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I recently came across an article that reminded me to keep perspective on how to succeed in becoming healthier and more physically fit (Finn, 2012). In today’s world, there are hundreds of programs that claim to be the best for losing weight. These programs range from Boot Camp, Interval Training, The Biggest Loser to P90X, on which I did my Master's Thesis.

The overwhelming amount of information and advertising about new exercise programs sends people into what Finn describes as paralysis from information overload. Essentially, people become so overwhelmed with the information that they choose to do nothing at all rather than try to pick the 'best' exercise regime. The good news is: choosing the best exercise regime is really quite simple. 

My master's thesis was performed on nearly two-dozen subjects on the effectiveness of P90X and found a clear and simple conclusion. It works….if you do it. The results of my study were that P90X is very effective for caloric expenditure, ability to improve cardiovascular fitness, and a dozen other measures. The problem with doing P90X or any other exercise program is that it does not work unless you do it.

The benefits of exercise are numerous. To name just a few benefits, exercise releases endorphins, which are hormones released in the brain that results in a good mood. Exercise dilates your arteries and reduces the stress on your heart for up to a day at a time. And, perhaps most pertinent of all, exercise also helps to expend calories that lead to weight loss. 

The bottom line is this: don’t make it harder on yourself than it has to be.

At Revolution Physical Therapy & Weight Loss, our exercise experts take into account your current fitness capabilities and goals, and work with each client to compose an exercise plan that is tailored to each individual client. But regardless of whether you work with an expert or follow a program such as P90X on your own, the most important step of all is to carry out your plan. Perform the exercises as outlined by the program, and finish the whole program. I can just about guarantee that you are successful. 

Finn, Christian. "The Most Important Muscle Building Tip You Will Read All year." Muscle Evo. N.p., 08 10 2012. Web. Web. 11 Aug. 2012. <


Have you ever dreamed of reaching a goal before you even got there? 

The mind is a powerful tool when you’re aiming for a goal, and can affect you both positively and negatively. Spending time picturing yourself reaching your goal can actually prepare the mind to achieve it. At RPTWL, Motivation Managers use visualization to help perfect the picture, view the details of how you can carry out each step of your goal, and of course see the end. 

For example, if you’re training to run one mile, you would want to close your eyes and see the start line at the beginning of your personal track, watch yourself power through difficult hills or long stretches, and spend a lot of time picturing making it to the end with energy to spare. Reflecting on the achievement of your mile may inspire you to go even longer, visualizing yourself completing a 5k race, making the once-impossible seem possible to your body through your mind. 

Visualization works by changing the structure of the brain, setting up neuromuscular templates as if you had actually completed the activity. It also allows you the time and clarity necessary to anticipate problems and think through them without the stress of being in the event. 

Any achievement can be visualized in detail, from running to working with weights to making healthy choices at the grocery store. Try it, and if you’re having trouble, ask a Motivation Manager to walk you through the process. 


We had a recent request to discuss one of the most common controversies in food trends today: carbohydrates. While quite a complex topic, carbohydrates are commonly demonized, but does this argument provide merit for health? Based on repeated clinical evidence, carbs do serve several important purposes in our bodies that make them worth keeping in our diets.

To better answer this question, it is important to learn the differences between sugars and complex carbohydrates. What happens when you give a lot of candy to a child? They become energetic and crash asleep in about an hour. This is a perfect illustration of what sugar does to us. It is a fast and taxing process that typically leaves us feeling worse than we did before. Complex carbohydrates, on the other hand, break down very slowly, providing a steady source of fuel for your cells over the course of up to 3 hours. This provides us with some sustainable energy for exercise and daily living. As a result of this, providing an appropriate amount of these complex carbohydrates and limiting sugars do provide worthwhile benefits for our physical self.

For another simple reason to include carbs into your diet, your brain runs purely on a type of sugar known as glucose. Your body will break down various types of carbohydrates into its simplest forms to provide your brain with this needed fuel. By restricting yourself of most/all carbohydrate sources, your brain function may be impacted.

As with just about everything in this world, too much carbohydrate will cause an issue. Water in great excess will cause hyponatremia, a rare but serious condition. Carbohydrate in excess will increase blood sugar and lead to weight gain. So in regards to our question of saint or sinner, I would contest that they are saints in moderation but become sinners in excess. So long as we are consuming better sources and appropriate amounts of them, carbohydrates provide a boost to both our mental and physical well-being. Talk to your Revolution dietitian to discuss better carbohydrate sources and appropriate amounts for your specific needs!




Finding Authentic Internal Motivation

Gaining motivation that comes from within yourself is much harder to earn as opposed to motivation that comes from external rewards. Outside rewards (like money) lose their value rather quickly compared to the rewards we get from internal objectives and desires. Finding real and genuine purpose in your daily actions can improve the level of internal motivation you possess.


Think About Motivation Every Single Day

Remind yourself why it is important to you to have that motivation. Whether your motivation is towards finishing college, working towards a promotion, moving on from a breakup, starting a business, etc., it’s concentrated towards something for a reason. Don’t lose track of what that underlying purpose and goal mean to you.


Set Long Term Goals

Set short-term goals as well. Short term goals are attractive because you can see the accomplishment shortly, but long term goals are the type of targets you have to set to change your life and moreover follow your dreams. Don’t overlook about your long-term goals because of temporary things happening around you.


Ask Why?

If you lack motivation, try to understand yourself and figure out why, ask yourself, what’s wrong? On a day you are feeling particularly motivated, try to understand where it’s coming from and manipulate that feeling or emotion more often. Actions often reflect an individual’s motivation level. When people do things because they love to do them, not because they have to, it makes life easier. Hence why it’s essential to decide what it is that you love to do and if you aren’t doing this you, ask yourself why.


Find a Role Model

Having a role model in your life that you can watch accomplish the things that you dream of, it can make an enormous impact on your level of motivation. Everyone can have role models at any age.



Reward Yourself

Recognize your successes and accomplishments. Don’t let them go unnoticed, even if no one else notices. It’s important to remember to not be so hard on yourself; this can do more damage than you presume.



Historically, resistance training has been associated with athletes and powerlifters. However, with more recent research outlining the benefits for all populations, accompanied by a strong push from the press and even social media platforms, resistance training is starting to get the recognition it deserves. Before identifying various modalities for resistance training, let’s properly define the term and outline the physiological benefits for the general population.

Resistance training is defined as “any type of exercise that requires the body’s musculature to move against an opposing force, usually presented by some type of equipment” (Fleck & Kraemer, 2014, p.5). Benefits of strength training include, but are not limited to: increase of lean mass, decrease of fat mass, increase in bone density, resting blood pressure, insulin sensitivity, and blood lipid profile (Fleck & Kraemer, 2014). In addition to the benefits listed, resistance training primarily has been utilized to improve strength and power for athletes. However, with the growing epidemic of obesity and pre-diabetes, the American College of Sports Medicine (ACSM) is calling for general population to include resistance training with aerobic exercise to promote improvements in body composition and insulin sensitivity to combat the growth of these co-morbidities. Now that we understand the benefits of resistance training, time to discuss how to do it outside of your traditional cable machines and dumbbells!

Before you start searching Amazon or Craigslist for cheap free weight sets, stop and look around. Everything around you is resistance! The random stack of books, elastic bands form physical therapy, the list goes on. If you have nothing around you, use you! Your body weight is resistance. Movements like squats, stationary lunges, step ups, will all provide the stimulus needed to change body composition and promote additional benefits listed above. Find the ledge of table and push up off it, that’s a modified push-up. For more information on a safe and effective resistance training program, consult with your nearest Revolution Physical Therapy and Weight Loss Physical Therapist or Exercise Physiologist. The best resistance program is the one the keeps you safe, and that you keep doing!

Fleck, S. J., & Kraemer, W. (2014). Designing Resistance Training Programs, 4E. Human Kinetics.


Iron is a mineral that is required for the formation of red blood cells, and in these red blood cells, iron carries oxygen to the other cells in the body. In relation to exercise, iron deficiencies can limit endurance and performance since cells may not have adequate access to oxygen. Females (due to menstruation blood loss), athletes (due to increased blood volume), and strict vegans/vegetarians (see below) have a greater risk of being iron deficient than the general population. If you are at least one of these populations, you may benefit from having your iron intake assessed.

When choosing iron sources of foods, it is worth knowing what sources are more beneficial to you. There are two main types of iron, classified as either heme iron or nonheme iron. Heme iron is readily useable to us, and is larger portion of the iron found within meats. Nonheme sources tend to be plant based and are harder to absorb. The easy (and crude) way to remember these types is that the animal was using the iron in a similar manner to how we will. No conversion needed. Plant systems are quite different from ours and the iron needs some conversion to be useable for us. Estimations project we only absorb about 16% of this iron compared to the 25% that heme iron provides. This is why vegans and strict vegetarians are at a greater risk of iron absorption as well.

Sources of iron include fortified grains, meats, eggs, tofu, beans, nuts, seeds, leafy green vegetables, and dried fruits. As stated earlier, include Vitamin C sources with plant sources of iron to increase absorption. Vitamin C can be found in most fruits and vegetables like, broccoli, bell peppers, cabbage, sweet potatoes, oranges, kiwi, pineapple, and grapes. Ask your Revolution dietitian about how to increase your iron intake to potentially improve performance!



Summer time is typically laden with frequent events to pair with the friendly weather Summer provides. With these events comes added temptation and pressure for large portions or unhealthy options. Here are a few tips on how to avoid having your social life reverse your weight loss efforts.

One of the best strategies for handling events is to be adequately prepared for the event. If the event is at a restaurant, try to look at the menu beforehand and show up with a plan in mind. Nutrition information for restaurants is becoming more common, so look for this information to avoid surprises. Restaurant entrees may exceed 1000 calories in a single dish! Since portions at restaurants tend to be large, aim for some leftovers. While ordering, you can always ask for half of your meal to be boxed to go or share the meal with a friend. This will limit temptation and calories. 

When many options are available to you, take the time to look at all them before making selections. If your plate gets pretty full before you find that must-try dish, you may be tempted to start stacking or coming back for a second round. Also keep in mind that protein and fiber will make a meal more filling. To limit hunger, make sure you have a protein source, preferably with some fiber like whole-grains, beans, fruits, and/or vegetables. 

Unless the event is first thing in the morning, eat beforehand to avoid being starving for the event. The temptation of worse options will be stronger when we are also hungry. In the same line of thinking, having extra water or veggies during the meal will help you fill up on healthy items, leaving less room for the worse options. Opt for these when you can! Filling half your plate with veggies can greatly lower the calories you will consume.

Lastly, try to practice mindfulness to get the most out of every meal you have. I am sure we all have had an experience where we have two bagels in front of us, and after eating one we realize both are now gone. What did the first bagel you ate do for you? I like to challenge my patients to think critically about this, as well as our enjoyment of feeling full. Do we actually enjoy the feeling of being full, or does that feeling just mean that we had the opportunity to enjoy food for an extended period of time? The vast-majority of responses I have received agree that we like the taste over the actual feeling. Let’s use that to our advantage and take our time with the meal to really savor each bite. Smaller bites over a longer period of time will trick us into thinking we are eating more than we are. This also provides more time for our bodies to tell us we are getting full.

By practicing as many of these strategies you see fit at your event, you can find ways to enjoy yourself and still be moving toward your health goals. Talk with our Revolution Dietitians to make a personalized plan for the events you have coming up!


Just about anyone who has been on a treadmill, elliptical, or used a heart rate monitor has seen the chart that tells you to take 220 and subtract your age to get your maximum heart rate. This gives you a percentage of that maximum which puts you in a “weight loss zone”, an “aerobic zone”, or an “anaerobic zone”. Many people take this to heart and use these numbers religiously to plan training programs— but have you ever stopped to wonder where that 220-age formula came from? Would you believe me if I told you that it was an almost arbitrary number? Brace yourselves, because it is almost that “arbitrary”.

The answer of where heart rate max = 220-age is derived from is actually not even completely known. It appears to have come from a very small study in which the author concluded that 220-age “was not far off.” Years later when the data from this study was actually crunched, they determined an inherent error of 21 beats per minute (BPM). This means that if your projected maximum heart rate was 180, it could actually be anywhere between 159-201!

So why is this important? Imagine that you are 40 years old and want to create a training program using the 220-age formula to exercise at 80% of your maximum. To do this you would have to take 220-40=180, and then account for the formula’s error. Meaning the actual heart rate maximum could most likely be somewhere between 169-191. When you do the calculations for 80% of 169 and 191, you get a heart rate that equals either 153 beats per minute or 135 beats per minute, two numbers that are vastly different. So which one would you use? The answer is that you can take your pick, because either one is just as likely to be wrong.

This is why sub-maximal cardiopulmonary exercise testing can be so beneficial. This test tells you precise heart rates that correspond specifically to the physiology of your body. Unlike heart rate monitors, which use nomograms and algorithms based on mass populations to determine your caloric expenditure, these tests determine your actual caloric expenditure at a specific heart rate. Therefore, knowing your caloric expenditure along with having an organized nutrition plan is the key to weight loss. Even if your exercise and nutrition calculations were 200 calories off, one can of soda would offset all of that progress, rendering all of your hard work worthless as far as weight loss is concerned!

Cardiopulmonary exercise tests use gas exchange, which determines exactly what your body is choosing as fuel. Therefore, instead of just guessing, you can determine if you are burning fat or carbohydrates, which are the actual determinants of the so called “aerobic” “anaerobic” and “weight loss” zones. Knowing fuel utilization can also help you determine the point at which lactic acid builds up in the muscle, which correlates to muscular fatigue. Knowing where this occurs helps you to determine exercise ranges that provide cardiovascular benefit and burn large amounts calories, but do not cause the muscles to rapidly fatigue or get too sore. Lastly, these tests can determine and track your VO2max over time. For athletes, a higher VO2max often correlates with better performance, however, more importantly, the VO2max has recently been determined to be on of the best markers of cardiovascular health as well. In fact, this number is so important, that a low VO2max is considered the best indicator of mortality, which means that improving your number may be the most beneficial thing that you can do for your health.

In closing, it’s clear that the 220-age formula really has no use in an exercise or clinical setting. In fact, there is a large push to get these numbers taken out of the textbooks. For healthy people with a physician’s consent, performing a symptom limited cardiopulmonary exercise test is the best way to determine heart rate zones and plan safe, effective exercise programs.



Robergs, Robert, and Roberto Landwehr . "The Surprising History of “HRmax=220-age” Equation." Official Journal of the American Society of Exercise Physiologists. 5.2 (2002): 1-10. Print. (Robergs, and Landwehr 1-10)


Hot weather running, is the best!  I love to get up early on a hot day and run along Chicago's lakefront. It's amazing how many runners and walkers are outside enjoying our short, but hot summer. My only concern for those of you hitting the pavement, trail, or track on these hot days is your preparation after being inside for many months.

Consider a few important points as you enjoy what I believe is the easiest and cheapest way to stay in shape.

Hydrate, hydrate and hydrate!  Too many runners neglect to drink water before, during and after their run. The basic rule is, if you are thirsty, then you waited too long to drink. Start the night before by drinking plenty of water. Even in the hours after your run, make sure you continue to drink water. If you run for over an hour consider drinking an electrolyte replacement, such as Gatorade.  If you are just starting a running habit try different electrolyte replacements/sport drinks to see what is best for your stomach.  Marathoners often eat electrolyte replacement gels, which I find helpful. Talk with the knowledgeable people in your local running stores as they usually not only sell these products, but also use them personally. In Chicago, Dave Zimmer at Fleet Feet, is my go to guy on anything running.

Clothing is also very important, especially in the heat. If the morning is starting out cool, wear a long sleeve, loose shirt, which is designed to wick off sweat and keep you from overheating. As the day heats up, lightweight breathable shorts and singlet in a light color should be worn to keep you cooler.

Warm up and stretch prior to running, but don't push too hard in the heat.

Eat something easily digested or nothing before a run. Marathons are the exception, where you will need to be awake very early and eating a substantial breakfast 2-3 hours before race time.

Don't be fooled by the notion that less water and more sweating will cause you to lose weight. This is only temporary water loss and too much can be a major problem and cause extreme dehydration.

Make these runs fun and you will come back to them often, that is the recipe for weight control and fitness.  Enjoy the heat before winter sneaks up on you!


EPOC is an acronym that stands for excess post exercise-oxygen consumption. What this really stands for is the amount of calories that are expended after an exercise session is over. The consensus from research studies is that lower intensity workouts (cardiovascular) do not elicit much EPOC. In other words once the workout is over, the caloric benefit from that workout is pretty much finished. Whereas, when a high intensity training session is finished (anaerobic) the caloric benefit has just begun.

The best way to elicit EPOC is through high intensity interval training (HIIT) and resistance training. When the body works at a high intensity creating an anaerobic state it uses carbohydrates and creatine to fuel the exercise. These fuels cause the body to produce certain waste products like lactic acid and signals the release of hormones like growth hormone and testosterone in order to repair muscle cells. It takes a lot of work for the body to shuttle these waste products, restore the body’s pH balance, repair and build muscle, and facilitate recovery after a workout. In order to do all of these things the body needs to use excess energy beyond what it used during the workout alone. This extra energy expenditure can be extremely helpful when it comes to weight loss.

A great example of just how beneficial EPOC can be is when comparing a long distance runner to a sprinter. Long distance runners and sprinters generally look very lean, but long distance runners typically have more body fat than the more muscular sprinter. In general, this does not make sense, because the long distance runner expends thousands of calories each week running upwards of 100 miles some weeks, whereas the sprinter only runs short distances that generally last less than a minute and expends much smaller amounts of calories. That is where EPOC comes in. Despite running shorter periods of time, the sprinter does much more intense short bursts, which cause the body to go into overdrive to repair the muscles, restore the pH and many other processes. This essentially turns the body into a fat burning machine long after the actual sprinting is over allowing the sprinter to expend large amounts of calories despite only working for short periods of time. Sprinters also spend much more time in the gym performing resistance training than long distance runners. Resistance Training at higher intensities can have a similar effect to sprinting and signal growth hormones that also help build muscle and expend fat at rest.

Working at high intensities may not be for everyone, but keep in mind that the intensity is relative. Michael Phelps feels the same way working at 80% of his maximum workload as a beginner walking at 80% of her maximum workload. That being said it can also take time before someone is ready to partake in high intensity workouts. For those people I have created a modified starters guide below. For healthy people looking to partake in HIIT workouts, you can start by warming up for 5-10 minutes on the treadmill. Then exercise at about 85% of your maximum for 1 minute followed by walking at a slow pace for 1 minute. Repeat this sequence 10 times. As you get more comfortable you can decrease the time and increase the intensity.

