How Sugar Affects Your Pain

You probably know that sugar is not the best for you, but do you know how it’s impacting your pain and inflammation in your muscles and your joints? Sugar is, in fact, at the top of the list as one of the biggest contributors to pain. Numerous studies continue to prove that sugar promotes pro-inflammatory markers. Why is that important? Chronic low level and systemic inflammation contributes to many of the health conditions that we face. In fact, 90% of all chronic disease is associated with inflammation.

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Let’s discuss five different ways that consuming added sugars in your diet contributes to inflammation and therefore, pain.

1) Stimulates free fatty acids in the liver

When free fatty acids are digested by the body, the compounds that are released contribute to pro-inflammatory markers. 

2) Produces Advanced Glycolytic end products (AGEs)

When sugar is combined with a protein or fat in the bloodstream, oxidation or inflammation in the body occurs. 

3) Causes leaky gut

Increased sugar intake can contribute to leaky gut, also referred to as intestinal permeability. We have tight junctions in our gut that function as a protective barrier to not let toxins and pathogens move through into our bloodstream. However, in the case of leaky gut, these tight junctions break down and foreign invaders can pass through to the bloodstream. This, in turn, creates an immune response. This can also contribute to leaky brain. Leaky brain is where these pathogens, toxins, and foreign invaders cross the blood-brain barrier and can contribute to brain fog, loss of clarity, memory issues, etc. 

4) Increases LDL

When we have increased LDL from overconsumption of sugar, there is an increase in inflammatory markers, specifically C-reactive protein. 

5) Causes weight gain

Increased sugar consumption can lead to weight gain, which thereby increases your insulin resistance as well as inflammation. That can contribute to a whole cascade of other symptoms. 

In one study that was performed, the participants who drank 40 grams of added sugar a day (one soda), increased their insulin resistance, inflammation, and LDL markers. Also, consuming 50 grams of fructose within 30 minutes can increase your C-reactive protein, an inflammatory marker. Lastly, 50 grams of refined carbohydrates in the form of white bread can increase your pro-inflammatory marker, niuclear factor-kappa B (NF-kappa B), and increase blood sugar. 

Now you have a little bit of a better understanding of how sugar impacts your body, specifically inflammation, and therefore pain. If you’re in a chronic inflammatory state, you’re pain will likey be higher. Your first step in evaluating sugar is to track it. See how many grams a day you are consuming.

There is a difference between natural sugars and added and refined sugars. That doesn’t mean you need to eat six fruits a day, however. As it relates to added sugars, you want to have less than 20 grams of sugar. That means you have to think about how many grams of sugar is in your creamer, salad dressing, tomato sauce, etc. In most cases, there is high fructose corn syrup in those as well. You want to evaluate how many grams a day you’re actually getting and then begin to slowly decrease it. You don’t need to do it overnight. It is important to recognize that if you are consuming a lot of sugar, you can have a significant die-off reaction as you begin to eliminate those sugars from your diet. Just begin to slowly work them out of your diet and transform to a more natural, whole food plan.

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Understanding Your Pain

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Understanding Your Pain

We have all experienced pain in our lives. Perhaps it’s been acute pain where you roll your ankle, or it’s more chronic pain, something like low back pain that’s been around for months or even years. It could also be from surgery or some kind of procedure that you may have had done that could cause a considerable amount of pain. Therefore, it is important to understand pain—understand the pain in your own body, and what implications it has. Just for a quick statistic, 15 million U.S. adults suffer from some kind of chronic pain, and 80% of our global opioid supply is consumed in the U.S. There are 125 deaths per day due to opioids, which are most commonly prescribed for low back pain, which is why it’s such a powerful topic to talk about and understand implicitly.

