorly prepared to withstand challenges sooner or later (and one might perhaps add, unavoidably) get injured we now have the dubious luxury of avoiding certain movements and positions out of a fear of causing more pain and injury. Anyone who’s seen a person with acute low back pain move (or perhaps been one!) knows what I’m referring to here. The problem with the logical assumption that it’s best to “take it easy” and act in a protective way when the body hurts is that it is completely wrong. Fear avoidance beliefs and the resulting behaviors have actually been shown to be the very gateway to chronic pain, and are to be avoided at all costs. When you move around stiffly and carefully in order to avoid pain, the stabilizing muscles that are part of the deep spinal structures atrophy and abnormal and, unfortunately, lasting movement patterns quickly form and contribute to pain that lasts way past the time it takes for the body to heal.
Avoiding movement in order to avoid pain has been shown to lead to chronic pain.
So assuming I have convinced you that the greatly reduced amount of strain on every system of the body that a per default modern-day existence in an industrialized information-age society leads to is a trap, what are you to do?
Here are some suggestions for steps to take to build a healthier, more resilient body and mind. But before you get going, bear in mind that a body that has adapted to a sedentary lifestyle needs some help adapting to increased levels and new types of activity. Have an evaluation and some treatment by a physical therapist to straighten that spine, loosen those hips and activate muscles to help prepare your body for physical activity. Skip this step at your own risk, and be prepared to sustain injuries and experience feelings discouragement if you do. Running has the highest injury rate of all recreational sports in part due to the lack of preparation of the (western) body for running. So get into prehab - prepare your body for activity before you start.
Once you’re ready, however, and take steps to become more active you will discover that Nature has created a strong incentive for us to move: the uplifting and extremely pleasant experience of the immediate and long-term effects of physical activity on your body chemistry. Way bigger a concept than merely a "runner’s high” , physical activity makes you feel happy, feel pleasure, energy, optimism, confidence and a stronger connection to the world around you.
Physical activity makes you feel good both immediately and in the long term
In chronic pain, pain is not a good indicator of whether you should move or not.
Lack of exercise causes depression.
When is referral for physical therapy appropriate?
A referral for physical therapy is appropriate any time a patient’s symptoms and impairment may be related to the musculoskeletal system.
Physical therapists are movement experts and address impairments in the locomotor system and its intersection with the nervous system. There are of course many areas of specialization. Mine is orthopedic physical therapy, which is the conservative treatment of musculoskeletal disorders and neuromuscular dysfunction through the use of orthopedic manual therapy, therapeutic exercise, ergonomics, movement- and posture re-education etc. There is strong support in the scientific literature for the combination of manual therapy and therapeutic exercise in the treatment of the majority of the most common musculoskeletal disorders.
The current entry level physical therapy degree is a clinical doctorate, and the state of Illinois grants direct access to physical therapy.
This means that physical therapy is the most appropriate initial referral for patients in need of conservative management and care for musculoskeletal disorders, as well as pre- and postsurgically for prehab and rehab. The physical therapist’s evaluation includes a screening for potential red flags and a patient not currently appropriate for physical therapy will be referred back to you. Therefore, a referral to physical therapy can also constitute a screening tool for whether the patient’s presenting complaint is musculoskeletal in nature or not.
After referring a patient for physical therapy you will receive a thorough evaluation report, as well as regular progress reports to keep you posted about your patient's progress.
Physical therapy does not need to constitute a stand-alone intervention, but can effectively be combined with medical management, acupuncture etc.
How do I write a script for physical therapy?
Your referral only needs to include the patient’s main complaint, e.g. “low back pain” and your name and credentials. The physical therapist will evaluate the patient and determine the classification, cause and appropriate treatment plan for the patient.
Who can refer to physical therapy?
In the state of Illinois any healthcare practitioner such as MD, DO, DPM and DDS etc are welcome to refer patients to physical therapy. Medicare requires a referral or a sign-off on the patient's treatment plan by one of the above-mentioned professionals writing the first month of care.
Will my patients be able to use their health insurance for physical therapy services?
I am in network with BCBS and I am a Medicare provider. Patients covered by other healthcare plans will receive an itemized superbill complete with ICD-10 codes and CPT codes and may submit this to their respective insurance company for reimbursement of their services.
