Wellfie Wednesday Tip #67: It's Good to be Good

Happy #WellfieWednesday! This week’s post is brought to you by Aaron (@AaronPerezPT).

     Today’s post is inspired by many current events. I just returned from a week in Haiti providing medical services with STAND: The Haiti Project. It was an amazing experience to say the least. I’d call it “once in a lifetime”, but something tells me I’ll be back. October is also Physical Therapy month, and this Saturday October 14th is Global PT Day of Service #PTDOS. Amidst these caring, altruistic efforts there are ongoing tragedies necessitating more volunteerism and service. Events like Puerto Rico’s ongoing recovery from Hurricane Irma, the recent Las Vegas massacre, and Napa fires. So, let’s explore the health benefits of giving. 

     There is some interesting science to support President Lincoln’s religion. Dr. Steven Post is a leading researcher on this topic and his 2011 open access article provides some great insight. It appears that acts of kindness can improve happiness, health, and even longevity. One study found that recovering alcoholics who helped others with their recovery nearly doubled the likelihood of successful sobriety over a one-year period compared to those who were not helping others. Similarly, people experiencing chronic pain have reported decreasing levels of pain, disability, and depression when they served as peer volunteers to others struggling with chronic pain. In a 2010 survey, the large majority of American adults who volunteered reported numerous health benefits including improved physical health and well-being, increased fulfilment, less stress and anxiety, greater resilience, better sleep, stronger social connections, and improved self-efficacy. That sounds like quite the return on investment. However, these benefits should not serve as primary motives for helping others and are certainly not guaranteed. Nonetheless, genuine benevolence is a powerful act for all parties involved. 

     There is such a thing as having too much of a good thing. Doing altruistic work can be overdone. Compassion fatigue and burnout among those caring for others daily are not unusual. Detrimental consequences can include severe stress, poor sleep, disrupted cognitive function, distancing from social connections, professional attrition, and depression. The “right amount” of altruism will vary from person to person and depend on several factors. This message resonates with me personally as a healthcare provider. I think the “helper's high” is lost in the day-to-day grind of helping patients through distressful situations on a daily basis. Add unwanted layers of administrative burden such as excessive documentation onto the situation, and it begins to feel more laborious and less joyful. I think it can be helpful to breaks from daily routine. Sometimes this means disconnecting from altruism to make time for yourself. It might be a full vacation, or it may just be a brief moment in your day to take a breath. Occasionally, it may mean reconnecting with meaning and purpose through sincere altruism. That’s what I feel I experienced over the past week volunteering with STAND: The Haiti Project, and I’m grateful for it. Although there was a healthy dose of disconnecting on the trip too, lots of fun.

     At the end of the day, we all need to help ourselves. And one powerful way to do that is through helping others. I hope you find some ways to do so that bring you meaning and happiness. Have an awesome week! 

     And thanks again for all of the #WellfieWednesday support, be sure to post your pictures this week and tag the WW crew members in your post (@PBernerSPT, @Eric_in_AmERICa, @AaronPerezPT, @DianaKlatt) and keep the wave of healthy change going!

- WW Crew

Wellfie Wednesday Tip #66: Lets Talk Running Surfaces

Happy Wellfie Wednesday! Welcome back! This is brought to you by Diana (@DianaKlatt).

     Running is one of the easiest sports that you can get into. You can run anywhere and anytime you’d like (as long as there are no signs forbidding you to do so) - road, dirt, grass, treadmill, track, gravel, sand, or any other terrain you can imagine! So how do you decide what surface is best for you?

     Before we get into the different surfaces and I try to convince you to be a trail runner (personal preference), let’s get down to the physics behind running. Running is a high impact sport with multiple factors at work. There is a horizontal force and a vertical force that occurs when your foot hits the ground. And then there’s gravity! During a run, the vertical force must be greater than the force of gravity in order to stay upright and with proper propulsion. The horizontal force is what causes forward motion. This horizontal force also dictates speed; the average runner applies 500 - 600 lbs of peak force during a run. Isn’t that WILD? 500 - 600 lbs! You’re putting that much force through your feet at each. (And for reference, Usain Bolt has about 1000 lbs of force coursing through his feet at each impact.)

Source

So how can we reduce that impact and make running a “softer” sport? One simple option is to change the surface you’re running on. Let me break down the 4 most common terrains for you: cement, dirt, grass, and the dreaded treadmill.

Cement: Running on cement, such as sidewalk or in the park, is easily the most convenient running surface. This is also one of the hardest surfaces that you can run on, which could cause you to be putting excessive force onto your joints. I personally end up spending a lot of time running on this surface out of convenience but always get off it as soon as I possibly can (I will literally hop onto any dirt path I see, even if it’s only for half a block). But if this is the only option you have then what do I suggest to make this a little less damaging and less stressful on your body? Proper footwear! I wrote a while back on how to pick the right running shoe for you and the type of surface you run on should 100% be taken into consideration when picking your running shoe. You can help counter the impact force by having a shoe that has a high shock absorption capability. But I digress, you can go read about shoes at your leisure, you’re here to read about surfaces.

Dirt: My one true running love. I may cycle through shoe companies and shoes but I will always forever love dirt like any true cross country raised runner. Dirt offers the hardness that concrete/asphalt has but at a lesser impact because it has more give since it is not a true solid surface. Running on dirt is prime for those that suffer from shin splints, ITBS, or other impact related injuries. HOWEVER, you must be extremely careful to watch where you’re running as running on dirt frequently leads to ankle injuries. I run looking at a slight downward angle so that I can assess the ground ahead of me and pay extra attention to the ground when I am trail running. Having a shoe with a bit more support around the ankles can help with this.

Grass: Grass is very springy and is the lowest impact surface you can easily find (unless you live near a beach and have access to sand but that has a whole slew of other issues since it is not solid at all). Grass gives you that extra spring while still providing a flat surface to run on. This is easily the best surface for you if you have joint problems (ie. knee or ankle issues). As I mentioned with trail running, you must watch where you are running and it’s a bit harder to fully see the surface since there can be rocks or holes hidden under the grass.

And last and also least… the Treadmill: Treadmills are no one favorite piece of equipment at the gym, I think we can all agree on that. But what you may not realize is that it is a relatively low impact surface in comparison to concrete/asphalt and dirt! You also don’t have to worry about tripping over anything or landing incorrectly while running on a treadmill (unless you’re like me and literally fall over while standing still…).

     So what’s the best surface for you? Honestly, it really depends on what you’re looking for and what kind of injuries you may already have or are prone to. If you’re training for a race you need to make sure that you are training specific. I don’t mean that you need to run 100% of all training runs on the same surface but you should definitely be running half of your runs on the same surface you’re planning on racing on. But if you’ve been hesitant to start running because you’re afraid of the impact of running on cement, try out one of the other surfaces! Join me in this love-hate relationship that we distance runners have found ourselves in.

     And thanks again for all of the #WellfieWednesday support, be sure to post your pictures this week and tag the WW crew members in your post (@PBernerSPT, @Eric_in_AmERICa, @AaronPerezPT, @DianaKlatt) and keep the wave of healthy change going!

- WW Crew

Wellfie Wednesday Tip #65: APHPT - A Fundamentally Different Way to Care

Happy Wellfie Wednesday! Welcome back! This week we want to highlight a quickly growing group of "Doers," that no longer want to just talk about our country's problem, but take action!

I want to welcome Ali Hartman (@alihartmanSPT), who's leading the membership team with Alexis Morgan (@AlexisMorganPT) over at APHPT, as this week's guest promoter of health.

WE HAVE A PROBLEM.

