By: Teresa Grant, PT

We tend to associate warmth with relaxation and a feeling of tranquility. But, heat can have physiological effects as well. Heat can be both superficial such as a heating pad or it can be deep. Ultrasound delivers a deep heat.

Ultrasound's physiological effects can be to decrease pain, stimulate an increase in blood flow, increase soft tissue extensibility and decrease muscle spasm. Ultrasound can prepare stiff joints and soft tissue for exercise and stretching.

As sound waves pass through the different tissues they absorb kinetic energy thus creating heat. Absorption varies with the different tissues as the waves pass through skin, fat, muscle and down to the bone.

By changing the duty cycle and intensity, ultrasound can have either a thermal or a non-thermal effect. Examples of non-thermal effects are soft tissue repair, tendon repair, and stimulating increased blood flow.

In the clinic setting, ultrasound is frequently used for tendonitis, carpal tunnel, muscle spasm, over trigger points and over joint capsules prior to stretching, to name a few examples.

With ultrasound, because of its deep effect, the heat is barely perceived. This leads some patients to question whether anything is happening. As patients experience a decrease in their symptoms, many become believers in the therapeutic benefits of ultrasound.

If you have any questions or would like to learn how to add ultrasound to your program Purcellville Orthopedic Physical Therapy will be happy to help in anyway.

We’re going to tell you about something you’ve heard talked about before. But it is important and we want to emphasize it; because this topic can be debilitating in so many ways.

We’ll be talking about inflammation. Inflammation is part of the body’s natural defense system.

When your body senses foreign invaders (not those from space), a specific cascade of events sets off in which your white blood cells and some special chemicals called cytokines mobilize to protect you. You’re probably familiar with the pain, swelling, redness, and heat that classically signify inflammation. It’s something just about everyone out there has experienced.

We have all had injuries such as a swollen knee after a fall or a fever due to a cold. In such cases, inflammation is not an issue. On the contrary, it is just the cells of our body doing an extra effort to help us heal. Acute inflammation itself is not the issue. The problem begins when things go wrong and it becomes chronic.

The symptoms of chronic inflammation vary widely depending on its stage and the organs affected. They can be easily mistaken for common allergies, tiredness and joint pain. Chances are that these reactions are in fact the manifestation of inflammation in the person’s body. More and more research is being conducted specifically on chronic inflammation and the body’s responses to it.

Chronic inflammation may cause diseases such as cancer, diabetes and depression just to name a few. Read about the most common triggers of inflammation below. Inflammation and Its Discontents: The Role of Cytokines in the Pathophysiology of Major Depression

So what causes the body to have chronic inflammatory responses? Here are some common triggers:

• Sugar
  Research shows that many Americans are eating more than double the recommended allowance for sugar (Dietary Sugars Intake and Cardiovascular Health – A Scientific Statement From the American Heart Association) everything from our favorite breakfast cereal, to those delicious low-sodium crackers, to that microwaved bowl of soup contain added sugars, mainly in the form of high-fructose corn syrup. Excessive sugar can cause an immune response and lead to inflammation and diseases such as diabetes.
• Processed Foods
  How many times do we choose fast food or delivery simply because we are just too tired to cook or running late? The consumption of processed foods is a reality that’s almost impossible to escape. Many foods cause inflammation, but especially processed meals because they contain high levels of sodium, fat, empty carbs and added sugar. At first they might give a boost of energy, but it does not last long and hunger quickly returns. Since they do not have the ingredients our body needs to function, it keeps on craving more, leading many to overeat.
• Fat
  Before starting any discussion about fat, it is very important to understand that fat itself is not the problem. Our body needs fat to function. Our brain craves fat. Unsaturated fats, such as the ones found in olive oil and almonds, are essential for our well-being. Trans fats, found in anything battered and fried, can be highly toxic and should be avoided as much as possible.
• Gluten
  The grains produced today are not the same as 50 years ago. In order to feed the ever-increasing population, genetic manipulation has created stronger and more resistant seeds. The side effect is that those grains, that were for centuries the main source of food, have changed dramatically. Even patients who do not have celiac disease can show similar symptoms (such as pain, bloating and fatigue) after the intake of gluten.
• Alcohol
  The effects of excessive alcohol consumption are well-known to anyone who has gone through a hangover. Most of the consumed alcohol is broken down in the liver. In this process, certain toxins that are even more harmful than the alcohol itself are generated, which damages the liver cells. Inflammation is only the beginning since these by-products weaken the body’s defenses. Having a weak immune systems leaves room for more dangerous inflammations such as alcoholic hepatitis and fibrosis.
• Smoking
  It is highly recognized by the medical community that smoking increases the risk for coronary heart disease, stroke and lung cancer (https://www.heart.org). What most people do not realize is these diseases are triggered by the inflammation of the arteries caused by nicotine.
• Stress
  In modern society, the constant rush against the clock is a reality. We force our mind and body to stay alert non-stop. There is little chance to rest in our hectic lives. This never-ending state of ‘fight’ or ‘flight’ triggers the release of the stress hormone cortisol, which influences our metabolism and can trigger chronic inflammation. From Stress to Inflammation and Major Depressive Disorder: A Social Signal Transduction Theory of Depression
• Poor Sleep
  Sleeping less than six to nine hours every night is associated with higher coritsol levels (Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity). The higher your coritsol levels, the more likely you are to suffer from chronic inflammation.
• Sedentary Lifestyle
  Unlike our predecessors, we do not have to grow and harvest our food or hunt for our next meal. We spend the majority of the day sitting, whether at work or in the car. These sedentary habits combined with poor diet can lead to inflammation associated with heart disease and diabetes. Many of our patients have heard me say, “A desk job is the most dangerous job in the world.” It may be an exaggeration, but the sedentary life style has a deep impact on the way we feel. Sedentary Behavior: Emerging Evidence for a New Health Risk