Please do not hesitate to contact me at any time via text or voice at 847-208-8063 or via email.
More news and information about physical therapy here.
Beattie et al. Patient Satisfaction With Outpatient Physical Therapy: Instrument Validation. Physical Therapy, 82(6). (2002).
Resnik et al. Predictors of Physical Therapy Clinic Performance in the Treatment of Patients With Low Back Pain Syndromes. Physical Therapy 88.9 (2008)
Ok, I admit, I actually made that diagnosis up, although it does make a whole lot more sense than a lot of other diagnoses out there...
Have you ever immobilized your body? If you've never had an arm in a sling or leg in a cast, your answer may initially be no, but without realizing it, you probably have subjected your body to far more immobilization that you've ever realized.
Our DNA needs the type of stimulation a more "primitive" lifestyle would create; movement and positions in varied terrains with varied loads, taking joints (not just shoulders and knees but even the small facet joints between your spinal vertebrae and the joints between the bones in your feet) through their range of motion on a regular basis.
We moderns, however, tend to walk on completely flat surfaces in a forward direction only and sit in the same position, in chairs, day after day. At night we sleep in beds and with pillows that are designed to keep all out joints in a neutral position. We wear shoes with rigid soles and arch supports (support sounds like such a nice word, who would ever suspect there was anything wrong with it?) that keep the many (over 30!) bones of the feet and ankles from moving. We even wear other types of clothing (bras, belts, tight pants, boxer briefs etc) that restrict the natural movement, expansion, jiggle, swing and bounce of our bodies.
I once treated a man that I only could diagnose with "Big Belt Buckle Syndrome". No, that's not an official diagnosis either, I must confess. But in reality, that's what he suffered from. He wore tight jeans, cowboy boots and a belt with a huge belt buckle every day, and his body had learned to move within the restrictions that his fashion sense created, with low back pain as one of the resulting problems. The moral of the story? Things (clothes, sleep surfaces, chairs, cars, walking surfaces etc) that look completely innocuous to us because we are so used to them do immobilize our bodies to varying degrees, and since we were not designed for it there is always some price to be paid (and, conversely and thankfully, many potential improvements at arm's reach!)
So does it really matter whether joints move or not as long as you're comfortable in the moment? It actually matters. A lot. You could put it this way: whatever evolution has prepared us for it also expects of us. What this means in terms of your musculoskeletal system is that all our bones and joints and ligaments and muscles need pressure and movement from and at various angles in order to stay fully healthy. When we remove a large percentage of the forces our bodies expect to be subjected to, our bodies become weak, unstable and rigid and this (not the number of birthdays you've had) over time results in degeneration of joints, osteoporosis, loss of muscle mass and stiff, malaligned bodies from our feet all the way up to our heads.
And here you thought you were taking good care of your body with that posturepedic sleep number bed and those custom-made orthotic shoe inserts! Sorry, but using such products, unless you absolutely have to due to an acute injury or advanced stages of degeneration, is doing your body a huge disservice. The bed that keeps you so comfortable is actually preventing your pelvic bones and spinal vertebrae from realigning themselves during sleep and muscles from stretching the way they would if your sleep surface was firmer. The way your chest sinks in in a soft bed deprives you from oxygen both during sleep itself and during the daytime due to a permanently collapsed ribcage, and that's just as bad as it sounds. The "supportive" shoe prevents the foot from acting as the shock-absorbing, mechanical force-conducting marvel that it was designed to be and instead over time makes it weak, stiff and painful.
But why do soft beds and supportive shoes feel so good to some people? Essentially, they are indulging your restrictions. A body made inflexible through years of positional deprivation can no longer stretch and yield enough to be comfortable on a harder surface. A hard surface now stretches the body's (already achy) tissues in a way that is perceived as discomfort. Similarily, a foot shod for decades may lack the stuctural integrity to hold up the body without collapsing, and hurts without the additional help of an arch support.