What’s a common course of low back pain in America? You have an acute episode of low back pain, go to your medical doctor, and get some kind of prescription pain medication. The pain medication doesn’t work, so maybe you get a muscle relaxer, too. Now your primary care is going to refer you for an X-ray, and it shows nothing, or maybe some degeneration that everyone over 35 years old typically has. Then you’re referred to get an MRI, and it shows a herniated disc or some degeneration as well. Of course, that doesn’t give you any information either because imaging in most cases does not correlate to your symptoms. So, then you are referred for an injection. You get an injection that doesn’t really do much at all or lasts for a short period of time before your symptoms return, and you’re referred to physical therapy. The course of low back pain in America is problematic because this is what contributes to moving from acute pain to chronic, which we’ll discuss.

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Let’s start with the definition of pain. Pain is an unpleasant sensory and emotional experience associated with tissue damage or potential tissue damage. Essentially, pain is an alarm system. What it’s telling us is where the pain is, the amount of pain, the nature of the pain, and it is signaling to us, danger.

Now let’s talk about acute pain versus chronic pain. An example of acute pain is when you put your fingers on a hot stove. We have nociceptors, sensory receptors in the skin that will signal through the spinal cord to the different areas of the brain, to create a motor response or reaction. With somatic pain as described, we are signaling to the brain to pull back. Now we can also have visceral pain of the organs or the lining of the organs. Lastly, referred pain, which can be something like a heart attack referring pain to the left shoulder. All of these can be different forms of acute pain.

Chronic pain is much different. Chronic pain is defined as pain that you’ve had for three to six months or longer. With chronic pain, there is no tissue damage, however, your brain is sensitized and signaling that there’s still danger. This causes you to have a heightened sense of pain because your brain is still perceiving that this pain is happening even though the injury has healed. The key take home with this is that pain is not directly correlated to the amount of tissue damage. For example, someone that has had chronic pain for years would indicate that there is no tissue damage at that point, yet the pain can be very heightened. Conversely, someone with an acute tissue injury could have a very low level of pain.

Now that you know a little bit more about acute versus chronic pain and that it is not necessarily related to tissue damage, it’s important to know what you can do about it. It is not simply a matter of taking Advil or Tylenol, because we actually have our own natural painkillers. Endorphins, enkephalins, and serotonin are some of the best natural painkillers; better than NSAIDs.

Also, it is important to recognize that pain is not simply a sensory experience. It is always an emotional experience as well. It has been shown that if you are in a positive mental state, this can impact your ability to manage pain. So, what can you do about your pain?

1) Don’t Panic

Pain is information. Whether you’ve had it for a day or you’ve had it for three years, it is information that your nervous system is either on high alert, or you have some kind of potential tissue damage. Either way, you want to explore it with a gentle curiosity. You want to understand your alarm system because that is your nervous system that is giving you this powerful information to be able to do something about it. Recognizing that no matter how long you’ve had pain, you can continue to make improvements, and be able to be in a pain-free state. 

2) Improve your Movement

You should get evaluated to see what your movement patterns look like so you can limit compensations that are so common. The more that you compensate, you continue to alter your motor control, and the more you will have pain. When you have pain, you have more distorted motor control, so it ends up being this vicious cycle of pain.

3) Stress Management 

This is one of the key things that you want to think about as it relates to pain. Incorporating things like mindfulness, yoga, and meditation into your life to make sure that you are in a positive emotional state to be able to manage the pain. If you have pain, and it’s already heightened, and when you add stress on top of that your pain tolerance will decrease. So, your pain is actually higher. 

4) Graded Exercise

With all of the pain science research, one of the most important things is exercise, specifically, graded exercise. This means it has to be done at a very slow pace and returning to a comfortable state over time. For example, if you’ve had chronic low back pain for 10 years, then beginning a walking program starting at 45 minutes is way too much. Starting with 10 minutes is more appropriate and then every other day progressing to 12, 15, 20 minutes slowly and working your way up to a point that feels great for you. 

That’s just a quick taste of a little bit of pain science and how you can manage pain in your life. I hope this was helpful for you.

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Why you should stop “stretching” your hip | HIP PAIN

Do you have hip pain that you are continually trying to stretch, roll, or smash, and nothing seems to get better?  Before we get into the role of the psoas, one of your key hip flexors, let’s speak about the local stabilizers and global stabilizers of the body. This is important to understand how you are going to treat your hip flexors and hip pain.

