Elevate Physical Theraphy & Fitness

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SHOULD YOU TAKE PROBIOTICS?

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  Probiotics are  “good” bacteria that are beneficial to the body. Probiotics exist naturally in some foods (such as some types of yoghurt and fermented vegetables such as pickles and sauerkraut), but can also be taken in dietary supplement form, via products such as Yakult. While our digestive system ordinarily contains trillions of microbes, including both “good” and “bad” bacteria, sometimes the balance between these can get out of whack. Diseases, poor lifestyle behaviours (such as not eating enough fruit and vegetables, heavy drinking, smoking, and physical inactivity) and ageing can all disrupt this balance.   Benefits Microbes in the lower intestinal tract help us digest food, fight harmful bacteria, and regulate the immune system. But sometimes an imbalance of microbes occurs, leading to diarrhea and other health problems. When the gut becomes unbalanced with unhealthy levels of certain bacteria, probiotics can help restore the balance. They’ve been shown to secrete protective substances, which may turn on the immune system and prevent pathogens from taking hold and creating major disease.  Some studies that suggest if you take a probiotic while taking antibiotics, you’re less likely to get diarrhea caused by the antibiotic. Probiotics taken as a supplement may also reduce the number of colds you’ll have in a year. Probiotics are commonly used to reduce gastrointestinal symptoms that are not due to acute illness, such as gas, bloating, and constipation. However, there isn’t  a lot of evidence to document that this works, particularly in older people. Risks There are many types of probiotics on the market. Some have been well studied, and some haven’t. One potential risk is if someone has an immune system weakened by illness or medication, that person could get sick from taking probiotics. Another concern about probiotics is that they’re considered dietary supplements, not drugs. As a result, the FDA doesn’t monitor the manufacture of probiotics. It’s hard to know if probiotics that can be bought at pharmacies and health food stores are high-quality products. It’s even possible that some lower-quality products may not even contain the probiotic bacteria that are listed on the label. Recommendations Don’t start taking probiotics without talking to your doctor or pharmacist about whether probiotics might help you. People who have immune deficiency or are being treated for cancer should not use probiotics without a doctor’s okay. The most common species of bacteria used in probiotics (among a potential 3,000 or so) are species of Lactobacillus or Bifidobacterium. The bacteria are usually freeze-dried (but remain alive); when you take the supplement, they warm up in your digestive system and become fully active. You can find probiotic supplements in most drugstores and supermarkets. They come as capsules or tablets to swallow and as loose powder to sprinkle on food. You’ll want a product that explicitly states a “sell-by” date. Dosages vary by product, so no general dosing recommendation can be made. However, common dosages for adults range from five billion to 10 billion colony-forming units per day. Take just one dose of probiotics per day. Some people may experience diarrhea in the first few days of taking probiotics, but this goes away. probiotics at the end of a meal may help to reduce the symptoms.

STICK MOBILITY

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    Here are 6 of our favorite mobility flow sequences with Stick Mobility • Ninja Flow From the shoulders and chest, down the thoracic spine and into the hips and lower limbs, the ninja flow is an excellent way to synergistically open up the entire movement system throughout the kinetic chain.  Slapshot Rotational range of motion and muscular coordination is critical for athletic and everyday activities alike – whether you are looking at improving your golf swing or reaching back behind the passenger seat to grab your bag, the slapshot will give you the edge you need to move smoothly and efficiently. • Split Stance Bow & Arrow The SS Bow and Arrow is an outstanding way to activate the muscles of the lower extremities for stability and balance while simultaneously encouraging mobility through the spine up the chain into the shoulder and upper extremities. • Single-Leg RDL Counterforce This movement flow adds a core activation and balance challenge to the traditional single-leg deadlift and is a must-have for the athlete or weekend warrior looking to take their RDL to the next level. • Half-Kneeling Bow & Arrow Tight hips and stiff shoulders? The HK Bow and Arrow is a perfect way to release this tension and open up the lateral chain for more fluid movement.   Half-Kneeling T/S Opener Not only does this seemingly simple mobility flow release tension in the hip flexors while activating the gluteal muscles, it also encourages rotational movement throughout the thoracic spine.  