For those who want to start out slower or are at a lower fitness level, you can start by warming up for 5-10 minutes on the treadmill. Then exercise at about 60% of your maximum for 1 minute followed by walking at a slow pace for 1-2 minutes for two weeks. After that you can increase the intensity by 5% every 1-2 weeks until you get to 85%.



We're constantly using the food we eat (fats and carbohydrates) as fuel, both during exercise and at rest. Understanding how our body uses that fuel can make a huge impact in knowing how to tailor exercise to create an effective weight loss program.

During lower intensity cardiovascular exercise, we mostly burn fat. However, we can't burn huge amounts of calories in short periods of time at low intensity. Contrarily, during higher intensity cardiovascular exercise, we use a much higher percentage of carbohydrates, but we also use all of the fat that is expended at the lower intensities as well. Therefore, we burn more of calories. During resistance training, we utilize a much larger amount of carbohydrates, even at moderate intensities, and the maximum amount of carbohydrates at higher intensities. So, how can we use this information to our benefit?

Theoretically, if we exercise at maximum intensities for extended periods of time, we would be using a large amount of carbohydrates, as well as fats. In this way, we burn the most calories and therefore lose the largest amount of weight loss. Unfortunately, this doesn't always work, because of many reasons. 

First of all, exercising at high intensities for extended periods of time can be a hassle and is certainly not enjoyable day after day. Secondly, exercising this hard, coupled with resistance training can use a large amount of the carbohydrate stores. This, in turn, lowers blood glucose,  which is a good thing for people with prediabetes or diabetes, but not good for those of us with normal blood glucose.  Low blood glucose can cause hunger, which we all know is difficult to ignore. The hunger associated with low blood sugar usually results in a person eating all the calories back in a desperate frenzy. Lastly, using such high amounts of carbohydrates causes muscular fatigue and lowers the pH of our body, which results in even more fatigue. Therefore, even if we wanted to exercise at high intensities every day, our bodies could not handle it due to soreness and fatigue. 

The alternative option is to exercise at lower intensities and just burn fats, but this isn't a realistic option. Most of us don't have three hours to spend on the exercise it would take to burn the amount of calories required to lose weight. 

Armed with this information, how can we make the most efficient workout for weight loss?

The answer is that everyone is truly different, and the workout that works for YOU is the best! Don’t trust anyone that says they have the perfect exercise program if they don’t know the physiology of your body. Everyone is different, and their bodies use different amounts of fuels for different exercise intensities. 
That being said, a very effective approach for new exercisers is to start slow. This will make things manageable in the short term and reduce muscular fatigue and soreness. As you become acclimated, work towards a moderate intensity program for large portions of your workouts. Moderate intensity will burn fat, of which we have an essentially endless supply (~20,000 calories). Then, integrate intervals which burn high amounts of carbohydrates for shorter periods. This causes the body to burn large amounts of calories, along with forcing the body to adapt to a higher intensity exercise. 

Physiologically, the reason our bodies can adapt to this high intensity is due to increased capillarization: the increased ability of the muscle to remove wastes, along with increased mitochondria. In layman’s terms, mitochondria are energy factories within every cell in the body, with the sole purpose of using oxygen to convert food to fuel for cells. By increasing mitochondria, we have a greater capacity to utilize fats instead of carbohydrates, even when exercising at higher intensity for longer periods of time. 
The bottom line is that a balanced approach to fitness will yield results without being so intense that you hate it. I've had clients who hated exercise and hated to be pushed.  But, because we started slow, they can do things today that they never imagined possible.  And that continued participation yields results 100% of the time. 


Summer is upon us and it is time to get outside and get moving.  Many people who typically work-out indoors during the colder months want to get outside when the weather gets warm. It is a great idea to mix it up a bit during the summer but it is also important to remember that there are certain things to consider when taking your work-out outdoors.  You will now be in an uncontrolled environment which can increase your risk for injury.

If you like to walk or run outdoors it is important to have supportive footwear. The terrain outdoors on the sidewalk, trail or street can vary greatly and creates a different impact then using the treadmill indoors. Old or worn out footwear may not have the appropriate level of support or cushion and this can lead to injury.  It may be beneficial to head to a shoe store that specializes in walking or running footwear to get properly fitted and to get shoes for the type of training you want to participate in.  If you want to get outdoors to play tennis, golf, or other recreational activities it is important to do a dynamic warm-up and perform movements that are the same as the movement patterns you would perform while playing.  You could perform arm circles, trunk rotations, walking lunges and other movements that mimic the motions similar to the movements you will make while playing tennis or golf.   If you like to cycle outdoors make sure you have a bike that is the proper fit to prevent injury and enhance comfort.  You will want to make sure the seat is at the proper height and the handlebars are positioned so that you are not bending too far over to decrease risk of back pain.  You can spend a few minutes on the bike in the store and ask someone to help you get the proper fit if buying a new bicycle.  The other thing to remember is to wear your helmet to prevent head injuries in the case of a fall.

For any outdoor activity you may decide to participate in this summer it is important to make sure you pay attention to your environment. The summer heat can cause problems if you are not careful on days when it is hot and humid.  Make sure you stay hydrated and protect yourself from the sun. You don’t want to get overheated while you are out on your run or bike ride and not be able to make it back home.  When exercising outdoors you may sweat more and when you sweat your body loses water, electrolytes and salt.  The balance of water and electrolytes is important to keep your body functioning properly. If you are not drinking enough water you can easily get dehydrated in the heat. Try to drink water before you go out to work out, bring water with you for during your work-out, and then remember to drink water when you are done.

You may also find that you need to take more breaks due to the heat that you may not have needed when working out indoors. Getting acclimated to the heat can take one to two weeks if you are not used to working out in hotter temperatures.  Keep in mind that just like your indoor training program you will want to have rest days with your outdoor regiment as well.  Wearing light clothing can help to protect you from overheating. Try to avoid the peak hours of the heat and sun and get your work out in during the early morning hours or evening hours when it is cooler.

Exercising in the hot weather can put extra stress on your body and exercising in the heat can cause serious illness if you are not careful.  When exercising in the heat your core body temperature increases and to help cool itself, the body will send more blood circulation to your skin which will decrease blood for your muscles and increase your heart rate. Wearing your heart rate monitor can help you monitor your body’s response to exercise.  Heat related illness can include heat cramps, fainting, heat exhaustion and heatstroke.  Pay attention to the warning signs of heat induced illness which may include muscle cramps, nausea/vomiting, weakness/fatigue, excessive sweating, dizziness/lightheadedness, confusion, irritability, low blood pressure, increased heart rate or visual problems. If you develop any of these symptoms, you need to lower your body temperature and get hydrated right way so you should stop exercising immediately and get out of the heat.

Trained physical therapists and exercise physiologists at Revolution Physical Therapy and Weight Loss can guide you through transitioning to a summer work-out program. If you have any questions or concerns make sure you ask a professional before beginning a new work-out.



According to the findings of Sabbahi and company at The University of Illinois at Chicago (in-press, 2017); patients lost approximately 12 lbs, decreased fasted blood glucose, and significantly reduced resting blood pressure after 8 weeks of comprehensive care.

Often the summer months can feel like a boon to exercise. Gone are the days when you have to hide inside from the snow and do hour after hour on a treadmill like a hamster on a wheel (at least for a few months). Warmer weather means options! Bike, swim, run, play sports with your kids or friends, or just go for a stroll. However, this new wealth of opportunity can lead to complacency and lapse in established behavior change.

During the winter, we’re often slaves to our gym’s hours of operation. However, this limitation provides structure and can help motivate us to get that workout done. Having multiple options and less structured time can often lead to thoughts like, “Oh, I can just go for a walk later,” or “I have a softball game this weekend. That counts.” It’s important to not forget the difference between scheduled set exercise sessions and physical activity. Outdoor physical activity can be fun and healthy, but cannot always replace your five weekly exercise sessions. When in doubt, consult with your Revolution PTWL Exercise Physiologist.

Keep in mind, summer also means heat which can be just as difficult to deal with as cold. Jackets and wool hats give way to sunscreen and water bottles. It’s easy to head outside into the newly warm weather without thinking how the increased heat is affecting your body. Protect your skin and stay hydrated! 

Summer also often means vacation! You’ve worked your butt off all year and now it’s time to have some fun! Everyone deserves a vacation but it’s important not to get into the “vacation mindset.” By that I mean, falling into the thinking pattern that vacation means NO WORK, NO RULES, ALL PLAY. Yes you may eat out more on vacation, you may consume more calories than normal, and it may be hard to get all of those exercises in. This is all reasonable, but that does not mean you should totally disregard your mindful eating habits and decide to not exercise at all. Remember, consistency is key to maintaining the healthy habits you’ve developed. So go into vacation with a plan. You’re already going to plan how you’re going to get to your destination, where you’re going to stay, and what you’re going to do for fun. Do the same for your eating and exercise. If you’re staying in a hotel, check online and see if they have a fitness center. Check a map of the area where you’re staying and see if it makes sense to go for a run, walk, or bike ride a few times during the week. If you don’t have access to strength training equipment, check with your Revolution PTWL Exercise Physiologist before your trip to see if they can suggest some bodyweight exercises to keep your strength up.


For more information/ideas check out the article on this topic posted on our Facebook page or consult with your Revolution PTWL Motivation Manager.



     Summertime is finally here! Pull out the bicycle, running shoes, bathing suit, whatever gets you excited to exercise outdoors. Time to get out of the gym and take your training outside. However before hitting the trails, it is important to understand the importance of making the transition with your program. In other words, you no longer can follow your usual speed/grade, RPM/level routine that has kept you afloat throughout the cold months. Before we can discuss optimization of outdoor training, we must understand the differences in field and lab setting training.

     Field training is defined as any structured exercise performed where environmental factors CANNOT be controlled (McArdle, Katch & Katch, 2010). Environmental factors include but are not limited to; temperature, humidity, wind, etc. Examples of field training include walking outside, cycling, swimming in a pond or lake. Lab training is just the opposite, and includes structured exercise that is performed where said conditions can be controlled and exercise is generally performed with some sort of equipment (McArdle, Katch & Katch, 2010). Furthermore, since lab setting exercise is generally performed on a piece of equipment, it is much easier to control intensity (speed, grade, etc.).

    So what are some of the key differences to take into consideration when moving from the gym to the path? The first and most important is always safety. You can't get results if you're hurt. Individuals should take into consideration the effect of impact on the body during weight bearing activity on different surfaces. Field setting surfaces (paths or cement) are much less forgiving than a treadmill or even indoor track. Always consult with a professional regarding proper footwear to decrease the risk of an overuse injury. Other considerations include proper hydration for heat, and protection from sunburn.

    Next, it is important to ensure you're achieving your calorie expenditure goals during your workouts. If you choose not to use any GPS devices during field activity, you have no idea what speed or grade you're walking or cycling at. Therefore, the recommendation is to switch to heart rate zone training to assure your intensity is relative and replicable in any setting. The worst thing that can happen is you end up decreasing the intensity of your exercise when you move outside. Since you don't have equipment holding you to a certain speed or level, it is easier to burn LESS calories outside if intensity is not carefully monitored.

    Finally, find something you will actually KEEP doing! I see it time and time again where people create an idea that they are going to start paddle boarding because they hear it's “great for my core!” It sure is, however you have to keep doing it! Think about the practicality of your field activity. If it is something that requires too much planning and time, you may not be able to keep doing it. No matter how much you enjoy it, it has to fit in with your lifestyle and schedule, otherwise it will get chopped from the day when you get busy!

    Anyone reading this who interested in starting their outdoor training should consult with a professional before doing so. Revolution Physical Therapy and Weight Loss is staffed with the perfect combination of Physical Therapists to keep you safe and Exercise Physiologists to keep you efficient with heart rate zone training!

McArdle, William D., Frank I. Katch, and Victor L. Katch. Exercise physiology: nutrition, energy, and human performance. Lippincott Williams & Wilkins, 2010.    



Now that your workout has been completed, it is time to fuel up with some appropriate food choices! The goal here is to recover as optimally as possible while encouraging the greatest beneficial change from exercise. To do this we need to focus on not only what we eat, but also when, and how much we should have.


Since our bodies are in recovery mode at this point, it is best to have an appropriate meal as soon after as possible. As a general rule, try to avoid waiting longer than 2 hours after exercise. As for what options to opt for, there are three main items to grab: a protein, a fast-digesting carbohydrate, and some water. The protein encourages the synthesis of proteins in muscle and helps repair the muscle tissue. The fast-digesting carbohydrate will get into the bloodstream faster and will help replenish glycogen stores that were spent during exercise. Replenishing those glycogen stores will help fight lethargy after exercise and provide energy at your next exercise! Lastly the water is there to help replenish the water you may have lost during exercise. In 2010, the International Society of Sports Nutrition describes water as “the most important nutritional ergogenic aid for athletes is water” in their sports nutrition recommendations due to the impact that dehydration can have on performance.


Now that we have briefly discussed the what, when, and why, let’s put it into practice with some appropriate options! Be sure to include 16oz of water with any of these options.

-Greek yogurt and fruit

-Turkey and cheese tortilla roll-up

-Mini bagel with peanut butter

-Strawberries and a protein bar

-Banana with almonds

-Rice cakes with peanut butter

-Chocolate milk

-Hummus with pita


Protein powders can suffice but they tend to lack some advantages that food can provide us. Vitamins, minerals, and other beneficial compounds may be lost in the process of making protein powder. Another downside of powder is that they tend to be less filling than food sources are, since protein powder is more broken down already. To be more technical, the reason for this more rapid breakdown is the increased surface area of the powder that allows more enzymes (called protease) to digest a larger portion at once. A good analogy of this would be ‘a pile of snow takes longer to melt than spread out snow.’ The spread snow has more direct sun which allows it to breakdown faster. Solid protein foods will act like this pile of snow which takes longer to digest and will keep you fuller longer. If food sources are not available, a protein powder will still be better than not having any protein at all!


Ask your Revolution Dietitian for more appropriate post-workout options that fit your lifestyle.


Kreider, Richard et al. "ISSN Exercise & Sport Nutrition Review: Research & Recommendations". N.p., 2010. Web.


Although there is plenty of literature to support and encourage eating before exercise (resistance or aerobic) people still tend to gravitate towards going into a workout on an empty stomach. Not eating before a workout may seem logical at first thought. “I’m going to expend calories, why would I consume calories? This will decrease my deficit!” However our bodies are like any other efficient machine, which requires the adequate amount of fuel prior to activity.

To be clear, this is no declaration that we all need to consume a Denny’s Grand Slam ® before hitting the gym. What we do want to focus on is the concept that fat burns in the flame of the carbohydrate (McArdle, Katch & Katch, 2010). In other words, consuming a light 100-200 kcal snack an hour or two prior to exercise, primarily consisting of carbohydrates, will help elevate blood glucose (McArdle, Katch & Katch, 2010). This elevation of blood glucose provides several benefits during your workout. One such benefit is when you utilize these fuels (carbohydrates) for activity, the waste products (think about it like the exhaust of your car) will stimulate the breakdown and mobilization of fatty acids for fuel. Furthermore, these extra consumed carbohydrates will help you preserve muscle glycogen longer into your workout. More simply put, you will have extra fuel in the tank to complete more work. The more work you complete, the more calories you will burn throughout the duration of your session.

Optimal pre-workout snacks one hour to immediately before exercise include, but are not limited to; a low-fat fruit yogurt, 1 to 2 servings of fruit (one serving being 1 medium-sized fruit, 1 cup of berries, half a large banana, ½ cup fruit juice). If choosing an option 1-2.5 hours before exercise, try having 1 piece of whole-grain toast with an egg, some cottage cheese with fruit, 1 cup of oatmeal (or reduce the oatmeal to add some fruit options), or even ⅔ cup of whole-wheat pasta with some red sauce. Limit high fat sources before working out, since they take longer to digest and may cause discomfort. (Imagine drinking a milkshake and trying to run). When it comes to exercise, fruit is your friend!

In conclusion, finding the right snack before your workout has the potential to increase calorie expenditure and assure you’re burning the proper fuel. The key becomes finding the right amount that will not result in gastrointestinal distress (i.e., bloating, gas, etc.). Stay tuned next week as we dive into proper POST workout fuel to assure you’re providing the proper building blocks for recovery and ultimately gains.

McArdle, William D., Frank I. Katch, and Victor L. Katch. 
Exercise physiology: nutrition, energy, and human performance. Lippincott Williams & Wilkins, 2010.






Rate of repetition is typically one of the first questions you receive working as any sort of exercise technician.  When performing a rep of an exercise for the first time, I often get “Is this too fast? Is it better to go slow?” As with all principles we discuss in this blog, there is no right or wrong, however there is always a more EFFICIENT way to do something based on your goals. In efforts to remains consistent in our discussion, let’s continue to focus on body composition and weight loss resistance training when examining the rate of repetition.

Before understanding which rate of repetition is most important for weight loss, we must understand how a muscle contracts and the velocity-tension relationship. To put it in layman terms, our muscles act as sliding filaments. Skeletal muscle is comprised of two different types of filaments, a thick (myosin) and a thin (actin) filament, which bind to one another and cause contraction upon stimulus. For those who are visual, view the image below to get a better idea of how a muscle contracts (McArdle, Katch & Katch, 2010).

Now onto the velocity tension relationship. The slower a muscle contracts the more binding of actin and myosin can occur, therefore more force is generated. It is important to understand that in order for binding to occur, calories must burned. Vice versa, the quicker a muscle contracts, the less binding occurs. Therefore at first glance, we can assume a slower muscle contraction would be more beneficial since more fibers are being used, and ultimately the more calories you burn and weight you will lose!

Not so fast! No pun intended. It is important to always identify the practical application of an Exercise Physiology principle. The slower the movements, the less repetitions you complete in a given hour. The less repetitions you complete, the less calories you burn due to decreased amount of work in that hour. So unless you have an extra hour in the day, on top of the hour you already set aside for exercise, you may find yourself spending much more time in the gym due to slower training.

