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Water aerobics for fibromyalgia pain

How Can I Stay Active with Fibromyalgia Without Overdoing It?

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Living with fibromyalgia can present unique challenges, especially when it comes to staying active. It is not uncommon for people with fibromyalgia to feel nervous about exercising because they are scared about making the pain worse. However, in reality, exercise can help those living with fibromyalgia.

Research shows that individuals with fibromyalgia who exercise routinely can enjoy the following benefits:

  • Less pain & fewer tender points
  • Improved ability to do daily tasks
  • Reduced stress levels
  • More energy
  • Better sleep
  • Less stiffness
  • Improved mental health

If you have fibromyalgia, you can safely participate in regular, appropriate exercise without worsening your symptoms. The trick is finding the right balance between staying active and not overdoing it.

Here are a few tips on how to stay active with fibromyalgia safely and effectively.

1 – Choose Suitable Exercises
Not all exercises are created equal, especially when it comes to fibromyalgia. Consider low-impact activities that are gentle on the joints and muscles. This includes activities such as walking, swimming or water aerobics, or yoga. These exercises can improve cardiovascular health, flexibility and strength without putting excessive strain on your body. They also reflect exercises that can be started for those at any fitness level.

2 – Build Up Your Exercise Tolerance
With any exercise, the goal is to start slowly and gradually increase the intensity and duration of your workouts. For example, begin with short sessions of 10-15 minutes a few times a week. Gradually extend the duration of exercise as your tolerance improves. Listen to your body throughout this process and don’t push yourself too hard, especially when symptoms are flaring up.

3 – Exercise with Breaks
Break up your exercise routine into shorter segments with rest periods in between. For example, instead of trying to complete a 30-minute walk at one time, divide it into three 10-minute walks spread throughout the day. This approach can help prevent overexertion, help you incorporate exercise into your daily routine, and minimize post-exercise fatigue.

4 – Consult with a Physical Therapist
There is great utility in speaking to a physical therapist before starting any new exercise routine. A physical therapist can teach you proper techniques to prevent injury and optimize the benefits of exercise, and they can give you a program to do at home to regain your strength and flexibility. Our physical therapists specialize in working with fibromyalgia patients and can provide personalized exercise recommendations based on your needs and limitations.

5 – Prioritize Rest and Recovery
Rest is just as important as exercise, especially for individuals with fibromyalgia. Allow yourself adequate time to rest and recover between workouts to prevent burnout and avoid triggering flare-ups.

6 – Stay Hydrated While Exercising
Proper hydration is essential during all forms of exercise. Drink plenty of water before, during and after exercise to stay hydrated and replace fluids lost through sweating. You should also fuel your body with nutritious foods that provide sustained energy and essential nutrients.

7 – Incorporate Exercise into Your Daily Routine (if possible)
Find creative ways to incorporate physical activity into your daily life, even on busy days. Consider taking the stairs instead of the elevator, park farther away from your destination to take extra steps, or do gentle stretches while watching TV. Integrating exercise into your routine makes it more manageable and sustainable over the long term.

8 – Monitor Progress and Adjust Accordingly
This point is crucial if you’re using exercise to reduce the severity of your symptoms. Keep track of your exercise routine, symptoms and progress over time. This will help you identify patterns and make informed adjustments as needed. Use a journal or fitness app to record your workouts, how you feel before and after exercise and any changes in symptoms. Use this information to help identify which exercises are most beneficial and track improvements as you go along. It can also be used as a motivation and goal-setting tool!

9 – Listen to Your Body
This is the most important point. Pay attention to how different activities affect your symptoms and adjust your exercise routine accordingly. If a particular exercise or movement exacerbates pain or fatigue, modify it or try something else. Remember that it’s okay to take rest days when needed and to prioritize self-care.

Incorporating exercise into your life with fibromyalgia can be empowering and beneficial. If you have fibromyalgia and would like help in incorporating physical activity in your life, please give us a call, we can help you. We’ll create a program that considers your goals and your limitations that will help restore balance to your nervous system and improve your symptoms.

References

Exercise and Fibromyalgia

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Just Do It! 5 Tips to Help You Exercise Safely

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From biking and jogging to playing golf, tennis and weekend basketball, millions of us regularly enjoy athletics. As we all know, there are many benefits to participating in sports. To do it safely, it’s important to take precautions, otherwise we run the risk of incurring injuries that not only cause us pain and inconvenience, but also cost us financially in terms of medical expenses and lost productivity.

At the Kaplan Center, we encourage all our patients to engage in some level of regular physical exercise to improve their health. Time and time again, however, we’ve found that most people can benefit from learning more about how to exercise properly — the goal being to gain strength and flexibility while avoiding injury.

Whether you are a competitive athlete or just starting a new exercise routine, here are 5 tips that everyone who is physically active should consider adopting:

1) Customize your workout to achieve your personal fitness goals.

Whether your goal is to improve your cardiovascular health, body composition (including the ratio of muscle to fat), strength, endurance, or your position and motion awareness, not all exercise is the same, and more is definitely not necessarily better!

