About the Author:

This is NOT one of “those sites” where the author gives advice without evidence or confuses their opinions with fact. My name is Nicole Mims. I am a Physical Therapist living in Austin Texas. I was an RRCA certified running coach and a NASM certified Personal Trainer before going to school for my Doctorate in PT. I plan to discuss health and wellness with a holistic perspective. My life and education have equipped me to do this. I believe that people should have access to evidence based information to better their lives. In my effort to give back, this site is free and non ad driven.

I walk many different paths in my day to day. I’m an avid gym goer, PT, artist, advocate for sobriety, dog mom, lay buddhist, and often simply a human with all the related strengths and foibles. Advice here will be fact based with resources, but it will also be a sounding board for what I’ve found to be true in my life. Some articles are just personal expression of feelings that need a way out (located under personal). Hopefully we’ll both find something we can use here.

With love,

Nick

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Safe Strength Training – Classic Squat alternatives

Yesterday I saw a tweet from BodyBuilding.com that claimed they would discuss the safety of an exercise known as a “pistol squat.”  I was disappointed to find that a total of 3 sentences mentioned that pistols could be risky, none of which explained why.  The rest of the article was on how to do/progress to a pistol squat (as if this exercise isn’t well covered already). The author finished by insinuating that those who warn against pistols were ‘fearmongering’ and that he wanted to empower people.

After leaving an encyclopedia for a comment, I got to thinking. How much quality information is available to the regular person regarding safe strengthening exercises and how is a person who doesn’t have a medical background supposed to sort through the din of misinformation and bait & switch articles to find the truth? As a Physical Therapist (Doctor of Physical Therapy) I feel I can help to fill this gap.

So what is wrong with the classic exercises for lower body? The answer is, it depends.  Are you already healthy with good movement patterns and joint mechanics? Great! Nothing is wrong with those exercises.  If the answer is no, then it might be time to look at some alternatives. Barbell squats put a great deal of pressure on the knees, lumbar spine, even the junction where your neck and upper back meet. if you have existing issues, this exercise will compound them. Are squats a bad idea? No, not necessarily.  Are other alternatives worth your attention? Absolutely!   Below I am going to provide 5 good exercises to build lower body strength (that are not traditional squats).  Several of these I wrote/did the pictures myself.  The other two are videos from a reliable source with good information.

Sit to Stands

Position: Sitting near the front of chair/stool/box
Feet positioned back, knees in line with and almost over toes
Draw navel in towards spine and lean forward from the hips
                            (nose over toes)
Back straight, head in neutral

Action: Squeeze through your glutes and the front of the legs
Push through the feet and come to standing
Stop just before knees and hips are fully extended
Reverse steps and return to starting position without ‘flopping down

Form: Do not arch your back.
Do not allow self to “flop down”
Push evenly through foot, not only heels
Keep glutes contracted the entire time

                            -To add difficulty you can try holding a weight in your hands (goblet squat), stop just before sitting down so that there is no rest between reps (this becomes a body weight squat), take a longer period of time for the “eccentric” phase of the exercise.  (This is when you are lowering yourself down.)

RDL’s / Single leg RDL’s –  I could explain how to do this exercise.  But here is an awesome video.  Credit to Coach PJnestler on youtube. 

Glute Bridge

Position: Laying on back, palms up
Knees bent ~100 deg, feet flat and about hip distance away from eachother
Draw navel in towards your spine and flatten your back

Action: Squeeze through your glutes
Push through your heels
Raise bottom up until shoulders, hips and knees are aligned
Hold 5 seconds, slowly lower to starting position

Form: Do not arch your back.
If you feel this in your back decrease how far you raise your hips.  Do not allow the knees to come in towards each other, keep them straight up and down.

To add difficulty try placing a band around the knees and don’t allow this band to pull knees towards each other.  You can also place a barbell across your hips (hip thrust exercise), or switch to a single leg.

