Exercising: Long-term.

Exercising Long Term

 

by: Dr. Brandie Nemchenko

 

Many of us will be out walking the streets after the mountains of snow melt to get exercise - walking or running.  Ever experience pain after your power walk or run to the point you just can't continue, thwarting your plans overall of not being able to exercise at all?

Let's make this year different! 

Wrong Intention

We've all been there.  It's a gorgeous day, the birds are singing, the wind is gently blowing, and you think - "Hey, I can take on one more hill - I haven't been out all winter and I've already run a mile, let's jog up one of the General's hills."  The next day, you can't walk.  Hobbling around - you wonder "Why do I always get hurt every.time.I.exercise.?"  

Research before going out.  Running seems simple, but it is a science.  Get a game plan of how to train.  I recommend the Couch to 5K program to my patients (www.coolrunning.com) which is a series of walking/running intervals to slowly and safely get you moving.  This provides a plan of attack with getting in shape, not only cardiovascularly, but also on your muscles and tendons.  

So how do you know what is the difference between the strain of getting back in the saddle an hurting yourself?  Sharp pain that hits and and reproduces consistently after when you "push it" means you are pushing your body past what it can take, leading to microtears or stress reactions in the bone leading to stress fractures.  If you have such pain - stop.  RICE when you get home.  If it happens consistently, seek out a sports medicine specialist chiropractor, physical therapist, or orthopedic.

A great way to ice your shins is to prepare by taking your kid's Dixie cups and filling them 3/4 of the way.  Freeze them and when you get back from a run - peel them around the top, and viola! You have a deep chill for your aching shins!  (Use only less than 5 minutes moving quickly up and down the shin.)

Wrong Equipment

Did you know there are three types of sneakers?  And it is not Nike, Adidas, and New Balance!

Shoe manufacturers make different types of sneakers to address different foot types. (www.runningshoetypes.com) The majority of people are pronators, which means your foot is flatter, or rolls in.  This puts tremendous stress on the middle of your shin, knee and hip.   This stress may be ok when you are just walking around - but add a little jog - and your feet and  knees start to scream.  

The opposite foot type is a supinator - or someone who has high arches.  That type of foot has it's own shoe type as well.

I used to buy shoes because I liked the color or design and wonder why they had no arch support.  If you plan on running more than just around your neighborhood and entering a 5K of more - seek a running store out to get fitted.  At least then you will know your foot type and can get the appropriate type of shoe for your foot type.

In going with that - be very careful shopping for sneakers in an outlet.  I used to buy my sneakers in Lancaster at the Nike outlet - and would be thrilled getting a cute pair for $39.  The material they make the shoes out of degrades over time.  If the shoes have sat and now are at an outlet - you could have one shoe degrade faster or they are in an outlet because they are slightly defective.

Before purchasing the shoes - put them up on a counter and get eye-level with them.  Look to see that the back of the shoe is the same height - or you may inadvertently buy one with a virtual heel lift on one - making your foundation off-balance.

Wrong Foundation

If you get hurt every time you exercise, it is a good thing to get evaluated by a sports-focused and trained PT or chiro who takes a structural approach.  Because just like your car, if you are unbalanced, you will wear down unevenly and that is what leads to injury.  How many of you have heard of a parent or friend needing a knee replacement because of "old age?" 

Here's a question....how old is the other knee and why is nothing wrong with it?

Our arches are held together by ligaments, the plantar fascia.  Over time (and kids!), these arches stretch.  Ligaments are like plastic fruit bags.  If you stretch a plastic bag - it doesn't rebound, like a rubber band (which is more like a muscle).  Most times, these arches stretch inconsistently - leading you to have one flatter foot on one side. 

This leads to having an unbalanced foundation without you even knowing it!  If any of you have been to chiropractors, they may talk about one leg being shorter (which is caused by either a prior break in that leg or a misalignment of their pelvis which causes their gluteal muscles to be too tight - drawing the leg up and making it "appear" shorter.  If your chiropractor is not checking your feet to see if that is that is making your one hip lower - they are missing the boat.  If something is wrong with your feet and they just adjust your pelvis - as soon as you step away from the table, the pelvis is not supported and your adjustment doesn't last.