To conclude, there are several benefits to slower training for resistance exercise. However, it suggested to start with a moderate pace to assure an adequate amount of work is completed in a timely manner. This appropriate pace would be 2-4 second range per repetition. Certainly be sure to integrate sets of slower training into your workout, to increase muscle fiber utilization, however avoid fast training as it may lead to inappropriate compensation and ultimately injury.


McArdle, William D., Frank I. Katch, and Victor L. Katch. Exercise physiology: nutrition, energy, and human performance. Lippincott Williams & Wilkins, 2010.



Per the blog entry last week, we learned the significance of rest between workout days to avoid burnout. However looking on a micro-scale, it is important to understand optimization of rest periods during resistance training when trying to lose weight. Before understanding optimal recovery between sets, we must define the culprit of initial onset muscle fatigue during resistance training; lactic acid.

Lactic acid is the waste product of a carbohydrate which fuels anaerobic glycolysis, the preferred energy pathway during resistance exercise (McArdle, Katch & Katch, 2010). The accumulation of lactic acid in the muscle is suggested to inhibit cross bridge cycle (AKA muscle contraction) therefore, emerging as one of the factors of early onset fatigue when performing mechanical work.

Now to examine the clearance or removal of this lactic acid. It is important to understand not ALL of this lactic acid can be removed or cleared acutely. A portion of this lactate will remain present in the fibers, the hydrogen ions will dissociate and cause soreness in the coming days (Brooks at al., 2002). However, a large portion of it can be removed via active recovery.

Active recovery, in terms of its meaning during resistance training, refers to any aerobic activity performed intermittently with resistance exercise to assist with removal of lactic acid. This removal is carried out primarily via the Cori Cycle, a process which shuttles this lactic acid to the liver to be reverted back to a carbohydrate, which can be used for fuel (McArdle Katch & Katch, 2010). The removal of this lactic acid will do two things; improve your ability to complete work (sets & reps) throughout your resistance workout, thus allowing more calorie expenditure, secondly it will prevent accumulation of lactic acid and prevent delayed onset muscle soreness (DOMS). Therefore, it is clear the benefit is two fold. You are able to burn more calories during a given resistance bout, and you will WANT to keep working out since not a lot of people enjoy being debilitatingly sore after resistance exercise.


In conclusion, the next time you are feeling fatigued during resistance exercise, don't head to the water fountain or sit on your phone for five minutes. Hop on any piece of aerobic equipment and exercise at a low intensity for those five minutes. Your body will thank you and most importantly you will maximize calorie expenditure.


Brooks, G. A. (2002). Lactate shuttle–between but not within cells?. The Journal of physiology, 541(2), 333-333.

McArdle, William D., Frank I. Katch, and Victor L. Katch. Exercise physiology: nutrition, energy, and human performance. Lippincott Williams & Wilkins, 2010.


Sometimes we take on that frantic “must work out every day” mindset and completely forget that one of the most important parts of exercising effectively is giving our bodies time to recover. If you’re just now starting out in the fitness world, your rest day should probably be a real rest day in which you do not do any activity at all. A more experienced athlete can have a greater tolerance for continuing to do some light activity during a rest day.


By giving yourself a day to rest and recover, you can avoid Overtraining. Overtraining is the result of giving your body more work or stress than it can handle. This occurs when a person experiences stress and physical trauma from exercise faster than their body can repair the damage. Overtraining can also be described as a point where a person may have a decrease in performance and plateauing as a result from failure to consistently perform at a certain level or training load exceeds their recovery capacity. They stop making progress, and can even begin to lose strength and fitness.


So if you are new to a workout program or resistance exercise, ease into it. By going from 0 to 100 on the first few days or weeks, you may often find yourself too sore to go back to exercise, or even worse injured. Overtraining can also cause a weight-loss plateau. You know that working out too often or too intensely can lead to too much weight loss, but most people don't realize that it can also have the opposite effect.Thanks to your body's built-in protective mechanisms, overtraining can cause a plateau in your weight loss or even weight gain (unrelated to increased muscle mass).


If your workouts are regularly making you crash in the afternoon or drag through your day, because you're so tired and sore you can barely move, then you're doing too much. Listen to your body! Overtraining often leads to burnout. In the end, life is all about balance. We all have limited resources—time, energy, money, physical reserves—and spending too much of them on exercise can lead to burnout.Burnout is a state of emotional, mental, and physical exhaustion caused by excessive and prolonged stress. It occurs when you feel overwhelmed and unable to meet constant demands. It's better to commit to a sane program that fits in with your schedule and goals, than to go all out and want to quit after one month. Coupled with mental stress, the signs and symptoms are physical, behavioral, and emotional, including:

  • Washed-out feeling, tired, drained, lack of energy

  • Mild leg soreness, general aches and pains

  • Pain in muscles and joints

  • Sudden drop in performance

  • Insomnia

  • Headaches

  • Decreased immunity (increased number of colds, and sore throats)

  • Decrease in training capacity / intensity

  • Moodiness and irritability

  • Depression

  • Loss of enthusiasm for the sport

  • Decreased appetite

  • Increased incidence of injuries.


Some tips for avoiding Overtraining or Burnout:

  1. Have planned rest days. Try not to exercise/workout 3-4 days in a row without a rest day. You can still do your daily physical activity such as walking the dogs, yard work, and chores, but no planned exercise.

  2. Plan something fun or relaxing for your rest days. Part of overtraining or burnout is being overstressed. By finding ways to “decompress” you can help recover. So plan things you like to do that are stress relievers such as going to the movies, reading, game night, etc…

  3. Recognize YOUR signs and symptoms of being over stressed. Everyone has different levels of stress and by identifying when YOU need a break , you can take the rest when needed. This means you may have to switch up planned rest days or events to take care of yourself.

Time and time again we read, or even hear from our peers, “you have to do more, to lose more”. In other words, if you’re not making your exercise harder (i.e. increasing weight with resistance or longer duration/mileage for aerobic) you will not get consistent weight loss results. Overload, defined as the manipulation of frequency, intensity, or duration of exercise (Plowman & Smith, 2013), is in fact one of the most important principles for any type of resistance training or aerobic exercise, and if followed correctly will assure consistent weight loss results. However, what is too often ignored are the different types of overload that can be introduced to increase specifically intensity.

Primarily, people tend to gravitate towards an increase in weight to increase the acute intensity of their resistance training. More simply, they move from the 10 to 20 lbs for let’s say a dumbbell squat. While this falls within the umbrella of overload, as it causes an increase of intensity, often other factors of intensity are too often ignored. These factors include, but are not limited to; stability, recovery between sets, changing grips or stance, unilateral exercise, ordering of your exercises, or timing of your repetitions. All of the aforementioned adjustments to your resistance programming can be utilized to achieve the similar overload results of increasing weight.

As a result of using a variety of factors for intensity overload, you create a much wider array of programming and prevent your routine from becoming “stale”. Not that you cannot ever perform the same workout, this tends to drive people to failure as it increases the effort and planning stage for every workout. However more applicable, would be taking these suggested changes and adding them to your current strength training routine, to assist with overload and provide variety.

Whenever starting a resistance training program you should consult with a professional to either assist with programming optimal overload, or seeking their services to help you overload SAFELY and also EFFECTIVELY.

Plowman, S. A., & Smith, D. L. (2013). Exercise physiology for health fitness and performance. Lippincott Williams & Wilkins.


Almost everyone trying to lose weight has had that month where they step on the scale and are consistently not seeing a change in weight. This instance has been deemed the dreaded “plateau” of weight loss. Following the lack of change in weight on the scale, two scenarios may occur.  First, people default to the fact their body will just not give off any more weight and quit their regiment. Why waste the time exercising and focusing on nutrition when the “results” aren’t there? The other scenario is a person may decrease their calories consumption further, up their exercise intensity or frequency, which in turn creates unrealistic habits.  This behavior will only lead to another plateau and eventually causing them to be right back where they started; wanting to quit.

I know what you’re all thinking right now. You’re preparing yourself for some cliche piece of advice to beating a plateau. Things you have heard hundreds of times before like meal timing discussions, macronutrient balance, hydration, etc. All extremely pertinent information to TRUE plateaus. However my goal of this piece is not to give you feedback to beat a plateau, but to accurately define a weight loss plateau.

The staff at the Mayo Clinic (2015) describes a weight loss plateau as “no change in weight in days or possibly weeks after following a regimented diet and exercise program”. The key to this phrase that most people ignore has been bolded and underlined for your viewing pleasure.  More simply said, are you still doing EVERYTHING you were doing when you lost that first 10-15 lbs? Or have you gotten comfortable? Too many times in our field, patients get lax on their weight loss journey. They go on cruise control after that first 10 lbs. They stop tracking their food as accurately, do not following prescribed HR zones and miss workouts, etc. A number of things they were all doing at the beginning that lead to their initial success have now stopped . All of a sudden as gradually as the habits decrease, the weight loss results decrease that much quicker.  

I’m not here to argue the science of plateaus. As unfair as it is, we know they occur. I am here to stay, take a step back and look at your data before waiving the white flag to the dreaded plateau. The easiest way to do this is simple, OBJECTIVE DATA (numbers). Always track your food and exercise no matter what. Even on routine days, when you know exactly how many calories you’re going to eat. Still track. Same with exercise, still wear your heart monitor and know exactly how many calories you burn and heart rate average. This way once you do reach an ACTUAL plateau (remember, defined as doing EVERYTHING you started doing and no weight loss results) you have the data to make adjustments that will re-ignite results.

To conclude, if you’re consistently keeping objective data for nutrition and exercise, and most importantly reviewing it, you will decrease the frequency of these “plateaus”. This being for the simple reason that the data doesn’t lie. If you overeat and don’t exercise as much on a given week, you will not lose the same weight you did weeks prior. I realize this may seem like a gross simplification, but you would not believe the number of times people proclaim “plateau!” after a month of not doing what they had originally done to result in their initial success.

Getting past a weight-loss plateau. (2015, January 07). Retrieved April 25, 2017, from


Attention current and former Revolution patients! We want to thank you for trusting us with the care of your friends and loved ones. We are extending the offer of one free week of personal training with one of our talented Exercise Physiologists for those who refer a new patient.

If one of your friends or family members calls one of our seven conveniently located Chicagoland clinics, tell them to mention your name when scheduling and we will take note. Once your referred patient has started care, you are welcome to call any location and redeem your free week of training. Please note all patients must have an up to date physician referral before starting care. 


Most people who are trying to lose weight have a very specific goal weight they would like to reach. This weight is something they were when they were younger, before they had kids, during sports, etc...and they would like to get back to it. However, many (if not all) have experienced losing inches, but not weight on the scale. There are also those  who have gained weight on a weight loss or resistance training program and often find themselves saying “I must be gaining muscle!”. This thought process happens by believing that Muscle weighs more than Fat. However, muscle and fat weigh the exact same. If you were to ask yourself “What weighs more a ton of bricks or a ton of feathers?” you would see they weigh the same (2000lbs). Muscle is more dense than fat.

Image result for body fat vs muscle

Body composition is used to describe the percentages of fat, bone, water and muscle in the body. Because muscular tissue takes up less space in our body than fat tissue, our body composition, as well as our weight, determines leanness.

Now, there are several models of determining body composition, but the one most relevant to our needs splits the body into two components:

  • Fat mass. This is simply all of the fat in your body.

  • Fat-free mass. This is everything that isn’t fat: muscle, bone, blood, organs, water, glycogen, and the rest. This is often abbreviated as FFM.

When trying to lose weight or body fat, the goal is to decrease the Fat Mass, and maintain or increase the Fat-Free Mass. Other than visually seeing the changes or noticing how your clothes are fitting, there are a few ways to measure your Body Composition.

  • Body Composition Scales & Handheld Devices

  • Ultrasound

  • Body Fat Calipers & Skinfold Testing

  • Dual-Energy X-Ray Absorptiometry (DEXA)

  • The Bod Pod

  • Hydrostatic Weighing

Once you know your number you can compare it to these numbers provided by the American Council on Exercise (ACE) to evaluate your body composition.


ACE Body Fat Norms for Men

  • Essential Fat: 2-5%

  • Athletes: 6-13%

  • Fitness: 14-17%

  • Acceptable: 18-24%

  • Obese: >25%


ACE Body Fat Norms for Women

  • Essential Fat: 10-13%

  • Athletes: 14-20%

  • Fitness: 21-24%

  • Acceptable: 25-31%

  • Obese: >32%

By measuring your body fat and starting a training program, you could retest and see your improvements, and compare them with your weight on the scale. This will help you determine if you are truly losing fat, gaining muscle, or both! Try not to fixate on the number on the scale, because it does not tell the whole story of your progress. Notice how you feel and how you look as you continue on your journey. For example, you may want to weigh 150 lbs, but due to changes in body composition may be happy at 165 lbs. To have you body composition analyzed, contact one of our seven conveniently located Revolution Physical Therapy and Weight Loss clinics throughout the Chicagoland area!

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It has been suggested approximately 21% of the adult population participates in some sort of resistance training at least 2 days a week (Chevan, 2008). While the popularity of strength training has increased from the days of it’s seemingly “cult” fad (refer to Arnold’s Pumping Iron), there still lies a massive misconception that those trying to lose weight should NOT focus as much on resistance training.  With more secondary information available than ever on health and fitness, it is important to dig down into the primary scholarly sources and identify of the necessity of resistance training for 31% of the population whom is categorized as obese (projected 51% of the population will be obese by 2030).

Resistance training is defined as “any type of training in which the body must move in some direction against some type of force that resists that movement”  (Stoppani,  2006). Although this definition may appear basic at first sight, it is important to place emphasis on the “some type of force” piece. Too many of us relate resistance training to meatheads lifting heavy barbells and slamming weights around. We don't take into account that your own body weight can be used for resistance in addition to using bands, free weights like dumbbells or medicine balls.There are multiple types of resistance that can provide the stimulus needed to achieve the desired result that will assist with weight loss.

Such results are achieved through neural stimulation which causes the muscle to contract and when the muscle shortens and lengthens it creates microtears. Over time, hypertrophy (muscle growth) occurs and muscle becomes thicker and can move more weight (McArdle, Katch & Katch, 2010). As an individual increases lean mass, they burn more fat during rest and aerobic exercise. Furthermore, as a result of resistance training, daily energy levels adrenaline and other hormones (testosterone) increase (McArdle, Katch & Katch, 2010).  

In conclusion, resistance training for weight loss should consist of large muscle group exercises (push, squat, pull, trunk, etc.). Repetitions should be 15-20, 2-3 sets of each exercise, preferably performed in a circuit format. It is encouraged that beginners with resistance training utilize cross training, integrating bouts of aerobic activity (walking, bicycle, elliptical, etc.) between resistance circuits to avoid accumulation of lactic acid, which can result in delayed onset muscle soreness. In practical terms, resistance training will increase lean mass that both assist with fat burn during your “cardio” days, and also keep the weight bearing joints strong to avoid injury during these “cardio” days. For assistance with understanding what your ideal resistance training circuit should look like based on your goals, please consult with one of our expert Exercise Physiologists at one of our convenient seven Chicagoland locations.

Armstrong, N., & Van Mechelen, W. (Eds.). (2008). Paediatric exercise science and medicine. Oxford University  Press.


Akabas, S., Lederman, S. A., & Moore, B. J. (Eds.). (2012). Textbook of obesity: Biological, psychological and cultural influences. John Wiley & Sons.


Chevan, J. (2008). Demographic determinants of participation in strength training activities among US adults. The Journal of Strength & Conditioning Research, 22(2), 553-558.


McArdle, W. D., Katch, F. I., & Katch, V. L. (2010). Exercise physiology: Nutrition, energy, and human performance. Lippincott Williams & Wilkins.

Stoppani, J. (2006). Encyclopedia of muscle & strength. Human Kinetics.


STRESS…we all have stress in our lives, yet, as individuals, we experience stress and cope with stress in different ways. Our coping skills may become taxed during stressful times, which, for many, can lead to weight gain. Becoming aware of how we experience and deal with stress in our lives can lead to healthy coping skills, which ultimately helps us meet our weight loss goals. Take a moment to bring awareness to the stressors in your life. How do you deal with those stressors? How do you feel during stressful events? What behaviors do you use to feel better?


For many years, I thought of stress as only intense stress when it becomes overwhelming, known as acute stress, but then my awareness shifted to the chronic, underlying stress we experience in our busy lives, and how chronic stress impacts weight gain. When we are stressed, our bodies produce more of the stress hormone, cortisol. Cortisol raises blood glucose levels, leading to an increased release of insulin to manage blood glucose levels. When insulin is released, blood glucose levels drop, which causes increased hunger (Shawn M Talbott, PhD, CNS, LDN, FACSM, FAIS, FACN). During stressful times, we typically crave foods higher in sugar and fat, otherwise known as comfort foods, due to the stress response. When we eat comfort foods higher in calories, our bodies produce dopamine, which activates the pleasure center of the brain (Singh M.Front Psychol. 2014 Sep 1;5:925. doi: 10.3389/fpsyg.2014.00925. eCollection 2014 Sep 1. Review.PMID: 25225489). This feeling of pleasure and gratification quickly becomes habit and we return to these foods over and over to relieve stress and feel better, thus leading to weight gain.


Here at Revolution Physical Therapy Weight Loss, we understand the importance of managing stress to reach our weight loss goals. Our bodies are designed to manage acute stress, yet in today’s busy world, most of us are carrying around chronic stress which our bodies are not equipped to handle in the same way, so it is important to build the skills to manage chronic stress. Here are a few tips to begin managing stress.


Reflect on activities that bring you pleasure and incorporate these activities intentionally into your life. Doing so will ultimately reduce stress. Some examples include: taking a walk, sitting outside to enjoy the fresh air and sunshine, taking a warm bath, watching your favorite show, talking to friends and family, reading a book, listening to music. Create your own list of activities that resonate with you which bring you pleasure. Write them down and post your list where you can see it so you can replace stress eating with a healthy coping skill to reduce stress.


Take deep breaths. Deep breathing immediately reduces stress. Take slow deep breaths which fill up down to your belly for 3 seconds, hold for 3 seconds and release slowly for 5 seconds. This takes only a few seconds and you can do this throughout your day in any environment.


Exercise. Exercise will not only help you reduce stress, it will help you reach your weight loss goals two fold through burning calories and decreasing stress.  


As with all lifestyle adjustments, remain patient and consistent, and eventually, these healthy coping skills will become more natural!

FDA plans to make it easier than ever to know what's in your food.

