COVID-19
I’m getting ready for a fight.
Like many of you, I’m so over the fear propagation. COVID-19 is just about the only thing being discussed on the news and social media. I’ve had many patients ask me about my thoughts on what can be done. My response is: I’m getting ready for a fight. What does that mean? If you’ve ever trained for a fight, then you know what I’m talking about. You must eat right, sleep right, manage stress and recovery and train like a beast. What does that equate to...A strong, healthy, and balanced me. Which also means I have an immune system that is operating like it should. Regardless of whether I get sick or not, I know that my body will have the best fighting chance because of my conscious choice to take care of myself.
Eating well
Now is the time to get serious about nutrition. I don’t care what diet you follow: paleo, keto, etc. It’s been my experience that even the same patient may require a different diet strategy depending on many of life’s variables. If you have food allergies or sensitivities, now is the time to eat perfectly and avoid the things that don’t process well in your body. Whole foods with plenty of good veggies, some meat and a little fruit prepared fresh and often. No processed or added Sugar (just don’t). We are what we eat and you can choose to be made of real, whole nutritious food or not. If you are unsure about what foods to stay away from or add into your diet specifically, set up a nutritional assessment in our office.
In addition to eating well, it is important that your intestinal tract is working properly. An easy appraisal of intestinal health is frequency and consistency of bowel movements. If you are not having at least one to two complete bowel movements daily, you are constipated. Complete meaning you feel satisfied with the voiding. You’d be surprised at how many people are chronically constipated. I often will point it out on x-ray imaging. Often, patients come in for an appointment because of low back pain and the pain is, in part, because they are constipated. If you are having more than two bowel movements daily and/or your bowel movements are loose, you may not be properly digesting your food. If you are alternating between constipation and loose stool, you may have Irritable Bowel Syndrome (IBS). Bowel health is important because most of your immune system resides in your gut. If any of the above is true for you and/or you’ve used antibiotics in the past couple of years, you could probably benefit from some probiotics. We use a four-stage process to re-introduce healthy gut flora.
One more thought on probiotics: if a United States Olympic athlete gets an upper respiratory tract infection, probiotics are the go-to treatment of choice. Why? Because they work. The US-Olympic athletes don’t take medications unless they absolutely have to (for possible legal reasons and they also understand how many drugs can negatively affect health and overall performance) and what they CAN take is limited due to drug test guidelines. Yes, COVID-19 is a viral infection, but probiotics have been shown to boost the immune system, which in turn will be better situated to deal with a viral infection as well.
It should also be understood that alcohol (ETOH) has a very damaging effect on intestinal health. It breaks down gap junctions in the lining of the intestines which could lead to conditions such as leaky gut, affect the way nutrients are absorbed, and can contribute to abnormal immune responses. Nicotine and other stimulants (caffeine) can decrease gut transit time which could in turn affect nutrient absorption. Additionally, stimulants activate the sympathetic nervous system which in turn inhibits the parasympathetic system. This shift in nervous system activation can also be stressful on your body and affect your digestive system and your immune system.
It may be important to also address clinical and subclinical food allergies, intolerances, and in some patients, infections from pathogenic bacteria, viruses, etc. For more information about gut health and or nutrition, set up a nutritional assessment in our office.
Sleeping Well
Did you know that lack of sleep can drastically affect sports performance and likewise, athletes that prioritize and optimize their sleep have a significant advantage to those that are sleep-deprived? Sleep also affects your immune system, making it harder for you to stay well.
Lack of sleep has also been shown to increase a person’s risk of developing serious medical conditions such as obesity, diabetes, and cardiovascular disease. A lack of sleep over time has been associated with a shortened lifespan.
Additionally, being asleep between the hours of 11:00 pm and 3:00 am is important for proper hormone levels, as this is the time that human growth hormone (HGH) is released. Having proper levels of HGH is important not only athletically, but also in the promotion of good health and also for healing and recovery from exercise and or injury.
The Harvard rowing team took part in a study that investigated sleep and its effects on performance. In addition to the athletes normal 8 hours of sleep, the athletes were encouraged to take 3-4 additional 15 minute naps throughout the day. The season that this study took place in was one of their best!
What are the steps you can take to ensure the best chances of a restful sleep?
Manage stress levels (meditate or pray before bed)
Go to bed at the same time every night
Turn off your devices a couple of hours before bed
Do not watch TV or use your devices in bed
Use “white noise” to drown out background noise that might be keeping you awake
If you sleep on your side, place a small pillow between your knees and use a side sleeping pillow to protect your neck and shoulders
If you sleep on your back, place a small pillow under your knees and use a back sleeping pillow to promote proper neck and shoulder position
If you're unable to get your normal amount or just need more, take a nap (15 minutes will work)
Limit consumption of alcohol because it can negatively affect sleep quality and quality
Stimulant consumption may also play a role in falling asleep, staying asleep and sleep quality
Address medical problems that affect sleep such as sleep apnea. The diagnosis of sleep apnea and its subsequent treatment is straight forward. Our office does make referrals to sleep clinics.
