Blog Archives

Put it to the Test - Part 3

Apr 30

Maybe you grew up hating tests - if so you're not alone. There's a reason why more than 35,000 academic articles carry the terms "test-taking anxiety" when we searched Google scholar....and that only included items published since 2020! But depending on the circumstances, most people would likely agree that tests are not a bad thing. They're how we measure progress and how we know something (or someone) is what it (they) claims. And in the situation when we are trying to differentiate between something that hurts and something that is harmed..."testing" is how we pinpoint.

In terms of aches/pains, there are a few tests that, when performed at the right time and with the right intensity, are particularly important... something we feel everyone should know about. They are the last bit of info in our Calm, Assess, Test (C.A.T.) method we've been covering these last weeks as we wrap up April and, if the area has already calmed a bit, and the self-check came up mostly clean, putting things to the test is all that's left to do. Here are 3 of my favorite:

(1) The body heat test - this test is exactly as it sounds... it's about generating a little body heat... that is, priming the body to MOVE and getting the blood pumping a little. The best part about this test is that it is indirect - we don't actively stress the achy area beyond "natural movement" but rather see what that area tells us after we stress some other area. For example, if the shoulder is the sore area we might say go out for a good walk, enough to get out of breath some or break a sweat....let your arms swing naturally as able, but nothing more specific than that. After 10-15 minutes, how does the achy area feel? If it has improved (or even stayed the same but didn't get irritated), you've passed the test - this is great news.

(2) The RECOVER Rate - after test 1, this is one of the most important tests as it tells us if the area is still sensitive. We go a bit more directly at it this time trying to "stress" the area a little (but not fully) and see how fast it returns to baseline. For example, if the back is the achy area and the self-check has come up clean, it's a great time to do something that will stress (but not strain the back), like perform a series of light exercise tests such as the first 45 seconds of this video where Ali describes the "90 90 hold" and the "deadbug" exercise. If you get through the activity and (even if it creates some discomfort initially) you return to your baseline within a few minutes (but definitely less than 10), you would have passed and know you are ready to "level up" to the 3rd and final test.

(3) Resistance Test - if we've gotten this far things are looking pretty positive.....which means it's time to put some final tests in place. For this test we are going right at the achy area and are going to make it our world we call this "loading" the area. Now, to be clear, the goal here is not to overload or even fully-load (after discomfort it's best to build up to that), but rather put some stress directly on the body area and see how it responds. This usually looks a lot like the exercise you might do in the gym, whether with weights or a medicine ball or something else, but the idea is to put some resistance on the area as a test. We might start with a light number of repetitions (3-5) at a low level of resistance and then add repetitions or additional resistance. The RECOVER rate is important after this test too, but typically it will be a day or two (similar to the soreness after going to the gym for the first time in a while).

If you pass all three tests - you are ready to proceed with confidence as there is a very low likelihood of injury. Of course, this doesn't mean that all's well and the ache can be ignored but rather more activity or training is probably needed to increase the resilience of that body area and lower the likelihood it will be irritated again in the future.

With any luck if you've been following along you've gotten past the "T" in C.A.T. Let us know if you need some additional support or something more specific.

Mike E.

Easy As C.A.T. Part 2

Apr 23

Sometimes when we try to explain "normal wear and tear" from a body perspective we use the analogy of "wrinkles....on the inside". It's surprisingly accurate because we can see them (sometimes called "wear and tear" on images like MRI) and, like the ones on the outside, whether we dislike the way they make us look or OK with being "refined" they are more a sign of time than damage, everyone gets them and if left up to nature they're more likely to multiply than go away... and so we don't worry all that much.

Last week we jumped into this a little and talked about how to know when an ache or pain is of more the "inside wrinkle" type than harm and we used a simple formula of C.A.T.; calm, assess, test. Although the "calming" phase is the first window and can last a few days (or even a week)it's really the assessment and testing that helps us to get where we need to go... back to full ability and on the road to flourishing.

So how can we perform a proper self-assessment?

In fairness, we could never fully cover this topic in a blog post. But in the same way you don't have to be a trained mechanic to know a flat-tire when you see one, you don't have to have a health-professional license to know when it's time to get checked by one. So although we are not referring to performing an "evaluation" here, working through some of these key points can help to determine when the situation is "red light" (have a professional evaluation), "yellow light" (proceed with caution) or "green light" (nothing to worry about). Here are my top 4.

Signs of harm - injuries have tell tale signs. Things like significant changes in temperature (heat or cold), swelling, changes in color (usually redness) or bruising fall into this category as "red light" signs. An area that doesn't look or feel "right" is also worth paying attention to. Sometimes these are obvious, sometimes they take time to show up, so watching for a few days is wise.

Weakness or Persistent Sensations - although pain or even numbness/tingling does not necessarily mean harm (last week we mentioned the pain of stubbing a toe!), when these symptoms are constant or travels/radiates without changing either with rest or altered positions/postures, they are worth diving into more thoroughly. This is the case for persistent weakness as well. Although temporarily (like when an arm falls asleep and feels numb and weak) doesn't always usually mean much, if it lasts, it's best to consider it "red light".

Response to movement - if normal movement (even lower intensity) keeps the symptoms the same (or makes them better) it is usually a good (green or yellow light) sign. It's one of the reasons we encourage movement in many cases of stiffness reduces, things often feel better. On the other hand if most or all movement makes the symptoms considerably worse, or normal intensities seem to aggravate/irritate things, having a closer look to determine why makes sense.

Interrupted Rest - an achy body part can get in the way of good rest. This can be a bit of a downward loop because poor rest (in-turn) makes everything hurt more as well. This is not the kind of "merry-go-round" we want to get on. With that in mind, if something is keeping you from getting rest, it's best to classify it as a "red light" if for no other reason than to explore tips/tricks to get more comfortable.

One of the more important keys to remember is that the "A" portion of the C.A.T. approach is on-going. It's not a one-and-done kind of thing. The body often gives us patterned responses to look for which is one of the reasons we often recommend a few trial items and follow-up after a few days when we are consulting on a case. This of course is the bridge that gets us into "testing"... and the direction we will go next week.

As always, we recommend staying on the side of caution.....if you're not sure, that's why we're here....give us a call.