If you have seen a dietitian for any length of time, reading nutrition labels has certainly come up. Many of us are familiar with reading nutrition labels, whether we are looking for saturated fat, sodium, fiber or protein. They serve as a guide to help consumers make the best decisions for their health, and now they will be changing ever so slightly. The changes will come in 2018, and will hopefully be a positive change to help consumers better sift through products.


Here are some changes that will soon ensue:


Firstly, serving sizes will be changed to reflect what people actually eat, in addition to being bolded. For example, the ice cream serving will now be ¾ cup instead of ½ cup because individuals typically opt for having ¾ cup when enjoying this type of dessert. This will help consumers make more educated decisions and do less math before enjoying a tasty morsel.


Secondly, the calories per serving will transform from being microscopic to LARGE and BOLD. This of course will be more attention grabbing and easier to see for those whose vision is not 20/20. So, if you forget to bring your glasses to the grocery store, there will be no need to panic.


Thirdly, “calories from fat” will be removed. This was much more a focus in the past, where it was believed that the less calories coming from fat was better. With advancing research, however, we understand that the type of fat consumed (unsaturated vs. saturated or trans fat) is a more important distinction than calories from fat.


Fourthly, under carbohydrates “Added Sugars” will be detailed in order to specify if the sugar is naturally occurring or being added through processing. This is a large change and one that will help consumers make more informed decisions, in addition to keeping manufacturing companies more accountable for the amount of sugar added to products. Research shows there is a greater challenge to get adequate nutrition consistently if an individual’s consumption of added sugars is greater than 10% of total daily calories ingested. Therefore, a percent daily value (%DV) will also be created and clearly marked on the nutrition label.  


Fifthly, and lastly, Vitamins A and C will no longer be listed, however, Vitamin D and Potassium will take their place. The reason for this change is that deficiencies in Vitamin A and C are rare to see in the United States at this time, whereas Vitamin D deficiencies are much more common, particularly for those of us in the midwest. Potassium being listed, will have significant implications particularly for those with hypertension, as it counteracts the effects of sodium in the body.


In conclusion, the changes that will soon come in 2018 will be, by and large, a very positive shift for consumers. The hope is that these changes will make choosing healthy foods and prioritizing one’s health easier for all.


Please feel free to contact any one of Revolution’s registered dietitians with any questions.  

Written By: Jacqueline Duca MS, RDN, LDN




Clamshells or clams, as some call them, are one of the most common exercises prescribed by a physical therapist. The exercise targets specific muscles of the hip that tend to be weak in a large patient population. It is clinically relevant for treatment of a variety of pathologies including low back and knee pain, balance deficits, and following knee or hip replacements.

The exercise is performed with the patient on a table or the floor in a side lying position with the legs and feet stacked and heels together. Other than, that, physical therapists have taught patients the exercise with the hips, knees, and pelvis positioned at varying angles based on past clinical experience. A recent article came out in the Journal of Orthopaedic and Sports Physical Therapy discussing the effects of varying hip angles and pelvic positions on muscle recruitment during the clam exercise.

In a previous study, it was determined that the best position for the knees to be in during the exercise was with the knees bent at 90 degrees, so this knee position was utilized for this study. In a current study, it was found that the most important position to facilitate activation of multiple muscle groups of the posterior hip was related to pelvic positioning. Specifically, when performing clams, it is important to make sure that the spine and pelvis are in a neutral position. When the pelvis tilts/rolls backwards, it decreases the activation of the muscles in the back of the hip (the targeted muscles for the exercise.)  

Furthermore, it was found that the best angle for the hip to be positioned at for proper muscle recruitment was at a 60 degree angle as compared to 90 degrees or fully extended (0 degrees).



Willcox, EL, and Burden, AM: The influence of varying hip angle and pelvis position on muscle recruitment patterns of the hip abductor muscles during the clam exercise. J Orthop Sports Phys Ther 43:5, 2013.


Achieving, and maintaining, weight loss is a significant challenge. The journey can become much harder when movement is difficult due to stiffness or even pain. Most people have experienced achy muscles or joints. However, another less common but equally restricting symptom is dizziness.

Dizziness is sometimes referred to as vertigo, which is often described as a sense that the room is spinning. This can also often be accompanied by nausea. Anyone who has experienced this in the past will be quick to say that it is nearly incapacitating when it occurs.

There are many causes of dizziness and vertigo, but a common and rapidlycurable variation is called Benign Paroxysmal Positional Vertigo, or BPPV for short.

Up to 2.4% of the population may experience BPPV in their lifetime, with up to 30% of all dizziness and vertigo complaints stemming from BPPV1.

BPPV is typically triggered when performing certain movements like turning the head or looking up, as well as when changing body position such as when getting into and out of bed.

A physical therapist can examine you and use their objective findings to differentiate between BPPV and another condition.

BPPV can often be resolved rapidly, taking as little at 3-5 sessions in some cases. Don’t let your dizziness or vertigo slow your weight loss journey, if you suffer from dizziness reach out to a physical therapist today!


  1. Von Brevern M, Radtke A, Lezius F, et al. Epidemiology of benign paroxysmal positional vertigo: a population based study. Journal of Neurology, Neurosurgery, and Psychiatry. 2007;78(7):710-715. doi:10.1136/jnnp.2006.100420.


Happy National Nutrition Month! The Academy of Nutrition and Dietetics (AND) picks a new theme each year. This year’s theme is “Put Your Best Fork Forward.”

So, what exactly does this mean?

In order to make sustainable health changes, it’s best to start small; “one forkful at a time.” Instead of drastically changing all of your eating habits at one time, think of one small change you can make - perhaps making one small change per week.

In order to make these beneficial, small changes, think of what you can add or substitute into your meals and snacks, instead of what to eliminate or restrict. According to the Academy of Nutrition and Dietetics, 82% of people don’t want to give up foods they enjoy in order to eat healthier. Someone does not have to eliminate their favorite foods in order to become healthier. Focusing on increasing nutrient-rich foods keeps the body satisfied and full so there’s less temptation to reach for the cookies or chips.

The Academy of Nutrition and Dietetics encourages Americans to include lean meats, poultry, fish, beans, eggs and nuts. In addition, they encourage fruit, vegetables, whole grains and low-fat or fat-free milk and milk products. Focusing on increasing these foods will leave less room for the high calorie, energy- dense foods.

For more information on how to change your eating habits, talk with a Registered Dietitian at Revolution Physical Therapy Weight Loss. They can help you make small, sustainable changes that fit into your lifestyle.





Throughout the mid-stages of one's life, the skill of balance can be taken for granted. In which one has the ability to effortlessly use balance to walk, run, and climb stairs without conscious thinking. However, as we age and venture into the later stages of life, balance should become a more conscious effort due to its correlation with accidental falls.

The Centers for Disease Control and Prevention states accidental falls are a leading cause of injury related deaths for populations of 65 years of age and above. Such falls in the elderly population are due to decreased balance. A recent study showed that weight shifting and stumbling influenced falls at a higher percentage rate when compared to slipping. Additionally, gradual changes throughout life such as inflexible muscles, decreased muscle tonality, slower reflexes, and eyesight can affect the sense of balance thus increasing uncontrollable weight shifting and stumbling. However, structured exercise can help with improving balance to assist with reducing the risk of falls and injuries.

At Revolution Physical Therapy Weight Loss, healthcare personals such as Physical Therapists and/or Exercise Physiologists can help develop a structured exercise regimen that is individualized and safe. Such exercise will focus on improving balance through increasing muscular strength, muscular endurance, and flexibility.  By incorporating exercises to enhance these components, one can also see multiple benefits in conjunction with improved balance such as Motor Coordination, Reaction Time, and Neuromuscular Control.

As mentioned before, balance is an important skill we utilize in everyday life during basic movements. However, as age increases, research shows there is a regression in the ability to control that skill. No matter your age, structured exercise can help improve balance. Rather it be for a young adolescent looking improve their skating abilities for hockey, or an elderly individual hoping to decrease their chances of falling. Take the step to be more conscious about your balance and talk to a health care professional today.



Centers for Disease Control and Prevention. WISQARS leading causes of nonfatal injury reports .2006. [Accessed November 13, 2006]. http://www​​/wisqars/nonfatal​/quickpicks/quickpicks_2006/allinj.htm.

El-Khoury, Fabienne, Bernard Cassou, Marie-Aline Charles, and Patricia Dargent-Molina. "The Effect of Fall Prevention Exercise Programmes on Fall Induced Injuries in Community Dwelling Older Adults: Systematic Review and Meta-analysis of Randomised Controlled Trials." BMJ. British Medical Journal Publishing Group, 29 Oct. 2013. Web. 27 Feb. 2017.

LeWine, Howard. “Balance training seems to prevent falls, injuries in seniors.” Harvard Health Publications. OCTOBER 31, 2013.

Publications, Harvard Health. "Better Balance: Easy Exercises to Improve Stability and Prevent Falls." Harvard Health. N.p., n.d. Web. 27 Feb. 2017.

Robinovtich, Stephen N., Fabio Feldman, Yijian Yang, Rebecca Schonnop, Pet Lueng, Thiago Sarraf, Joanie Sims-Gould, and Marie Loughin. "Video Capture of the Circumstances of Falls in Elderly People Residing in Long-term Care: An Observational Study." The Lancent. N.p., 5 Jan. 2013. Web.


Many individuals believe they need need to take expensive supplements to reach their peak health and performance. While a deficiency of a certain vitamin, mineral, or macronutrient will be detrimental to your well-being, many deficiencies can commonly be mitigated through adequate intake of appropriate foods. In the modern day, food still provides more advantages than supplements do. Your Revolution Dietitians can assist with providing the benefits you desire using food sources. If food options cannot provide adequate intake of the desired nutrient, a supplement may now be appropriate.

The main concern with supplements tends to be the safety and label accuracy of the product. Supplements are regulated under The Dietary Supplement Health and Education Act of 1994, which is much less stringent in regulation than many people believe it to be. There is no need to prove safety, efficacy, or benefit prior to being provided in markets.

Occasionally, you may also hear news stories and studies that test samples of various supplements and utilize chemical analysis to determine measurements of ingredients/contaminants through a 3rd party lab. Some of these have previously found supplements entirely devoid of the main active ingredient claimed. This situation may be entirely avoided by choosing a supplement that is NSF or USP certified.

NSF (National Sanitation Foundation) is an optional 3rd party certification foundation that can verify safety and accuracy of the supplement. They regularly audit the toxicology for formulation, label accuracy, marketing claims, contaminant levels, and good manufacturing processed (GMP) which verifies physical location, personnel, equipment, and records among many other items. It does not test for efficacy. Try the following links to search for an NSF Certified product.  

USP (U.S. Pharmacopeial Convention) is another optional certification body that is not affiliated with government but recognized in US law. They test for potency of ingredients, harmful levels of contaminants, safe manufacturing practices, and testing absorbability of supplements. For absorbability, USP will verify that the product dissolves or disintegrates properly to provide the possibility of absorption in the body. USP Verified Products Listing can be found in the following  link.

Either of these optional certifications will lead you to a safer supplement selection. Below, you will find the most common certification symbols that may be placed only on certified items. As stated earlier, food will provide the most benefit, so talk with your Revolution Dietitians for assistance with achieving your health goals from the best sources available to you!




We live in a fast-paced society. We are constantly being bombarded by advertisements with images of food to eat, products to buy, as well as emails, phone calls, and text messages. Our attention is being diverted in a million different directions. Mindfulness is all about slowing down, and pausing to listen to ourselves – to what we really want and need.

Mindfulness is cultivating awareness of our thoughts, feelings, and actions. Mindful eating means tuning in to our bodies, and paying attention to what we’re eating, and why. In our society, food is easily available, and ubiquitous. Advertisements aim to convince us we’re always hungry, and that consuming food will make us happy. We often end up eating for reasons besides hunger, such as boredom, or stress. How often do we stop to actually listen to ourselves, and what our own needs and desires really are?

To begin eating mindfully, first ask yourself whether or not you’re actually hungry. Pay attention to the physical sensations of hunger and fullness. Perhaps you’ll realize you aren’t hungry after all. Maybe you’re feeling stressed, and just need to go for a walk, or take some deep breaths. However, if you are in fact hungry, practice mindful eating by approaching your food choices with conscious awareness and intention. What food will you both enjoy the taste of, and make you feel good physically? Will this food give you more energy, or make you tired? Ask yourself if it will contribute to your goal of living a healthy lifestyle.

Once you choose something to eat, eating it mindfully will make for a much more enjoyable experience. By actively paying attention, and engaging our senses, we are able to notice and appreciate details that otherwise get overlooked. Notice the color, shape, temperature, and aroma of your food. Hold it in your mouth a moment – is its texture smooth, firm or spongy? When you bite into it, is it juicy or dry? Does it taste tart, sweet, spicy or savory? Rather than hurriedly scarfing down hundreds of calories and barely appreciating them, eating mindfully allows us to eat more slowly, and really savor the experience.

Eating more slowly also enables us to register when we are full sooner, and avoid overeating. Mindful eating allows us to find that comfortable spot, where we are perfectly satiated, yet not overly full. Whereas diets are associated with deprivation, mindfulness is about joy, because the only thing we’re depriving ourselves of is feeling overly full, and regretful afterwards. It enables us to enjoy a meal, and walk away still feeling good about ourselves. As we engage all of our senses and eat mindfully, the phrase, “less is more” rings true.

Mindful eating encourages us to be fully present, tune in to what we need, and make wise, fulfilling choices. Mindful eating empowers us by enabling us to reclaim the control we lose when we give ourselves over to emotional, or compulsive eating. It enables us to make healthier choices, enjoy our food more, and feel better about ourselves. So take a step back, and remember that a healthy lifestyle is something to be practiced each day, and each moment – one bite at a time.

For more information or help with mindful eating, a Registered Dietitian and Motivation Manager at Revolution Physical Therapy Weight Loss can help. 


There are many ways that stretching is incorporated into physical therapy rehabilitation for a variety of orthopedic conditions and injuries treated here at Revolution Physical Therapy Weight Loss. In addition, we recommend stretching as part of a comprehensive exercise program for weight loss and/or overall health and wellness. Stretching is prescribed to increase muscle length and joint range of motion (ROM), or to facilitate proper alignment of collagen fibers as the healing process occurs. Stretching can also decrease pain associated with a musculoskeletal condition such as a herniated disc or from compressive forces on a joint secondary to being overweight.

The benefits of including a stretching routine into one’s exercise program is clear, however the best type of stretching remains a controversy. As is true of most treatment/with most treatments, stretching outcomes are often is based on the individual patient and are affected by factors such as gender, pain tolerance, orthopedic condition, general mobility, and compliance.3

Recent research has looked into the effectiveness of various types of stretching, specifically active versus passive stretching, and compared how much they improved hamstring flexibility and thus joint ROM. Much of the research has focused on the hamstring muscles, likely due to the ease of measuring/measurement and common presentation of tight hamstrings in a clinical and the general population.  Passive stretching is defined as “a form of static stretching in which an external force exerts upon the limb to move it into the new position”3. This external force could include assistance from a partner, a strap, gravity, or a person’s body weight. On the other hand, active stretching is when a muscle is stretched by actively contracting its opposing or antagonist muscle.

Meroni et al. (2010) compared active stretching with static passive stretching of the hamstrings. The study assessed hamstring flexibility following 3 weeks of stretching and then 6 weeks (performed twice a day, four days a week).  In this study, it was found that the group who performed active stretching of the hamstrings had a significant increase in ROM relative to the passive stretching group following both 3 weeks and 6 weeks of stretching. This was the outcome despite the fact that the total duration of the passive stretching session lasted four minutes longer than that of the active stretching session. In addition, four weeks following the conclusion of the study, a subset of the initial group was reevaluated. Results demonstrated that the active stretching group maintained more than a 6 degree ROM improvement, while the passive stretching group maintained a 0.1 degree ROM  improvement.2

Fasen et al. (2010) also compared active stretching of the hamstring versus passive stretching in a randomized control trial. Four different techniques were used; two active hamstring stretches and two passive hamstring stretches, with a control group (no stretching routine) assessed as well. The study assessed evaluated the participant’s hamstring flexibility at the four and 8 week mark following initiating of stretching (performed five days a week). Results of the study demonstrated that both active and passive stretching is more effective in increasing hamstring flexibility than the control group. Although the study demonstrated that at the four week mark, three of the groups (two performing active hamstring stretches, one performing one of the passive stretches) showed improvement in hamstring flexibility, the two active stretching groups showed the greatest improvement. However, interestingly enough, the group that performed the passive stretch and showed improvement at four weeks, achieved the greatest gain in hamstring flexibility at the eight week conclusion of the study.1

Based on these studies and more, it can be concluded that six to eight weeks of stretching, either passively or actively, is effective in improving hamstring flexibility as well as other muscle groups. Clinically, stretching is often proscribed twice daily over a six to eight week period for maximum gains. Once flexibility goals have been met, frequency of stretching can be decreased. The duration and repetitions of a particular stretch tend to be at the discretion or clinical judgement of the clinician. ?

As part of a weight loss program or general fitness program, the American College of Sports Medicine (ACSM) recommends individuals should perform passive or active stretching following a light aerobic warm-up (to increase blood flow and warm muscles up), at least 2 to 3 days per week. It is recommended that each stretch is held for a duration of 15-30 seconds and repeated 2 to 4 times.

In conclusion, stretching is an important component of both physical therapy treatment and as part of comprehensive exercise program. Both active and passive stretching are effective in increasing flexibility and range of motion. Depending on the patient and clinician preference, one type of stretch may be more beneficial than the other in particular cases. Please seek guidance from a physical therapist or other medical professional prior to initiating a stretching routine for maximum benefits and to decrease the likelihood of injury.



1. Fasen, J.M., O’Connor, A.M., Schwartz, S.L., et al.(2010). A Randomized Controlled Trial of Hamstring Stretching: Comparison of Four Techniques. Journal of Strength and Conditioning, 23(2), 660-667.

2. Meroni, R., Cerri, C.G., Lanzarini, C., et al. (2010). Comparison of Active Stretching Technique and Static Stretching Technique on Hamstring Flexibility. Clinical Journal of Sports Medicine, 20(1), 8-14.

3. Page, P. (2012). Current Concepts in Muscle Stretching for Exercise and RehabilitationInternational of Journal Sports Physical  Therapy, 7(1), 109–119.



