Breathe Easily

Breathing is the most basic movement pattern and very often done incorrectly, having tremendous consequences in terms of our musculoskeletal health. If we think about how often we breathe (every moment of our lives), it is easy to see how incorrect patterns can lead to problems. Faulty breathing patterns and the impact they have are often overlooked because it is such a subtle and involuntary movement that we typically do not consciously think about.

Breathing is life. It is common to think of breathing only in terms of respiration, which is obviously essential to sustaining life. But the effects go beyond the basic respiratory function. There has been much research demonstrating a link between breathing pattern disorders and low back pain, neck pain, shoulder imbalances, TMJ pain, poor motor control and posture.

Posture and breathing are directly related. One cannot be addressed without the other. Breathing pattern disorders usually develop as we begin to develop poor postural patterns very early in life. Watching an infant is a great way to see proper breathing, as they have not yet learned to do it the wrong way.

The diaphragm, the main muscle responsible for breathing, can be seen as an essential component of the core function. If we think of the trunk as a cylinder or column, with muscles and fascia wrapping around as a belt, the diaphragm acts a lid, while the pelvic floor muscles make up the floor. Often when working the core, we often focus on the abdominal muscles and do not consider the importance of the diaphragm. If breathing is not correct, one cannot have full core stability.

An easy way to assess your breathing is to stand in front of a mirror placing one hand on the upper part of the chest and one hand over the abdomen. Take a deep breath and notice the movement of the hands. If the hand on the chest elevates, this indicates incorrect breathing, or thoracic breathing.

The correct pattern is when inhaling, the abdomen expands, pushing the hand over the abdomen forward, or outward. The hand on the chest should not move much. This is known as diaphragmatic breathing, and properly engages the diaphragm.

Thoracic breathing engages muscles of the chest, upper back and neck as the primary breathing muscles. Over time, these muscles will develop tension from overloading and doing more work than they are designed to do. While these muscles are overworking, the diaphragm is under-working, contributing to core weakness and the long list of consequences that result.

Awareness of breathing pattern disorders through the simple test above is an important step. To begin working on correcting the pattern, try the following. Lay supine (on your back) and prop your legs up on a cushion, or support, so that the hips and knees are both at 90 degree angles. If you cannot do that, simply laying on the back with knees bent will also work. Place one hand on the abdomen and the other on the chest and breathe normally trying pull the breath into the abdomen. With each inhalation, the goal is expand the abdomen lifting the hand. The ribcage will also expand a bit laterally, but should not elevate. Try to stay as relaxed as possible while doing this and don’t worry about taking deep breaths. Breathe easily and normally. Do this for a few minutes three to four times a day.

This will start to groove the movement pattern and reprogram the system. Gradually you will begin notice when breathing incorrectly and will more easily be able switch to diaphragmatic breathing. It is more difficult to do this while upright, which is why the supine position is the best way to start the training process. It is very important to work on posture simultaneously in order to achieve the best, long lasting results. It is very difficult to breathe correctly with poor posture.

Also keep in mind that this is a process. It will not change overnight. It takes a lot of work and consistency to retrain a system that has been in place for so long. Remember how often you breathe, and for how long it has been done incorrectly! Do not get frustrated if you feel like you are getting nowhere. Keep working on it. If you feel you need more help, consider seeking the help of a professional who has experience with this. Many chiropractors, acupuncturists, trainers, physical therapists, massage therapists and other types of body workers can be very helpful.

There are many other health benefits to proper breathing in addition to musculoskeletal health. One can write volumes on breathing in terms of musculoskeletal, biochemical, respiratory, mental/emotional, endocrine, neurological and spiritual health. Many types of meditation and relaxation exercise focus on the breath. It is synonymous with life. So contribute a few easy minutes a day to your breathing, and ultimately your health. It is a worthy cause.

Ankle Pain

As summer gives way to fall, we may find ourselves hitting the hiking trails. Many times, these uneven surfaces can lead to foot and ankle issues. Many people have sprained their ankle in the past, and are aware what this feels like. A lateral ankle sprain is an acute twisting of the ankle (often an inversion injury or an inward twisting of the foot and heel as compared to the leg). However, there is another condition which can cause pain on the lateral (outside) part of the foot, which many people will incorrectly refer to as “ankle pain”. I am referring to a pathology know as sinus tarsi syndrome.

