No place for...

In the pursuit of health and fitness, there is no place for...

Eliminating all fat from your diet.    If you eliminate all fat, you deprive your body of much needed nutrients.   What you really need to do is avoid saturated fat and trans fat.  That means read labels.

Polyunsaturated and monosaturated fats are the "good" fats and provide important nutrients and nutrition for your body.   Those are found mainly in nuts, vegetable oils, and fish.

No pain. No gain. Not really.  The reality of it is that if you hurt during your workout, you are probably doing something wrong.   Sure, it's OK for it to be difficult for you, just not painful.

One thing we all need to learn is the difference between post-exercise soreness that comes from either pushing our limits or trying something new and pain after exercising that might be an indication that you have injured something.   That's where a relationship with a physical therapist could be handy.

I would like to see a world in which everyone has a physical therapist.   You might talk about "my attorney" or "my accountant" but do you ever think about "my" physical therapist?  It's National Physical Therapy Month so I can get that plug in there.

But physical therapists have a great deal of expertise in musculoskeletal dysfunction and can offer techniques, exercises, and treatments that get at the cause of your problem.

Not having a primary care physician.  No excuse.  You need someone that knows you and knows your medical history.   Who greets you by name when they walk in the door because they know who you are. 

Not having colonoscopies and/or mammograms, if you are in any at-risk category.  I was asked recently if I thought we would ever  "cure" cancer.   I said, for a large part, we already had.

Statistics reveal that about 65% of Americans diagnosed with cancer survive past the crucial 5 year mark.  And for those that dismiss the quality of American medicine, that is significantly higher than the best to be found in the rest of the world. 

Take leukemia for example.   When I was a child, leukemia was  a death sentence.   There was no cure and hardly any treatment.   While it is still a horrible disease, over 50% of the people diagnosed with leukemia survive to 5 years.

With early detection and treatment, female breast cancer  has an 88.7% survival rate.  As for colon cancer, with early detection the survival rate is almost 100%. 

Stretch before exercise to prevent injury.   Nope.  After.   When your connective tissue is warmed up and more effectively stretched.

Focusing on one body part in a workout.  Oh, my, how many times have I heard that one.  Today is "my arm day."  Or "leg day."  The most effective workouts engage multiple body parts.  Every time.  Only if you want to make it bigger do you ever isolate your workout on one muscle.

Single rep max.  If you lift weights, you know what I'm talking about.   If you are preparing for a competition that will require you to perform a single repetition of a particular weight, it might be OK.  But it is generally a formula for injury.  And to what end?

You owe it to your body to investigate everything you do in the name of good health.  There are too many fads, bad ideas, and misinformation out there to do anything less. 

No Excuses!

I think I just got a new nickname.  I've never had many, other than always being called "joeblack" as though it were one word.  Growing up, other kids got to be Suzie and Ronnie and Jimmy but I was always joeblack. 

Such is the curse of those named single syllable first names and single syllable last names.  My son tried to fix it by always insisting on being called by his full first name, which is the multi-syllable Nicholas.   That seemed to work until sports, when coaches reduced his name to one word-nickblack.

The new nickname for me seems to be "Excuse Remover."  OK, maybe I should back up. 

I work in a fitness center.  Well, more specifically, I spend most of my work day at a physical therapy clinic (Total Rehabilitation-Cherokee) that is adjacent to a fitness center (BMH Wellness Center at Cherokee).  The two are under the same roof and are separated by only a counter and half wall.

In fact, my "desk" is a stool and a laptop computer that straddles the two.   So someone working out at Cherokee can simply step up to my "desk" and get a consult about their injury or their workout.   Happens all the time.

And since most folks know that health and fitness are very important to me (not to mention my day job), I get stopped regularly for advice on both.  I really don't mind.  I'm actually flattered when folks seek my opinion.  

The usual script is this: "I know you really don't want to be bothered with this, but can I ask you about my knee (or shoulder or exercise program)?"  But really, I don't mind at all.  

So today I was in a conversation just like that about a fellow that felt that he needed to lose 50 pounds.   He didn't really like to diet, his knees kept him from jogging, and his lifestyle might need some tweaks.

So I started removing his excuses.  I think I'm pretty good at it.

Dieting doesn't work for you?  Start by just eliminating fried foods from your diet.   Then maybe look at nothing to eat after dinner.   Reduce size portion and frequency of desserts.   That doesn't sound too hard, does it?

You don't have to make wholesale changes, just changes that you can stick with.   And do them consistently.   No excuses.   And start today.  Unless you've got a special meal scheduled, there's no reason to wait until tomorrow.

