Mind-Body Connection and Healthy Aging

You may know diet and exercise are important parts of maintaining or improving overall physical health but what role can mental health playing in aging into your best selves? According to the World Health Organization and the CDC health is defined as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity” (1). 

If you’re already getting enough daily exercise and making healthy nutrition choices then you are well on your way but what can you do to better your mental and social well being?

Exercise Doing Double Duty

As mental health has become a growing concern within our society, researchers have explored the connection between physical activity and the effects exercise can have on these no physical factors. One recent study found that participation in a regular exercise program provided older adults with significant improvements in adaptive emotion regulation and overall emotional well-being (2). They attributed these results to the physiological impact of moderate intensity exercise as well as the social network training programs can create and provide.

A few strategies to implement:

• Make physical activity a regular part of your daily routine
• Find an exercise program that you ENJOY doing whether its classes, group training, or independent exercise

Build a Community and Support Networks

Having a social support network can be an integral part of feeling your best and decreasing stress. Studies have shown that adults who indicated higher levels of support were more likely to have better self-rated health. Building and adapting your social network throughout stages of life is important. More or less you are never too old to make new friends and new connections.

Here are some great ways to meet people or build on connections you already have:

• Participate in group based programs 
• Classes or training programs at a gym 
• Continuing education classes 
• Sports or game leagues
• Reach out to family members or friends you haven’t spoken to recently
• Get involved within  your faith based community
• Join groups based on common passions or interests

Sources:

1)      https://www.cdc.gov/aging/pdf/mental_health.pdf

2)      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5992429/

Blog post by Rebekah Raber.

Outdoor Fall Activity Safety Tips

Fall is officially here! Although the weather is changing, we still have plenty of time for outdoor activities to supplement our exercise routines. Whether you are walking or biking and enjoying the scenery it is important to keep safety in mind.

Here are some tips to keep you safe during your fall activities:

If you are walking on roads or paths with traffic be sure to walk facing the traffic. If you are biking be sure to bike with traffic.

Looking both ways never goes out of style! Always check both directions before crossing any streets or paths.

Walk on roads single file, unless you are walking on a wide pedestrian/bike path or a sidewalk separated from the street.

If you are walking on a street or path with bikers and runners be aware of them passing. Bikers and runners should announce or use their bell if they are passing on the left/right.

Whether you are walking, biking, running it is important to be visible. If it is daytime wear bright clothing. For nighttime wear reflective gear and light colors.

One last tip to keep in mind is being aware of street safety. Choose routes that are used frequently by other walkers, runners, bikers. Avoid the path or area if you see something suspicious. Always be alert while you are out.

Blog post by Timarie Villa.

Sun Safety

Now that the weather has warmed and the sun is shining people tend to spend more time outside. But before you bask in the glory of the sun, here are some things to think about to keep your skin safe.

Did you know?

On average it takes just 15 minutes of unprotected time in the sun to cause a sunburn.

Facts about skin cancer:

• Melanoma, the deadliest form of skin cancer, is the most common cancer for 25 to 29 year olds and the second most common cancer for 15 to 29 year olds.
• Melanoma is increasing faster in females 15 to 29 years old than males in the same age group. In females 15 to 29 years old, the torso/trunk is the most common location for developing melanoma, which may be the result of high-risk tanning behaviors.
• Exposure to tanning beds increases the risk of melanoma, especially in women aged 45 years or younger.

What to look for in a sunscreen:

1. SPF 30 or higher
2. Broad spectrum protection (UVA/UVB)
3. Water resistant

Sunscreens containing all the above have been shown to reduce the risk of skin cancer, sunburn, premature skin aging, precancerous skin growths, and dark spots¹.  Once you have found your sunscreen, make sure you are applying it correctly. Always reapply sunscreen every 2 hours when you are outside, even on cloudy days!

Is my sunscreen from last year still good?

The FDA requires that sunscreen last for 3 years. Some sunscreens have a printed expiration date on the bottle. If your bottle does not have an expiration date, and you are not sure if it was from last year or longer, check for visible signs¹. If a sunscreen has a change in color or consistency are signs that it’s time to buy a new one.