We'll finish up with "T" next week. Until then, have a great weekend,

Mike E.

Body Barking? It Might Be As Easy As C.A.T.

Apr 16

A few months ago I had one of those moments. The kind where I only remember stepping a little "funny" when out for a run but, after waking up and putting my feet on the ground the next day, realized something wasn't right. My right knee was really stiff... painful even... and for the next several weeks (and a little now and again) it barked at me when I stressed it (especially squatting or kneeling for longer periods). For someone like me who tends to be "on the go" a lot, this was really tedious.....I had to slow down, think about, and even prepare for activities and movements I normally wouldn't give a second thought. I had to decide whether doing something a certain way was likely to irritate my knee and if so, explore options for a less stressful way to minimize my risk of setting things off. Ultimately I had to decide whether this "hurt" (pain) was going to resolve or whether these were the signs of "harm" (actual injury).

Not only is this limiting (and tedious), but it can even get worrisome. Somewhere in the back of our minds a little voice might ask "is this going to be a lasting problem?". We wonder if maybe we are just "getting old" and might even begin to worry that if we don't "do something" we could make the situation worse. Even for someone with a good, working understanding of the healing process, determining how best to proceed can get complicated really quickly.

All that glitters is gold?

The more we learn about the human body and how miraculous it is at healing, the more we realize how much more there is to learn. Even things that seem obvious like soft-tissue injury found on MRI isn't always what it seems. For example, in a 2017 study which evaluated episodes of knee pain like mine (as well as shoulder pain) using the gold-standard MRI, came up short in people over the age of 40. As it turned out, in more than half of cases studied (159 out of 294 people) even though the scan "found something", in side-by-side comparison, the MRI was worse on the non-painful (uninvolved) side than the painful side. Said another way.....the risk of a "false-positive" for knee and shoulder pain goes up dramatically after the age of 40. Another team arrived at a similar conclusion around the same time for lower back pain, replicating a common enough finding for groups like (which rates the effectiveness of health care services) to warn against MRI for lower back pain.

So how do we actually know what to do?

The short (and often best) answer to this question is: C.A.T. (Calm-it, Assess-it, Test-it) and so, with that in mind, we will dive into each of these components over the next couple weeks. Let's start with "C".

C, "Calm-it". Pain (alone) is not injury. It can go hand in hand with injury, but strictly speaking, they are not the same. Anyone who has ever stubbed their toe, hit their shin, or felt the burn in their muscles when they've done something really hard knows that pain can be incredibly intense, but after it subsides there's not much to worry about. On the other hand, pain IS a warning system....the brain's way of forcing us to press pause on whatever we are doing and direct us away from what appears to be a potentially harmful situation..... If it's unclear if something is harmful, pain acts as a strong motivator to fight, flight or freeze. With this in mind, step one at getting to the other side is calming that response down a bit, allowing the body to turn off the fight/flight/freeze instinct so we can get a good assessment of the situation.

Sometimes this involves first-aid tactics like rest/ice, sometimes it involves something to reduce the chemical irritation in the area (over the counter anti-inflammatory and adding in healthy foods and water for example) and although not exercise per se, it often it involves gentle movement to prevent stiffness and promote circulation. This usually takes a few days with age, health status, fear, fatigue and more all potentially speeding or slowing the timeline.

More to come. Next week we will dive into the "A" in C.A.T.; "assess it"..... of course, in the meantime if this hits close to home and you've got a 40+ year old knee (or shoulder or back, etc.) that's barking back.....don't hesitate to give us a call or schedule a consult with one of the professionals on our team who can provide more specific guidance.

Have a great weekend,

Mike E.

The Focused Mind? It Matters.

Apr 9

In 2013, Daniel Goleman, a well known psychologist and author, published the book Focus: The Hidden Driver of Excellence, where he dove deep into the skill of "attending" (deciding what to pay attention to) and made the case that it was, or would, become one of the most important skills for the modern world. He could've never known then exactly how valuable our attention would become. In an age when we can be interrupted hundreds of times per day (and that's only our phone pick-ups), we know that staying aware of what is going on around us (situational awareness) and bringing our mind back to the moment we are in when our focus wavers (mindfulness) are two critical strategies we use to get through the risks we face each day and get home safe at the end of it.

But where does this come into play from an injury/illness/disease perspective?

The short answer to this question is: It's never as simple as "mind over matter"... but where we focus our mind, matters, a lot when it comes to healing.

Excess Stress Slows Healing: This review, first published in 2019, makes it very clear that individuals who are under heavier emotional stress (mind), heal more slowly (body). The authors reviewed 21 different studies and were able to piece together findings that support and build on work like this article from two years earlier which showed that stress, as measured by heart-sensors which can capture changes in heart rhythm associated with physiological stress (heart-rate variability), was related to delayed healing for individuals with diabetes after a wound.

Rebounding from Injury: The phenomenon also seems to hold true in the workplace. In a brand new study from a team in Canada, full recovery from a musculoskeletal disorder (injuries like sprains/strains) was slower for individuals who were recently diagnosed with conditions that more classically fall within the realm of mental health than physical health driving home the point that the separation between the two may not really exist.

So if healing is delayed after injury when all resources (mind AND body) are not focused, it stands to reason the same thing is happening even if we are below the "harm" threshold (wound on skin or muscular strain). This is one of the critical reasons why we recommend that everyone, not only the folks who feel stressed, work on the skills of resilience which we call ENDURE.

Getting Started

A surprisingly easy place to start is to foster a "conversation" between the mind and body... literally getting them better connected; helping the mind to become aware of what the body is feeling and help the body to concentrate its feedback. In more technical terms this is called a "body scan" and is often a part of mindfulness-based stress reduction practice. Check out this short (12 min) guided version.

We (humans) are complex systems made up of complex component "parts" trying to navigate an increasingly complex world. Unfortunately, staying safe and out of harm's way takes energy, effort and focus. The good news is, it can be done. The better news is, even a small investment of time can pay big health dividends.

Have a great weekend,

Mike E.

Building Strength: I yam what I yam?

