Toxic Load: What is it and How Do I Fix it?

Toxic Load refers to the Accumulation of toxins in the body from ingesting them in the air we breath, food we eat, water or other things we drink and exposure to chemicals from lotions to cleaners. Toxic load is further affected by Genetics. If we have failed or broken Toxic removal pathways, Our ability to tolerate toxins is lower. (1)

What does that mean for you? Well, A lot of people don’t realize that they are exposing themselves daily and what to do to reverse exposure. If you use pesticides, household cleaners from a brand store and eat non-organic GMO food, you are exposing yourself. You also expose yourself to toxins if you live in an area with high radiation, overhead power lines, poor air quality and Highly dense cities. People who live in the mountains and countryside have fewer daily toxin exposures from city persons, but they may use chemicals in farming or farming equipment that cause a toxin load to increase. 

 

Toxin Build Up in the body has been linked to cancer, autism, neurocognitive decline and Mental health issues. (3) It also leads to chronic autoimmune conditions. Many people can reverse simple disorders with doing a full metabolic detox. The most

common thing to start with is increased water intake. If you have high exposure to toxins in your  environment, You should aim to drink 100 oz of water a day. If you are exercising, particularly outside with poor air quality, aim for 120oz per day.

Let’s talk about Bathroom habits:

 

Many people think it is not a problem that they only poop 1-2 times a week, but that lack of excretion causes a lot of toxins to build up in the gut.(4) The gut bacteria then start to grow out of control for the bacteria that make you crave more unhealthy foods and sugary drinks. They can actually tell your brain that you don’t like vegetables. Unbelievable right? Read the book the Gut Brain. It goes in detail about healthy gut bacteria and healthy brain function. There is even some research to suggest that people with poor gut bacteria 

 

are more likely to be overweight than people with good gut bacteria.(7)

 

Urine is a great way to get rid of toxins as well. Your kidneys filter out some things that are not processed by the liver and things that are processed by the liver and concentrate the urine to get rid of the un-needed items. They also have the ability to filter out toxins and concentrate them into the urine and push it out. Going Pee, every two hours is a normal amount, which means that you need to drink enough water to get to the bathroom every two hours. 

 

So what if we could help you with Bathroom habits and Detox and get your body supported in a Natural way?

 

Digestive enzymes are a great way to improve bathroom habits. A lot of people have concerns about probiotics, because they have heard mixed reviews about them. The problem with probiotics is this: Not all are created equal, just like supplements. You want to go with a refrigerated Probiotic in most cases. One that is not stored in Sugar (think yogurt). If you don’t want to go Probiotic route, go with digestive enzymes and Prebiotics. These things help break down food so you can better absorb it. This then makes it so that you can ease bathroom habits. 

 

Another Way to detox is drinking Lemon in the water, particularly in the morning and keeping it warm. Not hot, But warm. Lemon has high levels of limonene in it, which helps the liver detox well. Another way to help with detox is to do a cleanse. That cleanse can be for the Gut, the Liver or the Kidneys, but typically they all go hand in hand. A typical cleanse can go from no less than 10 days up to 90 days. It depends on the toxic load. 10 days can help you clean out, 23 helps you actually detox and form habits, 90 days will restore your health. This is the primary way that you start to reverse damage to the body. 

The hardest part about a cleanse is Budget. Whether it is time or money, budget is the most common complaint. Often, I will also hear “I can not eat like that because my family doesn’t like it”. Well, If your family is eating the same as you are right now, what is their toxic load? Are you wanting to start the family out with poor health or great health? 90 days to change the eating habits and health of your ENTIRE FAMILY. Can you imagine the benefits? Less physician visits. Less medications. What does that cost you?

 

Essential Oils can also help with Detoxification as well. Lemon,

 grapefruit, Cinnamon, Peppermint, Anise, fennel, Ginger, Caraway, coriander and Tarragon all help with Digestion motility. Increasing Digestive motility increases the body getting rid of toxins. 

 

So what detox is right for you?

That is subjective, but in general, the goal should be to eat 100 grams of protein, 5 servings of fruit (½ cup each) and 7 servings of vegetables (½ cup each) with most being organic. Also, 100-120oz of water daily. Snacks to a minimum and a healthy fat like a ¼ cup of nuts or ½ avocado with salsa.

 

Message me for more information about regaining your health. 

 

References:
Nutr Today. Author manuscript; available in PMC 2017 Jul 1.
(1) Jones OA, Maguire ML, Griffin JL. Environmental pollution and diabetes: a neglected association. Lancet. 2008 Jan 26;371(9609):287-8.
(2) Lang IA, et al. Association of urinary bisphenol A concentration with medical disorders and loratory abnormalities in adults. JAMA. 2008 Sep 17;300(11):1303-10.
(3) Environmental Working Group “Study Finds Industrial Pollution Begins in the Womb” (www.ewg.org/reports/bodyburden2/newsrelease.php)
(4) McCallum, J.D., Ong, S., M Mercer-Jones. (2009) Chronic Constipation in Adults: Clinical Review, British Medical Journal. 338:b831
(5) National Institutes of Health (https://digestive.niddk.nih.gov/ddiseases/pubs/constipation/)
(6) Crinnion, WJ (2011) Sauna as a Valuable Clinical Tool for Cardiovascular, Autoimmune, Toxicant-induced and other Chronic Health Problems, Alternative Medicine Review 16(3): 215-225
(7)Published in final edited form as:Nutr Today. 2016 Jul-Aug; 51(4): 167–174.doi: 10.1097/NT.0000000000000167; The Gut Microbiome and Its Role in Obesity. Cindy D. Davis, Ph.D.

Lemon Water: The Good, The Bad and The Ugly

What are the benefits and Negatives of Drinking Lemon Water daily?

 

 

Research suggests that the average female needs 91 oz of water while the average male needs 125oz of water daily,  But it’s so bland. So how do you get it in? What about flavored water or water with something added to it? 

 

The most common fruit placed in water is Lemon, and with good reason. The question is, is it for your betterment or does it cause harm. Well, just like anything, too much of a good thing is too much. Use best Judgement and guidance from multiple providers, including your dentist. 

 

So what is Lemon Water Used For? 

Ayurvedic medicine has long stated that lemon in the water plays a role in detoxification, hydration, weight loss, digestion, improved skin quality, prevention of kidney stones, and it’s a good source of Vitamin-C.  But which of those hold water?

Turmeric powder,Turmeric in Mortar Grinder drugs and ingredient herbs on wooden background

It turns out that most of it is correct. In a study published in 2016, they looked at the benefits of using lemon water with honey in it to decrease lipid profiles. 50 people participated and the results were conclusive. The Fat weight of the person decreased, Triglyceride levels went down and Free Fatty Mass decreased. The questions for the researchers that I have is in part around the fasting and in part around subject numbers. Intermittent fasting is also shown to improve Free Fat Mass and triglycerides, so is it a side effect of just that, or is it actually the lemon in the water? 

 

If i was not convinced that it had to do with the lemon in the water, a 1014 study with 100 participants showed similar results. They added daily walking for 20 minutes as a component of their study though, and took out fasting. 

 

The most conclusive results that I could find were in a 2019 study looking at changes in the gut microbiome and longevity. That study showed that microbial activity of bacteria that help the body break down and digest food was increased by 10% -30% depending on the individual’s microbiome at the start of the study. They showed that the persons had more energy and then they also were looked at over a period of ten years. They tested at younger ages via blood work, mental cognitive tests and agility than same aged peers. 

 

So why do some think it is harmful to drink lemon water? The answers might surprise you. 

Most of the time, we don’t think about washing fruits that we peel, but they can be a significant host for things like e.coli, staph and MRSA. One study of 20 restaurants across the US showed that almost all of the oranges and lemons contained at minimum E. Coli on the skin. You don’t want to stick that in your water (or beer).When it comes to restaurant lemons and oranges, Squeeze them into the drink, but leave the fruit on the plate please. 