Ever started a weight loss program, kept up the same routine for a long time, but notice the results dwindling? More often times than not, it can be difficult to achieve consistent results due to poor understanding of proper overload during your training. As corny as it may sound, the only way to get better is to challenge your body (overload). This can be as simple as walking faster on the treadmill, more incline, more resistance on the bike, anything that makes the exercise more difficult. Overload leads to adaptation, adaptation leads to result, in our case; weight loss. However, what most weight loss patients lack is a proper variable to monitor this intensity. Many patients use calorie estimations on aerobic equipment or rate of perceived exertion (RPE) to monitor intensity of their workouts. While variables like RPE and estimated calories expended are most certainly a start, limitations include lack of validity and reliability. One workload variable that can control for such limitations is heart rate (beats per minute or bpm).

Heart rate zone training (HRT) is defined as the integration of the heart rate variable (bpm) into a training program to measure intensity of a workout (Friel, 2009). Historically, HRT has been primarily used for endurance athletes such as runners, cyclists, or swimming to improve performance gradually over time. More recently, HRT has emerged as an effective strategy for optimizing training efficiency for individuals trying to lose weight during their aerobic exercise (walking, cycling, stairs, elliptical, etc.).

Based on our previous blog entry, “Pain does not always equal gain”, we have established that proper intensity for weight loss during aerobic exercise should be lower and intensity should be longer. It is now important to take this one step further and quantify the measurement of this intensity. Typical quantification of exercise is done so in an absolute format. For example, a patient starts a weight loss program that includes walking on the treadmill at 3.0 mph for 30 minutes, 3x/ a week. Let’s say they are motivated to keep this routine up for 8 weeks. However, it is often overlooked is that their body will adapt to this initial overload, and therefore will burn less calories each week (Brooks and company, 2014). Burning less calories each week will minimize the calorie deficit, leading to a slowing of weight loss.

Now let’s take that same individual and put them on a relative HRT program. At RPTWL, we assess HR zones using indirect calorimetry. More simply put, we measure oxygen consumption and ventilation during exercise to assess exactly how many calories you're burning at every heartbeat. Let's take that same patient and put them on the same 3x/week 30 minute program, but instead of saying walk at 3.0 mph, we prescribe maintaining a HR of 110 BPM. The same progression will happen over time in terms of initial overload and adaptation. However, different from our first example, this patient will have to continuously increase the speed and incline of the treadmill to achieve that 110 BPM. In conclusion, their calorie expenditure will not be compromised over time, as they are continuously increasing the absolute workload (speed and incline) to achieve the prescribed HR zone.

Furthermore, HRT allows the individual to control the choice of their modality (treadmill, bike, elliptical, etc.). When you are prescribed a HR zone, it is all about doing whatever it takes to get in that zone, however you choose. Patients are not limited to one modality like our first scenario with 3.0 mph of treadmill walking. HRT provides the flexibility and practicality to personalize your exercise program and freedom for variety while still being effective.

They say the best program is the one you keep doing. At RPTWL, we feel HRT is not only the most effective, but safest way to measure the intensity of your exercise. For more information on how to assess your most optimal HR zones, please reach out to one of our Exercise Physiologists.



Despite our recent spell of warm weather it is true that our winter season is in full swing.  Midwesterners know that inclement weather can be just around the corner and with the snow and ice comes an increase in weather related injuries.

A recent study by researchers at the Center for Injury Research and Policy found that over a 16-year period there was an average of 11,500 snow shoveling related injuries treated each year in U.S. emergency departments.  The injuries were largely musculoskeletal with the lower back being the most frequently affected area.  If you have symptoms that persist for a few days following snow shoveling head into a PT clinic for a free injury screen to see if you would benefit from physical therapy services.

So, before we clean off that sidewalk or dig out that car and parking space let’s take some steps to ensure our safety and prevent injury.

Proper Gear

First things first, make sure you wear the appropriate outerwear for the conditions.

It is important when out in the snow and cold that your layers stay dry.  You become more vulnerable to the cold when you are wet.  Exposed skin is more susceptible to frostbite and hypothermia than covered skin.  Make sure to cover your ears and nose.  Wear waterproof gloves and boots to protect your extremities.


It is important to have a good shovel and one that is sized right for you.  A smaller shovel blade is better in that you will not be tempted to carry a load that is too heavy.  Plastic blades are lighter than metal and that is also a help.  Use a shovel with curved shaped handle.  This will help you keep your back straighter and decrease the need for bending while shoveling the white stuff.  It is also recommended that you purchase a shovel with the correct length handle.  Try out your shovel in the store if the handle is too long you will find that you need to flex your back too far for comfort.


And, yes, snow shoveling is exercise!  So just as before any physical exercise you should warm up your muscles.  Stretch and loosen up before you tackle that driveway.  You can warm up your muscles by performing some jumping jacks and high knees exercises.  When possible, try to push the snow rather than lifting and hurling it.  When you do need to lift take small amounts and walk to wear you can dump it. Avoid twisting and hurling.  The American Academy of Orthopedic Surgeons recommends: “If you must lift the snow, lift it properly.  Squat with your legs apart, knees bent and back straight.  Lift with your legs.  Do not bend at the waist.”  Take your time, take breaks when necessary.  Remember, the snow will wait for you!

Let’s hope our mild winter continues but if a storm strikes keep these tips in mind for snow shoveling safety.  And, remember spring is just around the corner!


Snow Shoveling Techniques to Prevent Low Back Injuries. Retrieved January 18, 2017 from

In the Bleak Mid-winter: 10 Tips for Safe Snow Shoveling. Retrieved January 20, 2017 from

Prevent Snow Shoveling and Snowblowing Injuries. Retrieved January 18, 2017 from


Oddly enough, Jane Fonda actually came out and apologized for the “No pain, no gain” mantra that we all spent 80’s and 90’s reciting while cranking out some Richard Simmons aerobics. Not that there is anything wrong with Richard or Jane, they both have helped millions of people move towards a healthier lifestyle. That being said, it is time to use what we know about the science of exercise to clear the air regarding exercise intensity and its relevance with weight loss.

First things first, there are three fuels for exercise; fats, carbohydrates, and proteins. For time sake, let’s ignore protein, as it is only a primary fuel source used for aerobic exercise when an individual is fasted for a long period of time. Simply put, at lower intensities, primarily fat is burned as fuel. Low intensity being defined a rate at which you can comfortably converse with an exercise partner. As the intensity of the exercise increases (i.e, speed or grade of treadmill), the body shifts the preferred substrate from fats to carbohydrates. The term for when this switch from fats to carbs occurs is known as the Anaerobic Threshold. The carbohydrates used for fuel at this higher intensity initially come from blood glucose, which accumulates from the food we eat. As exercise continues, this blood glucose is maintained first by glucose stored in liver (glycogen), and when those stores deplete, stores of glucose in the muscle keep the blood replenished with glucose.  To summarize, low intensity exercise equates to fat burn whereas high intensity results in carbohydrate utilization.

Now that we understand the nuts and bolts of metabolism during exercise, let’s discuss the proper intensity for weight loss. For starters, weight loss is achieved primarily by expending more calories than we consume on a consistent basis. However, similar to nutrition, it is important to identify the TYPE of calories an individual is expending during exercise. According to the findings of Connolly (2015), exercising below anaerobic threshold (lower intensity, higher fat burn) is more productive for weight loss than a higher intensity, even though more calories are burned at this higher intensity. Connolly (2015) provides the following both physiological and practical justifications for such a statement: Lower intensity allows the body oxidate lipids more effectively (burn fat); lower intensity exercise results in less fatigue and the increased likelihood an individual would exercise longer and burn more calories; finally, lower intensity exercise is better for cardiovascular adaptations, which in turn helps patients breakdown and mobilize fat more for fuel during rest and recovery.  

So what does all this great information mean for the average person trying to lose weight? Turn down the intensity, increase the duration, and find an activity that you actually ENJOY doing. Although fat burn activity burns less calories in the short term, there is not only a physiological benefit of mobilizing and expending more fat calories at rest, there is the benefit that you will actually KEEP exercising. Remember, the most important exercise plan isn’t the one that works, it’s the one that you keep doing. Even if it works, that doesn’t mean you will keep doing it. Tune in next week for Revolution’s Lead Dietitian Claire Allen’s take on the power of seeds and sustainable weight loss.


Connolly, D. A. (2015). Slow Down to Speed Up: Using Intensity Threshold Indicators to Optimize Lipid Utilization during Exercise. Journal of Diabetes & Metabolism, 2015.


As mentioned last week, according to a study in the Journal of Clinical Psychology, just 8% of people who set New Year’s Resolutions actually achieve them. With so many people making resolutions at the beginning of each new year, what gives? Many times, people set unrealistic or overwhelming resolutions and struggle with such lofty expectations of themselves. Thanks to our post last week, SMART goals are an easy way to set appropriate, achievable (still challenging enough but not too intimidating) goals via a step by step process.

Many times the preparation is the key to success. If one doesn’t know what their resolution involves, it’s very difficult to achieve it! For example, the dietitians at Revolution often work with their patients to increase fruit and vegetable intake. But if a patient doesn’t buy produce to keep in their house or at work, it’s very difficult to actually consume their goal amount. So our job as clinicians is to help you prepare and set you up for success to achieve your goals or resolutions. In this example, the dietitian often discusses what to look for when shopping at the store, offers grocery store tours to interested patients, describes cooking and storing tips for vegetables, and even refers clients to our active Pinterest page with recipes (

Another way to help achieve your resolutions is to create an environment conducive to success. This could take many forms depending on the changes you desire to make. From a nutrition perspective, being smarter with food choices and the environment in which you eat can help you achieve your weight loss and health goals.


A few points to consider:

  1. Watch out for serving bias

Bigger bowls or plates can result in both adults and children dishing themselves more food and even eating more (up to 52% more!). (

Similarly, by switching out an 11 inch dinner plate and instead using a 9 inch salad plate for meals can easily save calories with less guilt.

  1. Use colors to your advantage

We’re wired to like brightly colored, attractive items. Shop for food and make dishes that you want to eat! Different colors of produce - whether red, blue, purple, green, orange, yellow, or white contain different phytonutrients, vitamins, and minerals that have specific health benefits. For example, eating spinach (green) and bell peppers (yellow or orange) one night and cabbage (red or purple) and onions (white) the next night mixes up the foods, colors, and nutrients (vitamin A, C, D, K, magnesium, etc) for our body.

  1. Location, location, location!

The “out of sight, out of mind” saying rings very true with regards to food. In “The Syracuse Study,” researchers found that on average, women with soft drinks sitting out on their counter weighed 24-26 lbs more than women who did not. Further, those who had a fruit bowl weighed 13 lbs less. Simple swaps like changing what food items sit on your kitchen counter can make a big difference! ( Foods that are accessible, convenient, and attractive are more likely to be consumed. Research suggests that subjects are more likely to grab a piece of fruit if it’s by their car keys on the way out the door or from a well-lit basket next to a cash register than travel back across the house or store to get ice cream or dessert. Use this placement to your advantage to incorporate more fruits and vegetables into your daily pattern.  (

  1. Psych yourself out

Marketers and managers design restaurants and stores in a certain manner to promote consumption. Don’t get caught in their psychology tricks! For example, on a restaurant menu, items that are highly descriptive, written in bold or color, set apart, or prominently featured are likely some of the least healthy items on a menu - and the restaurant wants you to order it! Carefully read items and consult your server for suggestions on healthier items. (

Your dietitians are happy to discuss more food psychology strategies and social eating tips with you. These are easy to implement and fun to try ideas to subconsciously change your eating habits and taking advantage of these can can promote eating less and potentially weight loss.

At Revolution PTWL, our patients use SMART goals throughout the year. We look forward to working with you and creating an environment for your success in 2017!


It’s the start of the new year and 45% of people are making their New Year’s Resolution. Unfortunately, according to a recent poll* only 8% of those people will fulfil their resolution. Rather than think, “How can I be part of that 8%,” I would like think on how we could make that number grow exponentially.

The way to do that it simple, labor intensive - sure, but relatively simple. We simply need to make sure we are making SMART goals. Smart meaning:

S - Specific

M - Measureable

A - Attainable

R- Relevant

T - Timely

It’s easy to make a goal. It is vital to put this method into place in order to achieve success. Think about the last goal you set for yourself. Why did you achieve this goal? You more than likely put it into this formal without even realizing it.

Lets think about “S,” Specific. It’s easy to make a general goal. Two of the most common New Year’s Resolutions are to “Lose weight,” and “Get organized;” but what does that really mean? Losing weight could range from one to one hundred pounds. In order for that goal to be specific you’d have to set a number to it, for example, My New Year’s Resolution is to lose 25 pounds.

This leads us to the “M,” Measurable. This goal of losing 25 pounds can be measured by weighing yourself on a scale. You want to be sure that with what ever goal you have, you are able to measure your progress. This task could be accomplished with something as simple as a completing a daily checklist.

Next, we need to make sure that we are working toward an attainable goal. Almost any goal can be accomplished if it is reasonable. For example, at Revolution we help patients work toward their weight loss goals by setting small attainable goals of losing one to two pounds a week. An unattainable goal would be setting a goal of losing 10 pounds a week. The last thing you want to do is feel like you “failed,” because you set an unattainable goal.

When we set a goal we want to be focused on bettering ourselves. You could set a goal to learn arabic, but if you never plan to put yourself in a situation to put it to use, is it really work putting your time and energy into that goal. You should be sure to set a goal that is relevant to who you are and who you want to become.

Finally, we have arrived at the “T,” timely. In order for a goal to be successful in achieving your goals, it must have a deadline. It’s vital to have that push to get you into the end zone. Losing 25 pounds in a year is a much different process than losing it in 4 months. You have to put a timeframe on it in order to get the results your desire and the satisfaction you deserve.

If your goal happens to be weight loss, recent guidelines released by the American Medical Association suggests consulting with a team of health professionals before you do so. At Revolution, you will work with a highly qualified group of passionate health professionals to do just that, reach your weight loss goals.



1. N.p., 1 Jan. 2017. Web.




Carbohydrates commonly get a bad rap in the media; with low - carbohydrate diets common among the weight loss community. But is there evidence to support this? What is the ideal amount of carbohydrates to include for health and/or weight loss? Luckily, one of the Registered Dietitians from Revolution Physical Therapy Weight Loss is here to clear up some confusion about carbohydrates.

Carbohydrates, protein and fat are the three macronutrients. According to the 2015 Dietary Guidelines for Americans, carbohydrates should make up 45-65% of one’s intake. In comparison, protein should make up 10-30% of one’s intake and fat should be 25-35% of one’s intake(1). As you can see, carbohydrates are needed in the most abundant amount - over half of one’s calories.

Sources of carbohydrates include fruits, vegetables, grains, dairy products and any added sugars (sugar sweetened beverages, desserts, etc). Carbohydrates are fuel for our body. Carbohydrates break down into glucose in our blood, which our cells utilize as energy.

So what’s the story behind low carbohydrate diets and weight loss?

Most studies investigating low-carbohydrate diets restrict carbohydrate intake to 20 grams/day (this is equivalent to 1 medium banana) and most are done for a short period of time (< 6 weeks) so limited long-term research is available(2,3).

Among the limited evidence, decreasing carbohydrates has been shown to produce some weight loss (2,3). However, this is primarily due to water weight. Carbohydrates are stored in the form of glycogen in the liver and muscle tissue. Glycogen is stored with water so when we decrease carbohydrates in our diet, the body breaks down the glycogen and releases water. When someone starts eating a moderate amount of carbohydrates again, the weight gain seen is just the water weight(4).

While short-term weight loss may be possible, long - term weight loss is more difficult with this regimen due to several factors. Several food groups have to be eliminated on a low-carbohydrate diet (any grains, fruits, starchy vegetables, dairy, and any added sugars). This can lead to nutrient deficiencies. Fiber is one nutrient that would be significantly reduced; which can lead to constipation, diverticulitis and colon cancer; just to name a few(5).

Furthermore, significantly reducing carbohydrates means that protein and fat will be significantly increased. This unbalanced macronutrient ratio can lead to other health problems. Increased saturated fat consumption can have a detrimental impact on cardiovascular health. Increased protein intake can have detrimental effects for those at risk for kidney disease(4). Sticking close to the percentages recommended by the Dietary Guidelines for Americans helps ensure that one is getting all the necessary nutrients for optimal health.  

So, what does this mean?

In order to have optimal energy levels, it’s important to include carbohydrate sources that are energy dense, provide fiber and other vitamins and minerals. Focusing on fibrous carbohydrates and/or complex carbohydrates (whole fruits, vegetables, whole grains, fat-free or low-fat dairy) is important in order to provide sustainable energy. Simple carbohydrates (added sugars, desserts, refined grains) metabolize very quickly, resulting in a quick energy spike and should be limited. While the quality of carbohydrates matters, so does the portion. Utilizing the MyPlate visual can be helpful in determining portions of carbohydrates to include at each meal.

Carbohydrates provide various health benefits and should comprise 45-65% of one’s intake. At Revolution Physical Therapy Weight loss, the Registered Dietitian’s work with patients to determine their individual calorie and carbohydrate goals to promote health and weight loss. If you have any further questions, consult with a Registered Dietitian at Revolution Physical Therapy Weight Loss to determine your individual goals.


  1. Dietary Guidelines for Americans 2015-2020.  

  2. Krebs, NF, et al. Efficacy and Safety of a High Protein, Low Carbohydrate Diet for Weight Loss in Severely Obese Adults. The Journal of Pediatrics.

  3. Brehm, BJ, et al. A Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women. Journal of Clinical Endocrinology and Metabolism: 88(4).

  4. Sherman, WM. Muscle Glycogen Storage and it’s Relationship to Water. Int J Sports Med.

  5. Anderson, JW, et al. Health Benefits of Dietary Fiber. Nutr Rev. 2009. Apr:67(4): 188-205.


During the course of my time treating patients at Revolution Physical Therapy Weight Loss, I have encountered several who have been given the diagnosis of osteoarthritis, most commonly in the knees.  Depending on the extent of the knee pain, it may limit a patient’s mobility and quality of life.  So what does this mean for exercise, especially with regards to the weight loss program?  In order to answer that question it would be helpful to examine the aspects of the diagnosis and prognosis of osteoarthritis related knee pain.