Apr 2

Every once in a while I have to "go to the videotape" to give my kids a little view into history. Thankfully we have YouTube for occasions like this. Recently, in trying to explain the phrase "I yam what I yam", I searched some old clips of Popeye the Sailor because they didn't know who he was. After the disbelief (and grief for my youth) wore off, I explained the saying, the basic storyline and (of course) the role of spinach in Popeye's arsenal in fending off Brutus (or Bluto if you're REALLY a connoisseur). They were only marginally impressed.

This week however a couple of studies emerged which might prove that ol' Popeye who, unlike "Wimpy" of course, was never reaching for burgers to get strong, might have been more evidence-based than we ever knew.

Here's why:

(1) When a team from The University of Illinois at Urbana-Champaign tested previously untrained 50-ish year old adults to see how strength training combined with high protein (1.6 grams of beef-based protein per kilogram body mass) compared with strength training combined with the average/recommended protein (1.1 grams per kilogram) they found that both groups increased their strength an almost identical level.....showing that the strength training worked but the bump in protein really didn't add much.


(2) When a different team, this time from Australia, looked at the strength and functional balance of individuals at around the same age, those who regularly consumed high amounts of dietary nitrate (which was about 80% from plant sources like spinach [and other leafy greens], beets, veggies, etc) had significantly higher scores than those with the lowest consumption.

This is a fantastic time of year to increase your strength.....and even though the yams aren't typically ready for harvest until the end of summer, the Popeye FUEL starts early!

Have a great weekend,

Mike E.

Much Ado About Something...

Mar 26

More than 400 years ago William Shakespeare wrote "Much Ado About Nothing", and shined a light on how easily something which seems (but maybe isn't?) important can emerge from "nothing" when people add energy, focus and time. On the one hand, maybe he was trying to explain the late-1500's version of a slow-news-day. Or, on the other hand, maybe he was providing an especially important warning to pay attention to what matters most, something that we can easily get wrong as we continue to work-through and adapt to the information age. I like to think he was talking to those of us who try to make sense of health-risk and research now :)

Making health research practical and usable is tricky at times. The incredibly specific nature of research which is required to find something "statistically significant" among all of the potentially confounding factors makes it very easy to get lost in the mostly-useless details (trees) while missing the important application (forest). Of course the opposite problem can be equally tricky; flying over the forest (over-generalizing) and never getting into the trees (study design) can lead to sensational sounding headlines only to find an "all sizzle, no steak" situation or something so specific it's only usable in the lab... which is why we like one of the very recent contributions made by an Oregon State University team.

The Headline? Everyday people, doing reasonable things, can get immediate results.

The details? 15 healthy (but not particularly fit) individuals in their late 20's were asked to ride a stationary bike for 60 minutes at an easy pace (easy enough to talk through the effort, but too hard to sing). Researchers took muscle cell samples before and after to determine whether this exercise volume (intensity x time) would change how their bodies burned sugar and/or fat.

The Findings? After an hour-long exercise session, participants were consistently burning +/-12% more fat and +/-15% more sugar (measured at the cellular level).

The Connected Dots? Last week we highlighted research that showed the benefits of being able to maintain our balance at mid-life, walk fast as we age, and battle back the 12 hour ramp up in fat-production by our liver after ingesting added sugar. This week's research makes it clear that investing even a small sliver of time (about 4% of our day) into light-to-moderate exercise can go a very long way at hitting the reset button on personal health.

The Take-away? When it comes to improving health risk through exercise, "something" is infinitely better than "nothing".

Whether you're shaking off the winter doldrums, ramping up to be ready for projects at work or at home, battling back health risks or trying to meet the needs of our bodies.....NOW is a fantastic time of year to do something on the MOVE.....anything hard enough to be slightly out of breath, building up to an hour or more can immediately change our physiology.

Have a great weekend,

Mike E.

Healthy Headlines: Beware the Triple S

Mar 19

Over the last few weeks we've tried to consolidate a variety of themes: (1) movement matters across the lifespan, and relates to viral susceptibility. (2) Viral susceptibility can also be impacted by food choices, sleep, stress and social connections. (3) Common inflammatory conditions (especially high blood pressure, heart failure, diabetes and obesity) have been closely linked to severe COVID19 reactions and surprisingly simple things, like (4) eating 3 veggies and 2 fruit servings daily can help reverse the risks.

Again this week, the case got even tighter on the fronts of viral susceptibility and severity, using the way we move to predict health and longevity and how food choices today are driving health problems of tomorrow... and it comes down to a triple "S".

Speed: Want to know if you're at a higher risk of serious COVID19 reaction? Assess your walking speed.

With now a year of connecting dots related to resilience in the face of COVID19 under our belt....1 simple question rose to the surface this week: How would you describe your usual walking pace? (i) Slow pace, (ii) Steady/average pace, and (iii) Brisk pace’

This question, asked 10-15 years ago was found to predict health across hundreds of thousands of individuals in 2017. Now it has also been related to severe COVID19 reactions (including hospitalizations and mortality) in several of the same individuals. People whose self-rated walking speed was a "slow pace", had the highest risk of a severe reaction, more than triple the odds in some cases. If you have an iPhone you can find your average pace in the "mobility" portion of the Health App.

Stability: Want to improve your odds of a long/full life? Work on your balance.

Info this week confirmed again that movement today (or stabilizing to be precise), predicts health tomorrow. The ability to balance ourselves under varying conditions at or around the age of 40 predicted longevity more than a decade later in a study of nearly 6,000 people. It may seem surprising that something simple like brushing your teeth on one foot or standing heel-toe while washing your hands can make a difference in how long we will live... but they can.

Sugar: If changes in metabolism drive change in weight... what drives changes in metabolism? The answer is - sugary beverages and the effect lasts for a WHILE.

Maybe you've heard us recommend a "more or less" eating plan for health. That is, more fiber by adding fruits/veggies, less sugar by eliminating processed foods/beverages. Last week we focused on the "more" side of the equation, this week the case for "less" became even more clear. It started in Canada where a "which came first?" riddle about altered-metabolism and weight change came into better view. Metabolic changes drove weight gain.....not the other way around. But in order to answer the question of "what drives altered metabolism?" a team in Switzerland went to sugary beverages. They found that under tightly-controlled conditions the equivalent of 2 sodas per day for otherwise healthy folks was enough to spike the production of fat in the liver and keep that production spiked for as long as 12 hours even without changes in total calorie intake. Added sugar hits us hard....and lasts for a while.

