Strengthen to lengthen?
The idea that strengthening muscles makes them more stiff or less flexible is one of the past; as is the thought that a long and flexible muscle is weaker. Both mobility and strength are necessary for performance and injury prevention, and it’s hard to improve one without the other.
Why not static stretching like we’ve done our whole lives? Although this can feel good, and can improve mobility in the short term, it doesn’t produce long-term change like we used to believe. Static stretching can dampen the nervous system response to a stretch so that it feels easier to move into this position for some time; however, this is short lived. Permanent changes in tissue length at the muscular and cellular level are not seen, so true length changes throughout the muscle don’t happen. We’ve learned in recent years that the best way to improve a muscle’s flexibility may be to load that muscle as it is stretched.
In the world of exercise this is called an eccentric activity. When thinking of how a muscle contracts there are three primary methods: isometric, concentric, and eccentric. Isometric occurs when there is no motion, i.e., arm wrestling against someone who’s an even match. Concentric involves shortening of the muscle as it moves against a load, i.e., the part of a bicep curl that brings the weight closer to your shoulder. Finally, eccentric involves lengthening the muscle while it lowers a load, i.e., the part of a bicep curl when you lower the weight to your side.
This eccentric load has been shown to create long term changes within the muscle that improve mobility around a joint and flexibility of that muscle, while simultaneously strengthening within that range. It does so by breaking down the tissue under a heavy load during the exercise. During recovery the muscle remodels to withstand this stretch better the next time it comes around. Just as you break down your hammies during a deadlift and can go heavier over time. This can be especially effective at the hamstrings or hip flexors, but really many muscle groups can benefit from this training as we use eccentric motions throughout our life! Bending over to pick something up, lowering our body weight off a step, lowering an object from a high shelf, etc.
What do these exercises look like? Think about the position you’re in when that muscle is in a big stretch. This is the motion you want to create through the exercise, simply adding a load. Some examples might include psoas lower, reverse Nordic curl, and a dropped heel raise.
Research and evidence are ever evolving. So much so that it seems hard to keep up! Our current body of evidence suggests this approach of eccentric loading may make more impact than static stretching, and that static stretching maybe doesn’t do what we once thought. Even so, it’s always best to analyze what your body needs, and what works well for YOU!
If you need guidance on where to start, or what approach suits your needs, head to our website to chat with a PT!
Elle Carlson, PT, DPT
What the heck is diastasis recti?
What is diastasis recti? It’s a common diagnosis in the pelvic floor world but what does it mean to you? Is it a problem? What can be done about it? Can it be avoided? Who develops it? These are all common questions surrounding diastasis, and things I hope to shed some light on this week.
Diastasis recti is commonly seen in pregnant people as they reach full term, as well as after a baby is born; in fact, nearly 60-70% of pregnancies will see diastasis develop. Even so, we can see diastasis in anyone who has a rapid change in the size of their abdomen, pregnancies, weight gain, or even toddlers with their cute little bellies. It is more common in women just because of the pregnancy and childbirth factor, but men can develop diastasis because all you need is that rapid change in shape. Ultimately it is a stretch and thinning of the connective tissue that connects our left and right ‘6 pack abs’. These abs, more specifically named rectus abdominus, run vertically from our pelvis to ribs and help to curl our trunk toward our legs and legs toward trunk. Between the two vertical muscle bellies, there is connective tissue that also runs vertically in line with our belly button – this is called the linea alba. Its job is to transfer load between the muscle bellies when we need stability at the center. Like when we lift, jump, brace, or transfer load from our arms or legs.
When we have a sudden increase in size that surpasses the tissue’s ability to adapt, this connective tissue can become less elastic, and less effective at transferring that load. This often shows up as a gap between the muscle bellies that can either dent inward or protrude out with an increase in abdominal pressure. This process in and of itself is typically not painful, and doesn’t appear to create direct problems; however, with this decreased ability to effectively spread load throughout our core, it can become harder to manage pressure within the abdomen and pelvis with exertion. This can potentially lead to other pelvic floor symptoms including pelvic pain, hip/low back pain, as well as incontinence.