     The American people are sick and hurting, and the American healthcare system has failed them. Half of all Americans in the US are suffering from one or more chronic conditions, which include conditions such as cardiovascular  disease, diabetes, musculoskeletal disease (arthritis, back/neck pain, etc), stroke, cancer, obesity, and more. These chronic conditions are responsible for 7 of the top 10 deaths in our country, and account for 86% of our almost $3 trillion dollar annual healthcare spend (healthcare accounting for over 17% of total GDP & growing). Despite the massive spend, people continue to get sicker and sicker and costs continue to climb with no real end in sight. The worst part- many of these chronic conditions share common root causes that are largely preventable and amenable if we are willing to widen our lense to see the bigger picture. Unfortunately, the future appears grim without a major disruption in our current system and mindset regarding healthcare. Enter the Academy of Prevention and Health Promotion Therapies. The APHPT is a collaborative of health-facing professionals who are deeply committed to bringing a fundamentally different way to care to the people of our society. APHPT is not a program, product, or system. Rather, it is an ecosystem of action-oriented professionals who believe that we, as a whole, are capable of SO much more, and that the people of our society deserve it. (Link to stats reference)

     We believe that to understand where we are going, we must first understand who we are. This is why APHPT established our four core values- EQUITY, ACTION, AUTHENTIC CONNECTION, and SUSTAINABILITY. With these values as our foundation, we have started to build an infrastructure that allows health-facing professionals to come together and collaborate, learn, grow, and connect with one another to produce actionable steps towards better health for our nation and beyond. As ideas, interests, passions, and talents emerge in our membership, we facilitate the creation of member-led “idea labs”, building a team that can accelerate that idea into action. We share both our successes and our failures so that we can learn and grow together. We cultivate experiences and environments that stimulate knowledge transfer to allow members to begin implementing this mindset into ANY situation or setting immediately. Finally, we believe that to truly make a difference, we need every single person who has the heart and desire to move the needle forward on our population’s health to join us in fighting the good fight. No matter who you are, your profession, your setting, or your experience, we would be humbled and honored to have you as a part of our tribe. Our nation’s health depends on it.

     If you are interested in finding out more about APHPT, what we are up to, our membership options, or other resources, check out the website at APHPT.org. You can also check out our social media channels (instagram, twitter, facebook), what our membership package entails here, or join us TONIGHT 9/27 at 9pm EST for our monthly live Twitter chat (details here) by following the hashtag #PopHLTHchat. Also, feel free to contact our membership team- Ali Hartman at alison.hartman@aphpt.org or Alexis Morgan at alexis.morgan@aphpt.org with any questions about APHPT membership!

Thanks for reading and looking forward to CONNECTing! - Ali Hartman

     And thanks again for all of the #WellfieWednesday support, be sure to post your pictures this week and tag the WW crew members in your post (@PBernerSPT, @Eric_in_AmERICa, @AaronPerezPT, @DianaKlatt) and keep the wave of healthy change going!

- WW Crew

Wellfie Wednesday Tip #64: Financial Wellness

Happy #WellfieWednesday friends!

     This week’s tip comes from @Eric_in_AmERICa is all about maintaining your financial wellness. As our #Wellfie team and most of our readership is primarily physical therapists or student physical therapists, I thought this topic would be near and dear to most of our hearts; especially as the cost of graduate education continues to rise in a disproportional manner to our reimbursement rates and overall payment.

Disclaimer:

I am by no means an expert in this area. I am not an accountant or a financial advisor, in fact I dropped the only accounting class I ever took in my undergraduate studies after two weeks when the concept of a balance sheet felt like I was learning Japanese. Later in this article I list some resources who are professionals who I would highly recommend reaching out to in order to translate this information into comprehensible terms.

     As I mentioned above, I am by no means an expert in financial wellness. I am, however, a 28 year old millennial with $200k+ in student loans, married to a wonderful wife who also has around $100k in student loans, a baby on the way, in the process of purchasing a home, trying to save for retirement, all while hoping to avoid the Ramen Noodle diet and maybe hold down a Spotify Premium account. According to the research, I would bet that you’re probably in a similar situation.

     The US Federal Reserve reports that Americans owe a total of 1.45 TRILLION in student loans, divided among 44.2 million people for an average of about $33,000 per person. (Sidenote- these numbers are only for FEDERAL student loans and do not include private student loan statistics.) Pretty overwhelming, right? Good news, it doesn’t have to be. Below I’ve listed a few steps to follow in order to take ownership of your financial wellness.

Step 1: Budget. Figure out how much money you have coming in vs how much money you have going out. There are several apps like Mint or EveryDollar that can help you with this, but I prefer an old school pen and paper list of every bill and it’s due date to have a better picture of my financial responsibilities. Set individualized, SMART goals to start chipping away at debt and keep yourself on track.

Step 2: Control Spending. The easiest way to save more money is to not spend it. Sounds easy in concept, can be incredibly difficult in reality. One of my favorite resources for advice in this area is Dave Ramsey (www.daveramsey.com). He gives tons of practical tips for cutting spending and practicing financial discipline in order to get out of debt as fast as you can.

*Step 2a: Increase Income. This is basically the opposite of controlling spending. Rather than letting less money go out, have more money coming in. This can be accomplished through a variety of ways, depending on your creativity, work ethic, and amount of free time you’re willing to sacrifice. Your loan servicers don’t care if your money comes from your 9-5 seeing patients in the clinic or your side hustle driving for Uber. Money is money, as long as it’s paid on time.

Step 3: Work the system. Look into refinancing loans for a lower interest rate, check out student loan forgiveness programs, and find trusted resources to help you along your path to becoming debt-free. One company that has been a huge help to me in both understanding my loans and formulating a plan to tackle them has been FitBUX (https://www.fitbux.com/). FitBUX is a free service that “...creates a holistic picture of an individual's finances by capturing your past, present, and most importantly, your future.  When you build an online profile with FitBUX, your human capital asset and financial situation is captured in one easy to understand score, the FitBUX Score. The FitBUX Score, combined with interactive charts and graphs, provide an easy way to compare your options. You can personalize a finance strategy by seeing how your financial choices impact your FitBUX Score.” (via FitBUX website). They are able to keep this as a free service by offering products and services that optimize your financial strategy, getting paid by the financial institutions when FitBUX members utilize their services. Worth checking out, even if you’re skeptical (like I was, and always am when it comes to financial advice). Just FYI on my part, this is a 100% unsolicited endorsement. I truly appreciate all of the help Joe and the rest of the team at FitBUX have given me and hope others will find as much value out of speaking with them as I have. Which brings me to...

Step 4: Be Smart. If it sounds too good to be true, it probably is, especially when it comes to getting out of debt. Many financial institutions will offer a free meeting to discuss your debt, however they are businesses and businesses need to make money. Make sure you do your research and ask questions to fully understand how they are getting paid for offering your this advice. Monitoring your credit is also an important part of understanding your financial wellness and how you appear on paper to companies. It can also be useful to make sure that there are not any suspicious changes made that you are not aware of. Apps like Credit Karma can be helpful in keeping an eye on your credit score and feel more secure about your financial wellness.

     This is timely news with the announcement that one of the major credit agencies, Equifax, suffered a massive security breach, compromising over 143 million Americans’ personal information like social security numbers, addresses, employers, etc. (Check this site to see if your information was included in the breach https://www.equifaxsecurity2017.com/).

     Again, I’m no expert, but these are all tips that have worked for me. Setting a budget and sticking to it, controlling spending, asking for help, and doing your due diligence to keep your financial wellness in mind.

     So put some of this information to use and let us know what you think! Thanks again for all of the #WellfieWednesday support, be sure to post your pictures this week and tag the WW crew members in your post (@PBernerSPT, @Eric_in_AmERICa, @AaronPerezPT, @DianaKlatt) and keep the wave of healthy change going!

