Ways to Move This Summer

Earlier this week, I had a unique opportunity to do some work with a small child, maybe about 3 years old? She wasn't my patient... it was a special circumstance...  and, though she was very, very cute, this was entirely out of my comfort zone.  Though I do work at Seattle Children's, my patient population is between ages 5-21, with the majority of them between ages 9-15.  That's right, I spend most of my day with teenagers. It's awesome.  The younger kids will still talk about Disney princesses or super heroes and the older ones can discuss books I read when I was a kid, sports, movies... nothing deep, nothing life shattering.  It is a rare occasion that an older patient comes in and discusses politics or religion or their job - though several of the younger kids talk about their church camps or youth organizations or really interesting volunteer projects they work on and some of the teenagers do work.  It's entirely different from the conversations I used to have when I worked with adults who had stress from jobs, older parents or younger children, money woes, car break downs, or deeper interests that required me to think.  A 3 year old was uncharted waters.

One does not simply sit and have a conversation with a child of this age.  This particular child didn't even really sit at all. She was constantly on the move, excited to explore the world around her, touch everything colorful in the Seattle Children's Rehab space.  I'm not sure how parents do it!?!  I'm not sure how my coworkers who do work with children this little do it!?!

Anyways, I was tasked with finding things for this little girl to do for about twenty minutes.  Fortunately, I had just read a new Community Education flyer from the Seattle Children's Sports Medicine Department entitled "35 Ways to Move Your Body This Summer."  My awesome colleagues - a rock star physician and three incredibly talented physical therapists (also team #StrongWomen) - collaborated on this project to provide families with ideas to keep moving.  (Message me or comment with email address and I'll send you the whole PDF!)  This list came in handy when trying to identify things to use with a small child - but could easily be applied to all ages - kids through adults - to find ways to stay active during the summer time - and beyond!  Here are some of my favorite suggestions from the list, and some that I used to survive working with a tiny kiddo!

1) Make an obstacle course: in the clinic we have access to lots of cool things to climb over, jump on and off of, balance on, and even a tunnel to crawl through. This is an easy thing for children to help build and then use to keep moving, and then rearranged.  Or, perhaps you're going to the playground and using the items there to make an obstacle course.  Either way - so much delight from that little girls face with crawling through the tunnel and jumping onto colorful circle dots.

https://www.amazon.com/Discovery-Kids-Adventure-Removable-Lightweight/dp/B07BR83L6J/ref=sr_1_55_sspa?keywords=crawl+tunnel&qid=1563483750&s=gateway&sr=8-55-spons&psc=1

2) Water Play: this could be in a pool or at the beach or running through the sprinkler in your back yard.  At the beach, you can bring various toys to play with - like a beach ball or shovels and pails to build a sand castle with a moat.  If the water isn't too cold where you are, and you're going in to swim - you can also play water games, swim races, hand stands in the water, or see how long you can balance on one foot while in the water.  For me, water play is kayaking.  In fact, I wish I was in my kayak right this minute.  But there are so many other options good for kids!  In Seattle, you can rent Canoes near UW, link  or rent kayaks or paddle boards at Green Lake or multiple places on Lake Union.  Tons of the teenagers coming into the clinic have been trying out paddle boarding this summer because it's so popular here.  Endless options to get outside and keep on moving.

3) Boot Camp or 4) Circuit Training and 5) Stretching: Attached to the "35 Activities" is a list of exercises and a list of stretches. But these additional lists can be organized in tons of different ways.  For example, boot camp directs you to choose a few exercises such as jumping jacks, push ups, sit ups, running in place and you do as many as you can for a minute, and repeat the routine a few times.  This idea is similar to circuit training, a technique I commonly use in the clinic, though the intensity is a bit different.  Using a variety of stretches, you could create your own home yoga class!  Even more fun, lay a towel out in the yard and do it outside!  I've previously written about my affinity for yoga here and strongly feel that though the intent is usually stretching, several stretches require you to work hard and also improve your strength and overall fitness. The list goes on with many ideas for games using these exercises such as assigning each one a letter, and then spelling out your name or a word.

So many great suggestions, and I've only touched the surface of the list from my coworkers!  This resource is really great - I can't wait to share it.  Don't forget about the tons of ways you can make walking fun: go somewhere different to explore a new neighborhood, make a list of objects to find (scavenger hunt) and see how many you find, walk your dog, go with friends, do it in the woods or at the beach, or make a game out of it like dancing every time you see a car drive by you.  Ride your bike or a skateboard or a scooter.  Also, a pack of sidewalk chalk makes your driveway into an endless number of games - like four square or hop scotch or into a race track.  My niece and nephew used to make a race track in their driveway with lava areas they had to avoid or stop signs or change of direction arrows that they drew before riding scooters or bikes or skates on it.

