Fri, 12 May 2017
I recently sprained my ankle during a workout and thought I'd use the experience as a teaching platform. Today I dig in to the idea that the commonly voiced R.I.C.E. strategy for soft tissue injury is hurting you and slowing your return to action. I cover the science proving that ice is a poor recovery strategy, and I present a strategy that truly is effective and allows you to get back into action as fast as possible.
Sat, 6 May 2017
I sprained my ankle today running in a workout. Most people go right to the R.I.C.E. (Rest, Ice, Compress, Elevate) strategy when they sprain an ankle or sustain an injury.
If your goal is to HEAL FASTER and return to the gym and/or quality of life ASAP, then the R.I. of R.I.C.E. is NOT a good strategy.
Rest (assuming no fracture) and Ice slow healing. Yes, Ice does decrease pain (for a short period) by numbing nerves, but it also slows healing by causing blood vessels to constrict. This means that the swelling and inflammation (which are causing the pain along with tissue damage) remain in the injured area (especially when paired with Rest).
To speed healing you want to C.H.E.M. (copyright Dr. Bartemus): Compress, Heat, Elevate, Move.
Compress with an ACE bandage or my favorite tool from MobilityWOD.com, Voodoo Floss.
While Compressed, you want to Move for a couple reasons:
Heat augments the benefits of Movement by causing blood vessels to open up (vasodilation). This increases the Movement of swelling and inflammation away from the damaged area and increases the Movement of white blood cells and healing factors to the area.
Elevation of the injured area (my ankle in this case) above the level of the heart uses gravity to increase Movement of swelling and inflammation away from the injured area, especially when the area is being Compressed. To really create synergy while Compressing, Heating, and Elevating (and therefore likely sitting/laying still), add Movement by putting a TENS or e-stim unit on the area and turning it up enough to create passive Movement (make the muscles jump).
In conclusion, to heal faster get rid of R.I.C.E. and use C.H.E.M.!
Category:Blog -- posted at: 7:50am EDT
Thu, 4 May 2017
It’s commonly thought that sleep apnea is simply a problem of obesity or structural issues that interfere with breathing. However, a commonly overlooked cause of sleep apnea in men and women is the brain. When the brain is not functioning properly, this can interfere with the body’s ability to maintain proper breathing function while asleep.
Sleep apnea and the brain in women
The brain’s influence on sleep apnea can be seen in women during perimenopause and menopause if their estrogen drops too low.
Insufficient estrogen causes the brain to fail in signaling the palate and tongue to maintain tone during sleep. The resulting lack of tone blocks the airway.
The brain-related cause of sleep apnea is different in men. In a rat study, young male rats responded to normal episodes of oxygen deprivation during sleep by automatically increasing brain activity to take deeper and more frequent breaths. However, the older male rats did not respond in the same way due, it’s theorized, to more aged brains.
Researchers observed a much different response to these normal episodes of sleep-induced oxygen deprivation in female rats. For one thing, older female rats responded much more positively to these hypoxic events than the older males.
Younger female rats had an even better response, especially during specific times in the menstrual cycle. This led scientists to believe female hormones play a role in how they respond to normal episodes of oxygen deprivation during sleep.
This theory is what leads researchers to believe estrogen deficiency contributes to sleep apnea in women during perimenopause and menopause. Estrogen influences serotonin, a brain neurotransmitter chemical that plays a role in giving the tongue and palate tone, including during sleep.
Estrogen tells the brain to breathe in women
To test the theory that the interplay between estrogen and serotonin plays a role in sleep apnea, researchers induced menopause in female rats by removing their ovaries. Sure enough, post-mortem brain biopsies showed less serotonin in the area of the brain that controls the tongue. This had made it harder for the female rats to respond to episodes of oxygen deprivation during sleep. This helps explain why sleep apnea affects more women in midlife.
Sleep apnea and the brain in men
Middle-aged men also experience higher rates of sleep apnea due to the effect of declining testosterone on the brain.
In midlife, men snore more and have more episodes where they stop breathing.