 

Lemons are acidic in nature, so they can irritate the skin, gums and cold sores or canker sores. The American Dental association recommends that you stay away from them in those instances. Also, if you have weak tooth enamel or start to notice your teeth feel rough when you run your tongue over them, re-consider your flavor of water. That acidity may also play a role in GERD. While some people get a benefit for their heartburn from lemon water, others can suffer because the pH balance in the stomach is upset by trying to balance out the acidity of the lemons. 

The last thing you may want to consider is about migraines. If you are unsure of your triggers, check citrus fruits specifically when you know you have some down time. Getting a migraine at work because you drink lemon water is not a good plan.

 

That’s all for now, Check back later for more health news!

 

Effects of Lifelong Intake of Leon Polyphenols on aging and intestinal microbiome; Shimizu et al. sci rep. (2019)9;3671
Effects on 8P of Daily Lemon intake and Walking. Y.Kato et al. J. Nutr. Metab. (2014)2014:912684
Does Short Term Lemon Honey Fasting Have Effect on Lipid Profile and Body composition. J. Ayurveda Integ Med (2016)Mar; 7(11-13).

What Role do Genetics Play in Pharmacology?

Ever Had a bad experience with a Prescription?

Ever thought it was an allergic reaction to a medication?

In 2017 I had a significant abdominal surgery that required me to take pain medication, anti-inflammatories, and Antibiotics. The Surgery was supposed to help with a significant abdominal umbilical hernia. It occurred on a Wednesday, and by Monday, I was having a significant reaction to the Pain medication, where my FACE went NUMB. Talk about scary.

Leading up to the surgery, I had taken part in 2 appointments where I discussed previous bad reactions to the pain medication and talked about my concerns. They told me it was a necessary evil in this case so that I could sleep. The Morning of Surgery, After long discussion with the Anesthesiologist, He asked If I had testing done to look at my response to different drugs. At that time, I didn’t even know that was a thing that could be done.

The News media and Medical Media lately has talked a lot about epigenetics, Epigenomics and now, we are starting to hear about pharmacogenetics. Pharmacogenetics can be done through DNA testing to specifically look at your genetics and how they might react to specific types of drugs. They can allow for better dosing, Better drug choice, so there is less guess work, And over all better outcomes. Pharmacogenetics can also help in looking at how some people may become addicted and others not to things like Marijuana, which the Prop 64 group in Colorado would have us believe is not possible.

Pharmacogenetics can also let us know when it might be time to change a drug, because the Epigenetics/Epigenomics, or the Environmental Factors that cause the genes to change, may have been affected over long term use of specific drugs. These drugs can be related to addiction treatment, Pain Management, Mental Health Disorders (Bipolar, Schizophrenia, Depression), Autoimmune Logical Drugs including Chemotherapy.

Along the line of Epigenetics/Epigenomics, there is a specific testing that can be done that supports your DNA sections. IT looks at what will optimally support your health and with that information, we can create a supplement that is SPECIFIC to you. Repeating the test about 6 months after initial testing and consuming of those supplements is recommended due to the changes you could potentially make. Then every year.

 

Why would you need a DNA specific supplement? Colorado has one of the highest levels of radiation exposure in the continental US. Specifically, We have a lot of naturally occurring Uranium and Radon. Both of those are known carcinogens. Also, think about how much and what type of sunscreen you apply every year in Colorado while enjoying the outdoor lifestyle you love. Chemical Barriers are more likely to interact with the radiation from the sun to create mutation of cells. It starts at the Skin level, But Quickly spreads to the body as the skin is an organ that ABSORBS things you put on it.

 

If you have questions about how DNA Testing can improve your health, life and longevity, Don’t Hesitate to reach out!

 

References:

*https://dnalife.academy/dna-health/

*Recent developments in genetic/genomic medicine, Rachel H. Horton and Anneke M. Lucassen, Clin Sci (Lond). 2019 Mar 15; 133(5): 697–708.Published online 2019 Mar 5. Prepublished online 2019 Feb 27. doi: 10.1042/CS20180436

*Pharmacogenomics in the treatment of mood disorders: Strategies and Opportunities for personalized psychiatry; Azmeraw T. Amare,1 Klaus Oliver Schubert,1,2 and Bernhard T. Baune1; EPMA J. 2017 Sep; 8(3): 211–227.Published online 2017 Sep 5. doi: 10.1007/s13167-017-0112-8
*Future Trends in the Pharmacogenomics of Brain Disorders and Dementia: Influence of APOE and CYP2D6 Variants; Ramón Cacabelos,1,2,* Lucía Fernández-Novoa,1,2 Rocío Martínez-Bouza,1,2 Adam McKay,1,2 Juan C. Carril,1,2 Valter Lombardi,1,2 Lola Corzo,1,2 Iván Carrera,1,2 Iván Tellado,1,2 Laura Nebril,1,2 Margarita Alcaraz,1,2 Susana Rodríguez,1,2 Ángela Casas,1,2 Verónica Couceiro,1,2 and Antón Álvarez1,2Pharmaceuticals (Basel). 2010 Oct; 3(10): 3040–3100.Published online 2010 Sep 29. doi: 10.3390/ph3103040
*Some observations on the role of environment and genetics in behaviour of wild and domestic forms of Sus scrofa (European wild boars and domestic pigs)S Robert, J Dancosse, A Dallaire – Applied Animal Behaviour Science, 1987 – Elsevier

The Rise of Alternative Medicine

Restorative Health: Being More Connected To Our Body and Mind

“While there is evidence to support that the natural environment leads to improvements in health markers, More evidence is needed to show what disease may benefit and why.” Bowler et.al. (2010)1

As a Person living in the 21st century, I am often confused by the significant lack of health I am surrounded by. It seems that people are less connected to the environment and people around them than they are to the devices they have available. We have stopped relying on our true person to person connections and moved to a world where we could go a full day without uttering a word to another human. If you type in a search for the effects of electronic devices on Health, the results are kind of scary. This chapter will focus on Restorative health and how we can get back to the last time our Body Agreed that it could do what we asked of it. Restorative health is very Individualized and takes a commitment from the Person and the Provider. It makes sure that both parties are invested to obtain the best outcomes for all involved.

For the last decade, I have been looking for ways to restore my health back to the way it was pre-kids. The things I am looking for are: Sleep, Workout Recovery, Feeling Comfortable in my Body, Less Seasonal Allergies, Less pain. I sought out the help of a physician in 2012 and was directed through a medical model that wanted to drug away my symptoms and maybe (definitely) cause some other symptoms. It was not the root cause of what was happening, It was a band aid approach. Cover Ups don’t work. They simply push the problem to a higher level while partially masking it. What I discovered was that I had a bunch of food allergies that had come back full force while pregnant that were wreaking havoc on my body. You see, true Health starts from within and from the environment around you.

Inflammation occurs when you take in foods that you have sensitivities and allergies to them. That inflammation starts in the mouth, continues to the esophagus, leads to the stomach and ends in the GUT through to the colon. There is another chapter in this book on the gut and microbiome. I would suggest a careful attention is paid to that chapter as well.

“All disease begins in the Gut” ~Hippocrates


The digestive tract is of utmost importance in our health because it is where 90% of the nutrients we take in each day are absorbed. Think of this area of your body similar to the skin, with a severe bug bite. That bug bite becomes inflamed, itches, swells more, you usually agitate it further and it perpetuates the problem. The same is true of the digestive system. If you have a sunburn, how healthy is your skin at the time when it is tight, dry and peeling? Does it absorb lotion well or just appear dry and irritated a few hours later again? If you are causing inflammation due to food sensitivities and allergies, What does the digestive tract look like and how does it feel? One of the problems we have as a society is if I can’t see it, it must not be real. I can ignore it and it will go away, or I can take something for it. This “Disease Mongering3” is part of the pharmaceutical industry push to sell drugs that should likely not be on the market, but also add to the symptoms you experience because they cover a Health Issue with a Band-Aid.

