Exercise & Vitamin D3 Save Your Noggin!

As a huge Tennessee Lady Volunteer fan, I am very affected and heartbroken by the recent diagnosis of Alzheimer’s Disease at the age of 59 years old in my favorite basketball coach, Pat Summitt.  While some people may have genetic influences that predispose them to this awful disease, lifestyle has been shown to play a huge role in helping prevent decline in cognition (knowledge) as they age with exercise and taking vitamin D3.  As people age, they normally see a decline in cognition and other bodily processes. New research shows that lifestyle factors have a huge influence on protecting that noggin of yours. Evidence supports that you can reduce your risk for dementia and Alzheimer’s by eating right, exercising, staying socially and mentally active, and reducing stress in your life.  You may even be able to reverse the deterioration of your cognition caused by aging by leading a healthier lifestyle. The main topics I am going to touch on today are exercise and vitamin D3 supplementation and their effects on cognition and prevention of disease. 

Physical exercise has been shown to reduce your risk of developing Alzheimer’s disease by up to 50 percent, according to the Alzheimer’s Research and Prevention Foundation (1).  As discussed in my last post about caffeine and exercise, regular exercise also helps reduce stress, improve mood and energy and can even improve memory! How awesome is that?! If you’re pretty sedentary, you don’t have to go crazy about exercise and start jogging, because you will probably injure yourself.  Start slow by adding daily activities that make you move more, such as taking the stairs instead of the elevator, parking farther away from the store and walking, or even taking daily walks outside around your neighborhood.  Even shopping can be seen as exercise….yup, you got it; you’re walking and burning calories.  Nothing like a little retail therapy ladies, right?? It’s easier when you have a partner in crime too, so grab a friend or significant other and take a walk together every night to help ensure you stick to your routine. 

You’re probably wondering why exercise helps improve your brain’s functioning.  Here are some reasons:

1.       Aerobic exercise increases the amount of oxygen in the bloodstream that goes to the brain.  This increased flow of blood (and oxygen) helps to create new blood vessels in the brain where its responsibility is to create/store memories.

2.       Exercise increases the amount of chemicals in the body (dopamine and norepinephrine) that are responsible for helping the brain with attention, memory, and learning.

3.       Exercise increases brain derived neurotrophic factor (BDNF), which is a protein involved in creation of new cells in the brain.  It also helps the brain in resisting damage and degeneration that occurs with aging.

So there you have it folks, exercise is not only good for your body, but it’s good for your brain! You only get one, so you better preserve it while you can.  Another way of doing so is by taking a vitamin D3 supplement.  Vitamin D3 is the form of vitamin D that your skin synthesizes from sunlight and is useful in disease prevention.  Many people will argue that they are in the sun enough and get the daily amount that way (if you don’t live in Wisconsin in the winter! Ha!), however, research shows that 41 percent of men and 53 percent of women in the United States have low vitamin D levels.  Those that have increased pigment in their skin are at higher risk of low levels, as it can take up to 5 times more sunshine for African Americans to get the same vitamin D response as someone with lighter skin pigment.  Not only is vitamin D important in maintaining brain health, it also has been shown to help prevent the following:

·         Cancer

·         Heart disease

·         Stroke

·         Colds

·         Muscle conditions & Osteoporosis

·         Depression

·         Autoimmune diseases

As with any supplement, it is important to talk to your doctor before you start taking one.  This is due to possible interactions with other medications and your body’s ability to metabolize the supplement.  Supplements are not required to be approved by the Food & Drug Administration (FDA), so it is important you ask a health professional about them before use.  The recommended dosage of vitamin D3 has been raised to about 1000-2000 IU/day to ensure prevention of the above diseases; however, research varies and continues to be done and it depends on the person’s body and how they metabolize the nutrient. 

In conclusion, lifestyle factors can help reduce the risk of Alzheimer’s and dementia by up to 50 percent; however, some people may still be at higher risk for the disease secondary to genetic factors.  Regular exercise is beneficial to your cognition by helping improve function of the brain, attention, and memory.  Vitamin D3 has also been shown to reduce the risk of dementia and several conditions/diseases when taken daily at a higher dosage.  So it’s time to start exercising and taking some vitamin D3 to help ensure a longer-lasting healthy brain. 

