Chiropractic As A Component of Medical Management
The Ontario Ministry of Health has funded a study to determine the value of MD/DC collaboration in the management of lower back pain. Study participants were evaluated by their primary care physician and also by a chiropractor, in the same office. Physicians and chiropractors partnered to discuss decision-making for; appropriateness of advanced imaging, specialist referral, patient education/ self-management and care plans.
The study’s outcomes are as followed: • High patient satisfaction (94% of patients said they were “very satisfied” or “satisfied”) with care. • High provider satisfaction. All physicians made reference to the value in referring Low Back Pain patients to the consulting chiropractor assessment. • The majority of physicians perceived the consulting chiropractor’s assessment and management of Low Back Pain as being of higher quality than physicians. • Increased patient confidence in diagnosis and treatment options. • Decrease in referrals for imaging and specialists (71% of physicians reporting).
Endicott, A. Working with MD’s to Treat Back Pain, Dynamic Chiropractic, Vol. 30:20, September 2012
It’s the first week of the new year, when our resolutions are still shiny and new and unbroken. As a healthcare provider, there are a few resolutions I consistently hear clients talking about (regardless of whether it’s a new year or the middle of July!):
- Growing family and friend relationships.
- Cultivating their value at work.
- Improving fitness.
While I can’t give you a step-by-step guide to achieving all of these things, I have learned tools for creating your own map and sticking with the journey.
- Pay attention to what you want, not what you don’t.
In martial arts, we study balance. An important principle of balance is that where the head goes, the body follows. You must keep your head pointing in the direction you want to move.
The same is true for life. Our actions go where our vision goes. If we’re focused on not eating a brownie, soon all we can think about is brownies, and we are more likely to end up eating the whole pan. A more effective approach to living well is focusing on what we want: to go for a walk, to read books with our children, to cook dinner with our partner, or to pick up the phone and call or text a friend.
A Native American proverb states that there are two wolves that live inside us. One is evil, full of anger, worry, and greed. The other is good, full of love, compassion, and peace. The two wolves are in a battle. The one we feed the most is the one that wins.
- Use precommitment: planning ahead.
Precommitment means planning what you will do to avoid obstacles that would derail you from meeting your goals. This could mean setting your alarm for ten minutes earlier in the morning so you can finish your physical therapy exercises before your day gets busy, or doing dinner prep on the weekends, so you have more time to help your kids with their homework on week nights.
As you practice precommitment, reach out to people who can help you come up with ideas for tackling those obstacles. If you want to grow in your job, ask someone you respect in your field if they could serve as a professional mentor, or if you could take them to lunch and ask them questions.
Of course, for increasing fitness, a healthcare provider is a great resource. Creating health plans with clients is one of my favorite parts of my job. Read my blog about precommitment for more practical ideas and schedule an appointment if you would like assistance in coming up with a plan to help you move more and feel better.
- Start small; grow big.
Your resolutions should be doable. We don’t start with 50-pound weights; we start with 5 pounds. If it’s the end of January and you still haven’t enacted your plan, your plan is too hard. Set your sight on an action that is easier for you to take right now, as you are. Haven’t run a mile yet? Try walking to the mailbox. Take the stairs instead of the elevator at work. Park at the end of the parking lot so you walk farther to get to the store. Believe it or not, the great Bruce Lee employed those exact strategies, and couldn’t we all be a little more like Bruce? The sense of accomplishment you feel when you achieve a smaller goal will give you the energy you need to do something harder.
If I had to summarize my advice for a healthy life into one sentence, it would be a short one: eat well, sleep enough, and move around (which happens to be the secret to avoiding the doctor entirely).
- Enjoy the now.
Planning ahead is good – I’ve already suggested you do it! – but a healthy life is one in which planning is balanced with being present in the moment.
In a research study aided by an app called Track Your Happiness, it was found that, “[P]eople are substantially less happy when their minds are wandering than when they’re not.” The researchers probed a little deeper to try to determine whether our minds wander because we are unhappy, or if we tend to be unhappy because our minds wander. The evidence seems to be shaping up that it’s the latter: a wandering mind makes us less happy.
Being mindful of the present is a habit, just like exercising. Some people start with small steps, like asking themselves a series of short questions throughout the day, such as, What does the room I am in feel like? Is it hot or cold? Can I feel my feet on the ground? What is my breathing like? Can I slow my breath down? What does it feel like to take a deep breath?
