Built from Broken – by Scott Hogan, CPT, COES
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So many exercise programs come with the caveat “consult your doctor before engaging in any new activity”, and the safe-but-simple “do not try to train through an injury”.
Which is all very well and good for someone in fabulous health who sprained an ankle while running and can just wait a bit, but what about those of us carrying…
- long-term injuries
- recurring injuries
- or just plain unfixable physical disabilities?
That’s where physiotherapist Scott Hogan comes in. The subtitle line goes:
❝A Science-Based Guide to Healing Painful Joints, Preventing Injuries, and Rebuilding Your Body❞
…but he does also recognize that there are some things that won’t bounce back.
On the other hand… There are a lot of things that get written off by doctors as “here’s some ibuprofen” that, with consistent mindful training, could actually be fixed.
Hogan delivers again and again in this latter category! You’ll see on Amazon that the book has thousands of 4- and 5-star ratings and many glowing reviews, and it’s for a reason or three:
- The book first lays a foundational knowledge of the most common injuries likely to impede us from training
- It goes on to give step-by-step corrective exercises to guide your body through healing itself. Your body is trying to heal itself anyway; you might as well help it accomplish that!
- It finishes up with a comprehensive (and essential) guide to train for the strength and mobility that will help you avoid future problems.
In short: a potentially life-changing book if you have some (likely back- or joint-related) problem that needs overcoming!
And if you don’t? An excellent pre-emptive guide all the same. This is definitely one of those “an ounce of prevention is better than a pound of cure” things.
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Almonds vs Pecans – Which is Healthier?
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Our Verdict
When comparing almonds to pecans, we picked the almonds.
Why?
In terms of macros, almonds have more protein, carbs, and fiber, as well as the lower glycemic index. A strong start for almonds here, though pecans have more fat (and the healthy blend of fats is quite comparable from one nut to the other).
In the category of vitamins, almonds have more of vitamins B2, B3, B9, E, and choline, while pecans have more of vitamins A, B1, B5, B6, and K. Numerically that’s a tie, though the biggest margins of difference are for vitamins A and E, respectively, and we might want to prioritize almonds’ extra vitamin E, over pecans’ extra vitamin A, given that vitamin A is more easily found in large quantities in many foods, whereas vitamin E is not quite so abundant generally. So in short, either a tie or a slight win for almonds here.
When it comes to minerals, both contain a lot of goodness, but almonds have more calcium, iron, magnesium, phosphorus, potassium, and selenium, while pecans have more copper, manganese, and zinc. A clear win for almonds, though as we say, pecans are also great for this, just not as great as almonds.
As a side-note, both of these nuts have been found to have anticancer properties against breast cancer cell lines. In all likelihood this means they help against other cancers too, but breast cancer is what the extant research has been for.
So, naturally, enjoy either or both (in fact, both is ideal). But if you want to choose one for nutritional density, it’s almonds.
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts
Take care!
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Thinking about trying physiotherapy for endometriosis pain? Here’s what to expect
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Endometriosis is a condition that affects women and girls. It occurs when tissue similar to the lining of the uterus ends up in other areas of the body. These areas include the ovaries, bladder, bowel and digestive tract.
Endometriosis will affect nearly one million Australian women and girls in their lifetime. Many high-profile Australians are affected by endometriosis including Bindi Irwin, Sophie Monk and former Yellow Wiggle, Emma Watkins.
Symptoms of endometriosis include intense pelvic, abdominal or low back pain (that is often worse during menstruation), bladder and bowel problems, pain during sex and infertility.
But women and girls wait an average of seven years to receive a diagnosis. Many are living with the burden of endometriosis and not receiving treatments that could improve their quality of life. This includes physiotherapy.
Netpixi/Shutterstock How is endometriosis treated?
No treatments cure endometriosis. Symptoms can be reduced by taking medications such as non-steriodal anti-inflammatories (ibuprofen, aspirin or naproxen) and hormonal medicines.
Surgery is sometimes used to diagnose endometriosis, remove endometrial lesions, reduce pain and improve fertility. But these lesions can grow back.
Whether they take medication or have surgery, many women and girls continue to experience pain and other symptoms.
