Wellfie Wednesday Tip #80: How to be Successful with Your 2018 Goals!

Welcome back! Happy Wellfie Wednesday! This week is brought to you by Alyssa @kuhnalyssa_spt.

     Most people tend to think about creating a set of goals when the new year hits, a majority of them addressing some aspect of health and wellness. Some adhere to these goals and succeed in accomplishing these throughout the year, while some tend to fall off the wagon after about a month or two. The question is, how can we prevent this from happening? How can we keep people committed to improving their health? It is relatively common knowledge that exercise is good for us and has an overwhelming number of health benefits. It can also prevent many diseases and decrease the risk for hospitalization in people of all ages-so we need everyone to stay on board. There are a few strategies that I have come across that can help you stay on track if you find yourself falling off the wagon come February and March.

1.     The most effective, in my opinion: Find someone you can work with to stay accountable. It can be a friend, coworker, family member, significant other, personal trainer, etc. When you have someone who is counting on you to show up to the gym or to enter your food log, many people are more likely to be successful. When you don’t want to show up to the gym or when you want to eat those cookies in the office, having someone that is counting on you to stay committed can really help you in those times of difficulty. If there isn’t someone that comes to mind that could help, going to group exercise classes or joining an online group of people with similar goals can also be very effective!

2.     Keep a calendar and have a plan: sometimes physically writing down or typing out a plan can help you stay on track. For example, writing out days you will work out and the workouts you will be doing can be helpful on the days that you don’t feel like going to the gym because you don’t know what you will do when you get there. Also planning something that help you mentally prepare to accomplish it that day instead of always making decisions on the fly.

3.     Be prepared. Many people tend to make unhealthy food choices when they are in a hurry or when they don’t have the energy to prepare a lunch or a dinner and need something quick. Meal prepping is such an easy way to help combat this! Taking 1-2 hours on the weekend or in the beginning of the week to prepare healthy meals is SO worth it. When you have everything prepared and already made, you are much more likely to stick to a plan!

4.     Have an open mind. Sometimes people tend to stop exercising due to pain they are experiencing and automatically go down the rest and medicate route. For most musculoskeletal injuries, rest can actually make things worse! Our bodies are meant to move and medication seems to just mask the problem. Having an open mind to other ways to address pain is key to your success with your health goals! When people fall into long periods of rest, it is so much harder to get back into the swing of things. Seeking help right away for guidance as to how you can ACTIVELY manage your pain can be huge in maintaining compliance with your goals. Low back pain is a great example. There are many people that experience low back pain in their daily lives. For most chronic situations, movement is actually the best treatment but some turn to passive treatments such as medications and sedentary lifestyles. Finding a licensed professional you trust to give you a structured and safe exercise program can help you improve your pain and prevent it from reoccurring!

     Keeping these 4 strategies in mind, hopefully we can all stick to our goals and keep living our best lives strong, healthy, and pain-free! 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 (@TheFuelPhysio@Eric_in_AmERICa@AaronPerezPT@DianaKlatt@kuhnalyssa_spt) and keep the wave of healthy change going!

Wellfie Wednesday Tip #79: Staying Healthy During Air Travel

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

     I am writing this week’s #WellfieWednesday from an airplane on my way to Australia! I am somewhere in hour 25-30 of this 30 hours of travel from the United States of America.  I can tell you that I am not looking forward to my next long flight any time soon but it will be coming up shortly. But let’s get to it, how did I prepare for the toll that much air travel was going to take on my body? There are two things I think that you can easily prepare for and work on while on-board: blood circulation and hydration.

     Most of us are probably economy class fliers, so I will discuss the effects of sitting in these types of seats. Sitting in a small, narrow seat with limited legroom isn’t the most comfortable thing for even the smallest of people.

     Blood circulation is restricted during flight because you are sitting in an upright position with your feet flat on the ground. This doesn’t put you in an optimal position for easy blood flow, it’s a position that frequently leads to swelling in your feet due to that angle of sitting and state of inactivity. (This is why you always want to take your shoes off on the plane! Your feet are swelling from lack of proper blood circulation.) So what can us economy and business class fliers do about this? (Since both these sections don’t have seats that allow you to lay down.)