Any small question that draws your attention to the physical sensations you are experiencing can help you begin to notice your present.
While you’re in the moment, find something to be thankful for. Again, it can be something small. You can be grateful for how good your morning coffee tastes. Thankful for the hug your child just gave you. Thankful to be wearing your favorite pair of shoes.
Studies have shown that gratitude has many benefits for our health, including improving our sense of wellbeing. Gratitude can help us keep our balance, standing in the present while looking up and ahead at the life we are creating.
Balance Chiropractic in the Charlottesville Community
Seven years ago, Dr. Sam Spillman moved to Virginia to work with Dr. David Brown, a fellow chiropractor and businessman who was also serving as the mayor of Charlottesville. Dr. Spillman was from upstate New York and had lived in Japan, but it didn’t take long for Charlottesville, with its friendly people and focus on healthy living, to begin to feel like home.
In 2008, Dr. Spillman became the primary chiropractor of Balance Chiropractic and Physical Therapy, the practice Dr. Brown had created in 1982. Dr. Spillman says of taking on the practice from Dr. Brown – who in 2014 was appointed by Virginia Governor Terry McAuliffe as eighth Director of the Virginia Department of Health Professions – “I had big shoes to fill. It was an honor and a challenge to take on the practice David had started.”
Since then, Dr. Spillman and his colleagues have worked hard to make sure Balance continues as a vital part of the community where it began and contributes to Charlottesville’s growth.
Through Balance, Dr. Spillman donates to local nonprofits that focus on empowering women who have experienced violence or are survivors of human trafficking. (For more information about the nonprofits and how you can help, please see the links at the bottom of this page.) Dr. Sarah-Ann Eng, a chiropractor Dr. Spillman brought on board at Balance, volunteers time with Habitat for Humanity.
Balance is also part of the revitalization of a historic Charlottesville area on Preston Avenue. In February, the practice is moving to the restored King Lumber warehouse. King Lumber was once the largest employer in Charlottesville, and at one time over 300 people were working in the warehouse. Its restoration is part of a larger plan to bring more employment opportunities to the Preston Avenue corridor.
The move will give Balance more space for performance enhancement services for Charlottesville’s running and sports enthusiasts, including Titleist Performance Institute golf analysis and corrections to help golfers improve their game.
Dr. Spillman gains a lot from Charlottesville, as well. An avid runner, he has participated in the Martha Jefferson Hospital Foundation 8 K, Cville 10 Miler, Run for Autism 5k, and the Pepsi 10k. He practices at Charlottesville Brazilian Jiu-Jitsu (he decided to become a chiropractor after chiropractic care helped him recover from a martial arts injury), attends classes at tru PILATES and Hot Yoga Charlottesville, and works out at acac.
When asked what his favorite part of Charlottesville is, Dr. Spillman replies, “My patients. They are always telling me about new things to try, from restaurants to the best running trails. I also like that everything is close. I have easy access to great food, fun, my work and my friends all within a few minutes. I’d much rather spend my time with people that are important to me than in the car!”
He follows up, “I look forward to being part of Charlottesville for many years to come.”
Balance Chiropractic supports the Sexual Assault Resource Agency and the Arbor. Please click on their names to follow the links to their websites, where you can learn more about these important Charlottesville community services.
The end-of-the-year holiday season may be the best time of the year, but it can also be one of the most stressful. Decorating the house and hosting parties and attending your children’s holiday pageants is a lot to keep up with. Learning to identify when we are stressed and techniques to take care of ourselves during stressful times is a tool that will serve as well throughout our lives and its seasons.
Here are six stress relief techniques that I’ve found helpful.
- Be Positive.
In my Thanksgiving blog, I mentioned the power of gratitude in keeping us healthy. Turning our attention to the good things in our lives and even in our day-to-day interactions promotes a sense of overall well-being.
Think of it as gratitude meditation. People who meditate often talk about the “monkey mind.” This is when our minds, like hyperactive monkeys, begin swinging between thoughts about the past and future instead of being in the present moment. Similarly, during stressful times we might be even more inclined than usual to focus on what is causing us anxiety. We have the ability, though, to recognize that we are doing this and remind ourselves of what is good in our lives.
What will help you bring your monkey mind back to gratitude? Some people find keeping a journal helpful. There are also several apps that can help you focus on positivity. Happier.com is a great website and app for cultivating positivity.
