Opitmal Blood Sugar Means Addressing ‘When’

When I teach The Blood Sugar Mastery Class™ I address a lot of topics in the 6+ hours of teaching including the what, why, where, when, how and  how much we eat that can make or break a blood sugar problem!  Most everyone gets it that what we eat is a big deal when it comes to controlling blood sugar as is how much we eat!  The remaining parameters of why, where, when and how we eat are equally important and I will address just one of them here:  the when of eating!

When you eat should make you think of schedule and schedule should make you think of planning!  We all have schedules for one thing or another and some of them are so automatic that you don’t really think anymore about when to bring the kids to school, when to leave for work or when to put out the cans for garbage day….you just do it!  But when it comes to planning time to eat, for many, this doesn’t fall in a category of something that needs planning let alone to be scheduled.  Most practitioners will not assess someone’s eating schedule and so this aspect of proper fueling, particularly for your brain, goes unaddressed and yet, can be the source of unrelenting symptoms and unstable health!

All of us at some point used to be on an eating schedule when we were very young!  If you are a parent you know that you plan on when to feed your kids. You would never let them go for 5-6 hours without eating as well as not letting them eat every 30 – 60 minutes throughout the day!  Eating at the same organized intervals each day is one of the key aspects to keeping  your brain health and blood sugar managed.  It actually trains your chemistry to work optimally. Somehow, the structure of eating on time started breaking down around high school and definitely by college!


Blood sugar chemistry is actually rather involved but I like to keep it super simple with an understanding that when we eat, blood sugar rises and if your pancreas is working, then your insulin rises too in order to lower your blood sugar. If you keep eating, insulin keeps rising!   If you don’t eat or wait too long to eat, your blood sugar lowers, and if your adrenals are working, the stress response chemical cortisol comes out which then raises insulin and further lowers your blood sugar that is already low!  Now you are headed for some BIG brain driven food behaviour!  The binge monster which also makes poor choices is on it’s way not to mention even more stress chemistry which turns on inflammation, breaks down healthy tissues like your muscles and your brain and alters how your hormones work so that sleeping isn’t pleasant anymore!  This would be training your chemistry to do the wrong thing!


So if you followed the information in the previous paragraph, you read that insulin stays up if you eat too often and if you skip eating or under eat, insulin AND cortisol comes out to play.  Here’s the clincher:  when insulin and/or cortisol are up too often or too long they do one of their jobs that they are so good at and that is to create belly fat! So just when you thought you’d watch your weight by under eating or skipping meals, sorry to say, fat chance!


I hope you can see that planning today for your food schedule tomorrow is a critical aspect of fixing health issues that are driven by mismanaged blood sugar!  You might already be eating healthy foods and even healthy portions but if you don’t eat at healthy intervals through out your day you may still be creating chemistry that fuels persistent and even serious health problems.  So join all those kittens, puppies and babies and put yourself on an evenly spaced, healthy eating schedule!



Man Edge of a CliffA physical cliff has the same vulnerable and perilous feeling that the fiscal cliff imposes and it is also at the mercy of pre-existing conditions and indecision!  You may or may not realize that you are on a physical cliff, it’s not always obvious!

Characteristics Of A Physical Cliff:

There are many, many clues that you could be approaching or even teetering on the edge of a very dangerous physical cliff, I’m listing just a few of the common ones!

You know your health is on the edge of a physical cliff when:

~ you want to exercise but you either can’t or have to stop short because some kind of pain limits you.

~ you are so out of shape that mentally and emotionally you already feel overwhelmed before you start, so you don’t!

~ your good intentions in the morning cave into fatigue and low energy later, exercising and eating well are no longer choices.

~ you are doing everything to diet and lose weight and it’s not coming off!

~ you have extra weight around the middle plus at least one more symptom of any kind and you have carb cravings that you regularly give in to.

~ you don’t even know that you have carb carvings because you feed your sweet tooth daily and frequently.

~ you never get a full night of uninterrupted sleep and particularly when it’s due to untreated apnea.

~ the engine of your nervous system is always revved up and you don’t have techniques to bring it back down again!

~ you have an addictive pattern of over eating or under eating and you are not getting help for it.

~ you chronically don’t feel well, you aren’t sure why and you aren’t seeking help to figure it out.

~  you are addicted to recreational or prescription drugs or alcohol and you are not getting help for it.

~ medications are controlling your symptoms more than a healthy lifestyle!

More People Are Walking On the Edge Than Ever Before!

We are part of a generation in the US where some children growing up today may actually have a shorter life span than their parents!  That’s appalling and scary!  Moving toward the edge of the physical cliff starts at some point in our lives and that can be when we are very young.  Practicing and teaching healthy habits with children is one of the best investments in illness prevention there is!

Arriving at the cliff’s edge is not an ‘all of a sudden’ maneuver even though it may seem like it when you are finally given a diagnosis or surgical procedure.  Many people are steadily moving toward the edge and even walking on the edge without realizing that they’re there.  Most people think that they couldn’t possibly be on a physical cliff if they are getting their daily work, chores and meetings accomplished.  Life on the edge can be fully functional, but closer examination reveals that stamina, focus and feeling well are missing.  Persistent use of medications to control symptoms helps keep us believing that we are no where near the edge while we are actually perilously close!

Move Away From the Physical Cliff!