Can't run?  Bike, swim, or row.  Don't own a bike, a pool, or a boat?  The bike shop can help, several fitness centers have indoor pools, and rowing machines work great.   Then, you've always got my personal favorite-CrossFit workouts.   You can do those with little or no equipment.  The secret is to find something that you can stick with.

Can't find the time to exercise?   Do you really need a sit-down lunch every day?   Brown bag and exercise through lunch.  If you went to bed on time, you could  get up early enough to exercise before work/school/your normal day.   Don't wait until the end of the day--it's too easy to find...yep, you guessed it...EXCUSES!

Don't know what exercise would work for you or don't know the equipment?  Every gym in town has personal trainers that can help you with that.  Don't want to go to a gym?  Google up workout advice. 

I know a lot of people who are very healthy, that have found the formula that works for them.   Somewhere along the way, they stopped looking for excuses and started doing the right things.  Things that would lead them to better health and help them achieve their personal goals.

No excuses.

You Know You're a Grandparent if...

It doesn't seem possible, but I am firmly entrenched in grandad-dom.  Grandchild #6 is on the way.  My wife and I are convinced that being a grandparent is about the best gig going.

You heard about Camp Blackberry a couple of months and those that know me know that I've fully recovered from the nervous breakdowns that happened on Days 5 and 7 (just kidding).  

So last week I was putting away the dishes and just stopped and thought...we are really, honestly 100% full-fledged grandparents.   The evidence was in front of me (and constitutes the first line in the rest of the column).

You know you're a grandparent if...

Your "sippy" cups outnumber your wine glasses.

Your dining room has a high chair.  Probably recycled from your own children.  We actually have 2--one for indoors and a plastic one for outdoors.

You've tried to recycle Strawberry Shortcake and My Little Pony.   Barbie is still out there but I'm too much of a feminist to embrace that whole arena.

You know how to change a diaper but wonder where the pins go.   When I talk about cloth diapers, I get looks that let me know with absolute certainty that I'm a dinosaur.

Your vacation plans just might include something that begins with Disney.  Oh, and you know what the "Hot Dog Dance" is.

You're pretty sure that swimming means they don't need a bath but your own kids would still have been scrubbed to their last layer of epidermis.

Pizza now fulfills four major  food groups (but it sure didn't used to). I mean, think about it.  Grains (the crust), fruits (tomato paste--remember, tomatoes are fruits), meat (pepperoni), and vegetables (other toppings).  See?

You know you're a grandparent if it is now OK if they eat too much candy and stay up too late.  You're just going to send them home anyway.

You find cereal in the couch instead of change.  And your meals involve 2 menus, one for the adults and one for the children.  Ham and plum baby food?  I ain't goin' there!

You think James Dobson's The Strong Willed Child is funny.

You put plastic sheets back on your beds and get excited about a phone update on potty training.

You have no idea how to put in the car seat or fold up the stroller.  Your own kids probably just used an adult seatbelt and you yourself might have stood on the front bench seat between your parents, unrestrained.   Yeah, it is a lot better now.  A LOT better.

And finally, you know you're a grandparent when you realize that even though you thought you had all the answers when you were raising your own kids you now understand that parenting is mostly about not messing them up--more like gently re-arranging clouds--than it is about grand design. 

 

Vertigo?

BPPV.  I thought I had it.

Benign paroxysmal positional vertigo (BPPV) is a type of vertigo caused by a disorder in the vestibular system in the inner ear.  Occurring suddenly with a change in the position of your head, it is characterized by dizziness and loss of balance.

At the core of the problem are crystals found in the inner ear that become detached from the lining of the vestibular system.  When the head changes position, these crystals shift.  Since the vestibular apparatus is responsible for balance, dysfunction can cause vertigo.

Vertigo sends over 6 million people to the doctor every year.   Of those, almost half can be BPPV. 

About a week and a half ago, I woke up in the middle of the night and stumbled to the bathroom.  I felt like I was falling forward.  I managed to make it to the bathroom then back to bed and once I was lying down again, I was fine.

When I woke up a few hours later, I certainly seemed fine-normal, really.   So I headed in for my morning workout. 

One of the exercises on this particular morning had me lying on my back.   When I started to get up, my world went upside down again.  I had to stop.   About 20 seconds later, I was normal.

It took  me about 3 times to figure out that I really didn't need to be lying on my back and then getting up quickly (yeah, I'm a slow learner).

