Why 7 Hours Sleep Is Not Enough
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How Sleep-Deprived Are You, Really?
This is Dr. Matthew Walker. He’s a neuroscientist and sleep specialist, and is the Director of the Center for Human Sleep Science at UC Berkeley’s Department of Psychology. He’s also the author of the international bestseller “Why We Sleep”.
What does he want us to know?
Sleep deprivation is more serious than many people think it is. After about 16 hours without sleep, the brain begins to fail, and needs more than 7 hours of sleep to “reset” cognitive performance.
Note: note “seven or more”, but “more than seven”.
After ten days with only 7 hours sleep (per day), Dr. Walker points out, the brain is as dysfunctional as it would be after going without sleep for 24 hours.
Here’s the study that sparked a lot of Dr. Walker’s work:
Importantly, in Dr. Walker’s own words:
❝Three full nights of recovery sleep (i.e., more nights than a weekend) are insufficient to restore performance back to normal levels after a week of short sleeping❞
~ Dr. Matthew Walker
See also: Why You Probably Need More Sleep
Furthermore: the sleep-deprived mind is unaware of how sleep-deprived it is.
You know how a drunk person thinks they can drive safely? It’s like that.
You do not know how sleep-deprived you are, when you are sleep-deprived!
For example:
❝(60.7%) did not signal sleepiness before a sleep fragment occurred in at least one of the four MWT trials❞
Source: Sleepiness is not always perceived before falling asleep in healthy, sleep-deprived subjects
Sleep efficiency matters
With regard to the 7–9 hours band for optimal health, Dr. Walker points out that the sleep we’re getting is not always the sleep we think we’re getting:
❝Assuming you have a healthy sleep efficiency (85%), to sleep 9 hours in terms of duration (i.e. to be a long-sleeper), you would need to be consistently in bed for 10 hours and 36 minutes a night. ❞
~ Dr. Matthew Walker
At the bottom end of that, by the way, doing the same math: to get only the insufficient 7 hours sleep discussed earlier, a with a healthy 85% sleep efficiency, you’d need to be in bed for 8 hours and 14 minutes per night.
The unfortunate implication of this: if you are consistently in bed for 8 hours and 14 minutes (or under) per night, you are not getting enough sleep.
“But what if my sleep efficiency is higher than 85%?”
It shouldn’t be.If your sleep efficiency is higher than 85%, you are sleep-deprived and your body is having to enforce things.
Want to know what your sleep efficiency is?
We recommend knowing this, by the way, so you might want to check out:
Head-To-Head Comparison of Google and Apple’s Top Sleep-Monitoring Apps
(they will monitor your sleep and tell you your sleep efficiency, amongst other things)
Want to know more?
You might like his book:
Why We Sleep: Unlocking the Power of Sleep and Dreams
…and/or his podcast:
…and for those who like videos, here’s his (very informative) TED talk:
Prefer text? Click here to read the transcript
Want to watch it, but not right now? Bookmark it for later
Enjoy!
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Qigong: A Breath Of Fresh Air?
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Qigong: Breathing Is Good (Magic Remains Unverified)
In Tuesday’s newsletter, we asked you for your opinions of qigong, and got the above-depicted, below-described, set of responses:
- About 55% said “Qigong is just breathing, but breathing exercises are good for the health”
- About 41% said “Qigong helps regulate our qi and thus imbue us with healthy vitality”
- One (1) person said “Qigong is a mystical waste of time and any benefits are just placebo”
The sample size was a little low for this one, but the results were quite clearly favorable, one way or another.
So what does the science say?
Qigong is just breathing: True or False?
True or False, depending on how we want to define it—because qigong ranges in its presentation from indeed “just breathing exercises”, to “breathing exercises with visualization” to “special breathing exercises with visualization that have to be exactly this way, with these hand and sometimes body movements also, which also must be just right”, to far more complex definitions that involve qi by various mystical definitions, and/or an appeal to a scientific analog of qi; often some kind of bioelectrical field or such.
There is, it must be said, no good quality evidence for the existence of qi.
