Arthritis

Do I Have Arthritis?

This is the question everyone older than forty worries about and no one under 40 thinks they could possibly have. The problem with arthritis is that it is an irreversible disease process that often progresses and gets worse.

What is arthritis? Arthritis is simply the damage to cartilage in a joint. The cartilage is the smooth white end of the joints that protects the underlying bone and allows your joints move smoothly. The most common joints affected are the knees, the hips and the shoulders. It also occurs commonly in the hand at the base of the thumb. It can occur in all other joints of the body including ankles, wrists, elbows, fingers and toes.

The most common symptom of arthritis is pain; pain with moving and pain when sitting too long. The joint can also swell and be affected by changes in the weather. Many arthritis sufferers feel stiffness in the morning and it starts to loosen up with activity. People with arthritis often feel popping and crunching in their joints.

Preventing arthritis is much better than treating it. Get your weight where it should be because wear and tear from carrying extra weight will cause arthritis. Stretching and strengthening will prevent arthritis. This is especially important for your larger muscle groups like quadriceps and hamstrings. Avoid unnecessary trauma to joints such as from falls or car accidents, but running does not cause damage to joints. Again, studies have shown that running does not cause arthritis.

Treating arthritis is not complicated and orthopedic sports specialists deal with this problem frequently. Therapy can be very effective. A steroid shot is called “a miracle” by many patients. However, the most important aspect of treating arthritis is first confirming that you have the correct diagnosis.

Almost every day I see patients who were told by another doctor that they have arthritis and that they need surgery. However, most people can be improved or even cured without surgery. If you did not have an x-ray, then arthritis has not been confirmed. Popping and swelling is a symptom of arthritis but the only way to know for certain is get an x-ray and have an orthopedist review it with you.

I always recommend getting a second opinion before you go for major surgery such as total knee or total hip replacement. Some surgeons push patients to surgery too quickly. Find an orthopedic doctor you trust and ask questions. Surgery is almost never the first line of treatment.

Carbs

Why We Need Carbs

 

Nutrition advice and diet books are a dime a dozen. It seems like every season there is a new diet fad, a new supplement to try, or a new book that guarantees weight loss. Even the educated consumer can become confused by all the different choices, which may make it difficult to determine the best way to be healthy and to lose weight.

The low carb/no carb craze became very popular with the Atkins Diet. Different versions of this model are still widely accepted as the best way to lose weight. Many people swear by the no carb diet, but is this the most effective and healthiest way to shed pounds?

Even though many people have success on carbohydrate free diets, it is not ideal because our bodies absolutely need carbohydrates to survive. Carbohydrates are the main energy source for the body because they are easier to break down than fats and they spare protein for more important roles in the body. Additionally, the brain ONLY uses glucose (which comes from carbohydrates) to function. Therefore, if you do not consume enough carbohydrates, your body will break down protein in your muscles to use for fuel for the brain. This is the last thing that we want!

That does not mean we should binge on carbohydrate rich foods. You must choose wisely among starches, but you should not eliminate all carbohydrates from your diet.  Fruits, vegetables, and starches all have carbohydrates. Most of your daily carbohydrates should come from fruit and vegetable intake.  Fruits and vegetables contain fiber, vitamins, minerals, and phytonutrients, which are essential to human health and well- being. Phytonutrients contain antioxidants, which are compounds that reduce oxidative stress and inflammation which, in turn, affect metabolism. Eliminating fruits and vegetables from your diet may have a negative impact on weight loss and on your health.

Since different types of carbohydrates break down into sugar at different rates, it is important to select high fiber, nutrient dense starches rather than simple sugars to avoid weight gain.  This is because simple sugars enter the bloodstream and are absorbed quickly, causing blood sugar levels to increase rapidly. This spikes insulin levels and over time your body may become resistant to this insulin. The job of insulin is to get sugar into the cells of your body where it is converted into energy or stored as fat.  As the body develops insulin resistance, there can be increased hunger and weight gain. Your body may also stop responding to the hormone, which could result in diabetes.

