A Time For Change: Stage 1 – Precontemplation

Changing our lives is not easy and as discussed in our last blog post there are five distinct stages that we must go through in order to achieve this change.  These changes can be as little as drinking one less cup of coffee each day or as big as entering a workout regimen in order to prepare for an Ironman.  Stage 1, precontemplation, is where almost 50% of the public is currently situated and getting past this stage can be very difficult.

This stage is marked by you not even thinking about change.  Your physical therapist, physician, spouse, family member, or friend may be urging you to make a change, whether it is working out more or eating better, for example.  During precontemplation you hold onto the belief that nothing needs to change and you think that things are fine the way they are.  You read a blog article or see a billboard explaining how much changing your health matters but you ignore it.  You sit there and say to yourself, “I am healthy; I am in good physical shape.”1  In your mind you are immune to any health problems that your peers or physical therapist is trying to explain to you.  If you have found yourself constantly dismissing the advice of others you may be stuck in this phase; here are some ways to move on to the next stage.

Weigh Your Options – In this stage “people tend to focus on the downside of adopting a healthy new behavior while ignoring the upside.”¹  Get past this by making a pro and con list.  Take out a piece of paper.  No, I mean right now, take out a piece of paper and write five to ten pros of changing to a new healthy behavior. On the other side write five to ten cons for changing.  Look at the two columns. “Is there a stronger case for or against making a change?”¹

Find a “Change Partner” – It is hard to take nutrition advice from someone who is extremely overweight.  Find someone who has made a change in their life that is somewhat similar to the change that you want to make.  If you have a physical therapist, friend, coworker or anyone else who wants to change or has changed their behaviors, start a conversation with them.

Just talking about your issue will catapult you into the next stage, Contemplation.  So start today.  Don’t worry about changing your unhealthy behavior now, just start to think about it and the consequences if you don’t change. Keep coming back as we will continue to talk about the next four steps, what they entail, what needs to be overcome and how to move to the next stage.

http://www.arthritisselfmanagement.com/newsletter/12-15-2011/time-for-a-change/?page=all

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A Time For Change: INTRODUCTION

Many people in America need to change in some way or another.  Americans have become unfit, unhealthy, overweight, have high stress levels, and deal with pain and disability on a daily basis.  We all could use a little help with changing our daily routine, our diets, and our other health habits to live healthier and more comfortable lives.  Everyone out there has some room for improvement.  The new year always comes with its ‘resolutions’ but the majority of people do not hang on to these for the long haul; this is part of the reason we need to have new resolutions each and every year.  “If you try to make a change but fail to stick with it, you may feel as if there is something wrong with you and your determination”¹  But there isn’t!

Almost everyone has trouble keeping the change in their life.  “Otherwise we would be a nation of calm thin, salad eaters.”¹  We need to understand that making change is an ongoing process.  In the late 1970’s a psychology professor found that in order to completely change, especially lifestyle changes, we need to go through five distinct stages.  Precontemplation, contemplation, preparation, action, and maintenance.

"Precontemplation is the stage at which you don’t intend to change a particular behavior in the foreseeable future. In the contemplation stage, you first start considering change, but you are still undecided about when to undertake it. That’s followed by the preparation stage, during which you make firm plans to change your behavior soon. Next is the action stage, when you actually begin exercising, dieting, or adopting some other healthy behavior. Finally, you reach the maintenance stage, by which time you have kept up the new behavior for several months. At this point, you are working to make your new habits permanent and trying not to backslide."¹

Does your physical therapist keep telling you that you need to correct your posture?  Does your physician tell you that you need to change your diet in order to decrease you blood pressure or control your diabetes?  Have you been thinking about losing weight?  Are you having a hard time joining or going to the gym?  If so, you are ready for change.  Let's do it!

Over the next couple blog posts we will talk about each of these steps, what they entail, what needs to be overcome and how to move to the next stage. 

1.  http://www.arthritisselfmanagement.com/newsletter/12-15-2011/time-for-a-change/

Fibromyalgia and Physical Therapy

What is Fibromyalgia?

Fibromyalgia is a pain condition which is characterized by chronic widespread body pain, fatigue, and tender points throughout muscles, joints, and other soft tissues.  These tender points can be located in the neck, shoulders, back, hips, arms, and legs.  

What other symptoms are found in people diagnosed with Fibromyalgia?

    --Headaches

    --Numbness and tingling in hands/feet

    --History of depression and/or anxiety

    --Difficulty sleeping

How is Fibromyalgia diagnosed?

It is important to know that the cause of Fibromyalgia is not known but it is believed that there is a change in how the brain interprets pain in the body.  Physicians will often diagnose a patient with Fibromyalgia if the patient has had pain for longer than 3 months and at least one of the symptoms from the list above.  Along with this there must be at least 11 tender points (out of 18) around the body.  Before a formal diagnosis is made a thorough physical examination should be completed to rule out other disorders.  Physical therapy is often used to rule out this chronic condition by decreasing symptoms with manual therapy and normalizing body movement.  

Once diagnosed with Fibromyalgia how can Physical Therapists help? 

Recent research has shown that exercise can help decrease the symptoms  associated with Fibromyalgia.  "Aerobic conditioning, aquatic exercise, stretching, strengthening ... recreational activities, and manual therapy/or modalities for pain relief have shown to decrease pain and  improve function, general physical health and sleep in individuals with Fibromyalgia."¹  The problem is that people with this diagnosis are often reluctant to participate in exercise secondarily to the fear of exacerbating their symptoms.  "A Physical therapist can help an individual learn to interpret pain signals, and manage and decrease symptoms through exercise."¹  Physical therapists are healthcare's experts in restoring and improving motion in people's lives.  Your physical therapist at Hayashida and Associates Physical Therapy Hcan help develop a individualized treatment program.

