Weight Loss Strategies

2012 is here and many of us have made resolutions and a majority of them will have to do with working out/losing weight. So, I thought I might list several ways to help in keeping those resolutions and meeting those goals.

First the best way to make the process of losing weight the easiest is to increase your metabolism. A few ways to do that…
1) Eat high metabolic demand foods such as berries.
2) Eat a small handful (~7) almonds an hour before a meal. Almonds help increase your metabolism and are a natural appetite suppressant.
3) Break up your cardio workouts to twice per day. Studies show that 2 twenty minute bouts of cardio exercise stimulate greater weight loss than one 40 minute bout.

Cutting Calories
1) Do not skip breakfast. People who skip breakfast typical snack more and take in more calories per day than people who eat breakfast.
2) Don’t just eat one breakfast, eat two. Eat a boiled egg and piece of toast then in an hour or two eat some yogurt and berries.
3) Eat a salad before lunch and dinner. Those who eat a salad before a meal consume 15-20% fewer total calories.

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What is necessary for great PT care?

Often we are lead to believe that fancy equipment or elaborate exercises are necessary for state of the art rehabilitation. While the shine of a new toy or gadget is intriguing it leads me to consider Occam’s Razor. The simplest solution is most often the correct one. Now fancy PT equipment or machines won’t inhibit your progress but it won’t significantly speed it up either.

What do you need then? The thing that is essential, is an astute understanding of joint mechanics and the mechanics of the movements that are restricted, impaired or no longer able to be performed. Once you compare how things are currently working with how they need to work it becomes a matter of simply improving the deficits. Whether that it is strengthening weak muscles, stretching tight muscles or decreasing scar tissue or adhesions.

Once identified things are straight forward and fairlly easy to remedy assuming patient compliance and the absence of significant predisposing medical problems that may inhibit healing. For strengthening resistance training can be achieved with weight lifting equipment, body weight , resistance bands etc.

I opt typically to use exercises that utilize body weight resistance. This way the patient is able to replicate the same exercises at home, work or wherever. Also the patient does not become dependent upon the PT or facility to be able to continue progressing toward their ultimate rehab goal(s).

It has always been my opinion that the most important Physical Therapy equipment needed for the best possible care is the PT him or herself. Look for that person versus fancy machines or gadgets. Also consider that the best PT care is not always the closest. Don’t choose your PT facility solely based on proximity. In the long run it will cost you much more than the extra few miles you may have to drive initially.

My words of wisdom for the start of 2012.

Chris Hohmann, MPT

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Alternative Treatments

I have recently been asked to review a potential alternative medicine treatment. I will not mention which one in particular. As I began researching I found numerous claims and lots of testimonials on the treatment. The substance of the treatment is basically a secret. As a clinician I also have to pay for the information about the treatment. The only way anyone can find out what the actual treatment is, is by paying for it. There isn’t any research available to support the treatment.

The moral to this story is that if a treatment claims extraordinary results but offers no proof, be very skeptical.

Another way to check quickly if there is any evidence to support a treatment, check with your insurance company. They usually have a ruling on most treatments. It is not a hard and fast rule that if your insurance company will not pay for the treatment that it is not a viable treatment. Using that information and your own research, if the treatment in question raises suspicion then it is likely it is very questionable and not worth the money you will have to pay out of pocket.

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Sweating to the TX heat

Well Summer is upon us and so are the high temps.  With high temps and low humidity dehydration is a quick little beastie that will sneak up on us.  If you are outside for more than 30 minutes you should be ingesting at least 8 ounces of water.  If you are exercising or doing yard work, double it!

Another thing to think about particularly during the summer is your diet.  This can help significantly with fighting that beastie dehydration.  Fruits and vegetables are chock full of water and good carbohydrates not to mention they are good for you.

A high protein diet will make you much more prone to dehydration than a balanced diet.  Protein requires water in order to break it down from its complex form to the amino acid form your body can use.  Therefore if you eat a high protein diet you will need to drink even more water than a person with a balanced diet.

In a previous post I gave readers a simple recipe for making their own inexpensive sports drink.  I will post it again with just a slight variation.  If you can tell me what that variation is you may claim a Momentum Sports Rehab water bottle with the sports drink in its original recipe.

1.75 cups of sugar

4 ounces of lemon or lime juice, fresh squeezed is the best, but out of the bottle is fine too

3/4 to 1 teaspoon of Morton’s Lite Salt (trademarked)…to desired taste.