Writer’s note, lest 41% of you want my head now: I’ve been practicing qigong and related arts for about 30 years and find such to be of great merit. This personal experience and understanding does not, however, change the state of affairs when it comes to the availability (or rather, the lack) of high quality clinical evidence to point to.
Which is not to say there is no clinical evidence, for example:
Acute Physiological and Psychological Effects of Qigong Exercise in Older Practitioners
…found that qigong indeed increased meridian electrical conductance!
Except… Electrical conductance is measured with galvanic skin responses, which increase with sweat. But don’t worry, to control for that, they asked participants to dry themselves with a towel. Unfortunately, this overlooks the fact that a) more sweat can come where that came from, because the body will continue until it is satisfied of adequate homeostasis, and b) drying oneself with a towel will remove the moisture better than it’ll remove the salts from the skin—bearing in mind that it’s mostly the salts, rather than the moisture itself, that improve the conductivity (pure distilled water does conduct electricity, but not very well).
In other words, this was shoddy methodology. How did it pass peer review? Well, here’s an insight into that journal’s peer review process…
❝The peer-review system of EBCAM is farcical: potential authors who send their submissions to EBCAM are invited to suggest their preferred reviewers who subsequently are almost invariably appointed to do the job. It goes without saying that such a system is prone to all sorts of serious failures; in fact, this is not peer-review at all, in my opinion, it is an unethical sham.❞
~ Dr. Edzard Ernst, a founding editor of EBCAM (he since left, and decries what has happened to it since)
One of the other key problems is: how does one test qigong against placebo?
Scientists have looked into this question, and their answers have thus far been unsatisfying, and generally to the tune of the true-but-unhelpful statement that “future research needs to be better”:
Problems of scientific methodology related to placebo control in Qigong studies: A systematic review
Most studies into qigong are interventional studies, that is to say, they measure people’s metrics (for example, blood pressure, heart rate, maybe immune function biomarkers, sleep quality metrics of various kinds, subjective reports of stress levels, physical biomarkers of stress levels, things like that), then do a course of qigong (perhaps 6 weeks, for example), then measure them again, and see if the course of qigong improved things.
This almost always results in an improvement when looking at the before-and-after, but it says nothing for whether the benefits were purely placebo.
We did find one study that claimed to be placebo-controlled:
…but upon reading the paper itself carefully, it turned out that while the experimental group did qigong, the control group did a reading exercise. Which is… Saying how well qigong performs vs reading (qigong did outperform reading, for the record), but nothing for how well it performs vs placebo, because reading isn’t a remotely credible placebo.
See also: Placebo Effect: Making Things Work Since… Well, A Very Long Time Ago ← this one explains a lot about how placebo effect does work
Qigong is a mystical waste of time: True or False?
False! This one we can answer easily. Interventional studies invariably find it does help, and the fact remains that even if placebo is its primary mechanism of action, it is of benefit and therefore not a waste of time.
Which is not to say that placebo is its only, or even necessarily primary, mechanism of action.
Even from a purely empirical evidence-based medicine point of view, qigong is at the very least breathing exercises plus (usually) some low-impact body movement. Those are already two things that can be looked at, mechanistic processes pointed to, and declarations confidently made of “this is an activity that’s beneficial for health”.
See for example:
- Effects of Qigong practice in office workers with chronic non-specific low back pain: A randomized control trial
- Qigong for the Prevention, Treatment, and Rehabilitation of COVID-19 Infection in Older Adults
- Impact of Medical Qigong on quality of life, fatigue, mood and inflammation in cancer patients: a randomized controlled trial
…and those are all from respectable journals with meaningful peer review processes.
None of them are placebo-controlled, because there is no real option of “and group B will only be tricked into believing they are doing deep breathing exercises with low-impact movements”; that’s impossible.
But! They each show how doing qigong reliably outperforms not doing qigong for various measurable metrics of health.
And, we chose examples with physical symptoms and where possible empirically measurable outcomes (such as COVID-19 infection levels, or inflammatory responses); there are reams of studies showings qigong improves purely subjective wellbeing—but the latter could probably be claimed for any enjoyable activity, whereas changes in inflammatory biomarkers, not such much.