All these suggestions are a great follow up to my post last week about the negative impact of early sport specialization.  That post discussed concerns with athletes starting to play only one sport too young.  Though there is varying information, it is recommended that kids should play multiple sports until at least finishing middle school, probably somewhere around age 14.  This 3 year old had NO problem with wanting to climb on things, jump on things, stack cones, hop, skip, jump, squat, throw, kick... you name it, there was a TON of variety.  I don't think you need to be participating in multiple organized sports - you just need to move in more ways.  For example, strength training in an organized manner rather than playing your sport year-round could be a great way to improve your fitness and make a more skilled athlete.  Or, have a dance party with your friends... it's certain to look different than your usual sports.

It Takes a Village

ID 6052480

© Sgame

| Dreamstime.com

Happy Thursday, blog followers!

Warning: In this week's blog post, I'm being selfish.  I'm making a situation that has nothing to do with me, entirely about me.  But it's OK to do that if you admit it up front, right?

This past week, I received some terrible news. The instructor of my weekly Turbo Kick class, Meg, informed our class that she is moving away.  I’m sure she’s making all the right decisions for her family, but to me, this was crushing, devastating, drop me to my knees in tears while unnecessarily over-reacting, punch me in the gut, painful news. I didn’t see this coming. I’m not prepared.  Do I have enough time to get used to the idea of a new instructor coming in?  It took me SO LONG to psych myself up into attending her class in the first place! And it just can't be the same with another instructor.  Say it ain't so!

So, this week I'm writing about the village of people I've assembled to help me get my health in order as well as the positive impact of attending group exercise classes. This was a great reminder that you might be changing someone else's life without knowing it.  Sometimes I forget this when I'm working with my patients.  I have no clue how I've impacted people other than with their physical therapy, but I hope I've helped others the way Meg has helped me.

I joined the YMCA in August 2018 as part of my elaborate and carefully plotted plan to combat my eating disorder and body image issues, which I first discussed here.  I had been in severe denial about what was going on in my life, blissfully ignorant to reality, and had started seeing my therapist at the same time.  I decided to create a small village of people to help me with my journey: a therapist, a dietitian, someone to revamp my physical fitness - who ultimately became Meg - along with some family and close friends. I was entirely unmotivated to move my body - which I was currently hating - and I was sick of my training routine. I wasn't looking for group classes when I joined, hoping could manage my physical health myself, but considerd I might need another person in my village to oversee that, too.

I was initially opposed to group classes because I experienced a particularly uncomfortable CrossFit situation when the instructor told me that "a girl of my size should be lifting a lot more weight." To some extent he was correct - I could squat and deadlift a lot more than I was using there.  But at that time I hadn't been training much and knew the planned workouts included high repetitions and the volume was too much for me to load up the barbell as they recommended.  They pushed me to lift more, I pushed back saying I wasn't ready, and it was ultimately an embarrassing and painful situation.  It is specifically why I treat my own patients meeting them where they are - not where I want them to be.  So I had that experience, plus, I hate the idea of people seeing my body moving.

2008 CT Sun Yoga Class

Those reasons led to apprehension for group classes with the exception of yoga. In 2008 I went to a group yoga class with the Connecticut Sun and have been able to continue with yoga intermittently since then. I wrote about my recent return to yoga here, but, as I previously wrote, I only do hot yoga where I get high (or delirious) from oxygen deprivation that I basically can't tell anyone else is in the room.  Group exercise class?  For sure the others would notice that I'm fat, that I can't jump, that I will get tired, that I sweat a lot and breathe heavy, and that I'm not very coordinated.  Now, many months later, I'm here to tell you none of this occurred.  It was all in my head!

In October 2018, after walking by Meg's class on several preceding Mondays, I finally talked myself into trying her class.  I told myself that I knew the music was good and that I had to complete the class but that if I absolutely hated it, I would try one different class before swearing off group classes for the rest of eternity.  Dramatic much? Thankfully, Meg ran up to me that first day, super spunky and upbeat, introduced herself saying that her class was super fun and that it didn't matter if I knew any of the steps, just keep moving however I wanted to. I've been hooked ever since.

Here’s why Meg’s departure hit me like a ton of bricks.  I was in a deep dark hole of emotions and confusion when I started this journey and quickly learned that I needed to ask for a lot of help. I built my village including three smart, beautiful, strong women to help me pick myself up off the floor and put my pieces back together.  My therapist and dietitian knew each other, use similar approaches for treatment, and know all about my issues. I don’t think they intend to be sympathetic towards me, but sometimes they are, and sympathy isn't what I want or need.