So what might another approach look like, one that would help our urbanized bodies stay healthy and happy? Here it helps to look at how non-industrialized folks do it. The ones that manage to get through the day wihout supportive shoes, chairs or beds and are walking around erect, comfortable and agile. They may walk around barefoot, or in minimal footwear, sleep without soft bedding and pillows and move three-dimensionally through their world exposing their bodies to forces by lifting, pushing, pulling, carrying, twisting and turning. At night they sleep in varying positions on much harder surfaces than we are used to, that stretch and mobilize joints in their bodies and even correct joint mal-alignments in their sleep. And speaking of joint mal-alignment, when you expose your body to a wide range of movement through most of your range of motion daily it is much more likely that mal-aligned joints correct themselves than if you keep your body relatively still or only move in the mid range of your joint range of motion the way most of us Westerners do.
When visiting west Africa many years ago I remember thinking that people sleeping on thin straw mats on the ground with only a thin piece of fabric covering them to protect against the terrorizing mosquitoes looked like they must be terribly uncomfortable But do you know what else I kept thinking throughout my stay? The people around me had the best posture I had ever seen anywhere in my whole life. Gradually, very gradually if you are stiff, moving towards a less supportive sleep surface and a flatter pillow is a move in the right direction.
Our feet are made for walking, barefoot. Wearing rigid shoes with thick soles and heels alters the alignment not only of the feet but of the entire body and prevents the foot from staying supple and strong. Gradually (again, very gradually if your feet are stiff and sore) move towards mostly using less "supportive" (there's that "nice" word again) footwear, removing the heels (that goes for guys too, just look under your shoe and you will find a heel) from your existing shoes or buying "neutral" footwear that doesn't have a heel. And no, you don't have to wear five-finger shoes to do that. Here's an example of a very formal-looking minimalist shoe Doing strengthening and corrective exercises along the way to prepare your feet for a more normal load will help make this in transition easier and smoother. And remember, this is not a binary issue. You don't have to take sides, choose only minimalist shoes and never wear heels. Juts wear them more, and see how you feel! Every little bit counts, and perfection and perfectionism doesn't have to enter into the equation. Our bodies are very forgiving, we just have to help them out a little bit.
Walk a bit more, and if possible walk in terrain and up and down hills, sideways etc. Walk barefoot whenever you can. If you sit or stand for work you can even place some pebbles in a flat pan and place your feet on them from time to time. It feels wonderful and invigorating, and gently wiggles the many bones in your feet and keeps the muscles and ligaments holding them together supple and healthy.
At home, don't use shoes, belts, bras or other restrictive types of clothing.
Sitting in is a position we find ourselves in way too often. The best thing to do about that is to try to stand and walk more. When you are sitting, vary the way which you sit and use props to keep your self from slouching and collapsing. Standing desks are becoming more and more popular, and you can even use a walking desk. If you're using a laptop, why sit at all? Sometimes you can choose lay on your stomach, for example.
Expand your positional and movement repertoire: find new ways of sitting, whether that means positioning yourself better in a chair or choosing one of the myriad ways you can sit on the ground. If ways of sitting other than straight up in a chair feel uncomfortable at first, you can use alternate sitting positions, such as crosslegged, kneeling on your heels, squatting etc as stretches that you only hold for 2-3 minutes at a time. As your body limbers up you may find yourself spontaneously choosing these positions over sitting upright in a chair. Use young children and images of people in more primitive cultures as a source of inspiration. There are literally hundreds of positions you can choose for sitting, lying down and moving about your day, and they all treat your body a variety of forces necessary to keep it healthy.
Once you get used to seeing movement and position as a necessary input in order to get the output of a healthy, well functioning body you will not only find yourself choosing a wider range of movements and positions, but actually craving them. You will develop a more intimate connection with your body due to the varying proprioceptive inputs and a greater confidence in your body through experiencing movements and positions you never experienced before. And hopefully you will also be ditching the outdated notion of "my body feels stiff - but I guess that's just because I'm getting older". No matter what your age or health status you can always nudge your body in a better direction by using it the way nature intended. And what better and easier way to do that than by doing what you already do: walk, sleep, sit - just in more varied and interesting ways!
You probably don’t know anyone that hasn’t suffered from a musculoskeletal injury or pain. Achy shoulders, sore backs and creaky knees seem to be part of life these days. Even children often suffer from these ailments, the more sedentary among them suffering from “text-neck” and the more athletically inclined from shin splints and, yes, from back and shoulder pain as well.