We hope you can put these findings to use and share them with friends & loved ones to stay on the right side of risk. Be sure to send us health headlines you see and we'll try to dive in and see what the science behind them is telling us!

Have a good weekend,

Mike E.

The Long Lever of Spring- A COVID-19 Update

Mar 12

Last week I provided an update on physical activity and a variety of newly published studies which continue to make the case for MOVE across the healthy lifespan. One of the articles I mentioned was THIS ONE, which was essentially a recap (by the lead research) of decades long research which fairly conclusively demonstrated the factors that predict whether a person who is exposed to a virus would actually develop symptoms... that is, who, in terms of their physiological state, was a "viable host" for the virus to complete its sole mission of "replicate and spread".

What's particularly fascinating to me about Dr. Cohen's 30+ years of contributions in this area is that he has uncovered, using experimental designs that actually expose volunteers to viruses (mostly the common cold and/or flu) and quarantine in order to understand more, risk factors in EACH of the 5 ELEMENTS we so often touch on:

MOVE: Physical Activity - those who are physically active have less than 1/2 the risk than those who aren't

FUEL: Nutrition - those who consumed (via food not supplements) the vitamin C equivalent to 2 oranges per day cut their risk in 1/2.

RECOVER: Sleep - those who get enough (7 hours) and are at least 80% efficient (stay asleep most of the night) are 2.5 to 3 times LESS likely to become infected.

ENDURE: Stress Management - those who have strategies to manage (or even grow from) the stress in their life have about 1/2 the risk of those who are chronically exposed. Alcohol consumption lowered risk when kept moderate (1/2 risk) but increased it when it stressed the body via over-consumption and smoking tripled the risk.

CONNECT: Relationships & Social ties - matter... a lot. Those who had the highest number and variety of social connections (family, work, school, social, volunteer, church, etc.) 1/4 the risk of those who were the most socially isolated or had the least support.

And if that's not enough, here is where it gets REALLY interesting. In a study of nearly 1 million hospitalizations due to COVID19, more than 6 of every 10 were attributable to 4 (largely preventable) conditions - Diabetes type 2, Heart Failure, High Blood Pressure (Hypertension) and Obesity - all of which respond to healthy actions like those listed above.

So where should we start?

The simple answer is - wherever you can build a habit.

But if that sounds ambiguous, boring or like a heavy lift - or if the sun peeking out a bit and the feeling of Spring in the air is enough of a nudge, one of the best options might be to start planning a garden with an eye on consuming 5 servings (3 veggie + 2 fruit) per day all summer long. That's right, another MASSIVE study, this time comparing the health trajectory of 2 MILLION people, found that 5 servings per day of the fresh stuff had a significant impact on the same category of conditions at the root of severe viral reactions.

Whether it's the 35 years of expertise being distilled at Carnegie Mellon, the nearly 1 million COVID19 hospitalizations, or the 2 million lives studied over a generation, the message is clear - we are figuring this thing out... we just need to pull the right levers.

We are in the final week of Winter... bring on the vibrancy of Spring!

Have a great weekend,

Mike E.

Choose to MOVE: A Solution at Every Age

Mar 5

Welcome to March, the journey-marker that says we are nearing the first official day of Spring. Maybe it was the cold weather or the apparent release of years worth of pent up snowfall that was our test. Or perhaps it was the unique challenge associated with the pandemic which came back strong during the colder months that pushed us the most. Either way, there is good news: with more than 80% of a Winter that clearly delivered on its promise to test us now in the rearview, the times, as one of the great poets once said, are a changin'.

Whether it's already a loud voice spurring you on or just a whisper in the back of your mind that still needs to be amplified a bit, there are many good reasons to use March as the time to start your MOVE toward thriving in 2021. The best news is that the benefits hold for every age across the lifespan. With that in mind, here are some of the headlines worth knowing about:

Early Life - starting with the little little ones in our life, HERE is a great reason to run, jump, climb and play - as published last month, preschoolers with greater fitness had better cognitive and academic scores.

In adolescents - it is clear from THIS STUDY that physical activity between 12 years and 18 years of age is linked with markers of health. It is also (unfortunately) clear that the COVID19 effect in this age group has been generally negative with a particular impact on mental health. Given that physical activity is associated with better well-being in this age group, it's a great lever if your teen is feeling the effects of a long winter. Specific to COVID19, this was also found to be the case for college students.

At midlife the theme continues. A very recent study shows that individuals who have a solid physical activity habit at midlife have better brain scans (MRI) in later life. This builds on important work from a couple years ago which showed that leisure time physical activity (i.e. not work-related) was directly correlated with better cognitive function and a lower likelihood for dementia as we age. Couple those with the many benefits for our cardiovascular, metabolic and other systems and a few minutes per day of MOVE can go a long way.

Still not convinced? How about taking the word of one of the world's top researchers on immune function and the likelihood to get infected with viruses that we are exposed to. Yep, after 35 years of work in the space (including running "The Common Cold Project"), the senior researcher wrote a paper which cautiously (but directly) suggests that physical activity among other things may lower risk of infection with viruses causing COVID19.

Late life - and what about our parents, grandparents and other most seasoned citizens? The story continues along the same line. Even at very low intensities regular movement in women aged 63 to 97 was significantly associated with better health outcomes including preserved mobility and function as we age.

Longer days with warmer sun are on the way. 84% of one of the more challenging winters in recent history is now history too. It's time to get moving. Let us know if you need some ideas.

Have a great weekend,

Mike E

Limiter or Lever? It's The Little Things.

Feb 26

A couple weeks ago I touched on the idea of performance longevity. I used stories of 3 different athletes who had been able to both attain AND maintain an incredibly high level of performance as examples of how, with a focus on the right variables and emphasis on deliberate practice, it is possible to hold off the physical effects of aging to allow for a maximum timeline of "productivity". What doesn't get talked about as much is when longevity actually IMPROVES performance.....which, in this case, brings us to a few stories about bricklayers.