Simple sugars and processed foods metabolize quickly into sugar (glucose) and are mostly empty calories. Additionally, most of these items are filled with chemicals and do not contain important nutrients. Conversely, fruits, vegetables, and beans are filled with fiber, vitamins, minerals and phytochemicals, which enter your bloodstream slowly and stabilize your metabolism.

Healthy grains with high fiber can be incorporated into the diet, but they should not contain sugar or be processed. People tend to overeat grains and they may cause inflammation, so it is best to limit them or measure them out into a very small portion if you are trying to lose weight. If you do eat grains, it is also a good idea to eat gluten free to decrease inflammation to the gut while dieting.

The bottom line is that carbohydrates are not the enemy, but sugar certainly is. Eat a variety of fresh, organic foods and stay away from anything processed. Drink plenty of water and exercise regularly. This is the answer to weight loss.

Golf Help

Dynamic Golf Specific Stretches

Are you a golfer?

Is it a hassle to get loose before a round? Is it time consuming?

Hitting balls at the range and spending time at the putting green is important, however; stretching for 10 minutes pre-round can be saving you strokes too! So maybe it is in your best interest to stop your practice session 10 minutes early and follow these golf friendly warm-ups!

Static stretching is not what you want to do prior to a round of golf.  Instead, opt for dynamic stretches.  Dynamic stretching accomplishes many things.  It increases blood flow, increases range of motion, increases your awareness of joint position, and improves your athletic performance.

These golf specific stretches will not only loosen your body but will provide you with a strong/powerful foundation leaving you with a faster swing and leading to further shots.

Shoulder Blade Retraction

Stand with feet shoulder-width apart and arms out perpendicular to the ground while holding a resistance band.  Pull the band apart while keeping arms perpendicular to the ground and posture still.

Overhead Squat

 Place a club over your head with your arms fully extended.  Have both hands on each end of the club.  Stand with your feet shoulder-width apart and squat down until your thighs are close to parallel with the ground.

Golfers Lunge

 Drop down into a lunge, then try and touch your elbow to the back of your foot. For example, if your left leg is the lead leg use your left elbow to touch your left foot. This extra movement will further stretch the gluteus muscle.

Bent-Over T-Spine Extension

This is a great stretch to open your thoracic spine, which is your mid-back. Get into a golf stance and bend over a little further than normal. Place both arms below with your palms up. Reach around and behind you with one arm while watching that hand.

Hamstring Stretch

 To perform this stretch, sit on the ground with your right leg stretched out in front of you and your left knee bent with your foot facing your right knee. Keep your chest up and back straight. Bend forward at the hips until you feel a stretch in the back of your thigh.

 

By Scott Sessions CPT

Man in bed

Sleep for Testosterone Production

Man In Bed Woken By Alarm On Mobile Phone

When men think of testosterone production and function, they mostly think about exercise and vigor.  But one very important component that is commonly overlooked, is sleep.  In a study that was conducted with young men, getting less than five hours of sleep per night drastically reduced their testosterone levels as compared with a full night’s sleep.  The reduction in testosterone levels were mostly observed between the hours of 2pm and 10pm on the days when they had five hours of sleep or less.  Five hours of sleep showed a 10-15% decrease in testosterone levels.  This study also found that skimping on sleep can reduce a young man’s testosterone levels by the same amount as aging 10-15 years.

Poor and little sleep have been shown to be endocrine disrupters, which means that many of our hormones are not able to function optimally, including testosterone.  Testosterone is not just important for your libido, but also involved in regulating metabolism, building strength, and reproduction.  There is a natural reduction in testosterone levels as men age by about 1%-2% each year.  Low levels of testosterone are associated with a low sex drive, fatigue, a depressed mood, and difficulty concentrating.  Paying attention to sleep quality and duration is one major way that anyone can mitigate their decline in testosterone, along with regular exercise.  Remember, it’s not just about being physically active.  Recovery is an equally important component, and specifically, a good night’s sleep.

By Rima Sidhu

Article

The Art of Bouncing Back

During Super Bowl 2017, we witnessed the New England Patriots being down by 25 points.  As improbable as it was, they scored 19 points in the fourth quarter, including a couple of 2-point conversions, to beat the Atlanta Falcons 34-28 in overtime.

