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July 15, 2019
July 8, 2019
Varden Lake – July, 2019
Trail Head
Varden Lake
Varden Lake
Me & ‘Cedar’
Shirlee & Cedar
Shirlee & Cedar
July 2, 2019
July 1, 2019
Who Decides What you Think About?
Here is a story (‘research’, pardon me), about what you think about verses what actually happens.
Well, it is actually way worse than this article implies: What is the third leading cause of death in this country? The cause not even mentioned in this research article that claims to list the top ten. (It is as interesting what you do not think about as it is what you do.)
But you may have read about the third leading cause of death in this country here recently. Shhhhhh, no one is supposed to think about that!
June 12, 2019
“Fasting” the movie (well documentary); Jason Fung, M.D.
It came out in 2017, but I only found out the other day. A great movie, staring (among others) Jason Fung, M.D. this movie is comprehensive, so it has a lot of stuff that will not apply to most people. But it is a very good documentary. Easy to find on Netflix – I do not know about the rest of it.
Also, it is a little scary, by design. The sicker you are, the more risky anything you do is, in terms of reaction – you have to be careful who you listen to.
It is interesting that it did not take them long in the movie to refer to T. Colin Campbell (the plant-based diet guy) – though they never did mention his China Study.
Now I am reading Why We Sleep by Matthew Walker, PhD., another very good book. In it he didn’t get too far along before he was referencing the Greek island of Ikaria – with regard to napping (important!). He never did mention Blue Zones though, by name. It is one of the five blue zones.
May 30, 2019
“Beyond Measure” – A Book Review
Beyond Measure (2015), by Vicki Abeles and Grace Rubinstein, is about rescuing an “over scheduled, over tested, underestimated generation”. It followed a documentary, also done by the author, called “Race to Nowhere.”
The issues of the current generation trying to become adults spills over into the conversations we have with patients – and their kids (they are all patients:-).
I had no idea the magnitude of the problem. Yes, we have – for years – talked about the heavy back packs; and now, of course we talk about “text neck”. That is the tip of the iceberg.
I would say that if you have school-aged kids, or will have, or they or their parents are in your life at all, this would be a book for you. It is well written, and though the authors spend a lot of print on the problem – details meant to convince and compel, which I do not need, but you may.
Here I would just like to share quotes that struck me.
“nature-deficit disorder” on page 79 – it becomes a health issue very quickly.
Meaningless (school work) leaving the kids with no sense of purpose. “Change the system not just the symptoms”. (They do a great job of getting to cause.)
“deep learning is as much about the process as it is about the product.
Become a “Rat Racer in Recovery” page 197. They do this a lot – it helps with retention:-)
“An act of cultural defiance” breaking old habit and familiar patterns – in maintaining balance – referring to digital detox.
“Define success with wellness at the core.” There is an idea that I can get behind!
In reclaiming a runaway schedule: ask what matter most (to yourself, and the kids – ask them the question).
Peace has to precede wellness – first measure of successful parenting – who they are verse what they do.
Focus on real connection
School work should be done at school.
“There is more than one path to a meaningful life.”
This whole book is about “project-based learning” as an alternative to what kids experience currently.
“Frustrated beyond function”
“A problem shrouded in silence a decade ago.”
“Childhood is not a race: say ‘no, it’s not a race'”.
“The most important lessons and qualities can not be measured – insisting on measuring them will never lead kids to thrive.”
Chapter 8, First Be Well – “The deliberate promotion of children’s wellbeing”, “Beyond healthy – strive toward happy”, Prevention: social and emotional learning; positive psychology (University of Pennsylvania, Martin Seligman); and… mindfulness (See 2014 cover of TIME magazine)
The coordinator of mental health services and outreach at Harvard started offering mindfulness classes in student dorms and found it to be the “single most effective tool” he’s encountered in his work so far.” Page 198
This hits home for me, of course, as a Tai Chi instructor, both at the local Community College, and a local gym. Mindfulness, relaxation, and developing both external and internal awareness, is at the very heart of Tai Chi.
I would like to end with a quote from the front cover of the book: “America. This is your wake-up call. With both heart and smarts, Vicki Abeles showcases the courageous communities that are rejecting the childhood rat race and reclaiming health and learning. Our kids really need us to listen.” – MARIE SHRIVER
May 29, 2019
The Big Three
Scroll down a ways and you will find a Post for each of the Big Three exercises…
Start here: https://doctordilday.wordpress.com/2015/07/
May 26, 2019
May 23, 2019
For Tai Chu Students: Paul Silfverstråle
Here is the newest offering by Swedish tai chi elder brother, Paul Silfverstråle.
May 21, 2019
The Context of “Exercise” – The Dreaded Re-injury
If the subject is back pain, the consensus among many of the ‘experts’ is that the “natural history” of back pain is a series of episodes: the #1 predictor of back is…? Answer: you have had back pain in the past. Ask any athlete that has been around for a few decades and they will tell you that old injuries tend to re-visit and re-occur – we call them relapses if they re-occur within a reasonably close time to relief of symptoms.