The ankle joint consists of three bones, the Tibia, the Fibula, and a bone called the Talus. There are several ligaments working to help support the ankle which are very commonly sprained or ruptured with inversion sprains. However, sometimes there is only a small trauma, or repetitive micro-trauma from uneven surfaces that can affect another joint. The Sinus Tarsi (sometimes referred to as the “eye of the foot due to its appearance on an x-ray) is a very specific part of a joint called the subtalar joint.

Ankle Pain

This is the joint between a bone called the talus and the heel bone (known as the calcaneus). This portion of the joint contains many ligamentous attachments between the talus and calcaneus themselves, and between these two bones and the other bones of the mid-foot. When this joint is injured, there is often nagging pain along the lateral foot or across the ankle joint. Patients will often complain of pain in the morning or after periods of rest. They may find themselves hurting at the beginning or a run or hike, with the pain actually subsiding after getting warmed up. Certain motions like stepping off a curb, or walking up and down steps may cause sharp sudden pain.

Two tendons know as the peroneal tendons border the outside foot and ankle and help invert and evert the foot. When the sinus tarsi of the subtalar joint is painful, these tendons often over act, leading to a tendinitis which can even extend all the way to the lateral calf. Patients may complain of a pulling or stretching pain which extends to the outside calf. Often, when people complain of an “ankle pain” but have a difficult time expressing just how they hurt, direct palpation of the sinus tarsi will recreate the symptoms.

Treatments often include the standard RICE therapy (rest, ice compression, elevation), range of motion exercises (often pretending the big toe is the tip of a pen and tracing the letters of the alphabet in broad motions), oral anti-inflammatory medications, or steroid injections into the sinus tarsi itself. Also, many times supporting the foot with an orthotic is extremely beneficial and/or wearing supportive shoe gear with increased shock absorption.

So the next time you have a lingering “ankle pain” that just doesn’t seem to be getting better, ask your foot care professional about a possible sinus tarsi syndrome.

Lower Back Pain

There is a price that we pay for walking upright, and that is namely lower back pain. About 80% of the adult population has back pain at some point in their lives. The pain varies from mild achiness to disabling, tear-drawing, searing pain. The cause of back pain is often due to weakness of the core musculature and tightness of the muscles along the spine. Also, tightness of the hamstrings can cause back pain or exacerbate the pain. It is very important to keep your abdominal muscles strong and your hamstrings stretched to prevent and even to treat back pain.

Besides the pain, it is important to treat nerve symptoms. If you are having back pain that shoots down your leg, that could be a sign of something much more serious. A herniated disc can actually put pressure on one of your nerves, which will not only cause tremendous pain, but can lead to irreparable damage to the nerve. If you have weakness or tingling down your leg, immediately call an orthopedic specialist and get it checked. Fortunately, most people with a herniated disc do not need surgery. Therapy, anti-inflammatory medication, and walking can often relieve the symptoms. Do not sit or lie down in one position too long as the muscle spasm will just get worse and cause more pain when you try to move.

As with most medical problems, getting the correct diagnosis is important. Back pain has many causes and I have diagnosed people with fractures and cancer who present with just with lower back pain. There are signs on physical exam that help identify where the pain is coming from. An MRI is a great test for identifying herniated discs. Simple x-rays will show fractures and arthritis. CT scans may be helpful as well, but we try and avoid getting them, as there is much higher radiation from this test.

If you have mild back pain, stretch out and walk around. Take Advil or another anti-inflammatory medications and give it a few days. If you don’t get better, the pain gets worse, or you have any nerve symptoms going down your leg, go see you orthopedic specialist.

Rick Weinstein, MD, MBA
Director of Orthopedic Surgery
Westchester Health Associates

Beware! Low Fat May Mean High Sugar

Many of us are constantly searching for the “best” foods to eat. Our grocery stores are filled with hundreds of products “designed” to help us eat healthier. Foods are labeled as low fat, reduced fat, low calorie, low sugar, sugar free, etc. to presumably aid us on our weight loss or healthy eating quests.