While sunscreen is the most commonly used skin protectant, some clothing brands offer special clothes with higher SPF protection. Hats can keep the sun off of your face, wide brimmed hats are suggested better for use over baseball caps as they cover the back of the neck and the ears as well as the face.

           

But what about my summer glow?

Any change in the skin color caused by exposure to the sun or tanning beds is considered skin damage. Although that tan may fade in the winter, the damage underneath is still there.  A skin healthy alternative is self tanner or a sunless tanning salon.

For tips on how to apply self tanner like a pro:

https://www.aad.org/public/skin-hair-nails/skin-care/self-tanner-how-to-apply

Sources:

American Acamdemy of Dermotalogy https://www.aad.org/public/skin-hair-nails/skin-care/sunscreen

Blog post by Erin Womboldt.

Running and Knee Health

When it comes to knee health, running often gets a bad reputation as being a cause for many ailments, the primary one being osteoarthritis.  However, as more research becomes available, these claims are found to be increasingly baseless, showing that running at reasonable volumes and intensities leaves the joint no worse for wear.  And according to some studies, possibly better than before!

What the research tells us:

There are many studies suggesting that running is not detrimental to the knees.  In one such study, 504 former collegiate cross country runners were surveyed to assess their levels of hip and knee osteoarthritis.  The follow up period for individuals was between two and fifty-five years, averaging twenty-five years.  Of those assessed, only 2% reported severe pain, and only 0.8% had surgery for their condition.  They compared these results to former collegiate swimmers, which had 2.4% reporting severe pain along with 2.1% having surgery (1).  The evidence from this study suggests that there is no association between moderate long-distance running and the development of osteoarthritis.  Additionally, it suggests that heavy mileage and the number of years running are not contributory to the future development of osteoarthritis.

That is all well and good, but those are former elite athletes!  How about when compared to people who do not run regularly? 

In another study, a group of male runners (who averaged 28 miles per week over 12 years) were compared to male nonrunners to assess a variety of factors.  The groups were compared in perceived pain and swelling in the knees as well as the hips, ankles and feet.  Additionally, radiologic exams were conducted to assess osteophytes (bony outgrowths in joints), cartilage thickness, and overall grade of degradation.  There was no statistically significant difference between either group for all measures, further suggesting that long-distance running is not associated with premature join degradation (2, 5).

A more recent systematic review conducted in Australia sought to analyze the effects of physical activity on the individual structures of the knee joint.  After analyzing 1,362 studies, the data suggested that there is an association between physical activity and osteophytes in the knee joint.  However, this is not necessarily a bad thing, and could possibly be an adaptation to the stimuli associated with exercise.  Additionally, the review states there is no strong evidence on physical activity narrowing the joint space from cartilage degradation.  In fact, there is strong evidence for an inverse relationship between physical activity and cartilage defects (3).  In other words, people who are active have stronger cartilage in the knees than those who do not.  This is further supported by a Swedish study, in which researchers gave people at risk of osteoarthritis a running program, and by the end showed improved biochemistry of the associated cartilages (5).

It is also worth noting that factors such as gender, education and mean exercise time do not appear to increase the chances of developing osteoarthritis in the knee.  Despite these findings, running is not an activity that everyone should participate in without the proper guidance.  Various factors such as genetic predisposition, higher than average BMI, and previous damage to the knee can all increase the chances of developing osteoarthritis (4).

What you can do to prevent damage to your knees?

If you are a runner and have not had knee problems, great!  Keep doing what you are doing.  

If you have had problems, here are some suggestions:

Try maintaining a stable BMI

Since it has been shown that having a high BMI while performing repetitive exercise can be a risk factor towards osteoarthritis (4), it is important to try having a consistent, average BMI.  Doing so will reduce the impact that your feet and knees take.  Did you know?  Depending on the intensity, running can create an impact of three to ten times a person's body weight! (6)

Watch your form

Improper biomechanics can place increased strain on the lower extremities.  Research suggests that running with a slightly forward-leaning trunk reduces stress on the patellofemoral joint (7, 8), which is the part of the knee where the thigh bone and knee cap meet.