Some of us were born at shorter distance from the cliff’s edge due to our genetics than others but this in no way means that movement toward the dangerous precipice is inevitable!  In fact, everyone has the ability to move further away from the cliff in some small or big way whether that’s changing what you eat, improving your level of exercise, getting help to stop bad habits, drinking more water, eating on time, getting enough sleep or learning how to care for yourself and your children.

Indecision doesn’t lessen the danger of the physical cliff, if anything, it heightens it!

Your first step is to decide to be healthier, your next step is to step away from the edge and then keep stepping…one foot after the other, away from the edge, toward an open field where your movement is pain-free,  your energy is dynamic, your mind is sharp, you’re unstoppable and passionate….. and anything is possible!

The next time you walk by that reflective window or look in the mirror, stop… check it out, can you see the physical cliff?  How close to it are you?


Everyone Should Eat Fruit, Right?

You can listen to the article here

fruitWrong, not if you have fructose intolerance!  Food intolerances as a source of health complaints have become more and more well known, and among the heavy hitters is gluten intolerance.  What used to be an almost unknown food issue just 5 years ago is mentioned now in almost every type of media from newspaper articles to television ads. I even saw a restaurant advertising their gluten free menu on the side of a bus just the other day!  Other common food intolerances include dairy, eggs, corn and soy.

But Fruit Intolerance, Really? 

Yes, that’s right,  the specific sugar in fruit is called fructose and different fruits vary in the amount of fructose that they contain.  For example, apples and pears have higher fructose content than berries, citrus fruits or stone fruits (peaches, apricots, nectarines).  Other foods that are high in fructose are corn syrup, honey and agave.  Even good old table sugar, otherwise known as sucrose, is half fructose and half glucose.  Someone with fructose malabsorption may not tolerate any foods that are too high in sugar.

Possible Symptoms …

woman with stomach acheFructose malabsorption, once called dietary fructose intolerance, is a problem of improper breakdown of fructose in the small intestine and so the undigested fructose particles get into the large intestine and cause IBS-like symptoms such as constipation, diarrhea or alternation of the two.  From here, additional symptoms like bloating, gas, headaches, rashes, acne and eczema can also be present as well as changes in mood and outlook.  These last 2 mental health symptoms are not uncommon with fructose malabsorption, research has shown that fructose specifically breaks down the amino acid tryptophan which is a protein building block to the feel good neurotransmitter serotonin.  The research that shows a strong correlation of women with depression and fructose malabsorption is very real.

Finding fructose malabsorption by testing is done the same way as testing for lactose intolerance, with a hydrogen breath test.  If test results are positive it still doesn’t distinguish whether fructose or lactose is the culprit so one is still left to do an elimination of fructose containing foods and assess any change in symptoms and functional experience.

You’ve Tried Everything…maybe.

So, if you are someone who has eliminated gluten, maybe even dairy, you’ve tried the Paleo diet, gone vegan, taken probiotics, enzymes and acid, you’ve added greens to your morning smoothie, made bone broths, increased your veggie intake, ate healthy fats and counted your carbs……and you still suffer from digestive, skin and/or mood problems…well, you just might have fructose malabsorption!  Have you ever noticed that  you tolerate small amounts of maple syrup far better than honey or agave which make you bloated and tired?  This might seem like splitting hairs but when you’ve tried everything in order to feel better you tend to have a vigilante radar as to how you respond to different foods!  If you notice this difference between maple syrup and the other sweeteners I mentioned, your next step just might be to eliminate fructose for 3-4 weeks and see how you feel!  Fructose malabsorption can be the problem for those people that have Celiac Disease or Gluten Sensitivity and say that they still don’t feel well!

If you feel you have tried everything, but haven’t tried fructose elimination, it’s worth a try, there’s really nothing to lose!




When Normal Isn’t Normal

You can listen to the article here.

I know that some of you are like me. You rarely go to the doctor, you read up on all of the latest health information which is easily done online and you work to relieve what ails you on your own and most of the time you can.  So when you finally go to the doctor because something clearly isn’t right and you’re sick and tired from functioning at less than you’re used to, you’re ready to face the music and find out what’s wrong!

Then Your Doctor Looks at Your Blood Work and Says, “Everything’s normal!”  

Now, which response do you have?!  Is this when you simply cock your head sideways like your dog taught you to do, look puzzled and walk out?  Or are you the one who feels totally demoralized, insulted and frustrated but find the energy to pull up your tired boot straps and march off to the next practitioner?  Or, are you the one who wants to scream  “are you out of your mind!? I wouldn’t be here if everything was normal, those blood tests might say I’m normal but I don’t feel normal, that’s why I’m here!”……..but you don’t and so you leave the office seething, never to return again!?

Missing pieceI’ve had this frustrating experience myself and it was only later in my training as a nutritionist that I understood what my doctor might have missed.  Part of a comprehensive assessment in my office is to  read through all of your previous test results, whether those are operative or radiology reports, blood test results or gastrointestinal studies. I don’t order these tests, I simply read through all of the results looking for puzzle pieces that may fit into the empty spaces of your unresolved health issue.