What: The Knee Joint

Synovial joints such at the knee and shoulder are important parts of the musculoskeletal system at which point two bones articulate (come into contact) with one another. The ends of these bones are lined with hyaline articular cartilage, which creates a smooth surface for load transfer during motion (Ateshian & Mow, 2005). The main function of cartilage at joints is to distribute the load equally across the surface of the bones and decrease friction during motion (Eckstein et al, 2006).  This allows us to perform many activities uninhibited: walking, running, jumping, climbing stairs, etc. In the presence of osteoarthritis, patients are more aware of their knees than previously, however this does not mean they are doomed.

How: The Process of Osteoarthritis

First of all, it is important to recognize the diagnostic process. Osteoarthritis is typically diagnosed with radiograph (x-ray), the results of which are not necessarily indicative of damage (Hunter & Eckstein, 2009). Imaging provides physicians and the medical community with information regarding the state of your joints, but is not the sole factor in diagnosis. It is important to remember that an image is a static snapshot of an area of your body, but does not necessarily indicate factors at play while your body is in motion.

In cases of osteoarthritis, synovial joints undergo structural and functional failure due to loss/erosion of cartilage, bony alterations, and meniscal degeneration (Nuki, 1999). This means that there are several physiological alterations that occur within the joint that may cause pain. Osteoarthritis is a result of excessive mechanical stress specifically in the context of systemic susceptibility, which is related to genetic factors, age, ethnicity, diet and female gender (Hunter & Eckstein, 2009). Therefore, not only does an individual have to undergo the process of joint changes, but one must also be susceptible to this process. A concept similar to that of predisposing factors associated with other disease processes.

Factors such as abnormal joint mechanics, muscle weakness, and structural changes at the joint itself can increase the potential for osteoarthritic progression and can be affected by joint loading (Hunter & Eckstein, 2009). The good news is that muscle weakness and abnormal joint mechanics are not permanent and can be improved over time with physical therapy and exercise. Resistance exercises increase muscle strength over time, which in turn gives greater support to the joints. Abnormal joint motion can be altered by feedback from a physical therapist or simple changes in squat form to execute a basic sit to stand motion.

Joint loading can occur through joint injury (acute or repetitive overuse) or increased weight gain related to obesity. For example, during walking body weight is transferred to the knees, and each additional kilogram of body mass increases the compressive load over the knee by about 4 kilograms, or about 8.8 pounds (Messier at el 2005). If you do the math, a weight gain of 20-30 pounds over the course of a year increases the compressive force through the knees by about 80-100 pounds. Weight gain can also be modified with proper exercise, nutrition and motivation, as seen in a well-rounded program offered at Revolution.

Why: Just Keep Moving!

Although there is an increasing awareness of the importance of exercise within the general population, the majority of individuals also believe that exercise is additionally damaging to one’s joints, especially in the lower extremities (Hunter & Eckstein, 2009). It is a common misconception regarding lower body joint pain and mobility. However, there is no strong evidence to suggest that vigorous low-impact exercise is associated with an accelerated rate of development of osteoarthritis (Hunter & Eckstein, 2009). In fact there are benefits from low-impact exercise (such as cycling and aquatic exercise) in comparison to high-impact (running, jumping) exercise. It allows patients to maintain cardiovascular health, increase joint mobility and stay healthy, while avoiding the potentially damaging effects of high-impact exercise (Hunter & Eckstein, 2009).

Individuals with osteoarthritis are likely to experience a sensation of joint stiffness, especially in the morning and after prolonged sitting. This is because the joints have been still for a long amount of time. It is important to keep moving and be aware that gentle walking is not going to cause any additional damage. In fact, not moving can have deleterious effects just as much as high-impact activity. Research has shown that cartilage undergoes a process of atrophy (thinning) in the absence of mechanical stimulation, such that there is a decrease in cartilage volume or thickness with reduced weight bearing (Eckstein et al, 2006). This means that without consistent activity, the cartilage that allows for that smooth motion at the joints may depreciate.

The joints of the body are constructed in such a way to manage increased mechanical loads over lifetimes without deteriorating (Ateshian & Mow, 2005). We are built to last and withstand lots of motion. Motion is lotion and it helps to lubricate our joints in order to be able to keep moving. A diagnosis of osteoarthritis is not a moratorium on your lifestyle and activity. Proper education regarding exercise and a strengthening program supervised by a physical therapist or licensed clinician can set you up for success with your weight loss program or your general return to activity.  


1. Ateshian G, Mow VC (2005) Friction, lubrication, and wear of articular cartilage and diarthrodial joints. In Basic Orthopaedic Biomechanics and Mechanobiology, 3rd ed (ed Mow VC, Huskes R), pp. 447-494). Philadelphia: Lippincott, Williams & Wilkins.

2. Eckstein F, Hudelmaier M, Putz R (2006) The effected of exercise on human articular cartilage. Journal of Anatomy, 208, 491-512.

3. Hunter D, Eckstein F (2009) Exercise and osteoarthritis. Journal of Anatomy, 214, 197-207.

4. Nuki G (1999) Osteoarthritis: a problem of joint failure. Z Rheum 58, 142-147.


Hydration, hydration hydration! It seems to be drilled into our minds the fact that it is important, but few of us understand the reasons why it is so beneficial for the body. Because the winter season is upon us, we’ll look at a few reasons why hydration matters for different functions, as well as what we should do in order to stay properly hydrated.

With the cold front coming in at full speed, proper water consumption of 64 oz/day or more will help the immune system fight more efficiently. One of the practical ways water helps strengthen our bodies defenses is by hydrating our mucous membranes, located in our nose and throat. This is paramount because the linings in our nose and throat are one of our body’s first defenses to trap and kill harmful pathogens. If these membranes are dry instead of hydrated, those pathogens are able to enter our body directly and cause us to become more susceptible to getting sick and contracting flu viruses and the like.

With the snow and the frigid temperatures, the holiday season is here! Which means that holiday parties and gatherings are in no short supply. For those of us who want to see pounds come off rather than pack on, the accessibility to food alone during this time can be a significant challenge. However, managing alcohol or “holiday cheer” as some affectionately refer to it, can be a whole different ball game. The hesitation with consuming alcohol usually comes from knowing that alcoholic beverages are caloric, but their dehydrating effect on the body is another aspect to consider. Alcohol increases urination which is the first step in the “dehydration loop” which is urination → dehydration → thirst. When people feel thirst they usually reach for another alcoholic beverage, but unfortunately this only perpetuates the dehydration loop. Instead the solution is to drink a nonalcoholic (preferably calorie-free) beverage in between alcoholic drinks.

Additionally, with holiday parties, catered events and lavish home cooking, sodium will be in high supply. Following the principle of osmosis, sodium consumption will increase water retention, thus impacting weight by holding on to excess water. Drinking adequate amounts of water or even increasing volume of water consumed will help flush out sodium and lessen impact on weight.

It’s common for an individual to start the new year with a renewed resolve to get healthy and lose weight, which is a very worthy goal indeed! However, discouragement can quickly set in when one steps on the scale to get their new year starting weight. Often times it is higher than where they were pre-Thanksgiving, which can deflate the morale of some, but this does not have to be the case. Certainly being careful to watch portions and quality of food throughout the holidays will help, but the simple act of hydrating can also be a big step in the right direction.

So this season, put in the effort and strive to stay hydrated, so you can ring in the New Year with your best foot forward. Make the end of 2016 be just as healthy as you want next year to be.


Obesity, defined as having excessive amounts of adipose, or fat tissue, is classified as a chronic disease that affects more than one-third of the American population according to the Centers for Disease Control and Prevention (CDC). This disease is also a common comorbidity in adults with prevalent health conditions such as diabetes and heart disease. However, many people do not consider how one’s weight can affect weight-bearing joints, such as the hips, knees and ankles.

An increase in body weight caused by excessive adipose tissue can increase the load placed on weight-bearing joints when completing daily activities, as well as physical exercise. For every one pound of additional weight, about four pounds of additional pressure are exerted on those joints. For example, an individual who weighs 200 pounds would be placing approximately 800 lbs pounds of pressure on their knees when walking. In combination with weak musculature around the joints, these additional forces can lead to discomfort and the possibility of additional damage on the joints,

Eventually, damage can result in Osteoarthritis (OA), or the breaking down of cartilage within the joint. As cartilage is lost, additional friction between adjacent/articular bones occur. This can lead to knee pain with daily activities including transitioning from a seated to standing position, as well as walking, especially when added forces such as body weight are factored in. Even though OA is present in individuals who maintain a healthy weight for their height, studies have shown there is an increased risk of developing OA in individuals categorized as overweight or obese. However, studies have also indicated that weight reduction in obese individuals diagnosed with OA can lead to a significant decrease in pain and improvement in daily function.

Obesity can cause a vicious never ending cycle for individuals. As mentioned above, excessive weight increases the amount of pressure on the weight bearing joints, which can then increase the level of pain and/or damage. Furthermore, this could lead to an individual becoming more sedentary that leads back to additional weight gain. However, if you feel that you are a part of this never ending cycle, then Revolution Physical Therapy Weight Loss can be the place for you. The Revolutionary approach will assist in improving eating habits, increase utilization of motivational strategies, and provide specific and safe exercise techniques to help not only reduce joint pain but reduce overall weight.



Astrup A., Bliddal H.,Christensen R., (2004). Weight loss: the treatment of choice for knee osteoarthritis? A randomized trial. Osteoarthritis and Cartilage, vol. 13, pp 20-27.

Centers for Disease Control and Prevention. June 16, 2016. Overweight & Obesity. Retrieved from

Davis, C., DeVita, P., Gutekunst, D.J., Messier, S.P. (2005). Weight Loss Reduces Knee-Joint Loads in Overweight and Obese Adults With Knee Osteoarthritis. Arthiritis & Rheumatism, vol. 52, pp 2026-2032.

Kane, A.  How Fat Affects Arthritis. Being overweight can make arthritis, gout, lupus, fibromyalgia and other joint diseases and conditions worse. Retrieved from


Creating an exercise routine and sticking with it can be difficult. At Revolution we help you achieve your goals by implementing these strategies below.

1. Know how much exercise you are getting

Work out for at least 150 minutes (2 1/2 hours) per week when completing moderate exercise (eg brisk walking/light jog) or 75 minutes (1 hour 15 minutes) of vigorous activity (eg running).  This is the amount of exercise recommended by the American Heart Association to improve health.   Exercise is a great way to reduce your chance of heart disease and stroke. Heart disease is the leading cause of death in the United States, and stroke is the fifth leading cause of death.  Increasing your physical activity can decrease high blood pressure, reduce high cholesterol, decrease high blood sugar and increase oxygen efficiency. If your goal is weight loss you will need more exercise.  The American College of Sports Medicine recommends 200 – 300 minutes of moderate exercise for weight loss.  Whatever your goal, just get moving. At Revolution we use polar watches to track your heart rate, and your activity, which helps keep you on track.

2. Have a workout partner

The Department of Kinesiology at Indiana University found that couples who worked out separately had a 43% dropout rate, while those who went to the gym together had only a 6.3% dropout rate. Whether your workout partner is a friend, or a professional, like a physical therapist or exercise physiologist, you are much more likely to stick with your program in a pair than going at it solo.  At Revolution you will always see either a physical therapist or exercise physiologist each exercise session.  We hold you accountable, increase your safety, add variety to your work out and make the experience more fun.

3. Work out 4-5 days per week

Consistency is important. Making exercising part of your routine will help you maintain a healthy lifestyle.  If you only work out when it is convenient, exercising will not become a habit.  Most likely you will soon find yourself back on the couch binge watching your favorite show.  Exercising 4-5 days per week will keep you on a schedule and keep you off that couch!

4. Include cardiovascular and strength training

Improving your aerobic capacity and muscle strengthening are both important to overall health.  When completing cardiovascular exercise you are using an aerobic source of energy which will raise your heart rate.  This will help strengthen your heart and lungs.  When completing strength training you are using an anaerobic source of energy which will cause your body to burn more calories after the workout.  This is due to the recovery process the muscle undergoes when overloaded.  The overload process is what causes the muscle to become stronger.  Stronger muscles support your joints, help you to complete your activities of daily living with greater ease and allow you to have more energy.

5. Do something you enjoy!

The fact that you will be more likely to do something you enjoy is a no-brainer.  There are so many activities you can do for exercise, there is bound to be one you enjoy!  Enjoy nature?  Take a walk outside. Like group activities?  Join a sports team such as volleyball, basketball, soccer or softball. When we were kids we used to call these activities play; so find your inner kid and go outside (or inside) to play!

6. Set realistic goals

If your goal is to lose weight don’t make a goal of losing 10 pounds in a week.  If you goal is to build strength, don’t set a goal of bench pressing what you did in high school so you can look good for your 30 year reunion 2 weeks from now. When you put your body through extreme measures this is not only unhealthy, but also not sustainable.  Set realistic goals and progress these goals as your body adapts to your new regimen. At Revolution we have a goal of 1 -2 pound weight loss/ week. This has been proven to be healthy and sustainable. 

7. Create a plan that works for your lifestyle

An exercise plan is not a cookie cutter item that should be the same for everyone.  It is important to create a plan that works for your lifestyle, otherwise it will not be sustainable.  Plan a time to workout when it is best for you.  There is no right or wrong time to exercise; morning, afternoon or evening.  The best time is what fits into your life. At Revolution we have both morning and evening hours to accommodate your schedule. Exercise is a vital part of a healthy lifestyle. If exercise was a pill, it would be the most prescribed medicine in the world. The best time to start is now. At Revolution we would love to show you how to safely and effectively start exercising to a healthier you!


How sleep impacts your workout (and overall weight loss progress)

Before starting at Revolution, many patients arrive not knowing the exact cause of their irritability and constant lack of energy. As they start care, nutrition is improving and daily activity levels are progressing, but many excuses could be made as to why they cannot get over the “hump” with energy levels, even though they are losing weight and feeling stronger. Rather than trying to reinvent the wheel and focusing on hard numbers and data, sometimes problems can be identified from the most basic areas. One simple component is often missing in the journey with exercise and weight loss: adequate sleep. 

Sleep is vital for everything, but specifically let’s discuss its importance in your body’s performance during resistance exercise and more strenuous activities. It provides the energy and recovery needed for full mental and motor capacities. Although sleep loss may not limit measures of maximal power output during resistance training, the body will certainly tire more quickly and be prevented from the comprehensive health and fitness benefits of resistance and aerobic exercise (VanHelder & Radomski, 1989) as compared to someone with proper rest that can keep going.

Without enough time to recover and restore the body to its needed homeostasis, it continues to lack the proper level of hormones like testosterone (which “anabolically” builds and protects the muscles from excessive damage) and insulin growth factor (which appropriately breaks down blood glucose). Your body suffers as a result and is slowly broken down itself while gaining fat and losing muscle (Patel, 2009). Cortisol is a hormone directly related to sleep which allows the body to respond to stress; it assists in regulation of blood glucose and metabolism in the body (Haff and Triplett, 2016), similarly to adiponectin which is also correlated to sleep in relationship to loss of body fat (Sawamoto et al., 2016). Have you heard of REM sleep? This is the deepest and most important cycle of your nightly sleep for recovery, often lacking in individuals with lowered hormone levels.

This goes beyond your physiology related to exercise. Appetite can also be affected as feelings of fullness, and conversely, hunger cues, can be impacted with lack of sleep (Taheri et al., 2004) to further complicate progress toward weight loss goals. Make no mistake, plenty of research is out there in support of sleep for fat loss and weight loss: One study showed that people who slept 8 hours per night as compared to those with a measly 5 hours, even with the same weight loss goals in their exercise programs, demonstrated 55% greater fat loss and 60% greater preservation of muscle (Patel, 2009). These examples are numerous in the literature, but let’s greatly simplify the subject.

When you provide your body with the proper fuel, it can run for longer and not break down. Fuel is not just what you eat, but the energy supplied with necessary recovery. The nice thing about the human body is that with a full tank it can advance and improve in response to challenges, so fuel up. If sleep is something you struggle with, feel free to reach out directly. Our team is happy put you in contact with one of our Motivation Managers to discuss strategies for improving sleep habits to aid with recovery and energy levels.


Haff, G., & Triplett, N.T. (2016). Essentials of Strength Training and Conditioning. (4th ed). Human Kinetics: Champaign, IL.

Patel, S.R. (2009). Reduced sleep as an obesity risk factor. Obes Rev. 10 Suppl 2:61-8.


Sawamoto, R., Nozaki, T., Furukawa, T., Tanahashi, T., Morita, C., Hata, T., … Sudo, N. (2016). A change in objective sleep duration is associated with a change in the serum adiponectin level of women with overweight or obesity undergoing weight loss intervention. Obes Sci Pract. 2(2):180-8. Epub 2016 Mar 14.

Taheri, S., Lin, L., Austin, D., Young, T., & Mignot, E. (2004). Short Sleep Duration Is Associated with Reduced Leptin, Elevated Ghrelin, and Increased Body Mass Index. PLoS Med. 1(3): e62.
VanHelder T., & Radomski M.W. (1989). Sleep deprivation and the effect on exercise performance. Sports Med. 7(4):235-47.



Center of Disease Control (CDC) has reported concerning statistics regarding unconventional injury among adults 65 and older in 2012-2013. Of all unconventional injuries, 55% were due to falls, which is nearly double the number from the year 2000.

Falls and fall-related injuries, such as hip fracture, can have a serious impact on an older person's life. Every year, one in three adults 65 or older falls at least once, and more than 90 percent of hip fractures result from falls. Falling can often lead to fractures of the spine, forearm, leg, ankle, pelvis, upper arm and hand. If you fall, it could limit your activities or make it impossible to live independently.

Maintaining the standing position requires multiple different body systems to be constantly working together.  These systems include the central nervous system (brain and spinal cord), the vestibular system (brain and inner ear), the visual system (brain and eye) and a vast web of position-sensing nerves. Muscles and bones are pressed into service as well. Balance is like muscle strength: The more you use it, the less likely you are to lose it. Balance exercises, along with certain strength exercises, can help prevent falls by improving your ability to control and maintain your body's position, whether you are moving or still.

Combined with weight loss and strengthening exercise programs, participating in Balance Specific Exercise is a step in the right direction to protecting yourself, and decrease your fall risk. However,  it is important to receive proper instruction on such exercises, as many are dangerous to perform unsupervised. Before engaging in a Balance Specific Exercise program, be sure to consult with a Revolution Physical Therapist or Exercise Physiologist to assure correct form for not only maximizing effectiveness, but also assuring safety.