- Organize and prioritize.
If your brain feels full trying to remember all the things you have to do and it is weighing you down (all that information gets heavy after awhile!), get your to do list down on paper (or the Notes function on your phone).
Does that idea sound overwhelming? Perhaps you need to say no to some activities this holiday season. Sometimes we remain disorganized to protect us from facing the reality: we’re simply trying to do too much.
Organize your to do list, then prioritize what is most important. Let go of the rest. You’ll be better able to enjoy what matters most this holiday.
In an article on stress management, the Mayo Clinic gives this good advice on how to say no: “If you have a hard time turning down requests, try saying, ‘No, I can’t do that now.’ Don’t hesitate — be direct. If an explanation is appropriate, keep it brief.”
- Communicate with people who care about you.
A recent study found that having a best friend present during a stressful situation prevented a spike in cortisol, the hormone that is released when we are stressed.
The Mental Health Center at the University of Texas points out, “Talking with someone else can help clear your mind of confusion so that you can focus on problem solving.”
Hanging out and talking with supportive friends and family make us better able to deal with stress.
Of all the prescriptions I give my patients, this can be the hardest for many to follow. We tend to believe that the best thing to do is, well, to do something. That is often true – this list includes several tips about what you can do to be healthy!
But it’s also important to take time to allow your body and brain to rest. Take a bath, listen to music, dance, or take a walk just for fun. A recent study found that practicing yoga and meditation is particularly helpful in helping us relax and relieving stress and anxiety.
Find what relaxes you and enjoy it.
The positive connection between exercise and less stress has been proven by study after study. Just type “effect of exercise on stress” into Google, and you’ll see what I mean. Articles by the American Psychological Association and Anxiety and Depression Association, emphasizing the power of exercise to relieve and prevent stress, will be a couple of the first results to pop up. A Harvard Health Publication even advises, “Exercising to relax”!
Whether it is thirty minutes of intense cardiovascular training or a good stretch and lifting weights, moving your body is one of the best tools you have to reduce stress. If exercise isn’t already part of your routine, it is perfectly appropriate to start small. A short walk during lunch time or a coffee break will be enough to begin stress reduction in your body.
If you are already active, keep it up – and remember that high intensity exercise helps you more effectively process cortisol out of your body! (Read more about high intensity interval training in my blog 8 Tips to a Healthy Weight and Active Life. The article includes links to HIIT routines.)
- Address the physical symptoms of stress.
Stress shows up in our bodies. Headaches, jaw pain, neck and upper back and shoulder pain are common physical manifestations of stress. This discomfort can itself raise cortisol levels, throwing us into a stress-pain-stress cycle.
Chiropractic care, such as spinal manipulation, can relieve many of these painful issues, as can therapeutic and relaxation massage. Along with exercise, chiropractic and massage will help our bodies be pain-free and stress resilient, so that we can enjoy the holidays and every day.
Book a chiropractic adjustment and a massage today with Balance Chiropractic and Physical Therapy by calling (434) 293-3800 or emailing [email protected]
WIN A $25 GIFT CARD TO MARIE BETTE!
With numerous studies showing that gratitude promotes health, maybe I should consider handing out prescriptions for thankfulness. Or even better, give you a chance to win a gift card to Marie Bette for telling Balance what you’re thankful for – just like this post and leave a comment with at least one thing you’re grateful for this year. Winners announced this Friday, November 27!
I’ll go first. I have a lot to be thankful for in 2015!
- The birth of my niece, Zoe.
Zoe made me an uncle. I was able to visit her and my sister and brother-in-law shortly after her birth, and we FaceTime every week. I have been most surprised by how quickly Zoe changes as she grows. Half the memory on my phone is now taken up with pictures of the best baby I’ve ever met, and I’m reminded to take care of myself so I can be an uncle who is around for a long time to come.
- The birth of Dr. Eng’s baby, Hannah.
I’ve also celebrated the birth of Dr. Eng’s daughter, who arrived last month. Everyone at Balance is happy that Hannah and Dr. Eng are doing well.
- Trying hot yoga for the first time.
As I wrote in a blog about my first yoga experience, it’s good to try new things. Getting in a rut of doing the same exercises over and over doesn’t give your body a chance to fulfill its greatest health potential and can even result in a repetitive strain injury. Realizing I needed more flexibility training, I took a hot yoga class earlier this year – and I liked it! I’ve attended several classes since and am making it a regular practice.