To identify a diastasis recti, a practitioner may press along the midline of the belly (on the linea alba), feeling for an indentation or gap between muscle bellies. This can be further examined by asking the person to engage through the abdominal muscles and assess for changes in that gap – does it widen even further, can I sink my fingers deeper between the bellies, or does it become taught, making it harder for my fingers to sink down? The latter is a normal response, and what we want to see; the former are responses we would expect with a diastasis.
Natural healing of this connective tissue occurs once the stretch placed on it is reduced, which in most instances is after delivery. We also see the extent of this natural healing complete within a few months. However, even with this natural healing, the tissue is never quite the same and one can continue to have difficulty with pressure management; especially for someone who enjoys higher level physical activity, or things that require lifting and bracing. Fortunately, there is so much to do to help despite the changes in tissue!
So what can you do about it? The large focus here is to re-train one’s ability to manage the pressure created throughout the abdomen by improving coordination and strength throughout additional core musculature, including transverse abdominus, obliques, and rectus. A focus is also placed on breathing and bracing strategies during functional activities to promote support to that connective tissue and improve the ability to transfer load throughout the core. As this strength and coordination is improved, as well as integration of appropriate strategies during activity, we see an improved ability to transfer load through the core which can reduce any current symptoms but can also prevent others from coming along down the road! The cool part is that the already changed tissue doesn’t have to change back for this to happen! So, even when someone is months or years out from pregnancy and feels like there’s nothing to be done – there definitely is!
These strategies are also put in place as someone progresses through pregnancy or is trying to avoid a significant diastasis from developing! Check out this table for helpful tips surrounding both prevention and treatment:
I want to prevent a significant diastasis!
Diaphragmatic breathing w/ abdominal squeeze on exhale
Plank / modified plank
Side plank / modified side plank
I want to help my current diastasis!
Diaphragmatic breathing w/ abdominal squeeze on exhale
Deep abdominal squeeze with curl up
Bent knee fall out
It’s important to note that the appropriateness of these exercises is largely dependent on the individual, and their circumstances; therefore, an individual assessment is so important! You can find videos by clicking on the bold print above.
As always, hit the "Talk with a PT" button above to dive into your specific case and see how we can best help!
This week we’re talking all about RED-S. Something many of you may have never heard of. If you’ve spent time in the world of sport and athletics, you may be familiar with the female athlete triad – a combination of disordered eating, lack of menstruation, and osteoporosis. This combination is typically developed through over training with inadequate intake (FOOD!) which results in poor calcium maintenance in bone and altered hormones affecting reproductive cycles. It’s important to clarify that inadequate food intake can be both intentional and non-intentional; both because of poor eating habits and too intense exercise. RED-S has come about more recently to capture all the bodily functions affected by over-training and under-fueling; and to address the fact that males can fall into these patterns just as commonly.
Really, any active person is at risk for developing RED-S – relative energy deficiency in sport. You don’t have to be involved in competitive athletics, training, or sport; however, competitive athletes may be at a greater risk due to more rigorous training schedules. Those who participate in endurance sports, or aesthetic sports like gymnastics or dance are also at a greater risk. RED-S captures both males and females and in its most simple form occurs when an athlete consumes too few calories for their activity level.
RED-S can be difficult to diagnose because it can present in a variety of ways. A large indicator for this in females is a cease in menstruation; especially if the cycle had been regular previously. Decreased caloric intake doesn’t allow for the energy required to maintain appropriate hormone levels and conduct these functions throughout the month. This can have a long-term effect on bone health as proper estrogen levels are essential for affective calcium storage. RED-S is often seen in younger females who are not typically concerned with something like osteoporosis; however, bone density peaks between ages 25-30 so this is a crucial period to assure strong bones are being developed! Bone loss can occur in just a few months of having an irregular or absent period. Other symptoms – for both males and females - can include repetitive stress injuries, decreased performance or difficulty training at a high level, dehydration, GI problems, cold intolerance, low heart rate and blood pressure, cramps, fatigue, and brain fog.
Behavioral indicators can also be spotted, including anxiety or depression, body dysmorphia, exercising beyond what’s required, difficulty concentrating, and avoidance of eating or certain eating situations.
