Listening to your footsteps: The impact of hearing and vision loss on fall risk

Written by Marissa Hoen | November 17 2021


Falls are a part of life that most of us try to avoid. While children bounce back fairly quickly from a fall, older adults share a different story. The Public Health Agency of Canada reports that in those over 65, falls are the number one cause of hospitalization due to injury (2014)- but why is this the case? Body function is complex and the answer to this question is unlikely to be a single source. In a recent CBC article, Ruby Buiza  sheds light on some factors in fall risk that you may not have been aware of (2021).

In the article, Buiza points out 6 factors that impact fall risk:

  • Hearing and Vision Impairments

  • Improper handrail shape

  • Improper size of steps

  • Using well-fitted mobility aids 

  • Fear of falling

  • Medication side-effects

    Some of these factors, such as handrail shape and fear of falling, are modifiable in that we may be able to buy a new handrail and work on overcoming our fears; however, many of these factors might not be easily altered. In those cases, such as hearing impairments, improper step size and handrail shape, great attention and external support should be regularly used. Today let’s take a deeper dive into how hearing and vision can impact fall risk and focus on what we can change to live life with fewer falls. If you’d like to read the original CBC article, click the link in the reference section below!


    Hearing and Vision Challenges

    The positive correlation between visual impairments and fall risk is an easy one to understand: the less you can see, the more you may trip over obstacles in your path. Improving your vision can come in many forms. Maybe you finally book that eye exam and get those corrective lenses. In the CBC article, Barbara Kowalski points out that proper lighting provides immediate support- especially for those who get up at night (2021). In this case she recommends motion sensor lighting to eliminate that risky search for the light switch. While the link between vision and falls might be easier to wrap the brain around, the link between hearing and falls is less understood.

    Recent research shows that whether you can hear your footsteps has an effect on your walking gait (Cornwell et al., 2020), which ultimately impacts your fall risk. Here is a summary on some research findings:


So what can we take home from these studies?

  • If you have trouble balancing, take short distance steps to increase stability. Train larger distance steps when you have the support, take shorter steps when you don’t!

  • Realize that walking and balance take a lot of brain effort! If you are dealing with hearing loss or another condition that impacts your brain’s energy reserves, walking without falling takes focus and energy that you may not have in that moment. Take time to rest when needed, become more aware of your fatigue levels and don’t push it if you are alone. 

  • Pay attention during your movements! This ties in with the last point- if there is too much stimuli (noise, moving obstacles, etc) you may become distracted and unaware of your limb positioning. While this was not mentioned in the above studies, I have heard from many clients that falls happen when they just weren’t paying attention. However, attention takes energy and we know that falls are more likely when the energy is low.

  • Face your fears of falling through various methods. Since balance issues and fear of falling go hand in hand, working on one will simultaneously help the other. Find a safe space with support (ideally people and grip support), practice your balance and strengthen the muscles involved. Be aware of the fear and put strategies and solutions in place to minimize this fear- which will in turn improve your balance. Think about situations in which you have fallen in the past- are there any common stimuli? Take your experience and learn from it!

  • All of these risk factors are just that: risk factors. This does not mean that if you fall into one or more of these categories that you are going to fall. It does mean, however, that you are more likely to fall and should implement as many tools as possible to reduce your fall risk so that you can continue living your life the way you’d like. 




References



Buiza, R. (2021, October 16). 6 overlooked risks of falls for seniors and how to prevent them | CBC radio. CBCnews. Retrieved November 15, 2021, from https://www.cbc.ca/radio/whitecoat/6-overlooked-risks-of-falls-for-seniors-and-how-to-prevent-them-1.6202152

Cornwell, T., Cornwell, T., Woodward, J., Wu, M., Jackson, B., Souza, P., Siegel, J., Dhar, S., Gordon, K. E., & Gordon, K. E. (2020). Walking with ears: Altered auditory feedback impacts gait step length in older adults. Frontiers in Sports and Active Living, 2https://doi.org/10.3389/fspor.2020.00038


Hearing loss linked to three-fold risk of falling. Johns Hopkins Medicine. (2012, February 27). Retrieved November 15, 2021, from https://www.hopkinsmedicine.org/news/media/releases/hearing_loss_linked_to_three_fold_risk_of_falling  


Seniors’ falls in Canada. Public Health Agency of Canada. (2014). Retrieved November 17, 2021, from https://www.phac-aspc.gc.ca/seniors-aines/publications/public
/injury-blessure/seniors_falls-chutes_aines/assets/pdf/seniors_falls-chutes_aines-eng.pdf

Szeto, B., Zanotto, D., Lopez, E. M., Stafford, J. A., Nemer, J. S., Chambers, A. R., Agrawal, S. K., & Lalwani, A. K. (2021). Hearing loss is associated with increased variability in double support period in the elderly. Sensors (Basel, Switzerland), 21(1), 278. https://doi.org/10.3390/s21010278

The impact of nature on our health and wellbeing

Written by Marissa Hoen | September 24 2021

Take a moment, close your eyes and think about the last moment you spent in nature. What did it feel like, look like, smell like, or sound like? How does thinking about this place make you feel?

As I write this, I am sitting on a mossy bench in the middle of the Finnerty Gardens. The wind and squirrels shake the trees as leftover rain falls from each leaf. It smells like mud, wet grass, and faint sweet flowers. In this moment I feel calm, tranquil, and whole. 

In the past few weeks, life has gotten hectic. Juggling school, work, relationships, finances, and recovering from an injury- all while trying to improve my health and wellbeing- it's a challenge to say the least. No matter who you are, we all have responsibilities (whether it be kids to take care of or phone bills to pay) that we need to address in order to meet our basic needs. These basic needs, as proposed by Maslow, include physiological (food, water, warmth, rest) and safety needs (Maslow, 1943). Once those basic needs are met, Maslow suggests that humans are driven to fulfill their psychological needs, such as finding fulfilling relationships and increasing self-esteem. Based on some recent studies, I’d like to add one more need that may be psychological (though I feel it’s a basic need for myself!): time spent in nature.

A recent study surveyed over 20,000 people across the U.K. and compared their self-reported health and wellbeing with the number of minutes the participant spent in nature the week following the survey (White et al., 2019). The results may not surprise you! Those who spent 120 minutes or more in nature reported greater overall health and wellbeing. 

When I first read this study I thought: this is an association, there must be other variables at play... right? In order to get to the garden I am currently sitting in, I needed to walk here- there’s a variable! I know exercise increases health and wellbeing, so is this one explanation? Another study challenges my exercise hypothesis. Park et al. found that individuals sitting and engaging in Shinrin-yoku, or taking in the forest atmosphere, showed physiological changes related to improved health and wellbeing (2010). These changes include lowered blood pressure, lower heart rate, decreased cortisol release, and lowered sympathetic nerve activity. From this information, we can no longer assume that exercise is solely responsible for the findings in the study by White et al. 

What else does the 120 minutes in nature study teach us? White et al. points out that this improvement in health and wellbeing was reported if the time in nature was spread throughout the week or if it was just one day in nature, it just needed to total 2 hours or greater. They also described the time in nature as ‘recreational nature contact’, and defined the outdoors as “open spaces in and around towns and cities, including parks, canals and nature areas; the coast and beaches; and the countryside including farmland, woodland, hills and rivers… However this does not include: routine shopping trips or; time spent in your own garden.” (White et al., 2019).  They also found that this 120 minutes threshold was consistent regardless of season!

Takeaways: If you are human, you will likely feel health and wellbeing benefits by increasing your recreational time in nature. Take a survey of your last 7 days- how much leisure time did you spend outdoors? If it was less than 2 hours throughout the week, can you find ways to increase your nature time daily? Or maybe simply start with one day per week. Get outside, take a breath of fresh air, and feel the relaxation in the reminder that you are truly home!

References

  1. Maslow, A. H. (1943). A theory of human motivation. Psychological Review, 50(4), 370–396.
    https://doi.org/10.1037/h0054346

  2. Park, B.J., Tsunetsugu, Y., Kasetani, T. et al. The physiological effects of Shinrin-yoku (taking in the forest atmosphere or forest bathing): evidence from field experiments in 24 forests
    across Japan. Environ Health Prev Med 15, 18 (2010).
    https://doi.org/10.1007/s12199-009-0086-9

  3. White, M.P., Alcock, I., Grellier, J. et al. (2019). Spending at least 120 minutes a week in nature is associated with good health and wellbeing. Sci Rep 9, 7730.
    https://doi.org/10.1038/s41598-019-44097-3



Reduce the swell, support your cells! An Overview of Manual Lymphatic Drainage

Written by Marissa Hoen | July 20 2021

What is the lymphatic system?

(Derrickson, 2017)

I like to think of the lymphatic system as the vascular system’s supportive best friend- always there to pick up the pieces, clear out the garbage, and give back what is needed. You may know that nutrients circulating in our arteries exit these vessels to supply all of our cells with nourishment. But how do these nutrients get to the cell? They diffuse through the interstitial space, or the space between cells. The fluid that holds these nutrients and proteins is called interstitial fluid, and in excess this fluid is referred to as swelling or edema. When reabsorbed by lymph vessels, this fluid again changes its name to lymphatic fluid, or lymph! 

In addition to reabsorbing excess edema, the lymphatic system plays a role in initiating immune responses and transporting lipids from the digestive system into the blood. This one way system requires pressure changes (through muscle contraction, gravity, breathing) to move lymph along the vessels. When damaged through systemic inflammation, certain diseases, and/or lymph node removal, certain areas of the system become inefficient and another route must be taken for the lymph to make it all the way back to the heart. That is where Manual Lymphatic Drainage comes in!

What is involved in Manual Lymph Drainage?

(Rattray & Ludwig, 2005)

  • Manual Lymphatic Drainage, or MLD, incorporates massage techniques aimed to pump lymph fluid away from areas of damage and into healthier, more effective lymph vessels

  • Techniques are mostly gentle, as large amounts of lymph vessels lie just below the skin

  • These techniques alternate between stretching and releasing the skin using palmar/fingertip stroking or circular kneading

  •  The techniques may be deeper in areas of more fibrous tissues (like scars) or around bony joints

  • Diaphragmatic breathing and abdominal massage are also involved to incorporate the deep lymph nodes

  • Usually treated in a supine position, but can be done seated, standing, or in side lying

  • MLD reduces edema (swelling) as well as pain and stress when done slowly and rhythmically

  • Uzkeser et al. (2015) found that complex decongestive physical therapy (CDT), which is the combination of manual lymphatic drainage, physical exercise, use of compression clothing, and skin care, is effective at reducing lymphedema in patients following a mastectomy. CDT is considered the gold standard treatment for lymphedema. 


Can I practice self MLD?

Stimulating lymphatic flow can be done by anyone, but before you begin read below to see if you are at risk for adverse effects. There are countless videos online demonstrating self MLD. My all time favorite technique is one that can be done anytime: diaphragmatic breathing with some added pressure: 

  1. Place your hands on your belly

  2. With an inhale let your belly expand with your hands giving a bit of resistance

  3. With an exhale let the belly relax and push gently into the abdomen

  4. Repeat for several breaths


Another great self MLD technique is dry brushing- which is exactly what it sounds like! Grab a dry brush that won’t irritate your skin and:

  1. Begin stimulating the lymph nodes of the neck and armpit area with circular brush strokes

  2. Move to the front of the hip, at the level of the hip crease 

  3. Then you can begin the rest of the body, brushing with straight strokes in the directions shown below. When brushing your arms and legs, begin at the top of the limb and make your way to the end (still brushing up toward the armpit). Complete the limb by brushing your way back up from bottom to top. 


Are there any potential risks with this treatment?

As this treatment may increase the return of blood flow to the heart, MLD for people with heart conditions such as congestive heart failure and cardiac insufficiency is contraindicated. Therapists should practice caution with those with systemic hypertension, as MLD may increase blood pressure. Esmer et al. (2019) found that in healthy participants, change in blood pressure varied depending on the area of body treated- for example neck MLD led to a reduction in blood pressure whereas abdominal MLD raised BP. The authors attributed some of these changes to the position of the body, so if you experience large fluctuations in blood pressure when you go from sitting to lying down (or vice versa), talk to your doctor or take caution before having MLD. 