In short: for most people, it indeed reliably helps with many things. And importantly, it has no particular risks associated with it, and it’s almost universally framed as a complementary therapy rather than an alternative therapy.
This is critical, because it means that whereas someone may hold off on taking evidence-based medicines while trying out (for example) homeopathy, few people are likely to hold off on other treatments while trying out qigong—since it’s being viewed as a helper rather than a Hail-Mary.
Want to read more about qigong?
Here’s the NIH’s National Center for Complementary and Integrative Health has to say. It cites a lot of poor quality science, but it does mention when the science it’s citing is of poor quality, and over all gives quite a rounded view:
Enjoy!
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Stop Cancer 20 Years Ago
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Get Abreast And Keep Abreast
This is Dr. Jenn Simmons. Her specialization is integrative oncology, as she—then a breast cancer surgeon—got breast cancer, decided the system wasn’t nearly as good from the patients’ side of things as from the doctors’ side, and took to educate herself, and now others, on how things can be better.
What does she want us to know?
Start now
If you have breast cancer, the best time to start adjusting your lifestyle might be 20 years ago, but the second-best time is now. We realize our readers with breast cancer (or a history thereof) probably have indeed started already—all strength to you.
What this means for those of us without breast cancer (or a history therof) is: start now
Even if you don’t have a genetic risk factor, even if there’s no history of it in your family, there’s just no reason not to start now.
Start what, you ask? Taking away its roots. And how?
Inflammation as the root of cancer
To oversimplify: cancer occurs because an accidentally immortal cell replicates and replicates and replicates and takes any nearby resources to keep on going. While science doesn’t know all the details of how this happens, it is a factor of genetic mutation (itself a normal process, without which evolution would be impossible), something which in turn is accelerated by damage to the DNA. The damage to the DNA? That occurs (often as not) as a result of cellular oxidation. Cellular oxidation is far from the only genotoxic thing out there, and a lot of non-food “this thing causes cancer” warnings are usually about other kinds of genotoxicity. But cellular oxidation is a big one, and it’s one that we can fight vigorously with our lifestyle.
Because cellular oxidation and inflammation go hand-in-hand, reducing one tends to reduce the other. That’s why so often you’ll see in our Research Review Monday features, a line that goes something like:
“and now for those things that usually come together: antioxidant, anti-inflammatory, anticancer, and anti-aging”
So, fight inflammation now, and have a reduced risk of a lot of other woes later.
See: How to Prevent (or Reduce) Inflammation
Don’t settle for “normal”
People are told, correctly but not always helpfully, such things as:
- It’s normal to have less energy at your age
- It’s normal to have a weaker immune system at your age
- It’s normal to be at a higher risk of diabetes, heart disease, etc
…and many more. And these things are true! But that doesn’t mean we have to settle for them.
We can be all the way over on the healthy end of the distribution curve. We can do that!
(so can everyone else, given sufficient opportunity and resources, because health is not a zero-sum game)
If we’re going to get a cancer diagnosis, then our 60s are the decade where we’re most likely to get it. Earlier than that and the risk is extant but lower; later than that and technically the risk increases, but we probably got it already in our 60s.
So, if we be younger than 60, then now’s a good time to prepare to hit the ground running when we get there. And if we missed that chance, then again, the second-best time is now:
See: Focusing On Health In Our Sixties
Fast to live
Of course, anything can happen to anyone at any age (alas), but this is about the benefits of living a fasting lifestyle—that is to say, not just fasting for a 4-week health kick or something, but making it one’s “new normal” and just continuing it for life.
This doesn’t mean “never eat”, of course, but it does mean “practice intermittent fasting, if you can”—something that Dr. Simmons strongly advocates.
See: Intermittent Fasting: We Sort The Science From The Hype
While this calls back to the previous “fight inflammation”, it deserves its own mention here as a very specific way of fighting it.
It’s never too late
All of the advices that go before a cancer diagnosis, continue to stand afterwards too. There is no point of “well, I already have cancer, so what’s the harm in…?”
