Susan, DPT

5 Secrets of Mental Toughness Set Yourself Up to Win While it’s important to improve your movement and keep your body healthy, mental toughness is what separ...ates the regular individual from a master. Anyone can achieve a decent level of success, but the top performers utilize not only their physical mastery, but take themselves to the next level by mastering their minds. Here are 5 secrets I’ve learned from masters that can easily be added to your daily routine. 1. Positive Self-Talk Positive self-talk is a crucial component used by professional athletes, top business executives, and spiritual leaders alike. Self-talk separates the top tier athletes from the rest of us. Training and practicing for tens of thousands of hours is not enough. Now, after speaking with top-level NASM trainers I know that this is the norm and is part of the training program used at U.S. Olympic Training Centers. When I pursued a master’s degree at Georgetown University, I was thrilled and grateful to attend an event with top Winter Olympic athletes. It was fascinating for me to hear about their training and personal account of their performances. I was most impressed by Evan Lysacek, the 2012 Olympic gold medalist in men’s figure skating. He spoke briefly on his victory and how he was able to overcome a major defeat just prior to the Olympics. He knew that he had to prepare both physically and mentally. He devised an intense training regime where he trained every day more hours than ever before. To address the mental component, he made another change in his routine involving his self-talk. We had a brief time at the end of the session to get a picture with him. Instead of having my picture taken, I asked him what he reads. He told me the best book that he used in preparation for the Olympics was Shad Helmsetter’s What You Say When You Talk to Yourself. This strategy of self-talk mastery has allowed me to completely transform my life. If you want to learn more about mastery and go deep into this topic, check out my book, The Learning Chrysalis: Learn and Master Any Topic. It can be found on amazon at The Learning Chrysalis. There are many different forms and ways to incorporate positive self-talk into your daily routine. It can be as simple as using affirmations. An affirmation is a positive statement about yourself that often begins with, I am. My favorite resource for affirmations is Louise Hay. You can do a quick search on youtube and she has many free videos with positive affirmations for everything ranging from your body, waking up in the morning, love, and financial abundance. It’s easy, you listen to the videos and it works really well to do while you’re falling asleep so the information can supersede your conscious mind and enter your sub-conscious mind. Your subconscious mind is the part of your mind that does things unconsciously. It’s the part of your brain that was formed in the first seven years of your life. If you want to change a deep-seated belief, it requires lots of repetition of the positive belief or self-talk that you want to engrain. At first, it’s common to feel foolish and not believe the self-talk or new affirmation, but with time, consistency, and lots of repetition, it shifts and becomes a part of yourself. My other favorite resource for self-talk is a podcast called My Thought Coach by Stin. She has a beautiful and calming voice and presence and I to this day continue listening to her affirmations that were recorded in 2013 (she has newer posts as well). While I don’t listen to them as often, I always notice a shift when I go back and have never regretted spending the time listening to them. They are a collection of short recordings that can easily be listened to in the car or at home. 2. Sleep I never fully appreciated or understood the importance of sleep until my daughter was born last year and I dealt with sleep deprivation for the first time. I’d always heard that sleep is essential to learning and important for weight loss, and recovery, but took it for granted. Studies show that it’s crucial to achieving peak performance and being healthy overall. Even a loss of 2-4 hours of sleep per day for a 2-week duration is linked to impaired mental performance, attention deficits, memory problems, and mood disturbances. Sleep is an essential time for your muscles to rest and repair. Sleep is also linked to cardiovascular health because as you sleep, your blood pressure lowers and your heart also rests and recovers (it’s also a muscle). Sleep is essential for maintaining a high energy level. This is critical for being successful. Getting regular sleep increases your mental stamina and the National Sleep Foundation reports that increased sleep time has been linked to increased shooting accuracy in basketball players and serving accuracy in tennis. Most Americans are highly sleep-deprived and don’t realize how much more effective they’d be in every area of their lives with increased time sleeping. The recommended amount of sleep is 8 hours at a minimum. Once you develop a sleep deficit, it’s difficult or impossible to make up for it. Some simple strategies and practices to implement for increased sleep are. 1. Have a regular evening routine where you allow yourself to wind down. 2. If you are going to be on a computer or screen, utilize blue blocker glasses in the evening to allow your eyes to rest and your body to adjust to the sun setting and it becoming dark outside. 