Category: exercise

Posted by Christine Pope on in Cancer support, exercise, Health Care, Pain, Research

Which bodywork therapies help you manage chronic pain more effectively?

For many people bodywork therapies, such as massage, chiropractic and osteopathy are an effective way to support themselves when they are managing pain and particularly chronic pain. At a recent symposium on pain it was surprising to hear that the research really wasn’t there to support the use of bodywork therapies for reducing chronic pain long term, however there were studies to show that it did have benefit in the short term for symptom relief. The absence of studies does not mean that it doesn’t work it just means that not a lot of research has been done.

The research that has been undertaken does show the value of an holistic approach to treatment for chronic pain and include the use of graded exercise therapy, cognitive behavioural therapy as well as bodywork. So what are the best options for people when they are experiencing pain and how do you decide what will work for you?

Generally if the problem is structural its ideal if you can be assessed by a chiropractor or osteopath. An osteopath can support patients with manual therapy interventions including exercise prescription, needling and education to improve movement and reduce pain. Osteopaths also work on soft tissue with either massage or gentle activation. Chiropractors tend to focus more on the spine and alignment and will do manual adjustments to improve the nerves and their function.

When you are considering massage therapy look at what type of pressure you can cope with? For example for those who cannot deal with a strong massage it might be worthwhile looking at lymphatic massage, reflexology or gentler therapies such as craniosacral therapy. Let’s consider the relative strengths and benefits of each style so that you can decide what will best provide you with support.

Remedial Massage

Remedial massage assists in improving soft tissue or muscle function by improving the flow of blood to the area. It can also support you through recovery from an injury and reduce pain. Remedial massage can be tailored to the pressure that you can tolerate but generally involves a stronger style of treatment.

Lymphatic Massage or Manual Lymph Drainage

This is a gentle style of massage which works on the superficial lymph structures that sit below the skin. This is ideal for anyone recovering from surgery or an injury with significant swelling. The gentle flowing strokes can assist to improve the flow of lymph and reduce swelling and pain. Ideally with a lymphatic therapist look for someone who has done additional training such as the Dr Vodder course in Applied MLD. The therapists who complete this training are often qualified in other tools such as low level laser, taping and bandaging. This type of therapy works well for those who have been treated for cancer to support them particularly after the loss of lymph nodes.

Reflexology

Predominantly working on the feet , reflexology can assist with pain management through pressure on the soles in areas related to the underlying source of pain. By identifying areas that are congested or unbalanced the therapist can assist with the flow of energy to assist in healing. Reflexology can slow down nerve transmission which may interrupt pain pathways. It also helps with releasing endorphins which can then make you feel better. Reflexology assists with circulation and increases the flood of blood and nutrients around the body. Reflexology by promoting the relaxation response is an effective way to release stress and tension.

Reflexology is often used in palliative care settings as it is a gentle therapy where the client does not need to be mobile.

Craniosacral Therapy

Craniosacral therapy is a type of bodywork that relieves compression in the bones of the head, sacrum and spine. It uses gentle pressure on the head, neck, and back to relieve the stress and pain caused by compression. It’s thought that through the gentle manipulation of the bones in the skull, spine, and pelvis, the flow of cerebrospinal fluid in the central nervous system can be balanced which then improve the body’s ability to heal.

Craniosacral therapy is deeply relaxing and it will often take 48-72 hours for the full benefit to develop. It is common to see improvements in sleep after a treatment and it is useful for people who have had a history of concussion or indeed other trauma.

To find a practitioner who is appropriately qualified make sure you refer to the natural therapy association websites such as atms.com.au and also look for referrals from your other practitioners.

If you are recovering from surgery or an injury and would like more information about the best strategies for managing chronic pain please have a look at the recent Understanding and Managing Chronic Pain webinar on my website.

Posted by Christine Pope on in Ageing, exercise, Healthy Ageing, stress

Find out how what factors might put you at risk of developing chronic pain

Why do some people experience chronic pain and others have complete resolution of that pain? One in six Australians suffer from chronic pain and there are a number of factors which can predispose you to experience that condition. Chronic pain is defined as pain that continues for more than 12 weeks after the initial trauma or injury.