WORKOUT ON YOUR TRAVELS

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Excited about your Summer vacation but worried about losing your fitness gains?  Here are some great exercises you can take on the road. All you need is a mini loop band and a resistance band. No matter how full your bag is or how little space you have to move, there’s no excuse !     ❇️Banded Pull Aparts: This is a great exercise to strengthen your upper back and increase shoulder mobility. Grab the band with an overhand grip with palms facing the ground. Your hands should be approximately shoulder width apart, go wider or narrower depending on the tension of your band. Your arms should be parallel with the floor with  elbows fully extended. Pull the hands apart squeezing your upper back musculature and bringing your shoulder blades together. The band should make contact with your sternum. ❇️Banded Bicep curls: Stand with one foot on your resistance band holding handles or ends next to your sides with palms facing forward.  Slowly curl hands up to shoulders, squeezing biceps and keeping elbows next to your sides. Slowly release arms back down to starting position• ❇️Banded Step-outs This is a great exercise for your glute medius. Place mini loop band around your legs just above your knees. Place your feet shoulder width apart, keep a slight bend in your knees and your chest up. Push hips back as though you were about to begin a squat motion. Step to the side with the right foot. Your stance should be well outside of shoulder-width. Pause, then step back into the start position. Repeat for the desired number of reps and then repeat on the left side• ❇️Squat Progression: A common form flaw with squats is the caving in (valgus) of the knees. This is often caused by weak glutes and abductors. The mini band is a great tool to correct this flaw in technique. The tension of the band increases bodily awareness, creating a mind-muscle connection in those areas. Performing banded squats for reps allows you to strengthen the proper squat form. Progress from a squat to a squat- jump, to a lateral or  an “In n’ Out” squat jump to increase the intensity.

HOW TO COMBAT BLOATING

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Bloating can often cause pain, discomfort and a “stuffed” feeling, while making your stomach look bigger.It involves excessive amounts of solids, liquids or gas in your digestive system.  Sometimes bloating can indicate a serious medical condition, but is more frequently  caused by the diet and some foods or ingredients you are intolerant to.   Don’t Eat Too Much at a Time Being overly full after a meal can feel like being bloated, but the problem is that you simply ate too much. If you’re eating big meals and tend to feel uncomfortable afterward, then try smaller portions. Add another daily meal if necessary. Chewing your food better reduces the amount of air you swallow with the food. It also makes you eat slower, which is linked to reduced food intake and smaller portions.   Avoid Swallowing Air and Gases There are two sources of gas in the digestive system. One is gas produced by the bacteria in the gut. The other is air or gas that is swallowed when you eat or drink. The biggest offender here is carbonated beverages like soda or fizzy drinks.  Chewing gum, drinking through a straw and eating while talking or while in a hurry can also lead to increased amounts of swallowed air.   Rule Out Food Allergies and Intolerances to Common Foods Food sensitivities and intolerances are fairly common. Consumption of food you are intolerant to can cause excess gas production, bloating and other symptoms. Some common foods and ingredients to consider: Lactose: Lactose intolerance is associated with many digestive symptoms, including bloating. Lactose is the main carbohydrate in milk. Fructose: Fructose intolerance can lead to bloating. Eggs: Gas and bloating are common symptoms of egg allergy. Wheat and gluten: Many people are intolerant to gluten, a protein in wheat, spelt, barley and some other grains. This can lead to various adverse effects on digestion, including bloating. Both lactose and fructose are a part of a larger group of indigestible carbs or fiber known as FODMAPs. FODMAP intolerance is one of the most common causes of bloating and abdominal pain. *If you strongly suspect that you have a food allergy or intolerance, see a doctor.   Avoid Swallowing Air and Gases There are two sources of gas in the digestive system. One is gas produced by the bacteria in the gut. The other is air or gas that is swallowed when you eat or drink. The biggest offender here is carbonated beverages like soda or fizzy drinks. Chewing gum, drinking through a straw and eating while talking or while in a hurry can also lead to increased amounts of swallowed air.     Try a Low-FODMAP Diet FODMAP stands for fermentable oligo-, di-, mono-saccharides and polyols. These are the scientific terms used to classify groups of carbs that are known to trigger digestive symptoms like bloating, gas and stomach pain.   Studies have shown that indigestible carbohydrates called FODMAPs can drastically exacerbate symptoms in people with Irritable bowel syndrome (IBS). A low-FODMAP diet has been shown to lead to major reductions in symptoms such as bloating  in IBS patients. If you have problems with bloating, with or without other digestive symptoms, a low-FODMAP diet could be a solution.   Here are some common high-FODMAP foods:   Wheat Onions Garlic Broccoli Cabbage Cauliflower Artichokes Beans Apples Pears Watermelon This diet can be difficult to follow if you’re used to eating many of these foods, but may be worth a try  if you have bloating or other digestive problems.   Be Careful With Sugar Alcohols Sugar alcohols are commonly found in sugar-free foods and chewing gums. These sweeteners are generally considered to be safe alternatives to sugar. However, they may cause digestive problems in high amounts. The bacteria in your large intestine digest them and produce gas. Sugar alcohols are actually FODMAPs as well, so they are excluded on a low-FODMAP diet. Try avoiding sugar alcohols like xylitol, sorbitol and mannitol. The sugar alcohol erythritol may be better tolerated than the others, but it can also cause digestive issues in large doses.   Peppermint Oil May Help Bloating may also be caused by a change in function of the muscles in the digestive tract. Drugs called antispasmodics, which can help reduce muscle spasms, are sometimes prescribed for this. Peppermint oil is a natural substance that is believed to function in a similar way. It has been shown to reduce various symptoms in IBS patients, including bloating. Peppermint oil is available in supplement form.     Drink More Water It might sound counterintuitive to drink more water when feeling bloated, drinking water can actually help relieve the condition . Drinking plenty of water helps to naturally flush our systems of excess water and sodium that we might retain. If drinking enough water is a challenge for you, try eating foods with high water content, like watermelon, tomatoes, grapefruit, and cucumber. Coconut water contains potassium, similar to a banana, and electrolytes that maintain regular fluid levels in the body, all helping to alleviate the symptoms of bloating.   If your symptoms of bloating persist for more than a few days then it’s important to contact your healthcare provider to rule out the possibility of a medical condition.

