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Fitness

In the world of exercise, there always seems to be a latest gimmick or piece of equipment that you need to own in order to have the changes in body composition that you want to see. Though the infomercials may seem tempting to help us achieve the results we want faster most of the time, the simplest exercises will work just as well and are much cheaper than what is being sold on TV.

One particular exercise that comes to mind when talking about cheap and effective exercises would be a Plank. Planks require no equipment besides a minimal amount of space and body weight to complete and have multiple benefits. A study completed by The Journal of Sports Science & Medicine concluded that plank exercises were more effective than trunk flexion exercises (sit ups) in engaging abdominals (Maeo et al). Some other benefits of a plank include:

  • Planks engage multiple muscles groups simultaneously including the glutes, hamstrings, low back, and abdominals.

  • Helping in reductions of low back pain

  • Increases in flexibility

  • Improvements in balance and posture

Planks are also an important exercise in any well rounded workout routine due to the ability to be completed anywhere. Planks can be done in the privacy of one’s home, at the gym or even at the office.

Proper form for a plank is critical in order to receive the maximal benefit from a plank. Form includes holding elbows directly under shoulder and wrists in-line with elbows. Then lift/lower your body into a straight line and brace abdominals, glutes, quadriceps and hamstrings, then hold for 30 seconds.

One stigma about performing a plank exercise is that if must be completed on the ground in order to be effective. This is not the case especially for beginners. Planks are effective as long as the person completing them feels the muscles of the trunk working. Good elevated surfaces to begin planks include kitchen counter, a table, or using the back of furniture if it is stable. After holding proper form for 30 seconds you can determine if a lower stable surface would be more beneficial for you.

Planks are a free and effective form of exercise requiring no equipment and only a minimal amount of space. Planks have many benefits including decreased low back pain and improve flexibility.

So next time you see an infomercial on TV, see how long you can hold a proper plank and see if a simple plank is harder than expected.  

 

Fitness

It is common knowledge that fitness facilities across America see an incredible influx of new clients in January and February, but by March, where is everyone? People stop exercising for two main reasons:

(1) the intensity is too high and they cannot maintain this level of exercise, or

(2) weight loss is not forthcoming and they become frustrated.

Research has proven that high intensity interval training (HIIT) is an efficient means of losing weight. According to the International Journal on Obesity, HIIT is easily tolerated and results in higher losses in percentage body fat.

HIIT Training can be extremely beneficial, but if it works so well why are millions of people giving up on exercise by March? The reason is threefold. Understanding these reasons plays a large part why our clients have been so successful at Revolution Physical Therapy and Weight Loss.

1: High intensity exercise utilizes large amounts of carbohydrates. Cardiopulmonary test allows us to learn which fuels are used at specific heart rates such that we can efficiently utilize HIIT training.

2: Utilizing large amounts of carbohydrates may cause insulin spikes, which can then result in an increase in carbohydrate consumption post-exercise.

3. Exercise adherence is closely linked to enjoyment levels. In fact, the International Journal of Sport Psychology found that ratings of enjoyment predicted exercise adherence. Finding a balance between hard work and enjoyment is a necessary step to keep clients moving forward through March and beyond.

 

1: http://www.carnevalijunior.com.br/wp-content/uploads/2010/03/a-role-for-high-intensity-exercise-on-energy-expenditure-balance-and-weigth-control-1998.pdf

Fitness

 

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. 

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. 

 

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. 

Nutrition

Many individuals can get confused in the world of fats since there are numerous sources, multiple types of fats, and long terms of describe those fats. Here are a couple memorable tips on how to remember how to get the most out of your fats.

1. Less legs (usually) equals less fat.
This is more coincidence than science, but the rule holds true for the majority of food sources. Cows and pigs have 4 feet. Chickens and turkeys have 2 feet. Fish kind of have 1 if you count the back fin as one. Beans have none. When choosing leaner meat types, try going with the ones that have less feet to keep fat sources in better check.