First up the concept of pain is more complex than originally thought. When you experience an injury the tissue that is damaged sends a series of signals through nerves to the brain. The brain then decides how to interpret that signal. It usually regards it as pain initially and then over time as the tissue heals the signal decreases and the brain usually acknowledges the signal as reduced pain. There can be times however in the presence of high levels of stress or anxiety that the signal to the brain is not adjusted as the tissue heals, this is what can happen with chronic pain.

The brain also interprets those signals through a filter of previous experiences and emotions, factors which may lead to an increased risk of chronic pain being experienced.

For many people testing or scans may no longer reveal the presence of an injury but they are still experiencing pain. This may lead to the feedback from practitioners that the sensation is not real, however it is real and the patient is still experiencing that sensation.

So what are the major risk factors for developing chronic pain (1);

  • Based on the earlier description you can probably guess that one of the major risk factors for chronic pain is a prior experience of chronic pain. That’s right the brain in filtering this information “remembers” a prior experience and this can increase your risk for developing chronic pain.
  • Two other significant contributors can be related to your workplace. Being in an environment where the injury is subject to compensation or being in an environment where your relationship with your boss is strained both lead to a higher risk of chronic pain. To a certain extent this relates to the elevated cortisol you produce when you are in a stressful situation which then leads to a reduction in the ability to modulate or reduce pain signals in the brain. When your nervous system is in overdrive you are less able to calm the signals.
  • There are gender differences in the experience of pain and responses to pain management. Women are more likely to express more sensitivity to pain and less likely to respond to conventional treatment. (2) In a 2007 review of pain research 79% of studies had been conducted solely in male animals and only 8% in female animals. Further women are more likely to experience chronic pain conditions than men.
  • Significant distress during the initial phase of the injury and high levels of anxiety in relation to the injury both predispose you to developing a chronic pain condition.
  • History of domestic violence or abuse increased the odds ratio of pain to 1.6. The data was based on a three year population study of over 24,000 women (3).

For those people who experience chronic pain it needs to be treated with a holistic approach that looks at physical, psychological and social factors. Whilst manual therapies for example can be of assistance in treating acute pain and assist in managing symptoms, graded exercise therapy provides more significant benefit in most of the research done to date. Combining this with appropriate counselling or stress management as well improves the overall resolution. Effectively this condition requires a team approach.

It also is clear that a lot more research is needed on the type of pain and what the best approach is in regards to it. Much of the research is 10-15 years old and often limited to common conditions like low back pain. For this reason you may find that you get more relief from a particular treatment than indicated as more commonly treatments like remedial massage are researched but there are very few studies on other forms of manual therapy such as lymphatic massage, myofascial release and Bowen therapy.

If you are suffering from aches and pains and would like to understand more about how to support yourself then this free webinar on my site could be really helpful, 6 Tips for Ageing Outrageously .

References

(1) Mills SEE, Nicolson KP, Smith BH. Chronic pain: a review of its epidemiology and associated factors in population-based studies. Br J Anaesth. 2019 Aug;123(2):e273-e283. doi: 10.1016/j.bja.2019.03.023. Epub 2019 May 10. PMID: 31079836; PMCID: PMC6676152.

(2) reenspan JD, Craft RM, LeResche L, Arendt-Nielsen L, Berkley KJ, Fillingim RB, Gold MS, Holdcroft A, Lautenbacher S, Mayer EA, Mogil JS, Murphy AZ, Traub RJ; Consensus Working Group of the Sex, Gender, and Pain SIG of the IASP. Studying sex and gender differences in pain and analgesia: a consensus report. Pain. 2007 Nov;132 Suppl 1(Suppl 1):S26-S45. doi: 10.1016/j.pain.2007.10.014. Epub 2007 Oct 25. PMID: 17964077; PMCID: PMC2823483.

(3) M Ellsberg, H Jansen, L Heise, et al. Intimate partner violence and women’s physical and mental health in the WHO multi-country study on women’s health and domestic violence: an observational study Lancet, 371 (2008), pp. 1165-1172

Are you missing out on ways that you can start ageing outrageously well ?
Posted by Christine Pope on in Ageing, exercise, Healthy Ageing, Multiple Sclerosis, Sleep

Are you missing out on ways that you can start ageing outrageously well ?