The Discipline to restore your health has to come from with-in, but I believe must also have support. That support can be a health coach, physician, family member, or trusted friends. The non-coach or physician should be someone willing to truly push you and not damage the relationship. The accountability from them must be true to your desire for health. It works best if they are trying to get back some measure of health as well. The typical start of restoring health happens through doing a series of blood work and allergy testing. The best thing about this is that a lot of allergies now can be tested via hair sample, blood work or mouth scraping and spit collection. The patch testing is still an option, but you can find cheaper, less invasive means through online labs. Once you find the things that are causing you inflammation on a daily basis, we tailor an elimination diet to those sensitivities. The Elimination Diet process is no less than 90 days. If you feel that you have extreme or severe food allergies and sensitivities, it may be recommended for six months. This is so the Digestive tract has a chance to heal. If it is still “sunburned” it can not absorb nutrients. The next step is to look at stool samples and find weaknesses in the microbiome and support them. Hormone testing may also be done to look at imbalances and supplements recommended for support.

With the Elimination diet, we focus a lot on the patterns of sleep. Sleep has been discussed a lot over the last decade as a major player in health. There is research to support the fact that lack of sleep causes your body to become insulin resistant, increasing your chances of diabetes. It can lead to stroke due to increased blood pressure, Adrenal fatigue, Thyroid dysfunction and Weight gain. Sleep is when your body truly restores itself. Most of the repair work done is during the time when you are sleeping. Your body goes through a significant amount of detoxification while sleeping. If you look through the Chinese Medicine Body Clock for organ detoxification, you can see that the detoxification of the liver and then the Gallbladder occur between 11pm and 1 am. Going to bed and sleep at a regular time also decreases the likelihood of insomnia and sleep disorders. There has been evidence to show that stopping device use, television and dimming lights in the areas of the house you will be in 30 minutes prior to bedtime will improve your ability to fall asleep quickly. We typically recommend both food and sleep journals. These journals should include what you ate, whether it was protein, carbohydrate or fruit and veggies; the time that you ate, and how much water you drink. It should also include any activity done in the day and your general feeling at the beginning and ending of each day based on mood and stress level. The sleep journal should include what time you went to bed, if you fell asleep easily; if you woke up what time was it; how you felt in the morning when waking up.

Restoring your health also includes periods of time outside, unconnected from the digital world. A four year longitudinal study in the UK showed that people who had access to green space had lower incidence of disease, particularly cardiovascular and Psychological. We encourage mindfulness during this time in the outside world. We ask for people to focus on how they currently feel, then change to how they want to feel that day or moment. We then ask them to say four positive affirmations on the type of feeling they want to have that day in relationship to work, home, Body Image, and Health overall. For Instance: “I enjoy working with each one of my clients. At home I am working well to encourage positive homework behaviors in my children. I am my perfect self every day and I am gaining control over my back pain each moment.”

Restoring Your health is a process that will likely take 18 months to three years, depending on the amount of damage that has occurred over time. We hope that your journey is fulfilling and guides you to a better place in your life. Schedule a Call with me

 

References:

1A systematic review of evidence for the added benefits to health of exposure to natural environments D.E. Bowler, LM Buyung-Ali, ™ Knight, AS Pullin. BMC Public Health 10:456 (2010)
2Article by Terry Hartig from the Lancet in 2018 reviewing a four year longitudinal study by R. Mitchell and F. Popham showed that people in England that had better access to Green Space in the day to day lives had less incidence of cardiovascular disease and Psychological disorders.
3Selling sickness: the pharmaceutical industry and disease mongering.Ray Moynihan, journalist,a Iona Heath, general practitioner,b and David Henry, professor of clinical pharmacologyc BMJ. 2002 Apr 13; 324(7342): 886–891.

New Year, New Health Insurance Benefits!

With the New Year, most insurance plans start over. This means that there could be changes associated with your health benefits, so the New Year is the perfect time to review your insurance coverage. At Agility Physical Therapy, we want to make sure patients have a full understanding of the costs associated with their visits. Here are some tips to stay on top of the new changes with your insurance:

  • Have a current insurance card with you. This will expedite the process in verifying your benefits.
  • Familiarize yourself with your new benefits. The more you know, the easier the check in process will be at the beginning of the year.
  • Understand that the amount you pay at one office may be different than what you pay at another office. Each office could have different costs depending on the level of care and service provided.

To better understand what your health insurance plan covers, you must first understand the terminology. Here are some common terms to help when looking over your plan:

  • Premium: the amount you pay your insurance company for health coverage each month or year.
  • Health Insurance Deductible: the amount that the patient typically must pay out-of-pocket before the insurance company will begin to pay. For example, if your deductible is $1,000, your insurance will not pay for anything until you have paid $1,000 for services subject to the deductible. Depending on your plan, even if you have met your deductible, you may still owe a copay or coinsurance. In most cases, the lower the premium, the higher the deductible.
  • Out-of-Pocket Maximum: the maximum amount an individual/family will pay for the calendar year for services covered under their health insurance plan (includes deductibles, copays, and coinsurance) until the insurance company pays for all covered expenses.
  • Co-pay: a fixed amount you will pay for a covered health service, as defined by your health plan. Copays usually vary for different plans and types of services. Insurance requires that copay is paid at every visit. In most cases, copays go toward your deductible.
  • Co-insurance: the predetermined percentage of costs you pay to a medical provider once the deductible has been met. In other words, the coinsurance is your share of the total cost for a particular service. Coinsurance amounts very based on each insurance plan. For example, if your insurance plan’s allowed amount for an office visit is $100, you have already met your deductible and you are responsible for a 15% coinsurance, then you would pay $15 at the visit. The insurance company would then pay the rest of the allowed amount for that visit.
  • In-Network: this term refers to medical establishments that deliver patient services covered under the insurance plan. In-network providers are generally the cheapest option for policyholders. Insurance companies typically have negotiated lower rates with the in-network providers.
  • Out-of-Newtork: this term refers to medical establishments not covered under your insurance plan. Services from out-of-network providers are usually more expensive than those rendered by in-network providers.
  • HMO (Health Maintenance Organization) Plan: With an HMO plan, you are assigned a specific primary care provider, and you can then only receive treatment and care from physicians and specialists within the established provider network. Referrals are required for certain providers. Please check with your insurance carrier to see if a referral is required for our facility.
  • PPO (Preferred Provider Organization) Plan: With a PPO plan, you do not have to select a primary care doctor and referrals are not required for specialists.

Remember, your health insurance benefits should be something you use all the time—from yearly check up visits to movement screenings and wellness benefits. Make the most of your plans this year, and make it a happy and healthy 2019!

The majority of insurance plans, including Medicare and private insurers, pay for physical therapy services that are medically necessary. In the state of Colorado, you can go directly to a Physical Therapist under a law that grants “direct access.” This means that, with most insurances, you can visit your physical therapist first without a physician’s referral. With direct access, you can reduce costs with fewer visits to multiple providers, such as your primary care physician or an orthopedic surgeon, for conditions that are affecting your movement. For example, if you were to sprain your ankle or “throw out your back”, you can simply walk into your physical therapists office, who can then diagnose your injury, order imaging to rule out bone fractures or breaks, and begin your plan of care all in one visit.

At Agility Physical Therapy, we are currently accepting all major health insurance plans, with the exception of Aetna no co-pay plans, BCBS Federal and Kaiser non-PPO plans. For a complete list of insurances we accept, visit our insurance page. In addition to accepting most insurance plans, Agility Physical Therapy offers payment plans as well as discounted packages for self-pay rates. For more information or if you have a question regarding whether or not we accept your insurance, contact us at agilityphysio.com or 303-773-0771 and we will verify your benefits for you.

 

 

Exercise is a Miracle Drug.