Many Americans choose low and reduced fat items thinking these products are good dietary choices that are lower in calories and therefore, healthier than their full fat counterparts. However, research has shown that low fat foods are not necessarily better for you, because many products that are low in fat or reduced in fat are often very high in sugar. In fact, some studies show that these so-called diet foods sometimes have as much as 40% more sugar than the regular versions and can have the same amount or even a higher number of calories! This is because fat supplies the flavor in many foods, and when fat is eliminated, sugar is often substituted to make the food taste good. Salt and other additives are also usually added to enhance flavor, which makes the food even unhealthier and causes additional health risks.

When people eat lower fat foods, they often wind up overeating. Part of this is psychological – people believe they can eat more of a “healthier” food. There is also a scientific basis for overeating products high in sugar. Sugar is a simple carbohydrate and is easily digested and absorbed. This can lead to blood sugar fluctuations and food cravings, which may make it difficult to control caloric intake. Overeating causes fat storage and weight gain. Additionally, sugar causes inflammation in the body and increases the risk of diabetes, heart disease, and high cholesterol.

It is extremely important to decrease the amount of sugar we consume. Last year, The World Health Organization changed its sugar intake recommendations from 10 percent of daily calorie intake to 5 percent, which is about 6 teaspoons, or 25 g, of sugar per day. Sugar is hidden in many processed foods, so it is important to read food labels so that you are aware of what you are eating. Be on the lookout for sucrose, corn syrup, dextrose, high fructose corn syrup, molasses, honey, and malt syrup to name a few.

Consumers should pay careful attention to the amount of calories per serving and the amount of sugar per serving before assuming that low fat or light is synonymous with healthy. The best way to ensure you eat a healthy diet that is low in fat and calories is to avoid processed foods as much as possible. Eat a diet filled with fruits, vegetables, lean protein, and drink plenty of water. This will ensure you receive all the nutrients that you need in a healthy way.

Can’t Control Your Hunger or Cravings?

It Could Be Your “Hunger Hormones!”

Do you find that you’re always thinking about food? Do you have an insatiable appetite? Are you having trouble losing weight despite cutting your calories way down? If so, you may be realizing that successfully achieving weight loss is not as simple as following the classic “calories in-calories out” model. Instead, you need to focus on the hormonal imbalances that affect metabolism and hunger.

At NY Health & Wellness, we’ve created a proven, science-based program that works with your hormones to control your hunger, appetite and cravings. Our new Balance 3H+ program resets the hormones that are making you feel sick, bloated, and unusually hungry! We specialize in hormonal weight loss programs and metabolic hormone balancing wellness plans that are designed to balance your hormones both naturally and effectively. All of our weight loss programs are predicated on a proven, integrative medical approach that has helped thousands of women nationwide achieve significant weight loss, look younger, and restore their energy at the fastest and safest pace possible. Our programs prove that “It’s not your fault, It’s your hormones!“

Balance 3H+ — What’s the “3H” and How Does It Affect Your Hunger and Weight?
Hormones are the body’s chemical messengers, and they travel through the bloodstream, delivering messages to tissues and organs throughout the body. Leptin, ghrelin and cortisol are the three most common hormones involved in the regulation of weight and weight-related senses like hunger and satiety. They need to be balanced in order for effective weight loss to take place.

Leptin
Leptin, which produced in fat cells, plays a significant role in the regulation of body weight. Through the effect that it has on the brain, leptin controls the feelings of hunger and satiety. Because it is secreted by adipose (fat) tissue, people who are overweight or obese tend to have higher levels of leptin, causing a vicious cycle that makes weight loss all but impossible.

Gherlin
Gherlin, also known as the “hunger hormone,” is produced by specialized cells that live in the lining of the stomach and the pancreas. When levels of ghrelin are high, the hormone works in conjunction with the brain to stimulate hunger, slow metabolism, and decrease the body’s ability to burn fat.

Cortisol
Cortisol is known as the “stress hormone.” It is produced in the adrenal glands in response to stress. When cortisol levels are high, the body will believe that it needs to store extra fat, making it impossible to lose weight. In this scenario, fat tends to accumulate in the abdominal region, which contains large quantities of cortisol receptors.

Learn about the revolutionary weight loss program that has helped thousands of women across the nation look and feel their very best. Call NY Health & Wellness at 914-703-4811 now to schedule a complimentary one hour medical weight loss consultation.

