Building & Maintaining Mobility
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Building & Maintaining Mobility!
This is Juliet Starrett. She’s a CrossFit co-founder, and two-time white-water rafting world champion. Oh, and she won those after battling thyroid cancer. She’s now 50 years old, and still going strong, having put aside her career as a lawyer to focus on fitness. Specifically, mobility training.
The Ready State
Together with her husband Kelly, Starrett co-founded The Ready State, of which she’s CEO.
It used to be called “Mobility WOD” (the “WOD” stands for “workout of the day”) but they changed their name as other companies took up the use of the word “mobility”, something the fitness world hadn’t previously focussed on much, and “WOD”, which was also hardly copyrightable.
True to its origins, The Ready State continues to offer many resources for building and maintaining mobility.
Why the focus on mobility?
When was the last time you had to bench-press anything larger than a small child? Or squat more than your partner’s bodyweight? Or do a “farmer’s walk” with anything heavier than your groceries?
For most of us, unless our lifestyles are quite extreme, we don’t need ridiculous strength (fun as that may be).
You know what makes a huge difference to our quality of life though? Mobility.
Have you ever felt that moment of panic when you reach for something on a high shelf and your shoulder or back twinges (been there!)? Or worse, you actually hurt yourself and the next thing you know, you need help putting your socks on (been there, too!)?
And we say to ourselves “I’m not going to let that happen to me again”
But how? How do we keep our mobility strong?
First, know your weaknesses
Starrett is a big fan of mobility tests to pinpoint areas that need more work.
Most of her resources for this aren’t free, and we’re drawing heavily from her book here, so for your convenience, we’ll link to some third party sources for this:
- Timed Up and Go—start with this, before progressing to the next!
- Sit To Rise Test—not to be underestimated (this page also has excerpts from Starrett’s mobility book, by the way)
- Shoulders/Spine/Hips—7 quick tests; note any that you can’t do, or struggle with
Next, eliminate those weaknesses
Do mobility exercises in any weak areas, until they’re not weak:
Want to train the full body in one session?
Try out The Ready State’s 10-Minute Morning Mobility Routine
Want to learn more?
You might enjoy her book that we reviewed previously:
Built to Move: The Ten Essential Habits to Help You Move Freely and Live Fully
You might also enjoy The Ready State App, available for iOS and for Android:
The Ready State Virtual Mobility Coach
Enjoy!
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Can Medical Schools Funnel More Doctors Into the Primary Care Pipeline?
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Throughout her childhood, Julia Lo Cascio dreamed of becoming a pediatrician. So, when applying to medical school, she was thrilled to discover a new, small school founded specifically to train primary care doctors: NYU Grossman Long Island School of Medicine.
Now in her final year at the Mineola, New York, school, Lo Cascio remains committed to primary care pediatrics. But many young doctors choose otherwise as they leave medical school for their residencies. In 2024, 252 of the nation’s 3,139 pediatric residency slots went unfilled and family medicine programs faced 636 vacant residencies out of 5,231 as students chased higher-paying specialties.
Lo Cascio, 24, said her three-year accelerated program nurtured her goal of becoming a pediatrician. Could other medical schools do more to promote primary care? The question could not be more urgent. The Association of American Medical Colleges projects a shortage of 20,200 to 40,400 primary care doctors by 2036. This means many Americans will lose out on the benefits of primary care, which research shows improves health, leading to fewer hospital visits and less chronic illness.
Many medical students start out expressing interest in primary care. Then they end up at schools based in academic medical centers, where students become enthralled by complex cases in hospitals, while witnessing little primary care.
The driving force is often money, said Andrew Bazemore, a physician and a senior vice president at the American Board of Family Medicine. “Subspecialties tend to generate a lot of wealth, not only for the individual specialists, but for the whole system in the hospital,” he said.
A department’s cache of federal and pharmaceutical-company grants often determines its size and prestige, he said. And at least 12 medical schools, including Harvard, Yale, and Johns Hopkins, don’t even have full-fledged family medicine departments. Students at these schools can study internal medicine, but many of those graduates end up choosing subspecialties like gastroenterology or cardiology.
One potential solution: eliminate tuition, in the hope that debt-free students will base their career choice on passion rather than paycheck. In 2024, two elite medical schools — the Albert Einstein College of Medicine and the Johns Hopkins University School of Medicine — announced that charitable donations are enabling them to waive tuition, joining a handful of other tuition-free schools.
But the contrast between the school Lo Cascio attends and the institution that founded it starkly illustrates the limitations of this approach. Neither charges tuition.
