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Understanding the Causes of Recurring Musculoskeletal Pain and Injuries

/1 March 2023/ All MFN blog/

Musculoskeletal injuries from trauma, repeated activities, or overused joints or muscles are very common — in fact, almost every one of us will get injured at some point in our lives. Most of the time, it will reoccur and become more serious when left unattended or untreated. When repeated injuries happen, it is very likely not due to a one-off fluke.

So why do we constantly get hurt at a specific joint or muscle? And why does the pain seem to travel elsewhere after?

The human body is complex and designed to move in countless movement patterns. When we move, kinetic energy travels from our feet to our neck and head. This concept is called the Human Body Kinetic Chain Movement. Our skeletal system consists of various joints linked in a chain, each with specific purpose and function.

Stability and Mobility at the Joints

When our joint is not functioning as it is intended to, our body will adopt a dysfunctional movement, which can lead to acute pain in our joints or muscles. If not corrected, chronic pain can happen. A sedentary lifestyle, past injuries, poor posture and misalignment, stress, health conditions, diseases, and other factors can lead to the development of dysfunctional movement.

Here’s an example of a common dysfunctional movement at the lower proximity. If your ankle (which is supposed to be mobile) is stiff, your body will seek mobility at the knee which is supposed to act as a stable hinge. A painful knee typically develops as a result. In another scenario, if you spend extended periods of time sitting and experience restricted mobility at your hips, your body may compensate by seeking mobility at your knee or lumbar spine. This reversal of joint roles can lead to injury or pain in the affected joint or muscle.

Continuing to compensate for the long term can cause a cascading effect such as muscle imbalances, poor neuromuscular function and muscle atrophy or hypertonicity.

One of the common mistakes we make is to only address the symptom (pain) with the use of NSAIDs, massage, chiropractic therapy and other non-invasive or invasive treatments, rather than addressing the underlying cause of the problem.

Another widespread misunderstanding is the idea that simply strengthening the muscle at a joint can solve the problem, without considering its kinetic chain relationship. For example, strengthening the quadriceps to alleviate knee pain, without taking into account the mobility of the ankles and hips or the stability of the lumbopelvic area.

That’s why it’s crucial to have a comprehensive understanding of how our bodies are designed to move, and to identify any weak links in our body’s kinetic chain to ensure optimal recovery through appropriate rehabilitation measures, and not view the problem in isolation.

Typically, it is advisable to conduct an assessment initially to pinpoint the root of the problem. However, when a patient presents to my clinic in pain, they often exhibit compensatory movement patterns that can yield false positives/negatives results. For this reason, my approach is to first identify the type of pain or injury they are experiencing and address their pain as a priority. To reduce their pain levels, I utilize methods such as soft tissue manipulation and other therapies that are appropriate for their condition.

Soft tissue manipulation and manual therapy, such as massage has been proven to:

  • alter pain signal at the central nervous system,
  • manage inflammation,
  • inhibit muscle spasm and reduce muscle tonicity,
  • improve blood circulation and oxygenation to the injured tissue,
  • and improve mobility and flexibility at the joint.

It is best to engage a practitioner who is trained or skilled in this field, or perform self myofascial massage by using a foam roller or trigger point massage ball under guidance.

Once the pain has been adequately managed, I will proceed with a thorough assessment to identify any potential weak links in the person’s kinetic chain. After that, they will begin an active treatment program that includes targeted stretches, mobility drills, and muscle reactivation exercises through a set of neuromuscular exercises. The rehabilitation program also emphasizes teaching the person to disassociate their movements and joints through specific exercise drills, which re-trains their brain to use their muscles and joints as it is supposed to. As soon as they are able to correct their dysfunctional movement, it is highly recommended to strengthen the entire structure based on function, rather than relying solely on brute strength.

Understanding the concept of our body’s biomechanics and how kinetic chain work can help you better manage or even resolve musculoskeletal injuries holistically, and not just detaching the problem to a specific joint or muscle.

Do take note that different types of musculoskeletal injuries may require different forms of therapy or approach. It is extremely important to seek a professional’s help to determine the appropriate care for your musculoskeletal pain or injury.

Ke Wynn Lee is an author and an international award-winning corrective exercise specialist currently owns and operates a private Medical Fitness Center in Penang. Apart from coaching, he also conducts workshops and actively contributes articles related to corrective exercise, fitness & health to online media and local magazines.