70 may be the new 50 but its possible that it won’t be that enjoyable if you haven’t looked after your physical health. Over the last decade through global challenges, like the Covid pandemic and personal challenges like three rounds of surgery I have been researching how to age well and there are some common themes.

In 2016 I was able to do the training on the Recode protocol, which was developed by Dr Dale Bredesen. The training was run in San Francisco (which was a very good reason for enrolling as well as the content) and involved looking at thirty six points of intervention based on the five major triggers for Alzheimers. Dr Bredesen has subsequently completed two case study series and more recently a clinical trials for his protocol and it is showing improvement in over 80% of cases who had been classified as having mild cognitive impairment (1). For more information on the protocol have a look at the blog on Delaying Alzheimer’s .

In Melbourne in 2018 Dr Terry Wahl’s presented her strategies for managing Multiple Sclerosis and neurodegenerative diseases and I have followed her work extensively after that symposium. Her focus in clinical practice is on using food rather than supplements primarily as well as looking at specific types of exercise that can support recovery. Dr Wahl is a neurologist who was in a tilt wheelchair with her advanced MS and is now back to riding her bike. Her programs have been implemented at the Iowa City Veteran’s Affairs Hospital and she has conducted four clinical trials on the program. To date the trials are showing significant improvements in fatigue scores and quality of life. Key features of her program involve balancing blood sugar and flooding the body with nutrients from whole foods, in particular up to 9 cups of vegetables and fruit a day plus good quality protein. Her program really encourages the use of organ meats, like liver, for good levels of key nutrients which are quite expensive as supplements. In particular CoQ10 which is essential for energy production in your cells.

There are six key areas that you need to consider in order to age outrageously well.

  1. Eat your vegetables! Flooding your body with nutrients in a form that you are best designed to absorb. Make sure you are eating the rainbow with vegetables and including at least one cup of green leafy vegetables, one cup of brassica vegetables and one cup of brightly coloured vegetables daily. If you are trying to add more vegetables to your diet it is always helpful to increase gradually and to look at adding them to snacks, soups and smoothies as well. It can also be a good idea to prepare extra vegetables with dinner and have them ready to add to lunches or soups the next day. Roast vegetables are a particularly tasty way to improve the vegetable content of your lunch and you can add them to spinach leaves in a salad or blend them with bone broth for an easy and quick soup.
  2. Balance your Blood Sugar ideally by including protein with every meal and minimising your intake of sugary foods and simple carbohydrates like bread and cereal. You do not need to be eating large quantities of protein but rather a palm size amount at each meal over the day. Adequate protein for most people would involve 2 eggs at breakfast, a small can of tuna with lunch and a chicken breast fillet at dinner. At the same time it’s important to include some carbohydrate in the diet as well but optimally it’s from whole foods and provides a slow release of glucose and a good serve of fibre as well. If you struggle to add enough protein then adding a protein shake or smoothie can be a good way to up it daily. Usually I do recommend clean brands, whey protein if you can tolerate it or plant protein for those who like variety. The plant protein options that I find useful at the moment are Nuut, Amazonia and Vital Protein. Nuut is offering sampler packs which is a good way to try a few different flavours. The other two brands are usually available in health food stores and the fermented split pea protein from Vital Protein is one of the better vegan options as its not grainy.
  3. Exercise regularly and mix it up. Ideally including both strength based training as well as cardio will really assist in maintaining good bone health as well as improving balance and energy levels. Start low and build exercise levels slowly to minimise the risk of injury and setbacks. The simplest and easiest way to start exercising is to walk regularly, starting with a five minute lap of the block and then building up over weeks by adding five minutes each week and then multiple walks per day. On e of my favourite quotes about exercise is from JIm Rohn “Take care of your body its the only place you have to live in”.
  4. Identify the sources of inflammation and manage them as well as possible. Key areas to consider are a history of infections, such as recurring sinusitis, food intolerances and allergies, heavy metal toxicity, sedentary lifestyle and chronic pain from old injuries. There are a wide number of sources of inflammation in the body and dealing with those assaults can be challenging. That’s why quite a number of “anti-ageing” programs remove common allergens like gluten and dairy as anyone with gut problems will have challenges digesting and absorbing nutrients from them. Lactose intolerance is increasingly common as we age as we were really designed to have milk in our diets only as babies and small children. Generally we should be able to absorb small amounts if our digestion is working well. Removing allergenic foods can really assist you in feeling better however test first to make sure its the right foods. For ten years I removed dairy from my diet and whilst it helped a little removing gluten was the game changer for my brain and energy levels.