RED-S can impair health and sport performance as an under-fueled human is slower and weaker, regardless of the activity being performed! As activity levels remain high despite inadequate fuel, we can see fatigue progress to a loss of strength and muscle size as the body uses this tissue to fuel essential functions. Inadequate fuel can also affect the brain, leading to difficulty concentrating or remaining on task. With these changes in strength, energy, concentration, and coordination, there can also be an increased risk of injury. Along with the potential implications of bone health, stress fractures – and repeated stress fractures – can be a sign of RED-S and inadequate bone density. With that, repeated stress fractures, or unexplained injuries should always be a red flag for further investigating one’s exercise and fueling routine!
So, what can be done to prevent RED-S; to make sure our young athletes and active adults are setting themselves up for success; or to allow you to recognize if you’re trending toward some of these patterns and how to move the dial in the appropriate direction?
As always, consult with a physician if you are concerned about anything discussed above.
In a world where we have people and things to compare ourselves to literally in our palm, it can be easy to constantly ask more of yourself or to continue to push despite signs that you need the opposite. It’s common to think that we’re not doing enough exercise, or the right exercise; or that we need to follow this diet, or that other one you heard about last week. In a lot of instances, we need to fuel ourselves MORE, and more appropriately for what we’re asking our bodies to do. Rest and recovery needs to be recognized and encouraged in order to have the most success… and far more importantly, to take care of our health for the long haul!
How does breathing affect leaking?
This week we’re bouncing back to the pelvic floor and diving more specifically into some of the topics within this realm. If this is a topic that interests you, or you feel you’re in need of some work here, we’d love to see you at one of our upcoming workshops! We unpack the pelvic floor, its function, and its potential dysfunction; as well as what we can do about it. As these evolve, we’ll dive deeper into specific aspects; so, if you’ve been to one already, keep your eyes peeled for something fresh!
At a pelvic floor workshop last week, we talked a lot about incontinence. Particularly stress incontinence (leakage with things like coughing, sneezing, lifting, jumping, etc.). Something that is SO relevant to many! This one can be a tricky thing to manage because we need to know exactly what is going on in YOUR body, not that of the person next to you. HOWEVER, there are some general concepts surrounding breathing and pressure management that can go a long way; so that’s what we’ll talk about today!
Incontinence, as well as many other symptoms of pelvic floor dysfunction, is impacted greatly by the pressure we create – and manage – through the abdomen and pelvic floor. Think of the area from your ribs to pelvis like a cylinder, or a pop can… do you say pop? Anyway, this cylinder is formed by the diaphragm on the top, pelvic floor muscles on bottom, and abdominal muscles/spinal muscles all around the outside. When we do things with exertion – sneeze, jump, run, cough, etc. – we create increased pressure through this cylinder. This in and of itself is not a bad thing – it helps us to move STRONGER and brace better. The problem comes when an aspect of that pop can can’t withstand the pressure created. This is often the pelvic floor, and this can result in leakage during activity.
Strength can be an issue here, but it seems to more commonly be increased tension or over-activity through the pelvic floor. One thing we can work on to address this is breathing. Through our breath, our pelvic floor is meant to stretch upon inhalation, and return from this stretch on exhalation. This is caused by a synchronistic movement with the diaphragm; when we breath in, the diaphragm and pelvic floor both lower, when we breathe out, they raise. If we don’t utilize the diaphragm as we should, this synchronistic lowering doesn’t happen, and the pelvic floor remains tense. This is fairly common because many of us breathe primarily through our chest for a variety of reasons. This can be because of anxiety or feeling stressed; but also, because we try to keep our abdomen tight and belly sucked in. Regardless of the reason, when we don’t get adequate belly movement during breathing, we have inadequate diaphragm and pelvic floor movement.
The first step in this is to work on breathing more into your belly and toward your pelvic floor. You can start by simply lying on your back when you’re hanging out in the evening or getting into bed. Place a hand on your belly, and as you breathe, send your breath toward your hand so that it raises as you breathe in, and lowers as you breath out. At the same time, you can think about sending that breath lower toward the pelvic floor, and feeling a gentle flare of your sit bones as you breathe in.
This is a super simple movement, but it can go a long way in the journey of addressing incontinence! It’s important to note that this alone will not likely have a large effect on leakage during activity – laying down on your back is much different than jumping rope after all! These breathing and bracing strategies need to be progressed to functional movements for ultimate success; and need to be part of a plan that tackles mobility, strength, and coordination! That being said, it is a great place to start, and to assess what your natural breathing pattern is.