But Meg is different.  She's not sympathetic towards me because she has no reason to be. She doesn't know why I'm in her class or what I'm dealing with. She barely knows anything about me, really, and that's just how I liked it. She's empowering and motivating because that's in her nature. And yes, it's her job, but there are other instructors in there with totally different vibes. I've walked by their classes a bit, too, wondering if I should add to my routine. Choosing her class was not a mistake. She welcomed me in, kick started most of my Mondays since October with high energy, a positive attitude, motivation, and joy. I purposefully attend her class right before going to see my therapist because turbo kick is basically a class where you can punch and kick your problems in the gut and my G-d I needed that.  It also lets out a lot of energy, which calms me and helps me organize my thoughts before saying them out loud.  When I started pairing turbo kick with therapy, I was really struggling to see my therapist because it was so vulnerable. Dance fighting with a room full of strangers is vulnerable, too, but way more fun than one on on conversations in a room with a couch and too many boxes of tissues.  I can’t actually tell which “treatment” has helped me more over the past six months, but I can tell you what this class did for me.

First- a group class has other people working towards their own goals- but the goals can be kept private as you work towards them together. I don’t know if people in the class are trying to lose weight, get stronger, let off some anger issues, or hear some current music. I don't know if they secretly wish to be a performer on a stage - but instead work as an accountant because they need to pay their bills. I don't know if they want to learn ways to protect themself if they were attacked, because truthfully, I would definitely use the moves I've learned there if someone came at me. I don’t actually care why they’re there. It doesn’t matter. We’re all going to do the same moves and at the end be disgustingly sweaty and high five each other with a sense of accomplishment towards our own goals.  I can go deadlift and have an awesome lift on my own, but there won't be anyone to high five me when I'm done. And because people start recognizing each other, it really does start to feel like community. Like if you missed a week, someone might ask if you were OK, or if you went on a nice vacation. Sometimes you just need that!

Second- all my concerns about other people watching me were entirely unfounded.  Nobody else is looking at what I'm doing in this class. They don't care. Once we get started, I barely even notice there are other people in the room, except to watch out for kicking my neighbor and to follow Meg instructing the moves.  Everyone is trying to get the steps right for themselves.  The rule is to keep moving even if you don't know the steps... but sometimes I know the steps and choose to do something different. For example, I CAN do burpees... but I hate them... so when there’s a burpee in the routine, I do jumping jacks or squats or whatever I want. Because for me, the whole point is to move. Not get better at burpees. Once I stopped exercising to lose weight and started doing it because it made me feel good, things in my life started to get a whole lot better. It’s still a struggle to make myself move regularly, so I attend a weekly dance party with some uppercuts and roundhouses thrown in and I actually feel like I’m prepared to conquer the week - whatever it may throw at me.

Third- and probably most important for my personal journey- the room is lined with a wall of mirrors. For the first several weeks, it disgusted me to see myself in the mirror. I was sure others could see how gross my body was. When I was diagnosed with my eating disorder, my testing suggested that I didn't have any body image issues. This was apparently very wrong. I've learned it was/is a huge problem. Prior to facing my issues, I didn't realize I was avoiding mirrors.  We have them at work, too, and I didn't even notice how much I put my back to them.  If I lifted at the gym, I didn’t want to see myself doing it. I don’t have a full length mirror at home and have never had one since I moved to Seattle.  I didn't actually realize how much I had been avoiding looking at myself until one class I caught myself in the mirror while doing a punching move and realized holy crap! That's me!  That's my body! It's doing all these things.  It's working hard and feeling pretty good. I’m actually able to tolerate looking in the mirror and smile at myself a little now.  That may not sound big... but for someone who went from not knowing what their body looked like at all and hating her own skin to tolerating her body and appreciating the things it’s capable of, I think it's huge. I’m sure somewhere down the road, there will be a time when I might like my body- and maybe even love it. That's not where I'm at right now, but I’m sure that the road started with the mirror in turbo kick.

And so, while I am sad to know my village is evolving, I’m eternally grateful for the role Meg played in it at the beginning.  Can't wait for the next Turbo Kick class.

Breaking Up With My FitBit

My Only Half Marathon

Towards the end of 2017, a friend asked me if I would be willing to commit to running 1000 miles in 2018 as a motivator for her training for some half marathons.  She's a good friend... like really good... like one of my favorite people on the planet... but that was an easy question. Heck no!

I'm not a runner.  In fact I think I hate running.  I can run. As in, if a bear was chasing me or I happen to be facing oncoming traffic, I could get out of the way at a faster pace than my usual walk.  I have run road races in the past - including running our first half marathon together.  There's a chance I'll run a 5K again... those are fun.  But after we ran the half marathon, she just continued running them.  She's probably past 30 half marathons by now.  I didn't run another... and I can't imagine I would.

There are so many ways to exercise that it's not a big deal that running isn't on my list of choices.  Occasionally at the gym I choose the treadmill and get in an interval training session instead of a bike or elliptical, but in general I choose lifting weights and a class whenever possible.  I think the only time I really choose to run is when the weather is nice and I can be outside or I'm exploring a new place.