References

Field, T. (2014). Massage therapy research review. Complementary Therapies in Clinical Practice.

Moyer, C. A., Rounds, J., & Hannum, J. W. (2004). A meta-analysis of massage therapy research. Psychological Bulletin.

Crane, J. D., Ogborn, D. I., Cupido, C., Melov, S., Hubbard, A., Bourgeois, J. M., & Tarnopolsky, M. A. (2012). Massage therapy attenuates inflammatory signaling after exercise-induced muscle damage. Science Translational Medicine.

American Council of Exercise (ACE)

National Academy of Sports Medicine (NASM)

walking shoes

Gait Speed… Chase It!

/20 February 2023/ All MFN blog/

Walking is our freedom to GO anywhere, anytime, automatically, to get somewhere ‘on our own’ without fear or assistance.

It is the antithesis to the slipper shuffle and a key player in fall resistance, that is, staying UP. A shorter, wider stride, stiffer ankles and feet, and a hunched posture are not a function of aging per se. We CAN be spry, walk tall, with spring in our step, well into our 80’s and 90’s.

gymnast-rings

Making Weight: Helpful or Harmful?

/13 February 2023/ All MFN blog/

Many athletes fantasize about losing weight (“Wouldn’t it be nice to lose a few pounds…”). But some athletes have to lose weight in order to meet a specific division for their sport. Athletes such as boxers might have to make weight for a day only once or twice a year, but others such as wrestlers are wisest to keep their weight low for a season. And then there are figure skaters, dancers, and gymnasts who live in long-term “food jail” to maintain a sleek physique for months on end because they get judged on aesthetics. This article will not focus on the problems with long-term under-eating, but rather offer help for athletes who have to/want to lose weight for the short-term.

Weight classes exist to supposedly even the playing field so, for example, a wrestler or a rower competes against someone who is about the same physical size. A problem with weight-class sports is too many athletes target a minimal weight that is unlikely their best performance weight and focus on a number on a scale instead of ability to compete well.  They often resort to last-minute restrictive dieting and dehydrating to make weight. Inadequate recovery between weigh-ins and the event can contribute to early bonking, poor performance, and disappointments. One champion collegiate wrestler shared his winning advice, “I ate well, competed at my natural weight, and clobbered my starving opponents. Easy!” The same goes for athletes in running sports, who believe lighter equates to faster. Not always the case. There’s a lot to be said for running well-fueled at your natural weight.

So what are weight-class athletes supposed to do?

Obviously, they are not supposed to wait until the last few days before an event to lose weight by abstaining from food and water, over-exercising, and abusing their bodies. The better path is to start chipping away at weight loss weeks in advance. If you have to lose 10 pounds, give yourself at least 5 to 10 weeks to do so, if not more.

Ideally, athletes should first have their body fat accurately measured to determine if they even have fat to lose. Females should not drop below 12% body fat, males no less than 5%. Some athletes will need to lose muscle to be able to reach their weight goal.

What’s the best way to lose weight? Push yourself away from the dinner table before you eat your fill! Plain and simple, you have to eat less than your body requires.  Easier said than done. Hence, these tips might be helpful.

• Knock off only 300-500 calories/day from your typical daily intake. Do NOT chop your food intake in half or eat as little as possible! As an athlete, you need fuel to train.

• Fuel by day; diet by night. Plan to lose weight when you are sleeping—not when you are trying to train hard.

• Surround your workout with food, so that you fuel-up and refuel.

• Do NOT cut out all carbohydrates. Athletes need grains, veggies, and fruits to optimize their muscle glycogen stores. A very low-carb diet results in depleted glycogen,  “dead legs,” and inability to train hard.

• Enjoy carb-protein combinations: carbs to fuel muscles; protein to build and repair muscles. Protein is also satiating and can help curb hunger.

• When it’s crunch-time, to lose the last few pounds, some athletes target about 1.5 g carb, 1 g protein, and 0.5 g fat per pound of body weight (3 g carb, 2 g pro,  1 g fat/kg). This means a 150-lb (68 kg) athlete would target about 200 g carb, 135 g pro, and 70 g fat (~1,950-2,000 calories/day).

• Athletes who have to lose muscle mass to hit their weight target should cut back on their protein intake.