Musculoskeletal pain can affect quality of sleep. It is hard to sleep well when you are uncomfortable. Somatic (body) Pain will inhibit normal sleep patterns. Temporomandibular joint disfunction (TMJD) is an example of a musculoskeletal condition that may affect quality of sleep. Temporomandibular joint disfunction (TMJD) may also affect quality of sleep. If you have or suspect you have TMJD, then come in and get treated. Additionally, if you have TMJD you may also benefit from a bite guard. We have very knowledgeable dentists that we refer to. If stress plays a role in your sleep, then keep reading and/or ask us. Again, we have behavioral health practitioners we refer to.
Lastly, if for some reason your normal sleep schedule has been affected, Melatonin may be beneficial. Melatonin is a hormone that your pineal gland releases when it senses nighttime. My preference is sublingual (meaning dissolves under the tongue). The current recommendations for Melatonin is to not exceed 3mg. If you have more questions or would like to purchase Melatonin, please ask.
Managing Stress
Some stress can be good, like the physical stress that is placed on the body while exercising. Too much physical stress can be bad and result in harm. There are different forms of stress, both actual and perceived. When we are exposed to stress, our bodies respond very predictably. Hans Selye is most noted for his studies into the stress response of the human body. Stress can affect our ability to fight infections by weakening our immune system over time, stress can affect our emotional state, stress can affect our hormones (which in turn can affect all body systems), stress can affect athletic performance, stress can affect job performance, stress can affect family dynamics, etc.
So what can I do about stress?
Eat well (food intolerances and food allergies stress your body)
Sleep well…
Exercise (keep reading)
Meditate or pray (keep reading)
Breathe properly, crocodile breathing, square breathing, 90/90 breathing, etc.
Use biofeedback to learn how to better control breathing, heart rate, brain wave patterns etc.
Just like alcohol, nicotine and caffeine affects our digestion and sleep quality it can also increase
stress and anxiety
“The Happiness Advantage” is a book written by Shawn Achor. This book was recommended to me by my Tang Soo Do sensei, Master Clark. In addition to being a 7th degree black belt and very active in the martial arts community, he is also a behavioral health therapist…cool combination. The book does a good job of outlining the science behind positivity and how operating from a higher base level of happiness affects your health, both mentally and physically. Additionally, the book gives actions steps that are easy to implement.
Gratitude exercise - Write down 3 things that you’re happy happened in the last 24 hours. It can be simple like you had a great cup of coffee this morning.
The “Doubler” - Take two minutes to write about a good experience you had today or the last 24 hours. He explains that in doing so it helps to imprint the positive experience harder into your brain.
The “Fun fifteen” - take 15 minutes a day to do what he calls cardio. He explains that cardio exercise has been proven to be as effective if not more than antidepressants, if done regularly. His examples were gardening or walking the dog.
My argument would be that HITT training would offer a better benefit for you both because of the neurological effects on your brain and neurotransmitters but also your hormone levels, both anabolic and catabolic (more to come on the exercise stuff).
Meditation. take two minutes daily to meditate, work on your breathing or use Muse*.
Conscious act of kindness. He mentions sending a positive text or email to someone and mentions that our brains operate better when we have helped others. This is one of the reasons I’m starting a blog. I have information that can help others and doing so makes me happy.
Deepen social connections. Spend time with family or friends. He explains that one of the best predictors for business success and health is to have a strong social environment. This is also something I am working on myself.
*Using biofeedback can be a very helpful way to manage stress. Muse is a headband you may use to learn how to better change your brainwave patterns, slow your heart rate, and relax your muscles. We use them in our office and have had great results. Please ask us if you're interested in trying Muse.
Finally, if you are not able to manage your stress, please tell us. We have behavioral health therapists we refer to often that would be happy to help.
Exercise
Exercise is important in keeping a normal functioning immune system. It helps improve your cardiorespiratory system and COVID-19 is an upper respiratory infection.
Exercise has been shown to be equally beneficial at treating mild-moderate depression as antidepressants, and obviously doesn’t have the same side effects as the medication. Weight bearing exercise is the best natural bone density enhancer. Weight bearing exercise has also been shown to help decrease the rate of muscle loss (and functional loss) as we age. Exercise can decrease stress and anxiety (stress being a contributing factor to a weakened immune system). Exercise has been shown to help people obtain regular and better-quality sleep (lack of sleep affects the immune system negatively).
There is also a neuro-endocrine response to exercise. When we train hard (utilizing glycolytic oxidation, think HIIT training) we stimulate natural hormone production such as human growth hormone, testosterone and other anabolic hormones. Anabolic hormones keep us strong, healthy, increase our ability to heal, and slow the loss of ability as we age.
My preference for exercise is to master movement (exercise form) and then load the movement with an implement that is best suited for the task your training for. In general, I like barbell lifting for strength and conditioning, kettlebells for training power, speed and conditioning and body weight exercise for agility, core stimulation and in the case of martial arts power production, range of motion and accuracy.