2. The shorter the name of the fat type, the worse it is for you.
You may have noticed the four fat types called Trans, Saturated, Monounsaturated, or Polyunsaturated on labels in the past. While those shortest two types are bad for heart health, the long two types are actually protective for the heart! Occasionally products will only label 2 of the fat types, which those are the ones we want to keep as minimal as possible. Having excess of any of these fat sources will lead to weight gain, but choosing healthy sources of fats will help reduce the risk of heart disease in the future.

3. Solid at room temperature = solid in blood stream.
Once again, this is not the exact science of how arteries are clogged, but it provides a good tool for identifying what types of added fats will contribute to heart disease. Oils will provide a better benefit to the heart than butter, lard or margarine will. Choose olive oil (or canola oil for high temperature) in place of the solid fats when applicable.

Nutrition


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

Quinoa Chili

Servings: 6, 16 oz servings

 

 Ingredients:

  • 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

Directions:

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.

 

Motivation

At Revolution, we work with you to find a program that works for you, your body and your lifestyle. You’ve probably tried other weight loss programs in the past. You’ve read books and thought, “If I just follow everything this book says, then I’ll be losing weight in no time!” But, people aren’t all the same. Books and off-the-shelf plans don’t adapt to fit every individual.

Our motivation managers are specialists in Behavioral Health. They can help you to make changes to your behaviors, like exercising and eating, that will contribute to your health. Nobody likes being told what to do. It’s one thing to have instructions for a perfect workout routine and the best possible diet. But, unless you can execute those instructions, you’re not going to lose weight any time soon. Our motivation managers will help you find creative ways to incorporate our evidence-based dietary and exercise work into your daily life.

We work with you to adapt our program to your needs and to manage any of the difficult emotional things that come up along the way. Weight loss isn’t easy, and anything that takes this much work is going to dig up at least some stress, if not more emotions. Our motivation managers are there to help you roll with these punches, rather than getting discouraged. They will pick you up when you need it, and keep you accountable as you move forward.

Motivation Management is way more than just a cheerleaders. They’re there to be your guide through this program, working to help you fit it to your life to maximize your success.

 

Motivation

At Revolution, our motivation managers work with you to set healthy goals to help you move through your weight loss program. To do that, we help sort out good goals from bad goals. Bad goals are like New Year’s Resolutions: they sound good on paper, but in the end you don’t meet them and it just makes you feel bad. Good goals should provide encouragement as well as a sense of progress so you stay motivated to reach your targets. So, let’s break down some characteristics of a good, helpful goal.

Good goals should be Specific. It’s easy to say “I want to lose weight,” but that goal is also easy to achieve. You could check it off as soon as you lose a single ounce. Instead, making it more specific like “I want to lose 10 lbs.” helps us and you to see how far along you are.

Which brings up our next point. Good goals should be Measureable. In our program, that usually means pounds lost, measured by a scale. But it can be other things as well. Bringing down your blood pressure, or your A1c, can be just as good a goal. The important thing is to have a way to track progress.

Good goals are also Action-Oriented. It’s easier to focus on doing something than not doing something, and it feels better to do something than not do something. For example, “I won’t eat candy” has you focusing on not eating candy. You might get anxious around candy when it’s offered to you, and now you’re spending a lot of time thinking about the candy. Instead, working with a goal like “I will eat healthy snacks” gives you something healthier to focus on and a task to complete. Going and doing is easier than sitting still and avoiding.

Realistic goals are better than non-realistic goals. 6-pack abs, 1% body fat, and other lofty goals are fun daydreams, but hardly achievable for the average person. And, if you set your sights on them, the eventual failure will only discourage you. Better to set several smaller, realistic goals for your progress. It’ll help you stay motivated as you cross them off your list, one after another.

Lastly, an open-ended goal is just an easy way to procrastinate. Make your goals Time-Limited so you know when to check in. At Revolution, we weigh you in once every week, and compare numbers from the start of the program to the end. We work with you to set a schedule and a timeframe that works for you, your body, and your lifestyle.