Resources:

1.       http://www.helpguide.org/elder/alzheimers_prevention_slowing_down_treatment.htm

2.       http://www.aurorahealthcare.org/yourhealth/wellness/whitcomb/default.aspx

3.       Exercise & Cognition: Can Exercise Make You Smarter Tri-fold by Katie Kowalski, DPT

Caffeine or Exercise??? That is the Question!

Last week a man came into my clinic and tried to advertise sales for “5 Hour Energy”.  He wanted to sell it in my clinic.  As a huge advocate for exercise, I firmly disagreed with the idea of selling an energy drink in my PT clinic.  So many people are turning to caffeine products to get their daily dose of energy, instead of realizing that this effect is only temporary and can cause health problems or even addiction to caffeine.  Caffeine is highly addictive and can cause withdrawal symptoms, leading to increased use of the product and ultimately leading to a downward cycle for dependence on more and more caffeine for that energy kick.  What people don’t realize is that exercise, adequate sleep, and a healthy diet have been shown to give you long-lasting energy that energy drinks can’t provide and they’re a much healthier option for you.  Don’t get me wrong, I love a good cup of coffee or a can of soda, but I know that they are only temporarily providing me relief for fatigue.  Today I am going to discuss the differences between caffeine and exercise for daily energy.

Caffeine is useful for short-term boosts of energy.  Most energy drinks contain a large amount of sugar and other substances that can lead to weight-gain and unhealthy side effects such as:

·         Nervousness

·         Increased heart rate

·         Increased blood pressure

·         Irritability

·         Decreased ability to sleep

·         Anxiousness

Foods and drinks with caffeine and a large amount of sugar may provide that short-term kick that you need; however, they can actually cause you to be more fatigued later, leading to increased use of caffeine for more of a boost.  They may also be loaded with vitamin B which will make you think they are healthy; however, fish and vegetables have plenty of B vitamins to jump start your energy, instead of the increased load of sugar and other empty calories your body doesn’t need from these energy drinks. 

Exercise has been shown to have awesome physiological benefits on the body, including reduction of fatigue.  Below is a list of positive effects brought to you by regular exercise:

·         Decreased blood pressure

·         Improved cholesterol and fat levels

·         Decreased resting heart rate

·         Maintained flexibility of arteries

·         Improved mood and energy level

·         Stress relief

·         Decreased pain (if pain is caused my disuse of muscles and joints that stiffen)

Now if you go ahead and compare the effects of caffeine and exercise on your body, you will see that they are complete opposites.  You can clearly see that exercise is the healthier option here. 

Most people will argue that they are too busy to exercise and I will argue right back with my favorite quote from a sports ad, “Someone busier than you is running right now.”  It’s true…most people can find time in their busy lives to exercise, but most often they don’t want to fit it in their schedules.  They feel they are too tired or stressed, but if you have learned something above, you will see that these things can be reduced with a regular exercise program! Yayyyy!  Stress is a huge contributor to fatigue in our society. We are overworked, undernourished or overnourished with poor food choices, and lack proper sleep and exercise routines.  Most people want that quick fix and don’t want to fix the underlying framework behind why you’re fatigued in the first place.  If you take a rubberband and wrap it around your finger as tight as you can, it’s pretty painful right? Well hmmm, we could numb it with a shot right??? Well that would only be temporary. Ok, well let’s kill the pain with pain killers….and again, the rubberband is still there and you’re masking the main problem. Well let’s just take it off of our finger! BINGO! That’s the answer. We have to fix the underlying cause and in this case, that's with regular exercise, a healthy diet, and improved sleep patterns. Now some people may have fatigue for other medical reasons, other than poor diet, lack of exercise, and stress.  These people that suffer from chronic fatigue and don’t find relief with change in their diet, improving sleep patterns, or regular exercise should seek a qualified physician for further medical investigation. 

So what are you gonna choose to do next? I guess that’s the main question.  If you decide that exercise is for you, the American College of Sports Medicine (ASCM) provides guidelines for exercise and its benefits.  Below is a list of these guidelines from their website:

Cardiorespiratory Exercise

·         Adults should get at least 150 minutes of moderate-intensity exercise per week.

·         Exercise recommendations can be met through 30-60 minutes of moderate-intensity exercise (five days per week) or 20-60 minutes of vigorous-intensity exercise (three days per week).

·         One continuous session and multiple shorter sessions (of at least 10 minutes) are both acceptable to accumulate desired amount of daily exercise.

