The key to enjoying the seasonality of Florida’s produce

The key to enjoying the seasonality of Florida's produce

Incorporating seasonal produce from the Naples, Florida area into your daily routine can be a great way to enjoy fresh, flavorful fruits and vegetables while supporting local agriculture. Here are some tips to make the most it.

April 16, 2024 | Ashley Jerry, MS

fresh produce

Incorporating seasonal produce from the Naples, Florida area into your daily routine can be a great way to enjoy fresh, flavorful fruits and vegetables while supporting local agriculture. Naples has many places to buy produce in season, eating seasonally and locally not only provides you with fresh and nutrient dense produce but also supports a sustainable and environmentally friendly lifestyle. Exploring resources for local produce creates exciting new habits and ability to have variety in your daily nutritional intake.

Here are some tips for making the most of Florida's seasonal produce:

  1. Visit local farmers' markets: Naples has several farmers' markets where you can find a wide variety of locally grown produce. The Third Street South Farmers Market and the Vanderbilt Farmers Market are popular options. Shopping at these markets allows you to interact directly with the farmers and learn about what's in season.
  2. Join a community-supported agriculture (CSA) program: Many local farms in the Naples area offer CSA subscriptions, where you receive a weekly or bi-weekly box of freshly harvested produce. This is a great way to try new fruits and vegetables and plan your meals around what's in season.
  3. Familiarize yourself with the seasonal produce calendar: In Naples, the winter months (December to April) are prime for citrus fruits like oranges, grapefruits, and tangerines. Early spring brings strawberries, tomatoes, and leafy greens like kale and spinach. Summer is the peak season for tropical fruits like mangoes, avocados, and papayas.
  4. Meal Planning: Plan your weekly meals around what's in season, incorporating a variety of fruits and vegetables into your dishes. This approach not only ensures you're eating fresh and nutrient-dense foods but also helps reduce food waste.
  5. Explore local recipes: Look for recipes that highlight the seasonal produce of Naples. Cookbooks or online resources focused on Florida cuisine can provide inspiration for incorporating local flavors into your meals.

Remember, a healthy lifestyle is about balance and moderation. While focusing on seasonal produce is an excellent way to incorporate more nutrients into your diet, don't forget to include other essential food groups, such as whole grains, lean proteins, and healthy fats.

Some ideas for spring and summer produce:

Spring

  • Tomato and avocado salad with fresh basil and balsamic glaze (add fish or chicken for protein source)
  • Zucchini noodles (zoodles) with a fresh tomato sauce and grilled chicken or shrimp.

Summer

  • Watermelon and feta salad with fresh mint and a honey-lime dressing.
  • Grilled eggplant and zucchini skewers with a tzatziki dipping sauce.
  • Greek yogurt bowl topped with fresh seasonal fruits, nuts, and seeds.

Ashley Jerry

Ashley Jerry

Ashley Jerry, MS, is a nutritionist who specializes in a variety of fields, including food sensitivities, medical conditions, and sports nutrition. Her expertise includes gut health issues, weight loss, self-image and an overall understanding of nutrition, as well as treating a diverse range of medical conditions such as high cholesterol, high blood glucose levels, obesity, pregnancy, gastrointestinal function, anxiety, depression, and overall health.

Meet Ashley

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From injury rehab to goal setting: playing pickleball at a higher level than ever before

From injury rehab to goal setting: playing pickleball at a higher level than ever before

Meet Kim Brasser. After finding Performance Optimal Health through a shoulder issue, Kim worked with a physical therapist and personal trainer to complete the transition to focusing on strengthening and return to playing pickleball. After working with our team, Kim now enjoys better range of motion, agility, speed and strength, and she can perform at a higher level, coming back stronger than ever after her injury.

April 1, 2024 | Stephanie Soete

 


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Stephanie Soete

Stephanie Soete

Stephanie Soete, CPT, is a personal trainer based in Westport. Her approach to her clients revolves around setting goals. She underscores the fact that not all goals have to be big, just attainable. By empowering her clients to be goal-driven, Stephanie empowers them to achieve victories every day, no matter how big or small.

Meet Steph

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How can a golfer perform at their best?

How can a golfer perform at their best?

How do you improve a golfer's performance? What about a junior golfer? There is no single answer, but a recommended holistic approach to improving performance.

April 1, 2024 | Michael Beecher, PT, DPT, OCS, SCS, TPI-M2 | Michael Semancik, PT, DPT, OCS, TPI-M2

young golfer by a hole

In this episode, host and physical therapist Mike Beecher, PT, DPT, is joined by fellow physical therapist and TPI certified golf expert Michael Semancik, PT, DPT, and John Schmoll, director of junior golf at Burning Tree Country Club, who has decades of experience working with golfers of all ages and helping them improve their golf game.

John, who is a 2x U.S. kids top 50 instructor (going for three title this year to become a master coach) dives into the winning recipe for a junior's successful performance, including hydration and proper nutrition, not specializing from an early age (at least until 13), monitoring anxiety and stress, and making it a fun outside activity, letting kids be kids.

The trio then expand their perspective across all ages, explaining why Titleist Performance Institute golf screens are essential to establish a baseline and pave the path forward for the most efficient golf swing possible. The screen includes mobility and stability tests, as well as an in-depth look at biomechanics and swing inefficiencies.

They also explain a team approach to the golfer is key — assembling a team of golf trainers, golf pros, physical therapists, mental performance consultants, and nutritionists will set the golfer up for success across all aspects of health and performance.

Listen here, or wherever you get your podcasts.


Michael Beecher

Michael Beecher

Michael Beecher, PT, DPT, OCS, SCS, is a Titleist Performance Institute medical professional, a Hospital for Special Surgery credentialed advanced hip clinician and a certified dry needling specialist. He enjoys working with patients to close the loop of injury and recovery, helping them on their journey to rehabilitation from start to finish.

Meet Mike

Michael Semancik

Michael Semancik

Michael Semancik, PT, DPT, OCS, TPI-M2, is a Level 2 TPI Certified Medical and Power Professional who specializes in working with golfers and young athletes, specifically with rowers, hockey players and football players. Michael also brings this passion with him outside of the clinic: He formerly served as the physical therapist for various teams at Princeton University, including men’s hockey and football as well as women’s lightweight crew and volleyball.

Meet Michael

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The team approach: how athletes stay in shape

The team approach: how athletes stay in shape

What is the professional athlete's secret to success? A holistic approach that not only includes rigorous training, but also a dedicated team of professionals working in unison to ensure every aspect of their health and fitness is finely tuned.

April 1, 2024 | Jonathon Mendola, PT, DPT, CSCS

team approach

As you embark on your journey toward recovery and optimal health, it’s insightful to peek behind the curtain of how elite athletes maintain their peak performance. The secret? A holistic approach that not only includes rigorous training, but also a dedicated team of professionals working in unison to ensure every aspect of their health and fitness is finely tuned.