Like many physically demanding jobs, the construction related fields are known for taking a toll on the people who do the work. Heavy equipment, environmental conditions that can accelerate fatigue and a variety of other demands that stress the working tissues can cut a career short. In some cases, such as professional masons, even 5 years can be a long time. Knowing this, as reported in 2017, a team of researchers studied bricklayers to see if there were any notable differences in the way work got done. What they found surprised them -- a "U" shaped phenomenon between safe technique and experience. Those with the least experience (less than 1 year) and those with the most (> 5 years) were at a lower risk of injury, but those in the middle of the experience spectrum (1-3 years) appeared to have a greater risk of injury. Why?

The answer probably shouldn't surprise us. It was about striking the balance between "ergonomically safe" work technique and "productivity". Those with the least experience were still learning so although they tended to practice the safe techniques they were taught in training they tended to be less productive. Those with the most experience had mastered the fine balance of BOTH getting a lot done AND doing it with safe technique. The risk of injury noted in the middle-experience group appeared to be related to handling heavier loads and possibly sacrificing safe technique in hopes to get more done, a common trap.

What made this research extra interesting however was a more recent and expanded study which added in even more experienced bricklayers. As it turns out the most experienced masons, those with more than 20 years of work experience, made subtle changes to their work technique as the job progressed; they adapted and adjusted their postures and positions as the conditions changed in order to maintain ergonomically safe technique.

The punchline of course is that not only did years on the job undoubtedly help the master-craftsman hone their skills, but doing so with a primary focus on safe technique helped supply them enough time to actually pull it off. Said another way, the case of bricklayers appears to supply proof that minimizing risk for injury/illness/disease isn't a limiter (for example of productivity) but a lever for longevity.

Have a great weekend,

Mike E.

Ready for Reset? Start Priming.

Feb 19

I was talking with a friend from Northeastern Nebraska this week and the topic of winter weather came up. I shuddered as he told me of temperatures reaching 25 degrees BELOW zero without the wind. We agreed that even with snow falling, my 25 degrees ABOVE zero sounded nearly balmy by comparison and that we were both ready for the season to change. This, of course, is one of the funny things about change - as hard as it can be most of the time, when we are ready, we can go from resisting it to seeking it out and even celebrating it.

Late winter is one of the times of year we might really feel the urge, ready to shed the layers and feel the sun. This, of course, is not just a "pandemic life" sensation. As I've touched on in other places, the root of the word February (Februa) relates to a roman purification festival known to happen around this time of year suggesting that even a few thousand years ago people were ready for change right about now. Couple this with other widely celebrated events that have happened in the last week, whether the spring festival commonly referred to as Chinese New Year or the transition from the party mode of Mardi Gras to a period of intense self-reflection between "Fat Tuesday" and Ash Wednesday, and it seems history and tradition support the notion too.

So if the world is beginning a seasonal reset....what are the things we can do now (or at very least prepare for) to make sure we hit the Spring in stride 30-ish days from now when it arrives? After a little time poking around what's new in the health research and keeping in mind the ages old QQS success formula I reintroduced last week (the right quantity of high quality effort combined with a spirit of growth & development), there were 2 that seemed to jump off the page for me:

1. Ramp up the MOVE - most of us feel an urge to get out and do something when the sun starts shining.....start priming now! There are too many good reasons to list, but in the last 30 days alone research has concluded that shaking off the rust and working those skeletal muscles can turn on genes that control how we use and store fat, stimulate 12 times more production of hormones that directly impact the aging process and of course lead to fitness which has been linked with future inflammatory auto-immune conditions.

2. A Long Winter's Nap - it may seem counterintuitive, but if you really want to improve performance, a final bit of hibernation may do the trick. I came across this study earlier in the week. It's not brand-new (2011), but the results are so impressive it's worth knowing about. Stanford University researchers wondered how closely sleep was related to physical performance, so they recruited some basketball athletes and asked them to maximize sleep over a 5-7 week period. The change they saw was impressive - shooting accuracy improved by nearly 10 percent both from the free-throw line AND from 3 point range and the athletes reported greater physical and mental well-being. If you want to be ready to do more in Spring, get your sleep.

It may be hard to believe, but Spring will be here in about 30 days. If we start priming our systems now with the right inputs, our bodies can be ready to embrace the reset in seasons when it arrives.

Have a great weekend,

Mike E.

Keep Growing - Performance Longevity

Feb 12

Being our best in the long term is really hard work. It takes a relentless drive to improve, a focus on the little things, and the ability to amass a vault of practice repetitions without extended setbacks from injury, burnout, or a variety of other obstacles. Maybe this is why there aren't many examples of people who've done it. Yet if we look back, even as far back as 8 decades, we might be surprised at how steady the fundamental formula has been.

Dive in to learn more.


The Rest of the Story

On the one hand, as a LONG suffering Miami Dolphins fan (last playoff win 20 yrs ago) who grew up spoiled watching Dan Marino do amazing things, it is VERY hard for me to type the next statement.....Tom Brady may actually be the greatest quarterback of all time. Winning a SEVENTH Superbowl at 43 years old, taking a team of mostly non-stars (1 pro bowl selection) who were on track for a good (but not great) season in terms of wins and losses at the midpoint and leading them to wins over multiple opponents who they had previously been beaten by and turning it into a Superbowl championship run is impressive work. Sure, he's only one person on a team of great athletes, coaches and staff, but on the other hand, as a person who is absolutely fascinated by top performing people who do it consistently over the long term, I find stories like Brady's, or Deena Kastor who set marathon records into her 40's, or Josh Waitzkin's who essentially did the same starting with chess (remember the movie?) and then in martial arts (really!), to be opportunities to learn from the few who seem to get better and better wherever they spend their time and effort.

So what does it take to defy the odds like Brady or Kastor or Waitzkin?

Well if you like history and you go back to one of the most well-known self improvement books of all time (originally published in 1937), you will very likely find some outdated ideas, word-choices and syntax. After all, the world has changed a bunch since then; but you might also find yourself intrigued by the staying power of some of the simple fundamentals like the "QQS" formula which boils down to: doing things right (Quality) as close to every time as possible (Quantity) which, when combined with a positive & growth oriented attitude (Spirit), yields amazing results.