5. Meditate like a Buddhist monk! Research is showing that twenty minutes of meditation can reduce levels of anxiety, depression and pain (2). Meditation is a relatively inexpensive tool with many apps which can be helpful like Gaia and Calm. Recent research undertaken at a VA hospital in the States showed that twenty minutes of meditation twice a day reduced PTSD symptoms (3). The Wellness experience provide a free thirty day meditation series in either ten minute or twenty minute increments which you can do through the website themeaningoflife.tv . One of the most essential attributes of meditation is its ability to increase grey matter in the brain and assist with clarity and focus.

6. Add appropriate supplements as needed. Look at the key symptoms and determine what is needed for you. For those who are experiencing significant inflammation for example it can be useful to look at supplementing with Tumeric and good quality essential fatty acids. If your issues are more around cramping and low energy then consider adding a magnesium supplement (preferably a powder for better absorption) and a multi vitamin. Just make sure that you do check the use of any supplements with your medications. Your pharmacist or practitioner can advise you on the right dosing and minimise the risk of any interactions.

Interested in more information on Healthy Ageing ? Click on this link Ageing Outrageously to receive regular updates.

Christine Pope is a naturopath and nutritionist based at Elemental Health at St Ives and is available for consultations online and in clinic.

1. https://content.iospress.com/articles/journal-of-alzheimers-disease/jad215707

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7287297/

3. https://pubmed.ncbi.nlm.nih.gov/29921143/

Posted by Christine Pope on in Detoxification, Energy, Environment, exercise, Fasting, Nutrition, Research, Sleep, stress

Six ways to increase your energy

One of the most common reasons for people to see a naturopath is that they are really tired and lack energy. If you are feeling like this at the moment its important to understand why your energy is low but there are also several things you can introduce which may help improve your energy levels on a permanent basis.

The area of the body that produces energy is a component of each cell called a mitochondria, think of them like little factories. As we get older the number of mitochondria in the body can reduce, typically we see a halving of the levels between 20-40 and then again by the time we reach 70. These mitochondria can also be damaged by a range of environmental factors which means they don’t work as effectively and produce less energy.

There are a number of “hacks” which can improve both the number of these little factories and also the quality. Most people are aware of the benefits of regular exercise however they may not be aware that muscle cells will build more mitochondria as a result and they will operate more effectively. However often when people are really fatigued they are not in a position to exercise so these are my top six strategies for improving cellular energy. There are other strategies however this list focuses on those with minimal costs.

  1. Thirty minutes of daylight as close to waking as possible. This is an invaluable reset for your body’s circadian rhythms and helps you produce a reasonable amount of melatonin. Melatonin is important to generate sleep but turns out it also helps with cell repair and can improve energy. Literally one week of eating my breakfast outside followed by a short walk saw a significant improvement in my energy levels.
  2. Mild stressors for the body such as cold can improve energy quality. Its really important with this strategy to start with a very modest amount and slowly increase. A cold swim in a mountain stream might be the goal but start by having a minute or two of your shower with cold water. If you are very temperature sensitive start with it on your arms and legs and then gradually move to the trunk.
  3. Eat in a 11-12 hour window. Allow the bodies waste systems to function effectively by giving them a reasonable window to operate with. This is particularly important if you suffer from brain fog as a result of tiredness. This is really fairly straightforward and may just see you have breakfast at 8am and dinner at 7pm.
  4. Reduce your exposure to blue light from computers and devices. This could involve using blue light blocking glasses however a lower cost solution is as simple as switching off all devices at least one hour before your bedtime. Blue light blocks the production of melatonin and results in more difficulty in getting to sleep. Low melatonin will also reduce the ability of the mitochondria to repair themselves and result in a worsening of fatigue.
  5. Sleep in complete darkness using blockout curtains and turning off all lights and devices. Good quality sleep is essential for energy as cell repair happens during our deep REM cycles. Typically if you aim for 7-8 hours of sleep you will have between 3-5 REM cycles. Each cycle tends to be longer with the first being about 90 minutes. For more information on improving your sleep quality read my blogs on Can you build up sleep Pressure and Six Sleep Myths Debunked
  6. Reduce inflammation in your diet as much as possible. Chronic inflammation reduces your ability to produce energy in your cells. The first step could be avoiding any known allergens or intolerances and the second to try and ensure that you are having at least three cups of vegetables a day. For more information on reducing inflammation my blog on Post Viral Fatigue has some useful resources. More generally to understand which vegetables are most useful for your health What are the best vegetables for feeding your gut ?