- WW Crew

Financial Resources

https://www.daveramsey.com/get-started/debt

https://www.fitbux.com/

Will Butler- @simplywillb on twitter

Statistics and Sources

https://www.forbes.com/sites/zackfriedman/2017/02/21/student-loan-debt-statistics-2017/#50b965605dab

https://studentloanhero.com/student-loan-debt-statistics/

http://www.marketwatch.com/story/40-of-americans-spend-half-of-their-income-servicing-debt-2017-04-27

http://www.bbc.com/news/business-41192163

Wellfie Wednesday Tip #63: Digital Detox

Happy Wellfie Wednesday! Welcome back! This week is brought to you by @DianaKlatt 

Did you know that…

• The average person checks their phone 200 times a day, that's once every 6.5 minutes
• One in four people spend more time online than they do asleep
• 70% of 16-24-year-olds say they prefer texting to talking
• The average teenager sends 3,400 electronic messages a month from their bed

     Isn’t that wild? People check their phones TWO HUNDRED times a day! People get stressed out when they’ve forgotten their phones at home or their precious mobile device is holding a charge of less than 15% and they’ve got hours until they find an outlet. There is even a term for the fear of not having your phone with you now, nomophobia! FoMo (fear of miss out), FoBo (fear of being offline), NoMo (no mobile)… nomophobia. I think we can all agree this is getting out of hand. With this trend, it seems like people are just becoming more and more attached to their devices and less attached to their immediate surrounds. Thankfully, there seems to be a trend of cafes that are trying to get people to engage a bit more with each other, saying their establishments are a no-wifi zone and that people should talk to each other.

     I know we all keep saying that sitting is the new smoking but can I make a different proposition? I think technology and social media is the new smoking. When I correlate these two things I mean that it’s something that we all know has negative side effects yet we find ourselves completely addicted to. Some people may experience greater effects than others, some people become addicted, some don’t, and some people can develop long-term problems (ie mental health issues) from over usage. Sounds pretty similar to smoking to me! There is no way around the truth of the matter, social media leads to increased depression in the youth of today due to the weird weight we have placed on “likes,” we see other people doing cool things and wonder why we never do cool things leading to vicious cycles of jealousy and FoMo (people only post what they want you to see, that’s the beauty of social media personas, it’s complete curated), people hold weird attachments to their number of friends/followers and somehow equate this digital value to their actual value of popularity… the list goes on and on. Social media is NOT social. Yes, it gives us the opportunity to keep up with people we would have otherwise lost contact with, it let’s us stay up to date and see things and places we might not have otherwise ever seen, but at what cost? (Forbes)

So what can we do about this? Digital detox! (Or at least a modified one…)

     Now I know what you’re thinking, “how can I possibly go 72 hours without checking my phone?!” Trust me, you can, AND you’ll come back feeling GREAT. In preparation for writing this I decided to a modified digital detox for the Labor Day weekend and then implemented a method to decrease my dependency on my phone and other social media outlets while making sure I was still staying on task with my work obligations and studies for the following 1.5 weeks. I completely understand that we are not all fiscally capable of just removing ourselves for potentially even 24 hours, I work remotely for a lot of my job and I had to really be strategic about figuring out how to go about this experiment.

     So how do you start? Be realistic. For many, 72 hours is an unrealistic goal. That’s understandable. Maybe you can go one day, maybe you just cut out half a day, maybe you just cut out certain things, anything is better than checking your phone 200 times a day. I knew it would be impossible for me to not check my phone at all because of my work obligations so rather than locking up all my technology I allotted two separate times during the day, for an hour each, to check emails and answer phone calls. For the rest of the time I was just reading or enjoying staying at my friend’s lake house. For the following week I decreased my phone time by putting my phone on “silent” during the day and therefore wasn’t constantly notified to check at each message. I couldn’t necessarily cut out looking at a computer while physically at work or in class but I was about to just stop myself from constantly signing into social media sites (if you struggle with preventing yourself from doing this, you can download software such as SelfControl which blocks different websites for a set amount of time). What can you do at home? With your family or roommates, you can make common time (ie meals, hanging out) a no tech zone so that you have to interact with each other. Also, make sure none of your tech is near your bed! This makes a huge difference in usage in the late hours of the night before going to bed. Just implementing these small things we can decrease our dependency and increase our technological freedom!

So what are my takeaways?

• be realistic while setting restrictions to create habits
• make small changes to your technology/social media usage
• try to take a day off, if possible
• no tech near the bed
• talk to others
• find someone to detox with you
• just leave your tech at home

Your phone doesn’t define you! Social media is not real life. Try not to check your phone 200 times a day. Digital detox with me, you’ll be glad you did.

Want a more in-depth look into the potential effects that smartphones have imparted on the youngest generation? Check out this The Atlantic Article.

As always, thanks for all of the #WellfieWednesday support. And be sure to tag the WW crew members in your post (@PBernerSPT, @Eric_in_AmERICa, @AaronPerezPT, @DianaKlatt) and keep the wave of healthy change going!

- WW Crew

Wellfie Wednesday Tip #62: It Starts with a Conversation

     Happy #WellfieWednesday everyone! In today’s tip, @AaronPerezPT is back with more change talk. His two previous posts discussed #ScienceSecretsToHealth and #SixSourcesOfInfluence. The major takeaways from those were:

• Knowledge alone does not translate to behavior change
• Behavior change is hard partly due to the many factors that influence our behaviors

     There is plenty of hope though. Although knowledge alone is unlikely to transform behavior, Knowledge is still powerful. For example, low health literacy is associated with poorer health outcomes and worse healthcare utilization. Furthermore, creating a comprehensive change plan that addresses the six sources of influence makes the chance of success with behavior change 10x more likely.  So, helping others with behavior change is still very possible and worthwhile. And it starts with a conversation.

Motivational Interviewing (M.I.)

     I’m no expert at motivational interviewing. Actually, at a mere two years into my career, I’m not an expert at anything. Nevertheless, I’m grateful for having learned a little bit about M.I. over the past year. I truly believe in the power of this awesome skill. And today, I’d like to share some of that with you.

Start with WHY (Importance)

     Behavior change discussions can be challenging, but they can also be crucial. I don’t find many of my patients coming to see me as a physical therapist expect to have behavior change discussions. This can make broaching these conversations all the more challenging, and yet all the more enjoyable and effective. One strategy in motivational interviewing is to find out why, without asking “Why…?” Also, it’s good to use open ended questions. This is easier said than done. So, it’s helpful to have some go-to questions.

“If could do one thing this year to make it the best year ever, what would it be?”

     I have to credit my friend/boss @mikerjrpts for that one. I love this question for a couple reasons. First, it’s a BIG question. It’s really asking the patient to reflect on what is really important in their life. Importance is one of the ingredients of readiness. Secondly, it’s unexpected. Sometimes, patients will struggle to come up with an answer. That’s perfectly fine. By just asking the question, I hope I’m changing the patient’s expectations. I hope they are surprised. I hope they think that this healthcare experience will be something unlike any other. That can be very important for patients who have seen multiple healthcare providers without much improvement, and therefore come in with negative expectations. I’ve also been surprised by some answers. For instance, I recall one patient with shoulder pain answering “To quit smoking for good.” It’s hard to imagine a more impactful response and behavior to address. 

     The most vital part of motivational interviewing is listening. Ideally, you won’t have to broach the topic. The patient may do so themselves. Listen for change talk. These are words or phrases that highlight a patient’s desire for change. Then, reflect back to the patient what you are hearing. Be curious, not critical. Also, avoid should statements. Don’t “should” on your patients. That would stink.