“Exercise is a miracle drug. I’m such a believer that it’s the key to health, wellness and longevity that I prescribe it to every patient I see. It’s the most powerful, readily available drug in the world, and it’s free.” Sports Medicine Physician Jordan Metzl expresses his support for physical activity as an intervention to mitigate the effects of almost any adverse health condition.

Many conditions that we as Physical Therapists treat could, if done correctly, be prevented by regular physical activity, as well. If a drug were invented that could do for human health everything that exercise can, people would fight to get their hands on it. It would be the most valuable pharmaceutical ever developed.

There are an unlimited number of benefits behind increased daily movement and PA that have been established in people of all ages, including:

  • Decreases risk of premature death due to coronary heart disease
  • Decreases risk of developing Type II Diabetes
  • Decreases risk of developing hypertension or high blood pressure
  • Reduces blood pressure of those who already have hypertension
  • Decreases risk of developing breast and colon cancer
  • Helps maintain healthy weight
  • Builds and maintains health bones, muscles and joints
  • Decreases number of falls in older adults
  • Reduces mortality rates compared to sedentary populations
  • Reduces arthritis symptoms and delay progression of Osteoarthritis
  • Increases self-esteem, promotes mental health, prevents depressive illness, and possible protective effect from cognitive decline
  • Possible increase in brain cell growth which enhances learning and memory (animal studies)
  • Possible link to increased capacity for learning and academic achievement in students
  • Reduces frequency of tobacco, drug and alcohol use among physically active
  • Reduces direct medical costs among Americans by $76.6 billion (regular moderate exercise)
  • Reduces workplace short-term sick leave by 6-32% and increase productivity by 2-52%

While many are aware of the physical and aesthetic benefits of exercise, not everyone realizes the significant positive impact on mental health. Physical activity has a role in management of severe mental illnesses in its ability to lessen symptoms and also potentially extend the life in these populations.

The European Psychiatric Association (EPA) has issued recommendations for supervised physical activity as a potentially effective intervention for individuals with severe mental illnesses, such as schizophrenia, bipolar disorder and major depression. According to researchers, those with severe mental illnesses face an increased risk of early mortality by as much as 10 to 20 years, with physical disorders accounting for as much as 70% of those early deaths.

In its latest edition of nationwide guidelines for physical activity (PA), the Department of Health and Human Services state “adults should move more and sit less throughout the day.” 80% of all Americans are not meeting current PA recommendations, a failure that is contributing to the prevalence of a host of chronic health conditions. Regular PA reduces your risk for many chronic diseases, including prostate and breast cancers, dementia and brain strokes, and is considered to be as effective as taking medication for many conditions.

The new guidelines emphasize the concept that some amount of PA is better than none in preventing disease and extending life, no matter an individual’s age. The revisions to the PA guidelines are the first in 10 years, and they do not significantly alter the goals for adults. Instead, the new guidelines further reinforce the benefit of PA at any level by removing the statement that activity must occur for at least 10 minutes to be effective. The Department of Health and Human Services recommendations for physical activity vary by age and are as follows:

Children and adolescents (6 to 17 years): 60 minutes or more per day of moderate-to-vigorous PA; with at least 3 days of muscle- and bone-strengthening PA per week

Adults: 150 minutes per week of moderate-intensity PA, or 75 or more minutes per week of high-intensity PA is recommended for adults; at least 2 or more days per week should include muscle-strengthening activities.

Older adults: If possible, 150 minutes per week of moderate-intensity PA, tempered by an individual’s “level of [PA] relative to their fitness,” and a clear understanding of how various chronic conditions can affect the ability to reach PA goals. No matter what PA level is achieved, activities should include balance training, aerobic, and muscle-strengthening activities.

A brisk walk, gardening, housework and cycling count toward the recommended 150 minutes of moderate aerobic exercise a week. If you are struggling to fit a gym routine into your schedule, yet you would like to begin incorporating more movement into your day, you can start with some of the following simple changes:

  1. Organize a walking group with coworkers during lunch or meet friends in the park. Bonus: fresh air and being social without food and drink.
  2. Get off one stop earlier on the bus or subway
  3. Choose one meal a day and walk for 10 minutes after it. Walking after eating regulates blood sugar and helps weight loss.
  4. Walk your dog rather than letting them out in the backyard
  5. Choose a parking spot in the back of the lot, further from the front entrance of your work or store
  6. Walk around the track or field while your kids play sports
  7. Walk to breakfast, lunch or dinner.
  8. Take the stairs instead of the elevator
  9. Drink more water. This will ensure you take breaks often to use the restroom (great tactic for mental clarity) and also keep you hydrated!
  10. Return your missed calls while walking

I am sure you have heard the phrase, “physical activity as medicine” at least once before. After reading through some of the general benefits of increased physical activity and simple ways to fit more movement into your day, one must be convinced.

 

This information is for informational purposes and is not intended to be used in place of seeking individualized care from a healthcare professional.

 

 

References:

Sallis JF, McKenzie TL. Effects of health-related physical education on academic achievement: Project SPARK. Research Quarterly for Exercise and Sport 70(2):391-5.

Physical Activity May Decrease Mortality Risk in Frail Older Adults, Says Researchers. PT in Motion News. October 30, 2018.

European Psychiatrists Recommend Physical Activity in the Treatment of Severe Mental Illness. PT in Motions News. November 9, 2018.

What You May Not Know About Cigarette Smoking and Your Health

Cigarette smoking negatively affects every organ of the body and is widely recognized as one the major causes of preventable disease. According to the Centers for Disease Control (CDC), smoking causes more deaths each year than the following causes combined: HIV, illegal drug use, alcohol use, motor vehicle injuries, and firearm-related incidents.

Most people know that smoking is linked to heart and lung diseases, as well as several cancers. However, many people are not aware that smoking has a serious negative effect on other parts of the body, including bones, muscles and joints.

Cigarette smoking negatively impacts the rate and quality of healing from injuries, illnesses, and chronic conditions on multiple levels. Adverse effects of smoking on tissue oxygen levels have been demonstrated immediately after smoking just one cigarette, regardless of smoking history. On a microscopic level, chemicals found in cigarette smoke cause many changes to the way the body handles oxygen. Carbon monoxide is a poisonous by-product of cigarette smoke that has a 200 times greater affinity to bind with hemoglobin than oxygen. Hemoglobin is the molecule that carries oxygen throughout the body and, when exposed to cigarette smoke, it replaces oxygen with carbon monoxide to deliver to tissues. Cigarette smoking also increases the thickness of blood and narrows blood vessels, which both further contribute to impaired oxygen delivery.

When oxygen is not delivered to our tissues, cellular metabolism in the tissues is inhibited and healing is delayed or disrupted completely as a result. Furthermore, smoking increases chance of re-injury, as bones, tendons, and ligaments do not regain their full strength without adequate oxygen and nutrients.

Healing of injuries is a complex process. The air we breathe is filled with oxygen, which is needed for most functions in the body, including the repair process after an illness or injury. The healing trajectory can be interrupted at any stage by lack of oxygen to tissues.

Imagine a busy four-lane highway filled with big trucks hauling precious cargo necessary to survive in the same way that oxygen is required for human function. If this were the body, smoking would have the effect of shutting the highway down to two lanes, shrinking the trucks down to small cars with half the cargo, and pouring sticky tar on the road to delay the delivery. Much less cargo would arrive at its destination in a longer time. In the same way, areas of the body that need oxygen will go without, and will receive a toxic chemical instead of an essential nutrient.

In addition to poor healing and increased chance of re-injury, lack of oxygen to tissues has been found to increase infection risk and also results in reduced tolerance for exercise, frequent headaches, dry and inelastic skin with wrinkles and dull and grayish skin tone.