Training Regimen

Athletes don’t just “work out.” They follow meticulously designed training regimens tailored to their specific sport, position, and personal strengths and weaknesses. These regimens often include a mix of cardiovascular exercises, strength training, flexibility work, and sport-specific drills. However, what sets athletes apart is not just the intensity of their workouts, but the precision with which these routines are crafted.

Nutrition and Diet

Fueling their bodies for optimal performance is a science for athletes. They work closely with nutritionists to develop meal plans that provide the right balance of macronutrients and micronutrients. Every calorie counts, but it’s not just about quantity — it’s about quality. Athletes understand that the right fuel can enhance performance, improve recovery times, and prevent injuries.

Rest and Recovery

Contrary to the image of non-stop training, rest is equally crucial for athletes. They incorporate rest days into their schedules to allow their bodies to recover and adapt to the stress of training. Moreover, they prioritize quality sleep, massage therapy, cryo therapy, and sauna, recognizing the role that these modalities play in muscle repair, hormone regulation, and overall well-being.

The Team Behind the Athlete

Perhaps the most critical aspect of an athlete’s success is the team of professionals supporting them. This team can include coaches, trainers, physical therapists, nutritionists, sports psychologists, and more. Each member plays a unique role, working collaboratively to ensure the athlete is functioning at their absolute best.

You can see this in athletes at all levels; for example, professional golfer Jon Rahm has a team of physical therapists, nutritionists, massage therapists, trainers, swing coaches and more, all to give him that extra edge when he's on the golf course. His hard work pays off: he's currently ranked No. 3 in the world.

Let’s also take Hilary, a 61-year-old competitive rower. Hilary maintains an impressive training schedule that includes hours on the water, strength training, recovery strategies, and focused nutrition. But it’s not just her physical efforts that keep her at the top of her game. Over her career, first as a collegiate level rower for Princeton University, through today, Hilary has acquired knowledge in nutrition, recovery, and sports psychology to add to her personal toolkit.

In addition to the well-rounded knowledge base, Hilary also works with a skilled coaching staff both on and off the water as well as a physical therapist specializing in the "aging athlete." This team, including Hilary herself, ensures that Hilary’s body is strong, her mind is sharp, and her nutrition supports her demanding training regimen. As you continue your optimal health journey, remember that you are part of your own team, working alongside your therapists and healthcare providers. By embracing this team approach, you’re setting yourself up for success, just like Hilary and other athletes who rely on their support systems to reach new heights.

Why the Team Approach Matters

1. Specialized Expertise: Each team member brings specialized knowledge to the table, ensuring that every aspect of the athlete’s health is addressed.

2. Comprehensive Care: By working together, the team can create a comprehensive plan that considers all facets of the athlete’s well-being.

3. Injury Prevention: Through regular monitoring and adjustments, the team can identify and address potential issues before they escalate into injuries.

4. Optimal Performance: Ultimately, the goal of this team approach is to help the athlete achieve and maintain optimal performance levels, training, competition, and life.

As you continue your optimal health journey, remember that you are part of your own team, working alongside your therapists and healthcare providers. By embracing this team approach, you’re setting yourself up for success, just like the athletes who rely on their support systems to reach new heights.


Want to live better and achieve your health goals?

Schedule an Optimal Health Assessment! Our team of experts will put a coordinated and highly-personalized strategy in place so you can reach your goals... and exceed them.

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Jon Mendola

Jonathon Mendola

Jonathon Mendola, PT, DPT, CSCS, is a detail-oriented physical therapist and certified strength and conditioning specialist. He is particularly interested in working with patients post-op, clients dealing with joint replacements, as well as weekend warriors.

Meet Jon

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The Optimal Health Assessment

The Optimal Health Assessment

Whatever your health goal, Performance Optimal Health can help you achieve it, and it all starts with an Optimal Health Assessment. Whether you want to recover from an injury, improve your fitness, enhance sports performance, or increase longevity, our team will put a highly-personalized strategy in place so you can reach your goals... and exceed them.

March 20, 2024

 


Want to get started on achieving your health goals?

Schedule an Optimal Health Assessment! Our team of experts will put a coordinated and highly-personalized strategy in place so you can reach your goals... and exceed them.

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Naples and Blue Zones

How does Florida mirror a Blue Zone?

People who live in Blue Zones enjoy healthier and longer lives than those who live elsewhere, and it comes down to a few key factors called the "Power 9." Here's what makes a Blue Zone so special, and how Naples residents enjoy some of those same benefits.

March 18, 2024 | Kayla Michalik, PT, DPT

blue zone

You may have heard the term “Blue Zone” recently, as the concept has increased in popularity within the wellness space in recent years. “Blue Zone” refers to areas around the world where there are lower rates of chronic disease and longer life expectancy. There are 5 key Blue Zones in the world including Okinawa, Japan, Sardinia, Italy, Nicoya Costa Rica, Ikaria, Greece, and Loma Linda California. All five of these communities shared similar lifestyle habits, which are also referred to as the “Power 9.” The Power 9 is a compilation of lifestyle habits that all 5 of these communities share and compiled into four main pillars; move naturally, eat well, right outlook, and connect.

Move Naturally

Those living in blue zones don’t dread participating in physical activity, They keep themselves busy, spending majority of their day on foot. study looking at physical activity and mortality, researchers found that those who performed 2-3 times the minimum physical activity recommendation showed a 37% lower risk of mortality compared to those who reported no leisure physical activity. But in Blue Zones, those performing no leisure time physical activity still had a 20% lower mortality risk among those who did not live in blue zones and performed less than the recommended exercises hours per week.

Eat Well

What is most unique about those who live in Blue Zones is that they don’t count macronutrients or even read the labels. Their diet consists of 95% from a plant source such as fruits, vegetables, and beans. In an article exploring food secrets of the world’s longest-lived people, researchers found that those who consumed a quarter pound of fruit daily were less likely to pass away within four years than those who didn’t. In addition to the 90% fruit and vegetable diet, they consume meat no more than twice a week. By comparison, Americans over 20-60% more than the recommended healthy intake. In addition, those living in blue zones follow “80 percent rule” which involves not consuming more food after feeling 80% full.

Right Outlook

With Right Outlook, this contains what Blue Zones refer to as down shift and purpose. Down shift is methods to reduce stress and inflammation with daily rituals such as napping and happy hours. The communities have stress just like you and I do but the way they handle stress is unique. Having a purpose provides the people with a goal or a desire to achieve something each and every day.

Connect

Those in Blue Zones really value loved ones first working on relationships with family and spouses. In addition to that, those in blue zones belong to a community and some of those communities may be associated with faith or those that share the same healthy behaviors.

How does Florida mirror a Blue Zone?

The biggest thing about Floridians is that everyone is physically active whether that be in the form of walking, gardening, or pickleball. Floridians are motivated to move their bodies naturally and it mainly has to do with our climate compared to more northern states.