In 2024, two-thirds of students graduating from her Long Island school chose residencies in primary care. Lo Cascio said the tuition waiver wasn’t a deciding factor in choosing pediatrics, among the lowest-paid specialties, with an average annual income of $260,000, according to Medscape.
At the sister school, the Manhattan-based NYU Grossman School of Medicine, the majority of its 2024 graduates chose specialties like orthopedics (averaging $558,000 a year) or dermatology ($479,000).
Primary care typically gets little respect. Professors and peers alike admonish students: If you’re so smart, why would you choose primary care? Anand Chukka, 27, said he has heard that refrain regularly throughout his years as a student at Harvard Medical School. Even his parents, both PhD scientists, wondered if he was wasting his education by pursuing primary care.
Seemingly minor issues can influence students’ decisions, Chukka said. He recalls envying the students on hospital rotations who routinely were served lunch, while those in primary care settings had to fetch their own.
Despite such headwinds, Chukka, now in his final year, remains enthusiastic about primary care. He has long wanted to care for poor and other underserved people, and a one-year clerkship at a community practice serving low-income patients reinforced that plan.
When students look to the future, especially if they haven’t had such exposure, primary care can seem grim, burdened with time-consuming administrative tasks, such as seeking prior authorizations from insurers and grappling with electronic medical records.
While specialists may also face bureaucracy, primary care practices have it much worse: They have more patients and less money to hire help amid burgeoning paperwork requirements, said Caroline Richardson, chair of family medicine at Brown University’s Warren Alpert Medical School.
“It’s not the medical schools that are the problem; it’s the job,” Richardson said. “The job is too toxic.”
Kevin Grumbach, a professor of family and community medicine at the University of California-San Francisco, spent decades trying to boost the share of students choosing primary care, only to conclude: “There’s really very little that we can do in medical school to change people’s career trajectories.”
Instead, he said, the U.S. health care system must address the low pay and lack of support.
And yet, some schools find a way to produce significant proportions of primary care doctors — through recruitment and programs that provide positive experiences and mentors.
U.S. News & World Report recently ranked 168 medical schools by the percentage of graduates who were practicing primary care six to eight years after graduation.
The top 10 schools are all osteopathic medical schools, with 41% to 47% of their students still practicing primary care. Unlike allopathic medical schools, which award MD degrees, osteopathic schools, which award DO degrees, have a history of focusing on primary care and are graduating a growing share of the nation’s primary care physicians.
At the bottom of the U.S. News list is Yale, with 10.7% of its graduates finding lasting careers in primary care. Other elite schools have similar rates: Johns Hopkins, 13.1%; Harvard, 13.7%.
In contrast, public universities that have made it a mission to promote primary care have much higher numbers.
The University of Washington — No. 18 in the ranking, with 36.9% of graduates working in primary care — has a decades-old program placing students in remote parts of Washington, Wyoming, Alaska, Montana, and Idaho. UW recruits students from those areas, and many go back to practice there, with more than 20% of graduates settling in rural communities, according to Joshua Jauregui, assistant dean for clinical curriculum.
Likewise, the University of California-Davis (No. 22, with 36.3% of graduates in primary care) increased the percentage of students choosing family medicine from 12% in 2009 to 18% in 2023, even as it ranks high in specialty training. Programs such as an accelerated three-year primary care “pathway,” which enrolls primarily first-generation college students, help sustain interest in non-specialty medical fields.
The effort starts with recruitment, looking beyond test scores to the life experiences that forge the compassionate, humanistic doctors most needed in primary care, said Mark Henderson, associate dean for admissions and outreach. Most of the students have families who struggle to get primary care, he said. “So they care a lot about it, and it’s not just an intellectual, abstract sense.”
Establishing schools dedicated to primary care, like the one on Long Island, is not a solution in the eyes of some advocates, who consider primary care the backbone of medicine and not a separate discipline. Toyese Oyeyemi Jr., executive director of the Social Mission Alliance at the Fitzhugh Mullan Institute of Health Workforce Equity, worries that establishing such schools might let others “off the hook.”
Still, attending a medical school created to produce primary care doctors worked out well for Lo Cascio. Although she underwent the usual specialty rotations, her passion for pediatrics never flagged — owing to her 23 classmates, two mentors, and her first-year clerkship shadowing a community pediatrician. Now, she’s applying for pediatric residencies.
Lo Cascio also has deep personal reasons: Throughout her experience with a congenital heart condition, her pediatrician was a “guiding light.”
“No matter what else has happened in school, in life, in the world, and medically, your pediatrician is the person that you can come back to,” she said. “What a beautiful opportunity it would be to be that for someone else.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
This article first appeared on KFF Health News and is republished here under a Creative Commons license.