• Pollution
  Very few places around the world are free from pollution. Breathing in pollutants in the air causes our body to fight back with an immune response. Extended exposure to these pollutants can lead to long-term inflammation.

Because so many health problems have been associated with it, it’s tempting to think of inflammation as a disease. But of course inflammation is not always a bad thing. It’s a vital part of a healthy immune response. Your body depends on inflammatory responses to defend you from bacterial and viral invaders and even cancer cells. Inflammation also helps the body heal from injuries.

The problem is one of balance. As a result of diet and lifestyle, our bodies tend to over-produce inflammatory chemicals. Healthy lifestyle habits such as exercising regularly, not smoking, maintaining a healthy weight, and minimizing stress all help to reduce inflammation. If you need help with creating a healthy lifestyle plan, we’re here to help. Superior Physical Therapy and Sports Rehab (https://frederickpt.com/) has certified strength and conditioning specialists that help you create a safe and functional exercise plan; provide advice for monitoring/managing inflammatory responses and provide general recommendations for nutrition. At Superior we believe for total wellness you must treat not only the body, but the mind and spirit too.

$60 billion dollars spent on diet products annually
Market Data Enterprises, 2012
US News - Money, Jan. 2, 2013

"95% of all diets fail" Is this true?
- based on a 1959 study by Stunkard and McLaren
- Hume but has been reinforced by many clinical studies over the years.

We all know someone who has lost weight and have kept it off. How did they do this? We also know those who have lost weight and gained it back, or, have tried to lose weight and not had success. Most studies consider a successful diet based on the following criteria; losing 30# and keeping it off for over a year.

Is there a trick? What am I doing wrong? What type of diet should I be on? What do I do?????????

Eric Westman, Duke MD has repeatedly studied and consistently found that a Low Carb and High Fat diet helps individuals lose weight (The New Atkins Diet). Dr. William Yancy of Duke University has also found that a "low-carb diet is just as powerful as the weight loss drug Alli".

A study by, Hagan, Wong, and Whittam (1986) demonstrated that diet alone helped people lose weight and that the exercise alone did not help individuals lose weight; therefore, diet is the most important aspect.

In contrast, Sopko et al. (1985) found that both the diet group and exercise group lost the same amount of weight if exercise caloric expenditure was equal to the reduced caloric intake by diet I could go on and on. But let me summarize what many researchers have studied and theorized.

Exercising can reduce risk of Type 2 Diabetes mellitus (Pratt, et al, 1995), reduce coronary heart disease (Grundy et al, 1999, NIH, 1998 Ross and Janson, 1999), and reduce depression (Babyak, et al, 1999).

Diet... there are so many! Which one is right for you? I will hopefully give you some insight on part 2 of my blog. First, I feel that it is more important to strategize, plan and create goals. I will review this with you in part 1 of my 2-part series. You may be surprised! Once you strategize, plan, create goals, and assess you may find that developing your own diet will be best suited for you!