Another reason why Florida mimics blue zones, mainly in Naples, everyone is aware of how they are fueling their bodies. Although many fuel their bodies with a lot of meat traditionally, Naples is a “shop local, eat local” community with markets and restaurants only carrying products that are locally grown. One thing that really stands out about Naples is the sense of community and belonging. There is something for everyone here in Naples, most residents are a part of a community that share similar healthy habits as one another such as pickleball, tennis, and even neighborhood community groups.

Lastly, many in the Naples community who have walked through our doors at Performance Optimal Health often give the answer of “I’m not stressed often” when asked about stress management. This community here is a very positive, upbeat, and motivated group. Naples is a great community to live in and demonstrates very similar qualities that Blue Zone communities do.


Want to live better and achieve your health goals?

Schedule an Optimal Health Assessment! Our team of experts will put a coordinated and highly-personalized strategy in place so you can reach your goals... and exceed them.

Contact Us


Kayla Michalik

Kayla Michalik

Kayla Michalik, PT, DPT, is a physical therapist based in Naples who enjoys working with athletes, among other populations, such as outpatient orthopedics. She works with clients of all levels and age ranges, including young and professional athletes in sports ranging from hockey, football, volleyball, baseball, dance, and cheerleading.

Meet Kayla

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Incorporating longevity into personalized fitness programming

Incorporating longevity into personalized fitness programming

After successfully recovering from a car accident, Kristen Conley shifted her focus to personal training and Pilates in an effort to build back her confidence and improve her longevity.

March 6, 2024 | Michele Tenney

 


Want to get started on achieving your health goals?

Schedule an Optimal Health Assessment! Our team of experts will put a coordinated and highly-personalized strategy in place so you can reach your goals... and exceed them.

Contact Us


Michele Tenney

Michele Tenney

Michele Tenney, CPT, is a personal trainer based in Hamden who enjoys working with all populations. As a trainer, Michele takes care to talk about the importance of nutrition in achieving goals. She also believes that proper nutrition is medicine for the body, and that one’s food intake needs to adapt to support the person’s current goals, age and limitations.

Meet Michele

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Women & Wellness: Building a healthy foundation

Women & Wellness: Building a healthy foundation

In the first part of our Women & Wellness series, some of our women's health providers discuss why setting yourself up for success as early as possible is crucial, and why those early years matter so much.

March 4, 2024 | Danielle Pasquale, PT, DPT | Koren Bradshaw, MS, CDN, CLC

mother and daughter

Setting yourself up for success as early as possible is crucial, yet often overlooked. Host and physical therapist Mike Beecher, DPT, is joined by women's pelvic floor physical therapist Danielle Pasquale, DPT, and nutritionist and lactation consultant Koren Bradshaw, CDN, to discuss why those early years matter so much.

They dive into bone health during adolescence and young adulthood, emphasizing a balanced approach to eating and body positivity to prevent future issues. Transitioning into the realm of childbirth, they share insights on the significance of pre/postnatal fitness, safe nutrition practices, and pre/postpartum pelvic health.

Listen here, or wherever you get your podcasts.


Danielle Pasquale

Danielle Pasquale

Danielle Pasquale, PT, DPT, is a physical therapist certified in dry needling, women's pelvic health, and pre/post-natal fitness. She has always had a passion for helping people, and decided to funnel that drive into physical therapy and teaching others how to live their healthiest life.

Meet Danielle

Koren Bradshaw

Koren Bradshaw

Koren Bradshaw, MS, CDN, CLC, is a nutritionist who specializes in working with new/expecting mothers and women’s health, as well as in autoimmune and thyroid issues, food allergies and sensitivities, celiac disease and anti-aging. Her previous experience includes working as a nutritionist and lactation consultant, as well as starting her own practice.

Meet Koren

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What is your fitness age?

What is your fitness age?

At Performance Optimal Health, we start by calculating a client’s fitness age before ever hitting the gym floor. The benefits of determining this key metric are not widely discussed, but can make a significant difference for those who want to approach fitness in a new way.

March 4, 2024 | John Lusk, CPT, CSCS

fitness age

At Performance Optimal Health, we start by calculating a client’s fitness age before ever hitting the gym floor. The benefits of determining this key metric are not widely discussed, but can make a significant difference for those who want to approach fitness in a new way. Everyone is familiar with the concept of age based on the earth’s trips around the sun, the agonizing time spent in our youth counting down the days until we are older, or the days spent growing older whilst wishing we were younger. Much to our displeasure, this is data that cannot be changed or influenced by external factors, regardless of how hard we wish for it to be!

But what about our fitness age? Our fitness age is a scientific estimation of how old our bodies are based on fitness level and other health markers relative to those of the same gender and age group. This is a key metric when looking to live a long, healthy life and is an age that we can change through a myriad of factors, such as proper exercise and nutrition that make it possible to become younger. No, the date on your license won’t change (sorry), but you will be on your way to living and feeling younger!

To determine a client's fitness age, we start with a Performance Optimal Health Assessment. This assessment is an analysis of a client’s health across four pillars: exercise, recovery, nutrition, and stress management. We use this information as our basis to set health goals and to develop a comprehensive strategy to achieve success. We then run a series of additional assessments that test the client’s overall strength, grip strength, flexibility, and mobility as well as their ability to maneuver their own body weight. Next, we test VO2 max, which determines how much oxygen a person consumes and uses during exercise. This gives our providers a measurement of aerobic fitness level and provides valuable insight into current cardiovascular health which must be kept in top shape to ensure longevity.

The data collected from these assessments is then combined to calculate fitness age and allows Performance providers to formulate a tailored health program to reach a client’s personal goals. Additionally, our providers ensure that fitness age is continuously calculated for accuracy, tracked, and tested during each session to reduce the risk of injury and major health complications. The lower your fitness age, the more likely you are to exercise regularly to maintain a healthy body weight and remain in excellent cardiovascular shape. This greatly reduces the chance of life-threatening conditions such as heart disease, diabetes, and stroke, resulting in the ability to not only live longer than most, but to maintain a high quality of life!


Want to know your fitness age and start achieving your goals?

Schedule an Optimal Health Assessment! Our team of experts will put a coordinated and highly-personalized strategy in place so you can reach your goals... and exceed them.

Contact Us


John Lusk

John Lusk

John Lusk, CPT, CSCS, is a personal trainer and business development associate with over 15 years of experience and is certified in strength and conditioning training, elite fitness training, and nutrition. He has worked with many clients throughout the years, ranging from K-12 athletes to individuals looking to maintain balance, health, and wellness.

Meet John

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Improve longevity and performance with Pilates

Improve longevity and performance with Pilates

At Performance Optimal Health, we often recommend Pilates to our clients, as it allows them to target specific muscles and teaches them about their body more than any other form of exercise. Whether you want to decrease joint pain, play better on the courts or simply live healthier, Pilates is an excellent choice for many.

February 21, 2024 | Jennifer Bohn

 


Want to get started on achieving your health goals?

Schedule an Optimal Health Assessment! Our team of experts will put a coordinated and highly-personalized strategy in place so you can reach your goals... and exceed them.