At that point, I was convinced that I had vertigo.  One of the physical therapists that I work with is Whitney Sharp, who has specialized in the treatment of vertigo.   Unfortunately for me, Whitney was in Oregon to watch her son play football (Tennessee Tech kicker Zach Sharp).   At our Springbrook office, is another physical therapist that is trained in the treatment of vertigo, Dr. Courtney Irons.  

So I took off to see her.  After a thorough examination, she decided that I didn't have vertigo.   Next stop: upstairs to see my personal physician, Dr. Kevin Turner.   Dr. Turner did his usual thorough job with an EKG (pretty normal) and blood work.

It was from the blood work that he discovered that I was dehydrated.   I had no idea.   This episode had started on a Tuesday night and I had a hard bike ride on Tuesday but I thought I had hydrated sufficiently.  Obviously not.

One of the problems with dehydration is dizziness and a form of vertigo.   I didn't really know that (and, quite frankly, I should have) but I sure do now.

I've had patients, friends, and colleagues with vertigo but I didn't really know what they were experiencing.   But when your world gets all topsy-turvy, it gets your attention.  I definitely have a greater appreciation for what they are going through.

And I know (and want you to know) that if you do have vertigo, there is something you can do.   For this episode, a combination of a physical therapist and a primary care physician fixed the problem quickly for me. 

And one thing you can be assured of:  I will drink more (written between sips from the water bottle that has become my constant companion).  I don't want to go down that path again.

Teens and Back Pain

Already this year, it seems as though the sports injury of the fall is a back or neck injury.   I've seen way too many of these and the fall sports season is young.

Teenagers aren't supposed to have back problems.   That's supposed to be for the middle-aged guy that tries to lift too much without using good body mechanics.  Or the senior citizen that has simply abused their spine for too many years.

Oh, I see enough bad posture among younger folks that I sometimes wonder why they aren't having more neck pain but then I do know that eventually they are going to have problems.   Sitting at a computer (which a lot more folks do for a job these days) will definitely take a postural problem and make it a significant medical problem.

And those backpacks.  I've ranted here more than once about the weight of the backpacks that our high school-aged kids are required to lug around every day.  It's obscene!

I weighed one of those backpacks, fully loaded, not too long ago.   It was 45 pounds.   And that one was carried by a 15 year old girl that might weigh 105, soaking wet.   That's over 40% of her body weight on her back.  Every day.

Something has got to be done about that one.   Those teens will be adults with serious back problems. 

But I'm also seeing athletic injuries to the spine that cannot be taken lightly.   Although not seen with the fear and gravity that concussions are, back problems among teenage athletes need to be evaluated by a health care professional.   For most teams, that starts with the team's Athletic Trainer.

One category of back problems, known as spondylolisthesis, is not uncommon in football linemen.   The mechanism of injury is often the repetitive nature of collisions with other large individuals, usually with the spine in extension.   Over time, a structural change can take place in the low back that only rest and no football can fix.

That's why offensive linemen with chronic low back pain should be seen by an orthopedic surgeon with x-rays done.

Protective equipment has gotten much better in the past few years, from better shoulder pads to fitted and padded undergarments that dissipate the force of a direct blow to the trunk and shoulders.

But still, a lot of times an injury to the back in football is from a direct blow, such as a receiver going up for a pass and being hit from behind.   Those usually aren't serious and require only time to be resolved.  Still, the kidneys are vulnerable and a potential kidney injury is something that cannot be ignored.  

That's why a medical evaluation is important.  If you remember one thing from today's column remember that if there is any blood at all in the urine (pink to red urine), then you need to see a doctor immediately.

As for those backpacks:  Parents, get involved.   Make sure that you help your teenager keep a proper fit with their backpack.   It should hit higher up the back than most of what I too often see, with the straps shortened and the bag fitting snugly against the back, not drooping down low.

When do you feel REALLY alive?

When do you feel really alive?   I mean, REALLY alive.   So alive that maybe you forget about everything else?   

This came up recently after I spent the afternoon swimming with my oldest grandchild.  She has discovered the joy of diving to the bottom of the pool with a mask on.  It seems simple but she really enjoys it.  I think she would do it for hours without stop.

And she allows me to share in that joy.  We will dive to the bottom, pose with our arms crossed, then drift to the top.  Or we will retrieve toys on the bottom just because we can.  We smile, we laugh, we hold hands, then down we go again.

When I saw photos of the two of us her dad took with an underwater camera, the thought popped into my mind--that's what being really alive is all about.  Joy.  Simplicity.  Lost in the moment. 