Mindfulness to achieve peak performance

If I could mange distractions during my sports performance, I’d be able to achieve my peak potential! Distraction and losing focus are very common experiences that athletes find challenging to manage. For example: A tennis player lost the last four games and, during the changeover, he starts having uncontrollable negative thoughts. Elizabeth is bound to shoot her best round of golf and, as she is about to tee off, she pays too much attention to the out of bounce on the right. Tom missed his first free throw and now must make the second one to tie the basketball game with one second left.

Regardless of how much we practiced, athletes are bound to feel the emotion of the game, especially when a significant achievement is on the line. Even top athletes feel the nervousness of the moment. A professional golf player will feel his knees shaking when playing in the Ryder Cup because he is representing his own country. Serena Williams succumbed to the pressure of wanting to win the Grand Slam when facing a fairly unknown rival. The wanting to win as well as the fear of losing is felt in our bones, muscles and skin. As much as we would like to control the external factors that are part of competition, it is the internal distractions that lead our minds into wandering.

When the mind is distracted, it follows scattered thoughts, negative scenarios or blank stares. The body responds by tensing up, sweating or shaking. Commonly executed shots, throws or pitches become so much more difficult to do well. Regardless of our competitive level, we are bound to experience pressure situations. In fact, it is the effects of our emotions that we feel while playing the sport that we love that makes its mastery so much more challenging, fun, and frustrating.

It is common that we find ourselves giving “orders” to our thinking brain so it avoids troubles. “Don’t double-fault now” or “don’t hit it into the water.” Unfortunately, the brain interprets such instructions by becoming even more aware of double-faulting and water. Contrary to our well intended message, the brain is channeling even more attention to either situation as they are both perceived as threats. On the other hand, if we said, “serve well,” or “hit it over the water,” the thinking brain is unable to consistently control all the multiple body parts necessary to always meet such an expectation.

So, how do we learn to manage distractions? Learning to master distractions rests on focusing in the present moment without judgment. Being mindful helps us to see the behaviors that create our discomfort rather than impulsively react out control. Rather than being overwhelmed by an unpleasant result or clinging on the highs that come from achieving a successful outcome, being mindful helps us to be less concerned with the final outcome and more present with the efforts that we put into achieving our goals. The experience of mindful acceptance helps us to enjoy the present moment where the critical mind is a brief episode rather than a permanent feature.

Novak Djokovic wrote, “Now, when I blow a serve or shank a backhand, I still get those flashes of self-doubt, but I know how to handle them. Mindfulness helps me process pain and emotions. It lets me focus on what’s really important. It helps me turn down the volume in my brain. Imagine how handy that is for me in the middle of a grand slam championship match.”

Mindfulness promotes resiliency. When consistently practiced for about 15 minutes on a daily basis, the right side of the brain, which is more connected with emotions, becomes less active. Meditation helps to contain emotional peaks and valleys. Whereas non-experienced meditators would emotionally quickly respond to adverse situation by losing focus and getting distracted, meditators would have a greater ability to emotionally contain such distractions. In a recent study conducted by Yale University, it was found that meditation lessens mind wandering and enhances emotional regulation.

Meditation can be practiced in many different ways. One of the most common techniques is that of paying attention to the breath. Start by choosing to either keep your eyes opened or closed. Sit in a comfortable seat where your back is straight and both feet on the ground or legs crossed. Then, pay attention to each breath by either noticing the colder air coming in and the slightly warmer air being exhaled through your nose or push your belly out with each inhale and down with each exhale. Continue to be aware of the breath, one cycle at the time. You may notice that thoughts are likely to enter the mind. Just notice and give them permission to move on. If you became distracted by the many thoughts that came in, you have just become mindful of that new experience. Rather than taking your mind to those thoughts, bring your awareness back to the breath. After 15 minutes, slowly bring back your awareness to where you are sitting, the space around you and your body.

As we gain awareness of our mind and breath, the external distractions will occupy less attention from us. We cannot avoid being distracted from everything around us, but we can gain the ability to bring our attention back to our present moment experience. Present focus is what really matters to any athletes.

Alex Diaz, PhD
Sports Mental Edge