Try it out, reach out with questions, and keep your eyes open for next week’s newsletter!
If you’re interested in learning more about the pelvic floor, or how to help yours, hit ''Talk with a PT' up top for to register for a free discovery call!
Dr. Elle Carlson, PT, DPT
Why Does my foot hurt?
This month we’re talking about the ever-so-annoying and common diagnosis of plantar fasciitis. That’s a fancy name, so let’s first break it down. Plantar describes the aspect of the foot. Plantar refers to bottom, dorsal to the top. You’ve probably heard of fascia in various areas of the body. Really, fascia encompasses everything. Among other roles, it allows our muscles to work closely together by connecting them to each other and connecting our muscles closely to our skin and bones. This specific fascia runs from our heel toward our toes and blends with the muscles that allow us to bend our toes and support the bottom of our feet. This fascia is important in supporting the arch of our foot, and in creating some ‘spring’ when we push off through our toes. That last part of the word ‘-itis’ means inflammation. Inflammation of the fascia on the bottom of your foot – plantar fasciitis.
This condition can be intense, and the pain is often described as tearing along the bottom of the foot, most commonly with those first few steps out of bed in the morning. Despite this intensity of pain, the condition in and of itself is benign, and typically does resolve on its own over time. Even so, there are things that can be done to move that along, and strategies to use moving forward to prevent it from returning!
Because this is an -itis, and inflammation is involved, the first course of action is typically to reduce inflammation and modify activities as needed to prevent large increases in inflammation with exercise. These modifications usually surround activities like running, jumping, walking, and explosive movements. Duration, frequency, terrain, and speed are all modifiable factors for these exercises that can improve symptoms and reduce inflammation. It can also be helpful to assess shoes worn during these activities and adjust as necessary to reduce irritation; or ask yourself if you recently changed shoes as sometimes that can be the culprit for a new case of plantar fasciitis. Over the counter orthotics are often helpful for improving symptoms in the short term, especially for those who spend a lot of time on their feet. Over the counter are typically just as good as the custom-made orthotics for plantar fasciitis, so don’t go running to a podiatrist for custom orthotics just yet!
After symptoms are improving and inflammation is controlled, it’s important to gradually load these tissues so they can build resiliency toward the exercises or activities that may typically aggravate the plantar fascia. These tissues need to be able to withstand both stretch and load, so we need to introduce these in a controlled manner. They become stretched when we go onto our tiptoes, or when we push off toes when walking or running. They also take on load in these positions due to the need to support the bottom of the foot as it stretches. Load is also felt when we move through standing on that foot when walking or running. This is because forces are attempting to flatten the arch of our foot, and this area needs to support that for reduced stress through joints as well as improved efficiency in our push-off in walking or running. We can mimic the activities that create stretch and increase intensity as tissues adapt through things like load and speed. For a good place to start, check these out!
There are also tiny little muscles on the bottom of the foot that help to take up this load and reduce the burden through the plantar fascia and surrounding muscles. These muscles can be addressed through specific exercises that you can find HERE, but they also get stronger by walking barefoot! People with plantar fasciitis are often told to never go barefoot out of fear of worsening symptoms or threatening the integrity of the arch. However, walking barefoot is a great way to strengthen the muscles of the feet and promote adequate mobility through the many joints of the foot! Now, if your foot is very sensitive, there may be benefits of wearing shoes more consistently in the short term, but as this sensitivity decreases, we encourage you to spend more time around the house without shoes!
Through a combination of controlling inflammation and decreasing sensitivity, strengthening throughout the foot and ankle, as well as promoting the natural strength and mobility of the foot when out of a shoe, we can reduce symptoms of plantar fasciitis and return to the activities that matter most!
If it seems daunting to tackle this on your own, or you’re in need of further guidance, we’d love to be the guide on your journey toward healthier feet!
What is the pelvic floor?
The pelvic floor is something that is simply just not talked about in some cultures, and especially not in regards to some of the functions it serves.