Comparing Success in Business with Success in Weight Loss

So how do the most successful business, become successful? It always helps to have a little bit of luck J, but we are taught that most are successful because they formulate a plan, put it in writing, stick to it and make changes (or progressions) as they grow. Most are in it for a long haul and take a vested interest in the business.

So I have taken what I have learned and have spent many years on determining what the best strategies are to own, run, grow, and market my business. I found that the strategies that work best for me are the ones I put on paper. I then establish goals and check lists and put them in writing. I then mend my strategies as goals are accomplished (not accomplished) or as the culture of my business changes. So what they teach truly works for me.

So, should we do the same for diet and exercise? My answer is YES!!!!

Come Up With A Plan
This plan should be long term! Don't state, "I want to lose 20 pounds by summer to fit into my bathing suit." Go at a slow and steady pace. If you set too lofty of a goal, it is too easy to get discouraged and walk away from it. You are also limiting yourself to just one aspect of diet. "I want to look good in a bathing suit". Don't limit yourself to one goal (i.e., look good in my bathing suit). You need to have short-term goals based on your long-term goals. Make sure you set several long-term goals. That way if you have 4 goals and you are achieving one, you are still successful. Also, make sure that you keep everything in WRITING and keep it in an area that you can see on a daily bases.

Focus On Health And Not Just Weight As A Number
You can lower your % body fat without losing weight. There have been studies that show that if you exercise and don't lose weight, you still lower your risk for heart disease and other comorbidities including diabetes mellitus, anxiety and depression. Knowing this can help drive you to continue to exercise and diet. From what I have read and reviewed a diet similar to The Mediterranean Diet is a good place to start.

Have A Partner
This may be why Health Coaching is the new fad. If you have someone there to support you, advise you, push you (if needed), or just to listen to you it may help you through times you stray or don't meet your goals.

Stick With The Plan
Make sure you have a diet and an exercise routine that you can stick with - even if it is just reducing caloric intake by 100 calories a day. When we exercise you don't start with a 60-minute workout followed by a 20 mile run. You start slowly and work up to it. AGAIN, created goals you can achieve.

Other Factors To Consider
Your ability to lose weight is also affected by stress, sleep patterns, allergies, genetic make-up, and environment. Most of these factors you can control!

I hope this first installment gives you a few important things to consider when coming up with your strategy to create a healthier you! We need to put ourselves in a position to succeed. My next blog will dive deeper into what diets and how much exercise is a good place for you start. So stay tune and I hope my blog helps with your mindset.

Earl Cox, PT, MS, OCS, CSCS

Written by: Lindsay Simmons
Clinical Director, Purcellville Orthopedic Physical Therapy

Do you ever get the urge to dance when a song comes on the radio, or even find yourself dancing around the house while jamming out to music? If that is a yes, then you are not alone! I find myself thinking to "All I want to do is DANCE!!" Well ladies and gentlemen Zumba is where you can be free and dance like no one is watching.

Every night I go to the gym and I know that I have to keep switching things up so I don't get bored with the same old routine. I have learned that if I have the same routine my body becomes familiar with this and I hit a plateau, which is never fun when you are trying to either tone, maintain or even reach a new fitness goal. But when there is a will, there is a way!!

I have found that Zumba is just what I need to keep things fun and interesting. Zumba is a workout known as a dance fitness party. I originally tried Zumba with a friend by following a fitness DVD. While the DVD was fun and the hip-swiveling moves were a blast (and effective at working up a sweat!), the best part of the workout was dancing with my friend. We would giggle at each other as we tried to get our hips to salsa, merengue and cha-cha-cha like the girls in the video. Zumba Fitness is a Latin-inspired cardio-dance workout that uses music and choreographed steps to form a fitness party atmosphere. While many of the types of dance and music featured in the program are Latin American inspired, classes can also contain everything from jazz to African beats to country to hip-hop and pop.

Don't worry if you think you can't dance or that it's not your thing, because Zumba is just people dancing. Well, let me tell you that no one is watching and if you lose the step all you need to do is move to the sound of your own drum. Just have fun with it! No one is expecting you to be amazing but just enjoy a different way of working out. For those who feel that Zumba is just dancing, boy you have no idea what you are missing. Researchers determined that Zumba is an effective interval-style, total-body workout with built in variety because every class and every instructor is slightly different. The heart-rate during a Zumba session, looks like an interval workout, going back and forth between high intensity and low intensity therefore; with Zumba you burn a lot of extra calories compared to a steady-state exercise like jogging.
With that being said, enjoy switching things up and live a little on the wild side.