HOW MANY PUSHUPS CAN YOU DO?

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The ability to do a lot of pushups may be a sign not only of strength, but also of good heart health, a new study in the JAMA suggests. The study tested the stamina of middle-aged male firefighters. It found that those who could do more than 40 pushups in a row had a 96 percent lower risk of being diagnosed with heart disease or experiencing other heart problems over a 10-year period, as compared with those men who could do fewer than 10 push ups. Pushup capacity could be an easy, no-cost method to help assess cardiovascular disease risk. The study was published Feb. 15  2019 in the journal JAMA Network Open. Being physically fit is linked with better heart health. But it can be difficult for doctors to accurately assess a person’s fitness level during a routine visit. Doctors sometimes use “treadmill tests” to evaluate a person’s fitness level. In these evaluations, people run on a treadmill until their heart rate reaches a certain level. But the tests are time-consuming and require expensive equipment, so they aren’t done routinely. The new study tested whether a simple exercise like a pushup could provide clues to heart health. To find out, researchers examined records from more than 1,100 Indiana firefighters (with an average age of 39) who underwent a pushup test at the beginning of the study. The participants were then followed for a decade to see if they experienced a cardiovascular event, such as a diagnosis of coronary artery disease, heart failure or cardiac arrest. During the study period, 37 cardiovascular events were found among the study participants, but only one cardiovascular event occurred among the men who completed more than 40 pushups. Those who could do 11 or more pushups had a lower risk of cardiovascular events, compared with those who could do 10 or fewer, the study found. And men who could do more than 40 pushups had the largest reduction in risk. Pushup capacity is not necessarily an “independent predictor” of heart disease risk. That is, there may be other factors tied to heart disease risk that are also related to how many pushups an individual can do. Such factors could include a person’s age, body mass index (BMI) and aerobic fitness level. But, in general, pushup capacity could be an indicator of overall fitness. More research is now needed to examine the link between pushup ability and heart disease in the general population, including among women and less-active men, the researchers noted in their paper.  Check out how many push-ups Elevate Founder Dr. Meredith Soelberg PT, DPT, MBA can do!    

SURFING DYNAMIC WARMUP

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Hey surfers! Here’s a dynamic warm-up just for you designed by Elevate Co-founder Dr. Meredith Soelberg PT, DPT, MBA. Research is clear that a dynamic warm-up (vs. static stretching) is best to prepare for sport ️ and to prevent injuries. A sport-specific warm-up is specially designed to move the body through the necessary range of motion and activate the neuromuscular system in ways that simulate the sport. ‍Surfing is a high demand sport with significant injury risk. Up to ⅓ of surfers sustain an injury each year requiring medical attention, missed work, or time off from surfing,  and 91% of surfers have sustained an injury surfing in their lifetime. We see lots of injured surfers at Elevate. Most often we hear that they don’t warm-up at all,🤭 and don’t have an exercise regimen to get their bodies strong for the great demands of surfing. A surf-specific dynamic warm-up will go a long way to help mitigate the risks and prevent injury (especially when combined with our surf-specific strength exercises coming next week). We know the waves are like a Siron song calling you the minute you feel the sand in your toes, but put earplugs in for just 5 minutes and prepare your body for the awesome intensity of surfing!   What a surf-specific dynamic warm-up can do for YOU: Increase core temperature Increase blood flow to muscles Increase stimulation to mechanoreceptors in joints Increase stimulation to the central nervous system Increase musculoskeletal control Increase confidence for performance Increase movement through the range of motion demands for the upcoming activities ️Improve exercise / sport performance Reduce risk for injury If you don’t have 5 minutes to spare, here’s the 60sec express version!    