1. Get up and walk around! I’m going to be completely honest, I am that person that walks up and down the aisles doing lunges every few hours. On this last flight I also happened to have a resistance band in my pocket so I did a little bit of exercise to get my blood flowing. Below is also an image of exercises you can do while seated. 

2. Wear compression stockings! This will help prevent blood pooling in your legs and help with swelling.

3. Wear comfortable and lose fitting clothing. You don’t want to wear clothes that cause any restrictions. You are already working against your posture, the lower levels of oxygen, and inactivity, you don’t need to add an extra factor.

     Blood circulation is not the only problem associated with flying! Think hydration! Due to the cabin pressure and recirculated air, your skin can slowly become very dry and you may feel symptoms of dehydration. What’s the best way to combat this? Drink water! You can’t bring water through airport security but you can bring an empty water bottle. Make sure you drink more water than you normally would when you’re on the ground. You can also drink whatever juices you may want but try to avoid alcohol (even if it is free on international flights… resist the urge!). Another thing, that I and many of my friends do, is to bring a sheet mask! These are full of hydrating serums and easily packable. You can pop it on before you go to sleep and take it off when you wake up with a nicely hydrated face.

      Remember these tips on your next flight! 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 (@TheFuelPhysio@Eric_in_AmERICa@AaronPerezPT@DianaKlatt@kuhnalyssa_spt) and keep the wave of healthy change going!

- WW Crew

Wellfie Wednesday Tip #78: Anti-Goals: What Do You NOT Want in 2018?

Happy Wellfie Wednesday! Welcome back! This week's post is brought to you by @AaronPerezPT. Enjoy! 

     2017 is winding down, and so the time for reflection and planning for 2018 is upon us. One question I love to ask patients is "If you could do one thing next year to make it the best year ever, what would it be?" I love this question for lots of reasons, and it certainly seems like an appropriate time of year to be asking that of ourselves and others. However, I'm always trying to find ways to ask better questions. A recent EIM Leadership Podcast with Daphne Scott about Anti-goals got me thinking…

Picture21.jpg

(I STRONGLY recommend listening to that podcast as Daphne describes these concepts far better than I can).

     For better or for worse, the majority of us are more motivated to avoid loss or discomfort than to seek additional benefits. This is especially true when those extra benefits are long-term results while the discomfort is a short-term consequence. We're hard-wired to focus on things we despise. So, why then do we set goals for things we desire? Would reverse engineering our goals motivate us more to take action and achieve them? 

Anti-goals

     If next year were the worst year ever, what would that look like? Did you find this question easier or harder to answer than the previous question about "your best year ever?" Perhaps the long-term nature of these questions is difficult to grasp. So, let’s bring a factor of immediacy to the question. "What about yesterday did you love?" versus "What about yesterday did you hate?"  

     I think asking both case scenarios, and comparing that to our "default future" or what is likely to occur if nothing changes, can be powerful. The worst case scenario might evoke feelings of discomfort or anxiety which motivates our short-term behavior. It might also bring about a perspective of gratitude for the present moment. The best case scenario may evoke feelings of excitement and hope which are also important motivational fuels. The default future might connect the dots in realizing how well are current behaviors align with our desired experiences. What, if anything, needs to change? 

     So, as we're setting goals for 2018, I encourage us to set some anti-goals. What about your day do you despise? What are your pet peeves? What does your worst day look like? What does it feel like? Write out a list as long as you'd like. But, don’t stop there! The absence of what you don’t want does not guarantee the presence of what you do want. So, next ask yourself what behaviors are needed to avoid those despised experiences, and make your desired experiences more likely. Then, voilà, you’ve created anti-goals.

     There you have it. By thinking about our problems differently, we can come to more actionable solutions. We wish all of you a healthy and happy 2018! 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 (@TheFuelPhysio@Eric_in_AmERICa@AaronPerezPT@DianaKlatt@kuhnalyssa_spt) and keep the wave of healthy change going!

Cheers,

-WW Crew

Wellfie Wednesday Tip #77: Lifestyle Changes to Reduce Heart Disease Risk in 2018

Happy Wellfie Wednesday! This week is brought to you by Alyssa (@kuhnalyssa_spt).