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Jennifer Bohn

Jennifer Bohn

Jennifer Bohn is a Pilates Instructor based in North Naples who is certified in a variety of Pilates disciplines, including mat, Reformer, Cadillac, and more. She enjoys working with clients of all ages, especially young athletes, and has been teaching Pilates since 2018.

Meet Jennifer

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How to optimize your pickleball game

How to optimize your pickleball game

At Performance Optimal Health, we want to serve as a resource​ and share with you simple, tangible steps you can implement​ to empower you to live better and play more pickleball.

February 10, 2024 | Larry Piretra, DPT, CSCS

pickleball

Top exercises for pickleball athletes

  • Dynamic warm-ups
    • Butterfly skips
    • Walking quad
    • Hamstring/calf reach
    • Walking lunges
    • High knees
    • SL kicks (Frankensteins)
  • Resistance training
    • Pushups (chest, triceps)
    • Rowing (back strengthening)
    • Internal/external rotation w/bands or weights (shoulder stabilization)
    • Lunges and squats (glute and hamstring activation)
    • Planks/bridges - w/ or w/out bands (core stability)
    • Wrist curls/extension (strength and stability in wrist)

Recommended recovery strategies

  • Stretching post matches
    • Sets: 3-5 reps; duration: 30-60 sec
    • Muscle groups: hamstrings, calves (Gastrocnemius/Soleus), quadriceps, wrist flexors/extensors, latissimus dorsi
  • Modalities
    • Normatec compression therapy reduces inflammation, improves circulation, flushing of lactic acid, promotes lymphatic drainage
    • Sauna reduces of muscle soreness, improves heart health, stress modulation, improves sleep
    • Cryotherapy reduces pain (reduces delayed onset muscle soreness), promotes recovery, improves metabolic panel, endorphin rush

Staying hydrated

  • Risks of dehydration
    • Can have a negative impact on performance, leading to cramping, fatigue, and a decrease in overall performance
  • How to stay hydrated
    • Drink plenty of water pre, during and post-match
      • Pre: 17-20 oz (2-3 hours before)
      • Warm-up: 8 oz
      • During 7-10 oz (every 10-20 minutes)
      • After: 8 oz within 30 min of playing, 20 oz over the next 2 hours
    • Incorporate electrolyte-rich drinks, which replenish the body's mineral levels, ensuring optimal muscle function and hydration

Healthy Carbohydrates

  • Carbs like quinoa, sweet potatoes, or whole grain pasta, replenish glycogen stores and enhance muscle recovery further.

Protein

  • Protein plays a pivotal role in repairing damaged muscle tissues and promoting muscle growth.
  • Including a protein source in your post-game meal or snack can help kickstart the recovery process.

Fats

  • Fats such as avocados, nuts, and olive oil, provide essential fatty acids that support joint health and reduce inflammation.
  • Healthy fats improve performance and decrease injury risk.

Vegetables

  • These food groups replenish micronutrients and antioxidants that support overall health.

Larry Piretra

Larry Piretra

Larry Piretra, PT, DPT, OCS, CSCS, TPI-M2, is a physical therapist and strength and conditioning specialist who serves as the Naples Site Lead. He specializes in working with racquet sport athletes, including pickleball, tennis, padel and more. As a Titleist Medical and Fitness Professional, Larry also serves as the Golf Programming Lead for Performance.

Meet Larry

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Nutrition and heart health at Performance

Nutrition and heart health at Performance

See how Performance Optimal Health utilizes nutrition to help keep our clients' hearts happy and healthy. From preventative care to management, the Performance team takes a whole-body approach to nutrition.

February 8, 2024 | Ashley Jerry, MS

 


Want to get started on achieving your health goals?

Schedule an Optimal Health Assessment! Our team of experts will put a coordinated and highly-personalized strategy in place so you can reach your goals... and exceed them.

Contact Us


Ashley Jerry

Ashley Jerry

Ashley Jerry, MS, is a nutritionist who specializes in a variety of fields, including food sensitivities, medical conditions, and sports nutrition. Her expertise includes gut health issues, weight loss, self-image and an overall understanding of nutrition, as well as treating a diverse range of medical conditions such as high cholesterol, high blood glucose levels, obesity, pregnancy, gastrointestinal function, anxiety, depression, and overall health.

Meet Ashley

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Optimizing cardiovascular fitness: a collaborative approach for health and performance

Optimizing cardiovascular fitness: a collaborative approach for health and performance

At Performance Optimal Health, we value a collaborative approach to improving cardiovascular fitness. Through personalized programs and adherence to ACSM guidelines, clients have seen significant improvements in their cardiovascular health and overall well-being.

February 6, 2024 | William Manzi, CEP

running on a treadmill

At Performance Optimal Health, our work revolves around collaboration, including doctors and other healthcare professionals in order to create a team for the client. When someone comes through our doors, we identify a baseline estimated V02 max, in order to establish a baseline of cardiovascular fitness. VO2 max is the amount or volume of oxygen your body uses while exercising vigorously, and it's a common tool to understand your fitness level. Knowing your VO2 max can help you train for sports, track your fitness improvement, and improve your overall heart health.

Once this number is established, we work with you and your healthcare team hand in hand in order to directly increase this number. That can involve checking in with the client's doctor, working with one of our nutritionists to establish a healthy diet, or collaborating with our physical therapists to address any potential musculoskeletal issues. Putting it all together allows for the best results for our clients, no matter their goals.

For example, in our 3 month cardiovascular care program where we work with you one on one, monitoring your heart rate, blood pressure, EKG, and MET levels, we have seen one individual increase her numbers by 155%! Another individual even increased her MET level from 32.4 to 50.2 mL/kg/bw in her 3 month program. Protocols were as followed, laid out by the American College of Sports Medicine (ACSM) FITT-VP principle.

At the end of the day, it's about establishing an exercise prescription given to you by your trainer who works with you extensively one on one and communicates with your healthcare team. In our initial intake we sit down to not only get to know you, but also to discuss the four pillars of health — exercise, recovery, nutrition, and stress management, to get a complete picture of your health. At Performance, we look at the body as whole and try to understand what the root cause of the problem is, and not just treat the underlying symptoms.

Here is what a FITT exercise program for cardiovascular exercise looks like:

  • Frequency: 3-5 days per week of moderate to vigorous exercise
  • Intensity: Low is 40-60% of MaxHR (Heart Rate); Moderate is 60-80% MaxHR; Vigorous is 80-95%MaxHR
  • Time: At a moderate intensity, minimum of 150 minutes per week or minimum of 75 minutes per week at a vigorous intensity. This could be 30 minutes of moderate exercise per day or 15 minutes of vigorous exercise per day.
  • Type: Aerobic, continuous, rhythmic exercises that incorporate large muscle groups, i.e treadmill, elliptical, rower, bicycle
  • Volume: Increase total duration of exercise 2-10 min each week
  • Progression: Increase duration before intensity, pushing from 150 min/week to 250 min/week of total duration

William Manzi

William Manzi

William Manzi, CEP, is an exercise physiologist and personal trainer who specializes in the ability to take care of any individual, regardless of any limitations. Over the past ten years, he has trained a variety of different individuals for over ten years, including US Navy SEALs, heart attack patients, and more.