Clams

Position: Laying on side,  knees bent, feet together
Heels, shoulders and hips aligned
Tilt body slightly forward (pointing navel toward the floor)

Action: Squeeze through your glutes (buttocks)
Keep your heels together and lift top knee up.
Hold 5 seconds, slowly lower to starting position. (In this photo I have a resistance band around my knees, this is a simple way to increase the challenge but is not necessary to benefit from this exercise)

Form: Do not arch your back.
Do not allow hips to rock back & forth.
–You may want to perform with a wall or other straight surface behind you
Keep glutes contracted the entire time.

To increase the difficulty you can add a resistance band around the knees or hold for a longer period of time.

Monster Walks/ Band walks.  – Here is a great video to show how to do band walks.  Credit to Coach Pj nestler

 

Stay tuned for more credible information and correctly titled articles.  Lets sort through the misinformation together and focus on the purpose of strength training.  To live healthier!

You may like:

Changing your training

Exercise for maintaining function

Best,

Nicole Mims. PT, DPT

 

Exercise for maintaining function

 

 

http://lolsnaps.com/funny/50398

Physical Therapists often work with older patients whose diagnoses have an underlying cause of either stiffness, weakness, or both.  Tragically, many times a loss of independence could have been prevented by a person having maintained their strength into later adulthood.

As we age we can lose muscle strength, bone density, skin elasticity, and metabolism. Balance can even become an issue. This results in a higher risk for obesity, fracture, wounds, poor posture and resulting pain or disability.  The forecast isn’t all doom and gloom though! Exercise can improve all of the above AND it’s never too late to begin.

You don’t need to be bodybuilding grandma to benefit from strength training and you don’t need to go to extremes.   Here are a few things what I recommend to help safely build strength. Everyone who has weakness, but especially older people can use this advice maintain function and prevent injury.

*THIS IS NOT A PRESCRIBED/PERSONALIZED HOME EXERCISE PROGRAM. THESE ARE GENERAL RECOMMENDATIONS BASED ON WHAT I COMMONLY SEE*

 

Sit to Stand: 

Position: Sitting near the front of chair/stool/box
Feet positioned back, knees in line with and almost over toes
Draw navel in towards spine and lean forward from the hips
                            (nose over toes)
Back straight, head in neutral

Action: Squeeze through your glutes and the front of the legs
Push through the feet and come to standing
Stop just before knees and hips are fully extended
Reverse steps and return to starting position without ‘flopping down

Form: Do not arch your back.
Do not allow self to “flop down”
Push evenly through foot, not only heels
Keep glutes contracted the entire time

Sets/Reps: 2-3 sets, 10-20 reps

Glute Bridge:

Modification to increase difficulty

Position: Laying on back, palms up
Knees bent ~100 deg, feet flat
Draw navel in towards your spine and flatten your back

Action: Squeeze through your glutes
Push through your heels
Raise bottom up until shoulders, hips and knees are aligned
Hold 5 seconds, slowly lower to starting position

Form: Do not arch your back.
If you feel this in your back decrease how far you raise your hips

Sets/Reps: 2 sets, 10-20 repetitions (increase hold of this gets easy)

Seated marching:

Position: Sitting upright, Using fingertips for balance. Engage your stomach muscles. Pulling your navel in towards your spine

Action: Pull knee up toward ceiling
Hold 5 seconds
Slowly lower
Perform, alternating sides

Form: Keep your body upright without leaning side to side.
Keep leg straight up and down without rotating in/out.

Sets/Reps: 2 sets, 10-15 repetitions on each side (total of 20-30 per set)

 

Clamshell:

Position: Laying on side,  knees bent, feet together
Heels, shoulders and hips aligned
Tilt body slightly forward (pointing navel toward the floor)

Action: Squeeze through your glutes (buttocks)
Keep your heels together and lift top knee up.
Hold 5 seconds, slowly lower to starting position. (In this photo I have a resistance band around my knees, this is a simple way to increase the challenge but is not necessary to benefit from this exercise)

Form: Do not arch your back.
Do not allow hips to rock back & forth.
–You may want to perform with a wall or other straight surface behind you
Keep glutes contracted the entire time.