Contraindications include:


(Rattray & Ludwig, 2005)

  • Chronic heart failure

  • Acute conditions (bacterial/fungal)

  • Recent Thrombosis

  • Edema due to Kidney dysfunction

  • Malignant Cancer


Precautions include:


(Wittlinger Lymphedema Clinic):

  • Edema following carcinoma treatment

  • Thyroid dysfunction 

  • Chronic inflammation

  • Bronchial asthma

  • Diabetes

Summary:

  • Manual Lymphatic Drainage is effective at reducing swelling/edema in many populations

  • You can receive MLD from a massage therapist, or at home with dry brushing, diaphragm breathing, and self massage

  • Those with heart conditions, acute infections, and chronic inflammation should consult their Doctor before receiving MLD


References


Derrickson, B. (2017). Human physiology. Wiley & Sons Inc. 

Esmer, M., Keser, I., Erer, D., & Kupeli, B. (2019). Acute cardiovascular responses to the application of manual lymphatic drainage in different body regions. Lymphatic Research and Biology, 17(3), 362-367. https://doi.org/10.1089/lrb.2018.0043

Manual Lymph Drainage (MLD) - contraindications. Wittlinger Lymphedema Clinic . (n.d.). https://www.lymphedema-clinic.com/manual-lymph-drainage/contraindications.html.  

Rattray, F. S., & Ludwig, L. (2005). Clinical massage therapy: understanding, assessing and treating over 70 conditions. Talus Incorporated. 

Uzkeser, H., Karatay, S., Erdemci, B., Koc, M., & Senel, K. (2015). Efficacy of manual lymphatic drainage and intermittent pneumatic compression pump use in the treatment of lymphedema after mastectomy: A randomized controlled trial. Breast Cancer (Tokyo, Japan), 22(3), 300-307. https://doi.org/10.1007/s12282-013-0481-3




13 Ways to Boost Your Resilience

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Written by Melissa Hansen | June 24 2021

Assume you're about to embark on a river rafting adventure. Your map indicates that you will experience inevitable curves in addition to slow water. How would you ensure that you can cross the choppy waves safely and deal with any problems that arise from the challenge?

You may probably solicit the help of more seasoned rafters to organize your itinerary, or you could rely on the company of fellow peers along the way. Perhaps you would carry a spare life jacket or use a more durable raft. Whatever course of action you take, one thing is certain: you will not just survive the rigors of your river expedition if you have the necessary tools and assistance in place. You'll also become a more self-assured and courageous rafter.

 

What Being Resilient Means

While life doesn't come with a map, everyone will undoubtedly encounter twists and turns, ranging from minor setbacks to life-changing catastrophes such as the loss of a loved one, a tragic accident, or a significant disease. Every shift has a different impact on people, bringing a unique stream of thoughts, powerful emotions, and uncertainties. On the other hand, people adapt successfully to life-changing crises and stressful situations over time, thanks in part to resilience.

The process of adjusting well in the face of adversity, trauma, tragedy, threats, or severe sources of stress—such as family and relationship issues, serious health problems, or workplace and financial stressors—is defined by psychologists as resilience. As much as resilience entails "bouncing back" from adversity, it can also imply significant personal improvement. Being more resilient allows you to get through difficult situations, develop and enhance your life. 

Being resilient does not guarantee that a person will not face challenges or be distressed. In fact, the path to resilience is going to be fraught with emotional turmoil. Emotional pain and tension are typical among those who have experienced substantial difficulty or tragedy in their lives.

Developing your resilience requires time and dedication, much like strengthening a muscle. Connection, wellbeing, healthy attitude, and meaning are four essential components that can help you endure and learn from challenging and painful events. Use these tactics to build your ability for resilience to weather—and grow from—adversity.

 

How to Boost Your Resilience

 

Below are some tips to improve your resilience which are mainly about connecting to the right people, encouraging you to maintain a healthy mind, and discovering a sense of purpose.

 

1.  Make connections a top priority

Connecting with caring and understanding people might help you remember that you're not alone when facing challenges. Concentrate on finding genuine and sympathetic people who will affirm your feelings since this will help you develop resilience. Some people withdraw themselves due to the anguish of traumatic experiences, but it's critical to seek encouragement and guidance from others who care about you. Whether you schedule a regular romantic evening with your husband or a lunch date with a friend, make genuine connections with those who matter to you a priority.

 

2.  Join a discussion group

Along with one-on-one interactions, being involved in community groups, religion-based societies, or other local organizations can provide social support and help you rediscover hope. Look for local organizations that can provide you with support, a feeling of purpose, or enjoyment whenever you need it.

 

3. Take good care of yourself

Self-care could be a trendy buzzword, but it's also a proven strategy for improving mental health and resilience. This is because stress is both physical and emotional. Positive lifestyle variables such as healthy nutrition, adequate sleep, hydration, and exercising regularly can help your body adapt to stress and lessen the impact of negative emotions like anxiety and sadness.

 

4. Make an effort to be mindful

Reflective journaling, yoga, and several other spiritual activities such as praying and meditating can also help people regain hope and create connections, preparing them to handle situations that need resilience. Even during personal challenges, reflect on good elements of your life and recollect the things you're grateful for when you document, meditate or pray.

 

5. Negative sources should be avoided 

It may be tempting to use a drink, drugs, or other substances to cover up your suffering, but that's like placing a bandage on a severe wound. Rather than attempting to avoid the sense of stress entirely, focus on providing your body with the tools it needs to manage stress.

 

6.  Assist others

You can gain a sense of purpose, promote self-worth, socialize with other people, and actively help others by volunteering at a local shelter or simply supporting a friend in their time of need, all of which can push you to develop resilience.

 

7. Be proactive in your approach

During difficult times, it's necessary to acknowledge and embrace your emotions. Still, it's also crucial to cultivate self-consciousness by asking yourself, "What should I do about a difficulty in my life?" If the difficulties appear to be too large to handle, break them down into smaller chunks. If you were laid off from your job, for example, you might not be able to persuade your manager that it was a misstep to fire you. However, you can devote time each day to honing your top skills or polishing your résumé. Taking charge will convince you that you can find drive and purpose even amid adversity, boosting the chance that you will rise to the occasion in the future.

 

8. Make progress toward your objectives

Develop some clear objectives and do something on a regular basis—even if it seems insignificant—that allows you to progress toward your objectives. Rather than focusing on seemingly impossible tasks, ask yourself, "What is something I know I can do today that will help me progress in the path I want to go?" You may, for example, attend a grieving support system in your neighborhood if you're coping with the death of a friend and want to move ahead.

 

9. Look for opportunities to learn more about yourself

People frequently discover that they have improved in some way as a result of a fight. People have experienced positive connections and a deeper understanding of strength following a tragedy or adversity while feeling vulnerable. This can boost their self-esteem and raise their enjoyment for life.

 

10. Keep everything in context 

How you think has a significant impact on how you feel and how strong you are when confronted with challenges. Identify areas of destructive behavior, such as a propensity to catastrophize problems or a belief that the world is conspiring against you, and replace them with a more balanced and sensible thinking habit. For example, if you're feeling helpless in the face of difficulty, tell yourself that what transpired isn't a predictor of what will happen in the future. You may not be able to affect the outcome of a highly stressful situation, but you can control how you perceive and react to it.

 

11. Accept that things will change

Accept the fact that change is an inevitable element of life. As a result of adversity in your life, certain ambitions or ideals may seem unattainable. Accepting conditions that you can't change can let you concentrate on those that you can.

 

12. Keep a positive attitude

When things aren't going your way, it's difficult to stay positive. With a positive mindset, you might expect wonderful things to happen to you. Rather than obsessing about what you fear, try envisioning what you want. Take note of any small ways you begin to feel better as you handle unpleasant situations along the way.

 

13. Use what you've learned in the past 

You can learn how to respond effectively to future challenging situations by reflecting closely on who or what was beneficial in earlier times of difficulty. Recall where you've found strength in the past and remind yourself what you've learned from those experiences.

 

When to Seek Help?

In order to increase your resilience, you must seek support when you need it. Many people may find that relying on their own strengths and employing the measures described above is sufficient to increase their resilience. However, on the pathway to resilience, an individual may become trapped or have trouble progressing.

Suppose you cannot operate as well as you would want or do basic daily duties as a byproduct of a catastrophic or other traumatic life situation. In that case, it is critical to seek expert help. A qualified mental health expert, such as a psychologist, can help people build a viable plan for the future. Remember that various people are more at ease with different interaction techniques. Seek help from a psychologist or a support network to take full advantage of your therapeutic connection.

The crucial thing to remember is that you are not traveling alone. Although you may never be able to control every area of your life, you may progress by concentrating on the components of life's obstacles that you can address with the help of family and trustworthy specialists.


This article was written by Melissa Hansen, a seasoned writer with contributions to niche outlets like Epic Firms, Forever After, and Bridgewell Group. When she is not crafting insightful content, Melissa enjoys her time with a hot cup of coffee in one hand and an inspiring book in the other.


Level Up! Creating Healthier Habits with Stages of Change

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Written by Marissa Hoen | June 22 2021

Have you tried to change a behaviour, only to find yourself right back to your old habits the very next day? You may set your goals, but then life comes in and presents you with a new idea or challenge that can feel like a roadblock diverting you right back to your original path. When you take a look at your daily habits, you may find areas that you have been trying to change for years but old habits seem almost impossible to overcome. A classic example comes around every year: the New Years Resolution.

Changing ingrained habits is hard- no doubt about it. But there are ways to make our lifestyle changes more doable based on where we are in the stage of that change. If you have a hard time sticking to a behaviour change, it’s possible that you’ve jumped too quickly into action, without taking steps to support the current stage of change that you are in! To ensure the change you want will actually stick, it is helpful to know where you are starting from so you can take steps appropriate for that stage.

http://www.pharmatimes.com/thought_leadership/the_concordance_conundrum_the_value_of_improving_patient_experience_1343288

http://www.pharmatimes.com/thought_leadership/the_concordance_conundrum_the_value_of_improving_patient_experience_1343288


The Stages of Change
(Hadjistavropoulos & Hadjistavropoulos, 2019)

  • Precontemplation: This first stage occurs before you decide to change a habit. Thought to last around 6 months, folks may remain in this stage due to lack of knowledge about the outcomes of their unhelpful habit.


  • Contemplation: This stage involves the want to change a behaviour, usually over another 6 month span. If you are thinking about a change, but don’t yet see that the benefits outweigh the costs, you may be in this phase.


  • Preparation: Those in the preparation stage are doing just that, preparing to take action in the direction of their goal behaviour. One might prepare by creating a plan or by gaining more knowledge on the habit. These individuals are usually planning to take action steps in the next month.


  • Action: In this stage, the individual takes actionable steps to change their habits. This stage may take 6 months, and is not indicative of the habit being established. Many in this stage revert back to old habits if the processes of change (see below) were not engaged in during the preparation phase.

  • Maintenance: People in this stage have made great efforts to change their behaviour, and have done so successfully for some time. The goal of this stage is to keep up with the newly formed habit and prevent relapse. Estimated to last anywhere from 6 months to 5 years.


  • Termination: It is not always possible to reach this phase depending on the goal chosen. This phase consists of no longer being tempted to revert back to old habits, almost as if the old habits didn’t exist. 

https://www.change4health.org/it-begins-with-you/motivation-and-readiness/frameworks/

https://www.change4health.org/it-begins-with-you/motivation-and-readiness/frameworks/

Processes of Change


Evidence has shown that certain processes of change allow for more effective movements through the stages of change (DiClemente et al., 1991). Table 5.1 connects the processes (or strategies) that are appropriate for each stage (Hadjistavropoulos & Hadjistavropoulos, 2019). There are many strategies to choose from, so here I will highlight a few of my favorites:

  • Consciousness Raising: increasing your knowledge about the behaviour you want to change. This will help you break through precontemplation and is an important aspect in increasing the pros and decreasing the cons of changing. One can increase awareness through reading articles on the topic, learning from experts, and getting feedback from those around them.

    • Pros of Changing > Cons of Changing: evidence suggests that a person is more likely to progress beyond contemplation to Action when they perceive the upsides to changing as outweighing the challenges presented ( Hall & Rossi, 2007).

  • Self-reevaluation: altering the way that you view yourself, “creating a new self image” (Hadjistavropoulos & Hadjistavropoulos, 2019). Identify the words you use to describe yourself and clarify how you would like to view yourself. It may be helpful to think of yourself as already being that healthy person, and ask “how would this person act? What actions would they take at this moment?”


  • Self-liberation: commit yourself to your habit change. Whatever the habit change is, write it down, make it noticeable, and remind yourself why you want this change. Make plans for the times when you may relapse, and know that you can recommit to your plan. This can help you get ready for the challenges that always arise during the action stage.