When you smoke, the number of white blood cells (the cells that defend your body from infections) remains high. Elevated white blood cell levels are a sign that the body is under constant stress as it is chronically fighting the inflammation and damage caused by smoking. With the immune system continuously trying to repair the damage done by smoking, the body’s ability to fight off any foreign pathogen, such as a virus or bacteria, is impaired. Chronic systemic inflammation also affects the way the body interprets pain signals. Many studies have found that smokers report more pain after surgery than non-smokers.

No matter your age or how long you have smoked, quitting can help. It is important to recognize that you are not alone in the struggle to stop smoking and there are many resources available to help you. By calling 1-800-QUIT-NOW or visiting www.smokefree.gov, you will be linked up with a professional “quit coach” free of charge to help you through this process.

Immediate benefits of quitting smoking within one day include decreased heart rate and blood pressure, and improved ability to breath. Within one month, quitting smoking will result in greater blood circulation, enhanced lung function and better sense of taste and smell. Within one year of quitting smoking, a person will have fewer colds and illnesses, decreased coughing, less shortness of breath and 50% decreased risk of heart disease.

It can be hard to quit because nicotine is addictive. Symptoms of nicotine withdrawal usually peak within 7-10 days and may include dizziness, depression, anxiety/irritability, trouble sleeping, difficulty concentrating, restlessness, headaches and increased appetite and weight gain.

To help get through this process and reduce withdrawal symptoms, you can take extra steps to manage the stress of quitting. Drink plenty of water, eat nutritious foods and get enough sleep. Avoid temptation to smoke by staying away from people and places that remind you of smoking. Keep substitutes ready when you are tempted to smoke, such as carrots, celery, pickles, apples, and sugar free gum. Utilize nicotine replacement therapy, such as gum, patches, inhalers and throat lozenges. Stay active by exercising, walking or cycling to help with restlessness and weight gain. People who exercise while quitting smoking have reported better success and fewer withdrawal symptoms. Finally, acknowledge that anger, frustration and worry are normal—you are worth the extra effort it takes to quit!

Article written by Dr. Jessica Khani, PT, DPT, CSCS

This information is for informational purposes and is not intended to be used in place of seeking individualized care from a healthcare professional.

18 Ways Physical Therapy Can Make a Difference

If you are reading this post, chances are that you have heard of physical therapy (PT). Perhaps you have attended PT as a patient or know a friend who has had PT in the past. But if asked, you might not be able to define physical therapy or describe all the ways it can benefit a person. That’s no surprise; physical therapy is such a large profession with so many practice settings that it can be tough to describe what PT truly is!

Physical Therapists are movement experts who combine their extensive education, clinical experience, and the latest medical research to assess and treat people of all ages and abilities, from highly athletic to extremely physically debilitated. PT is a dynamic profession with established theoretical and scientific bases for therapeutic interventions, with an end-goal being to maximize and optimize each person’s capacity for movement. With use of patient education, corrective exercises and manual therapy, PTs can help relieve pain and normalize imbalances to ensure patients are as independent as possible.

Physical Therapy is a high-benefit, low-risk solution to treat many conditions. PT is considered a conservative intervention, meaning that it is less taxing on the body than harsh medications and surgeries, which should be considered last resort options. PT can truly make a difference in the following ways:

1. Avoid surgery. Physical Therapy can often help avoid unnecessary and costly invasive surgery altogether. Research has shown that PT can be more effective than surgery in the long-term for injuries such as rotator cuff tears, spinal stenosis, and disc herniation. If it is necessary to perform surgery, physical therapy will expedite your recovery by increasing your strength pre-operatively and preparing your body for the rigors of an operation.

2. Assess your Injury risk. In the same way you visit your primary care physician for an annual check-up, you can visit a PT for a full movement screen and orthopedic examination every year. PTs are trained to recognize postural habits and biomechanical shortcomings of each individual’s unique body. Movement screens can bring your attention to areas of weaknesses that may predispose you to future injury.

While everyone has different muscle imbalances, range of motion and alignment, a PT can pinpoint your specific limitations. After recognizing your individual impairments, your physical therapist can then give you the tools to overcome these subtle postural habits or limitations to prevent future injury.

3. Reduce or eliminate pain. Chronic pain, pain that lasts several months, is a common problem and can be very frustrating, especially if the underlying cause is unknown.

People can suffer from chronic pain in a number of areas in the body, including headaches or neck pain caused by postural syndromes, hip and knee pain as a result of osteoarthritis, or low back pain due to work-related activities. Patients who are experiencing chronic pain often fear performing daily activities and experience tightness, stiffness or increased used of pain medications.

If you are experiencing pain, PTs can provide hands on treatment to mobilize your joints, release soft tissue and restore muscle function, thereby reducing aches and pain. Patient education is important in understanding that chronic pain is complex involving more than damaged muscles, tendons, ligaments and joint tissues. Emotions, depression, anxiety and nervous system hypersensitivity are important components of chronic pain that will be addressed by your PT. Finally, understanding how to properly lift, sit, bend, reach and perform specific daily activities will help facilitate healing and decrease repetitive trauma to your body. Physical therapy can give you the tools and guidance you need to live pain free and improve your quality of life.

4. Avoid Prescription Medications. The ongoing opioid crisis in the United States reflects the unintended consequences of a nationwide effort to help individuals control their pain. The health care system has, since the mid-1990s, employed an approach to pain management that focuses on the pharmacological masking of pain, rather than treating the actual cause of pain. This strategy has resulted in a dramatic increase in opioid prescriptions, causing widespread misuse and addiction. In recent years, it has also led to a growing realization that current strategies for managing pain have to change, as opioid-centered solutions for dealing with pain at best mask patients’ physical problems and delay or impede recovery and at worst may prove to be dangerous and even deadly.

Ensuring that patients are aware of and have access to various options for care is a significant step in addressing this complex issue. PT interventions are an essential component of the multidisciplinary undertaking that is required to improve patient outcomes and alter the trajectory of this public health crisis.

The CDC released opioid prescription guidelines in March 2016, which recognized that properly-dosed opioids are appropriate for pain management in cancer treatment, palliative care, certain acute care cases, and end-of-life care. For other conditions, the CDC recommends non-opioid approaches, such as physical therapy. The CDC’s recommendations reference high-quality evidence that treatments provided by PTs are especially effective at reducing pain and improving function in cases of low back pain, fibromyalgia and hip and knee osteoarthritis.

Similar to how PT can help avoid costly surgeries, it can replace the need to purchase and consume expensive drugs. PT will address the underlying cause of your injury or condition, rather than prescription drugs which mask pain, and is a safer alternative for long-term pain. During an initial evaluation, your physical therapist will focus on your symptoms and the movement patterns that may be contributing to pain.

5. Prevent falls. A fall can result in joint dislocations, fractures, reduced self-confidence, permanent disability or other health, psychosocial and economic consequences. There are many reasons that a person may be at risk for falls. Potential causes for imbalance include reduced joint position awareness, visual impairments or problems of vestibular origin.

During your initial evaluation, your physical therapist will perform a screen to evaluate your fall risk. After isolating the cause behind your imbalance, your PT will prescribe treatment to address deficits that are contributing to your fall risk.

PT intervention will improve your balance, increase your neuromuscular control and coordination, and decrease your fear of falls. Fall prevention is important to avoid further injury and ensure that you can carry out your day safely and independently.

6. Refer you to specialists. Although it may seem like physical therapists can do it all, we recognize that, at times, your health condition may be out of our scope of practice. PTs identify problems that may require consultation with or referral to other professionals when appropriate.

Sometimes a person might require simultaneous multidisciplinary care from a team of health care practitioners. In such cases, your PT will work hand in hand with your primary care physician or specialty provider to ensure your wellness goals are met.

7. Increase your functional independence. Functional independence is the ability to carry out activities of daily living safely and autonomously. Whether you are experiencing a physical disability or not, participation in daily living activities is essential to your health and well-being.

If you are having difficulty standing, walking, standing from a chair or other daily activities, physical therapy can help. The treatment approach chosen by your PT depends on your specific goals, the degree of functional limitation experienced and the type and severity of the skill impairments noted.