- Hiring Dong Ha, a massage therapist and physical therapy assistant for Balance.
I’m constantly thinking about how Balance can offer the best services to our patients and recently hired Dong Ha to offer therapeutic massage. Dong brings to Balance over twenty years of experience as a physical therapist and great massage skills. I am delighted that Balance patients are now able to receive massage as part of their treatment plan.
- Plans to move Balance to a bigger space, coming soon.
In early 2016, Balance will be moving into renovated space in the historic King Lumber Company Warehouse on Preston Avenue. Just a quarter mile away from our current office, the new location will be larger, allowing us more room for physical therapy and for performance enhancement services. The new office will also have more parking. Stay tuned to our blog and Facebook for updates on this exciting move!
- Introducing Gray Cook at the Virginia Chiropractic Association Fall Convention.
Gray Cook is the founder of Functional Movement and a professional hero of mine. Gray’s work has significantly influenced my professional development and my patient care. It was an honor to introduce him when he spoke to Virginia chiropractors at our fall convention.
And last but certainly not least…
- My patients.
I hope to be learning as long as I’m living, and I learn a lot from you, my patients! You are a wonderful source of new information. You’ve told me about therapies that you have had success with at other places. You’ve given me suggestions for good places to eat in Charlottesville and when traveling, hotels to stay in while visiting Costa Rica, places to visit in Paris, the best place to try hot yoga in Charlottesville… Each of you makes it really fun to come to work.
Thank YOU for choosing Balance Chiropractic as your partner in health in 2015. I look forward to helping you stay strong and healthy in 2016.
- Make sure kids can be seen in the dark.
Cinderella’s gown might not have included a reflective light band, but your princess’s costume should. Reflective bands – the kind worn by cyclists around their legs or arms – are cheap and easily available at local bike shops, Target, Wal-Mart, and online at Amazon. Wrap one around your child’s arm so they can be easily seen even as the sun goes down.
And slow down when you’re driving through neighborhoods on Halloween! Remember that children aren’t always aware of their surroundings or potential danger – so we need to be aware of them.
- Avoid face masks.
Encourage your children to choose a costume without a face mask, which has a risk of suffocation. A full mask may also make it harder for a child to see, causing lesser injuries like bumps and bruises from tripping and falling.
Opt for a hat, crown, or face paint instead. Easy to use face paint can be found on the costume aisle or at a craft store.
- Get to know your neighbors.
Throwing an old-fashioned block party lets your kids – and you! – have fun while finding safety in numbers. Invite neighbors to bring treats for all to share and throw some apples for bobbing in a large basin of water, and you have a party. Don’t forget to set out safety cones or “watch for children” signs to remind passing drivers to be extra careful in your neighborhood.
If your neighbors aren’t up for a party, find one at a local community center or church. In Charlottesville, you can join the popular Trick or Treating on the UVA Lawn, where UVA undergraduates living on the Lawn pass out candy. Several University groups also set up games and prizes at the end of the Lawn. If you’re worried about all the candy piling up in your child’s bucket, stop by the Department of Family Medicine’s booth, where they pass out books.
- Be aware of the limits of “fun scariness.”
Dressing up for Halloween gives children of all ages an opportunity to use our imaginations to be creative and have fun. For children in particular, the scary elements of Halloween can help them face fear in a controlled way, giving them a sense of power over it. For younger or very sensitive children, however, the scariness can become overwhelming. If your child seems anxious about all skeletons, scary masks, and faux headstones popping up in October, read her or him books about Halloween or being scared that have positive messages, such as The I’m Not Scared Book. You may also explain the how behind scary things: How does that skeleton move? Is it alive? No, it’s blowing in the wind!
Most importantly, just listen to your children and let them know that however they feel is ok, and you are there to protect them – and help them choose a non-scary costume!
- Donate some of your candy to care packages for overseas military.
Many dental offices have begun collecting excess Halloween candy, which they then send to military personnel serving abroad. Some dentists offer incentives in return. The Halloween Candy Buyback website allows you to input your zip code and find a dentist near you who is participating. Platinum dental participants are offering xylitol-based sweets in return. The Halloween Candy Buyback is also donating toothbrushes to overseas military.
- Recover from your race for candy.