Fast-forward 80 or so years and contemporary experts suggest some incredibly similar things:

1. Quantity - The idea of balancing "load" and "recovery" is not new; we talk about it a lot because it's the basic foundation of just about every growth activity for humans. When it comes to strength training, we overload the current capacity of our muscles to stimulate growth BUT THEN we back off and let a full recovery happen. If we don't overload a little? No growth. If we don't recover fully? Less growth. It's not just the hard push-forward, it's the pull back that lets us attain performance longevity. Just ask Kastor who is known for logging a massive number of miles in training - as many as 140 running miles PER WEEK! If that sounds intimidatingly huge, that's because it is. How'd she'd get there? She built up to it with ebbs and flows: "She describes this system, visually, as a “roller coaster.” Her weekly mileage might go: 70, 80, 75, 90, 80, 100." - any of those weeks are intense, but maybe the most impressive thing is that if we give the body a chance to pull back, it can do impressive things.

2. Quality - because quantity alone is never enough, doing the little things right matters. A few years ago (after winning the 2017 Superbowl), Brady said "When I was 25, I was hurting all the time, and I couldn't imagine playing as long as I did, just because, you know, if your arm hurts every day when you throw, how can you keep playing?". Maybe he has the perfect genetics for American Football... or maybe he's onto something in trying to put in a steady high quality effort at staying healthy. I'm admittedly skeptical about some of the specifics he adheres to, but the way he approaches it, deliberately with intense focus on improving, is almost definitely a big part of what's worked for him multiplying the effect of the volume of effort alone. After all, the often hyped 10,000 hour rule of mastery (if you read the some of the original work) was never only about the amount of time logged but the exacting nature of the practice itself....."how" it was being done, deliberately was the game changer.

3. Spirit - How does a child prodigy in a mental game like chess become a champion athlete/coach in an entirely different (physical) game in one lifetime? Well if you ask Waitzkin who achieved both of these things before midlife - the answer is that winning is a learning process first. In his 2008 book on the subject, Waitzkin makes it clear that learning for him is about getting outside of his comfort zone.....which often means doing the hard things that he knows will ultimately improve his results: “Growth comes at the point of resistance. We learn by pushing ourselves and finding what really lies at the outer reaches of our abilities.” Ask Carol Dweck, one of the world's experts on achievement through mindset, and you'll find a remarkably similar concept.

Of course, Brady, Kastor, and Waitzkin are not experts in what it takes to be safe or healthy in all domains. Throwing a football, running a marathon and dominating a chessboard are not the same as dodging strain risk, working long hours in sometimes harsh conditions, or strategically navigating through the complexities faced when working with industrial grade tasks and risks, but the principles are remarkably similar... at home, at work, and in life.

Performance longevity is not easy. It takes a focus on quality, a willingness to endure large volumes of effort, and a mindset that seeks out continuous improvement.. Some measure it in championships or records set... others measure it in healthy and safe days, everyday, season by season... culminating in the "wins" of more time doing the things that matter with the people we love.

We are +/- 60% through the Winter. Keep growing.

Have a great weekend,

Mike E.

Digging Deep - Respect the Surge

Feb 5

Predicting the future is a tricky business but this time they got it right... inch after inch and in some places, foot after foot... the snow fell just like the meteorologists said it would. By 9P on Sunday, I was ready to make a first effort at keeping up with the task - it wasn't going to be my last. 10 hours later was round two.....and then every four to six hours until it was time for sleep on Monday night. Thankfully, my 14 year old son was willing to tag team the task. At 6A on Tuesday when I looked out the window, I wondered if it would ever stop... but thankfully by 11A and almost 2 feet of snow later, the Northwest corner of NJ was mostly through it.

Great for the skiers.....rough on the shovelers.

Shoveling is hard work. First, it's a repetitive loading activity concentrated at the upper body which makes it more demanding from a cardiovascular perspective than even the same amount of work when done with the lower body. Second, it relies heavily on the (relatively) small muscles of the arms which are better at positioning and mobility than lifting as compared to the legs. So, muscle fatigue is always a lingering risk. Last, the task is often completed in a "leveraged" position, which mechanically speaking, means the load (end of the shovel) is further away from the fulcrum (hips/back/elbow) than the working tissues (muscles). With all that in mind, it's no surprise that shoveling safely requires a solid base of fitness (roughly equivalent to jogging) AND good technique AND the ability to use exhaustion preventing controls like breaks... and that's on a moderately cool day in reasonably uniform soil.

Add in slippery surfaces, large shovels built for pushing (more than lifting), and air temperatures that tend to cause less than ideal changes in blood flow patterns (vasoconstriction), and the stats that tell us large snow storms bring substantially increased risk of heart-related hospitalization and even death across the lifespan (but especially in men) don't seem all that far-fetched. But the risks don't necessarily end when the storm does.

This massive (276 page) review uncovered a variety of risks worth knowing about. Here are a couple that really jumped out at me:

Soft-tissue (musculoskeletal) injuries during shoveling accounted for about 55% of all injuries, with lower back pain the most common at 1/3rd of the total. Injuries are more common in men, peaking between 35 and 55 years old, and unfortunately, the trend has gotten a bit worse over time.

Fractures were 2.5 times as likely when at least 70% of the sidewalks were covered with snow. Upper extremity fractures were an eye-popping 15 times more likely! And since melting ice is even more slippery (lowest friction) than hard ice, injuries from slips, trips, and falls were not necessarily most common on the day of the storm or even the day after but peaked between 2 and 7 days AFTER the storm.

What's the take-home message this week?

Simply put - a surge in physical demands adds risk, so does a drastic change in our routines and environment. Whether it's a weather related event like a snowstorm or an unplanned surge in work (outage, etc.), ramping up quickly toward our physiological limits is a demand that can bring risk in the moment AND for a surprisingly long time after the event ends (e.g. firefighters show similar responses). So if we can't steer clear of the risks, we should do our best to be prepared with strategies that work - here are a few when workload surges:

1. If it's not an emergency, there's no need to make it one - pace yourself, listen to your body, and look for signs of fatigue in yourself and your coworkers.

2. We humans are not machines, in some ways we're even better... because with rest, we self-repair - Respect your rest and get enough of it.

3. The mental milestone of a finish line is critical. It's best to envision the finish as 7-10 days AFTER the storm ends - the risks linger and so must our focus. Heightened risk requires heightened awareness all the way to through the finish.