By setting good goals, you’ll be on your way to your goal weight in no time!

 

Fitness

One of the new buzz phrases in the medical community is “metabolic syndrome."  Metabolic syndrome stands for an individual having a combination of 3 or more of the following:

  • Waist circumference > 35 inches (88 centimeters) for women or > 40 inches (102 centimeters) for men
  • Blood pressure greater than 130/85 mm/Hg
  • HDL (good) cholesterol less than 50 for women or below 40 for men
  • Fasting blood glucose greater than 100 mg/dL, 
  • Triglycerides greater than 150 mg/dL

Metabolic syndrome has good reason to be gaining attention, as an estimated 1 in 4 Americans currently has it, placing them at a 3-fold risk of getting cardiovascular disease. Not surprisingly, it also puts them at an increased risk of developing type 2 diabetes. The frightening diagnosis of metabolic syndrome causes patients a great deal of anxiety, from not knowing what to do next, to a collection of costly medications.

The good news is that there’s a catch:

In most cases, metabolic syndrome is completely reversible, even without the use of any medications! The secret is a sensible nutrition plan along with cardiovascular and resistance exercise. By losing weight this way, each of the 5 risk factors for metabolic syndrome can improve. In fact, the Diabetes, Obesity and Metabolism Journal published a study by Case et al. that included a group of 125 people with metabolic syndrome who had dramatic results in less than 16 weeks using a low calorie nutrition plan and exercise. By the end of the study, the group, who averaged having 3 out of the 5 risk factors, went from levels well above the cutoff point for metabolic syndrome to levels well below the cutoff point. In addition, many of the subjects no longer had metabolic syndrome at the end of the study and this all occurred in less than 4 months!

The costs of joining a specialized program designed to treat metabolic syndrome may be significant, but in reality, we should consider how much money is be saved by not having to buy insulin, cholesterol medications or hypertension medications for a lifetime. Even more importantly, incur the cost of heart or kidney surgery. 

The key is to look at being diagnosed with metabolic syndrome less like a disease and more like a second chance. 

I urge you to take your second chance at health and make the most of it!

Nutrition

In my nutrition sessions with patients, I often find that people think that eating nutritiously means that they can never enjoy their favorite restaurant, snack or even foods ever again. I am always happy to inform them that this is not the case, and they always seem surprised.

That being said, meals at restaurants are notorious for being high in calories, fat and sodium, which can quickly derail any nutrition plan intended for weight loss. The best way to fit in your favorite meal is to budget your calories. The easiest way to explain this is to put it in terms of budgeting money on a vacation.

For example, if you have a budget of $750 spending money set aside for a five day vacation and you end up spending $250 of it the first day, you wouldn't just keep going at that pace, would you?  You would end up either out of money on day 3 or you would end up going way over budget.  Most people find it easy to just scale back the spending the following days without ruining the vacation.

This is exactly the same with calories. If you are trying to follow a 1500 calorie meal plan, and you eat 1000 calories during the day but then overindulge on an 800 calorie slice of deep dish pizza, you have now consumed 1800 calories; 300 calories over-budget. Its really no big deal if you scale it back over the next couple of days with several very small changes.  If you don't, going over-budget by 300 calories even just once per week could lead to a weight gain of 4.5 pounds in one year.

So how do we still enjoy our favorite foods while trying to lose weight? We budget.

Let's say you are going out to your favorite pizzeria for dinner. The first step to take is to look up nutrition information for the restaurant online. Often, I use a nutrition tracking application such as GoMeals or SparkPeople to search for the restaurant, or something comparable (i.e. small, locally owned Italian restaurants may not have nutrition information available, so I look up information on dishes from Olive Garden).

Once you determine the calorie information, you can appropriately budget in order to minimize the amount of calories you go over-budget. For example: you would like to indulge in a slice of Chicago-style deep dish pizza while on a 1500 calorie meal plan. The first step is to look up nutrition information online so that you are well aware that one slice of a regular sized, four cheese deep dish pizza is 650 calories (and 44 grams of fat).