ELEVATE SPRING CHALLENGE

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    The moment you’ve all been waiting for has arrived! The official announcement of Elevate’s Spring 60-second Fitness Challenge!  How much can you give in 1 minute?! With a little recovery time between each one, we’re sure you’ll be able to surprise yourself with what you’re capable of! Check out the video below to see each exercise in motion!! And the come on into Elevate and get your name up on our scoreboard!!          

WHY YOU MUST BOOST YOUR FIBER INTAKE!!

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A major study has been investigating how much fiber we REALLY need to be eating and found there are HUGE Benefits! 1️⃣ Reduced risk of debilitating heart attacks and strokes. 2️⃣Reduced risk of type-2 diabetes. 3️⃣Easier weight management. 4️⃣ Reduced blood pressure and cholesterol levels. 5️⃣It’s cheap and widely available in the grocery stores!! The national recommendations for fiber intake are 30-38 grams per day for men and 25g for women. For many people it can be a challenge to include that much fiber and most people top out at 15g. The lancet medical journal suggests that if 1000 people shifted from a low (<15g) to a high fiber diet (>25-29g) It would prevent 13 deaths and 6 cases of heart disease. This was based on research that followed people from 1-2 decades. They also found reduced levels of type 2 diabetes and bowel cancer as well as lower weight, blood pressure and cholesterol levels The more fiber consumed the better. Soluble fiber, which dissolves in water, can help lower glucose levels as well as help lower blood cholesterol. Foods with soluble fiber include oatmeal, nuts, beans, lentils, apples and blueberries. Insoluble fiber, which does not dissolve in water, can help food move through your digestive system, promoting regularity and helping prevent constipation. Foods with insoluble fibers include wheat, whole wheat bread, whole grain couscous, brown rice, legumes, carrots, cucumbers and tomatoes.