1 gallon of water

This is a healthy and cheap way to provide sports drinks to the baseball, football, volleyball, soccer or any other teams you or your kiddo’s are on.  Not to mention it is far more environmentally friendly than having all those plastic sports drink bottles lying on the ground.  I typically have a plethera of plastic reusable cups on hand for the kids. The other option is tell them in advance to bring their own water bottles full of water and once empty they can refill with your sports drink.  Another way to encourage them to stay hydrated.

Food, or more aptly water for thought.

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Blisters and Vibram FiveFinger Shoes

The other night we went to a major league baseball game. In the middle of the game a thunderstorm rolled in and we got soaked. With a 30 min delay already under our belts and the thunder and lightning persisting we decided to call it a night and walk back to the Jeep.

As you might suspect there were numerous puddles and wet feet were inevitable. As we walked I began to wonder if my wet feet combined with the long walk and no socks was going to produce blisters. From the centerfield bleachers all the way around the stadium and out to the parking lot not a single blister was formed.

The other thing I discovered was that even with being a leather shoe it dried incredibly fast. In the 30 minutes it took to drive home the shoes had dried half the way. By half way I mean the only wet portions of leather were around the toes. Ten minutes of sitting under the ceiling fan and they were dry. It was actually pretty incredible how quickly they dried.

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Fila Skeletoes vs Vibram Five Finger Shoe

There are a few differences between the two brands.  The main similarity is that they are both minimalist type shoes that encourage forefoot landing at initial contact versus a traditional shoe in which the heel contacts the ground first.

The Fila Skeletoes differ from the Vibram’s with their EZ slide feature.  This is basically a compartment that fits the 4th and 5th toes.  Consequently these are the most difficult toes to get into the Vibram’s.

I purchased a pair of Fila’s for my son who had been begging for the “toe shoes,” as he calls them, long before I decided to try out the Five Finger Vibram’s.  One thing I noticed is that they did not breath as well as the Vibram’s and within a week or so they definitely developed some distinct foot odor.  After having the shoes for less than two weeks the footbed began to separate from the material that covers the top of the foot.  We took them back and exchanged them for a new pair.  Sadly the same problem arose within a week of daily use by my son.

I have not been terribly satisfied with the quality of the Fila’s and have decided to purchase him either a pair of sport sandals or see if I can find a pair of more reasonably priced Vibram’s.  My advice is that if you are truly interested in giving the minimalist shoes a try, bite the financial bullet and go with the Vibram’s.  They are 1.5x’s the cost but are likely more than twice the quality based on my brief experience with both shoes.

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Coaching in Five fingers

Well I have had the opportunity to experience coaching pony league baseball in the vibrams. It was ok. Felt strange particularly while demonstrating proper hitting mechanics. The part that was odd was pivoting on my back foot. My toes had a tendency to for lack of a better word drag more while pivoting than in a traditional shoe.

I realize this may not be what these shoes were originally intended for but I, like many people, expect a pair of shoes to be used for numerous activities not just walking or trekking.

My foot conformed to the uneven terrain of the practiced field. This was not a good or bad thing. Part of me liked the increased contact and sensory information and part of me did not. I would imagine this is something you would need to get accustomed to before making a definitive like or unlike decision.

I have worn these shoes for 2 weeks and can say that I am pleased with their performance. My feet do not hurt any more than they did with wearing traditional shoes. Maybe even a bit less. I have had many people ask my assessment of the shoes…people I did not even know.

A final observation before I sign out is that these shoes do not provide much protection or padding to the top of your foot. As one of the boys inadvertently stepped on my foot last night with his baseball cleats I remembered that these are minimalist shoes. In previous practices this has occurred with traditional shoes it still was uncomfortable but there was definitely much more protection afforded my foot from the cleats.

Again these shoes were not designed for this activity specifically but an observation worth noting if you decide to give these shoes a try.

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Vibram FiveFinger Shoes use with Hiking and Camping

The Vibram FiveFinger shoes handled camping fairly well, but I encountered several definite and deal breaking shortcomings of the Vibram’s.  While walking on the uneven terrain and over the irregular rocks the shoes responded well and I did not have the foot discomfort I would have expected before this trial.