3. Make sure your room is dark and cool. 4. Keep your phone and all electronics outside of the bedroom and save the bedroom as a place for resting. 5. Get all books, pictures, and clutter out of your room to allow yourself to completely relax. 6. Regularly wash and have clean bedsheets. I like to wash mine at least once per week. You don’t have to do all of these strategies, but if you want ideal sleep these are some of the best non-supplement ways. 3. Meditation Our society today is fast-paced and especially in the U.S. where there is an emphasis on productivity. We are often racing from one event to the next. Our bodies are not really developed or equipped for all of this activity and constant information overload. In fact, many Americans suffer from high levels of worry and anxiety. This can be detrimental to our health and well-being. When we were hunters and gathers, our brains were hard-wired to react quickly and fast if there was an outside threat for example a tiger. The sympathetic nervous system would click into gear and our blood would be focused on our limbs to allow us every chance at survival. The problem is that now we are constantly exposed to different types of threats such as an offsetting comment or look or an argument with a spouse and unfortunately our body naturally gets triggered into fight or flight and a lot of people are not able to turn it off. This leads to all kinds of health problems as the body never gets a chance to rest and nourish itself, which is vital for recovery and digestion. The pressure of being on all of the time is taxing and it’s essential that you make time to recharge and allow nourishing quiet. This is where meditation comes in. When you meditate, you allow your body to be still, and even if you have lots of thoughts and can’t sit still, if you stick with it over time, meditation allows you to move from your sympathetic nervous system to the parasympathetic. Also, meditation over time has been proven to decrease the activity of the amygdala, which is the part of the brain that gets activated when you feel threatened or are stressed out. Meditation is a practice and works best when you are consistent. It’s better to meditate for 5 minutes every day than meditating for 20 minutes three times a week. It’s essential that you find the type of meditation and position that works best for you. I’m unable to meditate for a long time sitting cross-legged. One of my legs always falls asleep or I don’t want to continue holding my back up. For me, I prefer sitting upright in a chair with my feet flat on the ground and my palms faced up in my lap. There are several different types of meditations and I mix up what I do, but if you’re a beginner I encourage you to stick with one type for a few months until it becomes a habit. Then it’s easier to start experimenting. When I started meditating, I used a mantra. A mantra is a phrase or statement that you repeat over and over in your mind. If you have other thoughts floating around in your head, let them pass and stay focused on the mantra. It’s normal for your monkey mind to turn on when you start meditating, but with practice, it’ll become easier and you’ll start to experience inner peace and deep calm. The mantra can be in Sanskrit for example, So Hum, which means, I am. This is the mantra that’s used for the meditations at The Chopra Center. It’s also common to use passages from the Bible for example, Be still and know that I am God. Some people have an easier time meditating when they use music in the background. For newer meditators, I recommend doing the free meditation programs with Oprah Winfrey and Deepak Chopra 21 Day Meditation programs. They have a good mix of speaking and getting you set for the meditation and then the meditation is around 10 minutes. Also, they have them set for a fixed period of time daily so if you can fit 15-20 minutes into your day, it’s well worth it. For more advanced meditators or those who are interested in meditating specifically for physical health benefits I recommend checking out Dr. Joe Dispenza, D.C.’s meditations at Joe Dispenza. Dr. Joe was hit by a car while cycling and refused conventional surgery to treat his multiple level debilitating back disc injury. Instead, he fully recovered using his thoughts and visualizing himself healthy. He has recorded meditations along with conducting advanced live meditation workshops. His meditations are longer, but well worth it. He’s at the cutting edge of meditation and has orchestrated different studies where brain scans have been taken at the beginning and end of his workshops demonstrating scientifically the amazing benefits of meditation for overall health and especially brain health. He with a team of doctors and neurologists, has recorded cases of spontaneous remission, people who were once confined to a wheelchair getting up and walking, recovery of Parkinson’s disease, and remission of symptoms in patients with multiple sclerosis. I’m a huge fan of his meditations and did his, Water Rising, meditation daily for over a year. It was an integral part of my preparation for my physical therapy boards exam and while it is long at 70 minutes, it’s one of my all-time favorite meditations. He has shorter meditations as well. Now that I’m a mom, I focus on his 20-minute