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Why Do My Feet Hurt?

Many of you reading this are going to experience a foot problem at some point in your lifetime. Some of you are even going to develop a chronic condition that will introduce your body to a new level of suffering. Ever heard the old saying – “when your feet hurt, you hurt all over”?

The tendency for most of you will be to try to figure out what is wrong, and find a way to alleviate your discomfort. You may self-treat with over the counter products such as insoles, anti-inflammatory or pain medicine. Some of you will seek professional advice from your primary doctor or a specialist. A lot of you will look for answers online, to determine a diagnosis.

After doing this you may think that you’re going to get to the solution you’re after, but in actuality there’s something that should be looked at long before pursuing any of the steps mentioned above. From the 22 years I’ve been taking care of people’s feet, I can tell you that there is a key piece of information many never find. It’s honestly something few know about, but it’s much more likely to be causing your foot troubles.

The fit of your shoes

Yes, the commonly accepted shape of shoes and the method of assigning your feet a number and letter, based upon measurements with the Brannock device, are the most likely reasons for your foot pain. Why? Having your feet measured in this way ignores the natural shape of your feet, and guarantees that you will change this natural shape and inhibit proper function. For many of you this started in infancy, but because of the amazing compensatory abilities of your feet you are likely able to function fairly well in unnatural alignment. For a while, that is.

Picture from CorrectToes

Studies show that about 75% of people in the United States have foot pain at some point in their lives. When that day comes for you to experience your own personal suffering; instead of resorting to the means mentioned above, perform a free and simple in home test to show yourself the most likely reason for your pain.

We perform this test on every patient that comes in to our clinic, and the majority of their feet spread beyond the sock liner. This ensures that their feet are going to be misaligned, because the upper part of the shoe is the same shape as the sock liner.

This goes for you men as well. Even in athletic shoes.

So when your feet begin to hurt – resist the temptation to self-medicate, seek professional advice or try to figure out your diagnosis, until you have checked the fit of your shoes.

Be skeptical of any advice or treatment of your foot pain that does not include aligning your feet naturally. Your feet are designed to be widest at the ends of the toes, so be wary of any professional who ascribes your foot pain to genetics, biomechanics or overuse, but fails to ensure that your feet are aligned as they are naturally designed to be. It is impossible to achieve lifelong foot health and ignore this basic anatomic fact.

Register for Dr. Ray’s upcoming free webinar, Fashion Footwear Does Not Belong In Medicine Or Fitness

Originally printed on the Correct Toes blog. Reprinted with permission.

Dr. Ray McClanahan’s practice, Northwest Foot & Ankle in Portland, Oregon, allows him to care for those who find their highest joy when in motion. In his 18 years as a podiatrist, he has learned that most foot problems can be corrected by restoring natural foot function. He is also the inventor of Correct Toes, silicone toe spacers. His professional goal is to provide quality natural foot health services with an emphasis on sports medicine, preventative and conservative options as well as education on proper footwear.

Dr. McClanahan is an active runner and athlete. In 1999, he finished 14th in the U.S. National Men’s Cross-Country Championships and had a near Olympic Trials qualifying 5,000 meter mark of 13:56 in 2000. He then qualified for the World Duathlon Championships in 2001.”


Food, Anxiety & Athletes: A Troublesome Trio

As I write this column, the date is April 10th, 2020, three weeks into the coronavirus shut-down here in Boston. I continue to counsel clients from my virtual office. I am talking with gym rats and athletes alike who are stuck at home, hating what they see when staring at themselves during Zoom meet-ups, and are spending too much time fighting with food (Do I eat? Don’t I eat? Am I hungry—or just bored?). They are feeling anxious and self-critical.

When life feels out of control, athletes commonly end up trying to control other things, such as food, exercise, and weight. Some may be striving to chisel themselves into a perfect body (no excess body fat) and eat a perfect diet (no fun foods). Unfortunately, the same dedication and discipline that help them be top athletes are the same traits that foster eating disorders. For example, perfectionism is common to both athletes and people with anorexia. How else could figure skaters or gymnasts rise to the elite level without demanding perfection from themselves?

Yes, discipline, dedication, and perfectionism are driving forces that help good athletes become great. But genetics is fundamental, as is adequate­—but not necessarily perfect—fueling. That is, eating a cookie will not contaminate an athlete’s health nor ruin one’s ability to perform well.