Increase volume/intensity gradually

Among runners there is a training philosophy called the “10% rule”, in which during a training cycle weekly mileage does not increase by more than 10% from week to week.  The rule has validity, with one 2014 study showing that runners who followed this rule were less likely to become injured compared to a group that increased their mileage by 30% (9).

In conclusion:

If you are an experienced runner or someone who would like to start and have no underlying knee issues, do not fear that running will damage your knees.  That being said, always talk to a healthcare professional before making major lifestyle changes.  Train smart, and above all, enjoy running!

Sources:

1. Sohn, Roger S., and Lyle J. Micheli. “The Effect of Running on the Pathogenesis of Osteoarthritis of the Hips and Knees.” Clinical Orthopaedics and Related Research, no. 198, 1985

2. Panush, Richard S. “Is Running Associated With Degenerative Joint Disease?” JAMA: The Journal of the American Medical Association, vol. 255, no. 9, 1986, p. 1152.

3. Urquhart, Donna M., et al. “What Is the Effect of Physical Activity on the Knee Joint? A Systematic Review.” Medicine & Science in Sports & Exercise, vol. 43, no. 3, 2011, pp. 432–442.

4. Chakravarty, Eliza F., et al. “Long Distance Running and Knee Osteoarthritis.” American Journal of Preventive Medicine, vol. 35, no. 2, 2008, pp. 133–138.

5. Neighmond, Patti. “Put Those Shoes On: Running Won't Kill Your Knees.” NPR, NPR, 28 Mar. 2011

6. Elert, Glenn. “Force on a Runner's Foot.” E-World, 1999, hypertextbook.com/facts/1999/SaraBirnbaum.shtml.

7. Teng, Hsiang-Ling, and Christopher M. Powers. “Sagittal Plane Trunk Posture Influences Patellofemoral Joint Stress During Running.” Journal of Orthopaedic & Sports Physical Therapy, vol. 44, no. 10, 2014, pp. 785–792.

8. Teng, Hsiang-Ling, and Christopher M. Powers. “Influence of Trunk Posture on Lower Extremity Energetics during Running.” Medicine & Science in Sports & Exercise, vol. 47, no. 3, 2015, pp. 625–630.

9. Nielsen, Rasmus Østergaard, et al. “Excessive Progression in Weekly Running Distance and Risk of Running-Related Injuries: An Association Which Varies According to Type of Injury.” Journal of Orthopaedic & Sports Physical Therapy, vol. 44, no. 10, 2014, pp. 739–747.

Blog post by Robbie Papapietro.

Heart Health Month

Did you know that February is Heart Health Month?

Cardio Recommendations

20 minutes of walking a day can lower the risk of a heart attack and stroke

• Tips: Park farther away
• Choose the stairs over the escalator

150 minutes of exercise per week

• Trouble keeping track?  Just try to move more! Get up from your desk/couch and just walk around the room every once in a while

Heart Healthy Nutrition

Cholesterol: Adding more fiber to the diet can help naturally lower your body’s cholesterol levels

Squash is a great winter vegetable that is high in fiber

“Eat the rainbow”: When choosing fruits and vegetables try and get multiple colors. Different colored vegetables contain different nutrients, the more variety the better!

Heart Health and Wellness

Sleep: Recommended that you get 7-9 hours of sleep

• Tips for a better night time routine: Set an alarm to go to bed, lowered the brightness on your phone/tablet, turn your phone on “Do not Disturb” so notifications don’t wake you
• Stress: Lowering your stress helps lower blood pressure, boost your motivation, and help you sleep
• Things to try: Positive self-talk, meditation. Count to 10 before reacting. Take a break by reading a book, drawing/coloring, exercise, or listening to music.  

Talk to your doctor!

• About old concerns, new concerns, or more tips on how to keep you and your heart healthy!

Source: American Heart Association

Blog post by Erin Womboldt.

Stand Up

It’s time to stand up against sedentary behavior!

Did you know that 12 hours is the average time a person sits during the day?