Kramarow E, Chen LH, Hedegaard H, Warner M. Deaths from unintentional injury among adults aged 65 and over: United States, 2000–2013. NCHS data brief, no 199. Hyattsville, MD: National Center for Health Statistics. 2015.

Why are balance exercises important as we age?. (2013,  JANUARY 11). Retrieved from



Most people are generally aware that hypertension is a dangerous condition and is considered to be the “silent killer.” Many can even tell you “high blood pressure makes the heart work harder than it normally has to, that’s why it’s bad!” While these statements are true and important in spreading awareness about high blood pressure, it is important those diagnosed actually physiologically understand their condition.

The main goal of the human circulatory system is to facilitate gas exchange (bringing oxygen in and eliminating carbon dioxide) (Klabunde, 2005). This gas exchange cannot occur without adequate blood flow to working tissues (liver, kidneys, skeletal muscles, etc.). The most important aspect of adequate blood flow is the ability to move from a high pressure to a low pressure. Essentially, it is the job of the heart to receive venous (non-oxygenated blood) and not only replenish the blood’s oxygen supply, but raise the pressure of this blood to assure adequate flow to working tissues (Klabunde, 2005). Systemic arteries will then deliver high pressure oxygenated blood through capillaries to working tissues (smallest vessels where gas exchange directly occurs).

However, these systemic arteries themselves have their own pressure exerted due to the narrowing of arteries (vasoconstriction) controlled by a number of mechanisms and will ultimately raises arterial blood pressure (Klabunde, 2005). Constant vasoconstriction is brought upon by conditions such as stress, physical inactivity, poor diet, and plaque formation all work to increase systemic arterial pressure. Since we have already discussed blood flow works on a pressure gradient (blood flowing from high pressure to low pressure), the heart must increase the pressure of the blood it is sending through systemic flow (Klabunde, 2005). Therefore, the force of each heart contraction has to be greater in order to raise the pressure of ejected blood to assure adequate blood flow via the pressure gradient.

The following article by Cornelissen and Fagard (2005) is a meta-analysis (a research article combining several studies on the topic and giving the general conclusions) and suggests endurance training has shown to be the most effective modality of training for lowering systolic pressure, diastolic pressure, and systemic vascular resistance. Common endurance activities include but are not limited to; running, cycling,  and swimming. Individuals with hypertension are advised to refrain from heavy weight training programs due to the fact it puts added pressure on systemic blood flow. However, endurance weight training (15-20 reps) has shown little adverse effect on blood pressure and vascular resistance. Patients who are considered moderate to high risk for cardiovascular disease should consult with a professional exercise technician to assist with prescribing safe, but effective heart rate zones based on their comorbidities. Especially those with controlled hypertension (medicated). Most blood pressure medications blunt heart rate response to exercise, therefore the common percentage of max heart rate training programs based on age are invalid for these patients and create safety concerns.


Image retrieved from: on 11/3/16.  


If you’ve had foot or ankle pain, you’ve probably asked the question, “should I get orthotics?” While most avid runners and athletes may be familiar with foot orthotics, most of the population is unsure about what orthotics can do for them.

Surprisingly to some, orthotics are useful for all sorts of orthopedic diagnoses and can be beneficial for many different types of people. If you have foot, ankle, knee, hip or even back problems, orthotics may be a great adjunct to your physical therapy treatment! Recent research has demonstrated favorable evidence for the use of foot orthotics in daily life and for sports performance. Past studies have revealed that the use of orthotics can increase hip muscle activity during less dynamic exercises1 and help control ankle and knee motion during running.2,3 Orthotics have also been used as treatment for the diabetic foot for many years, with research indicating significant reduction in risk for ulcers with proper use of custom orthotics.4

Ok, so say you want to try orthotics - how do you know what type to get and which ones would be best for your specific foot? The first step would be to have your physical therapist analyze your gait and foot structure. Many podiatrist (DPM) offices can also do this for you. A podiatrist may also want to analyze your foot structure more closely with the use of diagnostic imaging or other measurements if he or she thinks foot structure might be causing some or most of your pain. Depending on the results of this analysis, your podiatrist and/or physical therapist may recommend an orthotic. Custom-made orthotics are typically made with a plaster that is molded to your foot and are often covered by insurance plans. They can be tailor made for your specific foot structure and support needs.

In conclusion, if you are having pain with walking or running and have tried physical therapy and other treatments, orthotics might be your next step! Don’t hesitate to ask your physical therapist for more information and seek out an evaluation from a podiatrist.  



  1. Hertel J1, Sloss BR, Earl JE. Arch Phys Med Rehabil. Effect of foot orthotics on quadriceps and gluteus medius electromyographic activity during selected exercises. 2005 Jan;86(1):26-30.

  1. Nawoczenski DA1, Cook TM, Saltzman CL. The effect of foot orthotics on three-dimensional kinematics of the leg and rearfoot during running.J Orthop Sports Phys Ther. 1995 Jun;21(6):317-27.

  2. MacLean C1, Davis IM, Hamill J. Influence of a custom foot orthotic intervention on lower extremity dynamics in healthy runners. Clin Biomech (Bristol, Avon). 2006 Jul;21(6):623-30.

  3. Albert S1, Rinoie C. Effect of custom orthotics on plantar pressure distribution in the pronated diabetic foot. J Foot Ankle Surg. 1994 Nov-Dec;33(6):598-604.

  4. Malkin K1, Dawson J, Harris R, Parfett G, Horwood P, Morris C, Lavis G. Foot (Edinb). A year of foot and ankle orthotic provision for adults: prospective consultations data, with patient satisfaction survey. 2008 Jun;18(2):75-83. doi: 10.1016/j.foot.2008.01.001

  5. Picture accessed 10/27/16 from: 
How does the set point theory effect weight loss?

Do you ever feel like you keep struggling to lose the same 4 or 5 pounds? Maybe your problem is plateauing at a certain weight that you can never get past? Have you lost some weight before and found yourself gaining it back? The reason for some of these common weight loss problems may be the Set Point Theory. A Set point is simply the weight range in which your body is programmed to function optimally. Set points vary for each person, and some people will have a high setting, meaning they tend to have a naturally higher weight, while others have a low set point and therefore a naturally lower body weight. Scientists estimate the average person has a set point range of about 10 to 20 pounds, meaning at any given time, there is a +5 to 10 pounds above your normal weight or a -5 to 10 pounds below your normal weight(1). 

So for everyone who has ever tried to lose weight may notice a loss in the first few weeks, but almost always gain it back as consistency and new habits start to slip. The faster the rate of weight loss, the quicker the rate at which your body will try to gain the weight back. That is a sign that the body is trying to fight to retain it’s natural weight. Think of simple physics as Newton's third law states: For every action, there is an equal and opposite reaction.

When you go below your body’s natural set point, (calorie deficit state) both appetite and metabolism adjust to try to return you to your set point. Your metabolism may slow down to try and conserve energy as your body starts to sense it’s in a state of semi-starvation. A study from MIT Medical shows that long-term caloric deprivation acts as a signal for the body to turn down its metabolic rate. The body reacts to strict low calorie dieting as though famine has set in. Within a day or two after semi-starvation begins, your metabolism shifts to a cautious state  designed to conserve the calories it already has. This will tell your body to make you more tired in an attempt to conserve calories (little calories in = little calories out), and try to gain weight back. Because of this innate biological response, dieting becomes progressively less effective, and a plateau is reached at which further weight loss seems all but impossible.

Just as your metabolism will slow down when you go under your body’s set point, it will also increase if you go above it. The body will try to fight against the weight gain by increasing its metabolic rate and raising its temperature to try and burn off the unwanted calories. However, this is very short term! The set point, it would appear, is very good at supervising fat storage, but it cannot tell the difference between dieting and starvation.

The interesting and uplifting news is that if you are able to maintain a safe and steady rate of weight loss (1-3 pounds a week) for a longer period of time, you can change your set point. After about a year, your body will start to “accept” your new set point, and it will actually become easier for you to maintain your weight loss. Thus, the body is no longer fighting against you, but actually [working] with you, which is good news for anyone trying to lose weight(2,3).

The graph attached shows that everyone will face plateaus, weight gains, and yes weight losses along a weight loss journey. The path is a long one that can be frustrating at times, but if you stick it out and “stay the course” your body will reward you in the end.







Seeds...small but mighty

The Power of Seeds

In today’s world people are constantly multi-tasking and juggling many angles in their lives. A quick way to boost nutrient intake and assist in weight loss is to add chia or flax seeds to meals by sprinkling them on salads, yogurt or cereal, or incorporating them into sauces or baked goods. Why are these nutrients important? In a nutshell:

Fiber: helps to control blood sugars, maintain digestive regularity, lower cholesterol, and achieve a healthy weight by keeping you full. Women 50 or younger should aim for 25 grams a day, and 21 grams if you are over 50. Men 50 or younger should aim for 38 grams daily or 30 grams if 50 or over.

Protein: A macronutrient that is a component of every cell in your body and is essential in many biological processes. Consuming protein is important for building lean muscle, recovering from exercise, maintaining a healthy weight, and curbing hunger. Adults are encouraged to consume 10-35% of their daily calories from protein. 

Omega-3-Fatty Acids: There are three main kinds of omega-3-fatty acids: EPA & DHA are primarily found in fish, whereas ALA is found in vegetable oils, nuts and seeds. Some of the health benefits include lowering blood triglyceride levels and blood pressure, reducing inflammation in the body, and reducing the risk of heart disease.  The Academy of Nutrition and Dietetics recommends getting between 1.3 grams and 2.7 grams of ALA each day for every 2,000 calories you consume.

Chia Seeds:   Chia seeds have a mild nutty flavor and can be eaten whole, which makes them easy to add to foods and beverages.  Just two tablespoons of chia seeds provide on average 10g of fiber, 4g of protein and about 5.7g of omega-3-fatty acids. Because chia seeds are very absorbent, they can easily be mixed into cooked dishes.  When combined with liquids, they take on a gelatinous texture which some people enjoy but others find unpleasant. Fortunately, these qualities make them easy to mix into other foods. In addition, they do not have a strong flavor, therefore they can easily be sprinkled on a variety of dishes.

Flax Seeds:  There are two main types of flaxseed, golden and brown, and they both are a great source of omega-3-fatty acids and fiber.  Two tablespoons of flaxseed provide on average 4g of fiber, 3g of protein, and 5g of omega-3-fatty acids. If you purchase the seed whole, then you will need to grind it before consumption and then refrigerate the meal when not in use.  Whole flax stays fresh for up to a year, whereas the ground up meal will go rancid more quickly. Flax does tend to have a stronger flavor than chia seeds, so make sure to start with adding just a little to your food until you are used to its taste.


The Nutrition Care Manual:  

Thompson, J., Manore, M., Nutrition an Applied Approach 3rd Ed., 2012 


Find out the optimal exercise intensity for weight loss

Oddly enough, Jane Fonda actually came out and apologized for the “No pain, no gain” mantra that we all spent 80’s and 90’s reciting while cranking out some Richard Simmons aerobics. Not that there is anything wrong with Richard or Jane, they both have helped millions of people move towards a healthier lifestyle. That being said, it is time to use what we know about the science of exercise to clear the air regarding exercise intensity and its relevance with weight loss.

First things first, there are three fuels for exercise; fats, carbohydrates, and proteins. For time sake, let’s ignore protein, as it is only a primary fuel source used for aerobic exercise when an individual is fasted for a long period of time. Simply put, at lower intensities, primarily fat is burned as fuel. Low intensity being defined a rate at which you can comfortably converse with an exercise partner. As the intensity of the exercise increases (i.e, speed or grade of treadmill), the body shifts the preferred substrate from fats to carbohydrates. The term for when this switch from fats to carbs occurs is known as the Anaerobic Threshold. The carbohydrates used for fuel at this higher intensity initially come from blood glucose, which accumulates from the food we eat. As exercise continues, this blood glucose is maintained first by glucose stored in liver (glycogen), and when those stores deplete, stores of glucose in the muscle keep the blood replenished with glucose.  To summarize, low intensity exercise equates to fat burn whereas high intensity results in carbohydrate utilization.

Now that we understand the nuts and bolts of metabolism during exercise, let’s discuss the proper intensity for weight loss. For starters, weight loss is achieved primarily by expending more calories than we consume on a consistent basis. However, similar to nutrition, it is important to identify the TYPE of calories an individual is expending during exercise. According to the findings of Connolly (2015), exercising below anaerobic threshold (lower intensity, higher fat burn) is more productive for weight loss than a higher intensity, even though more calories are burned at this higher intensity. Connolly (2015) provides the following both physiological and practical justifications for such a statement: Lower intensity allows the body oxidate lipids more effectively (burn fat); lower intensity exercise results in less fatigue and the increased likelihood an individual would exercise longer and burn more calories; finally, lower intensity exercise is better for cardiovascular adaptations, which in turn helps patients breakdown and mobilize fat more for fuel during rest and recovery.  

So what does all this great information mean for the average person trying to lose weight? Turn down the intensity, increase the duration, and find an activity that you actually ENJOY doing. Although fat burn activity burns less calories in the short term, there is not only a physiological benefit of mobilizing and expending more fat calories at rest, there is the benefit that you will actually KEEP exercising. Remember, the most important exercise plan isn’t the one that works, it’s the one that you keep doing. Even if it works, that doesn’t mean you will keep doing it. Tune in next week for Revolution’s Lead Dietitian Claire Allen’s take on the power of seeds and sustainable weight loss.


Connolly, D. A. (2015). Slow Down to Speed Up: Using Intensity Threshold Indicators to Optimize Lipid Utilization during Exercise. Journal of Diabetes & Metabolism, 2015. 

Clinicians could consider referring overweight or obese patients to commercial weight loss programs, although some programs will require more study to confirm long-term effects, a review found.

To compare the effects of commercial weight loss programs with control groups of no or few interventions or behavioral counseling among overweight and obese adults, researchers conducted a review of 45 studies (39 randomized, controlled trials) of at least 12 weeks' duration or prospective case series of at least 12 months' duration (harms only). The review adds studies that have appeared in the peer-reviewed literature since a previous review was conducted in 2005. It was published in the April 7 Annals of Internal Medicine.

At 12 months, participants in Weight Watchers achieved at least 2.6% greater weight loss than those assigned to control/education, and Jenny Craig resulted in at least 4.9% greater weight loss at 12 months than control/education and counseling. At 3 months, Nutrisystem resulted in at least 3.8% greater weight loss than control/education and counseling. Very-low-calorie programs such as Health Management Resources, Medifast, and OPTIFAST resulted in at least 4% greater short-term weight loss than counseling, but researchers found some attenuation of effect beyond 6 months, when such data were reported. Atkins resulted in 0.1% to 2.9% greater weight loss at 12 months than counseling. Results for SlimFast were mixed.

The researchers noted that Affordable Care Act (ACA) coverage may increasingly prompt clinicians to consider referring patients to commercial programs. A recent weight management guideline from medical societies recommends that clinicians refer overweight and obese patients to high-intensity programs but doesn't address commercial weight-loss programs.

"Because the ACA is likely to increase obesity screening, having an actionable plan that addresses weight management is critical," the authors wrote. "Health insurers and employers may want to consider providing benefits coverage or incentives of reduced program fees to beneficiaries and employees for commercial programs with strong evidence of effectiveness. On the basis of our findings, we would identify Weight Watchers and Jenny Craig for consideration for such benefits coverage."

An accompanying editorial noted that study data often do not reflect what actually happens in real life. Clinical trials test a single intervention in an optimal context, and studies also rarely leverage the physician-patient relationship.

"Although earlier studies have suggested limited effectiveness of physician counseling about weight when it is done in isolation, physicians can potentially play an important role," the editorial noted. "For example, they can encourage adherence to lifestyle changes by making the link between modest weight loss and health benefits and providing behavioral reinforcement in partnership with a structured behavioral program."


Article from the American College of Physicans 

Results. Every one wants them, and everyone wants them FAST. Time and time again I tell my patients to not get caught up with the rate of change, but rather, focus on the changes themselves.
Results. Every one wants them, and everyone wants them FAST. Time and time again I tell my patients to not get caught up with the rate of change, but rather, focus on the changes themselves.
A few years ago I discovered the motto of my life. “Progress not Perfection”. I found myself discouraged at making changes in my life because I knew I couldn’t do it perfectly. This perceived reality turned me off from even trying to change, rationalizing that it was pointless to try if I couldn’t do it perfectly. This couldn’t be further from the truth.
They say that the only way to guarantee an outcome is to never try at something. I have found this to be a profoundly true statement. Realistically, progress is a process, and to the dismay of many, not an expedited one.
Identifying progress can be a challenge for many of us. One of the reasons for this is because progress is often very subtle. We want that drastic, radical change, especially when it comes to getting healthy or losing weight, but that’s just not how it works. Because of that, it can be hard to pin point significant change, when we see ourselves day in and day out. The only encouragement I can offer in that regard is to use objective markers to track progress. Tracking your weight trends will be important, but that’s not the end all. Other markers to use are an old pair of jeans you want to fit into again, waist or hip measurements, fasting blood glucose levels and cholesterol levels just to name a few.
Ultimately, the secret to lasting change is commitment and consistency. As long as we stick to it, we will achieve the results we want eventually. It may take longer than we would have liked, but slow and steady wins the race.  
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Have you ever been overwhelmed by the oil aisle? The sheer number of options to choose from can lead to confusion. Often times, we will simply chose the most intriguing bottle or the one with the best price.

Have you ever been overwhelmed by the oil aisle? The sheer number of options to choose from can lead to confusion. Often times, we will simply chose the most intriguing bottle or the one with the best price.

Here are a few things to know when choosing the right cooking oil.

First of all, we should understand that oils are extracted from nuts and seeds through mechanical crushing and pressing. The word “virgin” that we see on so many products means that this oil was bottled immediately after pressing or was cold-pressed raw (some are pressed with heat and that compromises some nutrients). Thus, virgin oils retain their natural flavor and color. These oils are also rich with minerals, enzymes and other healthy compounds; however, these oils don't work as well with high temperature cooking and are more susceptible to rancidity.

Second, when choosing cooking oil, the temperature at which the oil begins to smoke should be considered. This is called the “smoke point”. Using the appropriate oil for the temperature desired is important because it will add the greatest flavor to your dish and also provide the most health benefits. When oil is heated beyond its smoke point, nutrients can be damaged to the point of even becoming harmful. Below is a basic guide on what oil to use for various cooking methods/temperatures.