The Scale Game

     After exploring motivations and determining a goal, it can be useful to have the patient rate the importance of their goal. Or play what I call, “The Scale Game.” Ask, “On a scale of 0 to 10, 0 being not important at all, and 10 being the most important thing in your life, how important is this goal to you right now?” I’ve never had a patient say zero, and it seems unlikely they would since they self-identified the goal. There are strategies if they do say zero. But, for the sake of brevity, I’m going to break one of the principles of M.I. and assume the patient says any number 1-10. My follow question then is, “That’s great. What makes it ___fill in with number patient said___ and not 0?” The objective here is to have them reflect on their motivations in relation to competing desires. Take note of any pros and cons the patient identifies.

Great, now HOW? (Confidence)

     The second ingredient to readiness is confidence. As mentioned earlier, knowledge alone is not enough to change behavior. We need skills too. A supportive environment is also tremendously helpful, but that’s another post for another time. Let’s imagine the patient has self-identified a goal. And that goal is really important to them. Now, the question is, “On a scale of 0 to 10, how confident are you that you will be able to accomplish your goal?” Again, let’s commit a cardinal sin of M.I. and assume they answer any number other than zero. If you’re following along, you know what’s next. The follow-up questions is, “Fantastic. What makes it ___fill in with number patient said___ and not 0?” The objective here is to have them reflect on their ability to accomplish their goal. Make note of any barriers and facilitators that the patient identifies.

Don’t Be a Hero.

     The last step in M.I. is to summarize the conversation succinctly and clearly, ideally using the patient’s words. Again, this is much easier said than done. It may help to break it up into steps. Start with the status quo, or the default future if no change is made. Follow with the expressed motivations for change, both pros and cons. Finish with identified barriers and facilitators to success. Then ask, “So, where does that leave you?” In other words, allow the patient to analyze the data and make a decision. Is it time to change? Maybe so, maybe no. Either way, it’s okay.

     Let’s again assume the patient is ready to change. Now what? Here is another excellent opportunity to empower the patient. Encourage them to create their own solutions. They will be more likely to follow through with them when they do. More often than not, the person most excited about your idea is you. So, let the patient be the hero. One way to do this is to ask, “Given all we’ve discussed, what do you think is one thing you can do starting today to help you make progress towards your goal?” This is my favorite way to prescribe home exercises, which don’t always have to be home exercises. I recall one patient answering, “I’m going grocery shopping once I leave here.” Maybe she was already planning on that though ¯\_(ツ)_/¯.

Summary

Do’s of M.I.:

• Ask open-ended questions
• Listen intently and reflectively
• Be genuinely curious
• Empower the patient

Don’ts of M.I.:

• Ask close-ended questions
• Make an ass out of you and me (Assume)
• Be judgmental or critical
• Don’t should on yourself or your patients. Remember, it’s not about the nail (if you click any link in this blog…make it this one…at least for entertainment’s sake).  
• Be a hero

I strongly believe M.I. is a worthwhile skill to continually refine because it:  

• Enhances therapeutic alliance
• Improves patient expectations
• Empowers the patient / boosts self-efficacy

I think we can all agree these are things we strive for in every patient interaction regardless of specialty or setting.

     I hope one take away from this post is that motivational interviewing is a nuanced conversation that can take significant time to do well. For that reason, I believe it is one of the most vital skills a physical therapist can have. Not only for the reasons listed above, but because we have the number one asset, time. Chronic disease is the leading physical and financial global health burden. It is largely preventable and even reversible through lifestyle intervention. This solution requires behavior change. Change is hard. And it starts with a conversation. 

     As always, thanks for all of the #WellfieWednesday support. And be sure to tag the WW crew members in your post (@PBernerSPT, @Eric_in_AmERICa, @AaronPerezPT, @DianaKlatt) and keep the wave of healthy change going!

- WW Crew

Wellfie Wednesday Tip #61: Support Victims of Hurricane Harvey

Happy Wellfie Wedenesday everyone! Thanks for joining this week.

     This week is about lending a hand to those in need. As we all know Southeast Texas has suffered major flooding these past few days and the rain hasn’t yet let up. This week’s tip is a small mixture of things and I wasn’t entire sure how to title it. So I made it more of a call to action to those who follow us. And that is Support Victims of Hurricane Harvey.

     Not to take away from the current devastating situation, but tonight as I write this, marks the 12th year anniversary of Hurricane Katrina. Being from New Orleans, my family and I were fortunate enough to not have lost all of our belongings as many of those in Houston have this week. But I have lived through the chaos that surrounds a storm. It’s no fun watching your city fall to pieces on the news, being separated from friends and family, living out of bag and prohibited from returning home for weeks, being referred to as a refugee, and living in the unknown, not knowing if things will get worse or better.

     That being said I do know that a little effort can go a long way. During these times and the long recovery period to come, those affected by this storm need our support. Whether it be time, money, a blanket, or simply prayer, anything can help. There are many websites and organizations out there with ways to do so. Here's a link with some to check out: https://www.charitynavigator.org/index.cfm…

     Be grateful for all you have, most importantly the people that surround you. As always, thanks for all of the #WellfieWednesday support. And be sure to tag the WW crew members in your post (@PBernerSPT, @Eric_in_AmERICa, @AaronPerezPT, @DianaKlatt) and keep the wave of healthy change going!

- WW Crew

Wellfie Wednesday Tip #60: Beyond the Traditional Benefits of Exercise!

Happy #WellfieWednesday friends!

     This week’s tip is brought to you by Eric (@Eric_in_AmERICa) and his take on the benefits of exercise. At this point the physical, mental, and emotional benefits of exercise have been well documented in numerous studies and articles, including our previous “Fitness vs Fatness” Wellfie Wednesday post brilliantly written by Aaron Perez. A simple Pubmed search on “benefits of physical activity” brings back over 16,000 results highlighting everything from improved cardiovascular function and decreased risk of falls, to improved symptoms of depression and decreased risk of dementia. However, I believe many of these articles miss one of the most important physical, mental, and emotional benefits of exercise: Building Resilience.

Merriam-Webster dictionary lists two definitions for the term Resilience:

1. The capability of a strained body to recover its size and shape after deformation caused especially by compressive stress

2. An ability to recover from or adjust easily to misfortune or change

     Let’s start with how exercise builds physical resilience in the body. Without getting too deep into the physiology, exercise is essentially the process of putting stress on muscles, tendons, bone, and other structures in order to break them down on a micro level so that your body can regenerate stronger tissues, capable of withstanding this increased load. The first definition refers directly to physical resilience as it presents in the body and how it can, with consistency, go on to improve strength, power, endurance, and other physical attributes.

     Physical activity builds greater mental and emotional resilience on several levels as it pertains to the second definition. The first step is the choice to move. Choosing not to exercise is easy and it requires little effort. Instead choosing to get up and move is already a small victory toward building resilience by deciding not to go with the easiest choice. As described above, the act of exercising introduces stress to your body and, over time, your tolerance for stress increases. Here’s where the magic happens- our brain is incredibly designed to transfer this effect from physical stress and also applies it to psychological and emotional stress! And so, as your strength, endurance, and other physical attributes improve, your tolerance for psychological and emotional stress also improve. Put simply, a hard workout makes it easier to tolerate other hard tasks in your life. Not to mention the endorphin boost that typically comes following a bout of exercise is a pretty beneficial mood enhancer! Check out the infographic below for more! 

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Stay strong, both mentally AND physically, friends!

     Give this week’s tip a try and let us know what you think! As always, thanks for all of the #WellfieWednesday support. And be sure to tag the WW crew members in your post (@PBernerSPT, @Eric_in_AmERICa, @AaronPerezPT, @DianaKlatt) and keep the wave of healthy change going!

- WW Crew

Wellfie Wednesday Tip #59: Get Your Stretch On!