Drawing your blood and measuring all of the different values follows a strict protocol and we all rely on the lab techs to do that correctly.  A computer will ‘read’ your test results and mark a value as high or low if that value falls outside of the laboratory’s reference range.  A busy practitioner will look for those computer scored high’s and low’s and leave it at that but the true artistry of interpreting your blood work to see if it tells a deeper story about your health comes from taking the time to assess your results while keeping the following principles in mind:

1.  What is Normal? Who is normal?  Who were all the people who got tested LONG ago to decide on what normal would be for any particular lab reference range?  Were they normal?  (Notice that we have seen accepted normal ranges for cholesterol change 2 times over the last 10 – 15 yrs).  What may be considered normal by the lab’s reference range may not be normal at all for someone who has their own unique  chemistry, genetics and function.  Do current lab reference ranges coincide with up to date research and cutting edge science?

2.  Optimal Ranges vs. Lab Ranges:  There are optimal ranges for any value that may or may not match the lab’s established reference range.  What is high normal or low normal  and yet still very normal for one person may be entirely too high or low for another person and may actually be a clue about what is destabilizing their chemistry and therefore their health. Everyone’s chemistry has a different window or threshold of ‘normal’ function. One of your lab values may be within the reference range yet is out- side the optimal range.  This may, in fact, be suboptimal function for you!

3.  A Blood Test is A Snap Shot:  Each blood value speaks to the status of particular physiology going on in the body which is actually a dynamic process in a living being.  Even if a particular blood value has a very narrow range of accepted normal there is still a fluctuating aspect of that value since it comes from the blood of a living person who’s body’s chemistry is always in a state of change, diurnal rhythm or dynamic balance.  A blood test is like a snap shot of a moment in time, was that blood value possibly on its way up or on its way down at the moment blood was drawn?  A momentary snap shot doesn’t give us the long term perspective of a blood value that can change day to day or even hourly.

4.  Patterns:  Even if all blood values are scored as normal by the lab’s computer there can be patterns that exist among these high and low normal values.  It’s critical that time is taken to look for patterns since these can sometimes be the only indicator that a particular dysfunction is occurring and can even be the best method for early detection of health issues.  Isn’t it better to catch a condition in it’s earliest phase before one’s health begins to change or fail?

Test tubesExamples of ‘Normal’ When You Don’t Feel Normal!

Fasting glucose:  This could be quite optimal at 87 or even considered normal at 99, it still says nothing about if your ability to process carbohydrates is working correctly or if your longer term storage of glucose in your blood is too high.

Hemoglobin A1-C:  This tells you about longer term storage of sugar in your blood and is normal up to 5.6%.  Diabetic levels are at 7.0%.  So what’s going on with you if you are at 5.9% or 6.4%?  The range between 5.6 and diabetic is one of insulin resistance and proper counseling to lower this value is critical to avoid cardiovascular and other degenerative disease and yet your doctor may not be aware of this.

MCV:  this stands for Mean Corpuscular Volume which just means the average size of your red blood cell.  Low iron pulls this value down and low B12 pulls this value up.  What if you have both low iron AND low B12 (not uncommon), this value will stay right in the middle at an  optimal normal range. What does your doctor do then?

Serum Iron:  many practitioners rely on this to find out about your iron level.  But this is a very transient value, it even changes with what you ate the day before, if you took iron supplements or even cooked in iron cookware!  Longer term iron storage is most important to look at your iron level and is seen with a value called ferritin.

TSH:  this is Thyroid Stimulating Hormone, the value that indicates how much your brain is telling your thyroid what to do.  There is so much confusion and consistent lack of correlation of this value with how the patient actually feels, that like Cholesterol, TSH has been assigned a new (narrower) reference range and yet that range is not yet used by all labs.  And even more confoudning, this value could be low indicating a high thyroid problem when in fact the patient has a low thyroid problem.  How confusing is that?

Vitamin D:  has a very wide ‘normal’ range of 32 – 100.  So your result could be at 35 and be considered normal and you might not be advised to take Vitamin D3 supplementation. Most research advises Vitamin D to be in the 50’s, 60’s and 70’s particularly for adequate immune balance.

Vitamin B12:  if investigated, a serum B12 is often drawn which has a Grand Canyon wide reference range of 211 – 946!  Cutting edge research shows that clinical signs and symptoms of low B12 can be present when serum B12 is in the ‘normal’ range of 250.  More acceptable ranges for serum B12 by those who study it are up in the 500’s and 600‘s.  Furthermore, serum B12 is actually not the most sensitive marker for low B12, a value called Methylmalonic is most sensitive.

Morning Cortisol: this would be ordered to assess adrenal function. While it’s great that your adrenal glands are being given attention at all, cortisol functions in a diurnal rhythm and only by taking sequential cortisol samples (4 in one day), would you find out your total production for the day but also if your pattern or rhythm of output is as it should be.

These are only a few of many, many blood test results that if read as normal may lead your practitioner to tell you that you’re fine. Misinterpretation of blood work is only one aspect of why perhaps no one is fixing your health, there may be many more reasons that I’m not discussing for this article. Blood work is basic though and although the blood draw and chemistry calculations that lead to your results are hard science, the interpretation of your results is much more an art than a science!


The Truth About Fat Loss

You can listen to the article here.