HEAD & NECK INJURIES

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Recently, the topic of head injuries, including concussions, has rapidly come to the forefront of sports medicine. The prevalence of head and neck injuries in all sports has led to an increased awareness and education on concussions; what they are, how they occur, and how they’re diagnosed. However, risk factors related to demographics and optimal treatment approach to a diagnosed concussion is still evolving. The “boom” of the concussion topic begs the question: why are there so many concussions? Are our bodies prone to head injury? Is there something we can do to decrease risk for a head injury? Recent studies have shown that women take longer to recover from a TBI (traumatic brain injury), report more symptoms and receive more concussions than men in similar sports, possibly due to neuroanatomical differences, weaker neck muscles and hormonal changes. Hormones and the physiology of women’s necks and upper bodies are two possible reasons why women experience concussions differently than men.1 Specifically in the sport of soccer, concussions are recorded to occur just as frequently as they occur in football and ice hockey, with the risk being higher in goalkeepers, females, and youth.2 Head-to-head contact is the most common mechanism for concussion diagnosis in soccer, while heading the ball is not a common cause. Many head-to-head contact injuries occur accidentally, or unintentionally, but there is less understanding of how intentional head impacts (i.e. heading in soccer) can also cause brain injury and affect cognitive function. Although concussions have been the “hot topic” in recent years, all head injuries are not diagnosed as concussions. In soccer, intentional head impacts (i.e. heading the ball) have been shown to worsen cognitive function, specifically associated with frequent ball heading, rather than unintentional head impacts due to collisions.3 Furthermore, another study revealed that kids between the ages of 9 and 11 who experienced at least one “subconcussive” impact associated with heading the soccer ball showed decreased cognitive test scores. These changes in cognition showed variation in gender, suggesting girls had memory changes, whereas boys had processing changes.4 Another study has shown that heading soccer balls is more damaging to the female brain than the male brain. These findings suggest that gender-specific guidelines for soccer heading may be required. Researchers suggest that females are more at risk for brain injury associated with heading a soccer ball due to differences in neck strength, sex hormones or genetics.5 Not only does heading in soccer cause head injury, but it can also lead to neck injuries associated with the cervical spine. These potential injuries include muscle strains, ligamentous sprains, compressive disc injuries and joint injuries. With all this risk for injury associated with heading the soccer ball, what should be done about it? Some researchers, after analyzing the data of their respective studies, have considered the question of whether or not heading should be allowed, but realized that that would be unrealistic. They have also posed rules and heading restrictions that are gender-based and age-based. Research is providing evidence that neck muscle development and protective headgear may play a role in the prevention of head injuries, specifically concussions.2 Additional research has found that cervical spine biomechanics is a modifiable risk factor in reducing sports-related concussions. This being said, preventative treatment of head injuries can be geared towards improving cervical spine biomechanics and postural education.6 Furthermore, a combination of cervical and vestibular physiotherapy has decreased the medical clearance time to return to sport in youth and young adults with persistent symptoms of dizziness, neck pain and/or headaches following a sport-related concussion.7 Therefore, the employment of both cervical and vestibular exercises to accelerate recovery and return to sport is important. Historically, treating a concussion has been quite passive, physicians and sports medicine staff relying heavily on pure rest to allow for the brain to heal and recover from the traumatic and potentially damaging event. Progressive research and evidence are now suggesting that an active approach to all types of head injury recovery is the most appropriate for returning an athlete to normal activities of daily living and his/her sport. This includes a multi-modal approach of collaboration among health care professionals who are able to apply their respective areas of expertise to a patient-centered recovery.8 Please contact us at Elevate to set up an appointment for an active approach to your PT treatment plan following a head or neck injury.   References:   Covassin, T., Swanik, C.B., & Sachs, M.L. (2003). Sex differences and the incidence of concussions among collegiate athletes. J Athl Training, 38(3), 238-244. Al-Kashmiri, A., & Delaney, J. S. (2006). Head and neck injuries in football (soccer). Trauma, 8(3), 189–195. https://doi.org/10.1177/1460408606071144. Stewart, W.F., Kim, N, Ifrah, C, Sliwinski, M, Zimmerman, M.E., Kim, M, Lipton, R.B., Lipton, M.L. Heading frequency is more strongly related to cognitive performance than unintentional head impacts in amateur soccer players. Frontiers in Neurology, 2018; 9 DOI: 10.3389/fneur.2018.00240 Lopez-Roman, LR, Diaz-Rodriguez, YI. Are subconcussive impacts harmless in youth soccer players?: 1965 Board #226 May 31 3. Medicine & Science in Sports & Exercise. 50. 475. 10.1249/01.mss.0000536644.03929.cd. Rubin, TG, Catenaccio, E, Fleysher, R, Hunter, LE, Lubin, N, Stewart, WF, Kim, M, Lipton, RB, Lipton, ML. MRI-defined white matter microstructural alteration associated with soccer heading is more extensive in women than men. Radiology 2018 289:2, 478-486. Streifer, M, Brown, AM, Porfido, T, Anderson, EZ, Buckman, J, Esopenko, C. The potential role of the cervical spine in sports-related concussion: clinical perspectives and considerations for risk reduction. J Orthop Sports Phys Ther. 2019 Jan 15:1-22. doi: 10.2519/jospt.2019.8582. Schneider, KJ, Meeuwisse, WH, Nettel-Aguirre, A, Barlow, K, Boyd, L, Kang, J, et al. Cervicovestibular rehabilitation in sport-related concussion: a randomised controlled trial. Br J Sports Med. (2014) 48:1294–8. 10.1136/bjsports-2013-093267. Ries E. (2017 March). Beyond rest: physical therapists and concussion management. PT in Motion, 18-27.

Boxing for Patients with Neurological Conditions

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An Elevate PT is shown here working with a patient with Parkinson’s Disease utilizing boxing as sensorimotor agility therapy. Movement is one of the most important things you can do if you are living with a neurologic condition. One of the most common neurologic condition today is Parkinson’s Disease which can affect one’s functional mobility including flexibility, speed, agility, and balance to navigate in a variety of environments.   New research suggests that intense exercise can improve brain function in patients with neurological disorders. Boxing is a fun and novel way to address speed, agility, dual tasking coordination, quick changes in direction, and balance to navigate tight spaces in patients with neurological conditions.  It does this by requiring patients to make postural adjustments and balance corrections, perform fast arm and foot motions, and coordinate timing and sequencing in different directions and planes of movement. Elevate PT Dr. Jasmine Burton, PT, DPT is shown here working with a patient with Parkinson’s Disease utilizing boxing as sensorimotor agility therapy. Laurie A King, Fay B Horak; Delaying Mobility Disability in People With Parkinson Disease Using a Sensorimotor Agility Exercise Program, Physical Therapy, Volume 89, Issue 4, 1 April 2009, Pages 384–393, https://doi.org/10.2522/ptj.20080214