If you are relentlessly pushing yourself hard right now out of fear of getting fat and losing fitness, please consider being gentler on yourself. This is a difficult time for many folks. Little is wrong with a bit of comfort food in the midst of chaos and crisis. Perhaps you can allow yourself to be “bad” and do something out of character, like bake cookies and enjoy some for an afternoon snack. Giving yourself permission to enjoy some comfort food is normal, assuming you also have other coping skills, such as writing in a journal and relaxing yourself with yoga.

When food has power over you

If you are spending too much time trying not to eat (Fill in the blank) ____ (cookies, cheese, ice cream, chips?) because you can’t eat just one serving, think again. Depriving yourself of your favorite foods makes them even more enticing. They can needlessly become too powerful. To take the power away from a “binge food,” you need to eat it more often. (Trust me!) Here’s the analogy:

Pretend you are caring for a four-year-old boy. You take him into a room filled with toys and tell him he can play with all of the toys except for the green truck. You leave the room and then look through the two-way mirror. What is he playing with? The green truck, of course! The same analogy holds true with food.

If you give yourself permission to eat, let’s say, some Oreos every day, after a few days, you’ll either have little interest in yet-another Oreo (because other foods actually make you feel better) or you will be able to eat just one Oreo; it will no longer have power over you. Yes, to gain control over foods that have power over you, you have to allow the food back into your life and eat it more often. Be curious; give it a try.

When the mirror makes you feel sad

Are you spending too much time these days critically evaluating your body in the mirror? Or hating what you see in the Zoom meet-up? Please, just, stop the body-hatred talk. Few humans have a perfect body. The imperfections you see are perfectly beautiful and acceptable.

Instead of being self-critical, be grateful that you are healthy. Grateful that you have two strong legs that help you be a good runner. Grateful that you have two hands that help you row crew. Grateful that you have a body that produced healthy babies that are now your beloved children. You could even apologize to your body for having tortured it with skimpy diets and excessive exercise in your efforts to control how it looks.

Rather than focus on how your body looks, turn your attention to how your body feels throughout the day, particularly before, during and after you exercise. Does your body feel hungry? Tired? Sore? Respond appropriately to that feeling by nourishing it with food, rest, a warm bath. Daily killer workouts that feel like punishment for having excess body fat inevitably end up with the athlete being injured and depressed.

Now is a good time to practice looking in the mirror (or the Zoom screen) and saying nice things about your body, such as, “I have pretty blue eyes.” “I like my silky hair.” “I have strong legs.” You can intentionally pay less attention to the crooked teeth, frizzy hair, and “too big” tummy. Do you really think others care about that stuff?

Note: For more information on making peace with your body, visit RealFoodWholeLife.com, JessieHaggerty.com, and Julie Duffy Dilllon’s podcast Love, Food.

When mindless eating gets out of control

If you find yourself grazing on snacks incessantly throughout the day and have fears about getting fat, try scheduling regular meals and snacks. Also give yourself permission to eat enough breakfast and lunch, so that you are fully satiated. Don’t stop eating those meals just because you think you should but rather because you actually have had enough to eat. Athletes who graze all day rarely feel fully fed.

Hunger is a physiological request for fuel. Hunger does not mean “Oh no, I’m going to eat and get fat. Rather, hunger is your body’s way of saying it has burned off what you fed it and now needs more fuel. Yes, food is fuel, not the fattening enemy. Honor hunger.

Another way to bring control to your eating is to eat only when 1) you are sitting in a specific place (kitchen table?), 2) the food is on a plate, and 3) you are tasting it mindfully. (i.e. you are not standing in front of the open cupboard, wolfing down handfuls of chocolate chips.)

My hope is the above tips will help you find peace with food and your body. Enjoy food for nourishment and survive the coronavirus shut-down with sanity.

Boston-area sports nutritionist Nancy Clark, MS, RD CSSD counsels both casual and competitive athletes, helping them eat to win. The new 6th edition of her Sports Nutrition Guidebook is a best-selling resource. For more information, visit NancyClarkRD.com.


Paving the Road to Hell with Good Intentions

Going bigger is not necessarily better.

Many of us have the very best intentions with our health. We try to eat right, exercise, take supplements, make choices we deem to be healthy. However, we frequently think more is better: more restrictive with our food choices, more intense workouts, more supplements. Let’s all examine our choices from the perspective of inflammation.

What is Oxidative Stress?