Your pelvic floor is comprised of muscles that act as a sling or hammock to support your pelvic organs. These muscles span from your pubic bone to your tailbone. They work to assist with the ‘5 S’s’:
1. Support - to pelvic organs including bladder/prostate, rectum, vagina, uterus etc.
2. Sphincteric – the ability to keep things in when we want them to stay in and to let them out when we want them out!
3. Sexual – achieving orgasm, erection, lubrication, etc.
4. Stability – assists to stabilize hips, low back, and pelvis during everyday function
5. Sump pump – can help with circulation of blood in and out of the pelvic and genital region
The pelvic floor plays a role in a lot, huh?! Its function is so important in so many things. It works closely with the diaphragm, deep abdominal muscles, and muscles of the spine to manage pressure within the abdomen. This is so important when doing things like jumping, lifting, running, coughing, sneezing, laughing. Your pelvic floor provides support during these demanding activities, maintaining sphincteric control, and stabilizing our center.
Since the pelvic floor muscles play such a large role in many things, if there is dysfunction in this area, it can lead to changes in all those things! With decreased support to the pelvic organs, one might develop a pelvic organ prolapse; poor sphincteric control could lead to incontinence with activity, or changes in urge or frequency to void; there may be changes in sexual function including difficulty with orgasm, pain, or erectile dysfunction for males; decreased stability may contribute to low back or hip pain with activity, difficulty with single leg balance or activities like lifting/pulling/pushing; and dysfunction in this region can reduce the effectiveness of contracting and relaxing which can influence blood flow to and from this area. Despite being involved in many functions and contributing to problems that can be very frustrating and debilitating, a lot of these can be helped through appropriate intervention! It’s important to understand that although a lot of these experiences are common, they don’t have to be a normal part of life!
Through pelvic floor physical therapy, a therapist can identify the most likely cause of whatever you may be experiencing. Sometimes this is weakness in the pelvic floor muscles, sometimes it’s tension or over-activity; other times it may have to do with the hips or low back, posture, or breathing. Whatever it may be, it’s important to narrow this down and create an accurate plan of attack!
If you are interested in learning more about the pelvic floor, the specific functions it serves and how these relate to everyday life, sport, exercise, and activities; as well as the role of a pelvic floor physical therapist, drop in to one of our upcoming workshops!
Looking for more specific guidance or one-on-one care? Click the "Talk With A PT" button and I’ll reach out within 24 hours.
Dr. Elle Carlson
What's the rotator cuff?
Do you know what the rotator cuff is? Do you know it’s not just one thing? Have you ever been told that you’ve hurt (or torn) your rotator cuff?
Despite being discussed as a single structure, there are actually four different muscles that make up the rotator cuff. These muscles travel from different parts of your shoulder blade and attach on the ball of your arm bone (humerus). You may have heard their names before – supraspinatus, infraspinatus, subscapularis, and teres minor. Although these names are fun, no need to become caught up in their differences just yet!
We talk about the ‘rotator cuff’ as one because these muscles work so closely together. It’s their job to help you lift your arm, rotate it when throwing, or reaching behind/across your body; and it’s also their job to assist with stability at the shoulder joint when you reach, lift, throw, push through your arms… or really anything that involves movement at the shoulder!
These muscles are extremely active much of the time – in life, work, exercise, fun, you name it! Because of this, it’s super common to have overuse injuries here. In fact, this is most often how we see a rotator cuff injury develop. There are some instances when a traumatic event leads to an injury; and sometimes these require more invasive treatment. However, most of the time, repetitive motions, certain movement patterns or biomechanics, and time in general can contribute to developing a rotator cuff injury. We often diagnose this as shoulder impingement, although more accurately should be called a rotator cuff tendinopathy.
A surprising bit of info here is how common these ‘injuries’ are! 1/3 of adults over 30 years old will have abnormal findings on an MRI… and that number jumps to 2/3 over the age of 70! Even more, 2/3 of people will have abnormal findings on an MRI even after a surgically repaired rotator cuff. With these stats, does it mean that all of these people need to see a physician or physical therapist? Not necessarily! An MRI detecting an ‘abnormality’ is not an absolute that that person will have pain or dysfunction. We need to assess their function, strength, and ability to do the tasks they need to in their life before making that decision! Many people go through life without issue, even if an MRI would argue otherwise. So, what about those people who do have problems? Shoulder issues are really common, right?
