Healthy Living

The Axial Spine and Adrenal Medulla Connection

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Scientist are discovering connections between the muscles and nerves that control the axial spine and the adrenal medulla. In other words, they are discovering that there is a neural connection between the core muscles and one’s ability to feel or handle stress. Perhaps standing up tall can actually make you feel more confident and less susceptible to stress?

“The Pitt team didn’t think the primary motor cortex would control the adrenal medulla at all. But there are a whole lot of neurons there that do. And when you look at where those neurons are located, most are in the axial muscle part of that cortex.” (Hamblin, 2016).             Read more here.

One Approach to Build a Habit and Why Exercise Should Never be Self Torture

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“If you hate the monotony of running on the treadmill, but drag yourself to the cardio room daily, believing self-torture will eventually become a habit—that’s not heroic; it’s bad design.” (MacLallen, 2017)

So many people initiate health goals by putting themselves on severe diets or exercise regimens believing that in order to see change in their bodies and health they MUST SUFFER. The truth is this approach often leads to failure and long term healthy habits are built gradually. Along with a slow and steady approach one should seek habits that bring themselves pleasure. If you don’t like running, as is my case, explore different cardiovascular activities that you enjoy until you find one that is enjoyable. For me this is anything dance related and cardio kickboxing classes. Also, build your exercise routine gradually. Maybe start with blocking out 2 days of exercise per week for 1 month, then add one extra day per month over the next few months; this will give yourself time to adjust physically and mentally.

A Stanford psychologist and researchers has developed a helpful 3-step method to establish habits:

Fogg Method

  1. What is your desired outcome?
  2. Identify some easily achievable “tiny habits”.
  3. Identify and implement trigger for “tiny habit”.

Read more about Fogg and his approach here.

The Importance of Strength Training and Protein

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This is a great article that goes over the importance of a well balanced diet and exercise routine. So many of us get stuck into eating limited food groups, i.e. limiting our mineral and vitamin intake. The same goes with exercise, I often notice people who just do cardio or just do strength training when both forms are important to complete health. This article reviews one of the key benefits of strength training, increased resting metabolic rate. Also, it reports on a study of a high protein diet. It’s important to note that this high protein diet was not high in protein because it was low in carbohydrates. I’ve mentioned this in previous articles, complex carbohydrates such as whole grains are a necessary component to cardiovascular health. Rather than a low carbohydrate, high protein diet, the diet was low in fat and high protein.

The Keys to Health – Diet, Exercise, and Altruism?

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altruism“When Canadian tenth-graders in a recent study began volunteering at an after-school program for children, the high schoolers lost weight and had improved cholesterol profiles compared to their non-volunteering peers. (Even in Canada, teenagers have cholesterol problems.) In the journal JAMA Pediatrics, the researchers concluded, “Adolescents who volunteer to help others also benefit themselves, suggesting a novel way to improve health.”

In another randomized controlled trial at Washington University in St. Louis, older adults who began tutoring children through a program called Experience Corps demonstrated improvements in stamina, memory, and flexibility, as well as levels of depression. When I spoke with Kim last year, he attributed at least part of those gains to the effects of a sense of purpose in life.” (Hamblin, 2015)

Read more here.

Just Breathe!

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whale-just-breathJust breathe! But, how, what does this look like, and why should I do it?

We will go over the how and what in a bit, but let’s start with the why.

Why Breathe? (Aside from the obvious)

Focused, deep breathing has been associated with a multitude of health benefits:

  • reduced stress
  • reduced depression
  • reduced anxiety
  • reduced insomnia
  • enhanced immune system
  • decreased pain

Here is a NYT article that briefly reviews some of the benefits of breathing. My favorite part of this article is at the end where it explains 5 deep breathing techniques that you can easily practice. Also, here is another article from Harvard Health Publications that again briefly reviews the benefits of breathing and provides some tips to incorporate a breathing practice into your daily life.

What does proper breathing look like.

In general, when you inhale (inspiration) your rib cage draws upward and expands three dimensionally. When you exhale (expiration) your ribcage drops and deflates 3 dimensionally. When I say 3 dimensionally, I am referring to the anterior, posterior, and lateral surfaces of your ribcage.

How do I breathe? What muscles are involved?

Did you know that there two different levels of inhaling and exhaling. These levels of breathing are known regular or passive inhaling/exhaling and forced or active inhaling/exhaling. Inhaling and exhaling, both in regular and forced forms require different structural movements and therefore different muscular actions. The following video summarizes these concepts nicely. Note how transversus abdominis facilitates forced expiration and how the neck muscles, sternocleidodmastoid and the scalenes facilitate forced inspiration.

And here is another video the reviews the mechanics of breathing in a more detailed fashion.

Enjoy and breathe on!

More on the Sacroiliac Joint – SI Joint Dysfunction

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More Arabesque!

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Yes, I am a dancer. Yes, I have an affinity for exercises that incorporate lengthening one’s self and balancing in odd positions. With that said, here is another arabesque variation, this time on the Stability Chair. This variation can be easily modified with increased/decreased resistance and repetitions to make for either an intermediation or advanced exercise.