Think of the local stabilizers as being muscles that are close to the joint. They create more of an isometric contraction versus concentric (shortening) or eccentric (lengthening) contraction. They control the joint centration which means keeping the joint centered in its axis. It’s also independent of the activity of motion so if you raise your arm overhead, the deep stabilizers in my spine are going to activate before your arm goes overhead. Essentially these local stabilizers are imperative for stabilization in the body so that we can have proper movement.

Our global stabilizers are equally as important. However, they have a different role, so they have more of an eccentric contraction. They decelerate the range of motion, are continuous with motion, and are farther away from the joint.

Now getting back to the psoas, which is what everyone wants to stretch when they have hip pain.  The posterior or the back of the psoas is a local stabilizer. Think of it as one of our deep core muscles that is helping to stabilize the spine and also prevent the femur, our leg bone, from shifting forward in the hip joint. The anterior or front of the psoas serves as a global stabilizer. So, it is necessary to think of the psoas muscle as a stabilizer. Not only is it a stabilizer but it works in an integrated unit with all of the other muscles, including the pelvic floor, diaphragm, multifidus, the deep five rotators in the hip, and the transverse abdominus. All of these have to work together, and once again in this integrated fashion to be able to stabilize the low back and the pelvis during any kind of movement.

For example, if you performed a chest press with 30 pound in each hand on a bench and then transitioned into doing that on a stability ball, your weight would naturally go down. Why? Because you now have an unstable platform to work from and therefore can not generate as much force.

There are a lot of different hip pathologies that we won’t get into today, but when you have hip pain it typically happens from losing the deep stability of the hip. There are two common muscle imbalances that will exist. One is the TFL(tensor fascia latae) muscle, which is right in the front lateral side of the hip, can get tight, especially with increased sitting. Based on this attachment, it will pull the hip forward, and that will therefore inhibit or shut down the psoas. The other common muscle imbalance is the hamstring muscles, which can get tight for various reasons, inhibiting the glute muscles. The hamstrings can push the femur forward and that also leads us to lose that optimal position on the hip joint. Overtime if we have these muscle imbalances, instead of the hip being centered in the axis, it will start to shift forward and up. This will cause all types of pain issues and pathologies. Whether that’s a labral tear, hip impingement, tendinopathy, bursitis, and so on. So, it is important to get the hip stabilized and centered in the joint in order to decrease pain and ultimately improve function.

You can begin to do this through a four-step process. This is a great way to begin to address your pain, as well as any kind of movement compensation, and most importantly, integrate your foot with your core, in a very integrated manner. First is inhibiting the tissue, in this case we inhibited the TFL muscle that typically pulls the hip joint forward and creates that inhibition of the psoas as a deep stabilizer. Then, mobilize the hip joint to center the hip joint. Remember that when it is not in that center position it’s shifting forward enough so we’re shifting it back to the center position. Next, stabilize it by activating the deep stabilizers, such as our diaphragm, pelvic floor, etc. Then we’re integrating it with the ground. This is super important because the foot is part of the core and they work as an integrated unit. To get those deep stabilizers of the hip firing, short foot, i.e. foot to core sequencing, allows us to do that in a very integrated fashion.

4 Steps

1. Inhibition

For the TFL release, place the ball right on the outside of the hip. When you lie down, you’ll naturally rotate the hip in, which will expose the TFL muscle. With the other leg, anchor it up at a 90-degree angle and come down to your forearms. Holding that position your leg will be nice and long, naturally rotated in, and breathing throughout the exercise trying to relax into it.

2. Mobilization

For the hip mobilization with a band, you’ll place the band high up in the groin. You’ll have it back at a 45-degree angle away from you. You’ll start in a table position rocking forward 15 times, making sure your spine stays nice and long, and you’re breathing. Then rock away from the band, so to the opposite side, once again about 15 times, making sure you’re breathing throughout the exercise.