Pelvic health physiotherapy is often recommended as a non-drug management technique to manage endometriosis pain, in consultation with a gynaecologist or general practitioner.
The goal of physiotherapy treatment depends on the symptoms but is usually to reduce and manage pain, improve ability to do activities, and ultimately improve quality of life.
What could you expect from your first appointment?
Physiotherapy management can differ based on the severity and location of symptoms. Prior to physical tests and treatments, your physiotherapist will comprehensively explain what is going to happen and seek your permission.
They will ask questions to better understand your case and specific needs. These will include your age, weight, height as well as the presence, location and intensity of symptoms.
You will also be asked about the history of your period pain, your first period, the length of your menstrual cycle, urinary and bowel symptoms, sexual function and details of any previous treatments and tests.
They may also assess your posture and movement to see how your muscles have changed because of the related symptoms.
During the consultation, your physio will assess you for painful areas and muscle tightness. Netpixi/Shutterstock They will press on your lower back and pelvic muscles to spot painful areas (trigger points) and muscle tightness.
If you consent to a vaginal examination, the physiotherapist will use one to two gloved fingers to assess the area inside and around your vagina. They will also test your ability to coordinate, contract and relax your pelvic muscles.
What type of treatments could you receive?
Depending on your symptoms, your physiotherapist may use the following treatments:
General education
Your physiotherapist will give your details about the disease, pelvic floor anatomy, the types of treatment and how these can improve pain and other symptoms. They might teach you about the changes to the brain and nerves as a result of being in long-term pain.
They will provide guidance to improve your ability to perform daily activities, including getting quality sleep.
If you experience pain during sex or difficulty using tampons, they may teach you how to use vaginal dilators to improve flexibility of those muscles.
Pelvic muscle exercises
Pelvic muscles often contract too hard as a result of pain. Pelvic floor exercises will help you contract and relax muscles appropriately and provide an awareness of how hard muscles are contracting.
This can be combined with machines that monitor muscle activity or vaginal pressure to provide detailed information on how the muscles are working.
Yoga, stretching and low-impact exercises
Yoga, stretching and low impact aerobic exercise can improve fitness, flexibility, pain and blood circulation. These have general pain-relieving properties and can be a great way to contract and relax bigger muscles affected by long-term endometriosis.
These exercises can help you regain function and control with a gradual progression to perform daily activities with reduced pain.
Low-impact exercise can reduce pain. ABO Photography/Shutterstock Hydrotherapy (physiotherapy in warm water)
Performing exercises in water improves blood circulation and muscle relaxation due to the pressure and warmth of the water. Hydrotherapy allows you to perform aerobic exercise with low impact, which will reduce pain while exercising.
However, while hydrotherapy shows positive results clinically, scientific studies to show its effectiveness studies are ongoing.
Manual therapy
Women frequently have small areas of muscle that are tight and painful (trigger points) inside and outside the vagina. Pain can be temporarily reduced by pressing, massaging or putting heat on the muscles.
Physiotherapists can teach patients how to do these techniques by themselves at home.
What does the evidence say?
Overall, patients report positive experiences pelvic health physiotherapists treatments. In a study of 42 women, 80% of those who received manual therapy had “much improved pain”.
In studies investigating yoga, one study showed pain was reduced in 28 patients by an average of 30 points on a 100-point pain scale. Another study showed yoga was beneficial for pain in all 15 patients.
But while some studies show this treatment is effective, a review concluded more studies were needed and the use of physiotherapy was “underestimated and underpublicised”.
What else do you need to know?
If you have or suspect you have endometriosis, consult your gynaecologist or GP. They may be able to suggest a pelvic health physiotherapist to help you manage your symptoms and improve quality of life.
As endometriosis is a chronic condition you may be entitled to five subsidised or free sessions per calendar year in clinics that accept Medicare.
If you go to a private pelvic health physiotherapist, you won’t need a referral from a gynaecologist or GP. Physiotherapy rebates can be available to those with private health insurance.
The Australian Physiotherapy Association has a Find a Physio section where you can search for women’s and pelvic physiotherapists. Endometriosis Australia also provides assistance and advice to women with Endometriosis.
Thanks to UTS Masters students Phoebe Walker and Kasey Collins, who are researching physiotherapy treatments for endometriosis, for their contribution to this article.