Oxidative stress (OS) is an imbalance of free radicals and antioxidants in the body. Simply summarized, oxidative stress is electron thievery. Electrons are stable when coupled. Single electrons, called free radicals, scavenge the body to seek out other electrons to couple. It really is a wicked dating scene inside our cells!

Long-term oxidative stress damages the body’s cells, proteins, and DNA. OS strongly contributes to aging and is accepted to be the root of chronic conditions including diabetes, cancers, heart and vascular disease, depression, neurodegenerative disease, arthritis, Alzheimer’s, insulin resistance, IBD… more and more of our chronic issues are being linked to oxidative stress, as it can lead to chronic inflammation, to chronic illness.

Sources of Oxidative Stress

OS has both endogenous (from within) and exogenous (from our world) sources.

Endogenous: Cellular metabolism. Energy production happens in the mitochondria of our cells. Our currency or energy is ATP (adenosine triphosphate). OS is a natural by-product of ATP. When do we produce more ATP?

The body’s natural immune response can also trigger OS temporarily.

Fat cells create OS.

Exogenous: Exposures in our environment and lifestyle choices: alcohol, smoking, cell phone, EMF, environmental pollutants, many chemicals in our food and on our clothing, processed foods, sugar.

Chronic Diseases Continues to be on the Rise

Our inner antioxidant system was not designed to manage our current barrage of OS from our environment and lifestyle choices. According to the WHO, chronic disease is on the rise worldwide. Our levels of OS and chronic inflammation are also dramatically on the rise. An aging population and changes in our environment and our lifestyle choices are contributing to this steady increase. By lowering OS, we have a better chance of staving off illness.

Healthy Lifestyle?

From a perspective of inflammation, what is a healthy lifestyle?


Bottom line: Too much exercise in terms of intensity and duration is proven to increase oxidative stress. Yes, exercise and physical activity are a necessity for every aspect of health. Exercise has been proven to lower oxidative stress, cardiovascular risk, but the mechanisms of this are still being studied.

  • It has been proven that starting “on an exercise program”, then quitting abruptly, increases OS.
  • Nutrition plus exercise is far more effective in lowering OS, than exercise alone.
  • Exercise has better control on lowering oxidative stress in people who have higher levels of CRP (inflammatory marker).
  • Exhaustive and prolonged exercise promotes the generation of ROS, depletion of antioxidants and vitamins, induces oxidative stress, renal impairment and inflammation.
  • Prolonged aerobic exercise is linked to dramatic increases in oxidative stress.
  • Less studied thus far, intense hypertrophy training (heavy weight lifting) has been shown to increase oxidative stress. Muscle mass is imperative for healthy aging; balanced training is key.

More exercise in terms of duration and intensity could lose the beneficial effects of exercise. It is very important for those engaging in stressful exercise to support their antioxidant system. Passive exercise is a liberating and invigorating addition to our lives. We can benefit from adding some range of motion and stretching, emphasize our cool-downs, Qi Gong, meditation, and passive exercise.

Nutrient Restricting Diets

Our body needs a variety of amino acids to function efficiently. Bioavailability of these amino acids varies amongst food sources. We need to eat antioxidants to counteract oxidative stress.

Let’s look at some research on a few popular diets, with respect to oxidative stress

  • Keto diet: Ketogenic diets have shown to increase inflammatory markers.
  • Paleo diet: can be good in some respects by eliminating sugar, alcohol. If not done carefully Paleo-ers have been shown to be deficient in fiber and certain minerals and vitamins, which is hurtful to gut health, and yes pro-inflammatory.
  • Vegan diets: Again, proceed with intense caution. Vegan diets tend to be very carb-heavy. Our grains are not what they used to be. Genetic modification and toxins abound, and our soil is not what it used to be as a source of minerals. Meat and dairy are rich in bioavailable amino acids, and of course, moderation is key.
  • A 2018 study showed that long term diets excessively low, or high in carbohydrates are both linked with a shorter lifespan.

There is NO utopian diet. Examine lifestyle decisions from the perspective of inflammation. The scale is not the omnipotent indicator of health. We need to examine what we are identifying as our markers of health.  Maybe our good intentions weaken our inner defenses. Be healthy and balanced. Balance is strength!

Shira Litwack has been in chronic care management and prevention for 30 years, specializing in lifestyle habits including holistic nutrition, medical fitness and oxidative stress reduction. She is frequently called upon by the media, has her own podcast bringing current research to the public.

She has created and provided oxidative stress assessments, to help clients identify potential health risks. From these, she provides guidance to lower inflammation.