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Small Changes For A Healthier Life
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
I am interested in what I can substitute for ham in bean soup?
Well, that depends on what the ham was like! You can certainly buy ready-made vegan lardons (i.e. small bacon/ham bits, often in tiny cubes or similar) in any reasonably-sized supermarket. Being processed, they’re not amazing for the health, but are still an improvement on pork.
Alternatively, you can make your own seitan! Again, seitan is really not a health food, but again, it’s still relatively less bad than pork (unless you are allergic to gluten, in which case, definitely skip this one).
Alternatively alternatively, in a soup that already contains beans (so the protein element is already covered), you could just skip the ham as an added ingredient, and instead bring the extra flavor by means of a little salt, a little yeast extract (if you don’t like yeast extract, don’t worry, it won’t taste like it if you just use a teaspoon in a big pot, or half a teaspoon in a smaller pot), and a little smoked paprika. If you want to go healthier, you can swap out the salt for MSG, which enhances flavor in a similar fashion while containing less sodium.
Wondering about the health aspects of MSG? Check out our main feature on this, from last month:
I thoroughly enjoy your daily delivery. I’d love to see one for teens too!
That’s great to hear! The average age of our subscribers is generally rather older, but it’s good to know there’s an interest in topics for younger people. We’ll bear that in mind, and see what we can do to cater to that without alienating our older readers!
That said: it’s never too soon to be learning about stuff that affects us when we’re older—there are lifestyle factors at 20 that affect Alzheimer’s risk at 60, for example (e.g. drinking—excessive drinking at 20* is correlated to higher Alzheimer’s risk at 60).
*This one may be less of an issue for our US readers, since the US doesn’t have nearly as much of a culture of drinking under 21 as some places. Compare for example with general European practices of drinking moderately from the mid-teens, or the (happily, diminishing—but historically notable) British practice of drinking heavily from the mid-teens.
How much turmeric should I take each day?
Dr. Michael Greger’s research (of “Dr. Greger’s Daily Dozen” and “How Not To Die” fame) recommends getting at least ¼ tsp turmeric per day
Remember to take it with black pepper though, for a 2000% absorption bonus!
A great way to get it, if you don’t want to take capsules and don’t want to eat spicy food every day, is to throw a teaspoon of turmeric in when making a pot of (we recommend wholegrain!) rice. Turmeric is very water-soluble, so it’ll be transferred into the rice easily during cooking. It’ll make the rice a nice golden yellow color, and/but won’t noticeably change the taste.
Again remember to throw in some black pepper, and if you really want to boost the nutritional content,some chia seeds are a great addition too (they’ll get cooked with the rice and so it won’t be like eating seeds later, but the nutrients will be there in the rice dish).
You can do the same with par-boiled potatoes or other root vegetables, but because cooking those has water to be thrown away at the end (unlike rice), you’ll lose some turmeric in the water.
Request: more people need to be aware of suicidal tendencies and what they can do to ward them off
That’s certainly a very important topic! We’ll cover that properly in one of our Psychology Sunday editions. In the meantime, we’ll mention a previous special that we did, that was mostly about handling depression (in oneself or a loved one), and obviously there’s a degree of crossover:
The Mental Health First-Aid That You’ll Hopefully Never Need
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Brazil Nuts vs Pecans – Which is Healthier?
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Our Verdict
When comparing Brazil nuts to pecans, we picked the pecans.
Why?
In terms of macros, Brazil nuts have more protein while pecans have more fiber. Both of these nuts are equally fatty, though Brazil nuts have much more saturated fat per 100g, which still isn’t terrible, but it does make pecans’ profile (mostly monounsaturated with some polyunsaturated) the healthier. They’re about equal in carbs. All in all, a win for pecans here.
In the category of vitamins, Brazil nuts have more vitamin E, while pecans have more of vitamins A, B1, B2, B3, B5, B6, B7, B9, C, K, and choline. An easy win for pecans.
The category of minerals is an interesting one. Brazil nuts have more calcium, copper, magnesium, phosphorus, potassium, and selenium, while pecans have more iron, manganese, and zinc. Before we crown Brazil nuts with the win in this category, though, let’s take a closer look at those selenium levels:
- A cup of pecans contains 21% of the RDA of selenium. Your hair will be luscious and shiny.
- A cup of Brazil nuts contains 10,456% of the RDA of selenium. This is way past the point of selenium toxicity, and your (luscious, shiny) hair will fall out.
For this reason, it’s recommended to eat no more than 3–4 Brazil nuts per day.
We consider that a point against Brazil nuts.