"The rate of musculoskeletal diseases far outstrips that of circulatory diseases and respiratory diseases" http://www.boneandjointburden.org
Half of all people over 18 and 3/4 people over 65 suffer from musculoskeletal pain
Apart from the obvious pain and suffering, decreased quality of life, financial cost and lost workdays caused by chronically or acutely painful body parts, musculoskeletal dysfunction carries an even greater risk than you might have realized. It unavoidably leads to physical inactivity, which in turn is a major risk factor for cardiovascular disease and decreased function of all major organs.
"250,000 Americans die prematurely from improper diet and lack of exercise each year."
This means that musculoskeletal pain and dysfunction should be taken very seriously, and that it needs to be demoted from its comfy position among “things that just happen with age”.
Don’t blame your age
The true cause of musculoskeletal degeneration is not Father Time, but the things we have, or haven’t, been doing with our time. As a matter of fact, elderly people who do exercise reap tremendous benefits not only in terms of increased bone density, muscle mass and functional ability, but also in memory, mood and cognition. Lifestyle factors such as being sedentary most of the day (yes, even if you exercise regularly), not sleeping long enough or deeply enough, nutritionally poor modern diets that don’t supply enough building blocks to keep the tissues supple and strong and “positionally monotonous” movement habits do not enable our bodies to keep renewing and rejuvenating themselves, and lead to the illusion that human bodies simply gradually wear out over time. Stress in all its various permutations plays a major role as well, as it alters hormone function, disrupts deep, healing sleep and in general signals to our DNA to stop repair and maintenance of the body, as there apparently is an emergency to be dealt with.
A multi-pronged approach that decreases the mismatch between our (mostly) stone-age-adapted DNA and the modern world, along with some targeted treatment of specific mechanical musculoskeletal problems such as skeletal mal-alignment, fascial adhesions and muscle weakness and -imbalance can significantly increase our ability to enjoy our bodies and all the wonderful things we can do with them. The subsequent increase in physical activity (assuming of course that you make that choice!) leads to increased bone and muscle mass, increased organ function and -reserve, increased levels of beneficial hormones, neurotransmitters and happy thoughts, and makes you smarter and keeps you smarter longer. In short, taking care of your musculoskeletal system increases both your lifespan and your health span, and no, there is no drug that can match that promise. So take care of them bones and forget Father Time!
12 ideas for an even better life
3) JERF - Just Eat Real Food. There are many reasons behind our neurotic relationship to food; the obesity epidemic, the rising prevalence of lifestyle-diseases, dietary information from self-proclaimed gurus that often contradicts everything else you've read, including itself. Take a deep breath - food is not out to get you, and the latest dietary "truth" is not here to save you, only to add more stress to your already heavy stress bucket. Focus on eating real, organic food instead of packaged processed food products, no matter how much kale they contain, and focus on good taste, quality and enjoyment. You know, kind how those Italians do. You do know that they live longer than Americans, right?
4) Be grateful- find something every day to be grateful for - the soft bed you woke up in, your car, your furnace that keeps you warm, the commute that gave you time to listen to a great audiobook, your children ( what a miracle!), the food on your plate before you eat, a friendly word, an opportunity to help someone, your ability to walk and move, how beautiful the sky is...you get the idea. You will decrease muscle tension, stress hormones and general grumpiness, and enjoy and appreciate your life more. You might even live longer, and at least you’ll enjoy whatever time you do live more.
5) When faced with a stressor, fast forward 6 months in time, and realize how trivial most things we worry about are.
6) but live in the moment. We tend to either live in the past ( regrets, grudges) or the future
(worry, fear and planning how to avoid what we fear) and miss out on the now. This makes time
(aka life!) fly by and increases ( again) muscle tension, stress hormone levels, and your ability to actually enjoy your life. Bring your attention to something tangible, like the taste of your food, the feel of your body, the temperature and softness of the skin of someone ( you?) you touch. What can you be aware of right now? Reach out and touch something, and let yourself take a moment to actually feel it. Do it often.