meditations either doing his morning or evening one, or if I have more time while my daughter’s napping, I enjoy doing a 40 minute one. He uses beautiful music and follows a process that allows your body to completely relax and then gives you the opportunity to visualize what you desire. It’s very powerful and well worth the time investment. There are also several powerful applications with meditations that I haven’t used much because I love the meditations that I already do, but in case you’re looking for something that’s more accessible and less of a time commitment, here are some of the ones to look into. 1. Calm 2. Waking Up 3. Mindful Meditation 4. God/Belief in a Higher Power The next superpower secret to mental toughness and mastery is a belief in something or someone greater than yourself. It doesn’t have to be a specific religion, but it can be. It’s knowing and having faith in life. There are different mindsets that people adopt and it’s easy for people to go into gloom and despair when things don’t go the way they’d like or planned. In these situations, it’s essential to have faith and know that there’s a larger and better plan at work. It’s important to have a healthy balance of knowing and taking responsibility for everything that occurs in your life and at the same time to know and believe in the good of the Universe. Masters have a deep inner sense of trust that things are working out and will work out. Some people say this is Pollyannaish, but it goes back to the importance of positive self-talk, which makes a difference. When you know, trust, and believe in something larger than yourself and own your power, then you can trust life. You can stay in a place of faith and belief even amidst chaos and difficulty. This is essential to being able to dig deep and push past failure as often your biggest breakthrough occurs when you keep on going past a failure. There are several ways to cultivate a deeper connection to God. Meditation is a great way to start. Some other suggestions or ways to deepen your relationship or connection to something greater are: 1. Walking in nature 2. Spending time at the beach 3. Gratitude practice 4. Scripture reading 5. Attend a Sunday service 6. Connect with animals 7. Deep breathing 8. Yoga It’s about getting to that sense of awe and it doesn’t have to occur in a church, but it can. It’s about not having all of the answers and being okay with what is. When you find a balance between taking responsibility for your life, taking necessary action steps, and also being willing to trust in life, then you can accomplish mastery and become an inspiration to others. 5. Affirmative Prayer This is one spiritual tool that I love and practice on a daily basis. I’ve always been a strong believer in the power of prayer. Science also proves in the power of prayer for our health and overall well-being. Research conducted at Harvard Medical School found that prayer can reduce doctor visits by up to 50%. Numerous research surveys and studies have recorded increased recovery in individuals who prayed or requested prayer. Prayer has been found to lower blood pressure, improve the quality of life of patients with cancer and help patients who suffer from depression, diabetes, and heart conditions. Affirmative prayer is a type of prayer that is powerful and highly effective. I prefer this form of prayer because it’s more of a positive declaration and knowing rather than a prayer of begging that comes from a place of disbelief or lack. This type of prayer is used by all types of denominations and while I was taught by the Centers of Spiritual Living, Joel Osteen, Joyce Meyers, and many Christian ministers also use it. Affirmative prayer has 5 key steps that are easy to use and follow. 1. Recognize God/your Higher Power 2. Know and claim that you are working with and are connected to your Higher Power 3. Realize and accept that what you desire is already yours 4. Express Gratitude for what you declared and your good 5. Release your prayer trusting that it is already done A simple example of this for example if I’m praying for peace and trust. 1. I know and claim that God is all there is. 2. I know that I am connected and a part of God. 3. I know and claim peace and health. I know and claim that I feel and am peaceful. I know that I’m breathing deeply and easily and that I’m trusting and knowing my best and highest outcome. I know perfect health. I know that everything that I need and desire is provided easily and effortlessly. 4. I’m so grateful for this deep feeling of peace. I’m so grateful for knowing that everything is evolving perfectly and for my best and highest good right now. 5. With this deep sense of gratitude, I let go and know that this or something better is already done. I claim it so. And so it is. Amen. Another important secret for mastering affirmative prayer is to really feel what you are writing or saying. That amplifies its power. In fact, the more you believe and know the truth about your words, the more powerful and effective your prayer is. Give these a try or amp them up if you’ve already been using them and let me know. I’m especially interested in hearing about the difference they’re making in your life. As always let me know here in the comments or DM me if you have any questions or would like to go deeper with any of these topics. Here’s to you living your best life now.