  • Counter Conditioning: find and use healthy alternatives to your habit. The more you enjoy these alternatives, the better! For example, if you are trying to quit smoking, common alternatives include the nicotine patch, breathing techniques, or keeping your hands occupied with another task (knitting, cooking healthy foods, writing in a journal, gardening, the list goes on!). 

While all of these processes focus on behaviours that put our health at risk, I agree with Psychology Professor Dr. Barb Bryden who also suggests taking time to also focus on what we are already doing right! Anytime you are listing your behaviours that may be harmful, also list those things you do that are supportive of your health. Only fixating on the improvements we need to make can leave us feeling like we aren’t enough or that we are neglecting health in its entirety! There are endless ways to improve health, and you are most likely doing many of these things without realizing! So of course, work on your challenges, but also be aware of your strengths and how far you have come.

Key Takeaways

A behaviour change is more likely to be successful if:

  • The first stages are supported by improving knowledge, preparing emotionally, and critically thinking about the causes and consequences of the unhelpful habit

  • The following stages address environmental factors, foster social support, and improve self efficacy and commitment

References

  1. DiClemente, C. C., Prochaska, J. O., Fairhurst, S. K., Velicer, W. F., Velasquez, M. M., & Rossi, J. S. (1991). The process of smoking cessation: An analysis of precontemplation, contemplation, and preparation stages of change. Journal of Consulting and Clinical Psychology, 59(2), 295-304. https://doi.org/10.1037/0022-006X.59.2.295

  2. Hadjistavropoulos, T., & Hadjistavropoulos, H. (Eds.). (2019). Fundamentals of health psychology. Oxford University Press.

  3. Hall, K. L., & Rossi, J. S. (2007). Meta-analytic examination of the strong and weak principles across 48 health behaviors. Preventive Medicine, 46(3), 266-274. https://doi.org/10.1016/j.ypmed.2007.11.006




Breathe in, Reach out. Coping with Stress

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Written by Marissa Hoen | June 9 2021

About a week ago I began an accelerated online course on Health Psychology at UVic. This course couldn’t have come at a better time in my life, having just experienced health stresses of my own. Thus far, I have been extremely lucky in my recovery- but that doesn’t mean it has been easy. Anyone reading this has likely dealt with some sort of stress in life, whether it be an acute trauma, a chronic medical condition, or COVID-related stresses. 

Stressors are all around us, but from my studies so far and my recent experiences I am coming to understand that the way we view these events and how we choose to cope with them are incredibly powerful and can transform our lives (both physiologically and psychologically)! 

Learning about different forms of coping with stress has helped me become more aware of my own habits around stress, and has enabled me to begin the journey of learning to cope in ways that are better for my health! I hope that this helps you do the same. 


Stress

Stress has been defined as some variation away from an individual’s resting state caused by a stressor or ruminations of past/future stressors (Hadjistavropoulos & Hadjistavropoulos, 2019). Not all stress is harmful, as some acute stress is needed to get us out of harmful situations or to promote forward momentum in our lives. It is more chronic or prolonged stress that becomes more harmful for our health and wellbeing. 

While we cannot control the stressors that come up in our lives, we can shift the way we think about them and which strategies we choose to cope with them.

Forms of Coping:

As outlined by Hadjistavropoulos & Hadjistavropoulos (2019), there are two general types of coping of which many other specific forms fall under.

  1. Problem-Focused Coping: this involves both identifying the stressor and the ways in which you can practically deal with it. For example, if you were just diagnosed with a digestive disorder, you may cope by seeking nutritional advice from a Registered Dietician and begin creating a new meal plan.

  2. Emotion-Focused Coping: this coping strategy is centered around addressing the emotions that accompany stressful circumstances. An example of this is seen in those who call friends or family to talk through their feelings during stressful times. 

    1. Avoidant coping: It is generally understood that type of emotion-focused coping is the least effective coping mechanism (Hadjistavropoulos & Hadjistavropoulos, 2019), as the individual ignores the stressor and avoids taking action around it.

Research has shown that when coping with a medical condition, a mixture of problem-focused and emotion-focused coping is most effective at relieving stress and the physiological consequences of that stress (Hadjistavropoulos & Hadjistavropoulos, 2019). When studying the coping strategies of 100 middle-aged men and women, Folkman and Lazarus (1980) found that both strategies are used together in varying degrees depending on age, gender, the context of the stress, and how stressful the event is viewed or appraised. One of the most effective forms of coping within these types is social support.  

Social Support

  • People with positive social support, or people in their lives who care about their health and wellbeing, are more likely to have stronger immune systems, lower blood pressure and faster healing times than those without (Uchino et al., 1996). In addition to the physiological benefits, I see the psychological benefits in my own life and in those around me- when we listen and support each other, the benefits are immediate and challenges feel slightly less challenging.

  • Connect with people however you can. Social support has shown to be one of the best methods for coping with stressors, and men especially need to be aware that it may not be a natural habit to reach out and communicate stress in their lives. Studies show that men do not seek out support as frequently as women, however they do benefit from this social support (Hadjistavropoulos & Hadjistavropoulos, 2019).

If you are experiencing stress and need help navigating through it, I highly recommend reaching out to a professional. There are many forms of therapy, so if you don’t have an ideal experience the first time- don’t give up! Find the right person for you and what you are going through. 

References

Folkman, S., & Lazarus, R. S. (1980). An analysis of coping in a middle-aged community sample. Journal of Health and Social Behavior, 21(3), 219-239. https://doi.org/10.2307/2136617

Hadjistavropoulos, T., & Hadjistavropoulos, H. (Eds.). (2019). Fundamentals of health psychology. Oxford University Press.

Uchino, B. N., Cacioppo, J. T., & Kiecolt-Glaser, J. K. (1996). The relationship between social support and physiological processes: A review with emphasis on underlying mechanisms and implications for health. Psychological Bulletin, 119(3), 488-531. https://doi.org/10.1037/0033-2909.119.3.488

Image Credit: https://www.istockphoto.com/illustrations/breathing-exercise



The Facts of the Fad: The Evidence behind the Wim Hof Method

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Written by Marissa Hoen | May 18 2021

Moments ago, I completed my first three rounds (11 minutes) of the Wim Hof breathing technique for beginners (link in the references). While the technique felt uncomfortable at times, I am now experiencing a heightened sense of clarity, alertness, depth and ease in my breath, and I can feel my fingers and toes beginning to warm up.

In a video on the Science behind the Wim Hof Method (WHM), Scott Carney shares that when we limit our environmental and physical activity exposures, our bodies (and minds) become efficient only in that set range (Medlife Crisis, 2019). This makes unexpected circumstances (such as getting caught in a snowstorm, or getting fired from work) harder for the body to deal with. When we train our bodies in different ways, we adapt to these new stressors- ultimately helping us deal with those stressors outside of the training session. 

In this post I hope to dispel misconceptions around his method and motivate you to expand your zone of comfort in whatever that looks like to you. We all have different bodies and minds that require slightly different levels of stress in order to help us grow. I hope that this inspires you to find the edge of your comfort and breathe with it!


What is the Wim Hof technique?

  • Wim Hof has broken icy world records such as fastest barefoot half-marathon in the snow and is able to stay immersed in crushed ice for almost 2 hours (Muzick et al., 2018). His entire method includes cyclical breathwork practice, relaxation meditation, and cold exposure in an effort to create a more resilient body and mind both in and out of the cold.

  • Created by Wim Hof (a.k.a the Iceman) as a way to control his body’s response to extreme cold, this technique involves periods of hyperventilation followed by breath holding (Muzick et al., 2018).

  • Each round of breathwork consists of:

    • 30 full breaths at a fast pace

    • Fully exhaling the last breath and holding breath (lengthening the hold in each consecutive round)

    • Fully inhaling and holding breath again before starting the next round

  • Breakdown of the Wim Hof breathing technique:

  1. Hyperventilation leads to a quick drop in CO2 levels in the blood (hypocapnia)

  2. Breath holding (hypoventilation) leads to a drop in O2 levels (hypoxia)

How does Wim Hof battle with the cold?

  • Studies on monks practicing g-Tummo meditation showed 2 ways in which temperature perception was mediated: heat is generated by muscular contractions needed for forceful breathing and the perception of heat is increased through intense focus on internal sensations (Kozhevnikov et al., 2013). Wim Hof shows the same increases in heat from his intercostal muscles and meditation (Muzik et al., 2018).

  • In an fMRI study on Wim Hof during cold exposure, Musik et al. (2018) showed that Wim was able to activate areas of the brain influencing the perception of cold as well as higher brain areas involved in focus- findings which have been supported in other studies on meditation (Medlife Crisis, 2019). In this same study, when using his breathing method, Wim was able to maintain a steady skin temperature despite the fluctuations of the temperature controlled suit he was wearing.


Do other’s show the same effects? Or is Wim just superhuman?

  • In a study by Kox et al., (2014) after being injected by a bacterial endotoxin, the group that was trained in the Wim Hof Method (mediation, cold exposure, and the cyclical breathing techniques) resulted in more alkaline blood, and an increased epinephrine release leading to a reduction in the inflammatory response when compared to the control group. The authors of this study conclude that through these practices, humans have the ability to voluntarily influence their autonomic nervous systems which change immune system function. The authors wrote a follow up paper after this, describing how the mental attitudes and expectation of the method working (placebo) impacts the effects of this method!

  • Hyperventilation is well known to cause a lowering of the levels of CO2 in the blood, resulting in more alkaline blood. Some claims of this method state that these physiological changes remain long after the breathing session is over- however this is yet to be supported. The body aims to remain in homeostasis, and will employ mechanisms to bring your blood back to a regular pH fairly quickly (Medlife Crisis, 2019). 

  • There are claims that this method can increase brown adipose tissue (BAT) levels in the body, however this is not backed by evidence. BAT is the type of fat in the body that is used for heat production (non-shivering thermogenesis). Wim and his twin brother (who does not practice the WHM) show higher levels of BAT than the average individual, increasing cold tolerance. Studies do not suggest that this method changes BAT concentrations, though studies on mice show that brown adipose tissue does increase in response to repeated cold exposure (Medlife Crisis, 2019). 

Summary of the Benefits

In his video debunking myths on the WHM, Cardiologist Rohin Francis sums up the benefits based on level of scientific evidence. Here is his summary table:

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Caution!

This method can pose risks if practiced without the following considerations:

  • Do NOT practice the breathing technique while in water (for risk of drowning) or while standing. This is a hyperventilation/hypoventilation technique that may cause fainting, so practice in a safe environment away from hazards if you choose to do so. 

  • All of the risks that I mentioned in the cold plunge post are present here if you choose to practice cold exposure. Anyone with heart issues should consult a doctor before trying cold therapies- even doing this deep breathing in cold air. Don’t enter cold water alone- and definitely don’t jump into freezing water if you have never done a cold dip!

  • Progress slowly. Try the beginner’s breathing technique first. Try a short meditation. Then try a cold shower. You are not on anyone else’s time frame but your own.

My Experience:

As I began the beginner’s version of the technique, I found that the breathing rate was a bit higher than I am comfortable with. The breathing reminded me of how I breathe when I am beginning exercise- a bit quicker and deeper, but not yet out of breath. I felt a light sense of nervousness or anxiety with this faster breath, but in his video Wim Hof guides you through and gives you reassurance that you are safe*. The changes in body temperature are very interesting to note, and as someone who enjoys meditation and breathwork it gave me something very different than I am used to. I will be continuing to use this method for it’s short term effects and will look out for more research for potential long term effects as time goes on.

If you are wanting to try this technique, but find that the beginner’s breathing is still to fast for you at the moment, try simply raising your breathing rate in small increments at a time. Just to a level that you still feel in control, and progressively increase the rate. Your method doesn’t need to look exactly like Wim’s to receive the benefits of breathing! If you’d like to see how others practice, check out this post on how 6 different people incorporate these techniques into their lives:
https://www.wimhofmethod.com/blog/tips-to-develop-your-own-wim-hof-method-practice


*If you choose to try this technique for the first time, I would highly recommend that you practice either seated or lying down in case you get too lightheaded. The seat gave me a sense of comfort and support in knowing that it was there to catch me should anything go wrong. Also, if you are experiencing high levels of anxiety this may not be the breathing method for you. 

