Recent Reading

As I mentioned previously, I have been reading more lately.  Most recently, I finished Robb Wolf’s Book:  The Paleo Solution: The Original Human Diet.  I chose to read this book because I liked how Gary Taubes used evidence to show us that fat is not bad for us, but that carbohydrates, specifically sugar and processed carbohydrates are the real problem, but I don’t want to live on an Atkin’s diet.  I just like fruit too much and I feel that fruits are good for me despite the sugar content.

Paleo presents other problems – the no dairy and legumes.  I have been cutting back significantly on grains (focused on wheat with its infamous gluten) over the past week and I think I can already feel a difference.  Anyone who knows me well knows that I am a diehard peanut butter fan and since peanuts are technically legumes, that means they should be out.  I have also read some criticism about Paleo in regard to beans because of the fact that we probably cook out the bad stuff (Lectins).  I will play around with beans to see how it affects me.  Right now, I haven’t cut back on dairy at all.

Overall, I can say that I feel like I am full longer between meals with less of a need to snack compared to prior to changing my diet.  I would say that is probably a good sign.  I also feel I’m sleeping a bit better and I have less nasal / sinus congestion when I wake up in the morning.  It is fun to experiment a little bit, especially with the knowledge that I’m probably not going to give myself a heart attack by eating a little more meat here and there.

What books have changed how you live?

Diagnosis Pages

I’m working on creating some patient education pages for different Physical Therapy diagnoses.  These are the Movement System Impairment diagnoses that Shirley Sahrmann et al. created.  I’m adding in various other information along the way as well.  I think these diagnoses are better than medical diagnoses in that they explain more clearly which movements cause pain.

You can find them under the Patient Education Menu above.

I’m done!

Let me know how I can improve any of those pages for you.

Nutrition / Health

Since I am off work, I’ve been doing a lot of reading lately.  I just finished Why We Get Fat, by Gary Taubes and I am half way through The End of Illness, by David Agus.

The first book is really interesting in that Gary Taubes spends a lot of time researching literature on diet and weight loss and can effectively point out that a high fat / low carbohydrate diet is the most effective way for overweight and obese individuals to lose weight.  One of my the most important concepts he points out is that overweight and obese people will be able to lose weight on a high fat / low carbohydrate diet, but they might not lose as much as they want.  He points out that everyone has a different genetic code for body composition and we are somewhat limited by that code.  My only question to him would be does this effectively work for weight management for individuals without a weight problem or are there any long term side effects.  A quick search on wikipedia indicates that a diet high in animal fat / red meat can lead to an increased risk of colorectal cancers.  My biggest takeaway is that sugar and carbohydrates are definitely bad, they will make you sick.  But I’m not sure I’m ready to jump on the high fatty red meat bandwagon.  But it is interesting to hear about the many benefits of this diet – check it out on wikipedia or read his book if you are interested in learning more.

The second book by David Agus talks more about genetics and how each of us has our own susceptibility to disease based on our genetic makeup.  I think this probably correlates to what Gary Taubes is saying and I would guess there are markers on our genome to identify people who would benefit more from the high fat, low carbohydrate diet and can tolerate the high fatty red meat diet.  It’s interesting to hear how he feels that vitamin supplementation is definitely unnecessary and possibly harmful.  Thus far after reading his book, I am very curious about my genetic code and what my susceptibilities might be.

Has anyone read any other health books that change the way you think about your health?

Why You Have Pain

As anyone progresses through a career, they develop certain biases for why things occur.  I began my physical therapy career, I believed joint stiffness (hypomobility) was the primary dysfunction and cause of pain.  I felt that grade III-V mobilizations and manipulations were the answer.  This is no doubt due to my orthopedic education, which focused on Maitland’s techniques for joint mobilization.  As my career has been progressed and I have treated more patients, my view has shifted to one of hypermobility or excessive motion as the primary dysfunction and cause of pain.  This comes from multiple sources, but I currently feel that Shirley Sahrmann is probably the best source for understanding this idea.  I recently bought her newest book and in one of the introductory chapters, she describes joint hypermobility as being caused by 3 things:

1) excessive physiological motion – you bend to far or hyperextend too much – this is obvious and these people are very easy to identify in a PT examination.