8. Recover from a stroke, neurological injury or chronic disease. PT is essential following a traumatic injury or diagnosis of chronic disease. Adults and children who experience a stroke, Multiple Sclerosis (MS), Amyotrophic Lateral Sclerosis (ALS), Cerebral Palsy and many other conditions have shown to benefit significantly from physical therapy.

After an unexpected injury, it can be difficult for patients to return to daily activities such as writing, eating, or climbing stairs. If you have been diagnosed with a chronic disease, PT can help manage symptoms or delay progression of the disease by maintenance of strength and mobility, incorporation of nutritional education, and improvement of gait and balance. It is current knowledge that nutrition, the intestinal microbiota, the gut mucosal immune system, and autoimmune pathology are deeply intertwined. Nutritional intervention can be very effective in managing autoimmune diseases, such as diabetes and hypothyroidism, which share the underlying pathology of chronic systemic inflammation.

At Agility PT, Dr. Marci has obtained her functional medicine certification. Dr. Marci’s training has equipped her with the scientific knowledge and experience to recommend individualized diet and lifestyle modifications to decrease your symptoms, restore hormone balance, and support the gut and immune system. Studies have shown that nutritional intervention is effective in controlling the progression of MS, Systemic Lupus Erythematosus (SLE), and Diabetes by modulating the autoimmune response and systemic inflammation. For example, symptoms of disease, such as fatigue in MS, pain and diarrhea in inflammatory bowel disease, or the need for acute medication in type 2 diabetes are considerably affected by food intake.

9. Recover from sports injury. While we try to prevent injuries, sometimes accidents occur. The fact that athletes place higher demands on muscles and joints increases their risk for injury. However, an injury on the field does not mean that you have to sit on the sideline indefinitely.

PTs have experience rehabilitating athletes with rotator cuff injuries, ligament sprains, muscle strains, tendinitis, overhead sports injuries, and pains that occur with running and cycling.

After a thorough evaluation of your condition, your PT will develop a custom rehabilitation program of hands-on techniques for pain and inflammation control. Your PT will also help you build up strength in your muscles, restore normal joint and soft tissue mobility, and recover neuromuscular control, speed, power and agility. It is important for an athlete to practice and feel confident in sport-specific drills before returning to play, such as deceleration, jumping and cutting. Studies have shown that instability activities which challenge the athlete’s balance after an injury make a successful return to sport 5x more likely.

If surgery is required, the physical therapists at Agility PT are trained to help athletes recover from operation of the knee, shoulder, ankle, hip and spine. Your PT is trained to monitor for signs of infection or complications that can occur in the operated joint or joints above and below as a result of injury or post-surgery. We will work with you to optimize your performance and help you reach your fullest potential following a sports injury.

10. Reduce or eliminate vertigo. Vertigo is a sense of rotation or rocking, even when a person is perfectly still. Movement of the head or body can worsen symptoms, and may lead to lightheadedness, nausea or vomiting. If untreated, this imbalance will likely lead to a fall or accident and cause further complications.

There are various reasons that dizziness and vertigo may occur. Some causes of vertigo include nervous system abnormalities, cervical spine conditions, vascular impairment, Meniere’s disease, vestibular neuritis, benign paroxysmal positional vertigo (BPPV), or inner ear infections.

PTs will perform an evaluation to determine the cause behind your symptoms. For example, if you have BPPV, our vestibular therapy experts can perform a series of simple movements, such as the Epley maneuver, which can facilitate the return of the crystals in the inner ear to their normal position. With this specific condition, symptoms can typically be completely resolved within one or two visits.

Dr. Marci at Agility PT has completed continuing education to receive Advanced Vestibular and Vestibular Rehab Certifications. With her specialization in vestibular rehab, Dr. Marci has helped numerous patients eliminate their symptoms.

11. Prevent an injury. PTs understand how different sports can increase your risk for specific types of injuries. For example, stress fractures and patella tendinitis are common in runners, while ACL tears often occur in female soccer players. PTs can design an appropriate injury prevention program individually tailored to you to keep you healthy all year long.

At Agility PT, Dr. Jessica has earned her certification as a Strength and Conditioning Specialist (CSCS). Her experience has prepared her with in-depth knowledge pertaining to biochemistry of energy systems and nutrition, exercise modalities, training strategies for performance adaptations, and most importantly, injury prevention. Her experience has prepared her to apply scientific knowledge in the design of safe and effective strength and conditioning programs with the primary goal of improving athletic performance and preventing injuries.

12. Find the best workout for you. PTs gather information from prior surgeries, diet, lifestyle, body mechanics, and personal preferences to determine what physical activities will best fit you.

Proper programming and prehab before starting a new type of exercise or increasing the intensity of a current exercise routine will help you address muscle imbalances, guarantee that you are progressing adequately and prevent injury in the long run.

Whether your goal is to manage weight, increase strength after an injury, improve athletic performance, or combat the effects of chronic conditions such as type 2 diabetes, PTs can develop a safe, individualized exercise plan.

With guidance on the fundamental principles of strength training and training cycles and individualized exercise prescription, you can avoid new and recurring injuries. Additionally, a model of progression needs to be implemented and followed, or results will be slow or non-existent.

13. Nutritional education. PTs are educated in nutrition, fitness and exercise. It is well known in the literature that nutrition plays a key role in both prevention and treatment of injuries.

When muscles are exercised, the result is tears at the microfiber level. This is a normal process that results in local inflammation in the specific muscle to repair the fibers and increase resilience against future damage. This is the process by which muscles grow, or hypertrophy. In a similar manner, when a person is injured, an inflammatory response is initiated.

The success of this repair and build process depend on the person’s body composition and is influenced by nutrition. If a person does not meet adequate dietary intakes when the body requires extra energy for recovery with exercise, repetitive stress injuries may result, such as tendinitis or ligamentous tears. Furthermore, nutrient deficiencies during recovery will delay the repair process and prolong healing. Therefore, nutritional status and energy requirements should be assessed throughout recovery and nutrient intake adjusted accordingly for optimal prevention and recovery from injury.

Often patients come in the clinic with a musculoskeletal condition, but sometimes working on mobility, control and strength aren’t enough to relieve their pain. These patients will truly benefit from lifestyle changes in addition to physical treatment. Nutrition is often the missing link to comprehensive care in managing and relieving musculoskeletal pain.

At Agility PT, Dr. Marci has completed training to become a functional medicine practitioner. Often there are multiple factors contributing to an individual’s clinical presentation and finding the root cause is the heart of functional medicine. Nutritional intervention is an effective and useful tool to improve overall health outcomes, optimize performance and help patients achieve goals.

14. Order Imaging. Incorporating greater purposes for imaging by PTs systematically improves patient management and cost containment.

The role of PTs in ordering diagnostic imaging has been in existence for several decades. The most notable example is in the U.S. military, where since 1972, PTs have practiced as direct access providers with imaging privileges. Imaging instructional content is foundational in PT education programs, allowing for competencies in imaging use and decision making in physical therapy practice.

The 53 United States jurisdictions define the regulatory scope of PT practice differently. The ability to perform certain skilled tasks, including imaging, may be granted overtly through explicit regulatory authority or denied by that same authority. The Colorado State Physical Therapy Board states that PTs may order diagnostic imaging.

How does this affect you? The ability for PTs to order imaging will reduce the delay in treatment that occurs with referral to another provider for imaging. Additionally, the combined advantage of direct access for PTs and their authority to order imaging will decrease costs for yourself and the healthcare system in terms of less visits to multiple providers.

15. Diagnose your movement pathology. PTs are recognized as practitioners of choice to whom consumers have direct access for the diagnosis of, interventions for and prevention of impairments, functional limitations, and disabilities related to movement, function and health.

In Colorado, you can go directly to a PT under a law that grants “direct access.” This means that you can simply walk into a clinic and a PT can diagnose your ailment. This is an advantage that is not legal in all states. Going straight to your PT, rather than visiting your primary care physician who will then likely refer you to a PT, can save you a trip and get you better faster!