5 Ways I Got My Body Back Postpartum As I embark on celebrating my daughter’s 1st birthday, I want to share my strategy for getting my body and health back afte...r her birth. It’s been a long and challenging journey. I’m grateful that my current weight is lower than it was when I got pregnant and I’m still nursing regularly! My daughter, Amalia, was born on June 21, 2019. She was 10 days late and weighed 10.7 lbs. I’m 5’4 and ended up despite my husband and I successfully completing the Bradley Method courses having a cesarean section. The end of my pregnancy was pretty rough. I continued swimming daily around 1 hour or 1 mile, but could barely walk and my blood pressure rose significantly. After my delivery and 2-day labor, I was so swollen, I couldn’t fit a Boppy pillow around my waist and I was in pretty bad shape. I went from weighing 140 lbs at my 1-month pregnancy check to around 200 lbs. It got so bad near the end that I didn’t even want to know how much I weighed. Even several months after my daughter was born, I continued to look 7-8 months pregnant. All of my weight was located at the center of my stomach. Here’s what I did to lose the weight and get my health and body back. 1. Pelvic Health Physical Therapy I knew right away that I needed to get professional help and now know that many if not all women would benefit significantly from physical therapy postpartum. Despite the fact that I’m a licensed physical therapist, until two weeks ago, I had not had specific training in women’s pelvic health and wanted to see someone who specialized in it. Despite knowing where I wanted to go and who I wanted to see my doctor would only allow me to go to the place that he recommended. I went there for around 10 visits. It was good in terms of me starting to get my abdominal muscles strengthened, but my physical therapist never did an internal pelvic exam and would do manual therapy on my hip despite the fact that the problem was in my pelvic floor muscles. My incision hurt, sex was impossibly painful, and while I enjoyed and did my recommended exercises twice daily including in the middle of the night, it wasn’t working. I then went to my old gynecologist who does not do labor and delivery. She committed to helping me recover fully. By that time, I was around 5 months post-partum. I went back to work after 3.5 months and I developed low back pain. It was very painful especially after sitting for my 1-hour commute to and from work. I continued working as I wanted to get back to normal, but it was challenging. I switched to a different physical therapy location and physical therapist. She did an internal pelvic exam at the initial evaluation and discovered that I was unable to relax my pelvic floor muscles. I was especially weak and tight on my left side. We worked on doing reverse Kegels and she lectured me about needing to relax. My abdominal muscles were so weak from my pregnancy that after standing or treating patients, they would give out resulting in low back pain. To make matters worse, when I got home after work, I took over taking care of my daughter and didn’t get much of a break or time to rest as my husband was working and going to school full time. Physical therapy was expensive, but it was helping and my pelvic floor muscles started to relax after several manual therapy treatments. I know I wouldn’t be where I’m at now if I hadn’t been proactive about my rehab. I’m grateful that I got the help that I needed, but it wasn’t until I lost my jobs during COVID-19 that I was able to make a full recovery on my own. 2. Walking At the beginning of my recovery period, I tried to rest as much as I could while taking care of my daughter full time. The first two months were the most painful of my life. When I started walking it was so painful and difficult that I could barely go down our driveway. I started walking to our mailbox and slowly progressed. By the time I was two months postpartum, I started walking to our neighborhood fitness center with my daughter and exercised there. Also, while walking I would stop and exercise along the way using benches and curbs, which I needed for my physical therapy home exercise program. I got back on the stationary bike as I’m a fitness instructor and was motivated to return to teaching my RPM classes. I had my daughter trained to take her nap during this time and it was essential for me. I prioritized my entire day around getting my exercise a typical day before I went back to work, I’d exercise around 2-3 hours. This included going on walks that went up to 4 miles per day. I was feeling better, but still had the pain and weakness despite my daily exercise commitment. 