     Happy Wellfie Wednesday! Welcome back. This week's tip comes from Diana (@DianaKlatt). So lets jump right in. Most people associate stretching with yoga or gymnastics, but it’s this misconception that gets people confused. Many people don’t seem to understand that stretching should be part of your daily routine, or at least part of your exercise routine.

     Most people spend the majority of their day sitting (in chairs, in the car, on a train, etc.) and thus end up with tight hamstrings, for example. Slowly over time this can lead to a reduction in your overall range of motion because of the elastic properties within your muscles and tendons. Regularly stretching can help prevent this! Stretching keeps muscles flexible, strong, and healthy – which all aid in maintaining proper range of motion for your joints.

     That’s not the only place you might start to notice issues if you’re not stretching. Lets say you’re working on your gym gains, lifting a lot, but not stretching at all. Over time that cumulative weight you’re lifting will cause a similar reaction of tightening and shortening in your muscles. See a pattern? Stretching isn’t just for yoga or for those that do sports that are demanding of flexibility, it’s for everyone – the average desk worker, bodybuilder, runner, weekend warrior, you name it – if you have a body, you should be stretching!

     When is the best time to stretch? After you’ve warmed up your muscles. Can you imagine trying to bend a noodle before it’s been cooked? No, it would snap in half. Stretching isn’t just going to work it’s magic overnight, for those that suffer from shortening hamstrings (ie everyone…) you can start by incorporating a bit of stretching into your daily routine, slowly working your way to being able to touch your toes but not forcing it. And once you gain that flexibility, don’t stop! Your body will revert back because muscles adapt to what you use them for, you can’t just expect your body to stay flexible once you get there.

     As always, thanks for reading. And be sure to tag the WW crew members in your post (@PBernerSPT, @Eric_in_AmERICa, @AaronPerezPT, @DianaKlatt) and keep the wave of healthy change going!

- WW Crew

Wellfie Wednesday Tip #58: Change Talk: Six Sources of Influence

     Happy Wellfie Wednesday! A few weeks ago, Aaron discussed #ScienceSecrets for health and longevity. The point of that post (#SPOILERALERT) was that knowledge alone is not enough to change behavior. Willpower alone is also not powerful enough to change behavior. So, what are the key ingredients to behavior change? That’s the topic of today’s post!

    Humans are hard. We’re amazingly complex in every facet of our being. Our behaviors are no different. Even our most mindless actions are the result of several sources of influence. Unveiling the sources of influence that affect our behavior can simplify our complicated lives. More importantly, awareness of these influences allow us to address each for a comprehensive behavior change plan. So, let’s reveal six sources of influence.

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From the book Change Anything: The New Science of Personal Success

1 & 2: Personal Motivation and Ability

     Willpower is usually where behavior change starts and often where it ends. Think about the times you’ve tried to make a lifestyle change. What inspired you to act? Was your motivation strong? If you got all the way to action, it’s likely your motivation was indeed strong! Which can then make it all the more upsetting when we fail to sustain our efforts.  Don’t fall into the willpower trap. Strong desire can be the spark that gets the fire started, but we need more than motivation to keep the fire burnin’.  

     So, tap into your personal motivation. Dig deep to find out what’s driving your desire for change. And get weird. I mean use descriptive language and paint a vivid picture of what the future looks like if you don’t change versus if you do change. Then, add some skill to your will. Be mindful of crucial moments. These are moments where you are most tempted to behave in ways that contradict your best intentions. Develop sayings and rules to follow during these crucial moments. Turn bad days into good data. Remember, progress over perfection. 

3 & 4: Social Motivation and Ability

     Maybe you’ve heard the phrase, “You are the average of the five people closest to you.” There is some truth to this. Humans are social beings. Much of our behaviors are influenced by our social connections. For example, obesity is in part a social disease. Sometimes our close friends might actually be accomplices to unhealthy behaviors. Recognizing this is half the battle. The other half can be more challenging. Crucial conversations can turn accomplices into friends. These discussions may be difficult to have, and you can’t expect everyone to support your change efforts. Ultimately, you may need to separate yourself from the unwilling. At the same time, you can discover new friends and support groups to encourage you. Think about a game of tug-of-war. You want as many people pulling towards your side to increase your chances of success. 

5 & 6: Structural Motivation and Ability

     The last sources of influence deal with our economy and environment. Humans are incredibly intelligent, and yet, indubitably irrational. That’s a lot of “I’s” (Shout out to the synonym function on Microsoft word). Our behavior is often influenced more by short-term pleasure than long-term consequences. Inverting the economy improves our likelihood to perform beneficial behaviors. Incentivize good behaviors, and raise the price on bad behaviors. Importantly, your incentives don’t need to be big. Your intrinsic motivation should be the primary incentive. Also, put some skin in the game. Humans are far more motivated to avoid loss than to receive a similar gain. In fact, there is a website dedicated to this “loss aversion” strategy https://www.stickk.com/ with all sorts of success stories.

     Finally, consider your environment. Our environment has an enormous influence on our behavior. It often works its powerful influence in subtle ways. For example, a larger plate size encourages us to eat larger portions. Similarly, the built environment has an influence on how physically active we are. The key is to first become aware of how your environment affects your behavior. Then, change your space to support your goals. Distance yourself from temptation. While “Out of sight, out of mind” may not always work, it will be much more successful than having frequent stare downs with temptation. Enhance your environment by providing visual cues of desired behaviors. For example, having your gym clothes already laid out in the morning may cue you to get up and put them on rather than keeping them in the closet. Write down your change plan. The simple act of writing it down dramatically increases your chances of success. It will also allow you to make changes. Expect to make changes. We are rarely successful with behavior change on our first attempt.  

Summary

     The goal of all the above is make the healthy choice the easy choice. Addressing all six sources of influence will greatly increase your likelihood of success. Check out the short YouTube video below to find out more! Reach out to the #WellfieWednesday crew and let us know what you’re working to change! Thanks for reading, and best of luck to you! And be sure to tag the WW crew members in your post (@PBernerSPT, @Eric_in_AmERICa, @AaronPerezPT, @DianaKlatt) and keep the wave of healthy change going!

Change Anything Stats: https://www.youtube.com/watch?v=DBIQLmESeU8&t=2s 

- WW Crew

Wellfie Wednesday Tip 57: No One-Size Fits All "Diet"

Happy Wellfie Wednesday folks! Welcome back!

     I cringed coming up with the title of this week’s piece, the term “diet” has become so skewed nowadays, and because of that, I try to avoid it at all cost. But none the less, people still refer to how they eat as a diet, especially when it is intended to reach a particular goal. We need to remember that everyone is different physically, metabolically, spiritually, and so forth. People have cultural preferences, likes/dislikes, intolerances, and allergies when it comes to food. Not to mention the differences in availability of foods, whether geographically or financially. It is virtually impossible for one “diet” to encompass all of that. So beware of those marketing promises.

Here are some quick general ideas to spot a poorly suggested “diet”:

• Significantly reduces caloric intake
• Completely cuts out entire food groups
• Replaces meals with supplements or specialty products
• Includes a bunch of pills or herbs

     The right foods are the foods that make your body feel good, as well as help make your blood values (glucose, cholesterol, etc.) and other measurements look good. Though there isn’t one special “diet,” an eating pattern focused around more colorful plant-based foods has shown to be beneficial for a majority of people. And the great thing about plant-based foods, you can build any meal you desire to meet your individual needs.

Eat for yourself, not by the rigid plan everyone else is!

     As always, thanks for reading. And be sure to tag the WW crew members in your post (@PBernerSPT, @Eric_in_AmERICa, @AaronPerezPT, @DianaKlatt) and keep the wave of healthy change going!