Meet Will

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The role of nutrition in promoting heart health

The role of nutrition in promoting heart health

Heart disease is the leading cause of death in both women and men in the United States; maintaining a heart healthy diet is key to lowering your risk. Here's a case example of a client who is looking to improve her health and body composition, and what a sample menu representing the recommended diet.

February 6, 2024 | Francine Blinten, MS, CCN, CNS

heart healthy diet=

Heart disease is the leading cause of death in both women and men in the United States. Risk drivers include high blood pressure, high low-density lipoprotein (LDL) cholesterol, high triglycerides, diabetes, smoking and secondhand smoke exposure, obesity, unhealthy diet, and physical inactivity.

As a clinical nutritionist, I work with clients seeking to lower their risk factors through dietary modifications. The dietary pattern I most often recommend is the Mediterranean diet*. Conformity with the traditional Mediterranean Diet is associated with better cardiovascular health outcomes, including clinically meaningful reductions in rates of coronary heart disease, ischemic stroke, and total cardiovascular disease.

The nutrition consultation starts with a review of the client’s current clinical data. Specifically, I’m interested in fasting glucose, lipid panel, blood pressure and C-Reactive protein (a measure of inflammation). Body weight and waist circumference are also measured. We establish metabolic targets for out-of-range markers.

Together we evaluate the baseline diet and identify areas for improvement to meet the targets. We discuss lifestyle factors such as cooking skills, meal and hunger patterns as well as food preferences.

If the client has extra bodyweight, we need to address it because being overweight influences several risk drivers of disease. In my experience, a 5% reduction in baseline weight leads to significant clinical improvement.

The diet plan is tailored to the client’s age, gender, activity level and metabolic goals. Food allergies and sensitivities are noted. Portion sizes for each food category are outlined. In my experience, it is better to make small permanent changes rather than a complete overhaul; the latter usually fails.

Case Example

A 50-year-old woman presents with:

LDL cholesterol elevated at 145 mg/dL

Borderline fasting glucose at 110mg/dL

Borderline triglycerides at 150 mg/dL

Normal weight but waist measures 38”

Blood pressure is normal 120/80

Her target is:

< 100 mg/dL

80 – 95 mg/dL

< 100 mg/dL fasting

maintain weight, waist < 35”

maintain 120/80

She eats three meals and an afternoon snack. Breakfast is cereal or a muffin; lunch is a sandwich or salad; dinner is chicken with a starch and a vegetable or pasta and a salad. She likes eggs but is afraid to eat them because of her cholesterol, so she eats cereal or a muffin instead. She likes fish but doesn’t prepare it at home. Snacks are protein bars or chocolate. She also exercises three times a week playing pickleball.

The remedy:

Her breakfast is low in protein and fiber. She plays pickleball after breakfast, so I recommended she start the day with more protein to better fuel her game.
I suggested 7 eggs/week for her, preferably with vegetables or fruit, as well as adding more fish and a few vegetarian meals each week. She should limit refined carbohydrates such as cereal and muffins, as they are likely raising her LDL, triglycerides, and blood sugar. The pancreas must produce more insulin in response to the rise in glucose. Over time, insulin resistance leads to fat placement in the abdomen.

Sample menu:

Breakfast

Yogurt with almonds and berries

or

Eggs with spinach and mushrooms

Lunch

Minestrone soup, cucumber and tomato salad

Or

Grilled chicken and chickpea salad with olives and feta, olive oil and balsamic vinegar

Snack

Bell pepper with humus

Or

Apple and almond butter

Dinner

Roasted salmon with garlic and brussels sprouts

Or

Turkey chili and roasted butternut squash

Or

Sweet potato black bean chili


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Francine Blinten

Francine Blinten

Francine Blinten, MBA, MS, CCN, CNS, is a nutritionist who specializes in disease prevention, management of chronic disease, weight management, gastrointestinal disorders and bone support. She also has a subspecialty in oncology nutrition.

Meet Francine

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Effects of stress on cardiovascular health

Effects of stress on cardiovascular health

In recognition of heart health month, our hosts shed light behind some of the science on how stress interacts with the cardiovascular system and provide education on stress so that you can increase your ability in managing or having more control over it.

February 6, 2024 | Brendan Copley, CSCS, ATC | Arianna Martignetti, Ed.D.

Stress and heart health

Personal trainer Brendan Copley and mental performance consultant Arianna Martignetti team up once again to discuss the effects of stress on cardiac health. In recognition of heart health month, they shed light behind some of the science on how stress interacts with the cardiovascular system and provide education on stress so that you can increase your ability in managing or having more control over it.

Brendan and Arianna delve into defining both normal healthy cardiovascular health and abnormal cardiovascular health, explore the definitions and responses to stress, and examine how mental well-being can affect cardiovascular health. They also discuss physiological and mental ways individuals experience stress, methods to manage and relieve stress, including exercise, meditation, and breathwork, and the associations of chronic stress with cardiovascular health.

Listen here, or wherever you get your podcasts.


Brendan Copley

Brendan Copley

Brendan Copley, CSCS, ATC, is a personal trainer who specializes in working with endurance athletes and post-rehab clients. Brendan is a marathoner and former cross-country runner and has worked as an athletic trainer for Quinnipiac University’s cross-country and track teams.

Meet Brendan

Arianna Martignetti

Arianna Martginetti

Arianna Martignetti, Ed.D., is a mental performance consultant who works with individual athletes, weekend warriors and teams at all levels, including competitive youth, high school, and collegiate levels, as well as recreational athletes.

Meet Arianna

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Unlock Your Best: Performance Golf Assessments

Unlock Your Best: Performance Golf Assessments

Maximizing the weather in Florida is a must, which is why the golf community is so vibrant down south. With personalized programming and a team approach to care, you can optimize your golf performance by improving your strength and mobility, allowing you to play stronger, longer, and without pain.

January 16, 2024 | Larry Piretra, PT, DPT, TPI-M2 | Garrett Rasmussen, CPT, TPI-F1

 

 

Improve your golf game with a Performance Golf Assessment!

Our team of golf experts will put a coordinated and highly-personalized strategy in place so you can reach your goals... and exceed them. Learn more about golf fitness at Performance.

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Larry Piretra

Larry Piretra

Larry Piretra, PT, DPT, OCS, CSCS, TPI-M2 is a physical therapist and strength and conditioning specialist who serves as the Naples Site Lead. As a Titleist Medical and Fitness Professional, Larry also serves as the Golf Programming Lead for Performance.

Meet Larry

Garrett Rasmussen

Garrett Rasmussen

Garrett Rasmussen, CPT, TPI-F1, is a golf trainer based in Naples who specializes in strength and conditioning. He has worked with a diverse population in one-on-one settings as well as small group training, having taught over 10,000 group fitness classes and worked with hundreds individually. As an avid golfer, he is constantly pursuing higher levels of education around the sport, and he is currently working to achieve the TPI Level 2 Power Certification.