In the absence of a significantly traumatic event, rotator cuff related pain responds very well to conservative interventions. Physical therapy is one of the first treatment options. Interventions include pain management, regaining shoulder mobility, strengthening the four rotator cuff muscles (as well as other muscles of the shoulder), and improving dynamic stability and neuromuscular control - all so those muscles can provide stability through all that life throws at you!
So, if you find yourself with shoulder pain, don’t go running to your physician, to get an MRI, or a cortisone injection just yet! Of course, there is a time and place for these, but we can often save time and money by identifying the root cause of that shoulder pain and providing it with exactly what it needs.
Shoulders are so important for a high quality life! Be sure to give yours the TLC they deserve, and to be proactive about keeping them healthy for the long haul!
Check out some of our favorites for the shoulder on our Youtube Channel.
If you find yourself having a hard time returning to the activities that matter, or your shoulder pain seems to be lingering around, seeking care from a professional can lead to a specific plan for what YOU need. I recommend setting aside 30 minutes to give us a call and figure out exactly what may be causing your pain and how you can resolve it.
We’re always here to talk and answer questions along the way. Cheers!
Dr. Elle Carlson
what should I do for back pain?
What should I do about my back pain? Probably one of the more common questions we get as physical therapists. First and foremost, know that it is extremely common and most of the time, will resolve on its own.
Maybe it happened when you went heavier in your deadlift last week; maybe when you picked up that box at work that was heavier than expected; heck, maybe it happened when you turned to grab your bag out of the backseat of your car - the same thing you’ve done countless times before. Low back pain (LBP) can sometimes come out of the blue, or with the least expected movement or activity… but man can it be intense!
So, you have this new case of low back pain and aren’t sure what to do. It hurts to stand up straight, it hurts to bend over, it hurts to exercise, maybe it even hurts to breathe. What should you do about it?
First, ask yourself these questions: Do I have tingling, numbness, or weakness into both of my legs? Have I had any changes in my ability to pee or poop? Does my back pain wake me in the middle of the night and not allow me to fall back asleep? If you answered no to those questions, it’s unlikely that you need to be racing to urgent care or requesting x-rays and MRI’s right now - yay!
Second, realize that LBP is SUPER common. Like the most common type of pain reported by patients, with 25% of adults reporting LBP in the last 3 months (CDC, 2020). It costs our healthcare system billions of dollars per year, and forces individuals out of work and away from the activities they love for months or even years.
Okay, you probably don’t care much about that… you HURT! What to do in this moment? It’s important to understand that over 90% of low back pain is benign and most cases resolve on their own over time. Even more important than that, it’s crucial to keep moving and maintain some amount of activity in your every day! Low back pain can be miserable and seem unrelenting; however, this part of our body responds very well to gentle movement and activity. Not only will sprinkling some movement into the spine help, but so will increasing your heart rate and participating in some amount of cardiovascular activity. When we increase our heart rate and get blood flowing through the body, we send nutritional products and oxygen to healing tissues, and we decrease the amount of inflammation here. This can all lead to less pain, improved healing, and to YOU feeling better! Another yay! Brisk walking can be plenty for that heart rate increase if your back pain leaves you feeling like you can’t do more. For some gentle activity and exercise related to low back pain, check out some of our videos on YouTube.
As you recover from this acute back pain, remember that the human body is resilient, it adapts to the stresses placed on it, and is stronger than you think! The thoughts and beliefs about our body influence our pain as well as physical capacity more than we may realize. So next time you hurt, ask yourself the questions above, remember that you are strong and capable, and keep moving!
If you find yourself having a hard time returning to your desired activities, or your back pain seems to be lingering for longer than you’d like, seeking care from a professional can lead to a specific plan for what YOU need.
We’re always here to talk and answer questions. Cheers!
Dr. Elle Carlson
Here we are, finishing up this wellness series! This week we’re chatting about the physical dimension of wellness. As physical therapists, we help our patients with physical health on the daily; but this cannot happen without taking the other wellness dimensions into account. This is why we’ve chosen to cover the physical dimension last. The other dimensions of wellness – social, emotional, spiritual, environmental, intellectual, occupational, and financial – have a large effect on physical wellness; and physical wellness has a large effect on these dimensions as well. While the other dimensions of wellness are typically more challenging to wrap our heads around, the physical dimension is relatively straight forward. It involves balancing our physical activity, nutrition, and mental well-being; and is crucial to our everyday health and wellness.