Some of my patients upon learning they have a short leg exclaim, "I knew it!  My pants never fit right - one side was always longer." or "I always feel as though I was putting more pressure on my right leg."  

A balanced body has less injury and less stress than one that is unbalanced. 

Getting outside and getting active are great ways to improve your health.  Think more longterm instead of quick fix this year - and your longevity with a program will expand.  You'll be less injury-prone and be able to reach the goals you set, pain-free.

Are You Skinny Fat?

Ah, spring time…time to clean up your closet, clean up your diet, and most importantly clean up your health. For many of my patients, I see them launch into a crash diet.  To be honest, I did the same.  But what happens when you are done?  You gain it back….but why?

Perhaps  you’ve gained weight from eating more of what you didn’t before.  But it goes deeper than that.  For those that have lost over 20 lbs. and put it back on quickly, it has more to do with how you took it off.

In 2001, I weighed 265.  I blamed it on having a baby – but I had her in 1998.  Admittedly, I’m tall – but 265 is pushing it.  My body hurt.  I wore a size 22.  After Christmas of 2000, my sister got cute little workout clothes, and I got kitchen equipment and mumu’s.   I had had enough!  Nearing the clinic in chiropractic school, I didn’t see any overweight chiropractors and said, “I don’t want to be the only overweight chiropractor.”  (Since then, I’ve seen many :) – but I used that as a mantra.  

Using Weight Watchers, over the course of a year, I lost 80lbs.  Sometimes I would fast if I ate too many points and eat a head of broccoli for dinner or their Cheese Soup that was 1 point.  I didn’t really change what I ate – only the amount.

When I lost the 80^th pound, I stood up and bragged how I never had exercised ONCE.  Not one single time in the entire year and I still lost weight.  How stupid I was.

After keeping the weight off – I looked great.  I wore a size 12 (I’m 5’11) so that was great for me!  

My first job was at Gold’s gym in King of Prussia.  People thought I looked fit and invited me to the circuit class.  

Again – thinking because I’m thinner – I am in shape, right?  The circuit class was held in the middle of the floor for all to see working out.  Within 2 stations, I was ready to puke.  With sheer embarrassment, I shook off to the bathroom and could not get out of the stall for an hour!

So embarrassing!

So here is what happened.  I lost 80 lbs. in 7 months.  I burned off the fat, along with lean muscle.  Lean muscle is an indicator of health and vitality. Because I burned off my lean muscle, lack of exercise resulted in rapid weight gain.  When you crash diet you take away the bad and the good.  Even if you exercise and diet – if you do it too fast (which is what everyone wants!) – you‘re setting yourself up for future failure.

When you diet to lose weight, your goal should be to maintain your lean muscle while losing the fat.  How do you monitor this?  We use a device called a Bioimpedance Analysis . A BIA evaluates your body fat, lean body mass, and calculates your fat content.  This is the most accurate, short of a DEXA scan.  People think the underwater body testing is accurate, but the BIA is just as effective, as you cannot express the oxygen out of your lungs which occupies mass and space.

How should you do it?

1.    Incorporate an exercise program, even if it is just walking.  For us women over 35, you should include a weight-bearing exercise program with weights.  Women will NOT bulk up using this.  If you need help, ask your sports medicine doc, chiro, or PT.  Perhaps you have a trainer at the gym and have never used your free sessions.

2.    Don’t push it.  It took time to put the weight on, and long-term, do you want to just lose it now, only to gain it back?

3.    Make sure you are eating whole foods that are nutrient-dense.  The more ingredients something has – typically the less healthy it is. 

If you ever have any questions, please ask.  I took off 18lbs. last year – and I know each one of them is off for good!  Losing weight is simple science, but it is important to understand the why’s to gain long-term weight loss.

Breech Babies

Me and my new niece, Quinnie - March 2011

One of the most spiritual moments in practice was in April of 2007.  I had a mom who was on her third pregnancy - and she had a transverse breech baby.  At 38 weeks, she was so nervous because her other two came early and she didn’t want a c-section.  On the second visit I saw her, I could feel the baby playing with me with her feet on the left side of mom’s abdomen.  I myself was 7 months pregnant - so we joked that our girls were playing together.  I adjusted her lower back gently and turned her over.  As we chatted - I applied a gentle pressure on a trigger point in her round ligament near her lower abdomen.  Her baby began to kick on the right side.  I talked softly to the baby - and all of a sudden, I felt the baby’s head which was on the right side poking out to the right side of mom come down and pass under my thumb like a Skee Ball just rolling down and RELIEF.  We both knew that her baby had moved right into position to be delivered.  It was incredible.  3 days later, she delivered a healthy happy little girl.