However, as for the negatives, the biggest and most important reason I prefer traditional hiking boots to the Vibram’s for camping and hiking is for protection against snakebites.  Hiking boots afford greater protection to the foot and ankle as compared to the Vibram’s.  When walking on rocks and through grass there is a definite risk for disturbing a resting or hidden snake.  As common sense will tell you a snakebite can easily be a life threatening event.  This is the biggest negative of the FiveFinger shoe that I have come across.  A hiking boot does not guarantee that you will not get bitten by a snake but it reduces the risk significantly greater than do the Vibram’s.

Secondly, the hiking boot also protects the foot and ankle from thorns, exposure to poison ivy/oak, ticks and chiggers better than the Vibram FiveFinger shoes.  The high top design better keeps the brush, grass and poisonous plants from contacting the skin.

Thirdly, a traditional boot keeps your feet dry far better than the FiveFingers when walking through wet grass, shallow creeks and puddles.  The Vibram’s do dry out quickly, but wet feet can become life threatening due to the risk of hypothermia.  Anyone who has taken outdoor survival and first aid realizes that hypothermia can occur at any time during the year, not just in winter.  During this weekend the temperature dropped rapidly as a storm system blew in during the middle of the night.  The temps went from the 80′s in daytime to the 40′s overnight.  Having my traditional hiking boots to keep my feet dry and warm made things more comfortable and safer.  We were car camping and hypothermia was not a real risk. We could get into the Jeep and warm up whenever we needed but if we had been backpacking it may have been a different story. To be fair you can buy socks specifically for the FiveFinger shoe but as for keeping them dry in creek crossing and wet grass you run into the above stated shortcoming of the shoe.

From the perspective of handling the terrain in and around the camping area, the shoes did well but, because of the shortcomings I encountered I would say that the FiveFingers have their practical limitations for use with backpacking and hiking.  I am not returning them to the store but I am also not throwing out my reliable hiking boot.  My hiking boot will be my shoe of choice on our next trip hiking and camping.

More to come later on my experiences and observations with these shoes…

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Barefoot Shoes…a contradiction?

Well I am a day into my Minimalist Footwear trial.  After Day One, or really 1/2 day, I noticed no soreness or discomfort.  My feet did not hurt but were a little fatigued as would be expected.  I did try the shoes out walking over some small stones that I scattered about the parking lot of my office.  Surprisingly to me they felt fine.  Probably felt them a bit more than a standard cushioned sole but not as much as I expected.  The thing I did notice is that you do need mindful of “stubbing” your toes as there is not the protection in these shoes as there is in standard footwear.

I did have several people comment and ask about the shoes.  This is something that is to be expected if you decide to give these shoes a try.  They are a bit odd looking and peoples natural curiosity will make them ask you about them.  Even with the most disguised pair I could find I had two different people approach me while I was grocery shopping.

More to come later…

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Vibram FiveFinger Shoe Trial

I have decided to try the Vibram FiveFinger shoe out for myself.  I will post regularly as I break my feet into this new style of gait.  I chose the KSO Trek (brown in case anyone was curious ha ha) model as it seems the most versatile and least noticeable when wearing.  This model is purported to be better with off pavement use than the Bikila LS and other shoes.

At first blush they definitely take some time to get used to the feel of the toes being spread apart versus bunched together as in a typical shoe.  The other thing to note is they definitely take some practice to get them on.  I was informed and later read for myself that you are to get the toes in first then slip the heel of your foot in.    A trick I have found that has worked for me to get them to slide into the toe slots easier, is to wiggle my toes as if playing the piano as I slide them on.  This seems to more easily separate the toes and get them into their appropriate slots.

As for comfort they feel good on and with the minimal walking I have done they seem to be ok.  I am still adjusting to this style of walking although I do not believe it will take me long to adjust as I am a typical lateral foot striker anyway.

As discussed initially on my first post on these shoes the normal contact pattern with traditional footwear is heel to toe and with minimalist footwear it is lateral forefoot contact to heel and toe simultaneously.

The premise is that the distribution of the forces is spread more evenly across the foot with the minimalist or “barefoot” style shoe as compared to a heel to toe pattern.  With the forefoot contact pattern there needs to be less cushioning because of this equal sharing of the contact forces.

I will check in next Monday with another post.  Weather permitting we will be doing some camping and hiking this coming weekend and that will give me a chance to test the off pavement aspect of these shoes.

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