All parents know that by the third or fourth block of trick or treating, there’s a decent chance you’ll be carrying a Minion or a Tinkerbell who is too tired to walk back home. Between that and staying up late the night before to make enough monster cupcakes for your kid’s class, you may be feeling drained come November 1.
Regain your wellbeing with a massage by Dong Ha at Balance Chiropractic & Physical Therapy. Dong is trained in both massage and physical therapy and has twenty years of experience, ranging from working with national-level athletes to post-orthopedic surgery rehabilitation. Book your appointment by calling (434) 293-3800 or emailing [email protected]
Prevent Running Injuries This Fall
With cooler temperatures and less humidity in the air, you may be inspired to lace up your running shoes and hit the road. There are always lots of races in and around Charlottesville this time of year. Whether you’re a seasoned runner or a beginner, it’s wise to take precautions to avoid injury, especially if you’ve been less active in the preceding months. Here are a few of the most common running injuries and helpful tips to prevent them. In general it is a good idea to spend several weeks and month building up mileage. It is also important to have great footwear. You can head out to Ragged Mountain Running Shop or Crozet Running to get the right footwear. Both stores do running and gait analysis and will take plenty of time to help you find the right shoe.
Plantar fasciitis is a painful irritation of the fibrous band running from your heel to the ball of your foot. It’s caused by chronic overstretching and is more common in women, overweight people, or those who participate in endurance sports, such as running. Hill running (especially down hill) can accentuate this problem and as we all know it is hard to find a flat place to run in Charlottesville.
Tip: To prevent this condition, avoid wearing shoes that lack proper arch support. Also try to run on soft surfaces and do not increase your mileage by more than 10% each week.
(Patellofemoral pain syndrome) This most common cause of knee pain results from an imbalance between the muscles that help to guide your kneecap in its V-shaped groove at the end of your thigh bone. Repeatedly flexing and extending a misaligned kneecap leads to pain, swelling, and eventually arthritis.
Tip: There are several things that you can do to help prevent this problem. Runners knee often arises secondary to weakness in the muscles that control your hip, so strengthening your glutes and hamstrings is critical- as is stretching after a workout. Wear shoes with good arch supports and avoid running with an excessively narrow or “crossover” stride.
Shin splints are caused by repetitive overuse stress- especially running or jumping on firm surfaces. Symptoms can arise from tears in the anterior tibialis muscle or even micro-fractures of the tibia (shinbone). The pain can range from mild to severe and can last for months.
Tip: You can help prevent shin splints by avoiding overtraining and limiting running on hard or uneven surfaces. Always perform a proper warm-up before running, especially when sprinting. Your training plan must be taken into consideration, as doing “too much”, “too soon” or “too fast” can contribute to any overuse injury. Help for your pain! If you notice symptoms related to any of these conditions, it’s best to avoid running, or at least decrease frequency and speed to prevent further damage. Cross training activities, such as cycling or swimming, can be good alternatives while you heal. Fortunately, each of these conditions can be treated conservatively. Our providers are highly trained to help you feel better, so you can get back on the road quickly. If you or someone you know is struggling with pain, call our office to schedule an appointment today.
“No pain, no gain” – that’s the mantra of many people dedicated to fitness. However, exercising through pain may mean that you are ignoring an underlying issue, a risk that can make the problem worse and result in having to take more time off later on while you heal from an exacerbated injury.
While some discomfort during activity – for example, when you would rather be sitting on the couch watching TV instead of lifting weights – is normal and necessary for growth, pain is an indication that something is wrong and needs to be corrected. You may simply have incorrect form or technique, or you may have an injury.
Here, Dr. Spillman is performing FMS screening at a local martial arts school. A Functional Movement Screen (FMS)™ can help determine which it is and how to fix it. One recent study, noting that “[e]stablishing a valid method of identifying athletes at elevated risk for injury could lead to intervention programs that lower injury rates and improve overall athlete performance,” concluded, “The Functional Movement Screen (FMS)™ is an efficient and reliable method to screen movement patterns during the performance of specific tasks.” The study echoes an earlier one that confirmed (FMS)™ is “able to predict injury in female athletes.”
During an FMS™, you are guided through a series of basic exercises. The screener then assigns a score based on your ability to perform the full range of motions with proper form and without pain.
The lower your FMS™ score, the greater your risk for injury. For example, a large study in California demonstrated that firefighters with an FMS™ score of less than 14 (on a scale of 1-24) were injured at a much higher rate and more severely than firefighters that scored above 14.