So I agreed to completing 1000 miles on foot with the goal being to walk that many miles in a year... and she would run them.  I got a FitBit that I wore pretty much every day for 2018 to track my progress and it was really fun.  The FitBit app lets you cheer others on and does some fun things when you meet your daily goals.  I completed 1000 miles towards the end of September and felt like wearing the FitBit tracker definitely motivated me to go a little bit further.  If I was wrapping up my day and it said anything over 9,000 steps, I almost always found a way to wander the house to hit that 10,000 step milestone.  I jogged in place reading a book that was resting on top of the laundry machine or paced the hallway back and forth listening to a Podcast just to finish that last 1,000.

There were certainly a few days where I did next to nothing... but overwhelmingly it increased my motivation to move.  When I looked back, there were only 5 days in 2018 where I walked less than 1 mile.   There were also a few days when I walked more than 10 miles in a day hiking.  So those are balanced out, right?  I started walking on my lunch hour a few times per week and when my job relocated to a much larger building, my step count increased just by having the bathroom and lunch room considerably farther away.  I really liked seeing how the tracker affected me and how the job change affected my movement.

But now it's 2019, and the FitBit is no longer on my wrist.  There's two reasons for this change.

First - I've decided it's time for my body to tell me when it wants to move... not a machine.  Some days after work I'm just downright tired and don't want to go to the gym.  I'm tired of making myself feel guilty for taking a day - or even a few days in a row - off from exercising.  I think I may have been torturing myself a little last year to make myself move more than felt good for me.  And... when you're on the stair climber or the elliptical at the gym, if you don't move your arms enough, the Fitbit didn't register it so it's like you didn't work out, and then a stupid machine was making me feel bad.  I'm not into that.  Funny enough, if I type aggressively enough during the work day, the FitBit also recorded key strokes as movement...and that's just ridiculous.  Sometimes I just type with purpose!

"A Beautiful Mind"

Second - I tracked everything I did last year.  Every mile I walked.  The food I was eating.  Workout days, stairs trained, progress towards personal goals, even the books I read. There's a beautiful thing about tracking in that it shows a lot of accomplishment and completion of tasks.  There's also the opposite effect - I was intimately aware of all my failures.  I set some goals that were not reasonable and every time I noticed how far I was from achieving them, I felt bad.  My 2018 planner looks like John Nash's office in "A Beautiful Mind."  Circles and lines and random numbers with symbols for workouts everywhere.  The tracking needs to go.

So... if I go for a long hike with my friends this year, I'll probably grab the FitBit to see what the daily mileage looked like.  If I can find it and was prepared enough to charge it. But it'll be because I'm choosing to move and curious to know how much.  If I need a day on the couch... which doesn't happen that often... I'm going to embrace it instead of feeling bad about it.  And maybe the sun will come back out in Seattle, and I'll chose to go for a run.  Or go kayaking... because I love that far more.

As always... if you have a FitBit or other kind of tracker... you should use it how you like.  You do you.  I'll do me.  

Special Olympics 2018

The Special Olympics just wrapped up in Seattle and, in case you missed it, there were some really awesome moments.  I don't have a TV so I didn't get to watch nearly enough - but there were highlights posted online that were heartwarming and inspirational and I had the opportunity to volunteer with them on Thursday.  Here's my favorite photo, thanks to the Seattle Times:

Virginia Wade, 17 year old gymnast from Seattle

This was the 50th Anniversary of the Special Olympics with athletes competing in 14 sports.  As a physical therapist, I was disappointed that I was not permitted to provide sideline coverage for any of the events, but I was still able to volunteer to help screen healthy athletes for risk of injury.  I supervised a great group of Physical Therapy Assistants students who were completing a series of balance tests for hundreds of athletes.  Other groups were screening flexibility, strength, and aerobic endurance.  Our four stations were a small part of the available resources for the athletes, all of which included collecting baseline data on these athletes and helping to provide education for them to improve in areas where they may be at risk for injury.  Competing athletes were also given the opportunity to have a dental examination, vision check, hearing assessment, health assessment for blood pressure and body mass index, and a podiatrist foot inspection.  By completing several of these stations - all for free - athletes could be provided new hearing aids, newly made glasses with proper prescriptions, dental care, referrals for physical therapy or other healthcare services and they were provided a free pair of sneakers.  All of these things were provided by sponsors which is really incredible. 

I met hundreds of athletes from at least 20 different states.  We know that about 2,000 athletes were screened during the week, and that all 50 states and Washington, D.C. were represented by athletes.  Several of the Washington (state) athletes were followed by cameras to their various stations which was cool to see them getting a little extra treatment.  Several athletes had finished their competitions and were wearing their medals.  Having personally seen Olympic Medals in the past, I was pleased at the caliber of the medals used at this event, as well.  Still so heavy!  Each athlete was also wearing a credential and usually a team jersey or Special Olympics shirt with their state listed on it.  States were trading pins with each other and collecting them.  When the Connecticut delegation came through, I was super excited to see people from my home state, and they gave me a 50th Anniversary Special Olympics Connecticut pin!