So if an old injury is a weak link, what can you do? Well, make the weak links as strong as they can possibly be. If structural stability is compromised, emphasize muscular stability way beyond what would otherwise be considered adequate.
But, it is going to happen (re-injury that is). Then what? You have to start the cycle over again, from the start, and go through each phase as carefully and mindfully as you did the first time. For us, and for most professionals in the business, patients’ injuries were never properly rehabilitated. As soon as symptoms were relieved, either the doctor or the patient discharged themselves from care, and went on as if they were back to “normal.” If exercises ever were seriously discussed, or done, they are dropped (how we got to this series in the first place); and how to maintain progress, or continue progress, never gets discussed: the patient is not there to discuss it.
The re-injury itself may or may not have been avoidable – remember Safety First! But the entire focus of this series is that a full and proper recovery, followed by mindful and correct use of the body, will ensure the fewest and least dramatic episodes in the future. In my case I had regular back pain episodes for 15 years. After I figured out what I just shared here, it was more than 15 years without a single episode – and really only one in the past 20-plus years.
Apply the principles described in this series of Posts, in the absence of symptoms, and you have prevention. Imagine that!
May 20, 2019
The Context of “Exercise” – The Recovery Phase
Then “core” stabilization or strengthening.
I kind of backed into this series of Posts inadvertently. Initially, I wanted to address some of the issues that could come up in the consideration of why or why not to do an exercise – when to stop doing it.
But, years ago, I did want to do a series on this cycle (injury-relief-rehab-recovery-reinjury). I began with the story about my own back injury and how I progressed to full recovery. (It took 15 years and had almost nothing to do with any of the health care professionals I came in contact with – the rehab and recovery phases didn’t that is.)
So why is it necessary to talk about recovery at all: you are ‘recovered’ after all. Well, in a word: relapse. In the tissues of a significant injury, aging is going to take place faster than in the surrounding, uninjured tissues. That injured spot is a weak link. Now might be the time to take a more global look. To find out if there are other weaknesses that need to be balanced out. Finally, the phrase, “I just want to ‘get in shape'” makes sense. This part is about your longer term future. The point I would make here is the same one I have made all along: what you do should be guided by why you are doing it. Elsewhere (all over) this Blog I have written about setting goals, assessing where you are now, “progressing” in steps to where you want to be. That is all covered. Use the search box on this Blog, using whatever key words seem appropriate, to find a list of Posts. (Start with “progressions” to get started.) Here, too, there are all kinds of ‘normals’ that can guide you into exercises that will give you meaningful benefits safely. And normal is a worthy goal: most people are far from it. It will keep you healthy. How you get there is a journey. And you know about journeys… they all start with a single step:-)
If you need help, let me know.
May 18, 2019
The Context of “Exercise” – Rehab Phase “Core Strengthening”
Now, finally, strengthening the ‘core’ muscles. To begin, there are the following four assumptions: (1) you are pretty much out of pain, (2) you are in adjustment, pretty much, (3) there is little to no pain with palpation during visits to the office, and (4) you do know how to move properly and can demonstrate that.
You can argue whether stretching hamstrings belongs in the Rehab or the Relief phase, but when it comes to core strengthening exercises, failing to factor in the above assumptions can come at a cost.
All of these ‘phases’ overlap in real life. That is where it becomes and ‘Art’.
If you are following the research, then strengthening the core begins with “The Big 3”. These are tried and true exercises that work. They have been studied enough to know that as a way of strengthening, they will work. The Big 3 amounts to abdominal strengthening (ala Stuart McGill if you are absolutely on the straight and narrow). (Personally, this is where I make sure that the Reverse Back Crunch is in place, effective and not painful, then I move patients into the McGill stomach exercise. Second, is the Bird Dog – on the hand and knees, then one arm and the other leg extended. (Like everything else here, we could spend all day talking about the Bird Dog – technique is everything!) Third is the Side Plank: a tough exercise, one which I always give last and bite into carefully. Here too, bracing (but this time the shoulder as well as the trunk) is critical to correctly doing the exercise. Don’t use anything that I have put in a Blog Post as instructions on how to do an exercise: get professional instruction from someone who knows what they are doing.
Strengthening can then proceed, typically, to the repetitive squat, lunge, one-legged standing, and eventually, the gym ball exercises that involve back muscle endurance.
One nice thing about many of these exercises is that they double as balance tests, or tests of what a normal. So if you fail the test, you know that you need to do the exercise – and you have not fully rehabilitated your back.
A reasonable time doing all of these exercises (at least to test), without pain, is the evidence that you have rehabilitated a back pain episode to the point where you can think about “going to the gym to get in shape”.