  • To improve your cardiovascular health: You will need to get your heart rate up to 70-85% of its maximal rate for at least 30 minutes per day, three days a week. To determine your maximal heart rate, subtract your age from 220. (e.g. The maximal heart rate for a 50-year-old is 170 (220 – 50 years = 170), so his or her target heart rate will be 70 to 85 percent of 170, or between 120 and 145.)
  • To improve your body composition (ratio of fat to muscle) and to optimize your body’s fat-burning capacity: You will want to exercise in a way that gets your heart rate up to 40-60% of your maximum heart rate.
  • To increase your muscle power and endurance: To maximize muscle power, you should engage in a lower number of total exercise repetitions at a higher level of weight/resistance, whereas to improve muscle endurance, you’ll need a higher number of repetitions at a lower weight/resistance. For example, athletes wanting to develop power might design a program where they perform 2-3 sets of 10 repetitions, with each lift set at 70% of their single-repetition, maximum weight. On the other hand, to develop endurance, the same athlete should perform 2-3 sets of 20-30 repetitions, with each lift set at 30-50% of their single-repetition, maximum weight. Your single-repetition, maximum weight is how much weight you can lift one time using the maximum effort that you can safely exert. Be very careful not to push past your maximum limit when you test yourself – you don’t want to get injured before you get started!
  • When strengthening: Work with a qualified and experienced physical therapist, personal trainer, or athletic trainer so that you can develop proper form and safe sports-motion habits early on. Give yourself a day between exercise sessions to allow for muscle cell repair and growth, for example, doing upper body strengthening on Mondays, Wednesdays, and Fridays, and lower body strengthening on the other days. When increasing your exercise intensity, a generally safe approach is to increase your weight/resistance level by no more than 10% every 2 weeks.
  • To improve your motion awareness and bone strength: Consider cross-training with yoga, soccer, basketball, tennis, or other activities that encourage side-to-side movement and speed changes. Research has shown that pure long-distance runners, particularly women, can actually be more at risk for stress fractures because the straight-line movement of running only strengthens bones in one plane, whereas cross-training strengthens bones in a more complete, multi-directional fashion.

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2) Ditch the myth about stretching prior to exercise to prevent injury.

Contrary to popular belief, scientific reviews indicate that stretching only before and after intense exercise does little to prevent injury. What does matter is your baseline level of flexibility. In other words, if you are already flexible, you have some reduced risk of muscle injury even if you do not stretch much before you exercise. But if you are not very flexible, doing a bunch of stretching just before exercise is unlikely to prevent muscle injury. Therefore, you need to stretch regularly over a period of time, and not just as a method of warming up before exercise.

  • To stretch correctly: Hold each position for a minimum of 30 seconds. If the stretch is not held long enough, then the muscle fibers will simply return to their pre-stretch length after you stop, and your stretching will be of minimal benefit. Once a muscle is properly stretched, the effect lasts for about six hours. Therefore, to improve flexibility most efficiently, one should stretch three times per day, for at least 30 seconds per muscle stretched.
  • Be aware that having too much flexibility can be as much of a problem as having too little. For example, with increased flexibility, the ligaments holding our joints together can become more vulnerable to being overstretched and sprained. How flexible is too flexible? The Beighton Hypermobility Score, which is easily located on the Internet, provides a quick method to rate joint hyperflexibility. If you are already very flexible, then stretching may not be in your best interest. Instead, focus on strengthening and balancing your muscles, which will help stabilize and protect your joints and ligaments.

3) Consider integrative treatment options if you sustain an injury.

Musculoskeletal injuries are extremely common; in fact, it is estimated that over 100 million injuries occur every year worldwide. Of these, 30-50% involve ligament and tendon injuries. Fortunately, there are several effective options available to treat these conditions, including osteopathic manual therapy (OMT), platelet-rich plasma (PRP) therapy and prolotherapy, which enhance the body’s own healing capability to repair damaged tissue. A growing body of medical research has demonstrated the effectiveness of these therapies in treating various painful conditions of the neck, shoulder, elbow, hand, low back, hip, knee, and ankle.

  • OMT is a non-invasive therapy that applies gentle pressure and movement to stretch muscles, soft tissue and joints for proper alignment.
  • PRP therapy involves taking a patient’s blood, centrifuging it to concentrate the platelets — which contain numerous growth factors responsible for tissue healing as well as blood-clotting factors — and then injecting it into the injured area to promote healing.  Professional athletes often use PRP to help them recover and return to their sport more quickly.
  • Prolotherapy is another injection method which uses simple fluid solutions other than blood for treating injured tendons, ligaments, and joints.

4) Be cautious about taking anti-inflammatory medications.

Although inflammation has a bad reputation for causing many painful conditions, it’s essential to the process of healing. After an acute injury, healing occurs in three complex phases over a long period of time, during which new connective tissue is created that replaces and reinforces the injured tissue. The first of these phases is inflammation, which causes pain in order to restrict our range of movement to protect the area from further injury. Perhaps even more importantly, the inflammation triggers cellular activity that initiates healing of the damaged tissue. The inflammatory phase typically lasts 4-6 days.

Although clinical research has shown that taking an anti-inflammatory after an acute injury can speed one’s return to activity by decreasing pain, several studies also have demonstrated that using an anti-inflammatory immediately after being injured can reduce tendon and ligament strength during healing. In sum, taking anti-inflammatory medication can interrupt the inflammatory process and thereby reduce the potential, maximal healing of the injured area.