In 1993, then world’s No. 1 tennis player, Monica Seles, was stabbed in the back, which led to a 2-year physical and emotional rehabilitation. In 1995, in her first tournament back, she wins the Canadian Open, followed by winning the Australian Open in 1996 and 19 single tournaments before retiring in 2008.

I am sure we all know many stories of remarkable individuals who, despite all odds, demonstrated ultimate achievements. They succeeded beyond people’s expectations, but not beyond their own expectations. But, what makes them apart from others? How were these individuals able to bounce back? And, what can we learn from their experiences?

  • Positive Mindset

Athletes do not approach their games wanting to fail or perform below their skills. However, they tend to underperform when their minds get distracted by negative thoughts or by circumstances that distract their minds. A positive mindset is like having control at the wheel. It allows them to take full charge of where they need to put their attention to while navigating around the obstacles that come along the way. Rather than being affected by distractions, athletes constantly shifts their attention into actions that will guide them to achieve their goals.

By no means their minds will not get distracted. On the contrary, they understand that distractions are bound to happen. Unfavorable referee calls, unexpected comeback from the opponent, and falling behind early in the game are situations that athletes have not control over. However, a positive mindset accepts these situations as part of the game by just focusing on controlling what is controllable.

Also, a positive mindset relieves athletes from carrying the additional pressure of needing to do well. All the preparation leading to the performance is behind. By fully trusting in a positive mindset, it allows athletes to face competition and all its challenges head on rather than carrying on their shoulders the unrealistic expectation of having to win or else. Instead, it allows athletes to trust in their skills, be more focused, and fully present.

  • Resilience

Resilience is seeing the glass half full rather than half empty. Athletes know that success is achieved by embracing all the experiences that take place along the way. Just like they fully enjoy celebrating winning performances, they also embrace failing. They understand the greatest source of knowledge comes from those experiences where they did not achieve their goals. Instead, they use those opportunities to analyze what happened in order to make necessary changes that will give them a greater opportunity to achieve success next time. Each opportunity is food for thought.

Success does not happen while navigating on a straight line. Instead, it is an up and down road that brings challenges along the way. Some of those challenges will test your mind, body, skills, stamina, commitment, and perseverance. Along the way, disappointments will be experienced. As disappointing as it is to achieve below expectations, top performers shift their focus to capitalize on strength and improve on their weaknesses. In so doing, they are true to themselves, which may lead to the realization that their mindset is not as positive as needed to be.

Resilience as an adaptation game. Each time a realistic goal is set, set your mind to achieve it. Put your full commitment and trust to achieve such a goal. If it is not achieved, rather than punishing yourself, take the time to understand you. Be honest with what you need to change and commit to making those changes next time. As Teddy Roosevelt once said, “courage is not having the strength to go on; it is going on when you don’t have the strength.”

  • Commitment

Verbalizing what you want to achieve is only the beginning; however, commitment to pursue your dreams will ultimately lead you to achieve them. Commitment rests on having self-belief. It is the notion that the goal will be achieved no matter what challenges need to be faced. Many athletes dream big and fantasize having a glamorous life style, but failed to achieve their goals. Athletes that are fully committed to achieve perseverance and focus ultimately reach their dreams.

Commitment starts by identifying what one wants to achieve. The clearer, time-specific, and realistic expectation is identified, the more focused one will be to steer the attention towards those goals. As a consequence, the better the focus and commitment, the more likely improvement will be achieved.  On the other hand, not being fully committed or focused on your goals will most likely lead to fall short of your true potential.

Einstein said, “genius is 1% talent and 99% hard work.” Those who achieved superb goals truly committed themselves to taking one step at the time while envisioning what they wanted to achieve. They understand that failing, not failure, is part of the journey. They remained positive despite all odds and used their experiences, both good and bad, as a continuous learning tool.

“It always seems impossible until it’s done.” Nelson Mandela

Alex Diaz, PhD

Sports Mental Edge

Eating Junk Food

Are You on Fire?