Understanding Dementia: How to Help and Support People with this Disorder

If you’ve dealt with a person who has dementia, you are perfectly aware of the hardships that come with the territory. It’s impossible to offer help and support unless you understand the condition. The most important thing to note is that it is an umbrella term pointing to the symptoms of an ailment, rather than an ailment itself.

In other words, the memory loss dementia denotes is usually one of many symptoms that accompany diseases such as Alzheimer’s, vascular cognitive impairment, Lewy-bodies syndrome, and others. To retain a satisfying quality of life, the affected individuals require all the knowledgeable assistance they can get.

This is where you come in as a family member or a caregiver. Here’s what you can do to help.

Set the stage with positivity

The most important thing to remember is that people living with dementia know how to read body language even if they don’t recognize you. As long as you reflect a modicum of modest positivity and ‘normalcy’ in your behavior, you’ll be providing a better environment for them to relax, find their ground, and feel valued as a real person.

A positive attitude is alpha and omega of your support. It requires little effort and it makes all the difference.

Certain ground rules you need to establish

As a caregiver supporting someone with dementia, you need to have some ground rules set in stone. Make a list of pointers on a large sheet of paper which you can refer to now and then, especially if you feel that relationships in the household have been going sideways.

Now, here’s a twist: these rules are mostly there for you. And they go as follows:

  • Keep your sentences short and your questions answerable. On some days, this will be more important than on others, but you’ll also be amazed at the opportunities to have meaningful and genuine conversations with them.
  • Let them make manageable decisions – like their choice of dinner, means of transportation (car or on foot), a set of clothes, etc. This will instill in them a sense of agency and confidence.
  • And while we’re on the topic of confidence, keep your intonation and enunciation distinct and reassuring. This will also improve the overall household atmosphere.
  • And finally, always maintain your sense of humor. Encourage them to crack jokes, let go, and get silly – humor heals!

Aim for small habits

When it comes to encouragement, there’s another factor that contributes to the perception of agency and confidence in a person with dementia, and that is habit. Your job is to support behaviors that lead to their better cognitive performance and improved quality of life.

Even the smallest habits can mean a world of difference, such as going through a family photo album several times a week or writing a journal daily. Also, creative activities such as painting can do wonders for people with dementia, especially when it comes to memory retention.

Make sure to keep track

As dementia develops, there’s a greater risk of the person in question wandering off. The nature of the condition is such that they may end up confused, disoriented, and unable to recall why they’ve left home or where they are.

Fortunately, it’s possible to minimize the danger and better keep track of your loved one. At the very least, ask them to always carry their phone with them or, even better, get them to take a GPS tracker along.

Better yet, provide them with a portable medical alert tracker to ensure that they never leave home unsecured. In fact, getting more than one can be useful. You can place them in their coat pockets, jackets, jeans, or put them on a necklace that they’ll be wearing whenever they leave the house.

Give them as much freedom as humanly possible, but make this a fundamental condition.

Label everything you can

Label dispensers and stickers will become the most useful items in your ‘toolbox’ for the following period. Sticking labels on doors, drawers, cupboards, and cabinets to denote what they hold makes everyone’s life significantly easier. But why stop with the name game?

You can take it a step further by compiling a list of all the crucial phone numbers and printing out several copies. Of course, it would be impractical to just leave them lying around. If you have a chance, laminate the lists and hang them on the most frequented doors in the household.

Keep their living space limited and orderly

Naturally, to avoid confusion, you’ll have to make an extra effort to return all objects to their designated spots.

Now, if your loved one is living in a large home, you also might want to rethink their living space. Not that they are physically unfit to navigate spaces, but you’ll need to work with them to help ensure they’re comfortably nested in a space that supports their well-being as well as maximum functioning. You might need to move some furniture around and get rid of clutter to create a layout that eliminates confusion and feels right to them.

Physical activity affects longevity

Simplifying their living space doesn’t mean that they should stay confined to it. On the contrary, people living with dementia need as much physical activity as possible to stay fit and improve cardiovascular health and blood flow through the brain.

Dementia is far from a death sentence – this cannot be overstated – and physical activity correlates directly with longevity and cognitive health.

Now, when it comes to older individuals living with dementia, simple daily tasks that involve physical exertion are perfectly valid. Don’t treat them as victims; instead, keep their hands busy and give them simple tasks they can occupy themselves with.