Enhance your Running Performance with Pilates

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eve's lungeAccording to Christine Carbo, of Women’s Running, Pilates cross training enhances runners performance for the following reasons:

  • Increased core strength
  • Improved postural balance
  • Reduced injury risk
  • Increased muscular endurance and speed
  • Quicker and more comprehensive recovery
  • Improved breath control
  • Improved balance

Read more details here.

What do the Mediterranean and Japanese Food Pyramids have in Common?

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As a new mother I am entering the phase where my son will be eating food from my plate, so I am even more inspired to make quick and healthy homemade meals. One of my favorite quick and healthy go to meals is an Asian chicken noodle salad with a peanut sauce base. I found this recipe which pretty closely mirrors how I make my version.

mediterranean food pyramidMy personal definition of healthy eating incorporates the following ideals:

  • As often as possible organic, hormone and pesticide-free products
  • Incorporate unsaturated fats such as fish and vegetable based fats
  • Limit saturated fats such as animal and dairy-based fat
  • Limit processed products as much as possible
  • I believe that breaking my own rules every now and then provides a much needed mental respite.

I don’t believe in diets that eliminate whole food groups. In fact I don’t like the word diet at all. Balance-wise I like my food intake to model the Greek or Japanese food pyramids.

Japanese_food_pyramidJapan and Greece rank among the nations with the lowest heart disease rates. Two things to note:

  1. According to the World Health Organization Ischemic heart disease is the leading cause of death worldwide.
  2. Grains are a major component to these food pyramids, the opposite of a trendy diet that rhymes with the word radio.

Eat well and be well!

Motherhood, Leaky Bladders, and Back Pain – Part 2

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In last week’s blog post, “Motherhood, Leaky Bladders, and Back Pain – Part 1” I introduced the musculoskeletal structures of the pelvic diaphragm and their purpose. This week’s follow-up post will cover:

  • Correlation Between Chronic Back Pain and Stress Urinary Incontinence
  • Pelvic Diaphragm Facilitation and Multifidus Facilitation
  • Exercises to identify the Muscles of the Pelvic Diaphragm!!!
  • Exercises to Strengthen Muscles of the Pelvic Diaphragm

Correlation Between Chronic Back Pain and Stress Urinary Incontinence

Research has established the role that the pelvic diaphragm muscles play in continence.  Given that the pelvic diaphragm muscles facilitate sacroiliac joint stability, which in turn support lumbar vertebral column stability, one could hypothesize that there is a positive correlation between chronic back pain and stress urinary incontinence.  That is, the likelihood of having stress urinary incontinence is increased if one suffers from chronic back pain.

Bush et al., (2013), conducted a survey of 2,341 women who suffered from chronic back pain and found that 44% of these women also suffered from stress urinary incontinence (p.4).  Furthermore, Bush et al., (2013), references multiple studies with similar findings:

Finkelstein et al reported a strong association between “back problems” and UI in both men and women.  A cross-sectional study of women only by Smith et al found a relationship between continence disorders and back pain “in the past 12 months.”  In addition, Kim et al found women with greater UI severity also have a higher perceived severity of LBP and LBP perceived disability.  Lastly, Elliason et al surveyed women who were receiving physical therapy for LBP and reported 78% of these women also reported UI  (Bush, Pagorek, Kuperstein, Guo, Ballert, and Crofford, 2013, p.2).

Multifidus
Multifidus

Pelvic Diaphragm Facilitation and Multifidus Facilitation

Multifidus originates at the sacrum, the posterior superior iliac spine, the mammillary processes of the lumbar vertebrae, the transverse processes of the thoracic vertebrae, and the articular process of C04-C07.  It inserts to the spinous process two to four vertebrae superior from it’s origin.  According to Martini, Nath, Bartholomew (2012), it’s action is to extend the vertebral column and rotate towards the opposite side (p.341).

A study involving thirteen men and women who had chronic low back pain was conducted by Huang et al.  The goal of this study was to investigate the effects of an intervention that involved: 1) proprioceptive neuromuscular facilitation, 2) neuromuscular joint facilitation, and 3) neuromuscular joint facilitation combined with pelvic diaphragm muscle exercises.  According to Huang et al. (2013), neuromuscular joint facilitation combined with pelvic diaphragm exercises produced the greatest multifidus change (p.813).  Huang et al. (2013), speculates that while neuromuscular joint facilitation promoted isometric contractions of the multifidus, the pelvic floor exercises promoted increased intraabdominal pressure, thereby increasing lumbopelvic stability and enhancing the effectiveness of multifidus (p.813).

Case Study

Jellad, Bouzaouache, Salah, Migaou, & Sana (2009), conducted a case study in which they designed a rehabilitation program for a patient suffering from osteoarthritis of the sacroiliac joint.  The rehabilitation program involved strengthening the transversus abdominis, internal obliques, coccygeus, pubococcygeus, and iliococcygeus, as well as stretching psoas (p.511).  The program was found to have a positive effect on reducing the patient’s pain and functional impairments.