3. Rest While I was doing better at 9 months postpartum and had completed physical therapy treatment sessions at two different clinics, I was still not back to my pre-pregnancy fitness level. My body looked like I was 6-7 months pregnant. In fact, it was common for new patients to ask me when I was due. I was struggling to provide the type of patient care that I desired and having a hard time balancing my duties at home and work. I felt like I was failing miserably at everything. Something had to give, but I wasn’t sure what. I felt like I didn’t have any options. I couldn’t scale down my hours at work and loved all three of my jobs. Then, something larger intervened. I was fired from my personal development coaching job. It was a huge blow to me as I had worked for the company for several years and was committed and devoted to its mission. Looking back, while I wish it hadn’t happened, it was a blessing. I started being able to rest and relax in the evenings after my daughter went to bed instead of needing to work. I hadn’t realized how distracting the work had been for me and how much of my mental and physical space it had occupied. The following week, the fitness center where I’ve taught for the past 8 years was closed due to COVID-19. I was devastated, but again, it allowed me increased time to rest, and while I missed working out and leading fitness classes, it was what my body needed. The following week around the third week of March I had a sore throat and called in sick to my physical therapy job. I then got fired at the end of that day. Again, it was a blow. I loved working there and had amazing patients, but it didn’t feel as bad as the other job losses because in the back of my mind I had a strong feeling that I’d be able to return once it was safe to treat patients. I was at home, not allowed to go anywhere and I resumed primary caretaking responsibility for my daughter. I couldn’t exercise because all of the gyms were closed. I was grateful to stop pumping and started getting more sleep and rest. My husband’s university closed and he started working from home. He was busy but he was around more and able to help out especially in the evenings. I started feeling lighter and healthier than I had since before my pregnancy, but I wasn’t able to lose weight. In fact, even though I continued to walk daily, I was gaining weight. I knew that it was time to get serious about my health and fitness. I knew I had to get my body and health back. If I wanted to help and coach others as a physical therapist I needed to get healthy. I didn’t feel right about being an advocate for health and fitness if I wasn’t living that lifestyle. Despite thinking that I’d always be a fitness instructor and never pay for exercise or exercising, I knew that I had to get a Peloton no matter what. I started asking my husband and explaining why I needed it and about how I would use it. It took around 2 weeks and once he agreed, I ordered it. Peloton was extremely popular at that time. I had to wait on the phone for over an hour to make my appointment for getting the bike and had to wait one full month for the bike to be delivered. I had my date set and it again worked to my advantage as I didn’t stress about working out. I let myself focus on getting the rest that my body needed while doing some Pilates and yoga exercise at home. By the time the Peloton arrived, I was ready. 4. Peloton I was thrilled and kind of scared when the Peloton arrived. I committed to trying it out at first to see where my body was. I made a concerted effort to not compare myself with the other riders and to start out without overloading the resistance. I instantly loved the Peloton and it became almost an obsession where I wanted to ride or workout all the time. I started with 20-minute rides and quickly within the first week increased my time to 45 minutes with 1-2 short breaks for upper body strengthening with light weights. I was slowly able to increase my resistance and after the first month started riding with my sister who’s extremely fit and probably in the top 10% of performers on the Peloton. For the first 20 days, I rode the bike every day. Sometimes it would be an easier scenic ride with my 9-year-old nephew, but most of the time, it’d be a challenging ride with the community and an instructor. After 20 days my legs were so sore that it was keeping me from sleeping well at night. Along with riding the bike, I did strength classes focused on abdominals and specific muscle groups. To start, I’d do 5-10 minutes of arms and then 5-10 minutes of chest and back. I didn’t do much lower extremity strengthening at first because I was already riding the bike and taking the Peloton yoga classes. I love yoga and before I became pregnant was practicing at an advanced level and would do 90-minute classes weekly. I quickly completed all of Peloton's longest 75-minute yoga classes (they only have 5 or 6). By my second month, I got into a routine that I continue following today. I made a conscious decision to ride every other day and really focus on the rides with the exception of shorter ones with my nephew where I went easy. On the days that I didn’t ride the Peloton bike, I did 30 minutes of full-body strengthening followed by 60 minutes of yoga. This routine has worked well for me. It allows me to do strengthening and yoga and I’m able to focus on riding hard when I’m on the bike. For my rides, I do 45 minutes with either a 5-minute cool