Important note: elaborate activities might be too much to ask. On the other hand, dish-washing, vacuuming, and other household chores could be a great choice, especially because they’ll be pleased to see the fruits of their labor. Also, if you plan to keep this going, you can print out a schedule spreadsheet and keep track of all activities they’ve already finished, in case they forget.

Apart from that, you might want to look into yoga and see what benefits it manifests for people living with dementia. Yoga strikes the perfect balance between a demanding physical activity and a relaxing stretching exercise with meditative qualities that greatly benefit anyone.


At the end of the day, never forget: the person comes first, not the condition.

You need to prioritize bracing yourself for the forthcoming changes in their behavior, because it’s not merely about being patient in tight spots. To reflect a positive attitude and flexibility, you’ll need to work out the best possible and the worst possible scenarios, and be grateful when the latter don’t transpire, thanks to your efforts.

The naturally positive attitude that follows this frame of mind will have an encouraging and enriching effect on your loved one. And when you provide that kind of supportive environment for them, you might just be surprised what you can learn from them – and the entire experience.

Sarah Kaminski earned her bachelor’s degree in Health Sciences. Due to her parent’s declining health, she decided to become their full-time caregiver. Now, she takes care of her loved ones and writes about the things she learned along the way.

Sarah is a life enjoyer, positivity seeker, and a curiosity enthusiast. She is passionate about an eco-friendly lifestyle and adores her cats. She is an avid reader who loves to travel when time allows.




Movement and Cognition

How our ability to maintain balance, walk, and move is directly reflective of our higher human functions (A brief overview and case study)

Balance and cognition are inextricably linked. Quantification of improvement in key performance indicators of cognition is directly related to precisely measured improvements in balance and postural stability. A thorough understanding of this relationship is paramount to the understanding of conditions related to cognitive impairment, leaning and behavioral struggles, brain injury, and so much more.

At the time of presentation to APEX Brain Centers, Roger was a 70-year-old male struggling with severe balance problems, clumsiness, fatigue, and a general disinterest in life. He used to enjoy life as a family man, successful entrepreneur and golfer. Just over 10 years prior he had undergone radiation therapy for cancer that damaged his 8th cranial nerve (the balance and hearing nerve). He had also undergone prism therapies and surgery for eye position abnormalities, which have caused further insult to his ability to maintain good balance and to learn effectively. Although not listed as a primary complaint, he also suffered from significant cognitive decline in several areas as evidenced by very low to low average scores on standardized cognitive testing.

Roger sought care at APEX Brain Centers in Asheville, NC in May of 2015 and underwent an intensive course of brain/body rehabilitation. He was admitted into an individualized program directed by extensive diagnostic testing and led by clinicians highly experienced in functional neurology. What follows is a sampling of some of the leading-edge clinical interventions and significant functional gains Roger experienced during his program.

Intervention for balance and cognitive decline

Roger underwent comprehensive brain/body rehabilitation at a frequency of 3 times per day over the course of 15 days (with 2 days off between each for much needed rest and recovery). His brain function was carefully monitored throughout the training process with measurement of EEG, vital signs, eye movements, balance, mental and physical timing, and more to ensure he was receiving the proper amount therapy to be effective, but not too much so as to be counter-productive. Modalities implemented included, but were not limited to: neurofeedback, Interactive Metronome, vestibular rehabilitation, metabolic and nutritional therapies, eye movement and neurological rehabilitation, whole body vibration, electrical stimulation, breathing exercises, and home care recommendations.

Outcomes after Brain Training

Subsequent to his rehabilitative program, Roger reported subjective improvements in the vast majority of his pre-intensive complaints. More profound than that, his wife was quoted as saying, “it’s like I have my old husband back.” She noted that he used to be the life of the party and had been slowly deteriorating over time to the point of sitting in his chair all day and sleeping more and more often. He was finally plugging back into life, putting an end to his isolation and apathy. As is demonstrated by his balance testing, he is also experiencing a renewed ability to maintain balance, allowing him to be safer and more efficient in navigating his physical environment and getting back on the golf course.