Exercises to identify the Muscles of the Pelvic Diaphragm!!!

Calais-Germain (2003) recommends the following two exercises for identifying muscles of the pelvic diaphragm:

  1.  Balloon Exercise
    1. While sitting, pretend you are blowing into a balloon.  Look to identify one of the three possible pelvic region responses:
      1. blowing caused the urge to urinate
      2. blowing caused the pelvic floor to be pushed down
      3. blowing caused the pelvic floor to draw up (p.104)

Calais-Germain (2003), notes that the urge to urinate is symptomatic or weak pelvic diaphragm, while the drawing up sensation is symptomatic of well-toned pelvic diaphragm (p.105).

  1. Face Cloth Exercise
    1. Fold a small face cloth into quarters.  Place the folded cloth between the two ischia, and between the coccyx and the pubis.
    2. Notice  pelvic sensations during normal breathing and while practicing the balloon exercise in this position.

Exercises to Strengthen Muscles of the Pelvic Diaphragm

Calais-Germain (2003) recommends the following exercises for strengthening muscles of the pelvic diaphragm:

  1. In a sitting, or supine-crook position, visualize your two ischia and your pubic symphysis.  From here mentally visualize two inches above the ischias and pubic symphysis.  Now, draw theses two areas of visualization upward and inward.
  2. Contract your anal sphincter.  Notice how it constricts and draws up.  Now, try to contract your anal sphincter without constricting it, but just drawing it up.
  3. After performing the above exercises, relax completely and feel the weight of pelvic organs dilate.

The research suggesting that pelvic diaphragm muscles enhance lumbopelvic stability is convincing.  Pel, Spoor, Pool-Goudzwaard, Hoek Van Duke, and Snijders (2008) showed a decrease in sacroiliac joint shear force by 20% with a 400% increase of transversus abdominis and pelvic diaphragm muscles (p.415).   Additionally, Bush et al. showed that nearly one-half of women who suffer from chronic low-back pain also suffer from urinary incontinence (p.4).  Huang et al (2013), suggests that the compressive forces that the pelvic diaphragm muscles can exert between the coxal bones and the scarum enhance lumbar vertebral and trunk stability (p.813).  Lastly, Jellad, Bouzaouache, Salah, Migaou, & Sana (2009) successfully applied a rehabilitation protocol for a women suffering from sacroiliac joint pain that involved pelvic diaphragm exercises (p.511).

That’s it ladies (and gents) not only will strengthening your pelvic floor muscle recover urinary incontinence it will also enhance lower back strength. Get to it, find those pelvic floor muscles and when you can, incorporate pelvic floor contractions into whatever exercises you are working on, whether that be supine ab exercises, standing arm exercises, leg exercises like squats, or whatever. Now, onward, upward, and inward!

References

Bush, H. M., Pagorek, S., Guo, J., Ballert, K. N., & Crofford, L. J.  (2013).  The Association of Chronic Back Pain and Stress Urinary Incontinence: A Cross-Sectional Study.  Journal of women’s health physical therapy, 37(1), p.11-18.  doi: 10.1097/JWH.0b013e31828c1ab3

Calais-Germain, B.  (2003).  The Female Pelvis: Anatomy & Exercises.  Seattle, Wa.: Eastland Press Inc.

Floyd, R.T.  (2012).   Manual of Structural Kinesiology.  New York, NY: McGraw Hill.

Huang , Q., Li, D., Yokotsuka, N., Zhang, Y., Ubukata, H., Huo, M., & Maruyama, H.  (March 1 2013).  The Intervention Effects of Different Treatment for Chronic Low Back Pain as Assessed by the Cross-sectional Area of the Multifidus Muscle.  Journal of Physical Therapy Science, 25(7), p.811-813.  doi: 10.1589/jpts.25.811

Jellad, A.,  Bouzaouache, H., Ben Salah, Z., & Sana, S. (July 2009).  Osteoarthritis of the sacroiliac joint complicating resection of the pubic symphysis. Interest of a rehabilitation programme.  Annals of Physical and Rehabilitation Medicine, 52(6), p.510-517.  doi: 10.1016/j.rehab.2009.03.002

Martini, F. H., Nath J. L., & Bartholomew, E. F.  (2012).  Introduction to Anatomy and Physiology.  San Francisco, CA: Pearson Education Inc.

Nestor, K.  (n.d.).  Sacroiliac Joint.  Physiopedia.  Retrieved from: http://www.physio-pedia.com/Sacroiliac_joint.

Pel, J. J. M., Spoor, C. W., Pool-Goudzwaard, A. L., Hoek Van Dijike, G. A., & Snijders, C. J.  (18 January 2008).  Biomechanical Analysis of Reducing Sacroiliac Joint Shear Load by Optimization of Pelvic Muscle and Ligament Forces.  Annals of Biomedical Engineering, 36(3), p. 415-424.  doi: 10.1007/s10439-007-9385-8

Visible Body Software.  (2014).  [All images].

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