If you have followed the topic of weight loss over the years you should have noticed a change in  what has been thought of as THE cause of weight gain and therefore the SOLUTION to weight loss!   If previous thinking was correct, shouldn’t most of the weight loss centers have closed down by now and that the United States wouldn’t rank 2nd among the fattest countries in the world?  (Australia just recently passed us to capture 1st).  Clearly, we haven’t gotten it right yet, so what is the real deal when it comes to weight loss and specifically, fat loss.  It boils down to the science that’s happening in your body that we can’t argue with and then there are some nuances person to person within the science that is true for each person.

It all started with calories…

Long ago, when I was in 7th grade science class, we learned about energy expenditure in the human body.  The unit of energy we were talking about is the calorie.  And we all thought that if you put a bunch of calories in, let’s say  2,000, and you use or burn up only 1,000 calories, then you have 1,000 remaining that could qualify as weight gain!

Simple!  You are gaining weight either because: 1.  you are consuming more calories than you are burning  OR  2. you are eating an ok amount of calories but your are not burning them up enough.  Weight loss regimens back then basically said a low calorie diet plus exercise does the trick! And maybe it did, temporarily.

If you are reading this and thinking, well yes, isn’t it all about calories in vs calories out?

Throw away your calorie counter right now and keep reading!

And then came pasta primavera…

Soon to follow the calorie theory was the era of heart healthy meals and low fat eating!

The US had a surge of non-fat, low-fat, lite and fat-free foods that were manufactured and that we still see on grocery store shelves today.  I’m not saying that ALL of these foods are bad but when it comes to eating fat free breakfast pastry or morning cereals are good for you because they are fat free as are some candies like licorice or gummy worms….you get the picture, we are totally missing the boat!

This is the same time when heart healthy eating centered around low fat eating and so dishes like Pasta Primavera were born.  This is basically a dish of pasta with some kind of fat free vegetable mixture on top. As most of you know now, that is one big plate of fat causing carbohydrate with some healthy fiber on top.  Heart disease in the US did not slow down nor did obesity or obesity co-morbidities using the fat free model for weight loss.

Finally, a look at the science…

So here we are, back to the basics of studying the science that really happens in the human body!  This is where things can sound a little complicated due to long chemistry words and hormonal mechanisms that can get even the top grad students lost!

To simplify it for you, here are 3 critical areas to take into account:

1.  What raises your blood sugar too high and too fast?

2.  What raises your Insulin too high and too often?

3.  What combinations of foods are creating 1. and 2. above specifically for you?

Carbohydrates are the primary drivers of blood sugar.  Elevated blood sugar is the primary trigger to ask Insulin to come out for a play date.  Insulin is the primary driver of fat accumulation!  For the purposes of and space within this article, this is THE basic concept to get:

Carbs  → blood sugar rise → insulin rise → FAT GAIN

Carbohydrates, particularly the simple processed ones, or what we call high glycemic carbs – the ones that raise your blood sugar quickly, increase fat storage and slow down fat burning. And then there is an efficient feed forward cycle where fat storage creates more fat accumulation, inflammation and so on. Not pretty.

Protein, healthy fat and vegetable fiber are best when it comes to keeping blood sugar stable, which means lower and slower ups and downs.

And now the nuances…

Sorry to tell you, but there are 3 other fat storing hormones  with big long names that will make you fall asleep if I tell you their names….like Acylation Stimulating Protein, Glucose-Dependent Insulinotrophic Peptide, and Grehlin….see what I mean?

The first two are triggered by fat intake!  So, even though I just said that fat is great to keep blood sugar stable it still has a component of increasing fat storage in the body.  This is where you have to figure out your own needs and nuances of how much fat do you tolerate and is fat accumulation your primary issue or is stabilizing your blood sugar your primary issue, or both?  What it means is, how much healthy fat you take in may be different than someone else and when it’s combined with a carb (ie. cupcakes with buttercream frosting, deep fried donuts, french fries, potato chips and sour cream dip), the combo is even more deadly for you in terms of gaining fat!

And finally, let’s talk about the 3rd fat storing hormone grhelin.  Listen up all of you under eaters, meal skippers and fasters!  Grhelin’s job is to increase hunger, especially to sugary, fatty and salty foods, and to store more fat in response to lowered food intake!  So when you finally do eat, you will crave sugary, salty and fatty foods AND get fatter more quickly!!!

So what does all of this mean?

Here are some key  points that you should take away:

1.  Keep your carbohydrates from whole, real food sources that are complex and

nonallergenic – quinoa, brown rice, wild rice, amaranth, beans, for example.

2.  Get to know your complex carb tolerance and keep your servings modest, maybe

that’s a 1/2 cup or maybe that’s just 3 – 5 forkfuls per meal.

3.  Do add lean proteins, healthy fats and vegetable fiber to your meals to stabilize

your blood sugar.

4.  Know your healthy fat tolerance, are you a fat with your carb or a fat without your

carb person?

5.  Make sure your diet has plenty of non-starchy vegetables, 3-6 cups per day!

To close, I love what award winning author Michael Pollan said:

Eat food

Not too much

Mostly plants


How Changing My Food Fixed My Back Pain

You can listen to the article here.

When I am in social settings and people learn that I am a Physical Therapist, it’s pretty standard  for people to tell me about their health that includes some kind of musculoskeletal complaint or surgery even though they have never had an accident, injury or any event that would account for their muscle, joint or spinal pain.

They talk about living on anti-inflammatories or needing an ample budget that allows them to attend to all of the complementary care and bodywork sessions for pain control which only gives them temporary relief.