·         Gradual progression of exercise time, frequency and intensity is recommended for best adherence and least injury risk.

·         People unable to meet these minimums can still benefit from some activity.

Resistance Exercise

·         Adults should train each major muscle group two or three days each week using a variety of exercises and equipment.

·         Very light or light intensity is best for older persons or previously sedentary adults starting exercise.

·         Two to four sets of each exercise will help adults improve strength and power.

·         For each exercise, 8-12 repetitions improve strength and power, 10-15 repetitions improve strength in middle-age and older persons starting exercise, and 15-20 repetitions improve muscular endurance.

·         Adults should wait at least 48 hours between resistance training sessions.

Flexibility Exercise

·         Adults should do flexibility exercises at least two or three days each week to improve range of motion.

·         Each stretch should be held for 10-30 seconds to the point of tightness or slight discomfort.

·         Repeat each stretch two to four times, accumulating 60 seconds per stretch.

·         Static, dynamic, ballistic and PNF stretches are all effective.

·         Flexibility exercise is most effective when the muscle is warm. Try light aerobic activity or a hot bath to warm the muscles before stretching.

Neuromotor Exercise

·         Neuromotor exercise (sometimes called “functional fitness training”) is recommended for two or three days per week.

·         Exercises should involve motor skills (balance, agility, coordination and gait), proprioceptive exercise training and multifaceted activities (tai ji and yoga) to improve physical function and prevent falls in older adults.

·         20-30 minutes per day is appropriate for neuromotor exercise.

It is important to fit these things into your workout routine to improve your overall health and well-being.  Going for a walk during a lunch hour is a huge start to jumpstart energy in the middle of the day to fight that post-lunch fatigue.  Movement is power. Join a yoga class to reduce stress and improve flexibility and mindfulness.  If you need that extra kick in the butt to get moving, get a personal trainer.  Visit http://igo-fitness.com/ and check out their awesome training and yoga classes.  You can still have caffeine in your life, but just remember the risks vs. the benefits.  Is that short-term wakefulness worth it overall or would you rather exercise and eat healthier to not only boost energy, but also improve overall health? That’s your ultimate decision. 

References:

http://www.livestrong.com/article/465128-the-effects-on-exercise-on-energy-levels/

http://www.greatist.com/fitness/new-acsm-exercise-guidelines/

http://igo-fitness.blogspot.com/2011/09/568-hour-energy-and-worx.html#!/2011/09/568-hour-energy-and-worx.html

http://www.mayoclinic.com/health/caffeine/NU00600

My Knee Hurts...So Why Are You Looking At My Hip???

Are you struggling with knee pain? If so, you may have gone on Google and searched treatments for knee pain and found a bunch of websites that advertise injections and other temporary pain relief solutions.  I have discussed pain in past posts and again I will tell you that pain is your body giving you the “check engine” light. You have pain for a reason and shouldn’t ignore it or mask it with medication or injections.  Injections, medications, and other modalities used to relieve pain can and should be used in conjunction with other forms of treatment to help relieve pain and reduce the body’s natural inflammatory response; however, you should not rely solely on them to help make your issue go away completely. Searching the internet, you may have also came across people discussing hip strength related to reducing knee pain.  Today, I am going to discuss the diagnosis of plain old “knee pain” that I get from referring physicians and the importance of looking at the whole picture, especially hip strength. 

Knee pain can be caused by several different factors, such as trauma, acute injury, the aging process, or onset of new activities.  Knee pain is not always the result of trauma.  Most of my patients with knee pain have it for years and they have no idea how it started, while others recently started running or exercising and their body did not tolerate it too well because they progressed themselves too fast.  If you have gone to physical therapy in the past, they may have tried to give you exercises to strengthen your hips and butt and you may have looked at them like they were crazy because your pain was in your knee.  The truth is that everything is connected when your foot hits the ground and your hips are key supporters of your knee.  Your quadriceps and hamstrings help control your knee in the plane of movement that causes your knee to flex (bend) and extend (straighten).  These muscles do not tend to help much with rotation as your foot hits the ground and this is where your butt comes in handy! Your gluteus medius (as shown below) helps stabilize your knee and prevents it from rotating too much as you take each step.  It does this by stabilizing your pelvis and core, to prevent it from placing the joints below, such as your knee and ankle, in a detrimental position. 