2) excessive accessory motion – your joints slide around too much – less obvious, but also pretty easy to identify in a PT examination.

3) you have excessive relative accessory motion at your painful joint – this is where everyone else falls, if they aren’t in category 1 or 2, they are definitely here, but this doesn’t appear as obvious.  This might be someone who appears to just have tight quads and has back or knee pain.  This is the person who has a habit of moving in one part of their body and not others.

I will be using Sahrmann’s movement impairment system tests more and more when I return to work in a hope to better diagnose and treat all of these problems.  But one thing she emphasizes is that it isn’t the exercises you do for PT that will make you better, it is the change in your lifestyle and movement patterns that will make you better.  If you are sitting all day at a computer in the same posture, you probably will have a problem.  If you are hunched over a laptop right now, you will have a problem.  It is only a question of when, not if.  When a patient tells me, but I’ve been doing “it that way” (a specific activity my whole life, but it didn’t hurt until now, it is still a problem.

I also really like her idea that as physical therapists / physiotherapists, we treat the body’s “Movement System.”  Everything is connected, we don’t treat joints, we look at joints to see how they contribute to movement.  She also recommends going to a physical therapist on an annual basis for a movement assessment to make sure your movement system is doing well and to help guide exercise for the next year.  I think it’s a great model and maybe some day I will be able to treat my patients in this way.

 

Great Research Review!

I found about this great new research review service for rehab and fitness professionals.  This is a great way to keep up on understanding exercise and how it actually changes our patient’s bodies.

For example, I learned that there is evidence that wearing high heels probably leads to knee arthritis this month – very important information.  I will be more confident when I am telling my female patients (and my wife) that they need to cut back on wearing high heels.

Bret Contreras and Chris Beardsley provide the summaries of 50 articles per month.  That’s a lot of work and this is a pretty low cost ($10 / month) considering how much information they provide.

Check it out at:

http://www.strengthandconditioningresearch.com/

CrossFit

I have been actively involved with CrossFit for the last 3 years now and I have learned a lot both positive and negative about it.  This is what I like the most about CrossFit:

1) the CrossFit definition of fitness, if you have not read it, it is a must read, just google “What is Fitness? and CrossFit”.  This dramatically changed how I view exercise and what I should or should not be doing.  This completely matched my feelings that there is probably something wrong about exclusively distance running for exercise.

2) Exposure to the deadlift, front squat, press, push press, clean, jerk, and snatch.  I always had a fear of looking like an idiot with a barbell, but after learning all of these lifts, I am very confident in how to perform them and how to perform them safely.

3) learning about kettlebells – this actually might be bigger than the barbell knowledge, especially learning the Turkish Get Up.  I totally agree with Gray Cook’s view that this might be the ultimate exercise.  I also love swings, cleans, and snatches with KBs.

4) Camaraderie – working out with like minded people that like to push themselves is great.  It takes me back to a feeling of being a part of a team and I love cheering others on and being cheered on.

5) Finding a new way to do Cardio – try any of the Met Con WODs and you’ll know what I mean.  Cindy is my favorite for new people.

6) Variety – self explanatory – this is what keeps people coming back.

7) Results – I have gotten much stronger and feel more fit overall.  I can pistol and do a handstand pushup, I also was able to deadlift over 300lbs and get 225lbs from the ground to over my head.

8) Theory – CrossFit teaches you that every rep should be a perfect rep and stresses teaching mechanics, then consistency with mechanics before finally adding intensity.  No one can disagree with this theory.

9) Scalability – I have been able see young, strong people kick butt in CrossFit and along side them, older, less fit people finding movements that are also similarly challenging.  It is a great program for everyone when applied correctly and helping people get going slowly.