3. Activation

Now it’s time to activate the deep core, so you can do this by diaphragmatic breathing. Inhale, breathing into the abdomen and into the base of the pelvis allowing the abdomen to expand 360 degrees. Exhaling, letting the abdomen contract and the belly button in towards the spine. Once you feel like you have this established, then on your inhale allow the pelvic floor to relax, so you can exhale and gently lift the pelvic floor about 20% contraction to get a deeper integration. You want to think of this as a rhythmical balance, so nice and fluid. Inhaling to the base of the pelvis and exhaling gently lifting the pelvic floor.

4. Integration

Lastly, it’s time for integration. This is to be done with short foot. Standing on one leg, sitting the hips back, knees slightly bent, taking a breath in, while your foot relaxes then exhale and gently root the tips of the toes into the ground. That will naturally lift the arch and lift the metatarsal heads or ball of the foot.

So whether you have hip pain or hip tightness and are constantly stretching your hips, hopefully, this video will give you a little bit of insight to allow you to think about your hip differently and recognize that it is part of an integrated unit. It is really important to understand how that works as it relates to stabilization and movement

If you’d like to schedule a free 15 minute virtual discovery session, please email drarianne@themovementparadigm.com or text 302-373-2394 to schdule. We’d love to help you get healthy again!

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WHAT IS A HEALTHY PELVIC FLOOR?

Let’s discuss a much-overlooked topic in modern medicine, especially as it relates to rehabilitative medicine… the pelvic floor. Yes, both men and women have a pelvic floor, and both can be compromised and contribute to many different conditions including but not limited to incontinence issues, sexual issues, and chronic pain.

The pelvic floor is essentially the base of our core. It has to be integrated with the rest of the surrounding anatomy. That means the organs, the bowel and bladder, the connective tissue, and the ligamentous tissue all have to be deeply integrated and fine-tuned for everything to work in this rhythmical dance back and forth.

It also helps to support our daily functions, prevent urinary and fecal incontinence, improve sexual function, and many other functions that we’ll discuss.

So, what does a well-activated pelvic floor actually do?

1) We are constantly transmitting force through the body. So, a well-activated pelvic floor is going to attribute to the closing force to prevent any leakage of urine, fecal, or gas.

2) Research shows that between 60 to 80% of women with stress urinary incontinence can cure it or significantly improve it with pelvic floor retraining.

3) A well-activated pelvic floor is also going to allow the appropriate relaxation response of the pelvic floor muscles to allow for proper emptying of the bladder and to prevent any post dribble or leakage after you’ve finished urinating.

4) It should also be relaxed enough for proper evacuation of the bowel, but provide enough resistance for optimal defecation.

5) It supports internal organs such as the vagina, the bowel, and the bladder. Especially as it relates to women and pregnancy, the more intact the pelvic floor musculature is, the less likely there will be a prolapse.

6) It increases the tone which allows for greater sexual awareness. You need to have a pelvic floor that can relax completely so that you can have more pleasurable pain-free sex.

7) A well-activated pelvic floor will relax and significantly stretch during vaginal delivery.

8) A well-activated pelvic floor will work in coordination with your diaphragm and the rest of the abdominals. This is very important in looking at overall movement and movement efficiency.

Why is a well-activated pelvic floor important?

In summary, a well-activated pelvic floor is important for so many necessary functions. When it is not functioning well, it can contribute to a whole host of problems. One of which, that we see consistently in our office is pain.

Chronic pelvic pain, low back pain, hip pain, and even knee pain can all be driven by pelvic floor dysfunction. It’s way more common than you think!  It’s also an area where we tend to hold our emotions. So, I want to point out that as important as it is for the pelvic floor to contract, it is equally important for the pelvic floor to relax.

If it is always tight, then we are not able to fully contract and fully relax it. This can contribute to the same issues. That is why it is very important to get evaluated properly. If you are having any type of symptoms that might indicate you have a pelvic floor issue, please contact our office to schedule a pelvic floor examination.

Reach out for a 15-minute FREE discovery session to see how we can help you on your journey.