Reference

This detrimental position I am referring to is called dynamic valgus (shown below), or the knee moving inward with squatting, jumping, walking, transferring from standing to sitting in a chair, running, or other daily activities.  It is important to note that some people have a natural valgus at both knees, and may be subject to further wear and tear at the knee joint with increased activity levels.  The strength of your hips/glutes and the way your foot hits the ground plays a huge role in the way your entire leg absorbs impact.  If you have weak glutes, your knee joint may be absorbing more impact when your foot strikes the ground instead of your hips, which may cause pain and increased chance for joint damage.  Another thing to keep in mind is that you may also need different shoes or orthotics (shoe inserts) to help stabilize your foot as it hits the ground.  If your arch drops when you squat or walk, you may be told that you “pronate”.  This also places your knee at greater risk for injury and should be analyzed further. 

Reference

There are so many factors that can contribute to knee pain, so proper analysis is recommended.  As a physical therapist, I take a look at the whole picture and find what is causing your knee pain.  I assess strength, range of motion, flexibility, and dynamic movement.  I also give suggestions for proper footwear and orthotics, as well as assess running mechanics if my patients run frequently.  My main goal is educating the patient to help fix the problem and prevent it from reoccurring in the future.  If your knee pain is caused by trauma, I assess the integrity of ligaments, muscles, and tendons around the area and refer to a physician for imaging, such as x-rays or MRIs, if my findings warrant further investigation.  I use modalities such as ultrasound, electrical stimulation, and ice/heat to help reduce inflammation and pain in the area to aid healing.  I recommend a combination of knee and hip strengthening exercises to my patients to help them improve their mechanics as they move.  Usually, with a combination of modalities for pain, flexibility and strengthening exercises, my patients are pain free within a few weeks.  (Please note that healing time varies by the person, lifestyle, age, and anatomy) If you want your knee pain further evaluated today, give us a call. It’s never too late to get back to the activities you love most!

608-222-2325

Runners Beware: IT Band Syndrome Can Haunt You

The weather is changing and avid runners are anxious to get off of those treadmills and begin running outside as the snow and ice begin to melt.  As people begin to train for races or start running for pleasure, they may not be aware of training principles and proper progression of distance and time of runs. Being unaware of properly progressing your runs or exercise routine can cause injury.  Even if you have been running a certain mileage for awhile, your body may not be strong enough to handle it if you are not performing a regular strengthening regimen.  Once your muscles get fatigued, your body can begin to compensate for tired muscles and cause your body mechanics to change eventually giving rise to injury.  Several injuries can occur, however, today I will specifically be discussing the ugly Iliotibial (IT) band syndrome that causes runners to have excruciating hip and knee pain. 

Reference Page 

As displayed above, the long white band of tissue on the outside of your leg is your IT band.  IT band syndrome is caused when your IT band, the band of tissue that attaches from your ilium (outer pelvic bone) to the outside of your tibia (shin bone) and patella (knee cap), becomes taut and can cause lateral tracking of your patella or friction (rubbing) on the top or end of your femur (thigh bone).  This can cause diffuse pain and tenderness in the hip region or the outside of your knee.  If irritated severely enough, you may feel like your knee is "locking" when trying to bend or extend your knee or you may feel like your hip is "popping" or "snapping".  This whole phenomenon can be caused by muscle strength and flexibility imbalances, as well as with fatigue during prolonged running causing faulty mechanics that lead to injury. 

If this sounds like something you're experiencing, there are some home remedies you can try.

1.  First and foremost, ice and rest are ways to help relieve immediate pain. Icing for 10-15 minutes every couple of hours can help relieve inflammation. Also, if you are able to take ibuprofen, it is best to take that with food for a few days as directed by the bottle to help reduce inflammation further.  If unable to take ibuprofen, other pain relievers can help with reduction of symptoms.

2. One of the best things to do for this injury is using a foam roller to massage the IT band to help stretch out and loosen up the tissue.  Let me warn you that this is painful and most people aren't fans of this exercise, however, I promise that it gives good results.  If you or your gym do not have a foam roll you can purchase one for a reasonable price at Amazon.com, or it is ok to use a tennis ball, coffee can, basketball, PVC pipe, or other object that is somewhat dense and able to roll along your leg.  The harder the object is, the more massage you will get, however, it can be pretty painful if you start with a very dense object like a PVC pipe or coffee can.