We tell patients to try to avoid using anti-inflammatories, such as Aspirin (unless you are taking it for heart protection), ibuprofen (a.k.a. Motrin, Advil, Nuprin) and naproxen (a.k.a. Aleve, Naprosyn) for at least the first few days after injury. Instead, I recommend taking acetaminophen (a.k.a. Tylenol) up to 4000 mg. per day, as long as you do not have any liver problems and are taking it for less than a two-week period. In cases of more severe pain, you should consider seeing your doctor for a check-up and, if appropriate, obtaining a prescription for a muscle relaxant or other pain medication that you can take for a few days until the pain from inflammation subsides.

5) Be diligent about getting regular physical exams to address significant or persistent injuries.

Routine physical exams are very important for identifying conditions that may affect your ability to exercise safely, such as certain heart and lung problems or uncontrolled high blood pressure. Let your provider know about any concerns you have regarding your exercise regimen. It’s also a good idea to see your provider if you are experiencing any of the following:

  • An inability to bear weight on an injured limb due to severe pain
  • Pain that persists for more than 3 or 4 weeks without improvement
  • New or progressive numbness, tingling or — especially — weakness in your arms or legs
  • Persistent dizziness or light-headedness during or after exercise
  • Head, neck or back injuries that are causing deterioration of your balance, problems with your mental faculties, or changes in your bladder and/or bowel function (any of these symptoms could indicate a rare but urgent medical emergency!)

When a medical problem is exercise-related, for the best results, you need a medical specialist who can not only comprehensively assess your musculoskeletal system, but also provide you with the widest range of treatment options, from the least to the more invasive procedures.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

This article was reviewed and updated in January, 2024.

lifestyle_medicine

Lifestyle Medicine and Chronic Disease

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Changing behavior is hard. Changing the way we think about a topic, an issue, or a pattern that we routinely engage in is hard. In fact, making change is so difficult that there’s an entire field of psychology dedicated to it. It’s the science of behavioral change and it looks at how we make change successfully and why.

Whether it’s the ability to start exercising, eating healthier foods, or just doing things to reduce stress levels, change takes effort. For example, study after study shows that after starting a new diet, most people will eventually regain the weight they lost. Experts think that as many as 80 to 95% of dieters gain back the weight they worked so hard to lose. Although that’s a bit disheartening, the point is that making meaningful and lasting change is a process and not a quick fix. This is true for many things, but it is especially true for lifestyle habits that impact our health. And this is where lifestyle medicine enters the picture.

What is Lifestyle medicine?

Lifestyle medicine is a field of medicine that uses behavioral change psychology to help tackle the rising levels of chronic disease. Chronic problems like heart disease, obesity, stroke, hypertension, cancer, and diabetes are among the most prevalent and costly health conditions in the United States. Consider that approximately 60% of all Americans suffer from at least one chronic disease; and this number is only increasing.

Lifestyle medicine can play an important role in the management of chronic disease because many of these conditions revolve around the same lifestyle issues – exercise, healthy eating, restful sleep, ideal body weight and reducing the esposure of harmful substances. Furthermore, promoting healthier habits and reducing stress can serve as an important tool for lowering inflammation and mitigating pain and depression – components of many chronic diseases. We know from research that engaging in certain positive lifestyle changes early on can dramatically lower the risk of developing these illnesses in the first place.

Lifestyle medicine focuses on these key aspects of health:

Physical activity

Study after study shows that regular and consistent physical activity is one of the best ways to improve mood, health, and longevity.

Stress

Periods of stress that come and go are natural but if stress becomes a constant part of an individual’s life, it can have negative impact on health. Ongoing stress can affect heart health, digestion, mental wellbeing (mood, focus), and physical health.

Nutrition

Research has highlighted the benefits of a healthy and nutrient-rich diet in lowering inflammation and reducing the risk of heart disease, high blood pressure and other medical conditions. The role of good nutrition in overall wellbeing cannot be understated.

Restorative sleep

Good sleeping patterns and habits can help bolster the immune system, remove waste products from the brain, improve focus and physical energy, and help lower the risk of stroke, obesity, heart disease and high blood pressure.

Mental health

Human beings are social creatures and meaningful social connections make up a large part of one’s mental and spiritual well-being. Research has shown that individuals who have stronger social connections are more resilient and less likely to develop cognitive impairment.

Lifestyle medicine attempts to address all of these areas. It does not mean that all of these items need to be fixed in a jiffy; it just means that the importance of these factors and their role in good health should be recognized. If there is a particular area where changes can be made to improve your health, then a discussion should be had with your provider.

Where do you begin?

The first step is being open to change; self-motivation is key. You should educate yourself and be open to understand the benefits of the change you want to make to keep you motivated and focused on your goals. Can you foresee some challenges? Try o identify any barriers that are keeping you from moving forward and be prepared to deal with setbacks because they will happen. Be forgiving and keep moving forward.

For many, having an accountability partner or being a part of a structured program that considers the key aspects listed above can be the difference between success and failure. Lifestyle program teams are trained and experienced in these challenges and are supportive to those who are ready to embrace these changes.