What prompted me to finally write about my personal story is the last conversation I had with Jill,  a 49 year old Mom of 2 who has already had a total hip replacement, has lived most of her life on Advil due to back pain and is now finally complaining of horrible digestive problems that really drain her energy, lower her mood and interrupt her sleep.  With just a few specific questions it was clear to me that Jill’s history of back pain and even her total hip replacement have been the result of a digestive problem that went  unnoticed.

I know I’m making a bold statement, that Jill’s pain and hip problem could actually have been caused from an unseen digestive issue!  Yes, that’s right and here is why I know that can be true and is actually more common than not as that is what shows up in my practice every month!

Here’s My Story

I was a good athlete from a very young age and was involved in competitive diving for several years which was ultimately replaced by gymnastics.  I was quite serious as a gymnast training long hours in the gym and even longer at 2 and 3 week summer gymnastics camps.  It only made sense later on in my 20’s and 30’s that my lower back pain was due to the high demand of flexibility and pounding that my back had experienced for so many years when I was younger.

I remember needing to sit in a special hard chair while in Physical Therapy school (I hated having to be different) and that I already started getting treatment for my back while attending Northwestern.  So not only was I an athlete but I was also a physical therapy intern and I knew how to stretch, keep my core strong and use proper body mechanics while lifting and pushing.

As time went by, I continued to get treatments from expert osteopaths around the country whose classes I was attending.  At one point, all of my right shoes had a 1/4 inch heel lift on them and after a year or so it was clear that that was wrong and so all the heel lifts were taken off!  My chronic back pain finally caved in in 1988 when I experienced a huge backward rotation on one side of my sacrum which left me in severe back spasms on the floor for about a day and a half.  It was a slow process getting back on my feet and rehabbing my back and pelvis which to this day do not tolerate running.  My back continued to go out in varying degrees of severity after that day.  Sometimes I would come to work bent over at 45 degrees and I would do my best to hide the fact that my back was in such distress!  There were those excruciating days when I knew my back was actually worse than the one I was treating!  I was ashamed and embarrassed and I hid that too!

I was constantly trying to understand what had happened to me and how did my life go from being a high level competitive athlete to needing specific back strengthening regimens which were not even keeping me from having acute episodes of back pain and constant tension!?  My own professional skills and knowledge were not solving my problem!

Finally, The Solution!

The solution to my back problem began when I started learning about the organ systems of the body, specifically the digestive tract.  I learned about the tension patterns of the digestive organs and how they pulled on their musculoskeletal neighbors creating abnormal patterns of force, that in turn, created more patterns of tension even further from the original organ in question.  Even with this understanding of the visceral organs and their tension patterns, there was still another bridge to cross to reach the aha! — that food was at the core of these digestive strain patterns!

Now it became a learning path to understand which foods were creating my digestive tension which I never realized I had!!  This process of discovering which foods were not compatible for me and how they contributed to my back problem,  was not an overnight process, it had twists and turns, back tracking, starting over, lots of note taking and many grey zones of confusion until I finally figured out the specific foods that were at the core of my spinal issues. All of this lead me to becoming a Certified Nutritionist who has a fine tuned radar for those people that have food and digestive problems central to their unresolved health issues!

It has been this personal process that has allowed me to be able to develop and take my patients through a customized Food Compatibility Program™ with clarity, step-wise progress and proper instructions about what to monitor, how to course correct and arrive at an empowered and successful outcome.  It’s not that every unresolved pain or health issue comes from a food or digestive problem, of course not, but the important point is to realize that unexplained, recurrent pain problems need to include the assessment for food intolerances and digestive issues as part of the differential diagnosis.  If you relate at all to my story, you’ve been to doctors and still are without answers, you need to get yourself to a professional who is an expert with food compatibility.  And very likely, that will be outside of your doctor’s office!


5 Tips to Avoid Sprains or Strains

You can listen to the article here.

I’m not sure if there is anything more inspiring than watching the summer Olympic Games.   Even though most of us will enjoy the games by television, it’s TV that makes it possible for us to get up close and personal with the athletes and really feel their physical and emotional wins and losses.

The energy and intensity of the Olympians and their performances are so inspiring and with that comes the spark and energy to get fit and go for our personal best too. But sometimes we take on too much, too soon, too fast and with an activity that’s too new.  Here are some tips for you to use so that your cheering and fist pumping from the couch doesn’t turn into wincing or limping from pain.

Remember that your soft tissues are very vulnerable to the physical demand you put on them and specifically, your tendons, muscles and ligaments need proper attention when you are asking them to either do a new activity or even more of the what they are already used to.

Tip #1  Assess Your Current Status & Proceed Accordingly

Where are you at right now with your overall physical fitness?  And where are you at with the specific activity that you would like to engage in either for the first time or maybe you want to increase what you’re already doing?

Being realistic with where you are at before you make a change is truly the first step to avoid overuse injuries.  If this is a new activity for you, then take a look at what’s involved.  Is this an upper body sport like rock climbing, swimming or tennis and you’ve never developed your upper body strength before?  Are you going into a sport that requires new footwear such as skates, hiking boots or dance shoes with heels?

Engaging with new equipment or footwear and using body parts that you are not used to exercising requires a careful start, a break in period, time to just get acquainted with the feel of the motion or equipment and to proceed slowly.