References

  1. Kox, M., Eijk, L. T. G. J. v., Zwaag, J., Wildenberg, J. v. d., Sweep, C. G. J., Hoeven, J. G. v. d., & Pickkers, P. (2014). Voluntary activation of the sympathetic nervous system and attenuation of the innate immune response in humans. Proceedings of the National Academy of Sciences - PNAS, 111(20), 7379-7384. https://doi.org/10.1073/pnas.1322174111

  2. Medlife Crisis. (2019, June 27). Doctor Dissects the Wim Hof Method - Cold Hard Science Analysis [Video]. YouTube. https://www.youtube.com/watch?v=D6EPuUdIC1E

  3. Muzik, O., Reilly, K. T., & Diwadkar, V. A. (2018). “Brain over body”–A study on the willful regulation of autonomic function during cold exposure. NeuroImage (Orlando, Fla.), 172, 632-641. https://doi.org/10.1016/j.neuroimage.2018.01.067

  4. Kozhevnikov, M., Elliott, J., Shephard, J., & Gramann, K. (2013). Neurocognitive and somatic components of temperature increases during g-tummo meditation: legend and reality. PloS one, 8(3), e58244. https://doi.org/10.1371/journal.pone.0058244

  5. Wim Hof. (2020, April 10). Wim Hof Method Guided Breathing for Beginners (3 Rounds Slow Pace) [Video]. Youtube. https://www.youtube.com/watch?v=0BNejY1e9ik



Join Our Team!

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Employer: MOVE Adapted Fitness and Rehabilitation Society of BC

Address: 100-775 Topaz Ave, Victoria BC. V8T 4Z7

Contact: Alannah Verville  - Executive Director 

Ph: 778-433-6559

Email: moveadaptedfitness@gmail.com

Website: moveadaptedfitness.ca 

Position: Assistant Program Coordinator

Period: July 5, 2021 - August 28, 2021(8 weeks)

 **This position is funded through the Canada Summer Jobs grant as a training position, MOVE hopes to extend this contract into a long term coordinator position once the 8 weeks have been completed**

Hours: 35 hours/ week 

  • Tuesday, Wednesday, Thursday 945 am - 5 pm

  • Friday, Saturday 930 am - 415 pm

Wage: $16.75/hour

Job Description 

MOVE is a non-profit rehabilitation facility for those with Neurological impairments. We are dedicated to making physical activity accessible for all members of our community who need assistance reaching their mobility goals. Our commitment to decrease physical and financial barriers is demonstrated through our provision of specialized equipment, trained support, and affordable services. The successful applicant will be responsible for day-to-day operations of the gym, administration, and supporting members with their exercise programs. Additional responsibilities include exercise program development, volunteer recruitment/training, and assisting with fundraising efforts.The assistant program coordinator will directly support  the Program and Volunteer Coordinator in clientele scheduling, conducting initial assessments, and one-on-one sessions. The ideal candidate will be able to foster a supportive, inclusive community for all of MOVEs members and volunteers. 

Qualifications

  • Successful applicant required to do a criminal record check.

  • Must have a degree in Kinesiology, Athletic Therapy or Exercise Science.

  • Current certification as an Athletic Therapist, Kinesiologist or CSEP-CEP.

  • Valid Emergency First Aid and CPR-C certification.

Relevant Skills/ Experience

  • Experience with physical therapy, fitness, or personal training.

  • Experience working with individuals with physical disabilities.

  • Confident working independently or with a team.

  • Planning skills including coordination for assessments, orientations and special events/fundraising.

  • Organizational skills including scheduling, document creation, data entry, charting and filing.

  • Managing volunteers including orientation, training, communication, and delegation of tasks.

  • Communication skills including responding to inquiries professionally in a timely fashion, and following up as needed.

  • Computer skills including Microsoft Office programs, Google email calendar etc.

  • Experience using scheduling software Jane App  is an asset but not required. 

Please send a cover letter and resume to moveadaptedfitness@gmail.com (Attention Alannah). While we appreciate the time and effort it takes to submit an application only those who qualify will be contacted for an interview. Deadline to apply is June 20, 2021. 



Find the Miraculous in the Mundane

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The Beauty of Qi Gong

Written by Marissa Hoen | May 1 2021

At this point, we probably all know the importance of physical activity in our general health and well-being. We know there are lots of things we should do for our health, but oftentimes we find that these aren’t the things we want to do. Until we can create a healthier attitude around physical activity, either the exercise will just be avoided or dreaded! As someone who finds so much happiness in my different activities, one of my missions is to help others find this simple happiness too.

It is so important that each of us find at least one movement that gives us joy. The choices of movement styles are endless and if you are willing to experience the joys and challenges of being a beginner, you’ve got a lot to look forward to. Today I want to give you another option, an option that fills me with joy (and not just because it has research to support it!) and one that I am a complete beginner in- that option is Qi Gong. 

What is Qi Gong?

Directly translated, qi means energy and gong means work. Qi Gong can be thought of as energy work or breath work. There are many different types of qigong including soft (healing), hard (used for preparation in martial arts), medical, and Buddhist or Taoist (Chand, 2017). Check out Jeffrey Chand’s video for a deeper introduction to the practice of qigong: http://www.acupuncturevictoriabc.com/qi-gong/

Brief History

  • Some legends claim that in the 5th century Qi Gong was introduced by the monk Da Mo from India, who wanted to improve the physical health of Chinese buddhist monks (Chand, 2017). 

  • However, throughout ancient Chinese history (4th century BCE and on) there have been many written recordings of different movement forms in coordination with the breath/energy flow that are now known as Qi Gong (Deadman, 2014). 

  • These practices were used to improve life force energy, improve breathing, and extend the lifespan. Without movement, breathwork, and the alignment of mind and emotions, it is thought that the qi will stagnate and the individual will be more prone to sickness (Deadman, 2014). 


What does the research say?

There are many claims to the great effects that regular qigong can have on a person’s life, but let’s look into which claims are supported by research!   

  • Evidence from many studies suggest qigong improves cardiovascular function, balance, lung function, joint mobility, exercise capacity, muscular strength, and cognitive function (Zhang et al., 2020)! Also helps to reduce pain!

  • Shown to decrease depression and number of falls in those with Parkinson’s Disease (Kamieniarz et al., 2021)

  • One month of qigong was found to improve mood and subjective sleep duration, as well as decrease symptoms of anxiety and depression (Manzaneque, 2009)

  • Shown to improve quality of life and reduce fatigue in those with various forms of Cancer, while also improving immune function and mediating the inflammatory response (Klein et al., 2016).

  • After 12 weeks of a qigong intervention, participants with elevated blood sugar levels showed reduced weight, reduced waist circumference, improved leg strength, and improved insulin resistance (Liu et al., 2011)

As you can see, there are many reasons to try out qigong! If you are interested, I have linked some resources below so that you can get started right away. 


Resources to connect with Qi Gong here in Victoria:


If you’d like to get started with live classes you have options!

  • Classes are offered via zoom and in person (maintaining distancing guidelines) at Willows Beach and Mount Doug Park

  • There are also daily morning qigong lessons at 830 am (except wednesdays) for anyone who is keen!

  • Click on the link for more information: https://victoriaqigong.wordpress.com/schedule/

If you would prefer to start with youtube videos:

  • Jeffrey Chand (TCM Practitioner, Acupuncturist, and Qi Gong teacher) has shared many qigong videos on his youtube channel: https://www.youtube.com/c/ThinkVitalityQiGong/videos

  • There are many options for seated qigong as well, simply search youtube for ‘seated qigong’ and try it out! If at first you don’t enjoy the instructor, keep up your search until you find someone you click with. 


My Experience

In my limited experience thus far with qigong, I have found the practice very grounding and enjoyable. The breathwork helps to clear my mind and improve my digestion, and the self massage helps to reduce tension! This practice is opening my eyes to the beauty inherent in our daily lives. Reading about the history of qigong in Deadman’s paper was fascinating, as he explored qigong through the ages, and the real goal behind these practices. In his paper, he shared a quote from Dr. Fei Boxiong which illuminates the magic of this practice: “There exist no miraculous methods in the world, only plain ones, and the perfection of the plain is miraculous”.  If you take anything from this post, I hope you open yourself to trying new things and become aware of the miraculous in the mundane.


References

  1. Chand, J. (2017, January 31). Qi Gong Victoria BC. Coastal Acupuncture and Wellness. http://www.acupuncturevictoriabc.com/qi-gong/. 

  2. Deadman, P. (2014). A brief history of qigong. The Journal of Chinese Medicine, (105), 5.

  3. Kamieniarz, A., Milert, A., Grzybowska-Ganszczyk, D., Opara, J., & Juras, G. (2021). Tai chi and qi gong therapies as a complementary treatment in Parkinson’s disease – a systematic review. Complementary Therapies in Medicine, 56, 102589-102589. https://doi.org/10.1016/j.ctim.2020.102589


  4. Klein, P. J., Schneider, R., & Rhoads, C. J. (2016). Qigong in cancer care: A systematic review and construct analysis of effective qigong therapy. Supportive Care in Cancer, 24(7), 3209-3222. https://doi.org/10.1007/s00520-016-3201-7

  5. Liu, X., Miller, Y. D., Burton, N. W., Chang, J., & Brown, W. J. (2011). Qi-gong mind-body therapy and diabetes control. A randomized controlled trial. American Journal of Preventive Medicine, 41(2), 152-158. https://doi.org/10.1016/j.amepre.2011.04.007


  6. Manzaneque, J. M., Vera, F. M., Rodriguez, F. M., Garcia, G. J., Leyva, L., & Blanca, M. J. (2009). Serum cytokines, mood and sleep after a qigong program: Is qigong an effective psychobiological tool? Journal of Health Psychology, 14(1), 60-67. https://doi.org/10.1177/1359105308097946


  7. Zhang, Y., Hu, R., Han, M., Lai, B., Liang, S., Chen, B., Robinson, N., Chen, K., & Liu, J. (2020). Evidence base of clinical studies on qi gong: A bibliometric analysis. Complementary Therapies in Medicine, 50, 102392-102392. https://doi.org/10.1016/j.ctim.2020.102392

How Sunlight and Light Therapy can impact our Lives

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Written by Marissa Hoen | April 14 2021

If you’ve ever worked with me at MOVE on a sunny day, you’ve probably heard my motto, “Nothing can get me down on a day like this!” I have noticed both in myself and in those around me that the sunlight hours can change our attitudes for the better. As spring has arrived, we can all feel the effects of the sun more regularly showing its face. 

Despite living in one of Canada’s sunniest areas, in Victoria we see a lot of gray a lot of the time. Especially through the winter season, this can lead us to feel more sluggish, sad, and not quite ourselves. Those that experience seasonal affective disorder, or SAD, feel symptoms of depression and fatigue during the winter months, often peaking in the spring (Kent et al., 2009). As I too have felt my moods change with the season, I wanted to try light therapy to see what all the hype was about! A few weeks ago I had my very first session of Light Therapy with Maggie Calder. I left feeling lighter and happier with a want to understand a bit more about why light is so important for us humans.   

Benefits of sunlight exposure 

(Razzaque, 2018; Lam et al., 2006; Kent et al., 2009):

  • stimulates production of Vitamin D*

  • decreases blood pressure

  • improves mood 

  • helps to regulate circadian rhythms (to improve sleep)

  • improves cognition in those with depression

*UVB radiation stimulates vitamin D formation in the skin. It should be noted that UVB radiation can’t penetrate glass, so don’t count on sitting next to a glass window for your vitamin D! It is believed by experts that sun exposure for about 30 mins 2 days per week on the face, arms, legs, or back without sunscreen can stimulate adequate Vit D production for our needs- however there are many other variables such as season, latitude, suncreen that influence Vit D production 

What about Light Therapy?

Now that we are nearing summertime, exposure to sunlight is not something that needs to be actively sought out (unless your work/lifestyle has you spending most of your time indoors). On the other hand, when it reaches fall and winter, light therapy may be of interest to all those who are influenced by the seasons. Light therapy has many different forms, as the wavelength of light emitted from different devices varies. Bright light therapy has been shown to improve mood and behavior in people with mild traumatic brain injuries, as well as the integrity of the white matter of their brains (Bajaj, Alkozei, & Killgore, 2017)!

While there is still more research needed to make definitive claims about the effectiveness of specific light sources and their impact on our brains, I found a very interesting study that compared the effects of light therapy to an antidepressant drug (fluoxetine) to treat the symptoms of seasonal affective disorder (SAD) in Canadians (Lam et al., 2006). After 8 weeks of daily exposure, both treatments had the same overall effectiveness, however the light therapy showed quicker improvements with fewer adverse reactions. 