Middle-aged women, however, more commonly complain of insomnia, as well as headaches, fatigue, and irritability caused by sleep deprivation and poor sleep quality. That estrogen deficiency promotes weight gain, and restless leg syndrome only worsens the problem of sleep apnea.
Hormone status that plummets too low in midlife can be the result of chronic stress, poor diets, lack of exercise, and other standard bad habits of modern living. These are areas we can address through functional medicine.
Functional neurology and sleep apnea
Sleep apnea can also arise in relation to traumatic brain injuries, childhood brain development disorders such as autism, or other brain-related issues. In functional neurology we can identify areas of dysfunction related to sleep apnea, such as with nerves traveling from the tongue to the brain through the brainstem. Based on findings, customized rehabilitation exercises may help address problems with sleep apnea.
Functional medicine and neurology strategies can profoundly improve both brain and hormone function so you not only sleep better, but also feel and function better. Ask my office for more advice.
Category:Podcast -- posted at: 6:00am EDT
Mon, 1 May 2017
Recent studies have shown rice can be dangerously high in inorganic arsenic, particularly rice grown in the southern United States. This is bad news for gluten-free people who eat rice-based products — one study showed people on a gluten-free diet have twice as much arsenic in their urine compared to controls (and 70 percent more mercury).
Although guidelines exist to minimize arsenic exposure (buy rice from California, eat white rice, wash rice thoroughly before cooking, and cook rice like pasta in a ratio of about 6 to 1 water to rice), what about rice-based gluten-free foods? It's nearly impossible to know where their rice comes from, how it’s processed, and what the arsenic levels are.
Arsenic levels in popular gluten-free foods
Keep in mind that what is considered an acceptable amount of arsenic varies. Codex, an international collection of safety standards, proposes a maximum of 200 parts per billion in white rice. The European Union proposes 100 parts per billion.
However, arsenic expert Dr. Andrew Meharg proposes a maximum of 50 parts per billion for children, who carry a heavier toxic body burden, and a maximum of 100 parts per billion for adults.
Arsenic levels in rice-based gluten-free foods
For results of inorganic arsenic testing on various brands of gluten-free foods that you can browse by category, visit Gluten-Free Watchdog. A paid subscription is required to access the reports. However, below are examples of arsenic level ranges in some categories of popular gluten-free foods.*
Inorganic arsenic in gluten-free breads
Inorganic arsenic in popular gluten-free breads ranged from 10 parts per billion to 40 parts per billion.
Inorganic arsenic in popular gluten-free pastas ranged from 20 parts per billion to 150 parts.
Inorganic arsenic in popular gluten-free cereals ranged from 70 parts per billion to 280 parts.
Miscellaneous rice products (rice bran, rice milk, rice syrup, rice cakes)
Inorganic arsenic in miscellaneous rice products ranged from 20 parts per billion to 540 parts.
Inorganic arsenic in several rice brands ranged from 80 parts per billion to 140 parts per billion. (Brown rice has more than white rice. Gluten-Free Watchdog reports a brand called Mighty Rice grown on the island of Mauritius shows very low levels of inorganic arsenic in their tests.)
Factor in frequency and amount of consumption
It's important to understand these numbers tell us the concentration of inorganic arsenic in each product. The frequency and amount of any item eaten and whether the eater is an adult or a developing child are also very important factors in the equation. For example, at 540 parts per billion of inorganic arsenic, one rice bran product looks pretty bad. But consumed in very small quantities as brans typically are, it may not pose as much a problem, relative to the other foods listed, as it first may seem.
It would be better if rice were not high in inorganic arsenic. Thankfully groups such as Gluten Free Watchdog are around to help us reduce exposures. Also, there is a group based at Cornell University working to shift the world to a rice farming method that uses up to 50 percent less water while increasing yields, thus saving precious water while reducing the amount of arsenic in the rice produced.
*Ranges included with permission from Gluten-Free Watchdog LLC.
Category:Blog -- posted at: 7:00am EDT