Who competes in the Special Olympics? These are athletes who have an intellectual disability which means that they have limitations in their cognitive functioning that could include delayed learning and development.  The games are an opportunity for these athletes to "demonstrate ability rather tahn disability" and, among numerous other benefits of participation, provides them with free access to healthcare, and this is one of the foundational purposes of the Special Olympics.  Washington Special Olympics will hold another Special Olympics event again in August in Everett and they'll be looking for volunteers then, too.  I encourage people to check out the Special Olympics website, find their local community page, volunteer for an event, and support this awesome group of athletes! 

Real Athletes Poop Their Pants - And love the Jonas Brothers?

It was the summer of 2007 and I was working as the Travel Coordinator and Equipment Manager for the Connecticut Sun WNBA Team.  I had just graduated from UConn so maybe all the time I spent studying meant that I was a little behind on my pop culture.  One game the ball kids were going crazy with excitement about the half time show performers: The Jonas Brothers.  I had never heard of these guys, but they were so excited so I managed to snap a photo of the ball kids and the Jonas Brothers together.  In 2008, the Jonas Brothers were nominated for the Best New Artist Award at the Grammy's... so they must have been pretty good.

#TBT - the Jonas Brothers (Kevin, Joe, and Nick) and the Connecticut Sun Ball Kids (Carly, Maggie, and Clare)

Interesting fact about Nick Jonas: he was diagnosed as a type I diabetic at age 13 in 2005 - not long before that photo was taken.  The Jonas brothers as a band were pretty big from 2007-2011.  In 2015, Nick Jonas co-founded the group "Beyond Type I" whose mission is to educate, advocate, and provide resources to those who face diabetes.   This past week, Beyond Type I featured one of my closest friends on their website telling a story about her experience with Type I Diabetes as a long distance runner.  Her post has been re-posted in its entirety below, but before we get to her humor - here are five things you should know about Type I Diabetes.

1) The difference between Type I and Type II Diabetes:
Type I Diabetics are unable to make sufficient insulin in their pancreas to regulate their blood sugar.  The function of insulin in the body is to bring sugar into cells so it can be used for energy.  Without insulin, sugar remains in the blood which can harm organs and even be fatal.  Type I Diabetes is not curable, but through constant attention to diet and supplemental insulin, people can live full lives with the condition.  This differs from Type II Diabetes in which a person has built up resistance to insulin at their cells over time but whose pancreas still makes insulin.  Type II can be reversed through dietary changes and exercise.

2) Signs/symptoms of Diabetes:
With both Type I and Type II diabetes, it is common to experience increased urination, increased thirst,  and dry mouth.  Type I diabetics may also experience fatigue, abdominal cramping, nausea, vomiting, and a breath smelling like acetone which are less commonly seen with Type II diabetics. 

3) Insulin supplementation:
Type I Diabetics use supplemental insulin to regulate their blood sugars because they are unable to do so naturally or by diet and exercise.  They have to constantly track their sugar levels and consider the impact of anything they eat and the effect it will have on their body. Because they supplement with insulin, they can also experience hypoglycemia (too low blood sugar.)  Signs/symptoms of too low blood sugar include sweating, shakiness, light headedness, confusion, and fainting.  Because of the severe impact of low blood sugar, if you happen to come across someone with an ID bracelet identifying that they are diabetic, it is potentially lifesaving to give them sugar and call 911. 

4) Global Issue
While 90% of diabetics are Type II, the trend has been increasing for Type I by about 2-5% per year.  The frequency is not evenly distributed around the world.  For Type I Diabetes, Finland has a high frequency, the US has a moderate frequency, and China has a low frequency.  Interestingly, the above linked paper also notes that none of the regions had more females than males with Type I Diabetes but I only know four people with Type I Diabetes and they're all women. It is important to recognize that there are essential differences between the two conditions and that because Type II is so much more common, you need to be aware of which type you're reading about because the information usually does not apply to both types.  Diagnosis, treatment, and medications differ between Type I and Type II. 

5) Genetic Disposition
Multiple genes have been identified to relate to Type I Diabetes, but 40-50% of family linked cases relate to chromosome #6 and variations in Human Leukocyte Antigen which is a regulator of the immune system.  In the USA, 1 in 20 Type I Diabetics have a family member with the condition compared to 1 in 300 from the general population.  Identical twins are seen to have >60% and fraternal twins 6-10% occurrence of Type I Diabetes.  Children diagnosed before age 5 are suspected to have a higher genetic predisposition in their family than those diagnosed later in life.

Enough of the serious business and back to the reason for this post.  The following article first appeared on the "Beyond Type I" site here on April 11, 2018 and was written by my friend Cat Carter (reproduced with her permission).  She has run 29 Half Marathons - at least half of those since she was diagnosed with Type I Diabetes.  I like to claim that her running habit is my fault, as her first half marathon was in Providence, RI, with me.  If she ever commits to running one in Seattle, I'll get back to training to do another one - but until that time, I stair climb and I don't run.  After Providence, she kept running them and I sat in a chair in the corner of Koon's Hall at UConn for the next 3 years. There has been extensive debate about how and when we met, but we've been friends for at least 15 years and I lived with her for all of PT School - so if she can suffer through the terrible person I was when hungry and sleep deprived, she's gotta be worth getting to know.  Enjoy her post!