Adding up the sections makes for an overall win for pecans; of course, enjoy either or both, just be sure to practise moderation when it comes to the Brazil nuts!
Want to learn more?
You might like:
Why You Should Diversify Your Nuts
Enjoy!
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No Bad Parts – by Dr. Richard Schwartz
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We’ve previously reviewed Dr. Schwartz’s “You Are The One You’ve Been Waiting For” and whereas that book doesn’t require having read this one, this one would be an excellent place to start, as it focuses on perhaps the most important core issues of IFS therapy.
We all have different aspects that have developed within us for different reasons, and can generally “become as though a different person when…” and some condition that is met. Those are our “parts”, per IFS.
This book makes the case that even the worst of our parts arose for reasons, that they often looked after us when no other part could or would, and at the very least, they tried. Rather than arguing for “so, everything’s just great”, though, Dr. Schwartz talks the reader through making peace with those parts, and then, where appropriate, giving them the retirement they deserve—of if that’s not entirely practical, arranging for them to at least take a seat and wait until called on, rather than causing problems in areas of life to which they are not well-suited.
Throughout, there is a good balance of compassion and no-bullshit, both of which are really necessary in order to make this work.
Bottom line: if there are parts of you you’re not necessarily proud of, this book can help you to put them peacefully to rest.
Click here to check out No Bad Parts, and take care of yours!
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Triphala Against Cognitive Decline, Obesity, & More
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Triphala is not just one thing, it is a combination of three plants being used together as one medicine:
- Alma (Emblica officinalis)
- Bibhitaki (Terminalia bellirica)
- Haritaki (Terminalia chebula)
…generally prepared in a 1:1:1 ratio.
This is a traditional preparation from ayurveda, and has enjoyed thousands of years of use in India. In and of itself, ayurveda is classified as a pseudoscience (literally: it doesn’t adhere to scientific method; instead, it merely makes suppositions that seem reasonable and acts on them), but that doesn’t mean it doesn’t still have a lot to offer—because, simply put, a lot of ayurvedic medicines work (and a lot don’t).
So, ayurveda’s unintended job has often been finding things for modern science to test.
For more on ayurveda: Ayurveda’s Contributions To Science (Without Being Itself Rooted in Scientific Method)
So, under the scrutiny of modern science, how does triphala stand up?
Against cognitive decline
It has most recently come to attention because one of its ingredients, the T. chebula, has been highlighted as effective against mild cognitive impairment (MCI) by several mechanisms of action, via its…
❝171 chemical constituents and 11 active constituents targeting MCI, such as flavonoids, which can alleviate MCI, primarily through its antioxidative, anti-inflammatory, and neuroprotective properties. T. Chebula shows potential as a natural medicine for the treatment and prevention of MCI.❞
Read in full: The potential of Terminalia chebula in alleviating mild cognitive impairment: a review
The review was quite groundbreaking, to the extent that it got a pop-science article written about it:
We’d like to talk about those 11 active constituents in particular, but we don’t have room for all of them, so we’ll mention that one of them is quercetin, which we’ve written about before:
Fight Inflammation & Protect Your Brain, With Quercetin
For gut health
It’s also been found to improve gut health by increasing transit time, that is to say, how slowly things move through your gut. Counterintuitively, this reduces constipation (without being a laxative), by giving your gut more time to absorb everything it needs to, and more time for your gut bacteria to break down the things we can’t otherwise digest:
For weight management
Triphala can also aid with weight reduction, particularly in the belly area, by modulating our insulin responses to improve insulin sensitivity:
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon 😎
Enjoy!
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Chia Seeds vs Sunflower Seeds – Which is Healthier?
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Our Verdict
When comparing chia seeds to sunflower, we picked the chia.
Why?
It was close, and they both have their merits!
In terms of macros, chia has more carbs and a lot more fiber, while sunflower has a little more protein and a lot more fat. While the fat (in the seeds, not processed seed oils!) is mostly healthy polyunsaturated fat in both cases, chia has a lot more omega-3. All in all, we’re calling it a win for chia on macros.
In the category of vitamins, chia has more of vitmains B3 and C, while sunflower has ore of vitamins B1, B2, B9, and E. Thus, a win for sunflower seeds this time.
When it comes to minerals, chia has more calcium, iron, magnesium, manganese, phosphorus, and selenium, while sunflower has more copper, potassium, and zinc. A 6:3 win for chia here.
Adding up the sections makes for an overall win for chia, but by all means enjoy either or both; diversity is good!
Want to learn more?
You might like to read:
The Tiniest Seeds With The Most Value: If You’re Not Taking Chia, You’re Missing Out!
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
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