*Start with the foam roll positioned under your hip on the painful side (as pictured above) and begin to slowly move your body upward so the foam roller rolls down the side of your leg towards your knee.  You can use your other foot and arms to help you move along the roller. 

*Once you have reached the outside of your knee (as pictured above), you can begin rolling back towards your hip.  You will repeat this slowly 10-15 times.  It is wise to perform this on both legs so that you can keep both IT bands from becoming tight.

3.  Strengthening of the gluteus medius (hip abductor) and gluteus maximus (buttocks) muscles is highly recommended for people with IT band syndrome.  If these muscles are weak or fatigue during running, it can cause your pelvis to be unstable with running and cause your knee to rotate inward when your foot hits the ground.  This inward rotation of the knee can cause not only your IT band to get stretched and irritated with every step, but can also cause further knee and foot injury.  Below are some great exercises you can perform to strengthen your glutes!

*Side Stepping with Band: If you have a theraband (elastic band) that you can tie around your ankles, this exercise is great to work the gluteus medius.  You will perform a slight knee bend, keeping your butt back and preventing your knees from going over your toes, while you step sideways across the room with the band. It is important to make sure your knees do not rotate inward with each step and that you keep your toes facing forward.  This should be performed with 15-20 steps in each direction once a day. 

*Sidelying Leg Lift: This exercise can be performed anywhere and is great to activate the gluteus medius. Lay on your side with your bottom leg slightly bent.  Keep the top leg straight and lift it straight up and down, making sure that the leg does not come forward at all.  To get good gluteus medius activation, it is recommended that you keep your leg slightly extended while you lift it.  Perform a couple sets of 20 repetitions once a day on each side.  If you have ankle weights, you can add one to three pounds to progress this exercise. 

*Singe Leg Bridge: The single leg bridge is a great way to isolate your glutes.  Bend one knee in towards your chest (or you can hold it out straight with your knee extended) and bend the other knee up and keep your foot on the ground.  Keep your stomach muscles nice and tight while slowly lifting your butt off of the ground and back down.  Be sure that your pelvis remains level the entire time. Peform a couple sets of 10-15 repetitions on each leg once a day.  ***Please note that this exercise is advanced and may be too difficult for some people.  If this is the case, start by keeping both feet on the ground and lifting the butt up with both legs, instead of one.***

*Body-Weight Squat (with or without theraband): Another great glute strengthening exercise is the body-weight squat.  This exercise, if done correctly, should not cause pain.  If it does cause knee pain, please do not perform it or contact a physical therapist or personal trainer for advice.  Start with your feet shoulder width apart and your toes facing forward.  Slowly squat down, keeping your butt backwards and your knees in line with your feet.  The key thing to remember with squats is that your knees should not go inward or over your toes.  You can stick your arms out in front of you or hold onto a sturdy object for balance if needed.  If you have a theraband, you can place it around your knees for added gluteus medius activation.  The band will want to pull your knees inward and you must resist it in order to keep them in good alignment.  Perform a couple of sets of 15-20 repetitions once a day.

It is important to note that the strengthening exercises should not cause pain.  You may feel a slight burning or achy sensation in the muscles when the muscle is working during the exercise, however, this is normal and should not be a sharp pain.  Also, with any new exercise routine, it is normal to have muscle soreness up to 24-72 hours after exercise.  To help with reducing this soreness, it is best to keep moving around, stretch, and drink a lot of water to help flush the muscular tissues. 

I suggest trying these exercises to help relieve your pain and take a break from running until your pain subsides. You can perform other non-painful aerobic activity in the meantime. If your pain does not relieve itself within a few weeks, it is best to seek help from a physical therapist.  If you do not feel comfortable trying these exercises without the advice of a professional, feel free to seek help right away.  Physical therapists can provide pain and inflammation relieving strategies such as ultrasound, electrical stimulation, and iontophoresis, as well as help mobilize the soft tissue with manual therapy and massage techniques and give further education on stretching and strengthening exercises you can perform to decrease and get rid of your symptoms.  We can also take a look at your feet and suggest types of shoes you should be wearing, assess your running technique and provide any helpful hints on improving your form to decrease likelihood of further or future injury, and give ideas on things to avoid or how to progress your training regimen. 

If you think you have IT band syndrome or if you just want your running form or shoewear assessed professionally, please give us a call today!

608-222-2325