With Cat Carter before the Providence, RI Half Marathon

I run half marathons for many reasons. a) I enjoy the physical and mental challenges each race offers. b) Runners are some of the friendliest folks around, so although I prefer to train alone, I have met some of the kindest and coolest people at races and in my running clubs. c) My internal motivation is super in the toilet, so it’s a safe bet that I won’t exercise without a race on my calendar. d) The world is full of blissfully ignorant fools. Harsh and unkind words, I know. But seriously, how often do you hear ridiculous diabetes jokes? How many instances can you think of when the media, a politician, or another individual or group with influence and power spread blatantly wrong information about the disease? I run to prove them all wrong and spread our Truth.

And e) I like medals. I like how they look hanging on my wall. I like how they sound when they clink together. And I love the memories and feelings of accomplishment each one of them evokes. I’m not at all above doing a race for the bling. I did a race in Amish Country one time because its medal was a horseshoe. A horseshoe. It was awesome. And my amazing wife was inseminated without me there because I was doing a race that had a shark finisher medal. (Yes, you read that right. Who knew it was going to take on the first try? I mean, really, what are the odds? Mama loves you, Liam, and I promise I won’t miss any other critical moments of your life.) So when I found a race for which the medal was a grilled cheese sandwich (a local race no less – you go, Connecticut!) you bet your ass I was all in.

Unfortunately, that particular June day in 2016 turned out to be rather rainy. Now normally I don’t hate running in the rain. It’s not the worst thing ever. Sure, putting all of my (diabetes tracking/treating) devices in waterproof bags is less than ideal and a royal pain in the ass, but it’s manageable. While we’re here, how many of you hate that word? “Manageable.” Ugh, gross. It’s almost as bad as “moist.” If I hear one more person say, “Hey, don’t worry, diabetes is manageable,” I’m going to come unglued. I think the world needs a quick tutorial on the meaning of “manageable.”

Aaaaaaaaaaaaanyway. I’m going to reel myself back in. Where were we? Yes, the grilled cheese race. Okay, so there I was plugging along mile after mile when I felt something … below. Like, below, below. In the bottom of my pants below. So I did what any human being who thinks they’ve just pooped their pants would do: I panicked internally for roughly three minutes. Which I know doesn’t sounds like a long time, but do me a solid – pun intended – and take a pause for three minutes. While taking that pause, imagine you’ve just pooped your pants, you’re in a very public place, and you have absolutely no idea where the nearest restroom is. Now, can we agree that three minutes is on the same level as an eternity?

Here was the major problem – not only was the medal a grilled cheese sandwich, but all finishers also got a real grilled cheese sandwich with chocolate milk. I was wicked hungry, and I really wanted that sandwich, but you cannot just roll into the food line at the end of a race with poopy pants. You will make exactly zero friends doing that. So I summoned the courage to nonchalantly check the damage, and much to my relief it wasn’t poop … but my Omnipod. That slippery little sh*t.  My pump! I never thought I’d be excited to learn my pump fell off, but at that moment in time I was damned near ecstatic. It was the first race I’d done in the rain since diabetes, and I didn’t even think to reinforce my pod. Stuck to my upper buttocks, it must have lost its adhesion in the *moist* conditions and slid down. Thankfully I had a pen in the car I could use post-race for my coveted sandwich, now only a short 2 miles away – crisis averted.

In closing, real athletes poop their pants. I’ve read about it on the Internet, so it must be true. See here, here, and here. What did I tell you? It’s totally, 100% a thing. So if I thought I pooped my pants and didn’t slow down (or cry!) … I must be a real athlete, too. Go. Me. And if you’ve ever pooped (or peed) your pants while getting your diabadass workout on, then go, you, too!

Who needs drugs when there's hot yoga?!

Photo Credit: Geralt

I once wanted to be a runner. Not an elite runner, just someone who liked going for a long, casual, weekly run as part of a healthy routine.  This seemed like a good plan for my future, so I read several books about becoming a runner - all of which said consistency was key.  So I ran.

In 2011, I trained for (and completed!) a half marathon.  Starting at three miles, I followed a charted training program with progressively longer runs every week for at least 12 consecutive weeks. Once I got lost while running an 8-mile route, ultimately going 13, and at some point I ran out of water and cried to a gas station attendant who gave me a cup and showed me a map to get home.  My sense of direction is THE WORST.  It was a few weeks before the race and the only positive of that experience was learning I could crawl 13 miles to complete the race if I had to, but I would cross that finish line.

