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).

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