If you suffer from any of the following: chronic pain, fatigue, depression, digestive issues, memory loss, or are over-weight, chances are you are inflamed.

We often hear about inflammation, inflammatory and anti-inflammatory diets. But what does it all mean?

Inflammation gets a bad rap but it is actually a healing response in which our immune system is stimulated and trying to fight something potentially harmful to the body.

There are different causes of inflammation including:

  • pathogens (bacteria, viruses, etc.)
  • chemical irritants
  • acute injuries
  • foods

This article will address dietary causes of chronic inflammation.

Chronic inflammation increases risk of:

  • cardiovascular disease
  • cancer
  • chronic pain
  • neurological diseases such as Alzheimer’s
  • autoimmune disease
  • IBS
  • Diabetes

Here’s an extremely simplified version of what happens.

So many foods that are staples of our standard American diet are not good for us. Some of these foods and additives should not be consumed by any human beings. Some things may not necessarily be bad for everyone, but some people may have sensitivities to them.

These foods and additives can cause damage to the intestinal lining and create imbalance in the bacteria that lives in our gut. This bacteria, known as the intestinal flora, or microbiome, is an essential component in digestion and immune function.

Now that the bacterial balance has been disrupted, foods that are harmful will not be broken down and excreted properly. And foods that ARE good for us may not be broken down and properly absorbed either, which can lead to deficiencies of nutrients. There can also be overgrowth of bad bacteria, which is fed by the bad foods, creating more problems and stress in the system.

The damage to the intestinal lining can cause something called “leaky gut” in which particles of food that should not be absorbed into the bloodstream will now “sneak in” and be absorbed. Because these bad particles of food are absorbed, it triggers the immune system to ramp up and fight, creating inflammation.

Inflammation should not be consistent or long-term. It should resolve so the body can repair and move on. So when we consistently feed this inflammatory process, it wreaks havoc on the whole body. In some people it can lead to autoimmune disease in which the immune system will start to attack the body’s own tissues causing damage. Research is demonstrating that most neurological disease is in fact autoimmune in nature and therefore a result of inflammation. In some it can lead to cancer, cardiovascular disease, etc, etc.

I’m often asked what supplements or pills help with inflammation. Without getting rid of the cause, supplements or pills may help a little but won’t fix the problem. It’s like trying to control a fire that you’re continuously dousing with fuel.

What can we do?

Here are major causes of inflammation that can be controlled simply by lifestyle changes:

  • Standard American Diet (S.A.D.)
  • Diets high in sugar
  • Diets high in processed foods
  • Vegetable oils (except olive and coconut)
  • Diets low in fruits and vegetables
  • Smoking
  • Toxins in food, water, cleaning products, environment
  • Certain drugs (always consult with your physician about drugs)
  • Lack of exercise
  • Dehydration
  • Essential fatty acid deficiency
  • Lack of sleep

Eating a clean balanced diet, getting adequate movement and sleep and avoiding toxins will surely help to decrease inflammation. Avoid the known, common triggers.

If problems persist, seek the help of a professional who can help further evaluate your situation, figure out the cause and formulate a plan to properly address it.

By Robert Inesta, DC, L.Ac., CFMP, CCSP

Check Yourself to Protect Yourself

October is Breast Cancer Awareness month. Currently, 1 in 8 women in the US have breast cancer. It’s critical for women to do monthly exams and to go for regular screenings. Let’s discuss what breast cancer is and how early detection is key for survival.

Breast cancer is a disease in which cells in the breast grow and multiply abnormally. This can happen if the genes in a cell that control cell growth no longer work properly. As a result, the cell divides uncontrollably and may form a tumor. These cells usually form a tumor that can often be seen on an x-ray or felt as a lump. Many breast lumps are benign, meaning they are not cancerous. That means they can’t spread and are not life-threatening. Malignant tumors are cancerous. If left untreated, the cancer can invade surrounding tissue and spread or metastasize to other parts of the body.