You all know how important it is to be physically active, and I’m sure you know how inactivity can be dire for health and wellness. ‘Sitting is the new smoking’ isn’t just a catchy slogan. But even with all this knowledge, less than 5% of Americans meet the daily exercise guidelines of 30min, and only 33% meet the weekly guideline of 150min. Physical inactivity is thought to be one of the 21st century’s largest public health concerns, and is linked to increased risks of cardiovascular disease, diabetes, and some cancers. It is also thought to be responsible for 9% of premature mortality. So, if it is so important for health and longevity, why is it so hard for Americans to meet the guidelines?
Let’s think about our other wellness dimensions. If you’re surrounded by inactive people, you likely won’t be motivated to exercise yourself. If you tend to bottle up your emotions, or have poor habits related to coping (stress eating, drinking), you likely won’t feel motivated to exercise (although, exercise is a great stress relief if you haven’t tried!). For many, with work and the pressures of today’s productivity, there just doesn’t seem to be enough time in the day for exercise. We’ve all spent time in the vicious cycle of “I don’t feel like exercising today” turning into days without activity and further feelings of ‘sluggishness’, decreased energy, and poor habits. Often when we are experiencing stress stemming from one of the other dimensions, our physical health is usually the first sign that something might be up; whether that’s an illness, fatigue, pain, or countless others.
Our nutrition also plays a large role in our abilities to exercise, energy levels, and of course, health. We won’t be getting into the details of nutrition this time ‘round but being mindful of how you are fueling your body is crucial to feeling your best and finding that motivation for your daily activity. Balancing your wellness dimensions, prioritizing physical activity, and providing your body with proper fuel are all ways to care for this physical dimension.
The American College of Sports Medicine recommends moderate aerobic activity for a total of 150min per week, or vigorous aerobic activity for a total of 75min per week; essentially 30min 5 days per week. Moderate vs. vigorous is determined by your heart rate and perceived level of exertion – moderate being 60-70% of your max heart rate (220 – your age) and vigorous being 80-90% of your max heart rate. You can also think of intensity this way: at a moderate level, you can carry on a conversation, but can’t sing. At a vigorous level, you can’t say more than a couple of words without pausing to catch your breath. It is also recommended that resistance training of major muscle groups occurs two days per week.
That last paragraph may seem a bit overwhelming and technical; and in reality, it’s best to keep it simple! Exercise is often over-complicated, and people are unsure how or what they should be doing – so they just don’t. Physical activity doesn’t have to equal gym membership, CrossFit, road running, or anything formal really. Physical activity can be gardening, going for walks, playing with your kids, doing home projects – anything that gets your heart rate up and makes your muscles work a bit. Formal exercise and training are often needed if you have a specific goal in mind, and for weight loss it is usually helpful to have a program. For the average Joe, find things that you enjoy doing! You are more likely to be consistent if you have fun while being active, and this is a great way to boost your other dimensions as well! (socializing, effective coping, getting outside.)
Along those lines, consistency is key. If you jump in headfirst only to burnout in the first week, it will be hard to start again. Instead, gradually increase your intensity and develop healthy exercise habits over time. In terms of the 30min per day discussed above, this doesn’t have to be in one bout. It’s actually been found to be more beneficial to your body to break this time up throughout your day – taking a walk on your lunch break, walking the dog after work, or a pick-up game in the park – it is often more attainable for people to disperse their exercise throughout their day.
As PT’s we often address physical impairments or limitations after injury, but prevention is key! This is something we can’t stress enough and hope to develop over time through Mobility Innovated. As members of the healthcare community, we hope to see a shift toward preventive medicine, and are eager to be a part of this.
Although we ended with diet and exercise, we hope this QuickRead series has shed some light on our complex wellness dimensions, how they interact, and how prevention and health is much more than just diet and exercise. Every wellness dimension deserves a little TLC for a healthy and fulfilled life, and this starts with you!