down ride or 5-minute post-stretch. I choose this time because it’s what works for me. My parents watch my daughter 1.5 hours in the morning and that’s when I exercise. When I do my rides, I have enough time to shower afterward, and on the days that I don’t ride, I don’t shower so I can exercise longer. I committed to this routine for 60 days for multiple reasons. First, Peloton rewards you for exercising 60 days in a row. Second, the timing was perfect leading up to Amalia’s 1st birthday, literally 60 days after I received the bike. I have 10 days to go and I am confident that I’ll accomplish my goal. 5. Intermittent Fasting Around the same time that my Peloton arrived, my period returned and I decided to try intermittent fasting. I had wanted to for a long time, but decided to wait until after my pregnancy. I had a hard time nursing my daughter as my milk didn’t come in normally at first. I had a low supply and made a commitment to doing whatever it took to be able to breastfeed her. This included working with several different lactation consultants and lots of pumping. The pumping was brutal. There was a period of 3 weeks where I pumped every 3 hours even during the middle of the night to increase my supply. It was horrible, but worked. I had to continue pumping in the middle of the night to have enough of a supply to feed my daughter while I was at work because I didn’t collect enough milk at work to account for what my daughter ate during the day even though my job was extremely accommodating with me pumping there multiple times. When my job ended, I was able to stop pumping and get on a more manageable schedule. I was feeling better and could try intermittent fasting knowing that if it affected my milk supply, I’d stop. I chose the schedule of eating between 11-6. I wanted to give myself enough time for it to be manageable. I’m able to go from 12-5, but in case, I have the extra 2-hour cushion. It was easier than I thought to make the transition and it didn’t affect my milk supply. Some mornings I’m hungry and wait for the clock to turn 11, but for the most part, it hasn’t been hard and I feel much better overall. I’m committed to staying on this schedule for a while as I have no plans to stop nursing my daughter. When I’m ready to transition out of nursing, I plan to shorten the hours where I can eat, and if/when I transition back to working will probably wait to eat until 12 for the first time. For now, this is working. The combination of increased exercise and intermittent fasting has produced amazing results. I no longer look like I’m pregnant and fit into my pre-pregnancy clothes. My weight has decreased to 130 lbs and while I still have a bit of a stomach, it's much less. I also want to highlight the fact that I didn’t change my diet or limit my food intake. This isn’t a prescription or advice, it’s what I’ve done. Please feel free to share your experience. Let’s support each other on the road to recovery. As challenging as everything has been I’m grateful for my experience and am excited about working with other women who are pregnant and during their postpartum.

5 Simple Movement Secrets from the Blue Zones to Increase Your Life Expectancy The Blue Zones are five places in the world where people live the longest and are... the healthiest. They range from all over the world and despite different cultural backgrounds, they all share similar lifestyles in terms of how they move. These are the places that were selected by Dan Buettner, Gianni Pes, and Michel Poulain. Okinawa, Japan Sardinia, Italy Nicoya, Costa Rica Ikaria, Greece Loma Linda, California They were selected because they share 9 commonalities that include moving naturally, purpose, downshift, 80% rule, plant slant, wine at 5, belong, love ones first, and right tribe. For this blog, I’m going to focus on moving naturally. 5 Simple Ways to Move Naturally and Increase Your Life Expectancy by 10-12 Years 1. Skip the gym and instead walk 5 minutes each hour People living in the Blue Zones do not exercise at a gym or fitness center. Instead, they get their movement through their lifestyle and their basic activities. In these communities, it is common for the people to walk to their neighbor’s homes or store, garden, and do their chores by hand. In fact, the American Cancer Society found that it’s better to break up your movement throughout the day than to exercise for 30-40 minutes in the gym and sit the rest of the time. It’s been shown that walking only 6 hours per week lowers the risk of cardiovascular disease, respiratory disease, and cancer. The best way to utilize this secret is by taking one 30-40 minute walk per day and getting up for 5 minutes to move around each hour. The 10,000 steps per day were taken from Amish communities where women and men average 10,000 steps per day and are something great to go for, but not completely necessary. 