Meet Garrett

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How can I golf longer — and with less pain?

How can I golf longer — and with less pain?

Here are some key strategies to help you extend your golfing years and play the game pain free.

January 11, 2024 | Garrett Rasmussen, CPT, TPI-F1

golfer=

Golf is a sport that can be played year-round in southwest Florida, and with the average daytime temperature reaching the mid 70s, it's a perfect time to get out and play. The game offers a lifetime of enjoyment and challenge; however, as with any physical activity, golf can take a toll on the body, leading to discomfort — and even pain. Here are some key strategies to help you extend your golfing years and play the game pain free.

The foundation for a pain-free round is a thorough warm-up routine. Engage in light cardiovascular exercises to increase blood flow to your muscles: this could be anything from a brisk walk or a short bike ride, followed by dynamic stretching to improve flexibility. Focus on the major muscle groups of the golf swing, which includes legs, shoulders, hips, and lower back, to enhance your range of motion. Flexibility is a key component to a powerful and pain free golf swing.

On off days, incorporate a well-rounded fitness routine into your regimen, focusing on strength, stability and flexibility. A Certified Titleist Performance Institute (TPI) trainer can screen you for stability, mobility and strength deficiencies and create a custom fitness plan to address these areas. The addition of a golf specific exercise routine enhances your body's ability to move through the golf swing with greater ease, preventing stiffness and discomfort while building power and endurance.

A factor that often gets overlooked in injury prevention is recovery. Take time after your round to assess how the body feels and identify any discomfort. Your TPI trainer can prescribe a cool down and stretch routine to relieve any stiffness or pain and help speed up the recovery. Be sure to hydrate and refuel with a healthy meal as well to assist in the recovery process.

Golf is a sport that can be played all year by all levels and ages. To continue playing as long as possible and with as little pain as possible,  remember to always warm up properly, work with a TPI trainer to improve your fitness, and take some time to cool down. By incorporating these strategies into your golfing routine, you can pave the way for a more extended and pain-free golfing journey.

 

Improve your golf game with a Performance Golf Assessment!

Our team of golf experts will put a coordinated and highly-personalized strategy in place so you can reach your goals... and exceed them. Learn more about golf fitness at Performance.

Contact Us

Garrett Rasmussen

Garrett Rasmussen

Garrett Rasmussen, CPT, TPI-F1 is a golf trainer based in Naples who specializes in strength and conditioning. He has worked with a diverse population in one-on-one settings as well as small group training, having taught over 10,000 group fitness classes and worked with hundreds individually.

Meet Garrett

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Break up with New Year’s Resolutions

Break up with New Year's Resolutions

Meet Paul Steed: an avid runner, tennis player, and horseback rider, who is looking stronger than ever. After starting with Performance as an physical therapy client for a torn abductor, he now trains with Will Manzi. As he continues to improve his strength and endurance, Paul doesn't actually believe in New Year's Resolutions — instead, he seeks to be the best form of himself year round.

January 2, 2024 | Will Manzi, CEP

 


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Will Manzi

Will Manzi

William Manzi, CEP, is an exercise physiologist and personal trainer who specializes in the ability to take care of any individual, regardless of any limitations. Over the past ten years, he has trained a variety of different individuals for over ten years, including US Navy SEALs, heart attack patients, and more. Through this, Will has been able to build his expertise, and add an arsenal of exercises to his toolkit that can be progressed or digressed depending upon the individual.

Meet William

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The psychology behind goal setting & behavior change

The psychology behind goal setting & behavior change

The beginning of a new year is a common and motivating time to want to set new goals. One way people achieve their goals is through systematic goal setting. Sometimes, however, we may have trouble achieving the goals that we set. Here are some reasons why reaching our goals may be easier said than done, explanations for how goal setting works, and what you can do about it.

January 2, 2024 | Arianna Martignetti, Ed.D

psychology behind goal setting=

The beginning of a new year is a common and motivating time to want to set new goals. One way people achieve their goals is through systematic goal setting. Sometimes, however, we may have trouble achieving the goals that we set. Outlined below are some reasons why reaching our goals may be easier said than done, explanations for how goal setting works, and what you can do about it.

Changing a behavior is difficult and complex, especially if it is a behavior that we have been exhibiting for a very long time, or learning a brand new one! The transtheoretical model of change (TTM), originally theorized and researched amongst smokers, breaks down stages to better understand the process of changing a behavior.(1) Five of them are briefly outlined below:

Precontemplation: In this stage, people do not intend make a change within the next six months, and may not consider or be aware that their behavior is problematic or unhealthy.

Contemplation: People intend to begin changing their behavior within the next six months, and start to consider the pros and cons of changing such a behavior.

Preparation: People are ready to take a step towards changing their behavior within 30 days and believe that a change can influence a healthier life.

Action: People have changed their behavior within the past 6 months. They intend to keep working on it by altering their problematic behavior and/or adopting new/healthier behaviors.

Maintenance: People have maintained their changed or new behaviors for more than six months, and intend to continue doing so.

It is important to note that there are limitations to the TTM, two of which include socioeconomic status and social contexts. Depending on which stage someone is in, there are interventions known as processes of change that can be implemented to help with changing/maintaining behaviors by altering our thinking and feelings.(1) Two examples are consciousness raising and reinforcements. Consciousness raising refers to information (either directly or indirectly) that raises our awareness of a problematic behavior and/or a healthy behavior. Social media and commercials do this a lot! An advertisement might share statistics of an unhealthy behavior or share images and anecdotes to promote healthy a behavior. Reinforcements are used to reward the desired behavior with hopes in reducing the unwanted behavior. For example, if you hit your exercise goal for the week, you might reinforce your behavior by purchasing a new workout shirt.

Consider the goal(s) that you are thinking about for the new year and which stage you think you are in. As for systematic goal setting, researchers suggest that setting goals can direct your focus, thus affecting your effort, influence and prolong your persistence, and help you develop new or improved strategies.(2) Factors that affect our goal setting process include the level of goal difficulty, how specific you are, and the use of both short-term and long-term goals.(3) Goals that are moderately-difficult-to-difficult are recommended compared to goals that are either too easily achieved or unrealistic and unattainable. Furthermore, if a goal that you set is too vague, it can be difficult to evaluate whether you are making progress.

When considering the relationship between goal setting and your performance, evaluation is a crucial factor. It is common to experience anxiety related to evaluating your progress; however, evaluation is necessary as it will allow you to adjust, re-consider, or set new goals for yourself. As for short-term goals, setting ones that are relevant to your long-term goal can help maintain persistence, and influence your motivation and confidence; this is especially true when you achieve those short-term goals! Some other forces that contribute to the relationship include the knowledge or resources that you have access to, your ability, and your commitment level. When assessing your level of commitment, reflect on the source of your goal. Are you setting it for yourself, or is it being influenced by somebody/something else? This can affect our motivation, and whether we feel more in control of our goal versus it being controlled by someone/something else.