Lifestyle medicine is relatively new as a field of practice and its principals are very similar to those of functional medicine (functional medicine also investigates and treats the root cause of disease and dysfunction). It sheds light on the importance of the day-to-day activities that we undertake, how they impact us, and why small changes can make a huge difference. Although change is hard, it is possible, and lifestyle medicine speaks to the tools and resources that we can use to help bring those positive changes about.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

 

References

https://www.acpm.org/initiatives/lifestyle-medicine/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5876976/

https://health.clevelandclinic.org/why-people-diet-lose-weight-and-gain-it-all-back/

https://www.cdc.gov/chronicdisease/index.htm

https://pubmed.ncbi.nlm.nih.gov/21056174/

https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-science-of-sleep-understanding-what-happens-when-you-sleep

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9985951/

 

 

Aerobic_exercise_health_benefits

Regular Aerobic Exercise Allows for Longer, Happier Lives

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These publications reinforce the benefits of aerobic exercise and provide even more motivation to get out and break a sweat.

Benefits of exercise on cognitive function.

A study published in Journal of Neurology, Neurosurgery and Psychiatry determined that adults who exercise as little as one time per month have improved cognitive function (thinking and memory) later in life. The study followed a cohort of 1417 participants over a period of 33 years who were asked to periodically categorize their physical activity level. At age 69, participants were assessed and those who were the most active showed the highest cognition later in life. However, the study clearly showed that any level of activity had cognitive benefits, even when physical activity was minimal or began later in life.

Benefits of exercise on mental health disorders.

A review published in the British Journal of Sports Medicine examined the existing evidence on the effect of physical activity on depression, anxiety and psychological distress in adults. Over one thousand trials were looked at and the results showed that physical activity is “highly beneficial for improving symptoms of depression, anxiety and distress across a wide range of adult populations–including the general population, people with diagnosed mental health disorders and people with chronic disease.”

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A 2018 review and meta-analysis, published in the journal Depression & Anxiety, looked at the association between aerobic exercise and major depressive disorder (MDD). The results of 11 qualifying studies were examined and it was determined that aerobic exercise had a significant anti-depressant effect and can be considered an effective intervention for MDD and other mental health disorders.

Benefits of exercise on chronic illness.

Another study, published in JAMA Network Open, found that sedentary lifestyles are as harmful to one’s health as having a chronic illness. Over the span of 23 years 122,000 adult patients underwent periodic stress testing to determine the link between mortality and aerobic exercise. The study found that better cardiorespiratory fitness was directly associated with longer life spans and better overall health, with the inverse also being true.

Look, we all know about the benefits of exercising, but we don’t always stick with it. These studies highlight the importance of daily movement for living longer and happier lives. Start slowly and find something you like and most importantly stick with it, consistency is the key to reaping the long-term benefits and safeguarding your health.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

woman talking to physician about prediabetes

Pre-diabetes: Are You at Risk?

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Approximately 37 million people in the United States have diabetes. Over the last decade, statistics show that the diabetes incidence rate (new cases diagnosed) has trended downward. In 2009, approximately nine out of 1,000 adults were diagnosed; in 2019 that rate declined to just under six. Statistics also show that there are more adults living with diabetes (diabetes prevalence) than a decade ago. This may be due to better detection and management of the condition.

These statistics are encouraging, but as the eighth leading cause of death in the United States, we must continue to be vigilant in identifying the risk factors.

Pre-diabetes is a condition where blood glucose levels are higher than normal, but not yet high enough to be diagnosed as diabetes. It affects over 96 million adults in the U.S. – that’s 38% of the U.S. adult population! Caused by a condition known as insulin resistance, an abnormal response to glucose regulation, pre-diabetes increases your risk of developing type 2 diabetes, as well as other conditions such as heart disease and stroke.

While the incidence rate of pre-diabetes has remained relatively steady since 2005, there has been a significant increase in the percentage of adults aware that they had the condition. This is good news in that in many cases pre-diabetes CAN be prevented or even reversed, and knowing you have it is key. Dietary modifications and lifestyle changes are the most effective ways to return blood glucose levels to a normal range.

What are some of the contributing factors?

Sugar:

The average American consumes 152 pounds of sugar and 146 pounds of flour per year. Could this have a correlation with diabetes? Yes! Waistlines are increasing because the sugars and refined grains that we consume increase insulin levels causing belly fat (or visceral fat) to accumulate around the organs. Insulin resistance then causes the elevation of blood sugar which increases that person’s risk of developing other serious health conditions, such as heart disease, stroke, cancer, diabetic eye disease, neuropathy, and kidney disease.

There are several ways to diagnose obesity and determine if one has visceral fat accumulation. A person’s BMI, or body mass index, is one measurement to take into consideration. BMI is a measure of body fat based on height and weight, and while it does not consider lean muscle mass, the measurement is still useful, with a recommended BMI of 25 or less. Waist circumference is another important indicator. Men should aim to keep their waistline circumference under 40 inches, and women should aim for 35 inches or less, with a waist-to-hip ratio (waist circumference divided by hip circumference) of less than 0.8. This reading in particular can be helpful in detecting those we call “skinny fat” – these people look thin but have a potbelly. All of these measurements taken together are good indicators of insulin resistance. The ultimate testing however includes glucose tolerance testing (fasting blood sugar and insulin levels) and/or hemoglobin A1C, which is a blood test that provides information about a person’s average levels of blood glucose over the past 3 months.