Cheers to finishing up our QuickRead series on the Eight Dimensions of Wellness! We are thankful to those of you who have followed along, and grateful to those that have shared our QuickReads and videos to others. We have some ideas for what’s coming next, but in the meantime have some big items on our plates.
We will see you in Oregon!
Elle and Taylor
Occupational & Financial Wellness
This week we’re talking about something that is a big stress factor for many of us. Something that is meant to support us through our lifetime, but something that many spend their lifetime trying to sort out. Something that was definitely NOT covered in school between math, history, and science. This week we’re combining the dimensions of occupational and financial wellness. Seems fitting to pin these two together as they often go hand-in-hand; however, each on its own can be quite daunting as well.
Occupational wellness, of course, has to do with your occupation – your work. It involves the compatibility of your talents, interests, and aspirations with your employment/career, and the satisfaction you feel toward this. Focusing on occupational wellness may inspire one to search for work that will provide personal satisfaction and enrichment toward life. It may inspire one to highlight the aspects of work that brings satisfaction and make the most of those. Developing occupational satisfaction and learning what you want out of your own occupation, can also lead to improved communication of your values and needs with current and future employers. Wellness in this dimension can involve developing effective job search strategies and skills such as interviewing; as well as understanding how a job may affect other aspects of life including family, spouse, recreational activities, and friends. After all, we spend a large portion of our lives at work!
Now, of course it’s not that easy! Not as simple as ‘find what you love and make it your job’. Sometimes a job is needed simply for the sake of making ends meet! Especially now with unemployment skyrocketing, and work hours changing. But, even so, it’s important to reflect on the aspects of work you enjoy, and the aspects of work you loathe. It’s never all going to be rainbows and butterflies, but these things are important! If the ‘Rona has caused your hours to be cut, or your work life to be turned upside down, maybe it’s a good opportunity to reflect on what you truly want out of your occupation; and to make a move if you are able. If you’re currently working, but dread the sound of your alarm clock in the morning, maybe start each day saying ‘I get to work today’ vs. ‘I have to work today’ and find those aspects of your job that bring you satisfaction and gratification; they’re out there.
Your dream job, a decent job, no job, or an okay job – they all have that dreaded counterpart… money. Financial wellness involves developing a satisfying ability for self-management and providing for the needs of yourself and your loved ones; and also, the ability to acquire and apply knowledge regarding financial matters (pretty sure I learned how to write a check in 4th grade??). As you all know, money plays a critical role in all of life; and not having enough is known to impact health. 78% of adults lose sleep worrying about everyday expenses, saving for retirement, and healthcare costs. We’ve already learned about the vicious cycle that sleep and stress live in. Money stress is often the top choice for life stressor across all generations, well ahead of issues with jobs, relationships, and health.
So, what? Better get started on making more money then, huh? We know that’s not easy either. But financial wellness doesn’t necessarily equal more money. After all, mo’ money mo’ problems, am I right? It really comes down to managing money well. Which is much more than writing that check you learned about in 4th grade. It means keeping track of expenses, making a budget and sticking to it more often than not. It means not putting your finances off but making them a priority; and trying to address any financial problems before they start. Keep records of your finances and set budget goals. And (shout out to wellness!) balance your other dimensions, as they tie into your financial wellness by allowing you to work, to work hard, and to have a clear mind about what is realistic, necessary, or obtainable for you personally.
Finances are not simple, and they’re hardly ever easy to manage; and we are by no means your resource for financial advice. However, being more aware of how your financial and occupational wellness dimensions influence your well-being and your livelihood (outside of being able to pay your bills and have a little fun) is important. This will allow you more clarity in making financial and occupation decisions, as well understanding what is important for you not only now, but through the seasons of life.
Next week will be our final week of this wellness series! We’ll be finishing off with the physical dimension of wellness. Something we’re knee deep in every day as physical therapists. This dimension was chosen as our last to cover because as the other dimensions change – for better or for worse – the ramifications often manifest physically. So, stay tuned, and keep your eyes peeled! We’d love for you to join in as we wrap this series up!
If you’ve followed along for this entire series, THANK YOU. We very much appreciate it and hope that we’ve provided some helpful information!
Elle and Taylor
Elle Morgan, PT, DPT