Actual, measurable objective improvements recorded with post-intensive diagnostic testing include:

  • Cognitive Testing: Increase in his Neurocognition Index of 48%. This is a standardized overall score of cognitive performance. Increases in various aspects of memory, attention, processing speed and more as great as 21%.
  • Interactive Metronome: 56% improvement in task average with motor timing, and normalization of hyper-anticipatory timing tendency with motor tasks (i.e. responding prematurely to a pre-set reference tone).
  • Computerized Assessment of Postural Stability (CAPS): 20.5% improvement in balance on an unstable surface with eyes closed – bringing him from severe to mild reduction in balance compared to his peers. Elimination of a posterior center of pressure (CoP); significantly reducing his risk of falling backwards.
  • Video Oculography (VOG): Significant improvements in numerous aspects of oculomotor (eye movement) functionality including: gaze holding, slow and fast eye movements, optokinetic responses, and spontaneous/involuntary eye movements.

Better Movement Equals Better Cognition

With an alarming increase in the number of baby boomers and seniors experiencing balance issues and cognitive decline (that are in fact related and measurable), it is important to recognize the symptoms of these potentially debilitating disorders and, more importantly, that something can be done about them. Early intervention is key, as the longer one waits and the more function is lost, the more difficult it is to recover and have full engagement with life. These same concepts apply to all areas of cognitive and mental health.

Learn more on this topic… join Dr. Trayford for his MedFit webinar, Movement and Cognition.

Dr. Michael S. Trayford is a Board Certified in Chiropractic Neurology and Neurofeedback; and is the Founder and Director of Clinical Operations at APEX Brain Centers in Asheville, NC. His primary areas of focus in clinical practice, associated research, and teaching are learning and behavioral disorders of adulthood (with a focus on addictive and compulsive behaviors), brain injury, and cognitive impairment.


Building Strength is an Important Component in a Prenatal Fitness Routine

You may have heard people warn that pregnant women shouldn’t raise anything over their heads or lift objects that are heavier than ten pounds when pregnant. These are warnings that still make the fitness trainer rounds when working with pregnant clients, yet these warnings aren’t based on science.  In fact, there’s no evidence for warning pregnant women to avoid lifting over their head unless it causes discomfort or balance issues, and the ten-pound limit is even more questionable, as ten pounds would be too heavy for some women and as easy as a feather for others.

It’s important to always remember that each pregnant woman has a specific fitness level and ability, so setting arbitrary limits is an ineffective way to provide guidelines for this population. In addition, when confronted with statements such as these, always review the research that supports the claim before implementing the information into your training guidelines.

Many women choose to continue their pre-pregnancy strength training program while they are pregnant, and most women may safely start strength training during their pregnancy as long as they are cleared for exercise by their healthcare provider. When developing a pregnant woman’s fitness program, you should take into account her current level of fitness and strength and pay close attention to how she feels during and after exercise. The key to maintaining a safe and effective routine is through consistent modification of the exercises for comfort as pregnancy progresses.

Strength training is an essential prenatal fitness component, providing the muscle power needed to compensate for posture adjustments and weight gain that occurs with pregnancy. Women who continue or even start a strength training routine during pregnancy can help prepare her body for all the lifting done with a new baby and reduce the risk of low back pain. Strength training has not been shown to pose any harm to either the fetus or the mother as long as these general guidelines are followed:

  • A gradual reduction in weight loads from pre-pregnancy will likely occur as the pregnancy progresses.
  • Women may continue their pre-pregnancy strength training routine (wt/reps/set) as long as they modify the exercises for comfort as pregnancy progresses.
  • If training causes muscle soreness during the pregnancy, it is recommended that overload be progressed by increasing the number of repetitions versus the resistance/wt.
  • Monitor exercise techniques carefully by mirror observation or supervision in order to correct for progressive postural changes that occur with advancing pregnancy. Improper lifting techniques may aggravate back problems and increase soft tissue injuries.
  • Avoid maximal static lifts. They may cause a sudden increase in cardiac output and blood pressure and employ the Valsalva maneuver. During the Valsalva maneuver, there is a significant diversion of blood from the internal organs (such as the uterus) to the working muscles.
  • Maximal lifts may also place extreme stress on the lumbar spine and other joint areas. Never overload an unstable or weakened joint.
  • Modify supine positions after the first trimester of pregnancy by using an incline board or wedge.
  • A strength-training workout involving all the major muscle groups should be performed three times per week, with a rest day between each muscle group training bout.
  • Machines, free weights, resistance bands, and body weight
  • are all options for building a strength training routine.
  • Remind client that she should exhale with the lift and avoid holding her breath or bearing down and straining as she lifts.
  • If a particular exercise continues to produces pain or discomfort are modification, it should be discontinued. If pain persists, the client should consult with her healthcare provider.

As always, all pregnant women should check with her healthcare provider before starting or continuing an exercise program during pregnancy.