Breast cancers can start from different parts of the breast. Most breast cancers begin in the ducts that carry milk to the nipple (ductal cancers). Some start in the glands that make breast milk (lobular cancers). There are also other types of breast cancer that are less common. A small number of cancers start in other tissues in the breast. These cancers are called sarcomas and lymphomas and are not really thought of as breast cancers. Although many types of breast cancer can cause a lump in the breast, not all do.  Many breast cancers are found on screening mammograms which can detect cancers at an earlier stage, often before they can be felt, and before symptoms develop.

You may notice symptoms on your own that could be suspicious. If you notice any of the following, consult your doctor immediately:

  • a lump or thickness in or near the breast or under the arm
  • unexplained swelling or shrinkage of the breast, particularly on one side only
  • dimpling or puckering of the breast
  • nipple discharge (fluid) other than breast milk that occurs without squeezing the nipple
  • breast skin changes, such as redness, flaking, thickening, or pitting that looks like the skin of an orange
  • a nipple that becomes sunken (inverted), red, thick, or scaly

Women with certain risk factors are more likely than others to develop breast cancer. A risk factor is something that may increase the chance of getting a disease. Having a risk factor does not mean that a woman will definitely get breast cancer. Many women with risk factors never do. Your risk for breast cancer rises as you get older. About 80% of breast cancers are found in women over age 50 — many of whom have no other known risk factors for the disease. Although you’re two to three times more likely to get breast cancer if you have a strong family history of the disease, only 5-10% of breast cancers are inherited, meaning that they are linked to gene mutations passed down in families, such as the BRCA1 and BRCA2 gene mutations. Several other risk factors may slightly boost your chances of getting breast cancer. These include:

  • Gender: Breast cancer occurs nearly 100 times more often in women than in men.
  • Personal Health History: If you have been diagnosed with breast cancer in one breast, you have an increased risk of being diagnosed with breast cancer in the other breast in the future.
  • Menstrual and Reproductive History: Early menstruation (before age 12), late menopause (after 55), having your first child at an older age, or never having given birth can also increase your risk for breast cancer.
  • Certain Genome Changes: Mutations in certain genes, such as BRCA1 and BRCA2, can increase your risk for breast cancer. This is determined through a genetic test, which you may consider taking if you have a family history of breast cancer. Individuals with these gene mutations can pass the gene mutation onto their children.
  • Dense Breast Tissue: Having dense breast tissue can increase your risk for breast cancer and make lumps harder to detect. Be sure to ask your physician if you have dense breasts and what the implications of having dense breasts are.

If you have breast cancer, knowing the stage helps guide your treatment plan. Breast cancer is typically staged with Roman numerals ranging from 0 (the earliest stage) to IV (the most advanced stage). The stages of breast cancer are used to describe the extent of your cancer at the time of diagnosis. Your doctor will base the stage of your cancer on a physical exam and other diagnostic tests. This is known as clinical stage. The final, or pathologic, stage is determined after surgery when the size of the cancer is measured under a microscope and it is definitely known if there is cancer in the lymph nodes. Cancer stages are based on:

  • whether the cancer is invasive or noninvasive
  • the size of the tumor
  • whether the cancer has spread (metastasized) to the lymph nodes, and if so, to how many of them
  • whether the cancer has spread to other parts of the body, such as the lungs or liver

Your doctor will assign a stage to your cancer after your physical exam and the initial results from your mammogram or other diagnostic imaging test. The stage may be adjusted after lab reports from your breast biopsy or surgery. In determining the stage of your cancer, your doctor will take into account what is called the T-N-M scale: T meaning tumor size; N relating to the involvement of nearby lymph nodes; and M referring to whether the cancer has metastasized (spread) beyond the breast to other parts of your body.

In conclusion, early detection is key to beating this horrible disease. Millions of women each year celebrate survival. Self-exams should be performed along with regular check-ups with your doctor. Those with a family history or other risk factors, should be even more diligent. A little extra time out of your day can make all the difference in your tomorrow.