Peter Stubbs, Senior Lecturer in Physiotherapy, University of Technology Sydney and Caroline Wanderley Souto Ferreira, Visiting Professor of Physiotherapy, University of Technology Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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It’s On Me – by Dr. Sara Kuburic
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This isn’t about bootstrapping and nor is it a motivational pep talk. What it is, however, is a wake-up call for the wayward, and that doesn’t mean “disaffected youth” or such. Rather, therapist Dr. Sara Kuburic tackles the problem of self-loss.
It’s about when we get so caught up in what we need to do, should do, are expected to do, are in a rut of doing… That we forget to also live. After all, we only get one shot at life so far as we know, so we might as well live it in whatever way is right for us.
That probably doesn’t mean a life of going through the motions.
The writing style here is personal and direct, and it makes for quite compelling reading from start to finish.
Bottom line: if ever you find yourself errantly sleepwalking through life and would like to change that, this is a book for you.
Click here to check out It’s On Me, and take control of what’s yours!
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Fasting Without Crashing?
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Intermittent Fasting: What’s the truth?
Before we get to facts and fictions, let’s quickly cover:
What is Intermittent Fasting?
Intermittent Fasting (IF) is an umbrella term for various kinds of time-restricted fasting, based on a schedule. Types include:
Time-restricted IF, for example:
- 16:8—Fast for 16 hours, eat during an 8-hour window
- 18:6–Fast for 18 hours, eat during a 6-hour window
- 20:4—Fast for 20 hours, eat during a 4-hour window
24hr fasting, including:
- Eat Stop Eat—basically, take a day off from eating once a week
- Alternate Day Fasting—a more extreme version of the above; it is what it sounds like; eat one day, fast the next, repeat
Non-fast fasting, e.g:
- 5:2—Eat normally for 5 days, have a very reduced calorie intake (⅓ of normal intake) for the other 2 days
- Fruit Fasting—have a small amount of fruit on “fast” days, but no other food
- The Warrior Diet—as above, but include a small amount of non-starchy vegetables
Why IF?
While IF is perhaps most commonly undertaken as a means of fat loss or fat management (i.e., keeping fat down when it is already low), others cite different reasons, such as short term cognitive performance or long-term longevity.
But… Does it work?
Here we get into the myth-busting bit!
“IF promotes weight loss”
Mix of True and False. It can! But it also doesn’t have to. If you’re a bodybuilder who downs 4,000 calories in your 4hr eating window, you’re probably not going to lose weight! For such people, this is of course “a feature, not a bug” of IF—especially as it has been found that, in an acute study, IF did not adversely impact muscle protein synthesis.
“IF promotes fat loss, without eating less”
Broadly True. IF was found to be potentially equal to, but not necessarily better than, eating less.
“IF provides metabolic benefits for general health”
Broadly True. IF (perhaps counterintuitively) decreases the risk of insulin resistance, and also has anti-inflammatory effects, benefits a healthy gut microbiome, and promotes healthy autophagy (which as we noted in a previous edition of 10almonds, is important against both aging and cancer)
However, results vary according to which protocol you’re observing…
For what it’s worth, 16:8 is perhaps the most-studied protocol. Because such studies tend to have the eating window from midday to 8pm, this means that—going against popular wisdom—part of the advice here is basically “skip breakfast”.
“Unlike caloric restriction, IF is sustainable and healthy as a long-term protocol”
Broadly True. Of course, there’s a slight loophole here in that IF is loosely defined—technically everyone fasts while they’re sleeping, at the very least!
However, for the most commonly-studied IF method (16:8), this is generally very sustainable and healthy and for most people.
On the other hand, a more extreme method such as Alternate Day Fasting, may be trickier to sustain (even if it remains healthy to do so), because it’s been found that hunger does not decrease on fasting days—ie, the body does not “get used to it”.
The American Journal of Clinical Nutrition wrote:
❝Alternate-day fasting was feasible in nonobese subjects, and fat oxidation increased. However, hunger on fasting days did not decrease, perhaps indicating the unlikelihood of continuing this diet for extended periods of time. Adding one small meal on a fasting day may make this approach to dietary restriction more acceptable.❞
“IF improves mood and cognition”
Mix of True and False (plus an honest “We Don’t Know” from researchers).