 

Reference:  www.moveforwardpt.com

Fat Busting Shoes?

As we have been looking at the advantages and disadvantages of barefoot running I thought it would be appropriate to look at the new revolution of oddly shaped shoes.  These shoes such as “Shape-ups” by Skechers and “EasyTone” by Reebok tout huge fitness results but, the question is, do these shoes produce their advertised results? And, more importantly, do they have the ability to cause injury?  First, an overview….

Reebok’s shoes describes a revolutionary technology where they have pads of moving air on the sole of the shoe which mimic walking or running on an unstable surface.  They explain that this makes your muscles work harder throughout the day, causing increased activation of the gluteus maximus (bottom), hamstrings, and calves.

Skechers “Shape-ups” also describes a ground-breaking technology where they have a dynamic rolling bottom on the sole.  According to Skechers this makes you feel like your heal is sinking into sand as you walk forcing you to activate your muscles more to get towards your next step.  The advertised benefits include more toned legs, back, and abdominal muscles, reduced body fat, improved circulation, and improved posture.

But, if my last two blogs show how we should be decreasing the amount of shoe wear that we put on our feet, is it really good to have these shoes which further alter our gait mechanics?  While Reebok does not actually show us any of their research articles, Skechers reports many clinical case studies that back their findings.  Their articles show an increased amount of weight loss, an increase in hamstring and calf muscle activation, and improvement in low back endurance.

So, do you buy them or not?  First, I must emphasize that under each clinical case study for Skechers there is a statement: “These independent case studies where commissioned by SKECHERS.  Results may vary from person to person”¹    This breaks rule number one in “research 101.”  You must gain your research based knowledge from peer-reviewed articles that are not endorsed by the company that is selling the product.  There is no way to tell if the money that Sketchers paid the researchers persuaded their outcomes. Second, according to Matt Powell of SportsOneSource, a sneaker analyst, the sales of these shoes “represent the fastest-growing segment of the $17 billion-a-year athletic footwear industry. It's a market driven by a customer base that is 90% women.”²  Anytime we see such a sharp increase in a product we must ask ourselves if this is due to a truly innovative product or fads and good advertising.

Without ever putting a pair of these shoes on I have some problems with their design.  Destabilizing the foot during walking, especially in a deconditioned person, will lead to problems of the knee (knee cap tracking problems causing pain), the Achilles tendon (increased stresses causing pain and possible tears), the plantar fascia (causing arch pain) or even falls causing serious injuries.  I have heard stories of people developing fractures from wearing these shoes after stepping awkwardly and “rolling their ankles.”

Wendy Shore of Johns Hopkins, says “consumers would get the supposed health benefits of toning shoes and save money if they skipped buying the shoes, then bought one less bagel a day — and walked an extra block."²

As a physical therapist I cannot say that I support the use of these sorts of shoes at this time.  Yes, my opinion may change as more peer-reviewed research articles are presented in respectable medical journals but without the evidence of true health benefits along with the high risk of injury these risks of these shoes outweigh their benefits. 

And as mom always told me, if it sounds too good to be true, it probably is.

References:

1.       http://www.skechers.com/info/shape_ups_clinical_case_study

2.       http://www.usatoday.com/sports/2010-06-30-toning-shoes_N.htm?csp=usat.me

Eat a Mediterranean Diet...For Your Heart...For Your Brain....For Your Health!

The common theme nowadays is to find ways to decrease the cost of medical services.  Part of this is done by prevention techniques that are often not covered by insurance companies.  The general population is quickly finding out that they need to take care of themselves whether it is by diet or exercise in order to save on their health care dollars.  It has been long believed that by partaking in a Mediteranian Diet one can keep a heart healthy and avoid extensive heart disease; the largest killer in America.¹

The Mediterranean Diet consists of eating large quantities of fruits, vegetables, grains, beans, nuts, olive oil, and fish.  Low to zero quantities of dairy, saturated fats and red meat are eaten.  Wine is moderately drunk in a Mediterranean diet.

Recent research shows that the Mediterranean diet not only helps with heart disease but can also decrease the chances of suffering from brain infarcts, which can be thought of as mini-strokes that cause mild cognitive changes such as memory loss, like we might see in beginning stages of dementia. 

“Researchers found that people who most closely followed a Mediterranean-like diet were 36 percent less likely to have areas of brain damage, compared with those whose eating habits were furthest from the diet.” ²

This news is important for those in America, as it is believed that 1-4% of all Americans over the age of 65 have some sort of dementia, a number as large as 4.5 million people, according to the Mayo Clinic.

This new information, although not completely correlated, can help prevent dementia-related illnesses.  As we all know, “knowledge is power.”  Now is the time to become healthier.  It makes financial sense to take care of yourself; Save money, live healthy!

      1. American Heart Association; 2010. http://www.americanheart.org/presenter.jhtml?identifier=4644

      2. CNN Health; February 8, 2010. http://www.cnn.com/2010/HEALTH/02/08/mediterranean.diet.brain/index.html?eref=rss_topstories&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+rss%2Fcnn_topstories+%28RSS%3A+Top+Stories%29