Sets/Reps: 2 sets, 10-20 reps (to challenge further, add a band around the knees or increase hold to 10 seconds)

 

Bent knee fall out:

Position: Laying on back,  knees bent, feet together
Draw navel in towards spine, contracting abdomen
Flatten back
Place hands on pelvic bones

Action: Keep hips and abdomen still
Allow one leg to fall out to the side, while keeping the other vertical.
Slowly return the moving leg to starting position.  Perform on opposite leg.

Form: Do not allow hips to rock side to side
You will be able to feel this movement through your hand placement
Keep abdomen contracted and still.

Sets/Reps: 2 sets, 10-20 reps each side

 

Push Up Modified: 

Position: Begin on hands and knees, knees together,
Feet extended back behind you
hands under shoulders
Keep back straight, head neutral
Knees, hips, shoulders in a line

Action: Slowly lower yourself toward ground/mat
Stop just before chest touches ground.
Push evenly through chest and return to starting position

Form: Do not arch your back.  Stomach should not touch before chest.

Sets/Reps: 2-3 sets, 10-12 reps

____________________________________________________________________________________________

Try performing the above exercises 3 to 4 days a week and see how you feel!  Feel free to ask any questions in the comments below.  Also, stay tuned for flexibility for older adults and cardiovascular exercise.

Best,

Nicole Mims.  PT, DPT

outtakes –  Zoee decided to try helping

 

 

 

 

 

 

Holiday truth bombs

I’ve always loved Teddy Roosevelt quotes. This one rings true, especially today.

Back to basics. Workout 7/3/18

Its been quite a while since I really structured my training phases like I ought to. Considering things are already ridiculously difficult I figured no time like the present to reset and do things right.

My training background is through NASM and so “back to basics” for me means Stabilization phase. NASM argues that to safely load the body later one should begin by building joint stability and muscle endurance. This entails 2-4 sets per exercise, 3 seconds on eccentric contraction, 12-20 reps, and increasing difficulty by making exercises more unstable.

Without further ado

3 sets/12 reps/ 1 sec concentric-1 sec isometric-3 sec eccentric

• Single leg Romanian deadlift (bodyweight)
• Stability ball dumbell chest press (2×20)
• Stability ball crunch
• TRX row up (bodyweight)
• Functional squat with band around knees (bodyweight)
• Single leg, shoulder fly on bosu (2×8)

Workout wise this felt pretty good. It was nice to slow down and challenge in a different way.

( Of course unexpectedly seeing the person who just hurt your heart while looking like a trainwreck (and apparently not warranting a glance after 3 years dating) can put a bad taste in your mouth. But hey, up and forward right?

Keep going, soon goals will be accomplishments

Credit to https://me.popsugar.com/fitness/photo-gallery/43830242/image/43830233/Motivational-Workout-Quotes-Memes

Meditation – Benefits and Basics

In my lifetime eastern practices have become more common with concepts such as mindfulness, meditation, feng-shui, and yoga entering the mainstream.  I imagine that this stems from a western need to unplug from our fast-paced techno-driven lives. People constantly have their attention pulled in 5 different directions.  Everyone tries to be everything.  Single moms or dads who try to balance obligations to the PTA, work, and their own hobbies with soccer practice or continuing education.  Millennials who are just beginning to dig themselves out of debt from college and the 2008 recession working full-time and trying to get their own personal projects off the ground… Perhaps we are just as busy as we used to be, but how we relate to one another has changed so much that we have lost touch with everyone, including us.  After all, how many real, intense, or transformative interactions have any of us had that were brokered by social media. Maybe these eastern practices are becoming more popular because they provide a way by which we can come to know ourselves.

For my personal story, I began drinking too much in 2015 as a (poor) coping mechanism for anxiety.  After life events  made me see this, I decided to give up alcohol entirely.  Searching for a way to calm my mind and develop a sense of peace I remembered meditating in martial arts classes when I was younger.  We would perform several minutes of seated mediation at the beginning and end of class.  I was always more focused after this.  My instructor had told me about great Buddhist practitioners in Tibet who could endure torture, captivity and immolation because they had so trained their mind’s through meditation.  I by no means was planning on such dire circumstances, but the idea of mental fortitude sounded exactly like what I needed at the time.  I sought out a local Buddhist temple and it was not long before I was hooked.