Something else to keep in mind is that all calories are not the same. A soda which has approximately 45 grams of sugar and 150 calories, causes a spike in insulin, whereas an apple and handful of almonds with the same amount of calories, does not. A 2007 study reported in the American Journal of Clinical Nutrition, demonstrated that certain types of carbohydrates, such as wheat and potatoes, up-regulated the genes for diabetes and inflammation in the abdominal subcutaneous fat, as compared to other carbohydrates like rye and corn, even though the caloric value was the same.

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Sleep:

Sleep deprivation also increases insulin resistance. One study showed that adolescents who slept less than 8 hours per night had an increase in central fat and insulin resistance. Another study recently reported that for every 30 minutes of weekday sleep “debt” the risk of obesity and insulin resistance increased by 18% and 41 % respectively over a year.

Exercise:

Besides lowering the consumption of sugar and flour and improving sleep, what else can we do to improve glucose control? Research is strongly supporting all types of exercise like walking, running, biking, and swimming for the regulation of blood sugar. Weight-training in particular increases lean muscle mass and metabolism long-term and increases a specific type of muscle (white muscle) that has been shown to lower blood sugar.

Digestive health:

Newer studies show that there is a link between the microorganisms living in your digestive system, central obesity, visceral fat, and insulin resistance. Taking a prebiotic (dietary fiber that feeds the good bacteria) and consuming foods like kefir, yogurt, sauerkraut, and supplements with probiotics, may help reduce insulin resistance.

Here is a summary of some of my recommendations:

  1. Reduce sugars and processed foods, and lower or eliminate wheat products. Avoid at all costs high-fructose corn syrup which has a strong link to insulin resistance. Eat more of a plant-based diet, grass-fed meats, and fish that are high in Omega 3’s, like wild-caught salmon. Be aware if you have a food sensitivity to gluten or dairy as these are highly inflammatory and can add to visceral fat.
  2. Get an activity monitor and aim for 10,000 steps per day. This is a goal, but any amount of extra steps that you can take each day towards this goal can make a difference. Consider getting a personal trainer to help you with a weight-training program, or take a yoga class at least once to twice a week or practice at home.
  3. Create a comfortable sleep routine and climate, and make good sleep a priority. If sleep is poor, then ask your doctor for a sleep study to rule out sleep apnea.
  4. Take a daily probiotic and switch them around every few months. Consider a prebiotic as well, but know that a good plant-based diet feeds your good bacteria too.
  5. Take a few moments to practice deep breathing and meditation. Start a gratitude journal and write down something every day. This lowers stress hormones like cortisol, and thus lowers insulin resistance.
  6. Get your vitamin-D checked and supplement as needed. Take 2 grams of Omega 3’s per day if you don’t consume fish regularly. Other supplements that help reduce insulin resistance include chromium and alpha-lipoic acid and magnesium.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

10_ways_to_get_good_nights_sleep

Are You Dying For A Good Night’s Sleep?

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It is estimated that over 70 million people suffer from a chronic sleep disorder in the United States, impacting not only the individual struggling to get a good night’s sleep but potentially all of us. It is conservatively estimated that more than 91,000 car accidents resulting in 800 deaths and 51,000 injuries each year are the result of driver fatigue.

And here’s another thought that might keep you up at night

One of the most common medical responses to helping you sleep may actually be putting your health at risk. About 4% of U.S. adults use a prescription sleeping aid in any given month. Yet taking as few as 18 sleeping pills a year increases your risk of dying 3.6 fold compared to people not using them. Those who take a prescription sleeping medication more than 132 nights a year have a 6.6-fold increase of death and a 35% increased risk of developing cancer.

A better response?

Individualized treatment to discern the underlying cause of sleep loss.

Sleep deprivation is the most common sleep disorder.

Newborns need as much as 18 hours a day, while teenagers — the most notoriously sleep-deprived group — require nine to 10 hours. Adults should have between seven and eight hours a night of restful sleep, yet a 2013 Gallup poll found that as many as 40% of Americans get only six hours or less of sleep a night.

Sleep deprivation can exhibit as insomnia, taking longer than 20 minutes to fall asleep, multiple awakenings during the night with difficulty returning to sleep, early wakening, and shortened sleep due to demands of work or school. Whatever the cause, its long-term consequences on your health and well-being are the same.

In the short term, your mental performance and reaction time when chronically sleep-deprived are the equivalent of being drunk. And like the inebriated, the chronically sleep-deprived do not recognize the extent of their impairment. Lack of sleep compromises the normal functioning of your immune system, and long-term sleep deprivation causes your body and brain to be in a chronic state of inflammation, potentially leading to an increase in heart disease, stroke, obesity, chronic pain, ADD, depression, and anxiety. The problem is also bidirectional; conditions such as chronic pain, depression, and heart disease can cause sleep disturbance, which then worsens the underlying condition.

Questions? Give Us a Call!

703-532-4892 x2

So how sleepy are you?

If you think you may be suffering from sleep apnea or another type of sleep disorder, don’t put off seeking help. Being this tired is a potential danger to your own health as well as the health of others. One way to quickly assess your level of daytime sleepiness is the Epworth Sleepiness Scale. It takes about a minute to complete the test and should be part of any medical exam when someone is complaining of fatigue. A score of 10 or higher is suggestive of a significant sleep issue.  At the Kaplan Center, we also utilize WatchPAT ONE, a recyclable Home Sleep Apnea Test (HSAT) to help us detect sleep apnea as well as providing markers for quality of sleep.