A great bike ride does that for me too.  When you're grinding up a steep hill, every thought, every bit of energy is put into that task.  It doesn't have to be something fun (some of those hills definitely aren't fun) but it reminds me that I'm alive. 

Did you ever laugh so hard that your stomach hurts?  At that moment, you really don't think about your problems, about life's difficulties.   You are in the moment. 

Really being alive isn't always the safe place.  Maybe my definition of really being alive doesn't amount to much more than being so engaged in what you're doing that you forget everything else.   That can include fear, heartache, and disappointment. 

But isn't that what tells us that we are alive?  The ability to feel, to experience?  We aren't promised that it will always be easy, just that we can get through good times and bad.

A friend sent me this quote:  "One of the biggest tragedies in life is to just settle...."

I like that.  We shouldn't "settle" for whatever is handed to us, the life that someone expects us to live.  It is up to us to explore new worlds, to dream our dreams, and to live our life to the fullest.  I believe that is what is expected of us.  And it requires us to often get out of our comfort zone.

I think another huge tragedy is to work at a job that you don't like.   A job that you dread.  That when the alarm goes off in the morning, you would rather do anything than go to work. 

Back in college, I wasn't interested in getting rich and famous.  I just wanted a job that I could enjoy.  At first, it was Wildlife Management but mostly because I thought I could hunt and fish for a living.  That didn't work out.

It took a knee injury to point me in the right direction (see "silver lining").  Now, when the alarm goes off, I can hardly wait to get to the office to see what patients are on my schedule, to discover the day's challenges.  I don't even know how the snooze button works.

So, back to my original question...what makes you feel really alive?

Maryville-Alcoa on ESPN

Unless you were totally not paying attention, there was a little game of football around these parts last Sunday.   One could make the argument that it was the biggest sporting event ever held in Blount County.

ESPN.  Sunday game.  Easily the biggest rivalry in Tennessee high school football.  (How many times do two teams only 6 miles apart with that many state championships play each other?)  Marine Corps All-American Rivalry Game.

An electric atmosphere.   A game that lived up to the hype.  An airplane trailing advertisements overhead.   A Kiowa Warrior helicopter on the practice field.  And a packed stadium of people, many of them a bit warm.  

OK, it was hot.   Not so hot that the game was in jeopardy of not being played.   We were way below that TSSAA threshold.   At game time, the temperature on the field was 89 and the humidity was 41%.  That produces a heat index of 90, well below the point where the game had to be changed.

But it was still hot.  For the players, we spent a lot of time and effort to make sure that the heat didn't affect them.   All week, Alcoa Athletic Trainer Peggy Bratt and I had been preaching hydration to our players.   We ask that they not pass a water fountain at school without stopping to take a drink and that they have a regular intake of sports drinks.

We practice in the heat, allowing them to acclimatize over several weeks before the first game.   The body can be conditioned to deal more effectively with hot conditions.

For the game itself, both sidelines had "misters," big fans with a spray of water that is very effective at cooling the players off.  Plenty of water and Gatorade were available at all times.   We broke out the ice towels (chamois towels soaked in ice water) early and even used them with the officials at times.  

I had a second athletic trainer on my sideline, Tracy Martin, and team physician Dr. Todd Griffith who helped me keep an eye on players that might be having difficulty with the heat.  And 10 student athletic trainers.  Peggy had Para-Medic Keith Amos and Alcoa team physician Dr. Mike Campbell on her sideline. 

The good news is that Peggy had only one significant problem with cramping but was able to effectively treat the athlete and return him to play without further problem.   And I only had one minor problem with heat cramps that didn't really interfere with his ability to play. 

The bad news is that the spectators didn't fare so well.    By reports that I have since heard,  Rural Metro transported six individuals to the hospital with heat-related problems. 

I would like to stop here and give kudo's to the Maryville Fire Department.   It seems like MFD Para-Medics and EMT's were everywhere on game day.   After the game, there were 3 spectators down with heat-related problems at once and there was at least 1 MFD employee with each of them.  

What could the spectators have done differently?   Drink more.   We think that we drink enough but probably don't.  I can tell you that the lines were already long when the gates opened at 9 and that means that by 3, folks had been out in the sun for a long time.

Fans that were passed out sure seemed to be popular.   Lack of moving air in the stands was a real problem.  Reflective clothing and hats would have helped.

But maybe the biggest thing is acclimatization.   Our football players benefited from having been out in the heat for long stretches of time in the preseason.  I suspect our spectators didn't have that advantage.

Please remember all that the next time you have to outside in the heat for an extended period of time.