     According to the Center of Disease Control and Prevention (CDC), about 610,000 people die of heart disease each year- that’s 1 in 4 people! Heart Disease remains the leading cause of death in both men and women and coronary artery disease (CAD) takes the cake as the most common form of heart disease. So what causes it?

     Many people used to believe that arteries became “clogged” due to high consumption of saturated fats- commonly found in animal and dairy sources, along with highly processed foods. When arteries get “clogged”, the clots can burst and travel to the heart causing ischemia of the blood- aka a heart attack. The British Journal of Sports Medicine (2017) recently discovered that saturated fats may not play a large part after all.

     A recent meta-analysis found that there was no association between saturated fat consumption and (1) all-cause mortality, (2) coronary heart disease (CHD), (3) CHD mortality, (4) ischemic stroke or (5) type 2 diabetes in healthy adults. Interestingly enough, another study found that in postmenopausal women with coronary heart disease, greater intake of saturated fat was associated with less progression of atherosclerosis (“clogging”), whereas carbohydrate and polyunsaturated fat intake were associated with greater progression. It has also been found that instead of looking to levels of LDL, typically deemed as “bad” cholesterol to determine risk of CAD, the ratio of total cholesterol (TC) to HDL cholesterol (“good”), has been shown to be the best predictor of cardiovascular risk.

But what does this tell us?

     Fat may not the enemy in our diets. It turns out that a high fat, Mediterranean diet (vegetables, nuts, extra virgin olive oil, oily fish) improved outcomes for recurrent myocardial infarctions and all-cause mortality discovered in the Lyon Heart study. We also need to find ways to decrease the TC to HDL ratio in order to diminish risk of CHD.

So, what do we do?

     It’s been shown that replacing refined carbohydrates (highly processed foods) with healthy high fat foods (notably plant fats and vegetables can decrease the TC to HDL ratio significantly. Physical activity can also play a part as those who walk briskly at or above 150 minutes/week (22 minutes per day) have been shown to increase their life expectancy by up to 3-5 years compared to physically inactive adults!

Overall, the two simple ways to reduce your risk of CAD and help to keep your heart healthy:

1.     Eat REAL food. Decrease the amount of refined carbohydrates and processed sugars. Stay in the outer perimeter of the grocery store!

2.     Get moving! Walk 22 minutes a day (which is only 2% of your day!) to keep your heart strong!

     Give it a try this upcoming new year! 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 (@TheFuelPhysio@Eric_in_AmERICa@AaronPerezPT@DianaKlatt@kuhnalyssa_spt) and keep the wave of healthy change going!

- WW Crew

 

References:

Malhotra A, Redberg RF, Meier P. Saturated fat does not clog the arteries: coronary heart disease is a chronic inflammatory condition, the risk of which can be effectively reduced from healthy lifestyle interventions. Br J Sports Med. 2017;51(15):1111-1112. 

Wellfie Wednesday Tip #76: Get Your App On! (Breathing/Mind)

Happy Wellfie Wednesday! This week is brought to you by Patrick (@TheFuelPhysio).

This tip was inspired by a recent twitter feed, as many things are. I won't go into the many health benefits of deep breathing, meditation, and mindfulness. Check out a past tip (#39: Just Breathe) for some info though. The following are iPhone or android apps that can help you start with practicing meditation, mindfulness, or beep breathing, each with its' own unique features. 

  • Headspace - Guided Meditation and Mindfulness
  • Breathe Deep - Personal Assistant for Breathing Meditation, Pranayama Breath, and Ujjayi
  • Universal Breathing - Pranayama
  • Prana Breath: Calm & Meditate
  • Paced Breathing - Includes a vibrating cue feature
  • Stop, Breathe, Think - Guided Meditation and Mindfulness
  • Buddhify - Modern Mindfulness for Busy Lives

I don't have any personal bias for any of these, I'v heard several positive things for each of them. So find which one works best for you. Enjoy!

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 (@TheFuelPhysio@Eric_in_AmERICa@AaronPerezPT@DianaKlatt@kuhnalyssa_spt) and keep the wave of healthy change going!

- WW Crew

Wellfie Wednesday Tip #75: Egg-cellent or Egg-stra Dangerous?

Happy Wellfie Wednesday! Welcome back. This week's tip is brought to you by another guest promoter of health (@FScottFeil_DPT)! 

     Hello all, F Scott Feil, PT, DPT here and I am so thankful and excited to be writing a guest blog post for the Wellfie Wednesday Crew. I use their blog as the basis for my Wednesday blog posts on PTEducator.com because they generally always have a good tip on there. So without further ado my blog post is entitled: Wellfie Wednesday Guest Blog Post: Egg-cellent or Egg-stra Dangerous?

     One of the difficulties I found when trying to get healthy was all of the conflicting information out in the world. The internet has become a great resource for those trying to live a healthy lifestyle, but you have to do your research. One week butter is good for you, the next week it is bad for you. One week avocados are the devil, the next week they are a savior. At the end of the day, you have to do your own research and figure out why a particular food source may have benefits or risks, and make your own well informed decision as to whether or not you are going to consume said food item.

So Are Eggs Good For You or Bad For You?

     One of my initial quandry's led me to the question of whether or not eggs were good for you or bad for you. It turns out that eggs are a nutrient-dense food. They are a high-quality protein source, meaning all nine essential amino acids that can't be made by humans can be found in eggs. The protein in eggs can be helpful in building and preserving muscle mass which is important for weight control.

     Eggs are also a good source of vitamin D and the nutrient choline, which has been shown to help protect against infantile birth defects. Eggs also contain vitamin A, vitamin B12, riboflavin (B2) and the antioxidant selenium, as well as lutein and zeaxanthin, which have been shown to have links to healthy eyesight.

     Most the calories, vitamins, and minerals in an egg are are located in the yolk. But what about the cholesterol in eggs? It is true that eggs are high in dietary cholesterol, which is also mainly found in the yolk, however it has been found that dietary cholesterol alone has little effect on  raising blood cholesterol levels. 

ONE THING I LEARNED TODAY:

     The thing regarding eggs that will likely affect your health most is how the eggs are prepared, as well as which other foods you combine with them. I used to eat 3 eggs scrambled, on a hero, bacon, sausage, ham, salt, pepper, ketchup (approximately 1100 calories). One large poached egg has 71 calories and 2 grams of saturated fat. An omelet made with spinach and one yolk is also a more lean choice. So feel free to enjoy eggs, but be mindful of how you prepare them. And as always, balance eggs with other healthy fiber-rich foods such as fruits, vegetables, and whole grains. I have attached a simple healthy, Whole30 Compliant (for those of you who enjoy Whole30 meals as well) recipe that I now make with eggs on occasion. This recipe will be featured on my Foodie Friday Blog at PTEducator.com, but you guys will get a sneak peak of it a few days early!

EGG WHITE VEGGIE BAKE RECIPE

6 eggs (whites only)
1 conatiner baby spinach
1 container baby bella mushrooms (or mushrooms of your choice)
1 tomato finely chopped
1 yellow onion finely diced
4 tablespoons ghee
4 cloves of garlic finely chopped
salt and pepper to taste

Separate your 6 eggs (whites from yolks, dispose of yolks or do with them what you will). Saute spinach, garlic, mushrooms, and onions in 3 tablespoons of ghee. Coat a baking dish with final tablespoon of ghee (especially edges). Add eggs, sauteed vegetables, diced tomatoes to baking dish. Bake at 350 degrees for 15-20 minutes or until eggs have completely cooked. Enjoy!

F Scott Feil is the founder and owner of PTEducator.com, a website aimed at increasing the public's health literacy through a daily blog. He is also the co-host of The Healthcare Education Transformation Podcast and The Fantasy Doctors NBA Podcast.

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 (@TheFuelPhysio@Eric_in_AmERICa@AaronPerezPT@DianaKlatt@kuhnalyssa_spt) and keep the wave of healthy change going!

- WW Crew

Wellfie Wednesday Tip #74: It's Good to be Good, Pt. 2

Happy Wellfie Wednesday! Welcome back! This week's post is brought to you by @AaronPerezPT.

     My last post on #WellfieWednesday discussed the health benefits of giving. Considering yesterday was #GivingTuesday and last week was Thanksgiving, I thought I’d continue with that theme.  I won’t rehash all the super awesome health benefits of giving, but just know that there are lots. If you’re really interested, check out this ted talk, this podcast, or website.  

giving tuesday.jpg

     Instead, I’ll keep this short and sweet, and simply ask you wonderful readers to give to an awesome charity that does a lot of good for a lot of people. That charity is STAND: The Haiti Project. STAND stands for Sustainable Therapy And New Development. A few times a year a fun-loving, caring, and passionate multidisciplinary healthcare team provides medical services to the people of Haiti who otherwise would not receive them. I was fortunate to have recently volunteered with this group and can personally attest to the amazing work that they do.

     #GetPT1st's own @SeanHagey recently started a fundraiser supporting STAND. As of writing this post, he is only $200 away from his $1,000 goal. Hopefully, this post inspires you to donate to his cause supporting STAND. Whether you donate to STAND or another charity, thank you.

Give a little, and get so much more in return. Have an awesome week! 

     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 (@TheFuelPhysio@Eric_in_AmERICa@AaronPerezPT@DianaKlatt@kuhnalyssa_spt) and keep the wave of healthy change going!

Wellfie Wednesday Tip #73: Be Thankful of the Relationships You Have!

Welcome back! Happy Wellfie Wednesday! And Happy Thanksgiving Eve! 

     This week's post will be short and sweet, as many of us are most likely gearing up for time with family and friends. And that is exactly where I want to bring attention to this week. Relationships and the social connections you have with friends and family play a significant role in your health. Yes, what you eat and how you move contribute factors as well, but more recent emerging research has indicted that relationships, specifically strong close relationships affect your health, quality of life, and longevity. Check out this TED talk on Face-to-Face Contacts (Not Facebook Connections). And if you're more into reading, check out one of these two studies that found social isolation and loneliness to be risk factors of increased mortality - Study 1 / Study 2. 

     So tomorrow, this week, and everyday for that matter, be THANKFUL for the relationships and people you have around you. And keep them close, as you never known when you'll need a shoulder to lean on.

     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 (@TheFuelPhysio@Eric_in_AmERICa@AaronPerezPT@DianaKlatt@kuhnalyssa_spt) and keep the wave of healthy change going!

 

Wellfie Wednesday Tip #72: Don't Get Overstuffed (Thanksgiving is Upon Us)

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

     Thanksgiving is coming up and if you’re like me, you’re probably excited to eat an entire pecan pie by yourself… but this year, I will refrain and attempt to eat just half a pie.

     The average American consumed 3,000 calories during their holiday dinner.  To put that into perspective, the average person eats 1,500-2,500 calories a day, give or take based on body type and level of activity. And that’s in a DAY. Thanksgiving dinner is a whole different situation, that 3,000 calorie count is a single meal. Now, before you get on me for spouting diet propaganda and saying that we should all be crazy calorie counters hear me out. I don’t believe in cheat days. I don’t believe in meticulously counting calories. And I believe that if you want to eat something, you should just eat it – but in moderation. MODERATION is what we should be focusing on.

     Many of us look forward to this day as a day for indulgence. Maybe we don’t think about the quality of our ingredients. Maybe we ignore the fact that our potatoes have 3 sticks of butter. Maybe we pretend it’s okay to just eat equal ratios of marshmallows and sweet potatoes in a single bite. I’m not saying we should give all those things up, but we can be much more aware of WHAT and HOW MUCH we are putting into our bodies.

OVEREATING AND PORTION CONTROL

    There is no need to just forgo the meal all together. All I’m saying is maybe you don’t need that third and fourth serving… The tradition we have of sitting down and overeating is quite unique to our nation. We all tell ourselves that this amount of overeating isn’t something we typically do and therefore it is okay… well, that is incorrect. Your body reacts to anything you put into it so when you overeat, your digestive system automatically takes action and starts to work on that massive amount of food you just ate; your insulin production increases to work with the excessive sugar you’ve consumed, your liver starts working to break down the extra fats, and the blood flow in your body is redistributed so there is more going towards your intestines and therefore less blood flow going anywhere else (like your brain)! Which is explanatory of why we get the feeling of being bloated, being gassy, sleepy, etc. You body is trying to accommodate for all those nutrients! So rather than making malaise the target of your meal, eat until you are comfortably full. It’s okay if you didn’t get to try everything, no one will get offended if you are too full and leftovers are just as good (if not better)!

     Don’t over eat on Thanksgiving just because you can. 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 (@TheFuelPhysio@Eric_in_AmERICa@AaronPerezPT@DianaKlatt@kuhnalyssa_spt) and keep the wave of healthy change going!

- WW Crew

Wellfie Wednesday Tip #71: Lets Pick Up the Pace!

     Happy Wellfie Wednesday! Welcome back! This week is brought to you by the Wellfie Crew's newest crew member, Alyssa Kuhn, SPT (@kuhnalyssa_spt), whose a 3rd year doctor of physical therapy student at The Ohio State University. She has a strong interest in the prevention and wellness aspect of PT, especially in the geriatric population. She loves continuing to find ways to help people get up and stay moving! As well as an avid crossfitter and a lover of all things Michigan State. Go green!

It’s time to pick up the pace with step counting!

     How many times have you heard people trying to reach 10,000 steps each day? Hopefully quite a bit because this is awesome! Keeping people moving is one of the easiest ways to stay healthy and combat chronic disease. But is this actually helping us meet our health goals? What if there was another way to approach this theory? Some are questioning whether intensity and duration of intensity when walking can lead to greater health benefits than simply the number of steps taken or the distance you’ve walked.

     Glancing at the current Physical Activity and Public Health guidelines from the American College of Sports (ACSM) and American Heart Association (AHA), it is recommended that American adults aged 18-65 years should continue to accumulate at least 30 minutes of moderate-intensity aerobic activity 5 days per week (instead of "most days of the week") OR engage in 20-minutes of vigorous activity 3 days per week. These have been around for a while now and guidelines for older adults are almost identical.

     Interestingly though, in 2007, the ACSM and American Heart Association (AHA) released clarifications to the recommendations further stating… 

Activity must be at least 10 minutes in duration to count towards daily goals (30 minutes) and that a combination of vigorous and moderate-intensity physical activity is acceptable

     Want to know a SUPER SIMPLE way to make sure you are hitting these 10-minute bouts? Public Health England has you covered. They have created a FREE app titled Active 10 through their health promotion campaign, “One You”, that is available on most Android and iPhone models to specifically track how much time you spent in “brisk” walking. They define brisk walking as a pace in which you are beginning to become slightly out of breath, a likely average speed ~3 miles per hour. They have coined these bouts “Active 10s” when you have reached 10 consecutive minutes of brisk walking tracked using the motion sensors on your phone. Many people find it much easier to stay accountable when they know their results are being tracked. I propose that even physical therapists or other health professionals can use this as a way to easily track their patient’s activity levels.

walkign.jpg
step counter.jpg

     Don’t have a smart phone? You can easily use a watch to time yourself walking at a slightly quicker pace!

How can more walking easily fit into daily life?

  • Taking breaks at work to walk at lunch, outside, or around the office
  • Parking in the furthest spot in the parking lot
  • Walking with pets
  • Walking with children to the bus stop or to the park
  • Walking to class on a university campus
  • ….there are so many ways!

ITS TIME TO GET MOVING (BRISKLY)!

Don’t get me wrong, getting people to move is the ultimate priority and this is just a way to take it a step further.

I am by no way endorsed or have any involvement with this campaign or with Public Health England, I just think this app is awesome 😊 - Alyssa 

     So pick up the pace the week! 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 (@TheFuelPhysio@Eric_in_AmERICa@AaronPerezPT@DianaKlatt@kuhnalyssa_spt) and keep the wave of healthy change going!

- WW Crew

 

References:

Haskell WL, Pate RR, et al. Physical Activity and Public Health: Updated recommendations for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;38(8):1423-34.