And then race day came. Several of my best friends were also running that weekend in Providence, RI.  Four of us had booked a hotel room near the finish line.  The race started without issue, mostly flat with a little bit of a hill at the 3rd mile.  Mid-way through the race, a lady thanked me because I had been belting "Party in the USA" by Miley Cirus at the top of my lungs and she had forgotten her headphones. Poor lady.  I remember hitting the 10 mile marker and thinking: only 5K left to go! I've run several 5K's.  No big deal! And then my body started to say "Nope!  No More."  It was horrible and I wanted to die right there on the side of the road. I decided then that running wasn't for me.

I think I recall the day so clearly because upon waking the next morning, incapable of moving my legs despite the ice bath I had endured the night before, I remember watching the news to see President Obama announcing that Osama Bin Laden was dead. Last night, I finally learned why running is the worst.  In all the training runs, the 5K races, the half marathon race itself, and in every road race or stair climb I've done since then, I’ve never experienced what is commonly called “The Runner's High”. Sure, I feel good after a workout, but something was missing. 

"The Runner's High," according to this 2008 publication from the journal Cerebral Cortex, is defined as "a euphoric state resulting from long-distance running." The paper goes into detail about how they were studying opioid receptors in the frontal and limbic regions of the brain (the brain parts responsible for personality, behavior, mood, fear, and pleasure).  The measurements were done when the runners completed about a half marathon distance, so likely I just don't run long enough distances to get there.  But I don't want to run those kinds of distances to feel so good.

Last night I achieved the fabled runners high in the most unlikely of places.  I went to a power vinyasa class at Fusion Hot Yoga.  Sixty minutes of constant motion with a room full of strangers (and one friend) sweating profusely. They were celebrating the company’s birthday with a day of free classes and the participants were packed in - sardine can style.

The instructor, Brian Pittman, started class off with some supine bicycles. I have patients do 20 of them in the clinic all the time - nice! I know what I'm doing.  When we hit 50 I started to lower my legs, and then he said half way! Ha! I was sure I was done for and basically ended up in a static dead bug pose thinking “what have I gotten myself into?!” I’m not sure how hot the room was but if I had to guess it was about 85F with 1,000,000% humidity. It felt like I was swimming in a bowl of soup. I LOVE the heat.

I was thrilled to remember the names of many of the common poses and a frequent sequence of a low plank into an up-dog followed by a downward-facing-dog. I only felt like I might pass out twice and gave myself a few extra breaths in child's pose and some water to recover.  Afterwards, the adrenaline started.  I turned off the audio book in the car for the ride home so I could sing along to the radio.  I stopped for gas and was jumping up and down full of energy, and still sweating.  I slept the greatest sleep ever.  And then I woke up today and felt the high energy continue for most of the day.  Maybe it's all in my head... but I'm happier believing that I had a whole day of runner's high from an hour of yoga.  All day long I've wondered - how is there an opioid epidemic in the world - yoga has to be cheaper than heroin and this high has to feel infinitely better.  It was hard work to get there, but it didn't require me running 13 miles.

So this is my new solution to the opioid epidemic: for treatment of back pain or for detoxing off a heroin addition - see a physical therapist and go to hot yoga.  I already bought my Groupon for more classes, so you can come join me to sweat it out!

Seattle Ignited Women Project #SIWP

 📷: http://seattleignitedwomenproject.com

Last night I attended an event that was devoted to women empowering women. The Seattle Ignited Project, started in 2017 by Allison Tenney to "redefine what strength and success means as a woman." The speakers, catering, sponsorship, and facility space were all consistent with the idea of inspiring women in all their roles - as female business owners or entrepreneurs or fitness pros or athletes or innovators or moms.

The Riveter is a space devoted to empowering women moving their businesses forward.  They host events that support female initiatives and serve as a work space for thinking, networking, and productivity to start or further develop your company.   I typically write my blog from my living room or from Walnut Street Coffee - but I loved this concept.  And the food! Catered by That Brown Girl Cooks were roasted veggies and chicken sliders with garlic aioli and Chef Kristi Brown's famous hummus.

The sponsors were a series of tables by mostly local companies - all women owned - with a variety of purposes and goods.  I'd love to tell you about them all - but instead I'll pick my two favorites.  I was super excited to see my good friend and fellow Seattle Storm sideline pal Emily Blurton to learn more about her personal training and athletic development business - Emblem Fitness.  She's bright and talented and I'm so fortunate to have her in my circle - Check out her site! I also really liked meeting the crew from Intentionalist - an online directory of businesses owned by women and/or LGBTQ individuals so that consumers can choose to spend their money intentionally in support of these organizations.