Consider the above information in reference to directing your focus, acknowledging how it affects your effort and persistence, and the influence of new strategies along the way. It is important to note that goal setting is not necessarily a one-size-fits-all approach. For more information on systematic goal setting, feel free to check out our previous post on how to set a New Year's Resolution.

References

1. Prochaska, J. O., & Norcross, J. C. (2001). Stages of change. Psychotherapy, 38(1), 443-448.

2. Locke, E. A., & Latham, G. P. (2019). The development of goal setting theory: A half century retrospective. Motivation Science, 5(2), 93-105.

3. Jeong, Y. K., Healy, L. C., & McEwan, D. (2021). The application of goal setting theory to goal setting interventions in sport: A systematic review. International Review of Sport and Exercise Psychology, 16(1).


Want to get started on your goals for the year?

Schedule an Optimal Health Assessment! Our team of experts will put a coordinated and highly-personalized strategy in place so you can reach your goals... and exceed them.

Contact Us


Arianna Martignetti

Arianna Martignetti

Arianna Martignetti, Ed.D., is a mental performance consultant who works with individual athletes, weekend warriors and teams at all levels, including competitive youth, high school, and collegiate levels, as well as recreational athletes.

Meet Arianna

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RECIPE: White bean and kale soup, perfect for balancing blood sugar levels

White bean and kale soup, perfect for balancing blood sugar levels

During the holidays we tend to eat delicious foods that are higher in sugar, carbohydrates, etc. A great way to balance this out is to focus on foods that help to maintain steady blood sugar levels throughout the day. Here's a recipe perfect for doing so.

January 2, 2024 | Ashley Jerry, MS

white bean and kale soup

Recipe from Culinary Hill, with modifications from nutritionist Ashley Jerry, MS.

This white bean and kale soup is a nourishing dish packed with the benefits of kale and creamy white beans recommended by nutritionist Ashley Jerry. During the holidays, we tend to eat delicious foods that are higher in sugar, carbohydrates, etc. A great way to balance this out is to focus on foods that help to maintain steady blood sugar levels throughout the day. Foods that help to balance blood sugar levels include oatmeal, beans, and other high fiber foods such as nuts, seeds, raspberries and apples.

This hearty soup is lightly seasoned with garlic and herbs, creating a delicious blend of flavors. Kale is known as a “superfood” because it is packed with properties that can help lower blood sugar levels, such as fiber and flavonoids antioxidants.

Beans are rich in magnesium, fiber, and protein, all that can also help lower blood sugar. Beans are also high in soluble fiber and resistant starch, which slows down digestions and helps against post-meal blood sugar spikes.

Ingredients

  • 1 tablespoon olive oil
  • 1 onion, chopped
  • 3 cloves garlic, minced
  • 2 carrots, sliced
  • 2 celery stalks, diced
  • 1 bunch kale, stems removed and leaves chopped
  • 1 can (15 oz) white beans, drained and rinsed
  • 4 cups low-sodium vegetable broth
  • 1 teaspoon dried thyme
  • 1 teaspoon dried rosemary
  • Salt and pepper to taste

Steps

  1. In a large pot, heat olive oil over medium heat. Add onions and garlic, sauté until fragrant.
  2. Add carrots and celery, and cook until slightly softened.
  3. Add kale and cook until wilted.
  4. Add white beans, vegetable broth, dried thyme, dried rosemary, salt, and pepper. Stir well.
  5. Bring the soup to a boil, then reduce heat and let it simmer for 15 minutes.
  6. Adjust seasoning according to taste.
  7. Serve hot, and enjoy this nourishing bowl of goodness!

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Schedule an appointment with one of our nutritionists!

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Ashley Jerry

Ashley Jerry

Ashley Jerry, MS, is a nutritionist who specializes in a variety of fields, including food sensitivities, medical conditions, and sports nutrition. Her expertise includes gut health issues, weight loss, self-image and an overall understanding of nutrition, as well as treating a diverse range of medical conditions such as high cholesterol, high blood glucose levels, obesity, pregnancy, gastrointestinal function, anxiety, depression, and overall health.

Meet Ashley

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RECIPE: Zucchini frittata, a high protein start to your day — and year

Zucchini frittata, a high protein start to your day — and year

Protein is one of the most important nutrients for weight loss and creating balanced meals; increasing the amount of protein you eat may help support weight loss by balancing certain hormones and helping you feel satiated longer, among other benefits.

January 2, 2024 | Ashley Jerry, MS

zucchini frittata

Recipe from EatingWell, recommended by nutritionist Ashley Jerry, MS.

Start your day — and the new year — strong with a protein-packed, delicious frittata. Protein is one of the most important nutrients for weight loss and creating balanced meals; increasing the amount of protein you eat may help support weight loss by balancing certain hormones and helping you feel satiated longer, among other benefits.

This Italian dish, similar to a flat omelet, can be filled with a variety of ingredients and makes for a perfect impromptu meal any time of day, but I especially love to eat it for breakfast. Whether you're in need of a hearty breakfast like me, a light lunch, or a satisfying dinner, frittatas are the perfect solution, and a great way to incorporate more protein and vegetables into your daily intake. You can also add smoked salmon for additional protein!

Ingredients

  • 4 teaspoons extra-virgin olive oil, divided
  • 1 cup diced zucchini, (1 small)
  • ½ cup chopped onion
  • 1/2 cup grape tomatoes, or cherry tomatoes, halved
  • ¼ cup slivered fresh mint
  • ¼ cup slivered fresh basil
  • ¼ teaspoon salt, divided
  • 2 large eggs 4 egg whites
  • Freshly ground pepper, to taste
  • 1/3 cup crumbled goat cheese, (2 ounces)

Steps

  1. Heat 2 teaspoons oil in a 10-inch nonstick skillet over medium heat. Add zucchini and onion; cook, stirring often, for 1 minute. Cover and reduce heat to medium-low; cook, stirring occasionally, until the zucchini is tender, but not mushy, 3 to 5 minutes. Add tomatoes, mint, basil, 1/8 teaspoon salt and a grinding of pepper; increase heat to medium-high and cook, stirring, until the moisture has evaporated, 30 to 60 seconds.
  2. Whisk eggs, the remaining 1/8 teaspoon salt, and a grinding of pepper in a large bowl until blended. Add the zucchini mixture and cheese; stir to combine.
  3. Preheat the broiler.
  4. Wipe out the pan and brush it with the remaining 2 teaspoons oil; place over medium-low heat. Add the frittata mixture and cook, without stirring, until the bottom is light golden, 2 to 4 minutes. As it cooks, lift the edges and tilt the pan so uncooked egg will flow to the edges.
  5. Place the pan under the broiler and broil until the frittata is set and the top is golden, 1 1/2 to 2 1/2 minutes. Loosen the edges and slide onto a plate.
  6. Cut into wedges and serve.

Want to get started on your nutrition goals for the year?

Schedule an appointment with one of our nutritionists!