Tip #2  Build Your Muscle Strength Both Generally and Specifically

Every sport requires muscular action in a specific pattern or motion.  It’s really wise to gain overall strength in a broad range of muscle groups as you take on new activity but so is it important to specifically train the muscle groups that are the key players in your chosen activity.  If you are going to take on or increase cycling, then spend extra time  strength training your legs.  If you are trying out tennis or windsurfing then work on strengthening your back and shoulders.  Core strengthening is important in all sports and a class, personal trainer or physical therapist could be very helpful to teach you the proper  exercises and form to do that.

You can get even more specific by strengthening the muscles and tendons in the exact motion that your sport requires.  This is done when you are progressively working on your sport but also by isolating that motion, stroke, kick, etc in the exact way it’s done during the sport.  Taking time to strengthen your soft tissues is absolutely KEY when it comes to avoiding sprains and strains from overuse!  And in a beginner, overuse happens very quickly!

Tip #3  Stretch and Warm Up!

Stretching before exercising is always a good idea!  This prepares the tissues for larger ranges of motion that most sports require.  Although many people see stretching as their warm up, warming up can also be distinct from stretching in that it allows you to increase your circulation by moving your entire body and actually raise your tissue temperature a bit.  Some people prefer to do a total body movement to warm up before they elongate and stretch their muscles and others prefer to stretch out first in preparation to warming up the total body.

Most important is to know what you  need and do BOTH components before you engage in your specific sport.  The 5 – 15 minutes it takes to stretch and warm up can save you weeks of overuse injury recovery.

Stretching again after a particularly long or vigorous exercise session can be very helpful since muscle groups tend to start building tension as they run out of fuel source during more intense exercise. Stretching again after this kind of exercise helps to restore normal muscle tension, length and flexibility.

Tip #4  Think Anti-inflammation

Overuse injuries of tendons, muscles and ligaments almost always involve inflammation of those tissues.  The first inkling that these tissues are being challenged usually comes in the form of some kind of discomfort.  Without therapeutic attention, this can progress to swelling, both internally in the tissue and externally, and then pain, heat, redness and more swelling which results in some kind of movement limitation.

To avoid the previous picture it’s great to know the variety of choices available for curbing inflammation from the very beginning.  Let’s start with ICE!  Ice is the simplest anti-inflammatory and should be used anywhere between 5 – 20 minutes and can be repeated as needed.  You might use a damp towel between the ice and your skin for really good penetration of cold or to avoid burning from super cold ice.  There are all kinds of nifty gel ice packs in many shapes and sizes, for kids and adults, just check your local drug store.

Other products that can be very helpful for calming inflammation and pain are creams with anti-inflammatory ingredients such as Topricin cream, a homeopathic formula that is quite popular.  I also like Arthrosoothe cream by Designs for Health.  This cream has white willow bark, capsicum and arnica that all combat inflammation. Using these products on sore areas after exercise or before bedtime can really help keep tissues calm and avoid the vicious cycle of pain and inflammation.  Taking warm baths that contain magnesium epsom salts can be a great pain reliever since it helps decrease the build up of acidic metabolic byproducts that tend to stay in the tissues.

Tip #5  Know Your Limits and Use Matching

I know you know what I mean when I say “know your limits”.  This is probably the hardest thing for people to do even though we know our exercise limits both intellectually and physically.  But if a little is fun, then a lot is ‘funner’!  We’ve all been there.  If you take heed of #1 above, work on your strength training and know your physical limit you will actually expand those limits slowly but surely and without injury!

I often talk about using the concept of matching when it comes to exercise.  This concept addresses the fact that we don’t always feel the same everyday, our energy can be up or down, we may have not slept enough or other stressors are draining us,  yet we want to keep exercising at the same intensity level at each session or maybe continuously build on each exercise session. You get it, right? Your energy or state of being and your exercise goal may not be a match, this is often when injuries and overuse happens.  If you start your session matching (respecting) where your energy is at, you’ll be surprised that you end up doing more in that workout than you thought you could and without an injury!

Whether it’s this summer’s Olympic Games or any other event that inspires you to take up a new sport, a past sport or maybe do more of what you already do, just remember to follow these tips so that your new level of exercise is injury free and enjoyable.  This way, you can progress your skill and stamina to your next level of ability, just like the top athletes have done many times over on their journey to become an Olympian!


Detoxification: A Silent System With Many Players

You can listen to the article here.

In recognition of those who have gone through my detox program and for those who arecurrently going through it I thought it only fitting to write about detoxification this month and highlight some of the aspects of this system.

Detoxification IS a System

Many people think that detoxification is something that happens only when we’re sweating in a sauna or fasting on water and juices. Although those are cleansing actions for the body, detoxification is a system that’s working everyday just like your respiratory system, digestive or cardiac system. You can tell when your breathing and digestion are working well or when they are congested and sluggish. The action of detoxification on the other hand is fairly silent while it works and you may not even know that its function is over taxed and slowing.

Despite the long list of very common symptoms that can indicate an overburdened detox system such as headaches, rashes, fatigue, restless sleep, acne, constipation, joint pain, irritability, inability to lose weight and so on, we usually don’t put two and two together and realize that the network of actions that make up detoxification may in fact be challenged and under functioning. While your doctor may be keen about identifying issues with your heart, your lungs or your kidneys, he may never realize or address that the system that keeps your body from accumulating dangerous levels of chemicals, hormones and other toxins may actually be impaired and even at the root of causing your symptoms.