The harm in it after a diagnosis will be the same as the harm before. When it comes to lifestyle, preventing a cancer and preventing it from spreading are very much the same thing, which is also the same as shrinking it. Basically, if it’s anticancer, it’s anticancer, no matter whether it’s before, during, or after.
Dr. Simmons has seen too many patients get a diagnosis, and place their lives squarely in the hands of doctors, when doctors can only do so much.
Instead, Dr. Simmons recommends taking charge of your health as best you are able, today and onwards, no matter what. And that means two things:
- Knowing stuff
- Doing stuff
So it becomes our responsibility (and our lifeline) to educate ourselves, and take action accordingly.
Want to know more?
We recently reviewed her book, and heartily recommend it:
The Smart Woman’s Guide to Breast Cancer – by Dr. Jenn Simmons
Enjoy!
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Families including someone with mental illness can experience deep despair. They need support
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In the aftermath of the tragic Bondi knife attack, Joel Cauchi’s parents have spoken about their son’s long history of mental illness, having been diagnosed with schizophrenia at age 17. They said they were “devastated and horrified” by their son’s actions. “To you he’s a monster,” said his father. “But to me he was a very sick boy.”
Globally, one out of every eight people report a mental illness. In Australia, one in five people experience a mental illness in their lifetime.
Mental illness and distress affects not only the person living with the condition, but family members and communities. As the prevalence of mental health problems grows, the flow-on effect to family members, including caregivers, and the impact on families as a unit, is also rising.
While every family is different, the words of the Cauchis draw attention to how families can experience distress, stress, fear, powerlessness, and still love, despite the challenges and trauma. How can they help a loved one? And who can they turn to for support?
The role of caregivers
Informal caregivers help others within the context of an existing relationship, such as a family member. The care they provide goes beyond the usual expectations or demands of such relationships.
Around 2.7 million Australians provide informal care. For almost a third of these the person’s primary medical diagnosis is psychological or psychiatric.
It has long been acknowledged that those supporting a family member with ongoing mental illness need support themselves.
In the 1980s, interest grew in caregiving dynamics within families of people grappling with mental health issues. Subsequent research recognised chronic health conditions not only affect the quality of life and wellbeing of the people experiencing them, but also impose burdens that reverberate within relationships, caregiving roles, and family dynamics over time.
Past studies have shown families of those diagnosed with chronic mental illness are increasingly forced to manage their own depression, experience elevated levels of emotional stress, negative states of mind and decreased overall mental health.
Conditions such as depression, anxiety disorders, bipolar disorder, and schizophrenia can severely impact daily functioning, relationships, and overall quality of life. Living with mental illness is often accompanied by a myriad of challenges. From stigma and discrimination to difficulty accessing adequate health care and support services. Patients and their families navigate a complex and often isolating journey.
The family is a system
The concept of family health acknowledges the physical and psychological wellbeing of a person is significantly affected by the family.
Amid these challenges, family support emerges as a beacon of hope. Research consistently demonstrates strong familial relationships and support systems play a pivotal role in mitigating the adverse effects of mental illness. Families provide emotional support, practical assistance, and a sense of belonging that are vital for people struggling with mental illness.
My recent research highlights the profound impact of mental illness on family dynamics, emphasising the resilience and endurance shown by participants. Families struggling with mental illness often experience heightened emotional fluctuations, with extreme highs and lows. The enduring nature of family caregiving entails both stress and adaptation over an extended period. Stress associated with caregiving and the demands on personal resources and coping mechanisms builds and builds.
Yet families I’ve interviewed find ways to live “a good life”. They prepare for the peaks and troughs, and show endurance and persistence. They make space for mental illness in their daily lives, describing how it spurs adaptation, acceptance and inner strength within the family unit.
When treating a person with mental illness, health practitioners need to consider the entire family’s needs and engage with family members. By fostering open and early dialogue and providing comprehensive support, health-care professionals can empower families to navigate the complexities of mental illness while fostering resilience and hope for the future. Family members express stories of an inner struggle, isolation and exhaustion.
Shifting the focus
There is a pressing need for a shift in research priorities, from illness-centered perspectives to a strengths-based focus when considering families “managing” mental illness.