• Divide the calories into 4 food buckets and eat a meal at least every 4 hours. (The clock starts ticking when you get up in the morning). An athlete who trains from 6:30 to 7:30 a.m. could divide breakfast into 100-200 calories pre-workout at 6:00ish, then 400 calories post-workout at 8:00; eat early lunch (500 cal.) at 11:00ish; later lunch (400-500 cal.) at 3:00ish, and dinner at 6:00-7:00ish (500 cal.). The rest of the night, chew gum, drink herbal tea, go to bed early? (If you are ravenous, please eat a bit more.)

• If you don’t have fat to lose, plan in last-minute water-weight loss of 2% to 3% body weight. For a 150-lb athlete, that’s 3 to 4.5 pounds. Ways to reduce water-weight include depleting muscle glycogen with a low-carb diet (3 grams of water are stored with one gram of muscle glycogen), restricting fiber (to reduce gut contents),  sweating, and restricting fluids.

Rapid refueling pre-event

After weighing in, some weight-class athletes have only 1 to 2 hours to refuel and rehydrate before they compete; others have 12+ hours if they weigh-in the night before. To rapidly refuel, they should consume carbs they know they can tolerate well—and be sensible so they don’t vomit during the event. Enjoy (well-tolerated) salty foods like soup, pretzels, and crackers.

• A large bolus of fluid gets absorbed faster than smaller amounts, so dehydrated athletes want to drink 20 to 30 ounces of fluid followed by repeated sips. Salty broth and lowfat chocolate milk retain water in the body better than sports drinks and plain water. Co-ingestion of some protein can help with glycogen restoration (Turkey sandwich? Chocolate milk?)

Post-event weight regain

While the standard advice for weight-class athletes to just lose the weight and keep it off makes sense intellectually, it is the opposite of what the body wants to do physiologically. After having been underfed, hungry athletes experience a very strong drive to eat, if not over-eat, and regain all the lost weight. This happens with most dieters, athletic or not.

The urge to devour food after having made weight is physiological, and not simply due to lack of will-power. Here’s the analogy: If you hold your breath for too long, you will uncontrollably gasp for air. If you rigorously restrict calories for too long, you will uncontrollably grab for food and easily binge-eat. No wonder eating disorders blossom in weight-focused sports!

The bottom line

Any way you look at it, losing weight when you really are not over-fat in the first place is not much fun. Yes, it creates a bond with other athletes doing the same thing—misery loves company—and is embedded into the culture of weight-focused sports. Ideally, it’s time to change that culture to focus more on health (both short and long term) and injury reduction. How about establishing height classes instead of weight classes?  Or at least offer better access to sports dietitians to help with the weight-reduction process? 

Nancy Clark MS RD CSSD  counsels both fitness exercisers and competitive athletes in the Boston-area (Newton; 617-795-1875). Her best-selling Nancy Clark’s Sports Nutrition Guidebook is a popular resource, as is her online workshop. Visit www.NancyClarkRD.com for info.

References

Langan-Evans C. at al. 2021. Nutritional considerations for female athletes in weight category sports. European Journal of Sports Science

Burke, L, et al. 2021. ACSM Consensus Statement on Weight Loss in Weight-Category Sports. Current Sports Medicine Reports

group of happy pregnant women talking in gym

Pelvic Floor Dysfunction in Pregnant Women and New Mothers, Preventable & Treatable

/10 February 2023/ All MFN blog/

Pelvic floor dysfunction, or PFD, is a broad term used to describe several physical conditions that occur mainly as a result from pregnancy and childbirth. As a pre and postnatal fitness specialist for over 20 years, almost every one of my clients has had some form of PFD. What does this mean and why is it relevant to women’s fitness? I will further define PFD in detail and explain how it changes the way we as exercise professionals program design for this clientele.

First, let’s look at the pelvic floor muscles. The pelvic floor looks like a sling or hammock that forms the floor of the bony pelvis and it serves several important functions in our bodies.  The internal layer or “pelvic diaphragm” work with the external muscles of the pelvic floor to support our internal organs, stabilize our bodies, allow for sexual function, urinary and bowel movements and assist in contracting and pushing in the birthing process. These muscles are prone to trauma from the various functions they perform.  The stress of the growing uterus in the body during pregnancy coupled with the changing gravity, posture and production of the hormone Relaxin all contribute to weakening the pelvic floor muscles.