Seated meditation or “Zazen” is the central practice of Zen Buddhism as Zen is very much focused on ‘doing’ to achieve the path.  Recently my sister asked a few questions about meditation.  Although far from a master, I felt both able and interested to discuss them here.

What is meditation? 

• Meditation is the practice of cultivating a sense of peace and self-awareness through a variety of techniques such as focusing on an object, chanting or visualization. The methods may vary but the end result is a sense of calmness and clarity. There are studies which have found that meditation actually affects your brain waves and over time, through neuroplasticity, can make real changes in anxiety, depression, chronic pain, learning and other disorders.
  • https://doi.org/10.1177/153321010731162
  • https://doi.org/10.1196/annals.1393.002

Types of meditation

• According to healthline.com there are 6 common types/styles of mediation
  • Mindfulness Meditation
    • Generally associated with Buddhist teachings.  Involves the combination of concentration and awareness.  Some people focus on an object, an image or a sensation such as their breath or heartbeat.
  • Spiritual Meditation
    • Generally associated with Hinduism, Taoism, and some flavors of Christianity.
    • Involves quiet and focusing on a deity or connection with earth/universe etc.
    • Many people use the sense of smell to heighten this meditation.  This may involve essential oils, incense, or candles
  • Focused Meditation
    • More modernish type of meditation.  Involves focusing on one of 5 senses.
    • May involve counting mala beads, focusing on a candle, or listening to a gong
  • Movement Meditation
    • Often people think of yoga here but this might also include walking, qigong, gardening or other form that encourages movement to guide you.
  • Mantra Meditation
    • Associated with both Hinduism and Buddhism
    • Uses a repetitive sound or phrase to clear the mind or connect to an image.
  • Transcendental Meditation
    • Involves the use of a silent mantra to calm and focus.
    • Considered on of the more popular forms of meditation.  

How do I begin meditating?

• I believe (as is the case with most things) this depends on what your goal is.
  • If one of the above types tickles your fancy, you might try looking up more information or books on the subject.
  • I personally recommend finding a group that practices the style you are interested in and ask questions.  (this could be a forum, a business which focuses on meditation classes, or a Buddhist or Hindu temple.)

“None of that works for me”

• If you don’t have any interest in reading about types of practice, you aren’t the group type, and/or you’re averse to trying a non-western theology, keep on reading.
  • Google play has many excellent guided meditations available for free download.
    • simply type in the goal you have:  “Guided meditation for anxiety” and try one out.

• Follow a meditation Podcast.  One of my favorites is “The Buddhist Society of Western Australia” (random I know)
  • they have a plethora of both Dharma talks (which I find insightful) as well as purely guided meditation

OR

• You can try what I do: Zazen
  • General advice
    • Start with shorter periods of time and build up.  Don’t be frustrated if you can’t sit for very long.  As we discussed, this makes sense considering our lives.  The things we need to do are usually the things that are challenging for us.
    • Set a timer for yourself.  If you are checking a watch, you wont be able to get in the right mindset.
    • Get in a comfortable sitting position.  I know this seems obvious but if you are uncomfortable, that is what is going to be on your mind.
    • Do not make judgments on yourself.  You may have thoughts crop up that you wonder where they came from. Instead of giving them your intention or being frustrated that you can’t clear your mind at first, try to allow them to drift back to where they came from.  If you analyze or judge it will only stay in your mind longer.
    • Find a quiet place.  If you have kids, pets, or others who might disturb you, tell them what you are doing and explain that you are not to be bothered for the next ______period of time unless it is an emergency.
    • Turn off the ringer on your phone as well as any alarms you might have other than your timer.

Steps

1) Set a timer for how long you want to try to meditate for.  Being conservative early on is usually helpful.  If you are frustrated during your meditation it will cause a toxic mindset.

Bonus: This gives you fewer excuses for why you can’t fit meditation into your schedule.  Maybe start with 5-10 minutes.

2) Sit down in a comfortable position.  This does not need to be on a cushion or cross legged. Try to sit with decent posture as poor posture will cause you back or neck pain  and this can detract from your experience.