- WW Crew

Wellfie Wednesday Tip #56: Planning for... Failure?

Happy #WellfieWednesday friends!

     This week’s tip is all about planning. I know in previous posts we’ve talked about meal planning and routine planning but this is a little different. Today’s tip is about planning for failure.

     Wait...what? But this is #WellfieWednesday, where we share tips on crushing our goals and pushing our limits...why would we plan for FAILURE?

     The keyword here is planning (which is not to be confused with expecting) because realistically making life changes can be hard and sometimes we can all make mistakes. Mistakes and failure are a part of the learning process. Preparing for them in advance can not only soften the blow when they happen, but also prevent a speed bump from turning into a downward spiral that overshadows all of the positive progress that has been made.

     Common example: You start a new eating plan and it’s going great. You’re about a week in when suddenly your willpower is tempted by something that’s restricted on the plan, let’s say some ice cream. In a moment of weakness you take a bite and BAM diet is ruined → all progress is lost → might as well finish the whole pint → wallow in guilt the rest of the night. Rinse and repeat.

     The reality is that first bite of ice cream probably didn’t derail your whole diet…but setting your expectations too high probably did.

“The imperfect method you follow is better than the perfect method you quit.” Tim Ferriss

     Translation: eat some damn ice cream once in awhile if you want to! Just get back on track ASAP and focus on making progress toward your goals. Celebrate the small victories along the way and use them as momentum to keep pushing forward. PLAN for failure, do not EXPECT it. Expecting to fail is counterproductive and leads to apathy, indifference, and ultimately (wait for it…) failure!

     Expect to succeed, but plan for failure. As always, thanks for reading. And be sure to tag the WW crew members in your post (@PBernerSPT, @Eric_in_AmERICa, @AaronPerezPT, @DianaKlatt) and keep the wave of healthy change going!

- WW Crew

Wellness Wednesday Tip #55: Choose the Proper Footwear for Running

Happy Wellfie Wednesday! Welcome back!

     With summer comes longer hours of sunlight and shorter work days, allowing for more down time. In addition to this, many people are choosing to spend more time outside and pausing/canceling their gym memberships to workout outdoors. One of the most common hobbies to pick up during warmer weather is running. However, many people are not equipped to handle the change of running on a treadmill to running on a concrete surface. In the gym, it’s easy to get away with low support/high fashion athletic shoes. It’s easy to get swept up in the hype of the newest Nikes and Asics, after all, those are the athletic shoe standards, the cream of the crop… right? Wrong. There is so much more involved in picking a shoe for your needs!

     Choosing the wrong shoe can lead to injury (think IT band syndrome, shin splints, etc.) There are plenty of running stores with staff that are well trained to help you pick out your perfect shoe. For example, in Brooklyn, NY there is a store that has a treadmill inside, and you can discuss your fitness goals and demands with a staff member. They will look at your foot shape and bring out shoes they think would be best suited for you and then you can test them out by running on the treadmill. Brooklyn is not the only place that has this option! The Fleet Feet I frequent in California has a half track for you to test your shoes on. In fact, there are a lot of stores with these types of options. Check out the Top 50 Running Stores in America. 

     So, what factors are important to mention and consider when choosing the proper shoe?

1. Type of surface you will be running on.
2. Gait pattern and foot strike. Are you a supinator, pronator, or neutral? Do you tend to run on your toes? (Unsure? Take a look: http://www.runnersworld.com/tag/pronation)
3. Arch height and shape of your foot.
4. Material.

     1. The type of surface you are running on makes a huge difference in the kind of shoe you choose. There is major variation in the options available to you. If you are running on cement, it is more likely that you would benefit from a shoe with greater shock absorption to help absorb some of the impact of hitting a hard surface versus running in barefoot/Vibram shoes.

     2 & 3. The way your foot lands on the ground changes the type of support you need in your shoe. If you hit the ground more on either the inside or outside of your foot and do not accommodate to create a neutral pattern, you may cause yourself injury (i.e., ITBS, shin splints). An excellent way to check for this is to have your running assessed. You may also need to put different insoles in your shoes once you’ve chosen the proper shoe. For example, I run in a neutral shoe and opt to put in the green SuperFeet insoles for better arch support, rather than the ones that come with the shoe. It is also important to recognize that not everyone has the same foot shape. Some people have feet that are wider at the toes that require a wider toe box, some people have narrow ankles and need something that won’t slip off your heel as your run. Occasionally higher arches will cause the top of your foot to rub against the tongue of the shoe uncomfortably and require a different type of lacing than is typical for the shoe (http://running.competitor.com/2015/05/photos/3-ways-to-lace-up-your-running-shoes_128380).

     4. A lot of people seem to neglect material of the shoe. This may be the primary culprit of opting for a fashion athletic shoe versus the practical shoe. Up until recently, I was one of those people that were blindly loyal to Asics based on the appearance of the shoe and recognition of the brand name. I ran in them despite the fact that my feet would constantly overheat because they looked good. I have since learned better and now run in a shoe that is more breathable. 

     Overall, there are so many factors involved in making sure you’re in the right pair of shoes! I know we all want to look good, who doesn’t want to impress the strangers you see in the park with a sleek pair of shoes? But the most important thing is for you to feel good in your shoes! By feeling good, I mean feeling comfortable, not feeling fly because your shoes light up each time you take a step.

     Need help? Shoot us a message. Always happy to give out store recommendations or help direct you on the right path. We can also hook you up with some pretty knowledgeable Physical Therapists, who can help with choosing the proper footwear for running. 

     As always, thanks for reading. Be well. And be sure to tag the WW crew members in your post (@PBernerSPT, @Eric_in_AmERICa, @AaronPerezPT, @DianaKlatt) and keep the wave of healthy change going!

-WW Crew 

Wellness Wednesday Tip #54: GROUNDING BREAKING NEWS! #SCIENCE DISCOVERS #SECRET TO HEALTH & LONGEVITY

Happy Wellfie Wednesday! Welcome back!

That’s right! The cat is out of the bag. #Science has discovered 5 keys for health & longevity.

This is groundbreaking news! Ground breaking in the sense that we’re realizing this guy may have had it right long ago.

Hippocrates, Father of Medicine 460-370 B.C. 

And the major keys are *Drum Roll Please*

1.     Be physically active

a. “Walking is man’s best medicine” –Hippocrates.

b. The current physical activity recommendation for adults is 150 minutes of moderate activity, 75 minutes of vigorous activity, or a combination of both.

2.     Maintain a healthy weight

a. “Let Food be thy medicine and medicine be thy food” –Hippocrates

b. It’s near impossible to outwork an unhealthy diet. While physical activity plays a role here, we cannot neglect nutrition.

c. What’s a healthy weight? In the study linked below, they measured waist circumference. Generally, the recommendation is for men to be less than 40 inches, and women less than 35 inches.

3.     Avoid tobacco use

a. “Smoking sucks for health.” –Not Hippocrates

b. Okay, I don’t have Hippocrates quote about smoking. I don’t think smoking tobacco was invented yet. We’ve known for some time though that smoking is bad for us. I did some searching and apparently U.S. physician Benjamin Rush wrote about the dangers of tobacco use in 1798. During the 1920s the first reports linking smoking to lung cancer appeared (link). 

4.     Limit alcohol consumption

a. “Everything in excess is opposed by nature.” –Hippocrates

b. In other words, drink responsibly. Maybe that’s not quite a direct translation. Nonetheless, many of us have probably experienced alcohol in excess being opposed by our bodies. Interestingly, moderate alcohol consumption (no more than 1 serving a day for women, and no more than 2 servings a day for men) may have some health benefits.