If you have a low FMS™ score – or if any part of the test causes pain – then it is likely that you already have an injury and should see a healthcare provider such as a chiropractor or physical therapist for further evaluation and to develop a treatment plan before engaging in physical activity.
A score below a 14 represents an elevated risk of injury. If you score in the mid-range, you could also benefit from developing a plan with a chiropractor or physical therapist to improve your mobility and stability. In the meantime, you would want to avoid situations that could aggravate an existing issue, such as large group classes at the gym, where you receive little personal attention and correction for improper form. At 14 and above you are likely to be able to perform any exercise without elevated risk of injury, but this is where the performance enhancing comes in. Increasing your score will likely result in improved performance in your sport, in and above any necessary skill training.
A good score means that you can feel free to engage in any activity, knowing you are at low risk for injury.
During a post-FMS™ visit, a chiropractor or physical therapist will perform an assessment (based on a Selective Functional Movement Assessment and a neurological and orthopedic history) to diagnose your injury and create a specialized plan to help you recover.
In addition to assisting with injury recovery, a chiropractor or physical therapist can use post-FMS™ assessments to identify ways an injury-free athlete can improve their strength and speed.
If you have reached a plateau in your training and aren’t getting faster or stronger no matter how much effort you put in, there could be a functional reason – a relative weakness that could be improved with the right exercises. An FMS™ can help identify specific areas for improvement, allowing you to focus your hard work on what will make the biggest difference in your performance.
Make an appointment today for a Functional Movement Screen! Dr. Sam Spillman is one of only a few people in Charlottesville to be certified by Functional Movement Systems and is the only FMS™ certified chiropractor in the area – remember, if you have a low FMS™ score, you should see a healthcare provider for an assessment. Dr. Spillman can provide both the FMS™ and the assessment, if needed. He regularly receives training on using the most up-to-date techniques for evaluating functional movement and creating treatment plans. He will also perform a functional evaluation at the end of your treatment to confirm that you can safely return to activity.
In addition to appointments at his clinic, Dr. Spillman is available to provide on-location screenings at offices and other facilities, including gyms, martial arts schools, sports teams, running clubs, or other fitness studios. Call Dr. Spillman at Balance Chiropractic and Physical Therapy at (434) 293-3800 or email [email protected]
“Eat less, move more” is supposed to be the one-size-fits-all prescription for losing excess weight. But our ability to follow the prescription varies greatly as we are seemingly sabotaged by stress in our lives or by simply being too busy, contributing to a yo-yo dieting pattern of weight loss and gain. Can a healthy weight become a long-term habit, despite the challenges we experience over a lifetime? Yes, if we take advantage of two powerful tools: plasticity and precommitment.
Scientific research confirms what many of us already know, that our impulse control, or lack thereof, affects our ability to lose weight and keep it off. How we set ourselves up for failure is to respond, “So all I have to do is control my impulses to overeat.” Not so fast. When that oversimplified approach fails, we beat ourselves up, resulting in even less energy to make good choices next time.
Instead, we need to understand that the degree to which we can exert effort to change behaviors (say, to eat sensible portions instead of overfilling our plates) is governed by the current state of our brains – which is a result of both genetics and the social environments we have lived in. It is also the result of the immediate situations we face. We know that stress seems to lower our self control, but numerous studies have also shown that making decisions – even decisions as seemingly innocuous as completing your wedding registry or ordering a new computer! – lowers one’s impulse control (a.k.a. “willpower,” “self control,” and “the way you stop after one doughnut”). Pretty much anything that requires mental energy is tapping into the same reserves that willpower needs.
In a cruel twist for anyone trying to lose weight, glucose will restore willpower in the moment. When you reach for the brownies after a hard day of work, with a long To Do list still waiting for you at home, you’re not a failure. Your body is doing what it knows to do to make sure you have mental energy.
The good news is that our brains also have an amazing feature called plasticity. Scientists used to think that the brains we were born with were the ones that we had for life. In recent years, however, we’ve learned that’s not true – our brains can grow new neurons! We have the ability to begin to think differently.
The question, then, is how to cultivate higher behavioral impulse control, and the answer is to practice precommitment.