Oils for Cooking Styles

High Smoke Point

Medium Smoke Point

Low Smoke Point  

For searing browning and deep frying

For baking, oven cooking or stir frying


For Light Sautéing

Almond, avocado, hazelnut, sunflower


Canola, grape seed, extra virgin olive oil, peanut oil

Corn sesame, soybean and coconut oils


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“I'm 50 years old, and this is the best year of my life.” These are the words of my high school gym teacher, which shocked my classmates and inspired me to start exercising. “Every year I am wiser, have deeper relationships with my friends and family, and as long as I have my health, every year is the best year of my life.”

“I'm 50 years old, and this is the best year of my life.”  These are the words of my high school gym teacher, which shocked my classmates and inspired me to start exercising.  “Every year I am wiser, have deeper relationships with my friends and family, and as long as I have my health, every year is the best year of my life.”

Unfortunately, many older adults do not have their health.  A main reason for this is that the ability of muscle to generate tension decreases by 15-20% per decade for individuals in their 60's and 70's1.  This means less strength to get up from a chair, walk several blocks, or navigate stairs.  It means an increased chance of having a fall. For many, it can mean a dramatic decrease in quality of life.

However, with exercise individuals can maintain their muscle mass well into their 90's and beyond.  This is because the rate of decline in muscle force generation decreases dramatically, to 3.0% per decade, for elderly individuals who maintain a high level of physical activity2.  In other words, aging is much easier with exercise. 

My gym teacher will be 65 this year, and my guess is that he would still say that this is the best year of his life.  While aging is inevitable, exercise is voluntary.  Let us all take time to exercise to invest in our health, and make every year the best year of our lives.

by Tom Fairbank, PT, DPT


  1.  Lindle, RS, et al: Age and gender comparisons of muscle strength of 654 women and men aged 20-93 yr. J Appl Physiol 83:1581, 1997.
  2. Greig, CA, Botella, J, Young, A: The quadriceps strength of health elderly people remeasured after 8 years.  Muscle Nerve 16:6, 1993.

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Do you find yourself sitting or standing for a prolonged amount of time? Ever feel stiff at the end of the day? These two-minute stretches can help reduce risk of chronic lower back pain.

Do you find yourself sitting or standing for a prolonged amount of time? Ever feel stiff at the end of the day? These two-minute stretches can help reduce risk of chronic lower back pain.

Prayer Stretch


  • To complete this stretch: Begin sitting with both feet under your gluts. Remaining in that position, slide both hands along the ground in front of you. To emphasize right or left side, slide hands 45 degrees to either side and hold stretch.
  • This stretch will work lower and middle back muscles, increase spinal segmental mobility to improve motion, and reduce present or potential low back pain. 

Posterior Pelvic Tilt



  • To complete stretch: Lie on your back on a firm surface with knees comfortably bent.  Then flatten back against the floor while contracting abdominal muscles and squeezing gluts as if pulling belly button toward ribs and pushing your low back into the surface.  
  • This stretch will reduce low back pain, improve sacroiliac joint alignment and improve core stabilization/strength.  

Consult a physical therapist for more details on improving lower back pain or stiff muscles. 


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Like many of my patients, the struggle to exercise is very real to me.

I woke up one day a few weeks ago determined to work out. I had every intention to make it happen in the afternoon, before I left work. After making sure my gym clothes and shoes were in my bag, I was out the door.

Like many of my patients, the struggle to exercise is very real to me.

I woke up one day a few weeks ago determined to work out. I had every intention to make it happen in the afternoon, before I left work. After making sure my gym clothes and shoes were in my bag, I was out the door.

The day was packed with seeing patients and accomplishing things around the office. When my last patient left, I began responding to emails, then busying myself with other tasks. Eventually, it was time to leave, and I hadn’t made any attempt to start exercising. The thought hit me as I put on my coat, “I was going to work out today. I really wanted to work out. Why didn’t it happen?” That was when I realized something needed to change.

Good intentions are not enough to change behavior, especially when distractions abound.  In the New York Time’s bestseller, The Power of Habit, the author describes what steps are required for creating what is referred to as a “habit loop”. Establishing habits will help you achieve your goals by turning your good intentions into action.

Now let’s talk about how to practically create a habit loop. First, find a cue to disrupt your typical daily routine and get you on track with the habit you want to create—exercise. Second, choose an exercise routine to follow. Third, consider a reward—is it satisfying enough to feel accomplished after a workout? Do you need to treat yourself to a cup of tea or sauna time afterwards? Having something to look forward to will help solidify your habit loop and continue to make the cue you created work in the future.

Cues look different for everyone—here are some ideas:

  • Dress for your work-out first thing in the morning, for all you early birds
  • Plan a stop to the gym before arriving home after finishing the work day
  • Set an alarm to remind you it’s time to exercise if you work at home
  • Plan to watch your favorite show while on the treadmill instead of sitting on the couch (watching your show can also be an example of a built-in reward).

At any rate, you need to decide what will work best for your lifestyle. For me, I decided that the moment my last patient left, I would put on my sneakers and get moving. This way, I had plenty of time to exercise and then finish up my work after feeling refreshed.

Now think about your habit loop. What cue will you create to trigger this habit? What routine will you follow? Lastly, what reward will help your habit stick?


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Nutrition fads. We have all heard of them. Many seem like a good idea; others are plain bizarre. Each plan promises results, but all too many don’t deliver and leave people worse off than when they started. As healthcare professionals, it is important to inform consumers on which fad diet are actually safe to pursue and which are flat out a bad idea. Below are some guidelines on how to sift through whatever fad diet you may be thinking of.

Nutrition fads. We have all heard of them. Many seem like a good idea; others are plain bizarre. Each plan promises results, but all too many don’t deliver and leave people worse off than when they started. As healthcare professionals, it is important to inform consumers on which fad diet are actually safe to pursue and which are flat out a bad idea. Below are some guidelines on how to sift through whatever fad diet you may be thinking of.

Aspects to consider before starting:

1.     Calorie Restrictions

Any nutrition plan that highly restricts calories is not a good one. Many will suggest 1200 calories for women and 1500 calories for men. They will choose these numbers because they are the lowest numbers that can still be considered “safe”. However, most adults need more than these amounts. Over restricting calories will cause someone to lose weight too quickly and ultimately starve the body of necessary nutrients.

 2.     Macronutrient Balance

It is paramount to choose a plan that has proper nutrient balance. The three macronutrients are carbohydrates, proteins and fats.

The general recommendation is that

  • 50% of total calories should be from carbohydrates,
  • 20% from protein and no more than
  • 30% from fat.

Many fad diets will recommend drastic restrictions to any one of these macronutrients, which will render less than ideal results and compromise your overall wellbeing.

3.     Drinking vs. Chewing

Human beings have a natural need to chew. Thus, fad diets, classified as detoxes or cleanses that call for liquid or smoothie meal replacements will leave someone ultimately unsatisfied.

4.     Sustainability

The most important aspect to consider when choosing a nutrition plan is sustainability. Most fad diets are not sustainable in nature; however, there can be valuable lessons to be learned, which can be incorporated into a sustainable lifestyle. If the fad diet you are considering has favorable answers to the first three points discussed, here are some questions to ask yourself after completing it.

Questions to ask after finishing:

  1. What were the positives elements about this temporary fad diet?
  2. What were the negative aspects?
  3. How will I incorporate what I found positive into a sustainable lifestyle, moving forward?

Discuss your answers with a registered dietitian to receive professional guidance and create further accountability for long term sustainability.


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The holiday season is in full swing! Unfortunately, along with the tidings of holiday joy come the high-calorie impact of holiday get-togethers, office parties, and big family dinners. Fear not-- Revolution has you covered. Make this healthy spin on a classic party appetizer, and you'll have a go-to option that won't break your calorie budget.

The holiday season is in full swing! Unfortunately, along with the tidings of holiday joy come the high-calorie impact of holiday get-togethers, office parties, and big family dinners. Fear not-- Revolution has you covered. Make this healthy spin on a classic party appetizer, and you'll have a go-to option that won't break your calorie budget.

Guiltless Spinach Artichoke Dip

Servings: 12; Serving size: ¼ cup


  • ¼ cup (1 ounce) grated fresh Romano cheese
  • Tbsp canola mayonnaise
  • Tbsp low fat sour cream
  •  1 teaspoon fresh lemon juice
  •  ¼ teaspoon salt
  • ¼ teaspoon freshly ground black pepper
  • 1/8 teaspoon ground red pepper
  • 2 garlic cloves, minced
  • 1 (15-ounce) can white beans, rinsed and drained
  • 1 (14-ounce) can baby artichoke hearts, drained and quartered
  • 1 (9-ounce) package frozen chopped spinach, thawed, drained, and squeezed dry
  • Cooking spray
  • 1/3 cup shredded part-skim mozzarella cheese


  1. Preheat oven to 350°.
  2. Place Romano cheese, mayonnaise, lemon juice, salt, black pepper, red pepper, minced garlic, and white beans in a food processor, and process until smooth.
  3. Spoon into a medium bowl. Stir in the artichokes and spinach.
  4. Spoon the mixture into a 1-quart glass or ceramic baking dish coated with cooking spray.
  5. Sprinkle with mozzarella. Bake at 350° for 20 minutes or until bubbly and brown. Best served with veggies, whole wheat pita bread, or baked chips.

Nutrition Info (per ¼ cup): 77 calories, 2 g fat, 10 g carbs, 5 g protein

About the authors: Kate Kloet MS, RDN, LDN and Kristen Doladee work out of the Revolution clinic in Glen Ellyn. 

Looking for a way to warm up? Try this spin on a cold weather favorite!

Looking for a way to warm up? Try this spin on a cold weather favorite!

Quinoa Chili

Servings: 6, 16 oz servings



  • 1 cup quinoa
  • 1 tablespoon olive oil
  • 3 cloves garlic, minced
  • 1 onion, diced
  • 2 (14.5-oz) cans diced tomatoes
  • 1 (15-oz) can tomato sauce
  • 1 (4.5-oz) can diced green chiles
  • 1.5 tablespoons chili powder, or more, to taste
  • 2 teaspoons cumin
  • 1.5 teaspoons paprika
  • 1.5 teaspoons sugar
  • ½ teaspoon cayenne pepper
  • ½ teaspoon ground coriander
  • Salt and black pepper, to taste
  • 1 (15-oz) can kidney beans, drained / rinsed
  • 1 (15-oz) can black beans, drained / rinsed
  • 1.5 cups corn kernels
  • 3 tablespoons chopped fresh cilantro leaves
  • Juice of 1 lime, optional
  • 1 avocado, diced


  1. In a large saucepan of 2 cups water, cook quinoa according to package instructions; set aside.
  2. Heat olive oil in a Dutch oven or large pot over medium high heat. Add garlic and onion, and cook, stirring frequently, until onions have become translucent, about 2-3 minutes.
  3. Stir in quinoa, diced tomatoes, tomato sauce, green chiles, chili powder, cumin, paprika, sugar, cayenne pepper, coriander and 1-2 cups water, making sure to cover most of the ingredients; season with salt and pepper, to taste.
  4. Reduce heat to low; simmer, covered, until thickened, about 30 minutes. Stir in beans, corn, cilantro and lime juice, if using, until heated through, about 2 minutes.
  5. Serve immediately with avocado, if desired

Nutrition Info (per 16 oz serving): 414 calories / 11 g fat / 70 g carbs / 15 g fiber / 16 g protein.

About the authors: Kate Kloet MS, RDN, LDN and Kristen Doladee work out of the Revolution clinic in Glen Ellyn. We are delighted to have them share their recipes on the Revolution blog!

Clamshells or clams, as some call them, are one of the most common exercises prescribed by physical therapist. The exercise targets specific muscles of the hip that tend to be weak in a large patient population. It is clinically relevant for treatment of a variety of pathologies including low back and knee pain, balance deficits, and following knee or hip replacements.

Clamshells or clams, as some call them, are one of the most common exercises prescribed by physical therapist. The exercise targets specific muscles of the hip that tend to be weak in a large patient population. It is clinically relevant for treatment of a variety of pathologies including low back and knee pain, balance deficits, and following knee or hip replacements.

The exercise is performed with the patient on a table or the floor in a sidelying position with the legs and feet stacked and heels together. Other then that, physical therapist have taught patients the exercise with the hips, knees, and pelvis positioned at varying angles based on past clinical experience. A recent article came out in the Journal of Orthopaedic and Sports Physical therapy discussing the effects of varying hip angles and pelvic positions on muscle recruitment during the clam exercise.

In a previous study, it was determined that the best position for the knees to be in during the exercise was with the knees bent at 90 degrees, so this knee position was utilized for this study. In the current study, it was found that the most important position to facilitate activation of multiple muscle groups of the posterior hip was related to pelvic positioning. Specifically, when performing clams, it is important to make sure that the spine and pelvis are in a neutral position. When the pelvis tilts/rolls backwards, it decreases the activation of the muscles in the back of the hip (the targeted muscles for the exercise).  


Furthermore, it was found that the best angle for the hip to be positioned at for proper muscle recruitment was at a 60 degree angle as compared to 90 degrees or fully extended (0 degrees). 

Willcox, EL, and Burden, AM: The influence of varying hip angle and pelvis position on muscle recruitment patterns of the hip abductor muscles during the clam exercise. J Orthop Sports Phys Ther 43:5, 2013. 
So many of us spend the majority of the day at a desk, watching TV or engaged with our phones. More often than not, we do not have proper posture when completing these activities. Poor posture can lead to muscle imbalances, shoulder impingement, increased muscle tension and of course, pain. However, poor posture can be reversed. Below is a list of simple exercises that will improve your posture.

So many of us spend the majority of the day at a desk, watching TV or engaged with our phones.  More often than not, we do not have proper posture when completing these activities.  Poor posture can lead to muscle imbalances, shoulder impingement, increased muscle tension and of course, pain.  However, poor posture can be reversed. Below is a list of simple exercises that will improve your posture.  I recommend completing these exercises twice a day.  It does take time to correct postural impairments.  These impairments occurred over years; you are not going to fix these problems in days or weeks. So keep at it!  You will see and feel a change within one to two months of consistently completing the exercises.  It is well worth your time, as you can increase joint range of motion, reduce pain, increase your energy,  and prevent future injury. To start these are tips to help maintain good standing posture:

Keep in mind good posture is not military posture where you are at end range. Go to end range by imagining a string attached to the top of your head pulling you towards the ceiling, and then back off about 10%.  The idea is to keep your head, shoulders and hips in alignment and maintain the spine's natural curvature.

  • Hold your head up straight with your chin in. Do not tilt your head forward, backward or sideways.

  • Make sure your earlobes are in line with the middle of your shoulders.

  • Keep your shoulders back and relaxed

  • Draw your bellybutton in towards your spine tightening your abdominal muscles

  • Keep your feet about hip distance apart

  • Maintain even weight on both feet

  • Keep your legs straight and knees relaxed

Below are exercises to improve postural impairments. These are general exercises; I will have more posts targeting specific postural impairments at a later time.

* If any exercise causes increased pain, discontinue and consult your physical therapist or doctor. *


Cervical Retraction

Sit upright in a supportive chair and tuck your chin BACKWARDS, not down. Add overpressure until you get to the end of movement. Repeat 10 reps x 3 sets.

IMG_1699[1]  IMG_1700[1]

Seated Rows

Sit with good posture.  Keep elbows by your side and squeeze shoulder blades back and down. Repeat 10 reps x 3 sets.

IMG_1701[1]  IMG_1703[1]

Chest Stretches

While standing in a doorway, place your arms up on the door jam and place one foot forward through the doorway as shown. Next, bend the front knee until a stretch is felt along the front of your chest and/or shoulders. Your upper arms should be horizontal to the ground and forearms should lie up along the door frame. Hold for 15 - 30 seconds, relax; repeat 3 reps.


IMG_1713[1]  IMG_1714[1]


While lying on your back, tighten your lower abdominals, squeeze your buttocks and then raise your buttocks off the floor/bed as creating a "Bridge" with your body. Repeat 10 reps x 3 sets.

IMG_1704[1]  IMG_1705[1]


While lying face down, lift your body up on your elbows and toes. Try and maintain a straight spine. Do not allow your hips or pelvis on either side to drop. Hold position for 30 - 60 sec increasing time as able.

IMG_1706[1]  IMG_1707[1]

Side Lying Leg Raise

While lying on your side, slowly raise up your top leg to the side. Keep your knee straight and maintain your toes pointed forward the entire time. The bottom leg can be bent to stabilize your body.


I would love to hear feedback from anyone who tries these exercises. Please tell me how you are feeling!

Sarah Jacobs, PT, DPT, CWC


You may have heard the term “functional movement” and asked yourself what it meant or how we use it. Functional movement is a term to describe daily movements we use to perform activities such as lifting, carrying, walking, or even sitting. With specific exercises, we can strengthen muscles that are used for these activities. Below are three we use every day, both in daily life and in the clinic.


You may have heard the term “functional movement” and asked yourself what it meant or how we use it. Functional movement is a term to describe daily movements we use to perform activities such as lifting, carrying, walking, or even sitting. With specific exercises, we can strengthen muscles that are used for these activities. Below are three we use every day, both in daily life and in the clinic.


The Squat

Even though the squat seems like a technical movement, and we have many instructions for performing a squat correctly, we use squats every day. For example, getting in or out of the car, sitting down into a chair, or even getting out of bed are some examples of when we use the muscles necessary to perform a squat. (Photo credit:



The Deadlift

If you’ve ever had to pick up something heavy off the floor, you know it can be difficult or even sometimes cause injury. A proper deadlift requires posterior chain strength, meaning gluteal and hamstring muscles. Proper lifting technique also requires core strength to maintain good posture. In the clinic, we target gluteal and hamstring muscles with band exercises, lunges, and even squats. We can target core musculature with isometric exercises such as planks. We combine these when performing the deadlift and insure proper form to protect against injury. (Photo credit:



The Overhead Press

Have you ever needed to ask a fellow passenger on the plane for help put your carry-on bag into the overhead compartment? You’re definitely not alone. The overhead press can be difficult to perform and requires full shoulder range of motion in addition to upper extremity strength. We practice this in the clinic using medicine balls, kettlebells, dumbbells, cables, and body weight, and work on strengthening biceps, triceps, pectorals, deltoids, and trapezius muscles to achieve proper overhead technique. (Photo credit:

Elizabeth J Racioppi, PT, DPT