Catherine Cram, MS started her company, Prenatal and Postpartum Fitness Consulting, in order to provide current, evidence- based guidelines maternal fitness guidelines to health and fitness professionals. She was a contributing author for the textbook, “Women’s Health in Physical Therapy” and co-authored the revision of “Exercising Through Your Pregnancy” with Dr. James Clapp.  Her company offers the certification course, “Prenatal and Postpartum Exercise Design” which provides continuing education credits for over 30 health and fitness organization, including ACSM, ACE, ICEA, and Lamaze.


Interesting Times for Interested People

So, we are all shut in our homes and are not supposed to go to work, movies, or restaurants to dine in, and we can’t even watch live sports on TV. Life is so bad, and unfair… or is it?

I have decided to look at the bright side of this event, and see it as an opportunity. While many are not in my particular position, and are actually out of job and income due to this pandemic, I want you to reframe it. Change the paradigm of this being a negative, to this being a time for catching up, reflecting, and perhaps actually changing yourself.

We all have parts of our lives that need attention. In today’s current society, it is basically impossible to be all things to all people, including ourselves. We must try to balance job, family, social contact, social media, our own diet, hobbies, medical attention, our education — professionally or otherwise, our spirituality, and even our environment. Having balance in a variety of areas is true wellness! We are often so busy teaching and preaching the benefits of fitness and wellness to others, we deny it to ourselves. I remember doing a self-survey several decades ago by some program discussing the “wellness wheel”, which many of you have probably heard of. The survey was showing areas that needed attention. (Back then I had a very lop-sided wheel, and it is not much better now.) The wheel consisted of a mnemonic (6 components. It has shifted slightly in past few decades, but the pneumonic still works well: SPICES.

Old Wellness Areas New Wellness Areas
S-ocial Social – all interactions with people outside of ourselves
P-hysical Physical – our physiological status
I-ntellectual Intellectual – includes cognitive and emotional health
C-ognitive Career – includes educational and skill acquisition and financial health
E-motional Environmental (could include emotional) – clean, organized?
S-piritual Spiritual – interactions with entities beyond people

I want to use this as a time to clean up many things that have been neglected — both around my house and inside “my house”, my physical body and mental space. I may even use this opportunity to shift my professional pursuits away from academic teaching to wellness coaching. Maybe I can chat on the phone more, spend time with my daughter, or spend more time cooking or reading. Whatever it is, start doing it now!

If nothing else, this has opened the world’s eyes to the need to stay healthy. It has shown people the need to be sanitary and practice good old-fashioned health care techniques, like washing hands and not running out of toilet paper! (Sorry, had to throw that one in!)

As an educator in both physical health and medical applications, we are perfectly positioned to show the communities we live in how to harness the power of exercise for both preventative and rehabilitation purposes. I have learned many new applications for teaching online and most people are focused on coming together for the “greater good”, and this is a breath of fresh air.

Good luck and stay healthy as you address the holistic health agenda in our society.

Dr. Mark P. Kelly has been involved with the health and fitness field for more than 30 years. He has been a research scientist for universities and many infomercial projects. He has spoken nationally and internationally on a wide variety of topics and currently speaks on the use of exercise for clinical purposes and exercise’s impact on the brain. Mark is a teacher in colleges and universities in Orange County, CA., where Principle-Centered Health- Corporate Wellness & Safety operates.


How to Stay on Top of the Game and Not be Vulnerable in Hectic Times

There are a lot of uncertainties currently.  We may feel confused, anxious and fearful — which may lower the frequency of our EMF (1) and our defenses. A depressed immune system is more likely to get sick with anything, not just the Coronavirus. Take this time positively, as a way to be introspective and find new things to do for yourself, your career and relationships. Obstacles are like gifts because without them, life would stagnate. Obstacles create evolution in our lives, taking us to the next level.

Protect yourself physically and mentally

Keep up good hygiene by washing hands when you touch surfaces that could have been touched by others — door handles, street light buttons, credit cards, gas nozzles. Use common sense. You can carry an alcohol spray bottle to spray surfaces and your car floor. Antibacterial can be used also but it is loaded with chemicals. If you go to public bathrooms and have to touch handles, use a paper towel to open doors and then trash it. Try to use your elbows instead of your hands when you can.

Maintain regular positive conversations and support with your friends and family, even if it’s on the phone. It’s not good to be isolated when you have to stay home. Communicate with positive people and not those who only speak negatively or with fear, especially if you are empathetic. This will keep your vibrations high.