Precommitment is defined by researchers as “the voluntary restriction of access to temptations.” Precommitment means taking steps before an event occurs to ensure that you will stay on track to meet your goals. Images of the brain have shown that precommitment changes the way the brain responds to the need for willpower, increasing its ability to delay gratification, especially in individuals who tend to be more impulsive.
In addition to limiting factors that might derail your weight loss goals, another key component of precommitment is self-care – knowing what you need to feel well and actively incorporating it in your life. This will help keep your emotional and mental bank account full, allowing you to make withdrawals later when you need strength for impulse control.
There are numerous ways to incorporate precommitment.
- When you go to dinner at a restaurant, ask the waiter not to bring out the bread bowl before the meal, so that you won’t have the chance to spend all your calories on carbohydrates and throw off your blood sugar levels.
- If you know you will be hungry waiting for your dinner out or at a party, eat a small snack full of fiber, protein, and fat – nuts are ideal – before you leave home. The snack will keep your blood sugar stable and help prevent you from glutting on calories later on, out of ravenous hunger and lowered self-control.
- Cut up servings of veggies and fruit at the beginning of the week that you can easily grab for lunches and dinners later. If you have older children who can help, make it a family project on Sunday afternoons. (Bonus: hands-on activities are the best ways for kids to learn new skills!) Order pretty, reusable storage packs. In my case, I like to make green smoothies for lunch. They taste good, are quick and are a good way for me to make sure I’ve got a healthy lunch.
- Devise ways around the obstacles that keep you from exercising. Turn off your phone and computer at a set time each night so you get to bed earlier and are able to stop hitting snooze instead of lacing up your sneakers the next morning. Load your iPod with new songs to keep your runs from being boring. Download an app that helps you keep track of your workouts.
- Schedule time with friends every week (or as frequently as you need). Conversation and fun with friends aren’t superfluous activities. People who have meaningful relationships with others are not just happier, they are healthier. Even the Mayo Clinic says so.
- Schedule alone time, especially if you are an introvert. Introverts are re-charged when they have time to themselves. Like time with friends, quiet time is important, not just something that should be tacked onto our lives if we are not too busy. One great way to achieve this quiet time of reflection is to…..
- You don’t have to sit a certain way for an hour and chant Om. You can start with just a few minutes, anywhere you find comfortable. You can even practice walking meditation. Meditation will make you feel better, and it will make those important brain changes mentioned earlier. In a study that took MRIs of people’s brains after meditating, “participant-reported reductions in stress also were correlated with decreased gray-matter density in the amygdala, which is known to play an important role in anxiety and stress.” And of course, there’s an app for that.
- Think about the life you want. A recent study indicated that overweight women are capable of demonstrating greater impulse control if they imagined themselves “in enjoyable future scenarios.”
- Make a chiropractic appointment. Don’t live with energy-taxing pain. Chiropractic care can relieve painful body conditions and prevent them from returning. A chiropractor can also support weight loss by providing diet and activity recommendations and managing any injuries that occur, so you can keep your momentum going.
If you’re like many of us, at least one of the above tips feels like an indictment.
“I could never convince my kids to help with kitchen chores!”
“How am I supposed to find time to meet up with friends? I brush my teeth in the shower and eat standing up!”
Fortunately, making changes isn’t a one-chance deal. Plasticity is achieved over time. If you didn’t reach your goals this week, you have another opportunity to practice precommitment by figuring out why it didn’t work and how to make it work next week. You can also change your goals if you continue to miss them, which can be a sign that they aren’t realistic, or at least not realistic for now. Your goal is to cultivate habits you can enjoy over a lifetime.
What many weight loss plans are missing – and what keeps us hopping from one fad diet to another – is that we are not machines, where you plug in a specific formula and an ideal weight pops out. We are humans, with rich lives and living brains, which respond to the choices we make over time.
That’s the secret. That’s the last diet you will ever go on.
Need inspiration for how to achieve a healthy weight and improve your fitness? We’ve put together top tips, based on the latest research.
1. Use High Intensity Interval Training (HIIT) to get the most out of your workout.
HIIT is exercising at a low to moderate pace followed by a short but very intense burst (or sprint) of exertion. Repeat.
The effectiveness of HIIT has been confirmed in numerous studies over the past few years, with Science Daily summarizing the results of a 2013 clinical study of HIIT: “Inactive people can achieve major health and fitness gains in a fraction of the time.”
One of the ways HIIT increases fitness levels is by promoting post-exercise oxygen consumption, which means you burn more calories, even after your workout is over.