There is transformative potential in harnessing strengths to respond to challenges posed by mental illnesses, while also supporting family members.
For people facing mental health challenges, having loved ones who listen without judgement and offer empathy can alleviate feelings of despair. Beyond emotional support, families often serve as crucial caregivers, assisting with daily tasks, medication management and navigating the health-care system.
As the Cauchi family so painfully articulated, providing support for a family member with mental illness is intensely challenging. Research shows caregiver burnout, financial strain and strained relationships are common.
Health-care professionals should prioritise support for family members at an early stage. In Australia, there are various support options available for families living with mental illness. Carer Gateway provides information, support and access to services. Headspace offers mental health services and supports to young people and their families.
Beyond these national services, GPs, nurses, nurse practitioners and local community health centres are key to early conversations. Mental health clinics and hospitals often target family involvement in treatment plans.
While Australia has made strides in recognising the importance of family support, challenges persist. Access to services can vary based on geographic location and demand, leaving some families under-served or facing long wait times. And the level of funding and resources allocated to family-oriented mental health support often does not align with the demand or complexity of need.
In the realm of mental illness, family support serves as a lifeline for people navigating the complexities of their conditions.
If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.
Amanda Cole, Lead, Mental Health, Edith Cowan University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Dopa-Bean
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Mucuna pruriens, also called the “magic velvet bean”, is an established herbal drug used for the management of male infertility, nervous disorders, and also as an aphrodisiac:
The Magic Velvet Bean of Mucuna pruriens
How it works is more interesting than that, though.
It’s about the dopamine
M. pruriens contains levodopa (L-dopa). That’s right, the same as the dopaminergic medication most often prescribed for Parkinson’s disease. Furthermore, it might even be better than synthetic L-dopa, because:
❝M. pruriens seed extract demonstrated acetylcholinesterase inhibitory activity, while synthetic L-dopa enhanced the activity of the enzyme. It can be concluded that the administration of M. pruriens seed might be effective in protecting the brain against neurodegenerative disorders such as Parkinson’s and Alzheimer’s diseases.
M. pruriens seed extract containing L-dopa has shown less acetylcholinesterase activity stimulation compared with L-dopa, suggesting that the extract might have a superior benefit for use in the treatment of Parkinson’s disease.❞
~ Dr. Narisa Kamkaen et al.
Indeed, it has been tested specifically in (human!) Parkinson’s disease patients, which RCT found:
❝The rapid onset of action and longer on time without concomitant increase in dyskinesias on mucuna seed powder formulation suggest that this natural source of l-dopa might possess advantages over conventional l-dopa preparations in the long term management of Parkinson’s disease❞
~ Dr. Regina Katzenschlager et al.
Read more: Mucuna pruriens in Parkinson’s disease: a double-blind clinical and pharmacological study
Beyond Parkinson’s disease
M. pruriens has also been tested and found beneficial in cases of disease other than Parkinson’s, thus:
Mucuna pruriens in Parkinson’s and in some other diseases: recent advancement and future prospective
…but the science is less well-established for things not generally considered related to dopamine, such as cancer, diabetes, and cardiometabolic disorders.
Note, however, that the science for it being neuroprotective is rather stronger.
Against depression
Depression can have many causes, and (especially on a neurological level) diverse presentations. As such, sometimes what works for one person’s depression won’t touch another person’s, because the disease and treatment are about completely different neurotransmitter dysregulations. So, if a person’s depression is due to a shortage of serotonin, for example, then perking up the dopamine won’t help much, and vice versa. See also:
Antidepressants: Personalization Is Key!
When it comes to M. pruriens and antidepressant activity, then predictably it will be more likely to help if your depression is due to too little dopamine. Note that this means that even if your depression is dopamine-based, but the problem is with your dopamine receptors and not the actual levels of dopamine, then this may not help so much, depending on what else you have going on in there.
The science for M. pruriens and depression is young, and we only found non-human animal studies so far, for example:
In summary
It’s good against Parkinson’s in particular and is good against neurodegeneration in general.
It may be good against depression, depending on the kind of depression you have.
Is it safe?