There are also a range of strategies to improve energy using tailored diet plans and supplements however these need to be prepared in consultation with a practitioner to ensure that underlying triggers are identified and addressed.

Christine Pope is a naturopath and nutritionist based at Elemental Health at St Ives. You can make appointments on 02 8084 0081 on online at Elemental Health .

Posted by Christine Pope on in exercise, Fatigue, Health Care, Tea, vegetables

Post Viral Fatigue (and other symptoms)

Most people when they get sick usually find that after the initial illness they probably need to spend one or two days recovering and then they are fine to get on with their work and lives as per usual. For a small percentage after a virus they may find that they are slower to recover and what usually took a few days is now taking a few weeks or months. If you are finding that your recovery is much slower than usual it might be good to review some of the strategies recommended below and see if adopting these assists with your recovery.

There are three main areas to focus on in terms of post viral recovery, namely, rest, immune support and good quality nutrition. In addition if recovery is protracted its a good idea to check with your healthcare practitioner and ensure that there are no other factors which are contributing. For example its not uncommon for women suffering with anemia (low iron) to find it takes a long time to recover from an illness. Another factor that can be problematic is a history of glandular fever as people who have had this virus are more prone to developing post viral fatigue.

REST

Once upon a time when people had a serious illness there was this concept called convalescence. It was expected that people continued to rest and recover after an illness. In today’s world I tend to recommend streaming sessions, find a series online that you enjoyed and rewatch it. A series that you have watched before does not require as much concentration and you can doze on and off without affecting your viewing.

It also important to ensure that even when you feel well enough to return to work you schedule rest into your day, whether it’s a short nap on the couch if you are working from home or just making sure you get out for a break at lunchtime. In this era of constant busyness it can be very hard for people to cut down their workload to allow time for this but adequate rest post virus will reduce the amount of downtime you need.

You may also find that its useful to gradually return to exercise slowly. This might mean starting with short walks of ten minutes and building up gradually, rather than just returning to a full on gym or pilates session. If you are coping with short walks once a day then build to twice a day consistently. However if you do find that heading back to the gym wipes you out for a day or two, then its time to regroup and gradually build up again.

IMMUNE SUPPORT

If fatigue and other symptoms are continuing for a protracted period then its possible you have a low level of the virus continuing in your system. There are a number of options for supporting your immune system to enable it to recover. These could include anti-viral herbs as well as nutrients which support the immune system, such as Vitamin D, Zinc and Vitamin C. With Vitamin C aim for 500mg three to four times a day however with Zinc 25mg daily is a useful dose. It is helpful to know your Vitamin D levels before supplementing however 2-3 weeks of higher dose Vitamin D 2-4000 IU daily should be manageable for most people when recovering from a virus.

One useful option for supporting the immune system is medicinal mushrooms in particular supplements with Reishi, Cordyceps, Turkey Tail and Shitake being useful. These are often supplemented in powder form rather than consumed as mushrooms. If brain fog is problematic post virus then Lion’s Mane is useful for brain function, however it is also important to consider other key nutrient to support brain health including good quality fatty acids, such as fish, avocado and nuts and seeds.

GOOD QUALITY NUTRITION

An over looked area for recovery is diet. To really assist your immune system to work effectively its important to ensure that you are eating a wide range of vegetables and fruit, up to 30 different types in a week. Its really easy the first couple of days to build good variety but then we often have the same vegetables every two or three days. This recent blog provides you with a good range of options for feeding your microbiome as well as possible What are the best vegetables for feeding your gut ?

In addition to the three cups of vegetables a day make sure to include a small amount of protein as well as a couple of serves of carbohydrates, from potatoes, rice or grains. At this stage in recovery easily absorbed carbohydrates are quick sources of energy.