5.     Sleep well

a. “Sleep and watchfulness, both of them, when immoderate, constitute disease.” -Hippocrates

b. Keeping in line with the last quote, moderation is key.  I think it’s safe to say lack of sleep is more of a common problem than excessive sleep for most of our busy American lives. It is recommended adults get at least 7 hours of sleep per night.

     These 5 behaviors are really powerful. Together, they were able to prevent 80% of heart attacks in men (link). The effect was cumulative meaning each behavior was beneficial on its own, and together the benefits compounded. Unfortunately, only one percent of study participants engaged in all 5 behaviors.

     Therein lies the point. We know what the essential behaviors for health are. We’ve known some of them for quite some time (Shout out to Hippocrates). However, knowledge alone is not enough to change behavior. And behavior change is the name of the game. That’s the real secret. Stay tuned for more on that topic in future Wellfie Wednesdays!

As always, thanks for reading. Be well. And be sure to tag the WW crew members in your post (@PBernerSPT, @Eric_in_AmERICa, @AaronPerezPT, @DianaKlatt) and keep the wave of healthy change going!

-WW Crew 

Wellness Wednesday Tip #53: Your Plate Size Could Matter!

Happy Wellfie Wednesday Folks! Thanks for joining us!

     This week’s tip is quick and easy. Your Plate Size Could Matter! Have you ever thought that the plate you’re eating off could be contributing to the amount of food you eat? If it hasn’t affected you, it surely has affected me. I remember when I first started college, moving into my own place, I for some reason wanted square plates, I thought they were cool looking, so I bought a set. The entrée plates were huge! And boy did I fill them up. Not saying it solely contributed the amount of weight I packed on during college, but I’m certain it played a role. Lately however, we’ve been using these smaller round plates, and it’s obvious that the food portions have been cut down.

     So what’s the point of this. For an odd reason, some of us have grown up with the notion of cleaning the plate, leaving nothing behind, eating it all regardless of feeling full. Which I, like most people I know, live by this. If your trying to cut back on portion sizes, changing your plate size could potentially help, if a calorie adjustment is what you’re looking for. Though, I think the more interesting gain from altering your plate size comes from swapping your entrée and salad plate. We traditionally load up our entrée plate with proteins and starches, throwing the highly important greens on a surface area of near nothing. Think about swapping those, loading up on your veggies instead, because there is surely nothing wrong with more plants.

     If you don’t end up making a plate swap, that’s fine, but try being more mindful about your plate size. Thanks for the support! And be sure to tag the WW crew members in your post (@PBernerSPT, @Eric_in_AmERICa, @AaronPerezPT, @DianaKlatt) and keep the wave of healthy change going!

- WW Crew

Wellness Wednesday Tip #52: Keep the Wave of Healthy Change Going! Happy 1 YEAR!

     Welcome folks! Happy Wellfie Wednesday! Today marks our ONE YEAR anniversary for starting #WellfieWednesday and boy are we excited to have made it this far. Since its’ start, we’ve seen hundreds of photo tags across Twitter, Instagram, and Facebook. What was once just two guys trying to spread a wealth of health information has turned into a greater team effort, and we are thankful for those whom have joined us.

     As a recap for those of you who may be recently seeing or using #WellfieWednesday, the initiative was basically started as a way to spread healthier habits, no matter how small or insignificant they may seem. Every single push towards a healthier you is an important one. Our hope is that these Wellness Sellfies (the Wellfie) create inspiration or encouragement to start or continue healthy habits, creating a community of health, and steering this ship (your family and your community) away from chronic illness.

     We’ve been told our tips are refreshing at times, coming from the point of view of a “real” person vs those social media famed fitness experts. Normalizing healthy ideas for the average Joe or Jane, again highlighting the smallest change makes a difference. Check out our latest hashtag posts to Instagram and Twitter below this article.

     Our tip this week is simple. We want your help in continuing to spread ideas and inspiration to those around you. So choose that healthy habit, snap a picture, tag it #WellfieWednesday, and give it a post.

     For those of you who have been with us since the beginning, with the continued dedication to spreading our message, we thank you. For those of you just joining us, welcome! And a special thanks to GetPT1st for featuring us as their Wednesday social media posts. We hope to inspire others together. Because only together can we make a difference.

     Thank you! And be sure to tag the WW crew members in your post (@PBernerSPT, @Eric_in_AmERICa, @AaronPerezPT, @fitnerdaimee, @DianaKlatt) and keep the wave of healthy change going!

- WW Crew 

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Wellness Wednesday Tip #51: Read a New Book!

Happy Wellfie Wednesday friends! Tip of the week comes from @Eric_in_AmERICa

     This week’s tip is simple, read a new book! With the ease of access to information that technology provides today, reading a book is a forgotten past-time that is often glossed over by cruising Facebook, watching a Youtube video, or skimming a blog (thanks for choosing ours by the way). Granted, some of the information printed in text can be outdated (looking at you, PT textbooks), and technology allows us to stay up to date with the latest information, but I would still argue that there are timeless classics like Dale Carnegie's How To Win Friends and Influence People whose principles are still applicable nearly a century after it was written.

     Pro Tip: technology is so awesome that you don’t even have to read books anymore, you can just listen to them instead. Check out Audible and it’s free alternative Overdrive in your phone’s app store. Overdrive is a free app similar to Audible, but rather than paying a monthly fee you can reserve books for free using your library card! Overdrive features both e-books and audiobooks that can be checked out as they are available. Full disclosure: I have found over the past few years of using Overdrive that many books I’m interested in checking out are not available at my library. I think it’s less of a knock on the app and more of a limited selection by my rural Maryland public library membership (C’mon Carroll County, get it together!)

     Two of the most impactful books I’ve read (or listened to) have both come in the past 6 months or so. The first is Grit by Angela Duckworth which examines how success is more determined by perseverance and passion than innate intelligence or having the right ingredients on paper. Duckworth illustrates this theory through research she performed on cadets at West Point and later by interviewing top performers in business, sports, and education. Fascinating read, especially for anyone going through a transitional period and struggling to see the light at the end of the tunnel.

     The second book is Mindset by Carol Dweck which examines how thought patterns tend to fall into two categories; “fixed” meaning that something is the way it is and can’t be changed, and “growth” meaning that any ability can be developed. Dweck illustrates how high achievers tend to fall into the “growth” mindset and often times can attribute their success simply to believing that their dreams were achievable. This book was utterly fascinating and dives deep into intrinsic vs extrinsic motivation, applications for raising children, and much more. Read it.

     So check out this week’s recommendations and let us know what you think! Or feel free to recommend some of your favorite books to help improve mindset, health, or wellness! Thanks again for all of the #WellfieWednesday support, be sure to post your pictures this week and tag the WW crew members (@PBernerSPT, @Eric_in_AmERICa, @AaronPerezPT, @fitnerdaimee, @DianaKlatt) and keep the wave of healthy change going!

- WW Crew

Wellness Wednesday Tip #50: Benefits of Traveling & Keeping Your Routine

     Welcome back and Happy Wellfie Wednesday! This week is brought to you by Diana and inspired by her recent travels.

     I have just returned from a trip to Italy and wanted to discuss the effects of traveling and your physical health. Many people are under the impression that when you travel you won’t be able to keep up with your fitness routine or that you will ignore your nutritional goals, but that’s completely untrue. During my trip, I found that I was far more aware of what I was eating, more active, and overall felt more invigorated and energized.