2. Don’t forget to strength train.
Too often, we focus on aerobic exercise – think jogging, cycling, and using the elliptical machine at the gym – and neglect strength training (also called resistance training). This is a huge mistake, as strength training has been shown to control belly fat; ease lower back pain; improve glucose control; improve cognitive function, including memory; and decrease the risk of osteoporosis. Scientists have yet to determine whether it will make your mother-in-law like you, but it probably won’t hurt.
Lifting weights is a method of strength training, as is using the resistance of your own body, such as when you do certain yoga poses.
3. Eat the rainbow.
Include lots of colorful vegetables and fruit in your meals and snacks. Michael Pollan encapsulates this idea in one of the shortest diet plans ever: “Eat food. Not too much. Mostly plants.”
The “eat food” part means eating real food, not the stuff we’ve created in the last century (ahem, Twinkies). Highly processed food should be avoided – the longer the list of ingredients, the more processed the food is.
Fill out your diet with lean protein and going easy on the carbohydrates, especially simple (and often highly processed) ones like bread.
4. Go to bed.
In research studies, people who had not had enough sleep ate 260–550 extra calories a day! Sleep deprivation may increase your risk for obesity and diabetes. Adults should sleep for 7-8 hours every night.
5. Practice a technique known as precommitment to avoid overtaxing your ability to make good choices.
Impulse control, the skill that keeps you from eating an entire box of Girl Scout cookies in one sitting, requires mental energy. You know what else requires mental energy? Pretty much any decision, from picking out what shoes to wear to whether to ask for a raise at work. (Many highly successful people are noted for wearing similar clothes every day – Steve Jobs’ iconic black mock turtleneck shirt is one example – so they can focus on decisions that are more important.)
Precommitment is planning beforehand (like Steve Jobs) how to minimize energy-tapping decisions and preserve impulse control. Make it easier for yourself to make good choices by practicing precommitment, especially during times like the evening when you are fatigued from a long day. On the weekend, cut up veggies to have on hand for dinners. Tell the waiter not to bring out the bread basket when you go to a restaurant after work.
And a tip you can really enjoy: eat your Girl Scout cookies with breakfast. Seriously. In one study, participants who ate dessert with their high carbohydrate, high protein breakfast lost more weight than those who ate smaller breakfasts and larger dinners. Having a slice of cake in the morning may take away the temptation to eat half a cake at night after a day of eating yogurt and fruit.
Read more here about precommitment.
6. Find an app for that.
It can be difficult to keep track of our wellness progress during the day. Plus, tallying calories uses valuable mental energy (see above!). Let an app do the hard work for you. MyFitness Pal will track both your diet and exercise. Other helpful apps include SparkPeople and Noom.
You can also download apps that monitor your heart rate while you exercise. Instant Heart Rate by Azumio is a good one. Remember that exercise intensity is important. A good goal is to keep your heart rate between 70-85% of your maximum rate. A rule of thumb for determining your maximum heartbeats per minute is subtracting your age from 220. (Click here to learn more about gauging your target heart rate during exercise.)
7. Identify your goals and make a realistic timeline.
The Mayo Clinic helpfully points out that we need to make two types of goals for successful weight loss: a process goal and an outcome goal. “Lose 30 pounds” is an outcome goal – the result you want. “Exercise every day” is a process goal – what you are going to do to achieve results.
Determine the results you want, then identify changes in your habits that can make them possible.
Here’s an obvious truth that we often ignore: if you consistently fall short of your goals, you need to set a new goal, one you can accomplish! If you’ve spent two weeks trying and failing to exercise every day, make exercising twice a week your new goal. When that becomes a habit, make a new goal of three times a week, and so on until you are able to exercise every day. Your timeline for reaching your goal may become longer, but your results will be sustainable and your overall health better as you work with yourself, not against yourself.
Or maybe you need to change your definition of what counts. Thirty continuous minutes of exercise may not be doable at first, but three 10 minute walks at different times throughout the day might be perfect for your current health level and schedule, and something you can manage every day.
8. Make a chiropractic appointment.
Our providers at Balance Chiropractic and Physical Therapy can support weight loss by providing diet and exercise recommendations and managing any injuries that occur, so you can keep your momentum going.
What tips have you found that help you achieve your health and fitness goals? Please share them in the comments or join us on Facebook to discuss with others interested in lifelong wellness!