My Experience

Prior to my appointment with Maggie I had not looked into this research, so I entered the room with a clear mind and low expectations. After discussing brainwaves and the treatment specifics, I laid down on the massage table with a weighted blanket and headphones playing incredibly relaxing sounds. Infrared lights were placed beneath my back, warming both me and my fascia! Then the light show began. With eyes closed, a bright white light flashed above me. At first, I began to have thoughts about what the heck I was doing, and why! But then I chose to listen to Maggie’s advice of breathing, not trying to pinpoint shapes in the light, and allowing myself to relax and simply absorb the light. After a minute, I started to feel greatly relaxed. The warmth, the light, and the music all worked in harmony to create an experience that reminded me most of being beneath the waves on a sunny day in Hawaii. When the light therapy was complete, I felt as though I had just finished an incredible meditation. My mind was clear, my body felt relaxed and pain-free, and I just felt all around more positive towards life.   

Take Home Tips

After the treatment, Maggie shared with me three tips that would help to put my brain into a similar state as the light therapy:

  1. Sit under a tree and look up at the light shining through the leaves. The light passing through the leaves has its own rhythm that she says stimulates certain waves in the brain that leave us feeling lighter and more connected.

  2. Feel gratitude. Feelings of true thankfulness and gratitude have been shown to activate many brain areas, leaving you with a sense of deep joy and safeness.

  3. Change up your morning routine. This doesn’t have to be complicated! Maggie suggested to simply change the order of the morning do’s. For example, if you wake up and immediately look at your phone, go to the bathroom, brush teeth, instead try to flip the order of those activities! This slight readjustment to the morning habits creates a sense of newness to your day that may help you change perspectives and your brainwaves!

References



Bajaj, S., Alkozei, A., & Killgore, W. (2017). 651. effect of bright light therapy on white matter abnormalities following a mild traumatic brain injury. Biological Psychiatry (1969), 81(10), S264-S264. https://doi.org/10.1016/j.biopsych.2017.02.1060

Kent, S. T., McClure, L. A., Crosson, W. L., Arnett, D. K., Wadley, V. G., & Sathiakumar, N. (2009). Effect of sunlight exposure on cognitive function among depressed and non-depressed participants: A REGARDS cross-sectional study. Environmental Health, 8(1), 34-34. https://doi.org/10.1186/1476-069X-8-34

Razzaque, M. S. (2018). Sunlight exposure: Do health benefits outweigh harm? The Journal of Steroid Biochemistry and Molecular Biology, 175, 44-48. https://doi.org/10.1016/j.jsbmb.2016.09.004

Lam, R. W., Levitt, A. J., Levitan, R. D., Enns, M. W., Morehouse, R., Michalak, E. E., & Tam, E. M. (2006). The can-SAD study: A randomized controlled trial of the effectiveness of light therapy and fluoxetine in patients with winter seasonal affective disorder. The American Journal of Psychiatry, 163(5), 805-812. https://doi.org/10.1176/ajp.2006.163.5.805



Overcoming Mental Obstacles and Taking Control of your Workouts

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Written by Marissa Hoen | March 29 2021

You may find it surprising that as a 4th year Kinesiology student, a Registered Massage Therapist, and someone who absolutely LOVES movement, I still find it challenging to stay consistent in a workout routine. COVID changed the gym scene, ending drop-ins and beginning a period of appointments and limited time in the gym. Before this time I found it so much easier to stay consistent because I had my gym, I could show up the minute I had an ounce of motivation, and I didn’t worry about how my gym could potentially expose me and my close contacts to COVID. It has now been over a year since beginning these changes, and now I feel ready to get back into consistent training. I feel ready to take control of my workouts and reach my goals- who’s with me?!  

 

Let’s start by focusing on what we can do to take back control of an aspect of our lives that will make us feel empowered, strong, and able to take on what life has to throw at us. Let’s address the obstacles to our consistency, leave our excuses at home (or push them out the door) and focus on simple steps we actually have control of. 

  1. Make a list of all of the things that are holding you back from getting in that workout. Seeing them all written out, can you identify which obstacles are mental/emotional, physical, financial, etc. Different barriers require different solutions, some simpler than others. The obstacles that we can alter here and now are the mental barriers. These aren’t easy to overcome, as you may have deep beliefs that lead you to think a certain way. When you become aware of your thoughts around exercise, you have the ability to address them and change them.

  2. Find movements you actually enjoy! There are so many ways to get in a great workout. Whether it be dancing, hiking, or weight lifting, there is a movement out there that will make you excited (or at least it will make the time fly!). If you haven’t found your movement yet, don’t give up! Anyone reading this has access to the internet- a portal that shows you all kinds of movement, you just have to search for it!

  3. Once you’ve found your movement, schedule it in! When you accept that exercise is just a part of life, a non-negotiable to being a human, you’ll need to make some time for it. One of the greatest excuses is the infamous lack of time. I totally understand that people have different levels of responsibility which take a great amount of time away from their own self-care. For people who truly feel like they don’t have time, go back to step 1 and see if there is any way you can find barriers related to time that aren’t really necessary (or that you can delegate to someone else). It may take some creativity and a reorganization of plans to create a more sustainable schedule that promotes your health!

  4. On the flip side, try to be open to changes in the plan. It’s morning time and you wake up an hour late because your phone died or you had a really bad sleep that night or your sister called and needed to vent during your scheduled workout time. It happens. Life happens. Sometimes I get so pumped on a consistent morning workout, that when I wake up late I feel like I’ve already messed up. This is when schedules should be broken! If there is still time in the day (and you aren’t sick/injured and need to take a day off), get on with that workout! Be aware of the thoughts that are holding you back, bid them adieu, and get moving!

  5. Get an accountability partner! It’s hard to workout consistently without a little help from a friend. Maybe you ask your brother to text you daily, asking how your workout went. Or maybe you don’t really know where to start with your workout, and instead you join MOVE, have a program created for you, and have members all around that can cheer you on. 



The challenges in becoming consistent in our workout routines and in progressing these plans are endless. Many of these challenges however, are mental excuses that we create and perpetuate ourselves. Sometimes these excuses become emotionally tied to us, leading us to believe that we can’t do it. Avoiding the gym to lower your risk of COVID is not what I’m talking about here. That is a rational step to take during this time. The excuses I’m talking about sound something like, “I can’t do any exercise because I don’t have the same equipment that they do in the gym” or “I just don’t have time to exercise” or “I’m just not the type of person who works out”. These are examples of limitations that are created by the mind, holding you back from feeling the benefits of pushing through a workout and reaching your goals. 

Taking control of your workouts doesn’t mean you have to do it all alone. Greater enjoyment (and retention) comes from exercising with a friend or in a community. To take control means to own our part in the training process. We need to show ourselves that we can commit and recommit to our goals each day. We are worth it! 


Image credit can be found here: https://www.vectorstock.com/royalty-free-vector/mission-possible-rubber-stamp-vector-11853163

How vision can be used in balance and skill training!

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Written by Marissa Hoen | March 16 2021


With more than 50% of the brain’s surface involved in vision processing, the visual system is obviously complex. In this past semester at UVic, I’ve been taking a course that has us diving into the nitty gritty of the visual system and how we understand what goes on in the world around us by deciphering the light that enters the eye. Beyond the numerous thoughts about how and why we have eyes in the first place, this class has had me thinking: how can we use (or neglect) vision to improve our movement?

If you’ve ever tried balancing with your eyes closed, you’ve probably felt just how important vision is to your balance. Sometimes when I’m practicing my balance, I close my eyes and all of a sudden I’m sideways, and my body starts wobbling all over the place in an attempt to rebalance. As I start to fall I open my eyes and regain balance almost immediately! This reliance on vision is quite evident in most people who try balancing with their eyes closed, and has been reported in several studies (Paul, 2014; Dhoriyani, 2013).

Testing Balance with Visual Deprivation

After 4 weeks of balance training in participants who have had strokes, the group who practiced with eye masks showed greater balance improvements than those who practiced with free vision (Paul, 2014). This highlights the importance of training other systems involved in balance to reach ideal balance gains. 

Balance is a two way street- the brain requires incoming sensory input to respond with proper neuromuscular output! Input comes from several sources:

  • Proprioceptors (or position detectors) around the joint and in the muscles and tendons

  • Vestibular system located in the inner ear, this system gives the brain feedback on the orientation of the head relative to the ground

  • Visual system involves eyes, muscles, and many brain areas to integrate information on orientation and position of our own bodies as well as identification of objects in our environment

When we limit visual input by closing our eyes, we are challenging proprioceptive and vestibular systems which improve function with training. Where there is challenge, there is growth!

In a study by Yang and Liu (2020), participants with MS were found to have greater balance difficulties with both eyes closed than in participants without MS. They also found that both groups relied more on proprioceptive cues than vision to maintain balance. When taking into account neurological challenges however, one size does not fit all. For example, though visual impairments are common for those with MS, they are not always present. An individual may have MS in the proprioceptive pathway and thereby have an increased reliance on vision for their balance.  

So are you saying I should keep my eyes closed during my workout?

Not quite! If you are looking to solely increase your balance, there is evidence that supports visionless training. However, there are studies that promote the efficacy of augmented visual training (eyes open training with visual cues from a coach), specifically in those with Parkinson’s Disease in decreasing related symptoms and improving motor performance (Kearney et al., 2019). If you are training to make your daily life activities easier, then you should train task-specific exercises and utilize any sensory feedback you have (eyes open, look where you are going, be aware of body sensations). When this becomes easier and you are in a safe environment, you can try taking out vision and testing your spatial memory, proprioception, and balance. 

Key Takeaways:

  • When you’re a beginner with a certain movement, visual cues can help you better learn that movement and may increase your performance after you’ve learned that skill. 

  • Adding vision-less balance practicing to your workout can help to improve balance greater than eyes-open practice. 

  • Try it all! Come in to MOVE and use the parallel bars for a safe way to practice balance and movements skills with or without vision!


References

Dhoriyani, N. B., Patel, F. B., Smitha, D., Kagathra, S., & Bhatt, K. (2013). A comparative study
of effectiveness of balance training with and without visual cues on activities of daily living in stroke patients. Indian Journal of Physiotherapy and Occupational Therapy, 7(3), 285-290. https://doi.org/10.5958/j.0973-5674.7.3.109

Kearney, E., Shellikeri, S., Martino, R., & Yunusova, Y. (2019). Augmented visual feedback-aided interventions for motor rehabilitation in parkinson's disease: A systematic review. Disability and Rehabilitation, 41(9), 995-1011. https://doi.org/10.1080/09638288.2017.1419292

Paul, J. (2014). Comparative effect of vision deprived balance training over free vision balance training among stroke subjects. International Journal of Physiotherapy, 1(2), 46-53.


Yang, F., & Liu, X. (2020). Relative importance of vision and proprioception in maintaining standing balance in people with multiple sclerosis. Multiple sclerosis and related disorders, 39, 101901.

Image credit: https://depositphotos.com/stock-photos/cartoon-eyes.html

Sleep and your Circadian Rhythm

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Written by Marissa Hoen | March 1 2021


Over the past few years of my undergraduate degree, I’ve had an increasing awareness of the sleep deprivation that roams the halls (yes even in the halls of the Health Sciences buildings!). The sarcastic phrase “What’s sleep?” still rings through my ears. We all know that sleep is essential for our physical, cognitive, and emotional wellbeing. We can feel this when we don’t get a good night's sleep- the next day can be a challenge to say the least. Then we try to amp ourselves up with caffeine or sugar, only to find short term energy gains and more difficulty sleeping. 

  In a recent seminar on circadian rhythms and sleep by some of my colleagues at UVic, I was reminded of the importance that sleep plays in our recovery from exercise and have been inspired to implement some tools to improve my sleep hygiene. In order to help improve our sleep, it can be helpful to know some of the basics.

What’s a circadian rhythm?

Often described as the body’s clock, an area of the brain called the suprachiasmatic nucleus (SCN) controls cycles of sleep, wakefulness, hormone release, and core body temperature. This circadian rhythm normally cycles every 24 hours, but is highly dependent on the light cycles in your environment. Light (especially blue light emitted from our tech) has been shown to greatly suppress melatonin production, moreso at night, making it more difficult to fall asleep. Here is an example of a general circadian rhythm, which can be shifted by your work schedule, food timing, food type, stress, pain, and more (Sack et al., 2007).

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Image: https://www.liveli.com/blogs/the-wave/circadianrhythm

In his TED talk, Matt Walker (Doctor and author of Why We Sleep) shares the many benefits of sleep, as well as the detrimental effects when we don’t get enough. He not only calls sleep your “superpower”, but also “the most powerful elixir of life”- when put like that, who wouldn’t want to head straight to bed?.