Stay safe. Get some rest. Schedule a consult if we can help.

Have a great weekend,

Mike E.

Zoomies for Humans: Resolution 5

Jan 29

Are you a dog lover? If not, do you know someone who is? If so, you may have heard of the term "zoomies", or even seen it in action. It's those times average Fido morphs into Super-dog, bursting at the seams with energy - running around uncontrollably or wildly chasing its tail. Of course, the AKC tells us there's a technical term, Frenetic Random Activity Period (FRAP), but it's not nearly as fun as "zoomies". Entertaining as it might be to watch (if youtube videos over 1 million views can be used as evidence), the reason why dogs click into this behavior, to release energy and work through stress, is something we can learn from... which, as we wrap up January 2021, gets us to our final micro-resolution, number 5.

The Power of Zoom

As a social species, we are made up of bonded individuals (families, tribes, organizations, communities, etc). We're not exactly the same as the family pooch, yet in some ways we are remarkably similar. One of those ways is how we achieve the right balanced/rested state we need to thrive. Just like a lack of energy (fatigue) is not ideal for our overall performance and risk, too much energy (or too much of the wrong kind), is also not ideal. Our bodies are built with a variety of control mechanisms, some involuntarily happening in the background while others are triggered by things in our experience. The state of the world and the continued need for distancing make it easy to feel a bit disconnected - physically (solitude), mentally (lonely) or even spiritually (seeking greater purpose in a challenging world) which can leave us feeling out of balance - but, just like the dog who finds a way to get all that pent up energy off the system - there are things we can do.....even without running around in a frenzy.

With that in mind, here are a couple "human zoomies"- ways to add or release energy as we work toward building longer term healthy habits:

First Zoom Out - CONNECT with the world around us. How we internalize the world around us (which is at the root of whether we are energized or disengaged) starts with how we receive and filter the information coming in. Each of our senses matters here. What we see, hear, smell, taste, and touch informs our reality as information passes through the filter of our personal experiences. Excessive inward (self) focus tends to inhibit our performance as shown in a classic 30+ year old paper on public speaking. Practicing an outward focus - putting our attention on what is happening around us in a highly objective but non-judgmental way (facts only, no interpretation) takes focus and energy. If recent studies on the brain activity of highly skilled meditators are accurate, it may even remap the default "idle" setting of our nervous system. If you've got the chance to do so "out there" and enjoy some nature in the process, even better. Combining the health and well-being benefits of physically being in nature (aka forest bathing), even in the winter with the outward sensory focus is a potent combination.

Then Zoom In - CONNECT with ourselves. If you tried the Positive Affect Journaling (PAJ) exercise I profiled last week you may have noticed it takes a real effort to look inward and dive into the details of the day and how it all played out. For many of us it feels easier to get stuck on the negatives and threats. Without diving too deep into why this type of thinking may have been an imprint handed down from our ancestors, what we now know is that having a structured approach to work through those thoughts, see them for what they are but not more than they need to be, a process called cognitive restructuring, can have an impact. Using a "What am I thinking?" exercise, as found outlined in this document can be a benefit. You might be surprised how the technique can help us tackle a variety of challenges - like building an exercise habit - which, with some emphasis on core strength for the abdomen and lower back (as discovered in this fantastic 2016 study) can have an extra large and direct impact on our stress response.....bringing us full circle to resolution 1 - short bursts of MOVE.

There's a lot there.....but if instead you just want to follow the dog's lead, to "let go" and spin around in circles, we'd suggest a dance party (because it works!) or at the very least, making sure the area is safe.....of course, we'd also like to see the video :)

We are nearly 45% through the winter, keep moving strong!

Mike E.

A Watched Pot Never Boils: Resolution 4

Jan 22

We're in the fourth week of January and so onto our fourth week of micro-resolutions. This week we build on last week's dive into chamomile with some enhancements that can add power to the time spent.

Did you try it? Did you run out to the local store and get some chamomile tea? Well, in case you missed it, last week I touched on some of the impressive medicinal effects of chamomile tea. Known mostly for its calming impact (with evidence that it helps generalized anxiety disorder), I was equally impressed with its impact on blood sugar in folks who struggle to control it.

But that's not all.

If you read closely you may have noticed that I alluded to this week's micro-resolution with a recommendation to carve 15 minutes out for the process of bringing the water to a boil, steeping the tea and enjoying it....but since everyone knows "a watched pot never boils" (as Ben Franklin's alter ego says) it's probably best to do something more valuable with the time. With that in mind, here are 3:

1. Put pen to paper - spending 15 minutes journaling using a technique known as Positive Affect Journaling (PAJ) has been shown to improve mental well-being, counteract distress and, if you can keep up the habit for 2 months, improve resilience (the ability to bounce back from adversity). Not bad for 15 minutes of time. Want to know how to do it? Try answering one these two prompts "What are you thankful for?", "What did someone else do for you?". The authors suggest there are 5 others although we've not been able to find them....yet :)

2. Breathe.....slow - did you ever count how many breaths per minute you average? It's a critical vital sign used all the time in health-practice and it can tell us quite a bit about our current state. Most experts agree that a normal range for most adults sits between 12 and 16. Most experts on breathing exercise agree that practicing a slower rate (like 6 breaths per minute for 6 weeks) can calm our physiology and change a variety of stress parameters. One of the tools we like to help pace yourself can be found here (the default is 4 in + 6 out = 6 breaths per min).

3. Breathe....part 2 - does the 6 breaths per minute seem a bit slow for you? Not to worry - some very interesting research from a team in Belgium showed that even at 12 breaths per minute (the lower end of the normal range), when individuals practiced an extended exhale (for example 3.5 sec exhale for a 1.5 sec inhale) they reported a greater relaxation even than the slower 6 breaths per minute group. There were also notable improvements in a variety of physiological parameters known to relate to stress.

Q: is a 15 minute investment of time worth the effort?

A: Maybe....but as Yerkes Dodson shows us (and this article highlights)....not always.

We wrap up the micro-resolution series next week when we will be marching toward the end of January (already!) and adding to our "Win the Winter" countdown clock (which has moved past 35%).