There are 2 main things with scientific evidence that you can do to maintain your high vibes and feel calm – which will help your immune system.

1. Meditation & Deep breathing:                        

When challenges are high, our emotions are also high and the situation becomes chaotic.

Our the body doesn’t know the difference between real danger ( i.e., being in war or being chased by a jaguar) and an imaginary one (i.e., not meeting a deadline, final exams, arriving late to a class). So, we can control these emotions as to not create more chaotic ones. Acute stress from these situations raises our cortisol levels, affects our cells and overall health. The mind gets blurry with a lot of thoughts and you cannot see the solution.

We don’t have to repress the situation but be aware and start controlling our breath. CONTROLLING OUR BREATH, concentrating in equal inhales and equal exhales, the body and the cells will understand they are safe and there is time to heal. The body will know that there is no way we are in a dangerous situation,  that it is time to relax, that we are safe, we are healing and we open our energies to receive better answers for our life choices.


Sit in a quiet area and concentrate on your breath. Start with 2 inhales and 2 exhales for one minute, then pass to 3 inhales and 3 exhales for 2 minutes,  then 4 inhales and 4 exhales for 2 minutes, until at least 6 minutes — or the most you can do. Observe how the more you concentrate on your breath, the less thoughts come to your brain.

Difference between deep breathing and shallow breathing

SHALLOW BREATHING is superficial breathing using only the lungs. The lungs have a limited air capacity contrary to what we think. This is the everyday breathing pattern we use in this fast paced society. It is the cause of stress, ailments, panic attacks, asthma, pneumonias, hyperventilation and many more problems. It makes stress a habit. It reduces the production of white blood cells that defend our bodies from external organisms that weaken the immune system. It also tightens the back, neck and shoulder muscles causing back pain and headaches.

DEEP BREATHING (2) is done using the diaphragm and the abdomen, which have more capacity for storing oxygen than the lungs. It is the breathing of babies. You inhale with a controlled rhythmic pattern (Pranayama). Retention of the air, exhalation and deep breathing every time, as practiced by the Yogis, can reverse health conditions, strengthen the immune system, lower high blood pressure,  alleviate heart conditions, muscle pain and respiratory conditions, like asthma and bronchitis.


Sit or lay down in a quiet area and put your hands on top of your diaphragm. Feel the diaphragm expanding as the air is filling your abdominal cavity like a balloon and then exhale feeling the air leaving the cavity. This will utilize the best amount of oxygen, keep thoughts away and relax the whole body. Do it for at least 5 minutes or the most you can do. Increase time progressively.

Maintaining the same breathing pattern concentrate on each part of your body especially where you feel pain or tension. Imagine a white light while you inhale and release. Visualize the tension leaving your body and evaporating.

2. Physical exercise and your immune system                                                                      

Gyms closed? No excuse to not keep or bodies moving. Exercise has something no other medicine can provide. When you move you are telling the cells, “I am alive, I am strong”. Even if we are not doing it consciously, our subconscious mind picks up the exercise habit and incorporates it as a pattern. This can change our subconscious from “I am weak” to “I am strong”. Thoughts can shape our whole body and our cells will benefit tremendously.

If you have to stay indoors, you can use any equipment you have to do at least 20-30 minutes of cardio to work on your strength and abs. You can see some ideas on my YouTube channel.

If you can go outdoors bike, hike, walk and run at beaches and parks.  The open environment is safer than indoors, especially because you can maintain the distance from others easily. You can do any routine or use my Beachblast video that can be done anywhere – in a park, at the beach or in a pool.  It combines cardio drills, core strength, pilates for abs and legs followed by relaxing Yoga posses.

Graciela Perez is a National Academy of Sports Medicine (NASM) Personal Trainer, Aerobics and Fitness Association of America (AFAA) Aquatic Specialist, CETI Cancer Exercise Specialist, Health & Wellness Coach and Energy Healer. She’s been helping people reaching their health and fitness goals since 2003. Visit her website, hollywoodfitness.org


(1) EMF: Electro Magnetic Field is the energy that surrounds our bodies and it is influenced by our thoughts and emotions. Our thoughts and emotions can pass to our EMF and can shape matter (the body, cells and how healthy we are). If we are in fear, this negative emotion will affect EMF (our energy) and affect our body’s immune system. For more info on Energy Medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2952118/

(2) For deep breathing: