Category Archives: Exercise

Back Pain and Exercise


In sessions, I hear a lot about chronic pain, particular back pain.  Many folks are  becoming more and more skeptical to the use of pain killers with all the headlines about the opioid epidemic.  They want to look at other options for pain and/or reduce their personal use of opiates and other pain killers.  Exercise comes up with mixed thoughts and feelings.  On one hand they hear that the increase of exercise can help with circulation, healing, and tension related to pain.  On the other hand, the wrong exercise or the wrong amount can cause serious damage and create more problems.

A recent article in the October 2017 edition of Scientific American highlights some research on this topic.  The research looked at over 300 individuals with chronic back pain and prescription painkillers.  They assigned these individuals to either a program of yoga, physical therapy, or a program of educational materials.  What they discovered is that the individuals in the yoga and physical therapy groups were able to significantly reduce their use on pain killers than the control and education only group.    The author described the yoga that was prescribed in the group as gentle stretches including cat/cow and child’s pose.

The article spoke to the evidence that what seems to work best is an overall combination of tools, which could be medications and movement.  When speaking to one’s primary care physician or pain treating provider, asking about other options for pain relief in addition to medications is recommended.  If there are no structural reasons for the pain or damage to any vertebrae many times movement is preferred over medications.   Although even with structural problems with someone’s skeleton, increasing flexibility and circulation is beneficial and necessary for healing.  Muscle relaxers may help obviously with muscle tightness, but you may get much more with exercise such as overall increase in circulation, relaxation and strengthening of muscles.

Bottom line seems to be that there are benefits to medication but much more for adding the right exercise with or without the medication.   Figuring out the right exercise may take a little research and time.  Speaking to qualified professionals familiar with one’s unique health history and getting a list of options to choose from is the best place to start.   A physical therapist is also a great place to start but if you want to try something at home, one could always begin with asking their healthcare provider to explain first off which exercises they shouldn’t do and why.  Then at least  an individual is able to stay safe while they sample different exercises to try at home.  As with any exercise program, when you find something that works, it’s the consistency that will give you the most benefit.   It’s better to start small and keep going than start too big and feel like you can’t keep it up due to time or energy.

Brain Health


Research on Alzheimer’s was again in Scientific American this month.  This particular article was reviewing research based on a clinical trial by “FINGER” (the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability) between 2009 and 2011.  The results of the clinical trials and the study show that it is never too early and in this case  never “too late”  to intervene with cognitive decline through changes in the way one lives.

The changes they were referring to were eating a Mediterranean like diet, getting exercise, and challenging the brain through learning new things and memory challenges.  These recommendations are by no means new to the public but just validates even more this life style.  To be clear the exercise that showed positive results in memory and organization was 2-3 times a week of 60 minute periods of exercise like muscle strength training, aerobic exercise and postural balance and the Mediterranean diet was fruits, vegetables, whole grains, rapeseed oil, a fish meal  at least twice a week.  The only supplement given was Vitamin D.

Of course the groups started slow and built up to this goal which is encouraging.  They started at 30 minutes.  The exercise sometimes is the most difficult to work in.  It’s important to note that the time they give is not straight cardio work, it combines strength building, cardio, and posture improvement such as in physical therapy, physiotherapy, and some types of yoga.

Motivation for change can be a slow process but building up reasons to change is one of the steps.  Looks like this study gives us more to add to that list of pros and cons.  Hopefully also  it will also help us to work through the ambivalence.


How Meditation Affects the Brain

zen rocks pic

I’m facilitating a new class, Monday Yoga /Wellness Class, that starts Monday June 20 at 7pm (space is limited so contact me if you are interested.)

This class is aimed at developing an individual wellness/meditation practice.  We will do yoga postures to let go of any tension and to open the body up for relaxation for the first part of the class.  The rest of the class is focused on progressive relaxation, breathing, and a variety of meditative techniques.   (Props, chairs, and mats are available).

I have many people who come to see me that want a meditation or a yoga practice at home.  I created this class to help with that.  We will be exploring not only how and why to prepare before meditation but also will practice different meditative techniques for students to “try out”.

We will also discuss how meditation affects the brain.

The research is suggesting that a regular meditation practice (15-30 minutes a day) can increase gray matter in the brain, build new connections, clean out plaque that causes dementia, reduce the size of the amygdala which causes the fight or flight response, and increase our resiliency to cortisol (stress hormone).

There are many reasons to work on a meditation practice, especially if you are trying to be healthy and/or reduce stress and its effects.  Of course this should be easy enough, right? Why is sitting 15-30 minutes every day so difficult to maintain (and for some even start)?  One is that sitting in general can be painful and uncomfortable. Two, establishing any new habit or change is difficult. Consistency, consistency, consistency.  The mantra for true success ……Oh if developing consistency itself was easy.

Even if you practice now and then, it is better than none at all.  I would encourage everyone to try for 5 minutes and go from there.  You may surprise yourself that you can actually develop your own practice if you keep coming back to it when you think of it, no matter how long the in-between.

One also does not have to just “sit”.  I’m also hoping this new class will educate students on what is meditation by research standards vs other definitions.

Here are some links that discuss the effects on the brain from meditation and the research behind it:

Psychology today

Washington Post

7 Ways to Begin Managing Stress

Stress is something that happens to us daily.  There’s good stress.  You know the type that makes you show up for a meeting on time and also enabled you to prepare the night before.  There’s also not so good stress.  The kind that wears at you and makes you want to run and hide (or eat chocolate, drink a beer, smoke a cigarette, etc… )  It’s the kind that may start out as good stress but then added to all the other little worries morphs into something that is not helpful.

There are a few things you can do when you start to feel this negative stress come on that may help you gain control and not run and hide.  Some such as the first item may seem deceptively simple. We tend to take these for granted but often they are neglected resulting in a low threshold for negative stress and its effects.

1.Take a drink of water.  Many of us stay dehydrated and when we are dehydrated it is more difficult to reduce stress hormones and that feeling of tension.

2. Take a breathing break.   Concentrate on long slow exhales. When we are stressed we hyperventilate (longer inhales than exhales) which signals the body to go into “fight or flight”.

3.Eat well.  Eat meals with a variety of protein, whole grains, fruits and vegetables.  Attempt to eat something with protein and fiber at least every 4 hours while awake.  This will keep blood sugar from dropping low enough to signal a stress  response.

4. Walk or do some sort of exercise.  Just 15-20 minutes a day will reduce stress hormones in the blood; 30-60 minutes will optimize this.

5. Shrink your to-do list and focus on only the top 3 tasks.  If that’s too much, shrink it to the most important task you can do right now.   Looking at 20 items can be overwhelming but when you are focusing on just the next step, you feel more in control.

6. Nurture close relationships.  Contact someone positive whom you want to keep in your life.  Soak in some of their positive energy to help give you more resilience.

7. Get enough sleep.  Work on things that will help you get better sleep like cutting out caffeine after 5pm.  Getting 4-8 hours of sleep a night enables your body to clean up toxins and excess chemicals like the stress hormone cortisol.  Sleep helps to give you a “clean slate” for the next day.

*If still no relief, reach out to a support group or professional assistance through a counselor or other healthcare provider.


Personal Practice Challenge – Self Judgment

The third sections of Judith Hanson Lasater’s book “Living Your Yoga” focuses on Self-Judgment.  She reminds at the beginning of the section of the yoga sutra that says the posture should be “steady and comfortable”.    She then goes into describing how we set certain expectations on ourselves and have certain thoughts in regards to our practice that gets in the way of our personal practice.  She discusses how we are a culture of “No pain, no gain” and how this is not necessarily the focus in yoga.

Her suggestions for this month is 1)Write down your internal dialogue right after your personal practice.  Keep notes brief and do not try to interpret. Keep track and note how the dialogue changes over time. 2) If you find yourself forcing in asana or other parts of your live ask, “is this in the spirit of yoga?” 3)If you notice that someone else is judging you, don’t be quick to agree or to internalize the judgment.  Think about what happened and agree only if his assessment aligns with yours. 4) If you are going into a situation about which you feel anxious, tense, or afraid say to yourself, “I am perfect just as I am” 5) Rather than approaching your yoga practice from an attitude of no pain, no gain, how about no pain, no pain? and 6) Do not criticize yourself, anyone else, or anything for one hour.  If this feels like too much, commit to doing it for the next 5 minutes.

These suggestions or homework feels quite freeing to me.  We spend so much of our time worrying about not meeting expectations that we forget the only real expectations are to grow and learn.  This should be interesting  lesson in letting go.

Weekly Wellness Post – Follow up on last post

I could not locate the research I mentioned in past post on exercising 3 days a week for 20 minutes for a month equal to that of taking antidepressant for a month but here is some similar research on exercise, mood, and antidepressants.  Looks like the overal result of these studies and research is that you can get the same final result from medications and exercise, but medications will get you there faster while exercise will keep you there longer.   I think exercise is a win-win but of course sometimes you may need help with the initial motivation to get moving and that is where medications can be very helpful.

( This article was first printed in the Special Health Report from Harvard Medical School “Understanding Depression”. For more information  go to

(This one isn’t necessarily research but I like it’s explanations.)

(This one is an actual abstract of a research experiment on aging adults divided into groups of those given antidepressant and those given different exercise routines to follow.)


Take Care and nerd up on these studies,





Weekly Wellness Topic – Balance and Stress Resiliency

In my clinical practice I always focus on balance with clients, not only so that we are well rounded and resilient to stress but more specifically so that we do not trigger the system that manages stress, our sympathetic nervous system unnecessarily.  Our sympathetic nervous system is important to keep us out of danger and respond quickly to threats.  When our body perceives a threat it activates our stress hormones like cortisol and if enough are released it will turn on our sympathetic nervous system.  When the sympathetic nervous system is on, it’s ON.  It takes control over all major functions, including executive functioning.  More accurately, it limits or stops the majority of executive functioning and goes into the well known fight or flight (or freeze) mode.  This is fine if there is a bear chasing you but when you are sitting at the dinner table with family, not so cool.  We need the other nervous system working when we are sitting at the table with family or friends that love us and support us.  The parasympathetic nervous system is the one we need to promote more. This is the system that helps us prioritize our day, helps us remember where our keys are, helps us learn and retain new information.  It also regulates certain bodily functions like our digestive system…. (Ever wonder why your digestion gets messed up when you are under stress?  It’s because you sympathetic nervous system has decided that you need to prepare yourself to run or fight.  If you don’t do these things quickly then your system has decided you must need to prepare for these things so let’s clean our digestive tract out so we are not be weighed down and will move faster…)

In our modern day culture, stress comes more likely in forms that are not truly life threatening like starvation and predators attacking (although there is still this form of stress as unfortunately we all know).   Most daily stress comes from interpersonal interactions or feeling overwhelmed.  This doesn’t necessarily turn on the sympathetic system directly, it’s what this makes us do or not do that actually will turn the system on.  We have so much at our finger tips with being plugged into our virtual worlds that we have much distraction to ignore important things that our body will interpret as a threat.  This is a double whammy.  Because not only are we dealing with this stress and frustration of all we have to do but we neglect things like eating regularly, drinking enough water, getting regular exercise, and/or getting enough sunlight.  When this happens, our body is more likely to perceive things as a life threatening situation and turn on the sympathetic nervous system.

So it is important to eat regularly.  You need to eat about every 4 hours because no matter what you eat or how much you eat at a sitting, your body has processed it in about 4 hours.  Your blood sugar will drop signaling time to eat again.  If you don’t eat something (preferably fiber and a protein for sustaining level blood sugar) your body will think there’s something wrong with finding food in your environment and perceive this as a threat.  Another problem is that when we are stressed we emotionally eat and many times this is in the form of what is quick and easy and sweet like a donut.  This has very little protein and usually no fiber.  Blood sugar will raise real fast and crash quicker than 4 hours making us hungry, angry, and or spacey.  We may eat again but unless we eat some fiber and protein  our blood sugar will continue to roller coaster.  We will probably either gain weight and/or have stomach issues.

You need to stay hydrated during the day.  Drink the recommended 6-8 glasses of water based fluid thru out a 24 hour period.  Again if your body is dehydrated it will interpret this as well as a threat.  If you are prone to headaches, stomach issues, light headedness, try drinking a glass of water when these symptoms arise as a first line of defense.  (If diabetic obviously sugar will need to be regulated as first line defense.)

When need to exercise 20 minutes (walking like you’re in a hurry  or more) at least 3 times a week.  This is the bare minimum.  To be healthier daily moderate exercise is recommended.  There is a study and I have lost it but will find it again that compared those that did the 20min workout 3 x a week vs a group that took antidepressants.  They discovered that if done regularly both groups had equal results in improving depression.  Of course like an antidepressant, exercise will need to be done regularly over a month before you see the same results.  Why did this happen?  Not only are endorphins (your body’s feel good chemicals)  being released thru exercise, you are also burning off excess stress hormones.   So this will raise your ability to manage stress.  It makes you more resilient.  It makes you healthier.   Cortisol also increases cholesterol, so if you are having trouble with cholesterol, exercise will definitely scientifically help.

You must get 20 minutes of sunshine daily.  This does not mean that you have to have it on your skin although some sun helps with Vitamin D absorbtion which is vital,   Seeing the sunshine (not staring up at the sun itself) but seeing the light around you helps regulate melatonin (necessary for sleep and relaxation) and serotonin (the neurotransmitter that is increased by a majority of antidepressants and helps give you a “duck’s back” where stressful things don’t bother you as much.  Causes you to feel peaceful.) It also helps regulate your biological clock which helps with all kinds of daily bodily functions especially sleep.  And during sleep, guess what happens?  Our body cleans out toxins including excess cortisol.  A recent study I heard on NPR  stated that they have found that people whom get less than 5 hours of sleep have increased cholesterol to those that get at least 7-8 hours of restful sleep.

So if you want to be resilient and not react so much to stress around you, you need to pay attention to these 4 activities in which we actually have some control, which is nice to know we have some say in these things.