Here are some steps you can take right now to improve the length and quality of your sleep:

  1. Go to your room! Try to tuck in and rise around the same time each day.
  2. Move it! Regular exercise improves sleep and regular sleep improves exercise performance. The regular practice of yoga, especially in older adults, has been shown to improve the duration and quality of sleep.
  3. Cut caffeine. If you have a sleep problem, minimize or eliminate your caffeine consumption. Caffeine in all forms — tea, chocolate, energy drink or pill — disrupts sleep.
  4. Eat more fish. Eating fatty fish, salmon, and tuna appears to not only lower your risk of heart disease but also betters your sleep.
  5. Eat at regular intervals. When and how much we eat, as well as the types of foods we eat, impact our internal clock, called our circadian rhythm. While we are just beginning to understand the relationship between food and internal clocks, it is clear that the two are related and the consequences of eating at irregular intervals are obesity and increased risk for disease, in addition to disruption of your sleep.
  6. Cooldown to sleep sound. People may have trouble falling asleep because they have trouble cooling down their core temperature, which reaches its maximum typically around 3 pm. A warm room will exacerbate the problem. Temperatures above 75 degrees and below 54 degrees Fahrenheit can disrupt sleep. So what is ideal for sleep? The consensus is that a room temperature between 65 and 68 degrees is probably ideal; this will vary among individuals.
  7. Go dark. Light is a major factor that regulates our sleep-wake cycle. Light exposure at night not only disrupts our sleep but also increases our risk for obesity, high blood pressure, and possibly breast cancer in women.
  8. Keep it quiet. Any amount of noise starting at 30 to 40 decibels, a level between a whisper and a quiet conversation, begins to impact sleep quality. That said, people generally find the sounds of their usual environment relaxing. Sound can also be used to help with sleep. One study looking at patients suffering from a generalized pain syndrome called fibromyalgia found that music embedded with a specific sound frequency called Delta wave that pulsated between .25 to 4 Hertz improved the quality of patients’ sleep and decreased their pain symptoms.
  9. Meditate. Numerous studies demonstrate that the regular practice of meditation can improve the quality of sleep, as well as help in the treatment of anxiety disorders, depression, and chronic pain.
  10. Sample supplements. Some supplements that might help in getting a good night’s sleep include 5-HTP and melatonin. The FDA does not regulate supplements, so be careful that the supplement you purchase actually contains the substance and the amount of the substance stated on the label. Also, supplements are drugs and can have side effects and interactions with other medications. If you are taking medications on a regular basis, please check with your physician before taking any supplements.

For more information on identifying & treating sleep disorders click here.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

Note: This post was originally published in August 2014 and has been reviewed and updated for accuracy. 

improving_brain_fog

3 Steps to Improve Brain Fog

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Doctors across the globe are seeing a noticeable uptick of patients concerned with memory problems, forgetfulness, and brain fog since the start of the coronavirus pandemic. If you are experiencing more frequent slips in memory, if you are more easily distracted, making more frequent mistakes at work, or feel like you are walking around with your head in a cloud, you’re certainly not alone.

For many people experiencing brain fog for the first time right now, the overload of pandemic-related stress and trauma from a very difficult year is more than likely to blame. Chronic stress and chronically disturbed sleep alone can cause inflammation in the brain which, over time, can damage neurons and affect cognitive functioning and memory.

But there is good news! Our brains are resilient, and when given the opportunity, the degenerative effects of chronic inflammation can be reduced – or even reversed – with certain lifestyle changes. There is light at the end of the tunnel, so, while we emerge from this pandemic let’s consider just a few basic strategies that will help improve your symptoms today.

3 ways to improve symptoms:

1) Get regular aerobic exercise:

Simply put, aerobic exercise increases blood flow to the brain, which helps your brain create new neurons and improve neural connections. A study by the University of Maryland School of Public Health, published in July 2013, showed that people who increased their heart rate with daily moderate exercise “improved their memory performance and showed enhanced neural efficiency while engaged in memory retrieval tasks.”

Regular exercise also down-regulates microglia in the brain. Try to incorporate just 30 minutes a day of moderate physical exercise – such as walking – for a significant impact on your brain health.

2) Eat smarter:

Not surprisingly, nutrition also plays an important role in brain health and there is an impressive amount of research confirming that essential fatty acids, like Omega-3’s, are very beneficial. If DHA levels are low (DHA is a form of Omega-3) the brain is more susceptible to degeneration. Omega-3 fatty acids also help scavenge free radicals (atoms, molecules, or ions with unpaired electrons) that attach inappropriately to tissue and damage it.

Since our bodies are unable to produce these fatty acids on their own, foods rich in Omega-3’s like salmon, shrimp, sardines, eggs, walnuts, and almonds, should make a regular appearance on our plates.

Fruits and vegetables, high in a type of antioxidant called flavonoid, also play a major role in brain health. Foods rich in flavonoids offer a number of neuroprotective properties, and can decrease rates of cognitive decline and potentially slow the progression of many neurodegenerative diseases, such as Alzheimer’s Disease. Foods rich in flavonoids include tea (black, green, oolong), bananas, blueberries, and other colorful berries, onions, apples, citrus, Ginkgo biloba, parsley, red wine, and chocolate!