Second, consider the whole Neuromuscular Core system. Pelvic floor muscles connect to the Transverse Abdominus (TVA) and they work together in harmony essentially hold the body upright. It is almost impossible to engage one without the other. Tightness in the hips combined with weak pelvic floor muscles creates PFD.

Diastasis Recti, Symphosis Pubis Dysfunction (SPD), Urinary and or fecal incontinence, pelvic pain, chronic lower back pain, Piraformis syndrome, sciatic pain, pelvic organ prolapse are all conditions under the pelvic floor dysfunction umbrella.  Below these conditions are listed and defined in more detail.

Diastasis Recti: This is a separation of the right and left side of the Rectus Adbdominus in the Linea Alba connective tissue more than 2 cm in width

Pubic Symposis Disorder: A separation of the pubic bones, which often occurs during birth but sometimes during the third trimester.

Urinary incontinence: Uncontrollable leakage from bladder.

Fecal incontinence: Uncontrollable leakage of fecal matter from colon. Usually as a result from severe tearing during birth.

Pelvic pain: This type of pain can be during sex or when performing a movement that is irritating or uncomfortable, many possible underlying issues.

Chronic lower back pain: Unexplainable chronic lower back pain

Sciatica: Pain that radiates from lower back down one leg along the sciatic nerve as a result of compression of the sciatic nerve

Piraformis syndrome: Also a result of an inflamed sciatic nerve but more localized

Pelvic organ prolaps: When organs of the pelvis fall as a result of weak pelvic floor muscles.

These conditions can be limiting for many women and go untreated because they are embarrassed or told that they are normal “experiences” after giving birth. Until recently, very few fitness programs existed to help women strengthen pelvic floor muscles. It is my opinion that every pregnant woman and new mother should be automatically screened for PFD and treated right away. If women do not learn proper strengthening exercises of pelvic floor muscles they can potentially live in discomfort for years. The sooner preventative care is offered the better the quality of life for these women.

As mentioned earlier, many of these conditions are preventable and remedied through a combination of functional strength with corrective, posture-based range of motion exercises. When a woman becomes pregnant there is an immediate increase in pressure to the pelvic floor muscles. The body begins to produce relaxin which affects the joints throughout the body, especially the pelvis as it prepares to accommodate the growing uterus and eventually for birth. If treatment begins to help women continue strengthening the muscles surrounding the hips immediately, the pressure on the pelvic floor muscles will be reduced.

It was common practice until recently that women were advised to learn and perform Kegel Contractions. We understand more now as movement therapists that Kegel contractions are very hard to teach, very isolated, and in most cases, when examined internally by a women’s healthcare PT, women are not performing them correctly.  A more effective approach to strengthening the pelvic floor muscles is to treat the entire hip complex as “one”– or a “global approach” — as described in applied functional science.

So, how do fitness professionals help create beneficial, safe and effective exercise programming for pregnant clients and new mothers that hone in on the core and pelvic floor? We must start by helping our clients improve their posture first and foremost, then work on proper breathing techniques and lastly incorporate larger exercises that do not isolate, but recruit many muscles from the hip complex and surrounding muscles groups. By incorporating all three planes of motion instead of working primarily in the sagittal plane (forward and backward) when performing even the most basic of exercises (i.e., the squat), you must change the movement by foot placement, arm placement, direction, tempo, range of motion etc. The variety in actions creates good stress to the pelvic floor and core muscles. Additionally, increasing the adduction and abduction action simultaneously while performing various exercises will help activate and recruit pelvic floor muscles subconsciously. Anatomically speaking, everything is connected in the body. Understanding that big global movements of the upper body and lower body together affect the position and strengthen of pelvic floor and core muscles is essential. The body is most efficient at strengthening the small muscles when big muscle groups are stimulated in combination. Throughout my years, I have seen much success with clients that incorporated these types of movements into their workout regimen and were safe and conscientious not to perform exercises that added bad stress to the external abdominal muscle group or impact exercises.

Each woman is different on how quickly it takes her to recover from PFD. The most important rule of thumb is to be reassuring and provide support and remember the time line is different for everyone depending on severity of PFD, the fitness level of the client, if the client is breast feeding and prior injuries that could prolong healing time.