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How to do an elimination diet

Have you been experiencing fatigue, chronic pain, allergies, sinus issues, depression, anxiety, bloating, cramping, abdominal pain, diarrhea, and/or constipation? Or maybe you just aren’t feeling your absolute best? If so, you might want to consider the elimination diet. The elimination diet is the gold standard for uncovering food sensitivities and food intolerances that are frequently overlooked as a major contributor to a whole host of inflammatory conditions. It’s been used by allergists and registered dietitians for decades and is currently used frequently in functional medicine.  It can be extremely valuable in finding information.  It uncovers foot triggers that can help you determine what foods are best for you…and of course, what foods are not. There is no one-size-fits-all.  Everyone is unique.

What does the elimination diet do?

The elimination diet helps to decrease inflammation, identify food triggers, reduce intestinal permeability i.e. leaky gut., decrease inflammation, reduce toxic burden, and it is high in phytonutrients and it is not calorie restrictive. If you have already been diagnosed with leaky gut, autoimmune, or any other inflammatory condition (nearly 90% of all conditions), then this would be something that is highly recommended to initiate a gut healing protocol to remove these potentially inflammatory foods. It is not a calorie-restricted plan, so it is not meant to be a weight-loss diet. Instead, it is meant to be an “information diet”, which means it is not a forever plan. This diet is comprised of all whole natural foods, there’s nothing processed. You are eliminating all of the potentially inflammatory foods. Some of those foods include coffee/tea, alcohol, corn, soy, peanuts, processed meats, red meat, gluten, dairy, and so on. (See below) You would be eliminating these foods for at least four weeks.

What foods do you eliminate?

  • corn
  • dairy
  • gluten
  • eggs
  • peanuts
  • white sugar
  • shellfish
  • soy
  • beef
  • processed meats
  • pork
  • coffe, tea, chocolate

How to prepare

For this to be successful, it is vital to have a preparation period. One to three months’ preparation time is recommended to prepare for it so that you can just go into it with ease. The last thing you want it to do is to create stress, ie. Inflammation, on your body.  You’ll want to make sure it is the right time in your life and things are relatively calm. It is extremely challenging to eat out when you are on the elimination diet. Lastly, it’s often easier if you slowly work out one to three foods at a time and find replacements for them before you begin. You want to be fully prepared, which is why it is strongly recommended to work with a professional to guide and support you through the process.   

How to reintroduce

The reintroduction phase is the most important part and many people fail to do this. They sometimes get frustrated and eat something that has multiple inflammatory triggers like pizza that includes gluten, dairy, and tomato sauce. Then, they don’t feel their best and don’t really know why. Was it gluten? The dairy? The tomato sauce with all the preservatives? This is why it’s really important to do a very careful and systematic reintroduction of foods. To give you an example of how that looks, you would do the elimination diet for 30 days. Then, on day 31 you choose a food that you really want to bring back into your life. Let’s say it’s eggs. So, what you would do is have eggs on day 31 in the morning and in the afternoon. You would wait four days, and you would see what kind of symptoms or adverse reactions you may have. A food reintroduction tracker is very helpful for this information. You might have nausea, bloating, abdominal pain, joint pain, etc. If you have negative or adverse symptoms within that four-day window, then eggs, right now, are a ‘no go’. You would wait at least three months before you reintroduce them again. This might mean that your gut needs more time to heal or that eggs are never going to be part of your diet. You can then make a conscious decision to include this in your life knowing the effects it has on you, or now that you have that information, limit or eliminate it. The goal is to find this information, so you know exactly what is helping you feel your best. That means having energy and living with vitality, versus feeling like crap every day, but not really knowing why.

Summary

The elimination diet is extremely valuable when you’re dealing with multiple medical symptoms. It is very challenging for many because they don’t realize just how many of the foods they are consuming on a regular basis. Most people need a lot of support and guidance through the process.  So, again I strongly encourage you to reach out to a registered dietitian or functional medicine doctor to help you through this process.

If you are interested in feeling your best and you need help, reach out to schedule an appointment to get you started on your journey.