Physical activity. I’m not sure about all of you, but when I am home I walk a decent amount. I try to walk places if I can versus driving, which is pretty easy for me given that I live in New York City. While I was traveling I found that I was walking an average of 15 km (9 miles) a day! This was the best way for me to get around and see everything as well as preventing me from mistakenly getting on a bus or metro in the wrong direction and getting more lost. Traveling makes you more active of a person because you aren’t sitting at your desk working or studying! You are out and about, trying to explore as much as possible. And as a #WellfieCrew member, I obviously also brought theraband with me to keep myself active. They take up very little space and can be manipulated in so many ways for exercise. Backpacking also acts as an indirect method of exercise as you are carrying around all of your things while traveling between cities! In American standards, I am an early riser. In European standards, I am considered mad! I told a few of my hosts that I wake up at 6am to run almost daily and they were all completely shocked! This turned out to be a great time to go out as cities were silent and you could run on a path to see monuments and landmarks to avoid the masses and crowds during the daytime (for example, the Trevi fountain in Rome).

Nutrition. What’s the first thing you think about when you hear “Italy?” Pizza. Pasta. Cheese. Wine. Not things you typically associate with a healthy diet. Italy is notorious for eating an abundance of grains, dairy, and meats. You would think that I would have gained weight and felt unhealthy after having pizza daily, but it was the opposite! I found that everything tastes lighter and fresher, which I at first thought was just the fact that I was in a new country but in actuality, the quality of the food is better in the European Union. The EU has higher regulations and restrictions on their treatment and production of food products and thus the quality of the food on your plate is greater (in comparison to the United States). This is certainly felt in eating as you feel lighter and less weighed down by a nearly identical meals of pizza and antipasta (appetizer) in the EU versus the USA. (13 Ways the EU Beats the U.S. on Food Safety) On top of the quality of ingredients, I found that it was easier to keep track of what I was eating while traveling because it was harder for me to succumb and purchase my guilty pleasure foods (ie. Haribo fizzy cola gummies…) because of my weak grasp of the Italian language.

Expand Your Perspective. “To my mind, the greatest reward and luxury of travel is to be able to experience everyday things as if for the first time, to be in a position in which almost nothing is so familiar it is taken for granted.” (Bill Bryson) Travel gives you a chance to interact with new people and new environments, which ultimately gives you a greater perspective of things. You are exposed to other people and hear about the way that others live in their hometowns or you see how people live if you happen to go to smaller cities and villages. It gives you a perspective you would have otherwise never known, especially as someone from a dominant country (ie. the United States of America).

Mental Wellness and Stress Reduction*. We lead busy lives, constantly occupied, and always trying to increase our multitasking abilities. Travel is a great way to escape the stresses and commitments of everyday life, offering novelty and change in the form of new people, sights and experiences. Traveling has many advantages, with stress relief topping the list. With a short list of activities each day, freed up from the complexities of ongoing projects and relationships, the mind can reset, as does the body, with stress relief the main outcome. Humans thrive on novelty, and travel offers the complete package with new faces, sounds and sights. (Dr. Margaret J. King, https://psychcentral.com/blog/archives/2017/02/24/how-travel-can-benefit-our-mental-health/)

     Overall, traveling and vacation tends to be misinterpreted as purely for relaxation and doing nothing but it’s quite the contrary! You can relax and stay active, recharge and explore, and open your mind to new things, all from the simple act of traveling! “Investment in travel is an investment in yourself.” (Matthew Karsten)

*Longer article to come. I met many people in my travels that I have reached out to in order to collaborate to write about the effects of travel on the mind, body, and soul. Check back in a few weeks at klattalyst.com/thetraveleffect

     Thanks again for all of the #WellfieWednesday support, be sure to post your pictures this week and tag the WW crew members (@PBernerSPT, @Eric_in_AmERICa, @AaronPerezPT, @fitnerdaimee, @DianaKlatt) and keep the wave of healthy change going!

- WW Crew

Wellness Wednesday Tip #49: Personalize Your Fitness

Welcome back! Happy Wellfie Wednesday! 

     Following last week's post, Fitness vs Fatness, we wanted to keep the theme of Fitness going and highlight the benefit of choosing to do something you love. This week is brought to you by Aimee.

     All too often we have some new fitness trend or workout that makes its way through the ‘inter-webs’ that claims to have helped a person lose 10 pounds in one week (okay so maybe I’m exaggerating a bit but you know what I mean!) The reality is that while this might have worked for one person, or even a few hundred people it doesn’t mean that you have to do it, especially if you’re not the slightest bit interested!

     I think it’s safe to say that we know fitness is important for our health, but the question always remains “what should I do?” The answer here is: Do What You Enjoy! I cannot stress enough how important it is to find some sort of activity that you love because you are much more likely to stick with it!

     This is not to say that you should disregard weekly recommendations for strength training and aerobic exercise, but more to promote that if you can find an activity that meets some of those requirements, it bodes well for your long term success!

Here are 10 of my favorite activities:

1. Walking

2. Running

3. Hiking

4. Yoga

5. Basketball

6. Soccer

7. Golf

8. Obstacle course racing

9. CrossFit

10. Stand up paddle boarding

     My challenge to you this week: find an activity you love, take a picture of you doing the activity, and post it with #WellfieWednesday in hopes that we can inspire the masses to personalize their fitness!

     Thanks again for all of the #WellfieWednesday support, be sure to post your pictures this week and tag the WW crew members (@PBernerSPT, @Eric_in_AmERICa, @AaronPerezPT, @fitnerdaimee, @DianaKlatt) and keep the wave of healthy change going!

- WW Crew

Wellness Wednesday Tip #48: Fitness vs Fatness

Welcome back! Happy Wellfie Wednesday!

This week's tip is brought to you by Aaron Perez (@AaronPerezPT)

     Today, I’d like to share some good news. At times that seems rare in a fitness industry and “health care” (sick care) system that frequently sells us on everything “wrong” with ourselves.  

Warning: We’re about to talk research. Bear with me while I nerd out. 

     I recently learned about this study looking at the relationship between physical activity, body mass index, caloric intake, and heart disease mortality. The researchers followed nearly 10,000 people over a 17 year period. Least physical activity and obesity were independently associated with higher heart disease mortality. Interestingly, those who ate the most calories had reduced heart disease mortality, but this was not significant after adjusting for physical activity and obesity. This graph from the article summarizes the info nicely. 

View fullsize

     The bars represent groups of people based on physical activity, BMI, and percentage of people with the lowest calorie intake. The lower the bar, the less heart disease mortality seen in those groups of people. Compare the bar on the lower left (skinny but unfit) to the bar on the upper right (fat but fit). The rate of heart disease mortality was about equal for those two groups. Several more recent studies (link, link, link) support these findings.

WTF is the point, Aaron???

     We’re getting there! The authors conclude the greatest practical advice from their findings is this: focusing on calorie burning via exercise, rather than reducing caloric intake, may offer the most productive strategy to avoid falling victim to the number one killer in the world, heart disease. In other words, being fat and fit is better than being unfit, period. This is an uplifting message for those exercising diligently to lose weight, but not seeing results on the scale. If you are working to improve your fitness, your body is likely becoming healthier…regardless of what that stupid scale might say…So keep going!

     Please, don’t hear what I’m not saying. Obesity is still a very important risk factor to address for your health. But, if weight loss is your goal, you cannot neglect nutrition. Combining exercise with good nutrition is essential for substantial and sustainable results. Media such as the T.V. show “The Biggest Loser” have popularized exercise for weight loss. However, it is much more difficult to burn calories off than to not consume them in the first place. To their defense, it probably wouldn’t make for a great T.V. show to just see clip after clip of folks consistently not overeating. 

I leave you with this. A nice short summary of all the above. 

     Thanks again for all of the #WellfieWednesday support, be sure to post your pictures this week and tag the WW crew members (@PBernerSPT, @Eric_in_AmERICa, @AaronPerezPT, @fitnerdaimee, @DianaKlatt) and keep the wave of healthy change going!

- WW Crew