Now determine how many calories this leaves you for the day: 860 calories. This can easily fit into your budget, as long as you choose wisely (read: low calorie, nutrient dense foods such as vegetables and fruit). Here is what a sample day could look like:

            Breakfast: 2 scrambled eggs + 1 slice whole wheat toast 270 calories

            Snack: 1 apple + 1 wedge Laughing Cow cheese 105  calories

            Lunch: 2 cups spinach + 1 cup chopped veggies (peppers, broccoli, etc) + 1/4 cup garbanzo beans + 1 Tbsp vinaigrette, 10 pita chips, 1 greek yogurt  465 calories

            Snack: 1 cup baby carrots + 2 Tbsp hummus 95 calories

Following this plan allows you to eat the slice of deep dish pizza for dinner, while only putting you ~100 calories over budget for the day. And, as I mentioned before, going over-budget once is no big deal, as long as you make up for it in other ways during the week. You can easily decrease calories in your nutrition plan without sacrificing volume of food by adding low calorie, nutrient dense vegetables, lean proteins, and whole grains.

The goal here is never deprivation: it's about budgeting and striking a balance so that you can still enjoy your favorite foods while still maintaining a healthy nutrition plan for weight loss. 

Spot Reduction

 

You may have heard or used the term “spot reduction” thrown around when starting an exercise program. Spot Reduction simply means “the attempt to remove subcutaneous body fat stores from specific areas of the body by performing exercises that target those areas”. For example, trying to do sit ups and crunches to reduce belly fat. Performing those exercises may strengthen the muscle responsible for those movements, but they are ineffective on reducing the amount of fat stored there. (breakingmuscle.com)

 

To start the conversation of spot reduction, let’s look at the process of reducing body fat. Your body breaks down fats into glycerol and fatty acids by the process of lipolysis. The fatty acids can then be broken down directly to get energy, or can be used to make glucose through a multi-step process called gluconeogenesis. In the fat cell, however, other types of lipases work to break down fats into fatty acids and glycerol. These lipases are activated by various hormones, such as glucagon, epinephrine and growth hormone. The resulting glycerol and fatty acids are released into the blood, and travel to the liver through the bloodstream. Once in the liver, the glycerol and fatty acids can be either further broken down or used to make glucose. (howstuffworks.com)

 

When you exercise your body uses calories to provide energy for exercise. According to Healthstatus.com, “when the body resorts to burning fat stores, it doesn’t use the stores nearest the muscles being flexed. Instead, fat from the entire body is burned. Blasting a given muscle group may be valuable exercise — just don’t expect it to spot reduce fat. If you want to lose fat from one area, you’ll have to lose weight overall.”

 

Another way to view the spot reduction myth is that it usually targets muscles that are relatively small through exercises that are relatively insignificant in terms of energy expenditure—regardless of how much you “feel the burn” when training them. Overall fitness, not small muscle fatigue, is a stronger determining factor of your body’s fat-burning effectiveness. People who are very fit burn fat more efficiently during workouts and while at rest than people who are less fit. This means trying to focus more on larger, multi-joint muscle groups and exercises. For example, doing squats instead of leg extensions. The larger muscle group exercises will burn more calories, and help to improve overall fitness. (acefitness.org)

 

In summary, you cannot pick a “spot” on your body and focus on exercises to directly target that area to reduce body fat. You can do exercises to strengthen the muscle, but should focus more on increasing overall fitness. The more muscle mass you have, the more you calories you burn at rest. By combining resistance training, aerobic exercise, and nutritional changes, you can lose weight and reduce the overall amount of body fat you have.

 

Sources:

 

https://www.acefitness.org/acefit/healthy-living-article/59/3629/myths-and-misconceptions-spot-reduction-and/

 

https://www.healthstatus.com/health_blog/body-fat-percentage-calculation/why-spot-reducing-fat-is-impossible/

 

Fitness

At some point in life, an acute injury is imminent; if you are cleared for exercise, mindful resistance and cardiovascular training will bring a host of benefits.