Online Course for Fit Pros: Prenatal and Postpartum Exercise

Danielle Spangler, C.PT, has been a fitness professional for over 20 years. Danielle is the creator of “Coremom” (Corrective Obstetrical Related Exercises) for purposes of creating a pre and postnatal small group-training program in a variety of fitness facilities. Danielle’s goal is to train other qualified fitness professionals and group exercise instructors on teaching pre and postnatal small group exercise classes using her method. Visit her website, daniellespangler.com

brain-thoughts

Harness the Limitless Potential of Your Mind with Meditation

/6 February 2023/ All MFN blog/

The mind is a powerful tool or weapon that can be used to work for us or against us. Everything begins with a thought. From the moment we wake up until laying our head on the pillow each night, our mind is consumed with thoughts; more than 60,000 a day by the time we reach age 40.

95% of those thoughts occur in the subconscious mind, making us unaware we have them or even what they are most of the time. Thoughts run on autopilot throughout the day unless we do the internal work to become aware of them and shift our thinking.

Awareness is the first step to reprogramming the mind with different thought patterns. Once we begin practicing a mindful lifestyle and becoming aware of the thought patterns that are regularly showing up in our lives, we can then learn and use tools to reprogram the mind to think differently. Think of it like this: the brain is the hardware, and our mind is the software, the software we use daily determines how we think, feel and react or respond to various situations.

The good news is, it is possible to “rewire the brain” a term referred to as neuroplasticity. The latest technology in science reveals that by creating new neural pathways in the brain, we are capable of rewiring neural pathways, creating new neurons that fire together which allows us to think and process differently, thus leading to less reactionary responses and more responding to our external environment.

The question is how do we do this if our mind is on autopilot and we are mostly unaware of our thoughts?

One answer is through the long-practiced method of meditation, a process of refocusing the mind. Meditation is a mental exercise that with practice trains the brain to think and process differently. It is through refocusing the mind to think about one thing and ultimately “no thing” that allows for us to tap into our subconscious mind and create new programming.

Often people say they cannot meditate or can’t calm their monkey mind. That is true for those who do not practice training it to be different. Being mentally fit is a practice that requires exercise, just as muscles do when training in the gym or recovering from a physical ailment. The mind must also be exercised and taught to think and react differently.

There are many different modalities to the practice of meditation, just as there are many workouts in the gym to become physically fit. It’s about exploring the types of modalities and finding one that works for you or your client. Mental resilience is built each time new neural connections are made, each time we go through a challenging time and overcome it, we become more mentally fit thus giving us resilience for the next time we face something hard.

Understanding how the brain works and how it pre-dispositioned to think negatively over positively, allows us to have compassion and patience with ourselves while learning to create a consistent routine of practicing meditation. Discovering the mind/body connection and how they work together also empowers us to be able to choose differently in situations where we become aware we are reacting from autopilot rather than choosing to respond.

Meditation is currently a $1 billion industry and is rapidly growing. Learning how to use meditation in your own life, while also learning how to instruct others through science-based, proven modalities expands your revenue offerings as well as helps clients heal faster and live happier lives.

Learn More: Online Education from Briana Bragg

Check out Briana’s short courses with MedFit Classroom for more. Click course for details:

Briana Bragg is the founder of Vacation of the Mind®, a mental wellness company dedicated to helping one million people or more reduce stress, refocus the mind, and lead healthier and happier lifestyles through practical techniques of nature-centered mindfulness and meditation.  Briana is the author of “Journey into Tranquility®”, a meditation teacher training course that utilizes science-based methodologies of nature, meditation, and creative visualization in a three-step process Breathe, Refocus, Journey, curating guided journeys that connect people to nature and stillness. Briana’s dynamic energy and passion are fueled by her devotion to the well-being of others.

Junk Food Concept

Blues-Busting Foods: Rx For Emotional Eating

/3 February 2023/ All MFN blog/

For many, negative feelings, such as anxiety and depression, lead to out-of-control eating…and ensuing weight gain. Knowing which foods can bust the blues, without weight gain, could reduce the odds of emotional eating episodes. Meet the foods that may help.

Mac and cheese. Chocolate chip cookies. A pint of Ben and Jerry’s. Some call it “comfort food”; others say it’s “food as friend.” However you phrase it, turning to food to soothe unpleasant feelings—from depression and anxiety to anger, loneliness, even fatigue—is the key cause of Emotional Eating. As a matter of fact, our research revealed that eating to cope with negative feelings is the #1 reason we overeat; and the key cause of weight gain.