References:

American Cancer Society

Memorial Sloan Kettering

National Breast Cancer Foundation

BreastCancer.Org

By Gina Stallone

Picture

The Fame and Fortune of Being a TV Doc

My patients often ask me, “What is like to be ringside for the biggest fights in the world,” or “What is Mike Tyson like?”  Having worked professional fights for over 20 years from Madison Square Garden and Barclay’s to Mohegan Sun and Foxwoods, I have really had a lot of fun being a boxing doctor. It is fun for my patients to see me on tv and I enjoy when they tell me they saw me on HBO or Showtime over the weekend. I have presented on Ringside Medicine at conferences in Beijing, China and Berlin, Germany and of course numerous times in Las Vegas and Atlantic City. Traveling is part of the fun of being a ringside doc but meeting and teaching my fellow doctors around the world has been extremely rewarding and I know I am giving back to this great sport.

Working ringside is really about one thing – protecting the fighter. When do I stop a fight? The golden rule of ringside medicine is to stop the fight when the combatant can no longer adequately defend himself. For example, this happened at a fight I worked at in Yankee Stadium when one of the fighters tore his ACL. Also, at a fight on Long Island when one of the boxers dislocated his shoulder.  I have stopped numerous matches when a fighter’s eye was so swollen he could not see out of it or when a fighter just stopped throwing punches. Rarely will a boxer want to stop a fight and hardly ever will his cornermen (even if it is the fighter’s father) be willing to quit. It is my job to step up, evaluate and stop those fights.
Although I sit in the corner for the fights, I am working and not there to just enjoy the fight. While people are cheering for their fighter to destroy his or her opponent, I am hoping no one gets too badly hurt. I really enjoy the fights and the energy of the crowds is electrifying. However, when one of the fighters is taking a beating, it can be difficult to watch. The crowd does not want the fight to stop and it is only through years of experience and working hundreds of fights that I have developed the sense when it is time to end the fight. I have had great teachers and I thank them for how they have educated me. I am still learning and it is a great responsibility and honor to help protect these courageous athletes.
The glory of being a TV doc is great, but people don’t realize how much we do behind the scenes. The day before the bouts, we examine every fighter from head to toe. We review their blood tests, EKGs, and brain MRIs. The night of the fight we arrive around 3PM and often don’t leave until 1AM. We re-examine every fighter before the fight and again after the fight and of course sit in the corner during the fights. Typically, there are 6-10 fights in a night.  Assuming everything goes well, it is a fun night but exhausting.
Oh, and the question of how is Mike Tyson? He is very nice, but I would have to say the most intimidating person I have ever met in my entire life.
Cutting calories on white background

Not All Calories Are Equal

From a young age we are taught that the key to maintaining weight is to burn off as many calories as we ingest. We also have learned that weight loss occurs when we consume less calories than we expend, and that we gain weight when we eat more than we burn off. However, research over the past decade has shown us that this formula may not be quite as simple as it seems.

A calorie is actually a measurement of heat energy. Specifically, it is the amount of energy  that is needed to raise the temperature of one kilogram of water by one degree Celsius.  This heat energy is what gives our body fuel.  Our calories come from the protein, fat and carbohydrates that we eat. Protein and carbohydrates have 4 kcal/g, fat has 9 kcal/g, and alcohol has 7 kcal/g.

Current research shows us that the source of our calories is extremely important, and that different food groups affect our weight status differently. It is a myth that a calorie is just a calorie. While all calories do have the same amount of energy – 4184 Joules of energy – our body reacts to the sources of calories differently. This is because we digest and absorb various types of food differently. Those foods go through diverse biochemical pathways and affect hormones in the body, which may also affect satiety and hunger.

As stated above, different foods are digested and go through different metabolic pathways, some of which are more efficient than others.  Protein requires a lot more energy to metabolize than fats or carbohydrates. When protein is ingested, it requires more energy to digest and absorb, which uses more energy.  Therefore, the calories ingested from protein are less fattening than carbohydrate or fat calories.

Another benefit to protein is that it increases satiety more than the other macronutrients. Appetite is reduced and less food and calories are consumed, which may lead to weight loss. This just demonstrates that the type of food that you eat is extremely important, and that all calories are NOT the same.