What are some of the benefits of regular 8 hour sleep?

Studies showing the benefits of regular sleep are often done by comparing performance outcomes or brain activity of a well-rested group or individual compared to individuals with varying degrees of sleep deprivation. In review articles and studies ((Kuula et al., 2017; Chandrasekaran, 2020; Walker, 2019), these well rested individuals showed:

  • Improved learning and memory

  • Improved executive functions (decision making, planning, attention)

  • Improved Immune function

  • Better muscular performance 

  • Better mood and quality of life


What are some ways to improve my sleep?*


If you aren’t already getting around 8 hours of sleep consistently, here are some evidence based tips (Chandrasekaran, 2020; Walker, 2019) that will help you fine tune your circadian rhythm and get a better night’s sleep:

  • Regularity- go to bed and wake up at the same time every day

  • Keep your room cool

  • Avoid caffeine, alcohol, or smoking late at night

  • Limit screen time before bed

  • Make your bedroom your place of sleep, so your brain associates the room with rest

  • Leave the room if you can’t fall asleep

*If you have issues with sleeping that are related to chronic pain, working with a healthcare team to help you with pain management will help you fall asleep, stay asleep, and have longer sleeps (allowing you to enter deeper stages of sleep), which in turn helps to further reduce pain. If you have insomnia, Walker recommends that you avoid naps throughout the day. 

References

Chandrasekaran, B., Fernandes, S., & Davis, F. (2020). Science of sleep and sports performance–a scoping review. Science & Sports, 35(1), 3-11.

Kuula, L., Pesonen, A. K., Heinonen, K., Kajantie, E., Eriksson, J. G., Andersson, S., ... & Räikkönen, K. (2018). Naturally occurring circadian rhythm and sleep duration are related to executive functions in early adulthood. Journal of sleep research, 27(1), 113-119

Sack, R. L., Auckley, D., Auger, R. R., Carskadon, M. A., Wright Jr, K. P., Vitiello, M. V., & Zhdanova, I. V. (2007). Circadian rhythm sleep disorders: part I, basic principles, shift work and jet lag disorders. Sleep, 30(11), 1460-1483.

Walker, M. (2019). Sleep is your superpower. [Video]. TED Conferences, ted.com/talks/matt_walker_sleep_is_your_superpower?language=en#t-1144955

Image credit: https://www.vectorstock.com/royalty-free-vector/blue-cartoon-face-with-sleepy-expression-vector-9419285

Benefits of Massage Therapy

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**Marissa has been a huge supporter of MOVE for many years now, we are so excited to announce she will also be joining the Neuromotion Physiotherapy team as a registered massage therapist. If you have any questions about massage therapy or would like to book a session, contact them at victoria@neuromotionphysio.com!


Written by Marissa Hoen | February 17 2021

As a practicing registered massage therapist (RMT), I have seen people with a wide variety of conditions find relief through massage. There are those who come in for a tune up- to relax and discover where they hold tension, and there are also those with pain- seeking help to find the cause or relief of an already diagnosed condition. In this post I hope to clarify when you would go to see an RMT, and what we can actually do for you!



Massage helps your body heal itself

 I like to compare a massage treatment to exercise: just one workout probably isn’t going to change your life (though it’s entirely possible!). While one workout can make us feel empowered, motivated, and give us a lovely endorphin rush, it is when we become consistent in our physical activity that we really start reaping the benefits. This is also true when using massage as a treatment for a specific condition. Only when treated consistently and effectively can one find long-term relief through massage*. In my experience, the greatest impact that I’ve seen in my clients is when they apply what they’ve learned in treatment to their day to day- whether that be changing their desk set-up, breathing with the diaphragm, or doing those lunges!   

*Certain conditions, such as headaches caused by muscular tension, can be greatly improved by just one treatment, however if the predisposing factors are not addressed the condition is likely to return.



What are some of the benefits of massage?

  • Decrease stress- on a physiological level. Even just 7 minutes of hand massage was shown to decrease cortisol and promote feelings of relaxation and safeness (Maratos, 2017).

  • Decrease pain and improve function. Studies show improvements in musculoskeletal pain (specifically low back, shoulder, and knee arthritis) and function following massage therapy treatments, though in most cases the effects are not long lasting (Bervoets et al., 2015). Combining exercise and massage has been shown to be more effective than massage alone for low back pain (Joseph et al., 2018). Neurological pain and function related to MS, Parkinson’s, or Stroke can also be improved through gentle massage (Backus et al., 2016; Angelopoulou et al., 2020).

  • Increase blood flow-   Depth of massage will affect the amount of blood to different tissue types. Certain conditions, such as chronic tendinopathies, benefit from increased blood flow to speed the healing process.

  • Reduce swelling- Joint swelling can be reduced through methods targeted to improve lymphatic flow (Goats 1994). Manual lymph drainage is used by many practitioners, though some are more highly trained in this method than others!

  • Reduces muscle bulk loss in those with nerve injuries (Goats 1994)- this ties back into the increase in blood flow. If your muscles don’t respond to your internal signals, external stimulation in the form of massage can help to keep muscles healthy.

  • Decrease spasticity. Massage has been shown to decrease spasticity in people who have had a stroke (Thanakiatpinyo et al., 2014), those with spastic cerebral palsy (Mahmood et al., 2019; Hernandex-Reif et al., 2005). The effect of massage on MS-related spasticity is not yet clear, as some studies report no changes in spasticity after treatment- despite the improvements in fatigue and pain (Backus et al., 2016).



If I have chronic pain, why see an RMT?

Certain clients with chronic pain find that after a treatment they have more mobility and energy to try movements I’ve suggested. Beyond this, my clients find that they are more thoughtful about their movement habits and if they know that they have another appointment soon, they are more likely to move their bodies in ways that support their condition. As RMTs, we have a great amount of one-on-one time to ensure you receive the treatment you need as well as address certain areas of daily life that may be worsening symptoms. Pain is complex, and is influenced by emotional states, physical activity, repetitive strains, thought patterns, and more. As an RMT, my goal is to listen, apply my knowledge, and provide my clients with support- so they know they are not alone. We are a team with a common goal: to get you feeling better, moving more (or less if you’re overdoing it!), and to allow your body to heal. Though massage can’t cure these chronic conditions, in our treatments you will learn ways to understand and work with your body. 

In summary, what you take out of the treatment room is just as important as what happens in it. I hope each of my clients leaves the treatment with:

  • Stress reduction techniques 

  • Movements specific to them 

  • Feelings of support

  • Enjoyment of a time dedicated to relaxation, a time that is just for them!

Resources:

If the financial aspect of massage therapy is holding you back from booking an appointment, the West Coast College of Massage Therapy has a student clinic with 45 minute treatments for $40. By going to this college, you are both helping a student become a better future practitioner and receiving a safe and relaxing treatment. They also offer a discount to seniors over 65 and active military members. As this is a student clinic, supervisors (RMTs) may come into the treatment room to observe and give advice to the students. Here is a link to their website: https://collegeofmassage.com/victoria/clinic/book-appointment/

If this price is still a barrier, self-massage or massage by a friend is a great starting point. Check out youtube for some basic neck and shoulders massage, or join my yoga class on saturday mornings where we do lots of self-care and massage. You don’t need to be treated by a trained professional to feel the emotional benefits of a massage. (For more specific conditions and to ensure safety however, I would highly recommend booking with an RMT.)


References

Angelopoulou, E., Anagnostouli, M., Chrousos, G. P., & Bougea, A. (2020). Massage therapy as a complementary treatment for Parkinson’s disease: A systematic literature review. Complementary Therapies in Medicine, 49, 102340-102340. https://doi.org/10.1016/j.ctim.2020.102340


Bervoets, D. C., Luijsterburg, P. A., Alessie, J. J., Buijs, M. J., & Verhagen, A. P. (2015). Massage therapy has short-term benefits for people with common musculoskeletal disorders compared to no treatment: A systematic review. Journal of Physiotherapy, 61(3), 106-116. https://doi.org/10.1016/j.jphys.2015.05.018

Goats G. C. (1994). Massage--the scientific basis of an ancient art: Part 2. Physiological and therapeutic effects. British journal of sports medicine, 28(3), 153–156. https://doi.org/10.1136/bjsm.28.3.153

Schroeder, B., Doig, J., & Premkumar, K. (2014). The effects of massage therapy on multiple sclerosis patients’ quality of life and leg function. Evidence-Based Complementary and Alternative Medicine, 640916-8. https://doi.org/10.1155/2014/640916

Sefton, J. M., Yarar, C., Carpenter, D. M., & Berry, J. W. (2011). Physiological and clinical changes after therapeutic massage of the neck and shoulders. Manual Therapy, 16(5), 487-494. https://doi.org/10.1016/j.math.2011.04.002

  • Increase neck ROM after therapeutic massage

  • Decrease EMG activity during MVIC after massage


Mahmood, Q., Habibullah, S., & Babur, M. N. (2019). Potential effects of traditional massage on spasticity and gross motor function in children with spastic cerebral palsy: A randomized controlled trial. Pakistan Journal of Medical Sciences, 35(5), 1210-1215. https://doi.org/10.12669/pjms.35.5.478



Maratos, F. A., Duarte, J., Barnes, C., McEwan, K., Sheffield, D., & Gilbert, P. (2017). The physiological and emotional effects of touch: Assessing a hand-massage intervention with high self-critics. Psychiatry Research, 250, 221-227. https://doi.org/10.1016/j.psychres.2017.01.066

  • Those who underwent hand massage had a greater reduction in the chemical indicators of stress*? Than those who participated in a compassion course. 

  • Evidence shows that massage can decrease stress by:

    • Decreasing sympathetic nervous system stimulation

    • Decreasing hypothalamic-pituitary adrenocortical (HPA) activity

    • “Indeed, given its potential to deactivate physiological and neurological systems associated with threat, touch may offer a means by which to calm and relax clients prior to the introduction of emotion/affiliative based therapies.”

    • This study took samples of saliva (salivary alpha amylase sAA, a marker of SNS activity; and salivary cortisol, marker of HPA activity) and a wellbeing questionnaire before and after interventions. The interventions included hand massage or a haptic control group(limitations: no control group, instead a crossover design).

Hernandez-Reif, M., Field, T., Largie, S., Diego, M., Manigat, N., Seoanes, J., & Bornstein, J. (2005). Cerebral palsy symptoms in children decreased following massage therapy. Early Child Development and Care, 175(5), 445-456. https://doi.org/10.1080/0300443042000230546

Joseph, L. H., Hancharoenkul, B., Sitilertpisan, P., Pirunsan, U., & Paungmali, A. (2018). Effects of massage as a combination therapy with lumbopelvic stability exercises as compared to standard massage therapy in low back pain: A randomized cross-over study. International Journal of Therapeutic Massage & Bodywork, 11(4), 16-22. https://doi.org/10.3822/ijtmb.v11i4.413

Thanakiatpinyo, T., Suwannatrai, S., Suwannatrai, U., Khumkaew, P., Wiwattamongkol, D., Vannabhum, M., Pianmanakit, S., & Kuptniratsaikul, V. (2014). The efficacy of traditional thai massage in decreasing spasticity in elderly stroke patients. Clinical Interventions in Aging, 9, 1311-1319. https://doi.org/10.2147/CIA.S66416



Risks and Benefits of Cold Water Immersion

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Written by Marissa Hoen | February 3 2021


Growing up in Hawaii, you can probably guess that I spent a fair amount of time in the ocean. As its temperature only ranges from about 21-28℃ (71-83 ℉) year round1, this part of the Pacific Ocean is so inviting that you may find yourself floating for hours. Here in Victoria, it’s a different story. The waters surrounding our southern coast range from about 6-12℃ (43-54℉)- cold no matter the time of year! This water is actively avoided by the majority of us, (and should be avoided for anyone with heart conditions), so why are we seeing so many people taking the cold plunge? Why did I just take the plunge?



Why cold water immersion?

After seeing a group of toqued heads floating at Willows Beach about a month ago, I wanted to dive deeper into why they would plunge, and if it was actually a safe activity at these bitter cold temperatures. In her blog post on this topic, Athena McKenzie talks with a few regular Victoria cold-dippers- check out the link in the references to uncover the ‘why’ behind their daily plunges2. Whether it be pain relief, social times, self-care or meditation, there are many reasons why people in our community choose to take the dip. Besides the fact that I just really missed being in the ocean, I chose to try out this cold experiment to show myself that I can endure the uncomfortable and take control of my response to stress.