Injured or not, we sometimes forget that exercise is a way of life. In fact, it is essential to life. Exercising will not only help maintain fitness but also, in the long run, increase your chance of survival. A study in The New England Journal of Medicine concluded that cardiovascular fitness is more important to survival than any other risk factor- including blood pressure and cigarette smoking! This reason alone should motivate you to exercise.

Another benefit of continuing cardiovascular exercise while injured is that it increases blood flow, which helps deliver nutrients to cells that repair the tissue. The increased amount of blood flow will carry the debris away from the injury into the liver to get processed and discarded. These two aspects can help to speed up your recovery time.

Resistance training during this time can provide equally important benefits, such as preventing muscle loss. This is important because muscle loss due to cessation of exercise could result in a lower metabolism.Therefore, maintaining muscle mass during injury can in turn fend off unwanted weight gain due to a reduced metabolism. So how can you prevent this from happening? Exercise! 

They key to overcoming setbacks is to become creative in the gym. There are many ways to work the muscles you’re accustomed to without compromising the injury or any other safety aspect of the exercise.

First, make sure the injured joint has been properly stabilized by a physical therapist or specialist, and take their advice seriously so as not to jeopardize your injury. The next step is to select exercises that target the muscles you are trying to work but does not require the injured joint to move.

Remember, it is better to exercise with limitations than to stop exercising all together. The science doesn't lie: exercising is essential to life. 

Fitness

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. <http://muscleevo.net/muscle-building-tip/

Motivation

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. 

Nutrition

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!

 

Motivation

 

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.

 

Fitness

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. 

Fitness

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).

 





References:


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.

Fitness

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!




Sources: 

  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.

Nutrition

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.







Sources:

  1. http://www.eatright.org/resource/food/resources/national-nutrition-month/national-nutrition-month

  2. http://www.eatrightpro.org/resource/media/multimedia-news-center/infographics/total-diet-approach-to-healthy-eating-infographic.

Fitness

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.

  

Sources:

Centers for Disease Control and Prevention. WISQARS leading causes of nonfatal injury reports .2006. [Accessed November 13, 2006]. http://www​.cdc.gov/ncipc​/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.

Nutrition

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.

http://info.nsf.org/Certified/Dietary/

http://www.nsfsport.com/listings/certified_products.asp  

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. http://www.quality-supplements.org/verified-products/verified-products-listings

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!

 

 

Nutrition

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. 

Fitness

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.

 

Reference:

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.

 

Fitness

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.

 

Fitness

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.

Equipment

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.

Technique

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!



Sources:

Snow Shoveling Techniques to Prevent Low Back Injuries. Retrieved January 18, 2017 from http://www.spine-health.com/wellness/ergonomics/snow-shoveling-techniques-prevent-low-back-injuries

In the Bleak Mid-winter: 10 Tips for Safe Snow Shoveling. Retrieved January 20, 2017 from http://www.coloradospineinstitute.com/subject.php?pn=wellness-snow-shoveling


Prevent Snow Shoveling and Snowblowing Injuries. Retrieved January 18, 2017 from http://orthoinfo.aaos.org/topic.cfm?topic=a00060

Fitness

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.



Sources:

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

http://www.omicsonline.org/open-access/slow-down-to-speed-up-using-intensity-threshold-indicators-to-optimizelipid-utilization-during-exercise-2155-6156-1000532.php?aid=53129

Nutrition

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 (https://www.pinterest.com/revolutionphysi/).

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!). (http://foodpsychology.cornell.edu/discoveries/big-bowls-make-big-appetites)

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! (http://foodpsychology.cornell.edu/discoveries/20-lb-cereal-box) 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.  (http://foodpsychology.cornell.edu/discoveries/three-secrets-healthier-eating)

  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. (http://foodpsychology.cornell.edu/discoveries/menu-secrets-can-make-you-slim-design)

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!