What is sedentary behavior? Time spent sitting, which includes watching TV, driving, eating, and work/school tasks. "Sitting Disease" is a term used by researchers to define those with metabolic syndrome and experiencing the negative impacts of sedentary behavior.

What can you do to decrease sedentary behavior?

• Try walking around your office more frequently during your work day.
• While watching TV, try to stand every 30 minutes.
• Set a timer to remind you to get up more often during your day.
• Stand more, sit less!

3 Benefits of decreasing sedentary time, there are many more!

• Helps to reduce the risk of cardiovascular disease
• Improve your mood
• Increase focus/productivity

Reference: https://www.juststand.org/

Blog post by Timarie Villa.

Exhale

When we do timed breathing exercises that make our exhale even a few counts longer than our inhale, the vagus nerve signals the brain to turn up our parasympathetic nervous system (relax mode) and to turn down our sympathetic nervous system(fight or flight). This means that by putting our awareness on lengthening our exhale we can signal to our body that we do not need to be in fight or flight mode and we can initiate the transition into rest and healing mode. With a long exhale we tell our whole being that it is safe to rest a moment, it is time to digest now, there is time to repair what needs attention within us. Interestingly, because breath modulates the nervous system, it is also a way for us to influence the other automatic, involuntary bodily functions. By setting the parasympathetic tone we slow our heart rate, lower our blood pressure, dilate our blood vessels and turn on our digestion. Just choosing to attend to our breath with intentional exhales allows us to shift our whole body into a restorative mode.

Bringing awareness to our exhale is giving us a lesson in the value of relaxation and surrender. The exhale is about letting go and clearing out. Physically, when we exhale we release the metabolites, the toxins, and the used up air. The exhale is clearing out space, giving us the ability to receive during our inspiration.

Timed Breathing Exercise

Let yourself get quiet and still for a moment during your day. Direct your attention to your breath and just notice, without trying to control or change, the flow of air that is coming and going in your body. Then, invite yourself to breathe out longer than you normally do. You may notice that this is followed by an effortless, expansive in-breath that is deeper than those that preceded. You can also spend a few moments doing an exercise of counted breathing. Breathe in for a count of 4, hold for a count of 7 and then exhale for a count of 8. Doing this a few times will accomplish the shift into parasympathetic mode discussed above.

Enjoy giving yourself this nourishing gift and know that it can have a cascade of healing benefits for your body, mind and spirit.

Blog post by Ally Wilson.

Planks!

While data on exercise changes as new studies are done, one thing that remains constant is that planks are great... but only when you do them properly!

The traditional plank (shown above) targets more than just your abdominals. It requires contraction of the quads, glutes, shoulders, biceps and triceps. It is a stabilizing exercise that can lead to improvements in other exercise moves.

3 Common Plank Form Mistakes

Arched Back

Note: In this position your abs will be inactive. This also put a lot of strain on your lower back!

Hips Too High

Uneven Hips

Other Plank Variations

On Hands

Side Plank

Taking Your Plank to the Next Level

Alternating Leg Lifts

Up, Up, Down, Down

Side Plank with Rotation

Side Plank with Hip Dips

Physioball Planks

TRX Plank

Planks can assist in many other areas!

Balance

The core stability provides and increases in your overall stability and balance.  Example: if you are bumped into while walking, having a stronger core can assist you in regaining your balance faster.

Maintain Proper Running Form

A stable core helps a runner’s body stay in proper alignment, rather than twisting mid stride.

Maintain Form in Many Other Lifts

One of the first steps in many lifting exercises is to engage your core. Having a stronger core can make it easier to keep proper form in many activities and can prevent injury to the back. 

Happy Planking!

Blog post by Erin Womboldt.

Prevention & Treatment of Shin Splints

Shin splints are a painful condition caused by microtears of connective tissue at attachment sites in the tibia (lower leg bone) from overuse or mechanical stress.  Symptoms include pain and tenderness along the front of the shin (tibia) and when chronic or severe, may be accompanied by swelling and the presence of ridges or bumps along the front of the bone. 