What are the risks? Can I jump in the ocean tomorrow?

As I had never really experienced cold water before, I was worried that my body may react poorly to this exposure. In order to know if the benefits were worth the risks, I needed to know what those risks really were, and how to minimize the risks as much as possible. So first things first: what does the research say? 


Risks3:

  • Cardiac Arrest

  • Upon initial whole body immersion, if the swimmer dunks their head in or a wave splashes their face, a dangerous activation of both the sympathetic and parasympathetic nervous system can occur, causing heart arrhythmias which can lead to fainting or sudden death. Factors that may lead to this reaction to cold immersion include: holding your breath upon initial immersion, long QT syndrome, heart disease, and myocardial hypertrophy. Reducing this risk means getting your heart checked out, slowly entering cold water, exhaling slowly as you enter, beginning with a temperature you can handle, and have someone with you in case of emergency.

  • Drowning

    • Upon initial immersion (first 3 mins), ‘cold shock’ may occur. This is the body's response to water temperatures beginning at 25℃ and peaking at 10-15℃, in which a gasping or uncontrolled hyperventilation occurs. This is a very dangerous response in water and leads to immersion deaths due to drowning.  I noticed this response when I began cold showering- the minute my belly touched the cold water, hyperventilation occurred and I was able to control it by taking steady slightly prolonged breaths. This told me that the temperature of my cold shower was more than enough to cause a physiological response, and I did not need to go into the ocean at that point! 

    • From 3 minutes on*, the skin is cooled and the muscular and nervous systems are beginning to directly cool. At low temperatures a nerve block may occur, leading to drowning due to the inability to use your muscles and get out of the water.

  • Hypothermia

    • Hypothermia arises at about 30 minutes of cold water immersion, and is characterized by confusion, shivering, disorientation, loss of consciousness, cardiac arrhythmias, and death.

*Water temperature, prior immersion experience, and amount of body fat alter the reactions your body will undergo and should all be taken into consideration when aiming for a duration of time of cold immersion. If you have pre-existing health conditions, talk to your doctor before attempting cold immersion. 

With the risks in mind… What are the benefits?3

  • Decrease pain sensation

  • Decrease swelling and inflammation at joints

  • Better Mood (due to increased dopamine, serotonin, and endorphin release!)

  • Improve insulin sensitivity (when done repeatedly, a.k.a. Cold-water habituation)

  • Cold-water habituation may increase cell’s protective mechanisms, so they are better able to handle cold AND other types of stress such as exercise and heat

  • Anecdotal evidence that repeated bouts can help reduce chronic inflammation

  • May improve immune function

Can I still get benefits by taking a cold shower instead?

  • YES! Some studies have shown great parasympathetic stimulation from cold water immersion of just the face! Splashing the face is a safe and effective way to stimulate your vagus nerve, which has shown to have anti-inflammatory effects3. 

  • The first tip in Joe DiStefano’s article about cold water immersion is “You can always make it colder”4. He also suggested 30 days of cold showering/bathing at home before trying a cold dip. Over the month of January, I did exactly that! By training this way, I was able to experience the physiological changes that occur when our bodies are exposed to cold water, and was able to control the temperature progression for safety. Those cold showers left me feeling a sense of clarity and happiness in the morning that followed me through the day. 


References

  1. National Centers for Environmental Information (NCEI). (n.d.). Retrieved February 01, 2021, from https://www.ncei.noaa.gov/access/data/coastal-water-temperature-guide/hawaii.html

  2. McKenzie, A. (2020, November 12). One With the Water: Cold Water Therapy. Retrieved February 01, 2021, from https://www.yammagazine.com/one-with-water-cold-water-therapy/

  3. Tipton, M. J., Collier, N., Massey, H., Corbett, J., & Harper, M. (2017). Cold water immersion: Kill or cure? Experimental Physiology, 102(11), 1335-1355. doi:10.1113/EP086283

  4. DiStefano, J. (2020, October 17). The 8-Step Beginner's Guide to Cold Immersion. Retrieved February 01, 2021, from https://www.coachjoedi.com/articles/cold

  5. Photo credit: Marissa Hoen


Coping with mask anxiety

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Written by Margaret Lyster | January 24 2021

For most people, wearing masks was thought of as something either part of costume or used by doctors and those in healthcare prior to a year ago. Nowadays, wearing a mask or face covering has become part of the norm when leaving the house. Back in July 2020, the World Health Organization confirmed that COVID-19 can be spread through respiratory droplets and airborne transmission. With this scientific briefing, the WHO encouraged the prudent use of fabric face masks in public places to limit community transmission. Face masks can prevent the spread of COVID-19, especially since the virus can spread from people with no symptoms.

Why can it feel like you cannot breathe? 

Although doctors and studies have repeatedly stated that masks do not inhibit the flow of oxygen, many people report feeling out of breath, sweating, nausea, and an increase in heart rate when they wear a mask. These symptoms can be caused by altered patterns in breathing that can be brought about by discomfort with the face mask.

Respirologist Dr. Christopher Ewing from Edmonton said in an interview that “most of us aren’t used to wearing face masks and the sensation of having a mask on your face might make someone anxious or uncomfortable.” Since wearing a mask can be uncomfortable, “people change breathing patterns unconsciously to try to make it more comfortable… [which] can actually give us shortness of breath.” An example of this could be when after exhaling, your glasses fog up and you might compensate for the discomfort this causes by not fully exhaling on your next breath.

What can be done about it?

Thankfully, Dr. Ewing has some suggestions for those who are suffering from these side effects of wearing a mask to help their breathing. Dr. Ewing gives the suggestion of using focused breathing techniques, including box breathing or belly breathing.

Box breathing is a strategy where you visualize a box and trace the outline of the four sides in your mind as you slowly inhale and exhale. Following the outline of the box, you breath in slowly for four seconds, pause for two, breathe out for four seconds, and then pause again. Dr. Ewing says this method helps you to regulate breathing in a more conscious way and reduce anxiety.

Belly-breathing is focusing on using the diaphragm breathing for a few moments. To practice belly-breathing, place your hand on the diaphragm which is located just below your ribcage and relax. As you breathe in, your hand should be pushed away from your body by your diaphragm. When you exhale, your hand should return to you. 

With some dysregulated breathing patterns, breathing tends to be focused on using the chest and neck muscles to breathe, which is inefficient in providing oxygen and uncomfortable. Focusing on deep breathing encourages the optimal exchange of oxygen and carbon dioxide, as well as normalizing heart rate and lowering blood pressure. Dr. Ewing also gives the encouragement that with time, breathing with a mask will eventually become a second nature, like wearing glasses or using contacts.

References

Labine, J. (2020, August 25). Masks don’t impede breathing but anxiety can, says Edmonton lung doctor. Edmonton Journal. Retrieved from https://edmontonjournal.com/news/local-news/using-masks 

Leung, N. H. L., Chu, D. K. W., Shiu, E. Y. C., Chan, K., McDevitt, J. J., Hau, B. J. P., . . . Cowling, B. J. (2020). Respiratory virus shedding in exhaled breath and efficacy of face masks. Nature Medicine, 26(5), 676-680. doi:10.1038/s41591-020-0843-2

Spitzer, M. (2020). Masked education? the benefits and burdens of wearing face masks in schools during the current corona pandemic. Trends in Neuroscience and Education, 20, 100138-100138. doi:10.1016/j.tine.2020.100138

Watts, S. (2020, September 14). Why it feels like you can’t breathe inside your face mask – and what to do about it. Discover. Retrieved from https://www.discovermagazine.com/health/why-it-feels-like-you-cant-breathe-inside-your-face-mask-and-what-to-do

World Health Organization. (2020). Transmission of SARS-CoV-2: implications for infection prevention precautions. Retrieved from https://www.who.int/news-room/commentaries/detail/transmission-of-sars-cov-2-implications-for-infection-prevention-precautions

Image credit can be found here: https://www.pinterest.ca/pin/798755683907183497/


Simple ways to break up sedentary time and increase your daily energy expenditure

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Written by Marissa Hoen | January 20 2021

In this past year of shifting to life with less travel, more restrictions, and facility closures, many of us have gotten out of our regular movement habits and are required to do a lot less physical activity than we are used to! I’ve noticed more and more complaints of pain in the body that seems to arise from inactivity in my own practice as a massage therapist this year. While we are lucky to live in a time with great technology to support us through a pandemic, we need to be aware of the amount of time we spend sitting. It is well known that decreasing sedentary time is key in helping to keep our bodies healthy and that positive metabolic changes can occur by breaking up your sitting time (Loh et al., 2020).

To help break up your Netflix binge and social media scroll (or honest online work!), here are some practical steps you can take to increase your daily movement:

  • If you spend a lot of time watching T.V. or Netflix, make it a rule or habit to get up/move your body after every show or during commercials.

    • More frequent breaks from sitting, even if they are short breaks, may result in greater health effects such as reduced waist circumference (Owen et al., 2010)

  • For those who have just shifted to working from home, try the the Pomodoro method:

    • Set your timer for study block intervals (I like 50 minutes study/work, 10 minute break; but you find what timing works best for your focus)

    • During the break times, get up from your chair or move your body as much as possible in your chair

    • If you want a music timer, check out one of many Pomodoro videos on YouTube!

  • Find movement you actually enjoy doing!

    • Don’t be afraid to be a beginner and try new movement styles, such as yoga or dance.

    • You are so much more likely to do the movement if you really enjoy it!

    •  If you find yourself saying things like “I really hate working out” or “I just don’t like the gym”, try moving in your home or outdoors. There are endless ways to move your body, so get out there and find yours!

  • Moving more in your daily activities

    • Breaking up sedentary activity doesn’t mean you have to get to the gym and do push-ups! Daily activities such as sweeping, wiping windows, and scrubbing the tiles can get your heart pumping just as well- depending on your intensity of course! 

    • For example, when I am mopping or sweeping, I like to put on music and lunge a bit more into the movements. Or when I am scrubbing the sink, I try to engage my core and use a bit more of my shoulder muscles.

    •  This tip just takes a little more mindfulness: it simply means taking our habitual movements and adding a bit more effort.

  • Stack movement onto an already established habit

    • In his book, Atomic Habits, James Clear describes a concept he calls habit stacking. Habit stacking is just what it sounds like: adding a new goal habit to a pre-existing habit. 

    • For example, you could get into the habit of stretching your hamstrings more often (goal habit) by taking a moment to breathe and stretch each time you put on/take off your shoes (pre-existing habit). 

  • Plan it in!

    • When I first set out to make daily exercise a habit, this is what got me to the gym every morning. Setting a time that fit with my schedule, writing it down, and having a plan as to the movements I wanted to do helped to keep me in action even when I felt really low motivation.

    • If you have a really busy lifestyle, then you know that things don’t get done unless they are part of the plan! Talk to friends and family and help delegate tasks that you feel are keeping you from getting your exercise. In my experience, time for yourself is crucial to prevent burnout- so make some time and move that body!

References

  • Clear, J. (2018). Atomic habits: An easy & proven way to build good habits & break bad ones. Penguin Publishing Group. 

  • Loh, R., Stamatakis, E., Folkerts, D. et al. (2020). Effects of interrupting prolonged sitting with physical activity breaks on blood glucose, insulin and triacylglycerol measures: A systematic review and meta-analysis. Sports Med, 50, 295–330. https://doi.org/10.1007/s40279-019-01183-w

  • Owen, N., Healy, G. N., Matthews, C. E., & Dunstan, D. W. (2010). Too much sitting: the population health science of sedentary behavior. Exercise and sport sciences reviews, 38(3), 105–113. https://doi.org/10.1097/JES.0b013e3181e373a2

  • Image credit can be found here: https://blog.flvs.net/brain-breaks-for-online-elementary-students/

Let gravity be your guide! Strength training with Eccentrics

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Written by Marissa Hoen | December 14 2020

A few months ago, I talked to you all about the benefits of isometric resistance training, which entails contracting your muscle without moving through a range of motion. Today I wanted to add a new tool to your belt to improve your strength and add some variety to your workouts: Eccentrics!

What is eccentric resistance training?

  • Eccentric contractions occur when the muscle is lengthening while still under tension- most commonly thought of as the lowering phase of the movement.

  • Example: Think about your classic bicep curl. Lifting the weight against gravity and towards your body is a concentric contraction. Lowering the weight with gravity back to its original position in a controlled way requires an eccentric contraction in that biceps muscle.

Does this help improve strength? 

  • When combined with regular strength training, eccentric training has been shown to elicit greater strength gains than regular strength training alone (Walker et al., 2016).