To learn more about barbell lifts, set up an exercise appointment and we can work with the basics as they apply specifically to you. Additionally, check out Mark Rippetoe’s “Starting Strength.” Mark is a strength and conditioning expert with many years of training athletes. I like his descriptions of the basic lifts and proper biomechanics. He also does a good job of keeping training programming simple. However, I do not like his version of the standing overhead press.
To learn more about barbell lifts, set up an exercise appointment and we can work with the basics as they apply specifically to you. Additionally, check out Mark Rippetoe’s “Starting Strength.” Mark is a strength and conditioning expert with many years of training athletes. I like his descriptions of the basic lifts and proper biomechanics. He also does a good job of keeping training programming simple. However, I do not like his version of the standing overhead press.
To learn more about bodyweight exercises, please feel free to ask at your next appointment, or book time for an exercise appointment.
Bodyweight exercises such as lunging and squatting are important for anyone who wants to continue to move pain-free throughout their life. Pushing and pulling exercises such as pushups, handstands, pull ups and chin ups help to maintain pain-free range of motion while also aiding in doing normal, daily activities without injuring ourselves. I also like to train striking exercises for combat. I feel it important to know how to protect ourselves and our family. Additionally, I think it is important that women are comfortable with basic self-defense movements and understanding. Lastly, I would add that striking is a great representation of your ability to produce power from your core to your extremities. Power production is the first physical ability we lose as we age and very hard to get back once it’s lost.
Hygiene
Yes, it’s important to wash your hands after coming into contact with commonly touched surfaces, people, before preparing food, etc.
Hygiene Tips
If your eyes are itchy because of allergens and to keep your ocular mucosa clean, wash your eyelids and lashes. Wash your hands and then use a small amount of baby shampoo to lather up your eyelids and rinse them off. I used to get red and itchy eyes often, but this is now part of my normal routine.
If you have an itchy nose or ears and/or to keep the mucosa clean, you can use a 50/50 mixed preparation of hydrogen peroxide and water. Dip a Q-tip into the preparation and use the Q-tip to clean out your nares (nostrils) and your external auditory meatus (ear canal).
To clean out my sinuses, I like to use Nasaline. For those of you who have not used one, it is like a neti-pot but instead of using gravity (putting your neck into weird positions), it uses pressure to irrigate your sinuses with saline solution. I also use this daily to minimize allergens in my sinuses and also to rinse out other stuff we collect as we breathe normally and while exercising.
To help aid your immune system in the upper respiratory tract, work with your breathing as described before either with meditation, breathing exercises, or using biofeedback. Follow a good diet that is free of allergens or food sensitivities. For additional information, ask during your next visit or call the front desk to book an appointment for a nutritional assessment. Additionally, I like a product called SinuInhaler by NeilMed. It uses essential oils that are natural anti-bacterial/viral etc. We have the SinuInhalers up front.
It’s also important to wash your fruits (eating some) and vegetables (eating a lot). I like a product called “Veggie Wash Organic” sold at Sprouts. I’m not sold on any one product; the point is to use something to wash all of those veggies you know you need to be consuming and also for the small amount of fruit you should be consuming.
Vitamin D
It is funny that over the past 10 years in practice in one of the sunniest places in the US, I have not had more than a handful of patient’s blood work show adequate levels of vitamin D. I think that we get used to using sunblock and staying in during the hot day that we do not actually get enough sunlight. The normal amount is considered to be somewhere between 20 and 40 ng/mL. At the Olympic training center, athletes under 40 ng/mL are placed on supplements. What this means is for optimal levels, I like all of my patients to be at or above 40 ng/mL. If it's good for Olympic athletes, it's good for my patients. The recommendations for vitamin D have gone up recently. I think this is because we are starting to understand that vitamin D acts more like a hormone than a vitamin and is crucial for overall health and hormone regulation and of course, important in our immune system. In addition to the recent increase in dosage, we’ve recently changed the unit of measurement. Instead of IU/day, the unit is micrograms. Thus, for patients who do not have Multiple Sclerosis (MS), they may safely take up to, and in some cases more if blood work indicates, than 100 micrograms daily. A patient with MS may take roughly double that dose. My preference is an emulsified version of vitamin D called “Hi-Po Emulsi-D3'' from Designs for Health. This should be taken with a meal that is fat-containing.
Zinc
Zinc is important for so many things in the body, including a proper functioning immune system. I like a functional test for zinc. Using an aqueous form of zinc as a functional indicator, we can detect when someone is low on zinc. This is most patients who have been tested. Once the zinc depletion is normalized, a smaller maintenance dose may be taken. Again, if you are interested in zinc, please ask at your next appointment or book a nutritional assessment.
In general, this is my approach at living well and simultaneously lessening my chances of getting ill. If I do get sick, then I know I’m giving my body the best chance at a complete and speedy recovery. I hope you found this article insightful. Feel free to talk about any of the finer points during your next appointment whether for Chiropractic Sports Medicine, Nutrition, or Exercise.