3) Don’t take your sleep for granted

Sleep deprivation, sleeping less than the amount of time your body needs for growth and repair, is the most common sleep disorder. Adults should have between seven and eight hours a night of restful sleep, yet CDC statistics show that as many as 35% of American adults are not sleeping enough, and this figure is likely to have increased since then.

During sleep, the body repairs itself by calming inflammation and maintaining hormone production. When these two processes – both important elements in brain health – are compromised it can negatively impact your memory, decision-making, the capacity to focus one’s attention, and the ability to complete complex creative activities, among other things.

Breathing techniques, meditation, and establishing a bedtime routine are 3 great ways to help you settle down and improve the length and quality of your sleep.

Moving Forward with Back Pain

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Has living with chronic low back pain affected your productivity, mobility, and overall ability to enjoy life?

In the United States, it’s estimated that nearly 16 million adults experience chronic back pain, making it one of the most costly health expenses annually and one of the most common complaints heard in doctors’ offices. Causes can include injury, disease (i.e. arthritis, cancer), obesity, poor posture, a sedentary lifestyle, even infection.

Patients with acute and sub-acute cases (pain that goes away within 3 months) may find that their pain improves over time without treatment of any kind. But not everyone has the ability to simply wait it out. In these cases, and when the pain becomes chronic, the American College of Physicians (ACP) recommends that non-invasive and non-drug therapies like exercise, acupuncture, massage, yoga, and other mind-body therapies should be the first line of treatment over surgery and narcotics, and we agree!

Remember, chronic pain, including low back pain, is a symptom of inflammation. Without targeting the root cause of the inflammation and treating it, your pain symptoms will not improve. Mind-body therapies help calm the inflammatory process in the body, promote healing, and present little to no risk to the patient.

Here are a few common misconceptions about treating back pain that can contribute to a slower recovery.

Myth: Exercise makes back pain even worse

Putting the brakes on exercise may seem like a good idea when you’re feeling pain symptoms, but research shows that the opposite is true. Strengthening and stretching exercises combined with aerobic activity will improve back pain symptoms by increasing blood flow, improving range of motion and flexibility, and strengthening core muscles.

· Physical Therapy is a great place to start if you’re concerned about further injuring or straining your back. Physical therapists have outstanding manual skills with a comprehensive understanding of body mechanics. They can work with you to decrease pain, improve movement, and provide instruction on how to continue moving safely in your everyday life.

· Going for a walk is one of the easiest ways to stay active. Try taking a short walk every day to keep your heart pumping and blood flowing.

· The poses, controlled breathing, and meditation involved in the practice of yoga can not only improve symptoms of chronic low back pain but can lower instances of depression and use of medication. As reducing back pain requires improving core strength, yoga is great for increasing core stability and strength while increasing awareness of other areas that may need stretching and strengthening.

Watch: Sun Salutations A & B with Dr. Lisa Lilienfield

Questions? Give Us a Call!

703-532-4892 x2

Myth: NSAIDs can’t hurt

Occasional use of NSAIDs can certainly be helpful if patients have seen little improvement with non-invasive treatments. But a big misconception about these OTC (over the counter) painkillers is that they’re completely safe and harmless. Regular use of NSAIDs can lead to problems with gut ulcers, liver damage, and kidney damage. Ironically NSAIDs can even heighten one’s sensitivity to pain. People who take them more than once a week should discuss this with their physician.

Myth: Mind-body therapies are unscientific

Dismissing the benefits of mind-body therapies is at the least, misguided. There is a mountain of evidence that supports the use of alternative therapies for pain management.

· Acupuncture: This 2000-year-old practice is thought to work by blocking pain messages to the brain with competing stimuli that cause an increase of endorphins, the body’s natural painkillers, and the secretion of neurotransmitters, which affect one’s perception of pain.

In 2007 the results of a large study of over 1,100 patients with chronic back pain were published in the Archives of Internal Medicine. After 10 treatments, the group that received acupuncture had a 47% improvement in pain and functioning after six months.

Read: Relieve Your Chronic Back Pain with Acupuncture

· Massage Therapy: A 2011 study concluded that people who were treated with massage therapy, whether relaxation massage or structural massage (deep tissue massage), for their chronic back pain, saw benefits that lasted at least 6 months.

· Meditation: A study reported in the Journal of Neuroscience showed that patients who had received only a little more than 60 minutes of meditation training were able to dramatically reduce their experience of pain. Patients experienced a reduction in “pain intensity” of about 40 percent and a reduction in “pain unpleasantness” of 57 percent. According to the lead author of the study, Fadel Zeidan, “Meditation produced a greater reduction in pain than even morphine or other pain-relieving drugs, which typically reduce pain ratings by about 25 percent.”

Bottom line

Whether you have an acute, sub-acute, or chronic case of low back pain, the first line of treatment should be a therapy that can help calm the body’s inflammatory process naturally and safely. While there is unquestionably a time and a place for surgery or narcotics, medical evidence indicates that conservative treatment of low-back pain is often as effective.