3) Close your eyes almost all, or all the way.
Zen practice says to keep your eyes a little open and focus on a spot on the floor in front of you.  However, if you are having difficulty ‘tuning out’ the world you may want to just close your eyes.

4)  Observe your breathing. Some people begin by counting their breaths up to 10 before starting back at the beginning. Breath in and out smoothly and try to relax your body.  Allow thoughts to drift away and think only about your breath.

5) When your timer sounds, open your eyes slowly. Thank yourself for taking ‘me time’

6) Repeat daily.

Yes, daily.  Make it into a habit, part of your life.  The benefits of meditating increase and become more permanent with time and frequency.

I myself have noticed that when I slack off on taking the time to practice, I become much more anxious, irritable and illogical. Like anything, the more you practice, the easier and more second nature it will become.  If you frequently are able to achieve a calm state at will, how much easier will that be when you are stressed or anxious?

**Note that this information comes from my personal practice.  I am not a guiding teacher, counselor, monk etc.   This is also not meant to be a cure-all in any way.  You may find that meditation is beneficial to you, you may not.

I hope that you have found this helpful.

With love,

 

Perception changes experience. How do you view you?

How I see myself vs. how others perceive me has always been a topic of interest.  I love to have people tell me their first impressions of me later on in a friendship.  Most often it goes something like “you seemed really intense,” “you were very no-nonsense,” “I thought you were angry.”   Occasionally people see through my guise, usually not though.  It’s been there for a while.

Sometimes people develop an opinion of you that is completely wrong.  When the person who holds that opinion is important to us this can be devastating, and it can even cause us to doubt our view of ourselves.  The saying “after the third time you’re called a horse, it might be time to buy a saddle,” comes to mind.

What do we do when that view of us is not just wrong, but destructive?  This can affect how the mistaken person treats us, how others begin to see us, and how we perceive and even treat ourselves.

My initial thought as I write this is “I’m not sure.”  If you correct said person they will cling to their view further.  If you change how you act then in a way, you have accepted it.  I think a good first step is to reaffirm how you perceive yourself.

How do I view me?

• I am passionate
• I am ethical
• I am stubborn (sometimes to a fault)
• I am quick to anger, but also quick to apologize
• I am intelligent
• I am protective
• I am kind
• I have been prone to jealousy
• I love infrequently, but intensely
• I am strong
• I am brave
• I am proud
• I am silly
• I am attractive

I do not always remember all of the above.

If you are going through a tough time, especially if you are doubting yourself like I am right now, try this exercise with me.  Be honest but have self compassion (not self pity).

Lets repeat these to ourselves regularly and see if things change.

With love –

Giving of yourself when you have nothing left. (my recent challenge as a health professional)

This is definitely one for the personal column.

I recently went through a loss (which I don’t have the distance from to discuss yet.)  What I will say is that by the time I got to work yesterday, I felt like I had absolutely nothing in the tank. I literally began the day wondering how I was going to manage to get out of bed.  I’d had about 3 hours of sleep, no food, and had been crying for so long it looked like I was trying to throwback to my teenage years, when red eye shadow was an acceptable  a thing.

Dame fate has a cruel streak as this was also one of those days where there were endless fires to put out, and my patients needed everything I would have had on a good day.

Being a patient in general is a scary experience and it is crucial that they feel like they can be vulnerable with you, that you won’t judge them, and that you actually care.  To quote one of my favorite Buddhist speakers Ajahn Brahm: “you must be a dust bin with a hole in the bottom.”  One should be able to listen to concerns and help or advise without holding on to how this affects them personally. This takes a balanced mind, discipline, and patience. If ever there was a day this was not it…

And yet there they were.   One person had a breakdown within 5 minutes of arriving.  An evaluation came in with red flags for a severe nerve problem termed Cauda Equina Syndrome that had somehow been missed by her primary care doctor and VA doctor.  Another person twisted their newly surgically repaired ankle… and so on.

As the day progressed, each time I thought to myself that I didn’t have anything else to give, I managed to find something.  People who know me know that I am nicer than I first appear.  I have an extremely abrasive layer covering an annoyingly soft heart.  With each new crisis I dug a little deeper and found a little more empathy, cajoling, advice, and caring.  By the end of the day I’d come to a half realization that a good deal of meditation and a bit of ice cream solidified.   I had been considering my own state a sign of weakness.   And yet weakness would have been giving up.