Many studies have found benefits to both mood and cognition, but in the short-term, fasting can make people “hangry” (or: “experience irritability due to low blood sugar levels”, as the scientists put it), and in the long term, it can worsen symptoms of depression for those who already experience such—although some studies have found it can help alleviate depressive symptoms.
Basically this is one where researchers typically append the words “more research is needed” to their summaries.
“Anyone can do IF”
Definitely False, unless going by the absolute broadest possible interpretation of what constitutes “Intermittent Fasting” to the point of disingenuity.
For example, if you are Type 1 Diabetic, and your blood sugars are hypo, and you wait until tomorrow to correct that, you will stand a good chance of going into a coma instead. So please don’t.
(On the other hand, IF may help achieve remission of type 2 diabetes)
Lastly, IF is broadly not recommend to children and adolescents, anyone pregnant or breastfeeding, and certain underlying health conditions not mentioned above (we’re not going to try to give an exhaustive list here, but basically, if you have a chronic health condition, we recommend you check with your doctor first).
WHICH APP?
Choosing a fasting app
Thinking of giving IF a try and would like a little extra help? We’ve got you covered!
Check out: Livewire’s 7 Best Intermittent Fasting Apps of 2023
Prefer to just trust us with a recommendation?
We like BodyFast—it’s #2 on Lifewire’s list, but it has an array of pre-set plans to choose from (unlike Lifewire’s #1, Zero), and plenty of clear tracking, scheduling help, and motivational features.
Both are available on both iOS and Android:
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Macadamia Nuts vs Brazil Nuts – Which is Healthier?
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Our Verdict
When comparing macadamia nuts to Brazil nuts, we picked the Brazil nuts.
Why?
They’re a lot more nutrient dense! But watch out…
First, to do due diligence in terms of macros: Brazil nuts have twice as much protein and less fat, as well as being a little higher in fiber and slightly lower in carbs.
In terms of vitamins, Brazil nuts are about 10x higher in vitamin E, while macadamias are somewhat higher in several B-vitamins.
The category of minerals is where it gets interesting. Macadamia nuts are a little higher in iron and considerably higher in Manganese. But… Brazil nuts are a lot higher in calcium, copper, magnesium, phosphorus, potassium, selenium, and zinc.
About that selenium… Specifically, it’s more than 5,000x higher, and a cup of Brazil nuts would give nearly 10,000x the recommended daily amount of selenium. Now, selenium is an essential mineral (needed for thyroid hormone production, for example), and at the RDA it’s good for good health. Your hair will be luscious and shiny. However, go much above that, and selenium toxicity becomes a thing, you may get sick, and it can cause your (luscious and shiny) hair to fall out. For this reason, it’s recommended to eat no more than 3–4 Brazil nuts per day.
In short… Brazil nuts are much more nutrient dense in general, and thus come out on top here. But, they’re so nutrient dense in the case of selenium, that careful moderation is advised.
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts
Take care!
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There are ‘forever chemicals’ in our drinking water. Should standards change to protect our health?
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Today’s news coverage reports potentially unsafe levels of “forever chemicals” detected in drinking water supplies around Australia. These include human-made chemicals: perfluorooctane sulfonate (known as PFOS) and perflurooctanic acid (PFOA). They are classed under the broader category of per- and polyfluoroalkyl substances or PFAS chemicals.
The contaminants found in our drinking water are the same ones United States authorities warn can cause cancer over a long period of time, with reports warning there is “no safe level of exposure”.
In April, the US Environmental Protection Agency (USEPA) sent shock waves through the water industry around the world when it announced stricter advice on safe levels of PFOS/PFOA in drinking water. This reduced limits considered safe in supplies to zero and gave the water industry five years to meet legally enforceable limits of 4 parts per trillion.
So, should the same limits be enforced here in Australia? And how worried should we be that the drinking in many parts of Australia would fail the new US standards?
What are the health risks?
Medical knowledge about the human health effects of PFOS/PFOA is still emerging. An important factor is the bioaccumulation of these chemicals in different organs in the body over time.
Increased exposure of people to these chemicals has been associated with several adverse health effects. These include higher cholesterol, lower birth weights, modified immune responses, kidney and testicular cancer.