Key Players in the System

The liver is the primary player when it comes to transforming toxic substances that cling to the body’s tissues to ones that are less harmful and that can easily exit the body.
The liver is an organ with complex chemical mechanics that we basically divide into two phases when it comes to its detox ability. These 2 phases require proper balance to take a fat loving dangerous toxin through transformation to a water soluble one that can easily exit the body. Genetic mishaps that involve these 2 phases of detox are fairly common and strengthen the argument for why we all need to take ourselves through a structured, science based detox program.

The kidneys are also key players in detoxification and are one of the final pathways to eliminating toxins in the urine. We actually refer to this as Phase 3 detoxification. This phase requires the correct alkaline pH for proper toxin elimination and this is achieved by eating enough vegetables!

The intestine is another exit pathway for removing toxins that the liver has readied for elimination. Again, a diet that is dominant with vegetables is essential to keep the bowel swept clean of its contents on a daily basis.

The skin is actually the answer to the question, “What is the largest organ in the body?”
Rarely do we think of the skin as an organ let alone as an organ of detoxification. But just as we can deliver medications transdermally (across the skin into the body) we can also have substances exit via the skin. This is why we practice dry skin brushing techniques during my detox program, to keep the pores open and free of old dead skin layers while stimulating the lymph fluid just under the skin that delivers toxins to the skin.

The lungs are the last organs of detoxification as we can actually release small amounts of toxins in the breath. Exercising during detoxification is beneficial and should be done so that one clearly notices an increase in the rate of their breathing but not at a strenuous level. Moderate exercise not only allows the lungs to process more toxins through the breath but also increases the body’s metabolism to enhance the entire detoxification process.

A Common Denominator

If you are someone who experiences several of the common complaints already mentioned, (skin, joints, pain, mood, digestion, etc……), then it’s time to realize that all of these symptoms just might share a common denominator: dysfunctional detoxification! When you are ready to engage in a science based program then take a look at www.cleanseandchange.com


BRAND X OR BRAND WHY: Which Brand of Health Care Do You Use?

You can listen to the article here.

From a very young age I always wanted to make a difference in people’s lives regarding their heath and even when I was newly licensed as a physical therapist I rebelled against one size fits all treatment protocols. Later, as I became a certified nutritionist  I realized that to only practice and dispense Brand X care was intellectually shallow, professionally irresponsible, not rewarding for myself or the patient and never really empowered people to regain control of their health.

Brand X health care is all about giving this because you complain of that.  You have sinus congestion so take an antihistamine.  You have heartburn so take an antacid.  You have muscle tension or spasm so use some heat.  You have acne, take an antibiotic.  Tight hamstring?  Stretch.  Don’t get me wrong, symptoms can be very serious and do need to be controlled to avoid debilitating health crises. But without bringing Brand WHY into the health care picture, one continues to suppress symptoms while the unfound reason for those symptoms continues to erode the foundation of one’s health.

Enter Brand WHY.  Brand WHY is not really a brand at all but a model of health care that seeks to answer the question……why?  Why do you have heartburn?  Why does your skin breakout? Why does your back keep ‘going out’?  Why do you have high cholesterol?  Could it be because you have an under functioning thyroid gland? (I did and when my thyroid problem was finally found and treated my cholesterol went down 90 points!).

This model of health care that seeks to answer the question why? is not a quick ‘grab and go’ model.  Seeking the answers to why a symptom is there requires deep and detailed knowledge of human physiology and an understanding that all systems in the human body communicate with each other and  that we can have physical responses to our emotions, our thoughts, our food and our environment.  The answer to why may require study and research and the putting together of seemingly disparate pieces of someone’s health history.  Treatment in the WHY model requires taking time with the patient to have a dialogue that brings out important wisdom filled words that exist within the patient.  The treatment approach in the WHY model of health care may require an action step that needs close monitoring, asking more questions, making course corrections and customized adjustments, there is no one size fits all!

Where as Brand X has much more to do with the question of WHAT?  What do I have and so what do I take for it? (ie.  you have a cough so take a cough suppressant).  Brand WHY is all about why do I have what I do?  Those people who continue to seek help for chronic or recurrent health issues know that the WHAT model no longer serves them and they may or may not know that they are looking for someone who will help them answer the question, WHY do I continue suffering from this problem?   Brand WHY takes more time, it requires advanced training and high level thinking from your practitioner, it demands patience with the process and asks for continued connection between professional and patient.  It’s not just a matter of thinking ‘out of the box’ because in the Brand WHY model of health care — there is no box!


Food and Pain: Oh C’Mon, Do They Really Go Together?

You can listen to the article here.

Yes they do!  And I can’t tell you how incredibly easy it is to forget that food can be causing not only your pain, but your skin problems, your irritable or low mood, your fatigue, your restless legs, infertility or PMS!  Whew……… I could go on but this article is centered specifically on food and pain.  People often ask me why I added nutritional therapy to my already established and busy practice of physical therapy.  Each profession by itself requires a ton of study, skill building, artful practice and work to keep up and stay on the leading edge of emerging information.