Many of you have heard me say that around 4 times per year - 85% of my entire practice is pregnant.  They come in crops.  :) I love, love, love seeing moms.  Especially first time ones.  They have NO idea what they are in for....the good (and sometimes the sleeplessness, etc) but overall - the amazing experience of having a baby.

If someone were to ask me what my favorite type of patient I see, it is a breech presentation mom.  They come to me by their trusted OB, midwife, or by doing a desperate search on the internet.  I can’t even imagine - a pregnancy that has been humming along so perfect and then **BAM** you find out the baby is breech.  Everything stops.  The priority is now turning the baby.  Before that - a woman is already dealing with the impending obvious that the end is near - and “How am I gonna give birth?”  (to which I always recommend gently for them to go to the mall and sit down - and watch the hundreds of people walking by - each coming out somehow and ok! :)

So breech.   There are a few types of breech.  Footling breech (meaning the feet are presenting first), frank breech (where the bum is presenting first) and my favorite (although not a favorite for a pregnant mom), the transverse lie.  Carrying a baby should look like a watermelon standing on end.  A transverse just looks painful, in that it looks like the “watermelon” went sideways - stretching, stretching, stretching.

Why does breech happen?  No one knows for sure.  I see about 100 cases a year.  Babies naturally should start to get into a head down position around 32 weeks.  Definitely by 36 weeks. Some moms can feel that the baby changed position - or in some cases can feel the kicking down below.  Ouch.

To a chiropractor - breech happens most times because of improper alignment/biomechanics or the structure of the mother.  Think of this.  If your pelvis is two moving pieces held together by ligaments (like plastic fruit bags that stretch and don’t come back to their normal shape, called plastic deformity) and one side of your pelvis is malpositioned - it pulls or puts an unequal stress on another part.  

So let’s say someone’s sacrum (part of that complex) is sticking too far back on the right.  It is in the wrong position and could have been for years without symptoms - the compensatory way your body deals with that being all the way back there is to tighten the other side as a counterbalance.  

It is more complicated and medical-esed that that - but I digress.  

The ligament that takes the brunt of that backward pull on the front - is the round ligament - which in a pregnant stomach is around the bottom underside of the belly.  If you were like me - a few times I thought I was being stabbed with my first there - because of the rapid expansion.  Anyway - that ligament gets too tight and causes what we pregnancy chiropractors call, “Interuterine constraint.”  I call it not enough room on the one side for your baby to “spin.”

How does a chiropractor assess if someone for Webster protocol?  In my office - I put them on comfy pillows on their belly.  I find out which side is “stuck” in the sacrum.  I adjust that side and nothing else.  That helps take the “slack” out of the tension in the front.  I turn them over (telling her to tell me if she gets dizzy because we are only going to be on the back for 2 minutes - when you lay on your back in a hospital bed for hours on your back it’s safe) and in a specific spot - find a trigger point that the mom and I can both feel - and I hold light pressure until that knot lets go a bit.  It is unbelievably gentle compared to a medical inversion.

Also helpful is acupuncture with moxibuxtion, I’ve seen.  

So the next time you hear of someone who has a breech baby, tell them not to fret.  Chiropractors have great results with Breech babies, the national average is around 85%.  My average over almost 10 years is around 92% which is awesome.   It’s gentle and safe!

How do you find a chiropractor who does this and is certified?  www.icpa4kids.com is a great resource for finding docs with that certification.

Until next time, if anyone has any questions about health or chiropractic, please feel free to get a no pressure answer email me at drbrandie@gmail.com.  Or I could write about it for next month! 