Theories abound about the causes of out-of-control eating. Is it linked to brain chemistry? Or is it a behavioral addiction? Or both? What is clear is that when some people experience unwelcomed feelings such as fear, anger, anxiety, or depression— because of physical (such as back pain), emotional (negative feelings), mental (stress-filled thoughts), or spiritual (emptiness) distress, they may turn to food to feel better. Why? Because food does, indeed, have the power to bust the blues! Here’s why.

Anatomy of Emotional Eating

Have you ever felt frustrated, and turned to carbohydrate-dense fries, cake, cookies, or potato chips—seemingly unable to stop until the whole bag (or bags) is gone? If so, it’s possible you’re self-medicating unpleasant feelings with food. How so? Certain hormones—naturally occurring “chemical messengers” released when you consume certain nutrients (such as carbohydrates, protein, fat, and so on) in food—have the power to “replace” negative emotions with feel-good feelings. This is because high-carb foods, such as chips, stimulate the production of serotonin, an emotion-friendly hormone that calms and soothes the psyche.

It seems so easy: load up on carbs, feel better. But you pay a price for this feel-good fix. This is because processed, sugar- and fat-laden junk food—from donuts, cookies, and cake, to chips, fries, candy bars, and soda—ultimately, are “downer” foods. This means these often tasty, high-carb foods may provide some short-term comfort by releasing soothing serotonin, but you won’t get long-term relief. Rather, sugar-laden comfort foods could worsen negative feelings, because after they drive up insulin (a hormone that controls blood sugar and energy absorption), your blood-sugar levels inevitably plummet, leaving you even more depressed and fatigued then prior to eating them.

Damage Control: Calming Carbs Without the Crash

If you’re an emotional eater—if you cope with unpleasant emotions by overeating and bingeing on high-carb, super-sweet foods—there are many proactive steps you can take to turn the tide. For starters, consider consuming some blues-busting foods that bring the benefits of serotonin—without the downside of the emotional “crash” and the weight gain that bingeing on processed, high-calorie, “downer” food (products) can cause.

Here are some quick-fix, mood-friendly foods and snacks that not only may bust the blues, they may crush cravings and curb your urge to splurge.

FLASH TIP: BE SURE TO WAIT AT LEAST 20 MINUTES AFTER YOU EAT TO GET THE CALMING AFFECTS OF SEROTONIN. THIS IS HOW LONG IT TAKES FOR YOUR BRAIN TO REGISTER THAT SEROTONIN IS WORKING ITS WONDERS.

Smoothie. Combine 2 cups chopped dark leafy greens, 1 cup blueberries, 3 walnut halves, 1 cup milk of choice (cow, soy, almond, rice), ½ cup juice of choice, 3 walnut halves, 1 teaspoon flax oil. Blend.

Avocado spread. Toast a piece of multi-grain bread or choose whole-grain rice crackers. Mash ½ avocado, add salt and pepper to taste. Spread the avocado on the bread. Or a tablespoon of nut butter (peanut, tahini, etc.) on it.

Popcorn. Pop some air-popped popcorn. Spritz lightly with olive oil. Sprinkle with a dash of salt and pepper. Toss.

Cereal. Enjoy a bowl of cracked oatmeal with a handful of blueberries and milk of choice.

Nuts/Seeds. Try a ¼ cup of raw, unroasted nuts or seeds of choice. A sampling: walnuts, cashews, almonds, pumpkin or sunflower seeds.

Veggies. Munch some carrots, celery, cherry tomatoes; crunch kale or Romaine lettuce leaves. Optional: Use the nut butter blend, above, as a dip or spread for your veggies.

Fish. Enjoy a tuna or salmon salad. Mix together water-packed tuna fish, 2 tablespoons mayonnaise, diced celery and red onion, juice from ½ lemon, salt and pepper.

Fruit. Have an apple, papaya, orange, frozen grapes, banana, kiwi, cherries, pineapple pieces, tangerine, or any other fruit you like.

Chocolate. Savor a piece or two of dark chocolate with 70% or higher cocoa content. Or make hot chocolate with 100% cocoa powder and milk of choice.

The take-away: Enhancing emotions by consuming fresh, whole, blues-busting foods—instead of processed foods that are high in sugar, fat, and calories—is a sound step toward overcoming Emotional Eating, the #1 overeating style our research on Whole Person Integrative Eating has revealed.

In other words, if you turn to food that enhances feel-good feelings, but that also nourishes your mind and body—without the “downer” crash—you’re more likely to lower your odds of Emotional Eating episodes. How so? You’ll keep your mind-body in balance.

Visit Deborah’s website, makeweightlosslast.com, for free evidence-based, credible information and education about optimal eating for weight loss and well-being. You can also visit her blog, integrativeeating.com.

Originally printed on integrativeeating.com. Reprinted with permission from Deborah Kesten. 

Deborah Kesten, M.P.H., is an award-winning author, specializing in preventing and reversing obesity and heart disease. Her expertise includes the influence of epigenetics and diet on health, Lifestyle Medicine, and research on the Whole Person Integrative Eating dietary lifestyle to treat overeating, overweight, and obesity. She and her husband, behavioral scientist Larry Scherwitz, Ph.D., collaborate on research and writing projects. 

exercise-fitness-at-home

Fit PACE: Substance Abuse & Exercise

/1 February 2023/ All MFN blog/

Research has shown the positive influence of exercise on alcohol use disorder (AUD) recovery as well as other drug-related substances. However, qualitative research has been missing regarding the influence of exercise on substance abuse disorders. In 2021, I performed a qualitative study involving interview and exercise journal data, which further validated the benefits of exercise during addiction recovery (specifically AUD). Most importantly, the results of the study showed how exercise can persuade the decisional balance a person has when working through the process of recovery. The benefits of exercise (pros) are better than the benefits of drinking (which are now cons). Another important theme participants expressed was that exercise does help recovery, but it should be a tool, not a replacement to other forms of treatment. Therefore, exercise shouldn’t replace strategies such as group meetings (e.g., AA or NA), cognitive behavioral therapy, or medications. Rather, exercise can compliment a comprehensive treatment program as a tool to maintain abstinence from alcohol and other substances, with the ultimate goal of avoiding relapse and reaching termination of the addiction. The intention of my study was to help medical and fitness professions better understand how persons connect exercise performance to their recovery process. This information also leads to better strategic planning programs for recovery, including exercise.

As a result of my research, I have developed the PACE Method to assist persons in recovery who are using exercise as a tool in order to combat not only relapse but also the threat of replacing one addictive behavior with another. One might replace exercise with the aforementioned forms of treatment, and in doing so, replace the psychology/physiology of their addictive habits with exercise performance. Even if exercise is considered “healthy”, in excess, there are consequences to the body. Currently the DSM-5 (Diagnostic and Statistical Manuel of Mental Disorders from the American Psychological Association) does not have diagnosis for exercise addiction. What is considered the appropriate/recommended, “normal” amount of exercise? Leaving that up to be self-determined, particularly to persons in recovery who are at risk for addictive forming thoughts and behaviors, can be problematic. Just like any program planning, a medical and/or fitness professional may refer/recommend, there needs to be an appropriate guide to properly integrating exercise into recovery without reaching excess.

PACE stands for Proactive Awareness Controlling Excess. Fit PACE is a guideline/tool to incorporate exercise into recovery safely by being proactive and ahead of excessiveness, being aware of your own addictive behaviors, controlling thoughts/actions, and deterring/avoiding reaching exercise in excess. I have just released the Fit PACE mobile app which details a program for persons in substance abuse recovery to follow for exercise performance. Users not only log days performing exercise for accountability (and to avoid excess), but they also log number of days sober. Graphical images display progress and track this information. Users can connect to other persons on the app, which emulates the group meeting, community support aspect recovery. Users can select their exercise goal and tailor workouts to their level of fitness. It is my hope that both fitness and medical professionals can refer/recommend the Fit PACE app to download and use as a tool during substance abuse recovery. This is in alignment ACSM’s Exercise is Medicine philosophies.

To download the Fit PACE app, look in the applicable store for your cellular device:

Online Course: Fit PACE – Alcohol, Addiction and Exercise

Want to learn more? Sign up for Dr. McCullough’s short online from MedFit Classroom, Fit PACE – Alcohol, Addiction and Exercise

Dr. Megan Johnson McCullough, owner of Every BODY’s Fit in Oceanside CA, is a NASM Master Trainer, AFAA group exercise instructor, and specializes in Fitness Nutrition, Weight Management, Senior Fitness, Corrective Exercise, and Drug and Alcohol Recovery. She’s also a Wellness Coach, holds an M.A. Physical Education & Health and a Ph.D in Health and Human Performance. She is a professional natural bodybuilder, fitness model, and published author.