Have a great weekend,

Mike E.

Resolution 3: Make Time For Tea

Jan 15

We started off January as many do - with a focus on change.....not monumental change of the transformation variety, but little things, micro-resolutions, that have powerful evidence backing them up in hopes to march strongly through the winter and come out safe and healthy on the other side.

Week 1 we covered MOVE - and talked about how even 1 minute of stairs could make a difference.

Week 2 (last week) we dove into FUEL - and gave a hat-tip to "the most important meal of the day" with a special focus on the evidence related to oatmeal's ability to counteract cellular stress.

This of course gets us, right on track, to RECOVER and a micro-resolution that, with some boiling water and 10-15 minutes per day can have an impressive impact on several health markers. It starts with a flower that looks a lot like the common daisy. After a bit of drying and maybe some additions for flavor, it is steeped in hot water for up to 5 minutes to produce a pretty impressive (and widely available) cup of warmth known to all of us as "Chamomile Tea".

Maybe you've heard that Chamomile Tea has some medicinal properties - in fact, it does. There is some interesting evidence that it can be a help for those who may be struggling with type 2 diabetes when taken after meals. It also appears to have a calming effect when we are feeling stressed. In this study, which included multiple years of follow-up, using chamomile tea as a self-management strategy for generalized anxiety disorder made a difference. It's also been used for its antioxidant, anti-inflammatory and in some cases (topically) even pain control capacity.

Q: So how can we get the most from this humble little tea as a micro-resolution?

A: Consider carving out 15 minutes per day to boil the water, steep the tea and mentally process your day.

There's no wrong way to inject a few minutes of calm, it can be done anytime, the key is being intentional about it. Rather than just consuming it, take the time to slow down and have that be the full focus of your time. If you really want to go all in, consider putting this in the time slot that is 30-60 minutes before bed as a reminder to cut back the bright lights/electronics/etc. - a really powerful way to ready the physiology for rest.

Next week I'll touch on a way to double up the habit with some techniques that are particularly good for those who may have a hard time getting to sleep.....but for now, just enjoy the tea.

We're +/- 30% through the winter - stay strong!

Have a great weekend,

Mike E.

Micro-habit 2: The Oatmeal Resolution

Jan 8

If you've read along for a while or sat through one of the presentations we've given you've probably heard us talk about the goldilocks know, the grading system for the perfect bowl of porridge.....not too hot, not too cold, just right. In mathematical terms this could be called "non-linear", that is a situation where more of a good thing doesn't necessarily produce better results (and less doesn't necessarily make things worse) which means there is a "just right" amount, a sweet-spot, which in the case of the Three Bears, was the temperature of baby-bear's morning hot-cereal.

There are so many aspects of life where this concept applies. Even things like water and Oxygen - definitely vital for us - can be problematic or even deadly in the wrong concentration. Certain kinds of Oxygen in fact ("reactive oxygen species") are markers of cellular stress which plays a role in aging and disease. This would generally be thought of as bad but, and this is where it can get really confusing, because even this too has a sweet-spot, short-term and resolving exposure can actually be good for our health such as in the case of exercise while constant or unresolving exposure such as in the case of regular e-cigarette use puts our nervous system on overdrive.

Q: So where does this leave us in terms of a New Year's micro-habit resolution?

A: Circling back to porridge......and oatmeal in particular.

Although oatmeal is not the ONLY type of hot cereal eaten for breakfast, the micro-habit resolution for this week centers on it because it is one of the most well studied. More than 100 years ago physicians started advocating for oatmeal as a way of reducing the impact of diabetes and there are countless other studies which have tested consumption of this whole grain and shown a positive impact on health. Of course it's important to remember that not all oatmeal is the healthy kind. Some pre packaged brands are very high in sugar and lower in fiber than the whole/cooked type, which may negate a lot of the benefit.

If you can make oatmeal for breakfast a 4 week habit you may be able to lower your inflammatory profile significantly as shown here.....but even if you don't get that far, this small study showed that a serving of oatmeal before even a single session of high-intensity exercise blunted the markers of cellular stress.....which means it likely has the same effect before a hard day's work.

We're 20 days into the Winter, which means we've got +/- 70 to go. Keep up the great start.

Have a great weekend,

Mike E.

Resolution Idea 1: Stair Snacks

Dec 31

Maybe it's a yearly tradition for you. Maybe you never do but somehow this year has been enough of wildcard that you're going to dust the old concept off. Maybe it'll be the start of something entirely new. Who knows where it could take you.

Yes, of course I'm talking about New Year's resolutions. Not whether they work for everyone (spoiler, even though change was 11 times more likely stick when a resolution was made, resolutions work less than 1/2 the time) but rather as a tip of the cap to those who are going to make an effort.....and to give a few ideas to those who are on the fence. After all, sometimes the hardest step is the first one.

Resolution 1: Take the stairs, 4 times in a row

In 2018 an interesting finding was reported by a cardiologist in Spain. In more than 12,000 individuals tested and followed, those who did not have the fitness capacity to walk up 3 flights of stairs "very fast" or 4 flights of stairs "fast without stopping" were approximately 3 times more likely to die of heart disease or cancer in the following 5 years when compared to those who could.

The elegance of this finding is in its simplicity. Stairs are not specialized fitness equipment. The whole thing can be done in a minute or so. The pay off, although not surprising since fitness capacity has been connected to MANY risks, is pretty huge.

The drawback (and some of the criticism at the time) however was in quantifying what "very fast" or "fast without stopping" meant. This left people wondering - was their version of fast, fast enough?

Well, now, almost exactly 2 years later, the findings have been refined in a smaller subset of patients. As it turns out, the ability to climb by walking (but not breaking into a run) four flights of stairs (approximately 60 stairs) in less than 1 minute was an important risk-lowering threshold for cardiac issues, with 45 seconds or less the lowest risk.

Health-geek-speak: I will achieve at least 8 METS of fitness capacity in 2021.

Resolution Translation: I will do at least 1 minute of stairs most days of the week, stopping for rest as needed, until I can do at least 60 stairs in under a minute without stopping.


Need some additional help making it stick? Here are some good tips on how to make the process work for you.

We'll bring you another one next week!

Happy New Year, have a great weekend,

Mike E.