Yesterday, today…I imagine quite a few of the days in my near future are going to be miserable.  They are going to be dark in the dead of summer. But a tiny little part of me knows I just found a slightly stronger version of myself.

–With love

Walking up to my best friend’s place for TLC yesterday.

Goals, Milestones, and Finish Lines

I began this blog approximately 5 years ago, at the same time I decided to go back to school to become a Physical Therapist. I was working in the gym as a personal trainer at the time, and honestly I was miserable. I was bored, I hated selling, and I wanted the skills and knowledge to help more people and help them in a deeper way.

Saying and doing are two very different things though. I set off on my path in Jan 2013 taking prerequisites and earning volunteer hours at clinics. I applied, interviewed for, and was admitted to the PT class of 2014… I was dismissed from the program 2 months later for technical bullshit on a practical. I dusted myself off (I drank too much…another story), and I was readmitted to PT school in the cohort of 2015. This time it took. It was an adventure, there were dragons. Lots of dragons. There were many times I had to compromise, bite my tongue, and pacify egos.

In May of 2018 the Odyssey ended. I graduated and found a great job within a month. Since that point there has been an amazing shift in my life. The politics and drama of PT school are over and I get paid to help people. In summary I accomplished my goal.

In the months since graduation I have had friends and acquaintances ask how I did this. How do you go from having a far reaching goal to making it your reality? To quote Dr. Strange “study and practice, years of it.”

Seriously though there were a few underlying themes to my story and I’d like to discuss them here.

• Set your goal: Know clearly why you want to accomplish this and what you’re willing to sacrifice to do so.
• Visualize and believe
• Maintain focus
• Set and celebrate milestones
• Count down

Set your goal: be specific, know when you will have achieved that goal and know what you are willing to sacrifice to do so (and what you aren’t). Know why you want to do this.

–For my case it was “I want to become a licensed physical therapist so that I can use my skills to help people while making a comfortable income.”

–I was willing to sacrifice a lot. Time away from home and friends, the better half of my twenties, and occasionally my pride.

Visualize and believe: there will be people who give up and those who will fail. Decide now that its not going to be you. If you’ve addressed the first bullet point you know what your end result will look like. When things get tough (and they will) take the time to focus on this. It sounds silly, but it is invaluable to check in with yourself and remember why you are going through whatever it is you are doing.

Maintain Focus: this goes hand in hand with the previous point. When you have far reaching goals distractions will almost definitely pop up along the way. You may become infatuated with a person, want to set another goal like “getting in shape,” or you may have doubters that will tell you all the reasons why you can’t or shouldn’t want to do, whatever it is you want to do. Remember the first two things we discussed. You may need to sacrifice that budding relationship (if they are a hindrance/distraction), keep your fitness goals small and build them slowly, or cut out the people who doubt you. It may sound severe but if a person is trying to make you doubt yourself, they are toxic and they can bring you down. Know now that you are going to miss out on things. What that means depends on your specific goal.

Set and celebrate milestones: you have set your goal, you know what it looks like and what you’re willing to do to accomplish it. Now break it down into bite sized pieces. In my case it was a set of steps that would take me to graduation. Ex) prerequisites, admission, year 1, year 2, comps, residencies, research project defense, graduation. What does yours look like? Can you break it down by time line or steps along the way? When you cross one of these off your list make sure you celebrate. You are one step closer. Reflect on all of the previous bullets. Get ready for the next step. Believe you will reach the next milestone as well.

Count down: All of the above is useless if you don’t keep the end result in sight. Sometimes it might seem like you are watching grass grow, but over time you will be able to look back and check how far you have come. If it’s possible to set a finishing date do so. If not, try to quantify what you can and then count down from there. Trying to lose weight? How many lbs to go? For me this was graduation. What is it for you?

Cross your finish line: this looks different for everyone. Recognize when you accomplished your goal. Celebrate, be proud, and then help others. (Where I am trying to be now)

(Did it!)

Set another goal.