Further, people who eat whole foods rather than processed foods tend to eat less and have less issues with obesity. Whole foods require more energy to break down and digest than processed foods. This is because many processed foods contain refined carbohydrates, which are low in fiber, low in nutrients, and usually have a high glycemic index. Foods with a high glycemic index are digested quickly and rapidly spike blood sugar levels. This causes food cravings and increased hunger and food intake.

Additionally, foods high in fiber are less likely to cause weight gain. This is because more energy is needed to breakdown the food, and much of the fiber is not absorbed into the body but rather is excreted as waste. Therefore, the body is not necessarily getting the amount of calories listed on the label.

The take home message is not to worry about counting your calories to lose weight. The food choices that you make are much more important for both your health and for your weight. Different food sources affect energy expenditure, hormones, and hunger, which all affect satiety and weight gain. Think about what you are eating rather than how many calories you are eating and look at your food a little differently. If you change your perspective, you will ultimately reach your goals and get healthy!

 

By Denise Groothuis

alex

How to Reach Your Peak Performance

Do you remember a time when you had to sink a 3-foot putt to win a championship, meet a deadline to present a project to your boss, or study for next day final exam? The simple perception or expectation we placed in ourselves to execute a task entails an arousal in our nervous system. The challenge we all face is how much of an arousal is optimum to achieve top performance? The Yerkes-Dodson Law, also known as the Inverted “U” Model, has attempted to help us identify our ideal level of arousal to achieve peak performance.

The Model indicates that feeling high level of tension or feeling too relaxed will not be ideal to achieve our best. Some level of tension is needed to stay focused and attain our peak performance. Identifying what level of arousal is ideal for you, it will depend on three factors: Trait Anxiety; Expectations vs. Acceptance; Focus Ability.

Trait Anxiety

Trait anxiety refers to the general level of anxiety that is experienced throughout all aspect of the individual’s life. State anxiety refers to the specific situation that is tension provoking. A person who has high levels of trait anxiety will be more likely to negatively respond to a particular stressful situation than a person with low trait anxiety. These individuals will more likely see the negative aspects of the upcoming performance and focus on the obstacles. Their mindset will be aligned toward pessimism or putting blame on others. They will be more easily distracted by outside factors, such as: referee’s calls, opponent’s good shots, weather, and opponent’s ranking.

Also, individuals who practice group sports or teamwork are less likely to feel state anxiety. One of the challenges for these individuals is not elevating enough their level of arousal while in practice only to feel not mentally prepared when the competitive arousal increases during competition or project is due. One useful technique is to simulate the real performance to elevate your arousal enough. The more you practice, the better your ability to manage stress.

Expectation vs. Acceptance

When an individual has doubts about his or her abilities to achieve the desired outcome, and such an outcome is important, the level of state anxiety increases. The perceived lack of control increases the level of state anxiety, particularly for those individuals who experience high levels of trait anxiety. For individuals who show low trait anxiety, they will most likely see the positive side of the situation. They will be more optimistic and/or focus on accepting what they can manage instead of being mentally derailed by non-controllable factors, such as zeroing in on meeting self or other’s expectations.

Placing focus on expectations may lead to an elevated increase in arousal. Given that there is no such a thing as a guarantee result, individuals who pursue expectations embark into a zero-sum game whereas winning, and only winning, matters. One of the key attributes successful individuals share is that of learning from defeats. Individuals who learn from unsuccessful experiences have consistently shown to have made persistent improvement in the pursuit of their goals. They focus on process and acceptance rather than expecting that an outcome must happen.

Focus Ability

Before a performance, individuals are either goal or behavior directed. Those individuals who are goal oriented will more likely give a negative interpretation to their arousal by labeling it as anxiety. Those individuals who are behavior oriented will interpret the same arousing situation as excitement. Highly achieving individuals know that focus is a short-lived experience. They understand that increasing focus rests on enhancing the awareness of the moment when loss of focus takes place. It is precisely then when they shift their attention back to the present moment. Unless they know they lost focus, they have no way of regaining it. Meditation has been shown to enhance one’s ability to shift attention to the present moment. Those who consistently practice it have been better able to regain their focus to what it is in front of them rather than being mentally derailed by non-controllable factors.