The speakers were inspiring.  I had never heard of Erin Brown before this event - TRAVESTY! She presented a list of "Ten Things She's Reasonably Sure Of" which included many valuable lessons.  One of those was "Take Time to Digest" from which she discussed that people are consuming information at a rapid-fire pace and we can't process or fully comprehend it all at the rate in which we receive it.  Her recommendation was to be mindful of how we choose to access these inputs - such as potentially spending less time with the social media and respecting other peoples' stories.  It made me think about how I just finished reading Pride and Prejudice about 2 weeks ago, and how in those days (early 1800's), you would receive a letter by horseback riding mail carrier, and you would take the time to sit at a desk with a quill and ink, carefully process the information,  and write a deliberate and thoughtful response. If you send me at text, I almost instantaneously respond - sometimes without actually even comprehending the full incoming message and too often with an impulsive reaction.  The emotion of our communications is lost with our new means of interactions and it's not moving us in a positive direction.  I like to think this blog post is a small way for me to digest the information from last night, process it and see what I really took away from it.  (CT Pals - she's coming your way soon!)

Gina LaRoche was the second speaker and she very eloquently spoke about three of the seven laws that are in her soon-to-be published book "The Seven Laws of Enough."  I understood her message to be more about introspection.  Spoiler Alert: Law Seven is "Love is the Answer" but the question surprised me:  "How well have I loved myself today?"  I'll be honest - I generally think meditation and mindfulness are garbage... but this view is an ignorant one because I have never given it a try.  In the past several months, I've been working on a focused program for a healthier me, and only last week did I even consider that there should be some amount of mindfulness practice included in that.  But I don't like doing it! (Maybe because I'm so terrible at it!)  Gina led a meditation practice and I could see the reaction others in the room had to this moment, and I decided I had to give this a fair shot for the next few months. I practice skills for my career and for getting better at this blog writing stuff and for my physical fitness - why couldn't I practice something to improve my mind?

The evening wrapped up with a panel discussion including: Crossfit Competitive Champion and Olympic Weight Lifter Elisabeth Akinwale,USA Soccer Olympian turned speaker/activist and performance trainer Lori Lindsey,  and ESPN Journalist Dianna Russini, moderated by The Riveter CEO Amy Nelson.  They talked about their journeys, obstacles, accomplishments, and what drives them to support women personally, in the world, in the workplace and in athletic endeavors.

I can't ignore the people in the crowd because the room was full of about 100 women and they were awesome too!  For example, I met Sally Roberts, two-time world bronze medalist in wrestling and founder of Wrestle Like a Girl which supports young girls through college-aged women who want to participate in wrestling.

Ultimately - it was a fun night that provided me with some new perspective and numerous ideas to ponder.  I'm excited to see where Allison Tenney takes the event in the future, and I'd definitely attend in the future.  I hope you'll click a few of the links and look into some of the people who participated to learn more about some really strong women working to improve the world for the next generation of girls to have better opportunities in the future.

Introduction

A blog needs to start somewhere, right?

I've been pondering a blog for a while - but was struggling to get organized.  Who would be reading? What topics should I focus on?  My focus has been narrowed down to three components.

1) Education
As a physical therapist, I'm constantly looking for new learning and resources and never able to read quite enough.  This includes discussions of rehab, nutrition, recovery, training, supplementation, psychology, pain science... the list goes on. This blog will be a place where I can share some of the knowledge I'm gaining from the experts. A place to be able to go back and find articles that are clinically relevant and making changes to the way I practice physical therapy.

The experts I've most admired in my first 3 years as a clinician - (not an exhaustive list) - but whose thoughts will inevitably shape some of my posts:
- Mike Reinold - and his whole crew at Champion Physical Therapy and Performance
- Eric Cressey - and his crew at Cressey Sports Performance (and a fellow UCONN HUSKY!)
- Bret Contreras - The Glute Guy
- Tim DiFrancesco - TD Athletes Edge
- John Rusin
- Grey Cook
- Sue Falsone - the lone lady in the crew.  Last, but certainly not least.

2) The Female Athlete and 3) Injury Prevention.
I have a tiny role in the women's basketball world, and I've been there, in varying capacities, for more than 15 years.  I've been at the high school, college, and professional level with opportunities to experience international competition on the world stage.  To me, when the women play basketball, it's an art form. When I see these incredible athletes suffer injuries, especially when they could have been prevented, I am saddened.

My grad school research was devoted to women's basketball injuries, thanks to the greatest mentor, Dr. Lindsay DiStefano.  Now, three years later, there still aren't enough publications in this patient population - or in other women's and girls' sports and I've let them down by not working harder to do something about that.  Hand-in-hand with the body of knowledge in women's sports is a focus on injury prevention.  I've had the opportunity to work with female athletes from so many sports, and when the injuries are from repetitive use and poor mechanics, there are things that can be done to prevent this.

Lastly, when looking to the list of mentors above and in searching for the experts in the physical therapy world, the field is dominated by men.  How is this possible when, according to the APTA website from 2010 - females were 68.3% of the profession?  So here's to trying to get the female perspective a little more publicized.  I am light years away from being an expert - I just want to see more females in the spotlight.  For this, I hope to have female colleague contributors as we move forward on this adventure.  Don't worry guys - you'll benefit from our contributions.


Abby