When people experience an injury, one of the first things they do is look up their symptoms on the web. Another common tendency is to follow the same treatment that a friend had for their injury. While we want you to be self-sufficient, diagnosing and treating yourself can be dangerous, costly and will likely lead to delayed recovery.

Physical therapists can distinguish a particular disease or condition from others that present with similar symptoms. For example, a PT can differentiate between kidney or liver condition and symptoms that mimic low back pain.

16. Save you money. Depending on your insurance, physical therapy treatment can be free or include copay. Although a copay may seem to be a burden initially, seeking treatment early on before your condition worsens will save future expenses.

Research shows that the longer you wait to treat a condition, the further delayed the recovery and the greater likelihood of developing compensations in surrounding joints. Additionally, the total costs of other treatments, such as surgery and expensive medications, can exceed the cost of seeing a physical therapist.

The scope of PT practice with direct access has demonstrated enhanced quality of patient care and reduced costs. The advantage of direct access to a PT will save you time and money as you can skip the steps of obtaining a prescription for PT from your physician.

17. Orthotics. Each step we take involves a remarkably intricate network of bones, muscles, tendons and ligaments functioning together as pulleys and levers to meet the demands placed on them with walking, running, jumping, and more. The complexity of this system, combined with the weight feet carry, account for why feet can be prone to many orthopedic injuries.

Some of the injuries PTs treat include bone fractures, arthritis, plantar fasciitis, bunions, and tendinitis, among many other conditions.

If you have had a foot injury, you know that it can cause a big restraint in your daily life. If left untreated, foot problems typically lead to more injuries up the chain, including the knees, hips and back. You can take a proactive approach by having a full evaluation by a physical therapist BEFORE symptoms occur in your feet.

The PTs at Agility Physical Therapy can make orthotics customized to fit your feet and promote proper alignment of your body from the ground up. While orthotics are appropriate for some patients, others don’t need them at all. For hypomobile or rigid feet, orthotics can cushion and support those stiff segments of the foot. For hypermobile conditions, as in pronated feet, orthotics can stabilize the foot. Orthotics can also help the foot redistribute forces during weight bearing activities to alleviate pain and prevent injuries.

18. Achieve Developmental milestones. At certain ages, children should reach specific gross and fine motor skill milestones. These skills are required to control muscles of the body for walking, running, sitting, crawling and other activities. While some children may develop faster than others, there are some milestones that should be achieved by a specific age.

Early identification of delayed developmental milestones allows communities to provide more effective and affordable treatment during preschools years. Proactive intervention can also lessen the need for expensive special-education services later in childhood or worsening conditions in the future. Physical therapists can provide early intervention services for children with developmental delay to achieve their age-appropriate milestones.

8 Tips to Get a Better Night of Sleep

If you are not sure how to get a good night of rest, look no further. To optimize sleep and wake up feeling refreshed, start by tackling some of the following tips.

1. Exercise!
Experimental evidence has suggested that exercise may be associated with better sleep quality. One study that evaluated exercise in patients with insomnia showed that an acute bout of moderate-intensity aerobic exercise about 3 hours before bed reduce sleep onset latency, total wake time and pre-sleep anxiety, while increasing total sleep time and sleep efficiency.
2. Limit use of artificial light during evening hours.
Blue light influences secretion of melatonin, which is a neurotransmitter that makes us sleepy and regulates our circadian rhythm. Circadian rhythms regulate nearly all of the body’s processes, from metabolism and immunity to energy, sleep, mood and cognitive function. Unfortunately, computer screens, tablets, televisions and cell phones all emit blue light. Many electronic devices have a “night shift” setting that automatically switches your device to a warmer color at a designated time. Set a curfew on the amount of artificial light exposure to get a better night of quality sleep. Also try to avoid checking your phone in the middle of the night if you wake up. As soon as the blue light from a screen hits the retina in the eye, the effect of melatonin is immediately reversed and actually promotes a state of wakefulness over sleep.
3. Avoid caffeine and alcohol 5 hours before bed.
Caffeine is the most popular drug in the world. While it is very beneficial to improve performance in workouts and keep us alert during the day, caffeine does not replace sleep. After consuming caffeine, its effects can occur within 15 minutes and take up to 5 hours to die down. Considering this timeline, caffeine should not be consumed 5+ hours before bed in order to avoid a restless night.

Consuming alcohol close to bedtime can also increase your heart rate and keep you awake. While alcohol is commonly used to aid a person’s ability to fall asleep, it can interfere with quality of sleep. Alcohol blocks REM sleep, which is the most restorative type of sleep. Alcohol consumption also affects the normal production of neurotransmitters and increases tendencies to wake up in the middle of the night.
4. Calm your mind.
Your body and mind need time to wind down and shift into sleep mode before bed. Incorporate a routine, bedtime ritual away from activities that cause excitement, stress or stimulation, will make it easier to fall or remain asleep. Relaxing activities include meditation, a warm bath, reading, foam rolling, stretching or belly breathing. It is best to take work materials, computers and televisions out of the bedroom to strengthen the association between bed and sleep. Checking email or doing work right before bed can also trigger anxious thoughts and make it difficult to fall asleep.

Practicing breathing and meditation exercises before bed can increase parasympathetic response to relax the entire body and decrease your heart rate. Lie down comfortably with one hand on your stomach and your second hand on your chest. Inhale deeply through your nose for a count of 5 while pushing your belly through your hand on your stomach. Then exhale through your mouth for a count of 10 as if you are blowing out candles very slowly while gentle pressing on your stomach to facilitate air exiting. Repeat this 3 to 10 times.

Essential oils have been proven to promote and induce a calmer state of mind and encourage a more balanced central nervous system, which allows us to more effectively prepare for sleep. Essential oils are broken down organic plant molecules that can be very powerful and aromatic. Natural fragrances such as lavender, chamomile, sandalwood, ylang, valerian, bergamot, and cedarwood are often used in the bedroom to infuse the air with calming molecules, relax our systems and encourage deeper breathing.
5. Tailor your sleeping environment.
Evaluate your bedroom to ensure ideal temperature, sound and light. The bedroom should be in the colder temperatures for optimal sleep. Your bedroom should also be free from any noise or extra light that may disturb your sleep. Using blackout curtains, eye shades, ear plugs, white noise machines, fans or other devices may help reduce distractions in the bedroom.
6. Have sex!

Experiencing an orgasm during sex has a sedative effect due to the rush of endorphins and other hormones towards the same part of your brain that regulates arousal and sleep-wake cycle. Endorphins are hormones that can activate the pleasure center in your brain and drop cortisol levels, which relate to stress. Additionally, dopamine and oxytocin are both released during orgasm, which relaxes the mind and eases anxiety.
7. Create a consistent sleep schedule
Going to bed early may seem obvious but also difficult to enact. Many of us are guilty of bedtime procrastination, or delaying going to because we didn’t accomplish everything on our to-do list. Sticking to the same sleep and wake time, during the week and on the weekends, will subconsciously regulate your body’s internal sleep-wake clock and help you fall asleep better at night. Life will inevitably interfere, but try not to sleep in for more than an hour or two, tops, to stay on track.

If you are currently going to bed at 11 pm, don’t decide that tonight you will go to bed by 9 pm, because it likely won’t happen. Your internal clock resets at a rate of about one hour per day. Generally, when making behavioral changes, aim to take small steps towards the bigger end-goal. Set a reminder and aim to go to bed 15-30 minutes earlier tonight.
8. Find a comfortable sleeping position.
There is no single sleeping position that works for every person. With that being said, your sleeping position impacts your sleep quality and general feeling the following day in various ways and is therefore very relevant in this discussion.