That’s a great question! And the answer is: it depends. For most people, in moderation, it should be fine (but, see our usual legal/medical disclaimer). Definitely don’t take it if you have bipolar disorder or any kind of schizoid/psychotic disorder; it is likely to trigger a manic/psychotic episode if you do.
For more on this, we discussed it (pertaining to L-dopa in general, not M. pruriens specifically) at greater length here:
An Accessible New Development Against Alzheimer’s ← scroll down to the heading that reads “Is there a catch?”
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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Get Fitter As You Go
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Dr. Jaime Seeman: Hard To Kill?
This is Dr. Jaime Seeman. She’s a board-certified obstetrician-gynecologist with a background in nutrition, exercise, and health science. She’s also a Fellow in Integrative Medicine, and a board-certified nutrition specialist.
However, her biggest focus is preventative medicine.
What does she want us to know?
The Five Pillars of being “Hard to Kill”!
As an athlete when she was younger, she got away with poor nutrition habits with good exercise, but pregnancy (thrice) brought her poor thyroid function, other hormonal imbalances, and pre-diabetes.
So, she set about getting better—not something the general medical establishment focuses on a lot! Doctors are pressured to manage symptoms, but are under no expectation to actually help people get better.
So, what are her five pillars?
Nutrition
Dr. Seeman unsurprisingly recommends a whole-foods diet with lots of plants, but unlike many plant-enjoyers, she is also an enjoyer of the ketogenic diet.
While keto-enthusiasts say “carbs are bad” and vegans say “meat is bad”, the reality is: both of those things can be bad, and in both cases, avoiding the most harmful varieties is a very good first step:
Movement
This is in two parts:
- get your 150 minutes of moderate exercise per week
- keep your body mobile!
See also:
Sleep
This one’s quite straightforward, and Dr. Seeman uncontroversially recommends getting 7–9 hours per night; yes, even you:
Mindset
This is key to Dr. Seeman’s approach, and it is about not settling for average, because the average is undernourished, overmedicated, sedentary, and suffering.
She encourages us all to keep working for better health, wherever we’re at. To not “go gentle into that good night”, to get stronger whatever our age, to showcase increasingly robust vitality as we go.
To believe we can, and then to do it.
Environment
That previous item usually won’t last beyond a 10-day health-kick without the correct environment.
As for how to make sure we have that? Check out:
Want more?
She does offer coaching:
Hard To Kill Academy: Master The Mindset To Maximize Your Years
Take care!
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Treat Your Own Hip – by Robin McKenzie
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We previously reviewed another book by this author in this series, “Treat Your Own Knee”, and today it’s the same deal, but for the hip.
A quick note about the author first: a physiotherapist and not a doctor, but with over 40 years of practice to his name and 33 letters after his name (CNZM OBE FCSP (Hon) FNZSP (Hon) Dip MDT Dip MT), he seems to know his stuff.
He takes the reader through first diagnosing the nature of the pain (and how to rule out, for example, a back problem manifesting as hip pain, rather than a hip problem per se—and points to his own “Treat Your Own Back” manual if it turns out that that’s your problem instead), and then treating it. A bold claim, the kind that many people’s lawyers don’t let them make, but once again, this guy is pretty much the expert when it comes to this. Ask any other physiotherapist, and they probably have several of his books on their shelf.
The treatments recommend are tailored to the results of various diagnostic flowcharts; essentially troubleshooting your hip. However, they mainly consist of exercises (perhaps the greatest value of the book), and lifestyle adjustments (these ones, 10almonds readers probably know already, but a reminder never hurts).
The explanations are thorough while still being comprehensible, and there is zero sensationalization or fluff. It is straight to the point, and clearly illustrated too with diagrams and photographs.
Bottom line: if you’re looking for a “one-stop shop” for diagnosing and treating your bad hip, then this is it.
Click here to check out Treat Your Own Hip, and indeed Treat Your Own Hip!
PS: if you have musculoskeletal problems elsewhere in your body, you might want to check out the rest of his body parts series (neck, back, shoulder, wrist, knee, ankle) for the one that’s tailored to your specific problem.
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