So why did I take on a second profession?  Because my manual therapy skills showed me that those patient cases that were the most difficult to improve with physical therapy skills had the most soft tissue tension patterns leading to or coming from their digestive tracts.  It didn’t matter what kind of high level manual techniques, stretching or exercise programs I did with this group,  they either did not improve at all or improvements were temporary at best and they would always return with the same pain complaints!

It is an advanced skill to be able to feel the relationship of the digestive tract with other parts of the body and it is because of honing this skill over many years that lead me to realize that I didn’t have the tools to fully resolve someone’s recurring pain complaints.

If I wanted to help more people with their hard to resolve pain issues, then that meant becoming a Certified Nutritionist to clearly understand digestion, food compatibility, metabolic and nutrient therapy.   I’ve been integrating that work for quite a few years now so I thought I would give you some examples of how the food and pain picture presents and how I resolved each patient’s pain.

Case #1:  Erin and debilitating low back pain!

 Erin was in her mid to late 30’s when she came to me with complaints of low bak pain that occurred about 3 – 4 times each year and when it did, it was so debilitating that she would be totally stuck in a forward bent position, couldn’t go to work and would need 2 – 4 days just to be able to stand upright, let alone be free of back ache which took another 2- 4 weeks.  Manual mechanical treatments helped as did her exercise program but none of this prevented these acute painful episodes from reoccurring.

My assessment with Erin revealed some mild digestive complaints, and irregular bowel pattern but nothing really that she felt was a problem.  My manual assessment, however, showed that Erin had tremendous tension in her lower colon creating significant restriction with her sacrum.  Her stomach and spleen tension were also strong and made me highly suspicious of a food intolerance.

My treatment plan with Erin included education and instruction about how to find her incompatible foods and to improve her digestive function with whole, real foods and a couple of supplements.  It took some time to assess the benefits since Erin’s acute episodes only happened 3 – 4 times in a year but even after 3-4 months of her new eating plan she could tell that something was different.  That first year she only had one  acute back pain episode and now, 18 months later, Erin’s back never ‘goes out’!

 Case #2:  Lynda and her annoying upper back pain!

 Lynda had upper back pain that ached and ached and was so annoying.  She got frequent massages and all kinds of mechanical treatments with chiropractic, physical therapy and rolfing.  She loved rolling on foam rollers and tennis balls to relieve her constant muscle tension that was across her upper back, mostly on the right.

Lynda had seen very good practitioners but none of them dealt with nutrition or digestive dysfunction. My exam showed that Lynda’s upper right ribs were chronically in poor alignment along with several of the vertebrae of the mid and upper back.  Her soft tissue tension pattern included the area of the liver and gall bladder.  More verbal inquiry with Lynda confirmed for me that her gall bladder function was less than optimal.  Her stools were often light in color and almost always floated in the toilet water.  She experienced a fair amount of burping after eating and more so after certain meals.

I advised Lynda to make some changes with her foods, gave her some supplements that  would enhance the action of her liver and gall bladder and specifically taught her what to look for to know that what she is doing is moving her in the right direction.  In this case, she still needed manual treatments and exercises for her ribs and spine since they had adopted a compensatory alignment over many years.

Lynda had only small changes initially but over several months with her dietary changes and manual treatments Lynda began to be upper back pain free for the first time in years!  Now, Lynda uses the first shadow of tension in this same area of her back as the  canary in the coal mine about having just eaten something that slows her gall bladder function.  She knows to stay away from that food and feels totally empowered now about being able to prevent her pain!

 Case #3:  Shelly and her big toe pain!

 Shelly saw me in my office several years ago with complaints of right big toe pain.  Not just “my toe kinda hurts”, but “my toe REALLY hurts, I have to limp and walk on the side of my foot when it’s bad and that throws everything else off too!”
My exam of her entire structure revealed a clear cut tension pattern right to her liver!  She also appeared slightly swollen with water retention, her tongue looked very congested and she said she would get constipated somewhat frequently although tried to control this with prune juice and fiber.Of course I wanted to make sure that she had had Xrays, had seen an Orthopedist and or a Podiatrist which she had.  Her Xrays were negative and no one had a

clue what to do with her except togive her a hard flat bottom shoe so that her toe wouldn’t bend when she walked. This really didn’t allow her to walk normally at all and almost caused more back problems than it was worth!

I remembered that several of the acupuncture meridians go to the big toe and I didn’t think it was a coincidence that  my manual exam showed a congestion feeling around her liver, spleen and kidneys — all the meridians that end at the great toe!  I told Shelly that she really needed to change her diet, find her food intolerances, clean out her system and then let’s reassess the situation.  Well, that went over like a lead balloon and I never saw Shelly again………until this year when she joined my group detoxification program.  She went through the 21 day program flawlessly and looked lighter and brighter each week.  Several days after the program we talked and she told me how great she felt and oh by the way, the toe pain was gone!  She admitted to me that she thought I was nuts years before to have suggested that she improve her diet and detox her system in order to heal her toe pain!  Now she wishes she had done it then and not suffered another 2 years with a limping gait!

These are very typical examples of what I see every week when it comes to pain and how food can be a critical and often missed component to the treatment plan.  So the next time you have an ache or a pain that’s all too familiar and the help you are getting isn’t resolving it, do remember that your digestive tract may be a silent (or not) source of your pain and that you may need some help there too!





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