7) Throw out all vegetable oils right now. They are not good for you, and are among the biggest contributors to inflammation (pain, degeneration) in your life. Let the canola, safflower, corn etc oil go. (And while you're at it, if you're using it, let your flax seed oil go, too. It is not a good source of omega 3 oils of the kind your body can use, and very likely rancid and thus even more harmful to you.) Use high-quality olive oil, grassfed butter or coconut oil instead.
8) Stop associating with people that don't make you happy. If they don't make you happy, you don't make them happy, and you are both wasting your precious life making each other miserable. Respect your short time on earth and the miracle of the life you've been given enough to make quality choices, especially when it comes to the thing that's been shown to have the greatest impact on your health - the relationships you have with other people. Remember, happiness = health and unhappiness = lack of health. Pretty simple.
9) Move more, but not for too long - your body will deteriorate (= age, "fall apart") if you don't use it as it is supposed to be used. You need to move it every day, often through the day (see #2), you need to use your muscles and bones if you want to keep them. Lift something heavy - your own body is great for starters. Do some squats, push-ups (against the wall or chair if you can't (yet!) do them on the floor. You don't need to do them at the same time, or at a gym. If you sit for work, the overall benefit will actually be greater if you intersperse your sitting with the squats and push-ups throughout the day. Most people don't move enough. Those that do move, tend to not exercise vigorously enough. A leisurely stroll with a cup of Starbucks i your hand is much better than only sitting still (congratulations!) but not nearly enough to maintain muscle and bone mass and a youthful look and disposition.
10) Stretch. Place your body in positions other that the fetal position ( which you are in when you sit by your desk, dinner table, car, sofa, sleep curled up on your side)on a regular basis. Otherwise you'll soon find yourself unable to assume other positions, and will need a walker to hold yourself upright. I know you've seen people that this has happened to ( they are often referred to as the elderly, and it is assumed that their condition is an inevitable stage of life. Not so). Straighten your body completely before you walk, if you've been sitting for a while. Stretch a little ( just let your body lead; if your dog can do it, so can you). Get used to existing in other positions than a sedentary one- lie down or to read and watch a movie, walk instead of calling or driving.
11) Get some light ( and avoid it at night). Our bodies need help keeping the rhythmic and cyclical production of hormones and other bodily functions in sync. Bright light is one of the signals to the body that it is daytime, and thus functions as an important pacemaker for the body. It follows, then, that if you want easy and deep sleep, you should not be shining bright light ( computers, backlit reading devices, bright ambient light) into your eyes at night, thus telling your body to perk up and get ready for action.
12)Don’t be too trusting. Develop a good conspiracy theory from time to time, realize that drug companies, governments and media do not first and foremost have your best interest at heart. Realize that it can take between 10-15 years for research findings to reach the office of your primary care physician to be implemented as standard practice. That means that at any given time, you probably are being given obsolete advice and that you can probably benefit from some thinking and digging of your own. PubMed is a way to directly access scientific studies online, and there are many independent healthcare professionals that make an effort to stay more up-to-date than big medical associations and the government.
13) Laugh. Only stressed-out adults do not find life hilarious. Little children laugh often throughout the day, 72 percent of centenarians laugh or giggle every day, and anthropologists and other travelers often find the behavior of"primitive" peoples around the world puzzling - they actually seem to laugh at life's hardships and the crazy and sometimes absurd little twists and turns we find ourselves in as we go through life. Maybe we should all aim for a bit of that attitude? Take in medicinal amounts of funny movies, books and vines (google it). Train yourself to be more lighthearted, and above all, don't take yourself so seriously, because it will just increase your level of stress ( although others might find such pompousness humorous). Laughter, on the other hand, has been shown (in case you haven't experienced it lately and had a chance to notice) to decrease stress and thus increase health. Oscar Wilde was right when he said “Life is too important to take seriously!”
Now choose one thing from the list and try it out! Dive right in and do all of them right away, or make a commitment to incorporate them one at a time, choosing a new one once a week. Either way, the list is intended to demonstrate that health-enhancing changes are easily within your reach, they do not need to be dramatic or hard. As the Pareto principle (somewhat paraphrased) states, 20% of the work accounts for 80% of the results. And remember to stay humerus!