Muscle weakness, stiffness, and poor alignment of the lower extremity joints (such as flat feet) and use of non-supportive shoes may predispose you to developing shin splints particularly if training or activity is accelerated too quickly, you walk/run on hard, ramped or uneven terrain, or you play a stop and go high impact sport such as basketball.  Shin splints can side line even the most seasoned athlete. 

To prevent and treat the condition try the following exercises.  Stretches should be held for a minimum of 30 seconds to allow time for tissue elongation and to avoid reflex shortening. Repeat 2-3x, 3x/day. Strengthening should be done 10-20 repetitions for 2-3 sets daily.  Icing, kinesiotaping, and non-steroidal medications may be helpful in the management of pain.  Consult your physical therapist for assessment and always speak to your doctor before taking any medication.

Stretching

Calf stretch (gastrocnemius)

Stand upright holding chair or hands on wall for support with one leg behind you, foot flat and pointed straight ahead.  Keeping back heel down and knee straight, bend front knee.  Stretch will be felt in calf and Achilles. 

Tip: Tighten abdominals and don’t lean forward with trunk.

Soleus stretch

Stand upright holding chair or with hands on wall for support with one leg behind you, foot flat and pointed straight ahead.  Keeping back heel down, bend BACK knee. Stretch will be felt in lower part of calf deep under Achilles tendon. 

Tip: If you cannot keep your heel down, shorten your stride.

Toe stretch (toe flexors and plantar fascia)

Place 2-3” book or small platform/step against wall.  Place toes against edge of step. Keeping knee straight, lean towards wall. Stretch will be felt in arch of foot.

Dorsiflexor stretch (tibialis anterior)

Sit on knees on cushioned surface with ankles pointing down.  Sit back on heels to stretch front of foot and ankle.  Leaning back with upper body will intensify the stretch. 

If unable to kneel, or if ankles are too tight, sit up with foot crossed in front of you and use your hand to pull ankle and foot downward. 

Strengthening

Ankle Dorsiflexion (anterior tibialis)

Long sit on bench or floor. Anchor tubing away from you with loop around foot.  Keeping foot and ankle aligned with toes facing up, flex ankle up towards you to the count of 2, and return down to the count of 4.  

Tip: To maintain proper alignment, keep 2nd toe in line with your shin bone.

Wall Toe Raises (toe extensors and anterior tibialis)

Stand with back against wall, feet slightly away and facing forward.  Lift toes off ground keeping knees straight. Hold 5 sec.  

Tip: If unable to raise, toes, bring feet a little further from wall.

Calf Raises (gastro-soleus)

Stand with feet shoulder width apart. Go up on toes to count of 2, lower to count of 4.  Challenge yourself by doing on one leg.  

Tip: To progress strengthening through greater range of motion, do off edge of step.

Toe Curls (toe flexors and plantar fascia)

Sit in chair. Place towel on tile or wood floor.  Position bare foot on towel.  Keeping heel down, curl toes to “scrunch” towel. 

Single Leg Bridge (gluteal muscles)

Lie on your back with knees bent and feet on floor.  Straighten one leg keeping thighs in line. Tighten abdominals and lift hips off ground using bent leg. Keep pelvis level.  Hold 5 sec.  

Tip: If too difficult, keep both feet on floor while lifting hips.

Heel to toe walking

Start in standing position. Step out with right foot flexing ankle toward you as your foot contacts the ground.  Transfer weight to ball of right foot, go up on toes, then step forward with the left foot contacting heel first with ankle up.  Repeat cycle.

Blog post by Jody Coluccini PT DPT.

About Jody Coluccini PT DPT

Dr. Coluccini received her Doctorate with distinction from Arcadia University and her BS in Physical Therapy from Boston University. She brings 39 years of continuous clinical orthopedic, sports and geriatric physical therapy experience to patient care. Prior to relocating to Cape Cod, Dr. Coluccini owned a successful private practice in NY and is currently licensed in both New York and Massachusetts. Jody believes that successful rehabilitation is a collaborative effort between the therapist and patient achieved by mutual trust and respect, constant therapeutic reassessment, mutual goal setting and patient compliance. She understands that being "fit" as one ages or returns from injury or illness requires a constant modification of goals and activity.