To find out more information about Active 10: https://www.nhs.uk/oneyou/active10/home#G4VTwkQcEL6y1wWI.97

 

Wellfie Wednesday Tip #70: Don't Let Food Labels Confuse You!

Happy Wellfie Wednesday! Welcome back! This week brought to you by Patrick (@PBernerSPT). 

     This week's tip highlights one of the many things wrong with how companies label their food products. It's an issue I have been aware of for quite some time, but this post was sparked when I came across Peel Back the Label, a movement aimed at separating facts from fear mongering in food labeling (@PeelBackLabel). "Consumers have a right to both truth and transparency in food labeling. It’s time to peel back the label on deceptive marketing tactics." And that's really what some companies are doing with their labeling. They utilize the latest buzz words to draw in consumers, phrases such as "Gluten-free" "GMO-free" "No Hormones Added" are used time and time again, even when the products will never contain them anyway. You've probably noticed "Gluten-free" being placed on literally everything now, even fruits and vegetables. Though gluten is the protein portion of wheat flour, providing structural characteristics to baked goods, and will hardly ever be found elsewhere. 

     However, my favorite misleading claim is "No Hormones Added," especially when added to poultry/chicken products, as it is ILLEGAL to sell poultry in the United States that was raised with added hormones. From the USDA: "Hormones are not allowed in raising hogs or poultry. Therefore, the claim "no hormones added" cannot be used on the labels of pork or poultry unless it is followed by a statement that says "Federal regulations prohibit the use of hormones."" If you were to look close enough on your packaging, you'll notice the claim followed by ** and than that federal regulation phrase in small print, likely hidden somewhere else. 

     Take a closer look at what you're buying and let us know what you find. 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 #69: Omega-3s for Heart Health

Happy Wellfie Wednesday! 

     Welcome back! This week is brought to you by Patrick ( @PBernerSPT ). These past few days I had the pleasure to spend time at the annual Food & Nutrition Conference & Expo #FNCE in Chicago, an amazing experience every year that I go, though as the Academy of Nutrition and Dietetic's 100th year, it was above and beyond. And I could go on and on about the things I learned and new connections that were made, but as you are our Wellfie Wednesday audience, I digress. 

     This week I do want to share though information from one of the presentations that I attended,  THE BEAT GOES ON: THE LATEST ON OMEGA-3 HEART HEALTH RESEARCH. I'm also going to share it in an unordinary fashion, by only showing you the handouts that were provided, which contain quite a bit of beneficial information, the last one being my favorite. Enjoy!

     Find a way to increase your Omega-3s and let us know how it goes! 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 #68: Walk with a Doc

Happy #WellfieWednesday friends!

     This week is brought to you by Eric (@Eric_in_AmERICa). I wanted to highlight a great resource, www.WalkWithADoc.org. Walk With A Doc uses a simple, yet powerful concept to empower and educate patients to improve their health. Via their website: “Walk with a Doc was started in 2005 by Dr. David Sabgir, a cardiologist in Columbus, Ohio. Frustrated with his inability to affect behavior change in the clinical setting, Dr. Sabgir invited his patients to go for a walk with him in a local park on a spring Saturday morning. To his surprise, over 100 people showed up, energized and ready to move.”

     How does it work? A provider sets up a date, time, and location to meet, gives a brief presentation, then goes for a walk with participants who are interested. The concept is beautiful in its simplicity. By eliminating the cultural barrier between patient/client/customer and healthcare provider, you create an open line of communication where people can finally ask those nagging medical questions that they’ve been avoiding (or asking Dr Google) for so long. Furthermore, it allows individuals an opportunity for simple health screenings, such as blood pressure checks, which may increase the likelihood of catching and preventing more serious health issues down the road.

     Since its inception, Walk With A Doc has grown to over 300 chapters across the US, Europe, Asia, and Australia so it’s likely that there’s an event you can join in a city nearby. If not, have no fear, WWAD makes it incredibly easy to start an event in your town by offering marketing materials, a “how-to” guide, and even a few t-shirts to promote your event!

     So give it a shot and let us know how it goes! 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 #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. 

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     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. 

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     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.)

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.

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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.

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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.

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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)

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     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.

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     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.

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     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)_/¯.

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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.:

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…

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     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