If low back pain is interfering with your quality of life, please give us a call to learn more about how we can help with these wonderful and science-based therapies that can benefit your mind, body, and soul.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

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7 Minutes a Day For Better Health

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Get moving and boost your immune system!

A N.Y. Times article cited a 2020 study out of Stanford where 36 subjects with various fitness levels exercised on a treadmill for 9-10 min and using the latest techniques showed almost 10,000 molecular changes during and after exercise.

With these new techniques, called “omics”, the researchers have isolated various molecules in our bloodstream that alter our biology. Metabolomics looks at molecules like appetite hormones and enzymes produced by the microbes in the gut; genomics looks at changes in gene expression; immunomics looks at the changes in the immune system; and, proteomics and lipidomics look at changes in proteins and fats. The list goes on. The author of the study quotes there is an “ orchestrated choreography of biologic processes” demonstrated to occur.

Why is this research important?

Recently we find that we are spending more time at home. We find ourselves sitting in front of the computer more than ever. Sitting too much weakens our immune system, increases the risk of diabetes, heart disease, depression and decreases bone density. We need to learn to be more creative about how we move our bodies.

We are all concerned about how robust our immune system is against potential illnesses.

One of the best immune boosters is exercise and this recent study out of Stanford, published in the journal Cell, showed even less than 10 min of exercise produces changes in thousands of molecules which affect inflammation, DNA and tissue repair, insulin resistance, oxidative stress, metabolism, immunity, and appetite.

Questions? Give Us a Call!

703-532-4892 x2

With less access to gyms, we need to be creative about making sure we incorporate exercise into our daily routine.

Hiking, biking, running, and many online classes including yoga are available. In addition, a total body workout is ideal to keep all of our muscles strong and stimulate bone density.

If time is short, one way is to do a 7-8 min workout using body weight and minimal props. Combining this with yoga improves bone density, strengthens our immune system, and stimulates proteins that reverse aging. So get out of your chair and move!

And there’s more to keep in mind…

  • Post-menopausal women have an increased risk of osteoporosis. Exercise is a key factor to improve bone density. Make sure you get a DEXA scan and review options for treating osteopenia and osteoporosis.
  • Evaluating gut health not only can boost your immune system but also can improve brain health. We have several tests to look at digestive health and a dietitian to help you navigate food choices.
  • Balancing your hormones (i.e. thyroid and sex hormones) can improve your metabolism. We have advanced testing to look at these hormones including cortisol to evaluate adrenal function.
  • NAD infusions can reduce DOMS (delayed onset muscle soreness), improve cognition and fatigue, reduce pain, and improve sleep.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

Maximizing Sleep During COVID-19

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Life’s demands before COVID-19, like keeping up with work, relationships, health, and finances, were already enough to negatively impact sleep for millions. Today, we are learning to deal with new stresses including how to live in isolation, along with the constant worry and uncertainty of the future. Despite our best efforts to remain focused on the mundane and simple pleasures of life – if for nothing else but to keep our sanity – our thoughts are diverted by fears. Getting to sleep and staying asleep seems impossible.

But preventing and recovering from the COVID-19 virus requires our immune system to be as strong as possible. Sleep is a crucial factor that cannot be overlooked.

If you are having trouble sleeping, here are some actionable steps that may help you wind down and get a good night’s rest.

1. Stick with a routine.

Although our lives turned upside down in just a matter of days, keeping a routine, particularly a nighttime routine, is important to regulate your body’s internal clock. Aim for a bedtime that will allow 7-9 hours of sleep each night.

2. Turn it off.

We all want to stay informed about the COVID-19 pandemic, but a continuous barrage of negative news can have a profound effect on sleep, mental health, and immune system. Avoid watching the news before turning in for the night.

3. Avoid caffeinated beverages after 3 pm.

4. Get regular physical exercise.

Regular exercise will help tire you out and reduce stress levels. If you can safely exercise outside while keeping within today’s social distancing guidelines set by the CDC, try to do so every day. If that’s not possible, look to the web for home workout appropriate to your fitness level.

5. Avoid artificial light at night.

Light from the computer screen at night may interfere with melatonin production.

6. Meditate*.

Quieting the mind with a regular meditation routine can help shed the day’s worries and fears.

7. Breathe deeply*.

Research has shown that breathing exercises can change the body’s response to stress and improve sleep quality.

8. Talk to your doctor about sleep supplements.

Sleep aids can help individuals who have difficulty falling asleep but may come with side effects. It’s also very important to note that the FDA does not regulate the supplement industry with the result that some products may have labeling inaccuracies. For these reasons, be sure to talk to your doctor before taking any type of sleep aid. Click here for a list of supplements to help regulate sleep, naturally.

9. Try herbal teas.

Herbal teas are a very gentle way to reduce stress and anxiety that also promotes sleep. They have been used across the globe for centuries, and are very accessible to all of us. Click here for a list of herbal teas recommended for sleep.

We hope the tips above will make a difference in your sleep routine. We are all going through the hardest of times, but remember, you are not alone. Most importantly, please call your healthcare provider right away if you feel overwhelmed and are in need of help.

 

*If you are a patient of The Kaplan Center, our psychotherapist, Jodi Brayton, is currently offering these services via cloud visit/telemedicine appointments. Please call today for more information: 703-532-4892.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

 

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