Motivation

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.

 

Source:

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

2. http://www.bing.com/images/search?q=smart+goal&view=detailv2&&id

 

 

Nutrition
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.








Sources:

  1. Dietary Guidelines for Americans 2015-2020. https://health.gov/dietaryguidelines/2015/guidelines/appendix-7/.  

  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.





Fitness

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.

Nutrition

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.



Fitness

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.

 

Sources: 

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 fromhttp://www.cdc.gov/obesity/data/adult.html

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

http://www.arthritis.org/living-with-arthritis/comorbidities/obesity-arthritis/fat-and-arthritis.php

 

 
Fitness
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!

 

Fitness
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.
 

Resources:

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.

 

Fitness

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.

 

Sources:

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 http://www.askdoctork.com/why-are-balance-exercises-important-as-we-age-201301114100

 

Fitness

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: http://www.hellodoctor.co.za/wp-content/uploads/2014/06/Hypertension.jpg on 11/3/16.  

Fitness

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.  

 

References

  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: http://helpinguheal.com/clients/10956/images/custom_orthotics.jpg. 
 
 
 
 
 
Fitness
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.

 

Sources:

1. http://www.mirror-mirror.org/set.htm

2. http://calorielab.com/news/2016/04/21/set-point-theory-and-weight-loss-new-ideas/

3. https://medical.mit.edu/sites/default/files/set_point_theory

 

Nutrition
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.

References:

The Nutrition Care Manual: https://www.nutritioncaremanual.org/  

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

http://media2.onsugar.com/files/2014/03/18/028/n/1922729/2884e142400fde4f_chia-seeds.jpg.xxxlarge_2x.jpg. 

 

Fitness
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.


Sources:

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

http://www.omicsonline.org/open-access/slow-down-to-speed-up-using-intensity-threshold-indicators-to-optimizelipid-utilization-during-exercise-2155-6156-1000532.php?aid=53129.

http://blog.codyapp.com/wp-content/uploads/2014/01/exercise-old-age-fitness.jpg. 

Fitness
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 

Motivation
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.  
 
Photo Credit: http://thrivingmen.com/wp-content/uploads/Slow-And-Steady-6001-300x300.jpg
 
Nutrition
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

 

Photo Source: http://i.huffpost.com/gen/1714505/images/o-PEANUT-OIL-facebook.jpg

Fitness
“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

References:

  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.

Photo Source: http://fitdads.com.au/jupgrade/images/stories/Fit_Old_Guy___Nutrex_Solutions.jpg

Fitness
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

imgres-3.jpg

  • 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

imgres-4.jpg

 

  • 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. 

 

Photo Sources:
http://myperformancerehab.com/wordpress/wp-content/uploads/2011/04/Prayer-Stretch-II.jpg
http://health.wikinut.com/img/2vrqb2u2sagoduly/Anterior-and-Posterior-Pelvic-Tilt

Motivation
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?

 

Picture Source: http://habitsofmind.org/wp-content/uploads/2014/09/Pic-22.jpg

Nutrition
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.

 

Picture Source: http://www.dailyhiit.com/hiit-blog/hiit-diet/diet-tips/top-5-fad-diets-avoid/

Nutrition
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

Ingredients:

  • 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

Directions:

  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. 

Nutrition
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

 

Ingredients:

  • 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

Directions:

  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!

Fitness
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). 

 
References:
 
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. 
Fitness
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.

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Seated Rows

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

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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.

 

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Bridges

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.

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Plank

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.

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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.

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

Sarah Jacobs, PT, DPT, CWC

References: http://www.nhs.uk/Livewell/Backpain/Pages/back-pain-and-common-posture-mistakes.aspx

Fitness
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: www.healthylombard.com)

 

 

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: www.myprotein.com)

 

 

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: www.mensfitness.com)



Elizabeth J Racioppi, PT, DPT