  • One study found that attenuated eccentric training (using more weight during the lowering phase of the movement than the lifting phase) results in greater maximum force production, work capacity, and muscle activation than regular strength training (Walker et al., 2016).

  • Training intensity has a significant impact on both strength improvements and muscle mass changes when compared with other training variables (Fry, 2004), which helps to  explain why attenuated eccentric training results in strength improvements.

How can I add this to my workouts?

  • Eccentrics can be done for any muscle group! I like to add them when I’m a bit too fatigued to complete my repetitions the regular way, so I just do the lowering part! For example, when I am practicing push ups and can no longer maintain alignment in my spine, I lower to my knees during the push-up and pick my knees back up for the lower down (see image below).

Push Up: Eccentric Phase, no knees           Push Up: Concentric Phase, with knee assist

Push Up: Eccentric Phase, no knees           Push Up: Concentric Phase, with knee assist

 Simply choose a movement you’d like to improve or a muscle you’d like to strengthen and keep in mind:

  •  The movement that leads to eccentric contraction for one muscle is caused by concentric contraction of the antagonist muscle (the muscle that does the opposing action, usually on the opposite side of the limb, ie. biceps and triceps).

  • If you don’t have a partner to help spot you, you may need to use other body parts to help you get into position for the lowering phase. For example, if you wanted to practice tricep pulldowns, first pull the cable down with both hands, then use only one arm for the eccentric phase of the movement.

  • If you’ve never used weights in your workouts before, start with a light weight to prevent injury.

  • As always… remember to warm up before your weight training!



References

Fry A. C. (2004). The role of resistance exercise intensity on muscle fibre adaptations. Sports Med. 34, 663–679. 10.2165/00007256-200434100-00004

Walker, S., Blazevich, A. J., Haff, G. G., Tufano, J. J., Newton, R. U., & Häkkinen, K. (2016). Greater strength gains after training with accentuated eccentric than traditional isoinertial loads in already strength-trained men. Frontiers in Physiology, 7, 149-149. doi:10.3389/fphys.2016.00149

Image credit can be found here: https://www.wikihow.fitness/Use-Eccentric-Training

May your days be merry, mindful and bright!

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Written by Katie Dabbs | December 16 2020


After a year full of ups and downs, we know the holidays will look a bit different this year. While the decorations are up and the festive films are back on TV, not being able to see friends and family will mean some holidays traditions will be put on hold for another time. If you’re feeling a touch of the Holiday Blues or looking for a way to relax (aside from coming to MOVE if you can!), thankfully there are a few ways to help bring ourselves some peace and calm. 

Mindfulness is a “collection of practices aimed at helping us to cultivate moment-to-moment awareness of ourselves and our environment” (Smith et al 2017). It is basically an awareness of our thoughts and feelings the moment that they appear in our mind. When we practice noticing our emotional and physical sensations in this way we can steer our responses and choices purposefully and unconsciously, which can help us achieve our goals.

Mindfulness has lots of benefits aside from helping you find some peace and quiet for yourself amid a challenging festive period! Researchers have found that meditation can help people tackle habituation - the tendency to stop paying attention to new information in our environment (Antonova, Chadwick & Kumari 2015). Other studies have shown it can help us recover better from stress (Taren et al 2015). Even better, evidence suggests that mindfulness can be beneficial long term to help stick to exercise goals and keep on track (Ulmer, Stetson & Salmon 2010) - perfect for those of us looking at new goals for 2021!

What are some mindfulness techniques?


There are lots of ways to begin a mindful practice - a quick Internet search returns lots of insightful articles and apps like Headspace and Insight Timer are extremely popular. Here are a few suggestions via Positive Psychology and Anxiety Canada.

1. The Raisin Exercise

This might sound funny, but it is a great introductory exercise for beginners. Don’t worry if you don’t love raisins - pick a fruit or vegetable with an interesting colour, smell or texture - perhaps a festive food like clementines?!

Pretend that you have never seen a raisin (or your chosen food!) before. Pay careful attention to:

  • The way the raisin looks;

  • How it feels;

  • Its smell;

  • Its taste.

Focusing on the raisin helps bring your mind to what is right in front of you. Taking time to notice these small details is helpful - you are less likely to focus your attention or energy on worries or other things going on around you. Don’t worry if your mind wanders - this will happen! Gently bring yourself back to the exercise. 

2. The Body Scan

The Body Scan is another great mindfulness technique, contemplating the sensations we experience through each part of the body and paying special attention to the way each area feels. The scan usually moves systematically through the body, for example, starting at the feet and moving upwards. Anxiety Canada has a useful PDF document to help you conduct your own Body Scan.
A typical Body Scan could go as follows:

  • Step 1: Lie or sit down in a comfortable place like a carpeted floor, couch or bed.

  • Step 2: Gently close your eyes. Let your shoulders drop down and away from your ears. Bring your attention to your breathing - notice the rhythm and experience of breathing in and out. Move with awareness if you need to adjust your position.

  • Step 3: Bring your attention to your body: how it feels, the texture of clothing against your skin, the contours of the surface on which the body is resting, the temperature of the body and the environment. Perhaps you’re chilly after having been outside admiring holiday lights...

  • Step 4: See if you are able to just notice what you feel without judgment – for example, if you notice tingling, warmth, pulsating, tightness, or other sensations. Again, it’s not about whether these sensations are good or bad, it’s just about noticing them.

  • Step 5: Scan your body from your feet to your head, bringing awareness and curiosity to areas you notice different sensations.

3. 10-minute Mindfulness Routine

This quick three-step mindfulness practice is ideal if you only have a short amount of time to practice.

Step 1: Bring awareness to what you are doing, thinking, and sensing at this moment. Sit comfortably and notice any thoughts and feelings that come up by acknowledging them without judgement then letting them pass.

Step 2: Bring awareness to your breathing for at least six breaths.

  • The goal is to focus attention on one thing: your breath. Be aware of the movement of your body with each breath, of how your chest rises and falls, how your belly pushes in and out, and how the breath feels in your nose - is there a specific part of your breath you notice most?

Step 3: Expand your awareness outward from your body to the environment.

  • Begin to become aware of your body. Notice any sensations you are experiencing, like tension, aches, or perhaps a lightness in your face or shoulders.

  • Expand your awareness out to the environment around you. Bring your attention to what is in front of you. Notice any colors and patterns, smells and textures or sounds. Maybe you notice sparkling holiday lights, the smell of the Christmas tree or some holiday tunes playing!

When you are ready, slowly open your eyes. This short exercise helps you build awareness by allowing yourself to notice thoughts and feelings then letting them pass by.

Try out different durations, types, and frequencies of meditation and write down how you feel before and after the practice—and see what seems to work for you. You will notice as you begin that your mind might wander often as different thoughts come up - don’t feel discouraged, this is normal and is one of the things mindfulness can help with in the long run: choosing which thoughts we want to engage with. This will not only be useful over the holiday period, but also help you focus on your existing or any new goals at MOVE. With a little practice, mindfulness techniques can help us stay present and focused, through Christmas and beyond!

**Reminder - Move will be CLOSED from December 24 to December 27 and December 31 and January 1, 2021 - On behalf of our board of directors, staff and volunteers we wish you a happy and safe holiday season!

References

22 Mindfulness Exercises, Techniques & Activities For Adults (+ PDF's). (2020, October 16). Retrieved December 16, 2020, from https://positivepsychology.com/mindfulness-exercises-techniques-activities/

Hasenkamp, W. (n.d.). How to Focus a Wandering Mind. Retrieved December 16, 2020, from https://greatergood.berkeley.edu/article/item/how_to_focus_a_wandering_mind 

Greenberg, J., Reiner, K., & Meiran, N. (n.d.). "Mind the Trap": Mindfulness Practice Reduces Cognitive Rigidity. Retrieved December 16, 2020, from https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0036206

Mindfulness Exercises. (2019, September 11). Retrieved December 16, 2020, from https://www.anxietycanada.com/articles/mindfulness-exercises/ 

Taren, A., Gianaros, P., Greco, C., Lindsay, E., Fairgrieve, A., Brown, K., . . . Creswell, J. (2015, December). Mindfulness meditation training alters stress-related amygdala resting state functional connectivity: A randomized controlled trial. Retrieved December 16, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4666115/ 


Ulmer, C., Stetson, B., & Salmon, P. (2010, May 01). Mindfulness and acceptance are associated with exercise maintenance in YMCA exercisers. Retrieved December 16, 2020, from https://www.sciencedirect.com/science/article/abs/pii/S0005796710000835

Image credit can be found here: https://www.mindful.org/5-mindful-tips-navigating-holiday-stress/

Key training principles to help you continue making progress toward your movement goals

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Written by Marissa Hoen | December 1 2020


Covid-19 has impacted everyone in one way or another, and it’s not surprising that many of us feel like we have either lost progress or have simply hit a standstill when it comes to fitness gains. Sometimes it’s the goals that need re-evaluating, and sometimes it comes down to our fitness routine. Are you doing the same workout each week and not seeing results? Read on for some tips on how to break out of that plateau!

  1. First, can you change one of these variables?

    Specificity- in order to improve in a certain skill, you need to practice that skill. If you aren’t practicing the movement you aim to gain, get on it!

    Frequency-how many days per week do you train? Can you increase this by one day (safely)?

    Progressive Overload- you can overload in terms of reps, sets, weight, duration of training session, and intensity. To decrease the risk of injury, increase one variable at a time every other week at most.  
    *altering all of these variables at once may increase the risk of injury if the intensity is too high

  2. Improve your performance during your training sessions1:

    Warm Up and Cool Down: Allowing yourself time to warm up before the main event can improve your performance, decrease early onset fatigue, and decrease your chance for injury. Warming up allows your body to adjust to the new physiological demands of exercise. Cooling down helps your muscles replenish oxygen to burn more energy and flush byproducts before muscle building occurs!

    Eat enough carbohydrates so you can perform DURING your workout. It is definitely a challenge to increase your strength when you run out of fuel during your workout! Carbohydrates, aka carbs, are stored in muscles in a form that can be easily broken down for energy during our workouts. We start feeling fatigue when our stores run low, as our body attempts to protect the muscle from severe depletion. This gets in the way of making our gains! Choose carbs like fruit and grains for energy, carbs like veggies for fiber (not for performance, but for all around good health), and try to avoid the simple carbs like cookies and sugary drinks unless you don’t have another option!

    Ensure you are properly hydrated! Drink water hours before your session (or regularly for that matter!) so your body and the cells that need it have enough time to absorb the water. Water is a main component of blood, inner substance of cells, the fluid that lubricates joints, and so much more. No wonder we are 60% water!2

  3. Continue to build strength after your session

    Eat enough protein- keep in mind that muscle and strength building require a positive balance of protein synthesis and breakdown. This means consistency in strength training AND eating protein is needed for for 3+ weeks before you will experience muscle building (hypertrophy).1

  4. Change your mindset/re-evaluate goals

  • Are your goals really yours? In her podcast called ‘Borrowed Goals’, Dr. Shanté Cofield discusses the importance of reflecting on your goals, and thinking about the why behind them (2020). If your goals are more a reflection of what other people want (or what you think they want) instead of a reflection of what you want, it is way less likely you will reach them. And even if you do reach these goals.. Will you be satisfied? Take this time to re-adjust and find goals that fit you.


Keep in mind:1

  • It takes weeks to months before your body adapts to resistance training to produce noticeable strength changes, however muscle protein synthesis and collagen production increases after just one session.

  • 3 weeks+ of resistance training is needed before muscle hypertrophy (increase in muscle size) occurs 

  • The fastest changes occur in the first few weeks of training for beginners due to neurological adaptations! If you are a beginner, enjoy this time of relatively rapid strength gain before you reach a plateau!


References

  1. Powers, S., Howley, E., & Quindry, J. (2021). Exercise physiology: Theory and application to
    fitness and performance     (11 ed.). McGraw Hill LLC.

  2. The Water in You: Water and the Human Body. (n.d.). USGS Water Science School. Retrieved
    December 1, 2020, from https://www.usgs.gov/special-topic/water-science-school/
    science/water-you-water-and-human-body?qt-science_center_objects=
    0#qt-science_center_objects

  3. Cofield, S. (Producer). (2020, October 1). Borrowed Goals [Audio Podcast]. Retrieved from
    https://open.spotify.com/episode/1Ne8zkI8KDt8QmgRTDaYLT

  4. Image credit: https://www.headspace.com/blog/2018/01/12/fitness-plateaus/