2. Stand up 5 minutes for every 30 minutes that you sit People living in the Blue Zones tend to have higher NEAT scores than everyone else. NEAT stands for Non-Exercise Activity Thermogenesis and is the heat that is produced in our bodies when we are performing all of our daily activities except for sleeping and exercising. These include doing housework, gardening, walking, and even fidgeting. The more we move throughout the day, the higher our NEAT score, which results in an increased metabolic rate or calories burned. For those of you who work in sedentary jobs, the minimal amount of NEAT recommended is around 2.5 hours of standing and light walking around the home or office. According to the Journal of American Diabetes Association the C-reactive protein related to inflammation, triglycerides, and blood sugar increases in those who don’t achieve NEAT on a regular basis. They have a study outlining how inactivity for just one day can cause cell processes to fail, allowing for the breakdown of fats in the blood, which lowers your HDL (High-Density Lipoprotein) or good cholesterol. 3. Plant a garden People living in blue zones tend to grow their own food and don’t have mechanical conveniences for house or yard work causing them to depend on natural movement. There are numerous benefits to planting a garden and growing food naturally. You have the benefit of increased levels of Vitamin D from being outside. The manual labor from being outside that includes using upper body strength from digging, planting, and weeding is beneficial for cardiovascular health. Many people’s grip strength declines with age, but gardening is one way to maintain strong hands and fingers. Also, when one gardens often squatting is involved for both planting and weeding and it’s essential for maintaining mobility in your knee joints along with maintaining lower extremity strength. 4. 7 Easy Ways to be More Active During the Day It’s as simple as moving more throughout the day and you don’t have to give up your electronics or conveniences, but you can still utilize natural movement by making these simple changes. 1. Step away from your workstation every hour and take a 5-minute activity break 2. Walk during phone calls 3. Park your car as far away as possible in the morning or walk to work 4. Take the stairs instead of the elevator 5. Ditch the phone, e-mail, etc. and walk to speak to your colleagues in office 6. Move around while watching TV 7. Set your cell phone alarm for a 30-second stretch and five minutes of standing 5. Incorporate Simple Exercises Throughout Your Day Here’s a collection of exercises that I recommend doing daily for health and longevity. They’re easy to do throughout the day at work or at home and even if you only do one or two, you’ll get the benefit of increased movement to boost your NEAT score. It’s time to get moving and have some fun doing it! Here’s to a longer, healthier, and happier life! Check out the album I added to view the exercises with pictures and descriptions.

Check out my latest blog on Urinary Incontinence. I'm now certified to treat pelvic floor this includes women with pelvic pain, incontinence, or postpartum.

Check out my latest blog Key Lessons from ESPN's The Last Dance

What does a Doctor of Physical Therapy really think about the Peloton bike. Is the Peloton worth it?

Recover Like a Physical Therapist Blog Post Series The 5 Best Initial Exercises for Post-Op Knee Meniscal Repair Disclaimer: This is NOT a substitute for medica...l advice and going to a physical therapist as each case is different and may require or benefit from a different approach, but with COVID-19 or if you have to wait for an appointment here’s what to do in the meantime. Knee Meniscal Repair Surgery is an outpatient procedure done to repair or clean up torn cartilage that lies in between the femur and tibia bones. Knee meniscal injury can be caused by injuries related to cutting movements, from an impact injury with direct contact from a forced twist or rotation or from degeneration, which could result from minor events as the meniscus becomes less elastic with aging. The tear can occur in the middle part of the knee in the medial meniscus or on the outside part of the knee lateral meniscus or in both parts. Another common tear occurs in the middle part of the meniscus which is divided into three parts; anterior horn in the front, body in the middle section, and posterior horn in the back of the knee. Won’t the meniscus just heal on its own? That depends. The outer part of the meniscus is viscous meaning that blood flows to it so healing is more likely. Often it depends on the type of tear and whether or not it is affecting the patients’ mobility, function, and the amount of pain it’s causing. It’s best to try conservative care or do physical therapy before surgery. This improves the patient’s overall recovery, but if you’ve already had surgery, don’t worry about it. If your doctor has a post-operation protocol, I’d recommend asking for it. This is a helpful list of guidelines for recovery, and can help the patient better understand the necessary time-line for recovery and types of exercises to engage in and what to avoid to prevent additional injury or prolong the overall recovery