Some people are most comfortable sleeping on their stomachs and have no issues, but it does put the neck, spine and shoulders in poor positions for blood flow, muscle imbalances and nerve tension. Regardless of your ideal sleeping position, try to strive towards keeping the body in neutral alignment to avoid kinks and imbalances. This is especially important when it comes to the neck position. Pillows that are too soft or bulky, as in the photos, will lack support for the neck or overstretch the soft tissue and likely lead to shoulder and neck aches. Aim to use a pillow that will keep your neck in line with the rest of your spine.

Sleeping on the back is typically the most recommended position, as it allows the body to rest in a neutral position. If this position is uncomfortable on your back, try putting a small pillow under both your knees. Sleeping on your back has also been shown to minimize the formation of face wrinkles. This position may be uncomfortable for people (or their partners) because it usually causes a person to snore more than other positions.

Side sleeping may prevent snoring completely. If you are most comfortable sleeping on your back, use a rounded pillow to support the natural curve of the neck and a flatter pillow beneath the head. Also, having a pillow under the knees will support the low back. In all sleeping positions, avoid using a pillow that is too high and takes the neck out of neutral alignment, as this leads to pain and stiffness the following day. If sleeping on your side, use a pillow between the knees and arms to keep the front body open and supported, promoting optimal body alignment. Side sleeping is recommended for those with sleep apnea. Sleeping on the left side is advised for those with heartburn and acid reflux.

Sleeping on the stomach is very hard on the cervical spine and the remainder of the system as the neck must be turned to breathe in this position and the rib cage doesn’t expand in the anterior direction as it should.

Finally, If you have an injury on one side of the body, it is not advised to sleep on that side.

It may seem difficult and overwhelming to follow all these recommendations right off the bat. Start by identifying the factors that are most disruptive to your own sleep and then focus on altering particular behaviors to overcome those factors. Happy sleeping!

If you haven’t already read our last post on the importance of sleep, you can find it here

Article written by Dr. Jessica Khani, PT, DPT, CSCS

The information provided is not medical advice and is not intended to be used in place of seeking advice from a professional.

Sources:
“Sleep Duration as Risk Factor for Diabetes Incidence in a Large US Sample.” Sleep Research Society. Sleep. Dec 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2276127/.

“Association Between Sleep Disorders, Obesity, and Exercise: A Review.” Nature and Science of Sleep. Dovepress. March 2013. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3630986/

“How Much Sleep Do We Really Need?” National Sleep Foundation. 2018.

You should be getting at least 7 hours of sleep. Here’s why.

We all know sleep is important, but it is often under-appreciated. Sleep is a low hanging fruit to make progress in almost any goal, no matter what it may be. By tending to our sleep-related needs, we can maximize our productivity throughout the day, enhance immune system function, balance hormones, improve recovery, and overall cultivate a deeper connection with the world around us with the extra boost of energy.

The National Sleep Foundation recommends that adults ages 18-64 years old should sleep 7-9 hours a night. However, every person has a different load of stress and activity in their life. Therefore, an individual’s workload, amount of exercise, underlying sickness, or other stressors influence the amount of sleep required for adequate rest each night.

Regardless of the individual amount of sleep needed per night, if your body learns to function on low levels of energy over the course of a period of insufficient sleep, there will be less energy to facilitate recovery from daily stressors. While caffeine and other stimulants cannot substitute for sleep, but they do help to counteract some of the effects of sleep deprivation. Additionally, the body excels in managing acute damage or stress by utilizing our fight or flight system to allow us to meet challenges while performing at a high level. While it is beneficial that our bodies can adapt and function at low energy levels, chronic stress without recovery is temporary and will lead to burnout and decreased function of all bodily systems.

Not getting enough sleep, while still allowing us to function in a seemingly normal manner, impairs motor and cognitive functions. A person who is sleep deprived will typically experience reduced ability to concentrate, memory lapses, loss of energy, fatigue, lethargy, difficulty with complex thought, delayed response to stimuli, and emotional instability.

Furthermore, chronic lack of sleep has been associated with many adverse health conditions, including chronic fatigue, diabetes, high blood pressure, heart disease and even musculoskeletal injury. Studies in which subjects underwent short-term sleep deprivation to examine the immediate effects of a lack of sleep were found to have heightened blood pressure, lowered blood glucose levels and increased inflammation. It follows that long-term persistence of these symptoms could lead to more deep-rooted dysfunction. Sleep disturbances are also highly prevalent in chronic pain patients and have been shown to deteriorate the pain condition. It has been hypothesized that descending pain control may be compromised by disturbed sleep.

Sleep is the number one recovery mechanism from stress and it affects the way we look, feel and perform on a regular basis. We tend to think of sleep as a time when the mind and body shut down, but this isn’t the case. During sleep, the body is in an elevated anabolic state, meaning that repair mechanisms are used throughout the body when we are resting. Sleep is an active process during which important processing, restoration and strengthening occur.

One of the essential roles of sleep is to consolidate memories. Our brain takes in unlimited amounts of information throughout the day. While we sleep, experiences, memories and skills are processed and stored from short-term memory to long-term memory in more efficient and permanent brain regions. This results in higher proficiency and better recollection the next day.

In addition to improved memory of past information, sleep also helps us synthesize new ideas. While you are sleeping, pieces of knowledge can be pulled together from different experiences and parts of the brain to create novel concepts.

A recent study found that when subjects slept abundantly throughout the night, cellular waste byproducts that were accumulated in the interstitial space were removed. This clearance of toxins also allows the brain to function optimally the next day.

An internal biological clock, known as the circadian clock, regulates the timing for sleep in humans. The activity of this clock is coordinated by light input during the day, which promotes wakefulness, and melatonin secretion during the night, which makes us sleepy. Most hormone secretion is controlled by the circadian clock or in response to physical events.

Sleep is one the events that modify the timing of secretion of certain hormones. Hormone imbalances that occur as a result of sleep deficiency increase the prevalence of mood swings and anxiety and predispose the body to weight gain.

While we are resting, our body stimulates the parasympathetic nervous system. Lack of sleep stimulates our fight or flight system instead of the parasympathetic system, which has been associated with greater secretion of cortisol, a stress hormone. Elevations of evening cortisol levels in chronic sleep loss are likely to promote the development of insulin resistance, a risk factor for obesity and diabetes. Additionally, the regulation of leptin, a hormone released by the fat cells that signals satiety to the brain and thus suppresses appetite, is markedly dependent on sleep duration. Decreased leptin levels in individuals who lose sleep may lead to feelings of hunger, despite adequate food intake. One study that examined shorter sleep duration found decreased leptin levels to be significantly correlated with increased BMI.

Another hormone that is influenced by sleep is growth hormone. Growth hormone plays a key role in growth, body composition, cell repair and metabolism, with the highest secretion levels occuring at night. It has been hypothesized that nocturnal growth hormone increases are involved in various tissue repair mechanisms throughout the body.

Studies have shown that sleep deprivation also decreases levels of glycogen, which is the body’s principal store of energy used for mental and physical activity. Because the brain does not typically utilize fat for energy, glycogen is the only source of spare energy for brain cells. During the metabolically active wakeful period, glycogen is exhausted. Glycogen supply takes time and reduced activity to restore. Both muscle and liver glycogen levels have been shown to replenish with recovered sleep, providing our brain with the energy to function optimally.

If you are not sure how to get a good night of rest, look no further. To optimize sleep and wake up feeling refreshed, start by tackling some of the following tips in the blog post next week!

Article written by Dr. Jessica Khani, PT, DPT, CSCS

The information provided is not medical advice and is not intended to be used in place of seeking advice from a professional.

Sources:
“Sleep Duration as Risk Factor for Diabetes Incidence in a Large US Sample.” Sleep Research Society. Sleep. Dec 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2276127/.

“Association Between Sleep Disorders, Obesity, and Exercise: A Review.” Nature and Science of Sleep. Dovepress. March 2013. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3630986/

“How Much Sleep Do We Really Need?” National Sleep Foundation. 2018