Depending on whether your stomach was affected you may find that its easier to start eating bland food initially and then gradually add more variety. Start with warm foods as it requires less digestive energy to break it down. This might include soups, steamed vegetables or casseroles if you are up to meal preparation.

For those who are struggling with thinking about what to cook there are a few blogs on the site meal plans Meal Plan Week One and Meal Plan Week Two could be a couple of options or if you would prefer lighter healthier foods then Spring Reset Meal Plan might be useful for you.

For more support with post viral illness book in an appointment with me at my St Ives clinic or online. Bookings are available through http://www.elementalhealth.net.au or on (02) 8084 0081.

Posted by Christine Pope on in exercise, Gratitude, Health Care, Online Courses, stress

The high points of 2021

Lately I have had a song stuck in my head, not sure what its called, but I just remember the line – I fall asleep counting my blessings. So rather than making a bunch of New Year’s resolutions this year I prefer to reflect on the positives from 2021, both personal and professional ( and there were some!!).

First up for me was my son returning from Canada where he had decided to stay after the border closures in March, 2020. The return trip was a little fraught as he had had COVID a few weeks before departure. We were a little worried about him testing positive still and being unable to fly. At the point in time many flights were cancelled and friends of his had multiple attempts at getting home. Anyway lots of worry but at the end of the day turns out a flight on JAL when the Olympics was on was a good call. It kept to schedule and he made it home. Not only that but the flights were fairly empty and there was lots of room to spread out and sleep. Two weeks of hotel quarantine after he had already done two weeks of COVID isolation was a bit much for him but many care packs were delivered to his room. His sister organised technology to entertain him and we sent in food as well as recommending deliveries from Lettuce Deliver for in room salads.

Inevitably when he got home I was on a Board call on Zoom but pre-warned I just ran to the door and hugged him for a long time (and there were a few tears as well).

The protracted lockdown starting in June, 2021 came with new restrictions regarding your LGA and distances you could travel. This actually resulted in the family focussing on finding new walks as much as possible. Two big positives were finding some lovely walks in the Lane Cove National Park to add to our rotation and meeting a friend on a regular basis to walk around the Wildflower Gardens at St Ives. The weather through this lockdown fortunately was very favourable and we did improve our fitness levels overall.

Another big decision for me at the start of lockdown was continuing to do a weekly Pilates class with Village Pilates on Zoom. Initially I wasn’t convinced but it was a great decision to try it and it really gave my week structure as well as helping to maintain the fitness and balance that classes had already developed. The other benefit was having three other people to catch up with on a weekly basis and this led me to developing my own webinar series initially “Reset in Lockdown” and then a “Spring Reset”. Each week I really looked forward to the challenge of developing content and also the great questions each group asked. (If you want to listen to some of the content click here for the Reset and Recharge in Lockdown ).

Zoom or Microsoft Teams was also instrumental in giving me access to a range of Government consultations and meetings on behalf of my two Boards, COSBOA and the Australian Traditional Medicine Society. In one week I attended consultations on re-opening in three States and our CEO did a further consultation for Tasmania, something that would not have been possible before as physically I would have been unable to attend meetings in three different States. Online access really assisted in my advocacy efforts as it enabled me to participate in a much broader range of meetings than our association budgets would have enabled. Further it helped keep me sane as I love being able to assist in solving problems and working for small business and natural medicine.

The real eye opener for me about inclusion was in part due to an event I attended in early May as part of my COSBOA role. The National Innovation Games was in Newcastle where the theme was Inclusion 365: Navigating physical and digital worlds. For many people with disabilities COVID had opened up access to a broad range of events through digital access, as well as providing better access to medical services with the broader provision of telehealth. The National Innovation Games is a design and critical thinking challenge where teams work on real world challenges for businesses. In this Games we were working with the City of Newcastle to develop concepts to support disability access. The team I was working with developed a concept for an app which would provide information on the best path for someone to travel around Newcastle, incorporating real time updates from existing sources to advise of possible obstacles. We did come in second place although another team with a similar concept came first so we will claim equal first place.

Another personal highlight for me was being told by my daughter that she had referred to being brought up by a strong kick-ass woman. So I will finish the year on that high point. Strong women, may we be them and may we raised them.

Wishing you all the best for 2022, please share your highlights from 2021 in the comments.