It has been very difficult to accurately track and measure effects of different levels of PFAS exposure on people. People may be exposed to PFAS chemicals in their everyday life through waterproofing of clothes, non-stick cookware coatings or through food and drinking water. PFAS can also be in pesticides, paints and cosmetics.
The International Agency for Research on Cancer (on behalf of the World Health Organization) regards PFOA as being carcinogenic to humans and PFOS as possibly carcinogenic to humans.
Is our drinking water safe? What about long-term risks? Volodymyr TVERDOKHLIB/Shutterstock Our guidelines
Australian drinking water supplies are assessed against national water quality standards. These Australian Drinking Water Guidelines are continuously reviewed by industry and health experts that scan the international literature and update them accordingly.
All city and town water supplies across Australia are subject to a wide range of physical and chemical water tests. The results are compared to Australian water guidelines.
Some tests relate to human health considerations, such as levels of lead or bacteria. Others relate to “aesthetic” considerations, such as the appearance or taste of water. Most water authorities across Australia make water quality information and compliance with Australian guidelines freely available.
What about Australian PFOS and PFOA standards?
These chemicals can enter our drinking water system from many potential sources, such as via their use in fire-fighting foams or pesticides.
According to the Australian Drinking Water Guidelines, PFOS should not exceed 0.07 micrograms per litre in drinking water. And PFOA should not exceed 0.56 micrograms per litre. One microgram is equivalent to one part per billion.
The concentration of these chemicals in water is incredibly small. And much of the advice on their concentration is provided in different units. Sometimes in micrograms or nannograms. The USEPA uses parts per trillion.
In parts per trillion (ppt) the Australian Guidelines for PFOS is 70 ppt and PFOA is 560 ppt. The USEPA’s new maximum contaminant levels (enforceable levels) are 4 ppt for both PFOS and also PFOA. Previous news reports have pointed out Australian guidelines for these chemicals in drinking water are up to 140 times higher than the USEPA permits.
Yikes! That seems like a lot
Today’s news report cites PFOS and PFOA water tests done at many different water supplies across Australia. Some water samples did not detect either chemicals. But most did, with the highest PFOS concentration 15.1–15.6 parts per trillion from Glenunga, South Australia. The highest PFOA concentration was reported from a small water supply in western Sydney, where it was detected at 5.17–9.66 parts per trillion.
Australia and the US are not alone. This is an enormous global problem.
One of the obvious challenges for the Australian water industry is that current water treatment processes may not be effective at removing PFOS or PFOA. The Australian Drinking Water Guidelines provide this advice:
Standard water treatment technologies including coagulation followed by physical separation, aeration, chemical oxidation, UV irradiation, and disinfection have little or no effect on PFOS or PFOA concentrations.
Filtering with activated carbon and reverse osmosis may remove many PFAS chemicals. But no treatment systems appear to be completely effective at their removal.
Removing these contaminants might be particularly difficult for small regional water supplies already struggling to maintain their water infrastructure. The NSW Auditor General criticised the planning for, and funding of, town water infrastructure in regional NSW back in 2020.
Where to from here?
The Australian water industry likely has little choice but to follow the US lead and address PFOS/PFAS contamination in drinking water. Along with lower thresholds, the US committed US$1 billion to water infrastructure to improve detection and water treatment. They will also now require:
Public water systems must monitor for these PFAS and have three years to complete initial monitoring (by 2027) […]
As today’s report notes, it is very difficult to find any recent data on PFOS and PFOA in Australian drinking water supplies. Australian regulators should also require ongoing and widespread monitoring of our major city and regional water supplies for these “forever chemicals”.
The bottom line for drinking tap water is to keep watching this space. Buying bottled water might not be effective (2021 US research detected PFAS in 39 out of 100 bottled waters). The USEPA suggests people can reduce PFAS exposure with measures including avoiding fish from contaminated waters and considering home filtration systems.
Correction: this article previously listed the maximum Australian Drinking Water Guidelines PFOA level as 0.056 micrograms per litre. The figure has been updated to show the correct level of 0.56 micrograms per litre.
Ian A. Wright, Associate Professor in Environmental Science, Western Sydney University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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