time. Post-op protocols are readily available with a simple google search. Just type in for example knee meniscal repair post-op protocol physical therapy and numerous examples will come up. From there you can read through some of the different ones and will start to get an idea about what is safe for you to do. It’s important to engage in exercises and rest at the same time. It’s best to have a balance between the two. Initially, after surgery, it’s best to follow the RICE principles. This is R-Rest, I-Ice, C-Compression, and E-Elevation above the level of your heart. One rule to follow is icing regularly, but not for too long. Don’t leave your ice on overnight, but it’s okay for ice to be on for up to 20 minutes. I usually recommend icing for around 10 minutes. While icing, it is normal to experience a process called CBAN. CBAN is an acronym for what the patient experiences while icing. C is for cold, B for burning, A for aching, and N for numbness. This is normal to experience and is not cause for an alarm as long as you are following the guidelines. Depending on the swelling that you’re experiencing, you can ice several times per day at least 3-4. I especially recommend icing at the end of the day with your leg elevated above the level of your heart. You can prop it up on a chair or with several pillows. There are several stages of healing that you will progress through on your road to recovery. The Acute Phase is immediately after surgery. Specifically during this time you want to avoid squatting and avoid bending beyond 90 degrees so be careful when you’re putting your shoes on. Also, depending on where the tear was located, which section was fixed, and how you should NOT engage in resistive work for the first 4 weeks to allow the joint to calm down, have swelling reduced, and the goal is to have enough blood supply in the meniscus for it to help with the overall healing. Especially be careful if you had a posterior medial tear or an ACL tear to not load the HS meaning bending the knee or resistance training into flexion for the first 6-12 weeks. Instead focus on open-chain isolated quadriceps exercises. For example, don’t use the leg press machine or do lunges. Initial 5 Exercises to do right after surgery: One of my favorite places to get exercises from is a website called hep2go.com. This site is amazing because it provides many different exercises that you can get for free by signing up for an account. You don’t even have to be a practicing physical therapy to have access. It does help to know what you’re searching for, but if you want you can click on Exercises and choose, knee, for example, and pages of different exercises will come up. The goal for the first two weeks of rehabilitation is to regain full extension, or your ability to straighten your knee. It’s important for the patient to keep your knee straight and elevated when sitting or lying down. Follow your doctor’s weight-bearing suggestions. Often at this stage the patient is wearing a brace in the locked position and is ambulation with crutches. Exercises include performing ankle pumps, glute set, heel slides with a towel, prone hangs, and ankle prop. Ankle Pumps Bend your foot up and down at your ankle joint Note: Keep on doing Ankle Pumps throughout the day, as it is a most important exercise for leg blood circulation, prevents blood clotting and swelling Repeat 10 Times Hold 2 Seconds Complete 3 Sets Perform 1 Time per Hour GLUTE SET - SUPINE While lying on your back, squeeze your buttocks and hold. Repeat. Repeat 10 Times Hold 3 Seconds Complete 3 Sets Perform 1 Times a Day HEEL SLIDES - SELF ASSISTED While seated, slide your heel towards your buttock with the assist of the unaffected leg. Hold at the end range, but don't force. You can also scoot your body forward instead of moving your leg back towards you. Repeat 10 Times Hold 3 Seconds Complete 3 Sets Perform 2 Times a Day PRONE KNEE HANGS While lying down on your stomach, allow your leg to hang off the end of a table/bed. Position yourself so that your knee cap is just over the end of the table/bed. Just relax your body and allow gravity to stretch your knee into a more straightened position. Add an ankle weight for increased stretch. Start by holding 30 seconds and progress up to 2 minutes. Repeat 3 Times Hold 30 Seconds Complete 1 Set Perform 1 Times a Day KNEE EXTENSION GRAVITY STRETCH ANKLE PROP While lying or sitting with a small towel roll under your ankle, fully relax your leg. Your knee should move lower as you allow gravity to stretch your knee into a more straightened position. You can perform this exercise as much as you want depending on your comfort level. I recommend doing it multiple times during the day and starting with a 10-second hold increasing to several minutes. Repeat 5 Times Hold 10 Seconds Complete 1 Set Perform 5 Times a Day My next blog post will address the best 5 exercises to perform in the post-acute phase occurring around 3-5 weeks after surgery. Please feel free to share this with any of your friends and until next time stay safe and healthy.