Breech
By: Dr. Brandie

One of the most spiritual moments in practice was in April of 2007. I had a mom who was on her third pregnancy - and she had a transverse breech baby. At 38 weeks, she was so nervous because her other two came early and she didn’t want a c-section. On the second visit I saw her, I could feel the baby playing with me with her feet on the left side of mom’s abdomen. I myself was 7 months pregnant - so we joked that our girls were playing together. I adjusted her lower back gently and turned her over. As we chatted - I applied a gentle pressure on a trigger point in her round ligament near her lower abdomen. Her baby began to kick on the right side. I talked softly to the baby - and all of a sudden, I felt the baby’s head which was on the right side poking out to the right side of mom come down and pass under my thumb like a Skee Ball just rolling down and RELIEF. We both knew that her baby had moved right into position to be delivered. It was incredible. 3 days later, she delivered a healthy happy little girl.

Many of you who attended the UMMC Fit Fest in my office heard me say that around 4 times per year - 85% of my entire practice is pregnant. They come in crops. :) I love, love, love seeing moms. Especially first time ones. They have NO idea what they are in for....the good (and sometimes the sleeplessness, etc) but overall - the amazing experience of having a baby.

If someone were to ask me what my favorite type of patient I see, it is a breech presentation mom. They come to me by their trusted OB, midwife, or by doing a desperate search on the internet. I can’t even imagine - a pregnancy that has been humming along so perfect and then **BAM** you find out the baby is breech. Everything stops. The priority is now turning the baby. Before that - a woman is already dealing with the impending obvious that the end is near - and “How am I gonna give birth?” (to which I always recommend gently for them to go to the mall and sit down - and watch the hundreds of people walking by - each coming out somehow and ok! :)

So breech. There are a few types of breech. Footling breech (meaning the feet are presenting first), frank breech (where the bum is presenting first) and my favorite (although not a favorite for a pregnant mom), the transverse lie. Carrying a baby should look like a watermelon standing on end. A transverse just looks painful, in that it looks like the “watermelon” went sideways - stretching, stretching, stretching.

Why does breech happen? No one knows for sure. I see about 100 cases a year. Babies naturally should start to get into a head down position around 32 weeks. Definitely by 36 weeks. Some moms can feel that the baby changed position - or in some cases can feel the kicking down below. Ouch.

To a chiropractor - breech happens most times because of improper alignment/biomechanics or the structure of the mother. Think of this. If your pelvis is two moving pieces held together by ligaments (like plastic fruit bags that stretch and don’t come back to their normal shape, called plastic deformity) and one side of your pelvis is malpositioned - it pulls or puts an unequal stress on another part.

So let’s say someone’s sacrum (part of that complex) is sticking too far back on the right. It is in the wrong position and could have been for years without symptoms - the compensatory way your body deals with that being all the way back there is to tighten the other side as a counterbalance.

It is more complicated and medical-esed that that - but I digress.

The ligament that takes the brunt of that backward pull on the front - is the round ligament - which in a pregnant stomach is around the bottom underside of the belly. If you were like me - a few times I thought I was being stabbed with my first there - because of the rapid expansion. Anyway - that ligament gets too tight and causes what we pregnancy chiropractors call, “Interuterine constraint.” I call it not enough room on the one side for your baby to “spin.”

How does a chiropractor assess if someone for Webster protocol? In my office - I put them on comfy pillows on their belly. I find out which side is “stuck” in the sacrum. I adjust that side and nothing else. That helps take the “slack” out of the tension in the front. I turn them over (telling her to tell me if she gets dizzy because we are only going to be on the back for 2 minutes - when you lay on your back in a hospital bed for hours on your back it’s safe) and in a specific spot - find a trigger point that the mom and I can both feel - and I hold light pressure until that knot lets go a bit. It is unbelievably gentle compared to a medical inversion.

Also helpful is acupuncture with moxibuxtion, I’ve seen.

So the next time you hear of someone who has a breech baby, tell them not to fret. Chiropractors have great results with Breech babies, the national average is around 85%. My average over almost 10 years is around 92% which is awesome. It’s gentle and safe!

How do you find a chiropractor who does this and is certified? www.icpa4kids.com is a great resource for finding docs with that certification.

Until next time, if anyone has any questions about health or chiropractic, please feel free to get a no pressure answer email me at drbrandie@gmail.com. Or I could write about it for next month! Have a great April!