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Ashley Jerry

Ashley Jerry

Ashley Jerry, MS, is a nutritionist who specializes in a variety of fields, including food sensitivities, medical conditions, and sports nutrition. Her expertise includes gut health issues, weight loss, self-image and an overall understanding of nutrition, as well as treating a diverse range of medical conditions such as high cholesterol, high blood glucose levels, obesity, pregnancy, gastrointestinal function, anxiety, depression, and overall health.

Meet Ashley

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RECIPE: Carrot and celery soup, using a seasonal ingredient

Carrot and celery soup with thyme pecan crumble

Throughout the year, there are certain vegetables that are considered "in season," which means they are purchased and consumed around the time that they are harvested — when they are freshest, and typically tastiest.

January 2, 2024 | Ashley Jerry, MS

carrot and celery soup

Recipe from It's a Veg World After All, recommended by nutritionist Ashley Jerry, MS.

Seasonal eating is a term used to describe the practice of eating foods, produce in particular when it’s at its harvest peak. For this reason, seasonal food is fresher, contains higher nutrient levels, and tastes better than out of season foods. Seasonal fruits and vegetables produced on local farms are often fresher, as they do not require long distances for transport. Eating seasonally may have health benefits and may offer a sustainable alternative to other practices. That's why our nutritionist, Ashley Jerry, recommends to her clients to eat seasonally when possible, and shop at your local farmers market to find the highest quality of seasonal produce depending on the season!

Here are some of January's in-season foods:

  • Beets
  • Brussels Sprouts
  • Carrots
  • Citrus
  • Kale
  • Leeks
  • Parsnips
  • Pomegranate
  • Turnips
  • Winter Squash

To celebrate one of the highly nutritious veggies of the season, the carrot, here's the recipe for a carrot and celery soup Ashley recommends, perfect for the winter. This recipe serves four people, with each serving totaling 340 calories.

Ingredients

  • 2 tablespoons olive oil
  • 1 sweet onion peeled and diced
  • 2 cloves garlic pressed or minced
  • 4 carrots sliced
  • 6 stalks celery sliced
  • 4 cups vegetable broth
  • 1 tablespoon butter
  • 1 cup pecans chopped
  • 2 tablespoon fresh thyme
  • 1 teaspoon brown sugar or coconut sugar

Steps

  1. In a large soup pot over medium heat, heat the olive oil and add the garlic and onion. Sautee for a few minutes before adding the carrots and celery. Cook for 5-7 minutes, or until the vegetables are slightly tender, then add the vegetable broth and bring to a boil. Cover, reduce heat to a simmer/low boil, and cook for 20-25 minutes or until the carrots are tender.
  2. When the carrots are tender, remove the soup from heat and use an immersion blender to puree it. You can also transfer the soup in batches to a regular blender to puree it.
  3. While the soup is cooking, heat the butter in a small skillet over medium heat. Add the chopped pecans, thyme, and brown sugar. Cook, stirring frequently, until the pecans are fragrant (about 3-5 minutes). Be careful not to burn them. Remove from heat and set aside.
  4. Ladle the soup into bowls and top with the thyme pecan crumble. Enjoy!

Serve with fish or chicken breast for a complete meal.


Want to get started on your nutrition goals for the year?

Schedule an appointment with one of our nutritionists!

Contact Us


Ashley Jerry

Ashley Jerry

Ashley Jerry, MS, is a nutritionist who specializes in a variety of fields, including food sensitivities, medical conditions, and sports nutrition. Her expertise includes gut health issues, weight loss, self-image and an overall understanding of nutrition, as well as treating a diverse range of medical conditions such as high cholesterol, high blood glucose levels, obesity, pregnancy, gastrointestinal function, anxiety, depression, and overall health.

Meet Ashley

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Telehealth is here to stay: a client interview

Telehealth is here to stay: a client interview

Telehealth and virtual training over platforms like Zoom have proven to be more than just a temporary solution; they are here to stay. The convenience and accessibility offered by remote health services make them particularly beneficial for individuals who travel frequently. Virtual sessions eliminate geographical barriers, allowing people on the move to access personalized training or healthcare guidance seamlessly. Here's how one of our trainers works remotely with his client.

December 7, 2023 | Carter Bushway, CPT

telehealth

Telehealth and virtual training over platforms like Zoom have proven to be more than just a temporary solution; they are here to stay. The convenience and accessibility offered by remote health services make them particularly beneficial for individuals who travel frequently. Virtual sessions eliminate geographical barriers, allowing people on the move to access personalized training or healthcare guidance seamlessly. This shift not only accommodates the demands of a mobile lifestyle, but also underscores the enduring value of remote health services in providing flexibility and continuity for individuals on the go.

A great example of a client of mine who primarily works with me remotely is Tara N., who we interviewed for this article. Tara has been a phenomenally dedicated client that has been with me for the last three years. She started with me in person as a client coming off of physical therapy with Todd Wilkowski. She's always looking for challenges, but knows her own limitations and what is smart for her to do. To be able to work with someone who not only wants to push herself, but is also smart about how she goes about it and really cares about the how and why of what we are doing every session, it’s been such a privilege for me.

At first, coming out of physical therapy with Todd for a meniscectomy, we initially focused on regaining strength in her legs and stability in her knees to hopefully eventually return to playing tennis. This resulted in a lot of accessory work, focusing on her glutes and inner hip muscles to stabilize gross movement, as well as heavier compound lifts such as squats and deadlifts. As she went to grad school, and then later moved across the country for a job, I shifted programming her workouts that would prepare her for other activities, like volleyball and hiking.

When she moved for grad school, we shifted to all Zoom, with her coming back for evaluations and check-ins during her breaks. Now that she lives across the country, we are basically 99% Zoom, and whenever she comes back to the area to visit family, she stops in and has a session with me, which always warms my heart. We've always been open and honest about what she can do with her schedule, and we've always found a way to make things work.

I think that one of the reasons Tara is doing so well is because she has a great support system around her. Even though she moved locations, she still had her support system with them no matter where they go. I am always a text, phone call, or Zoom call away, and if she ever needs any help, guidance, support, or confidence boost, I'm there for her. Training is tough, anybody who tells you otherwise is selling you something. So, for anyone looking to train virtually, continuing to have their support system to help them do the tough stuff makes all the difference.

Technology is here to stay, and it's up to us to make the most of it.


Our interview with personal training client, Tara N.

  1. How did you first join Performance?
    I first joined Performance when I was about 14 years old. I had sustained an injury while I was rowing in high school and shortly after, was recommended to visit Todd. Fast forward a decade or so, I ended up tearing my meniscus in graduate school and came in for physical therapy and got set up with Carter!
  2. What has your recent training experience been like?
    Carter is genuinely the best. I am a relatively reserved person when working out; all I want is to be worked hard, and for someone to push me when I need to be pushed. Carter did exactly that and more. When I would feel low and not comfortable in my body, or unhappy with my post-surgery recovery progress, Carter would always be quick with encouragement, and a kind word. He truly understands his clients and is not only an amazing trainer, but a friend as well.
  3. What are your goals?
    Funnily enough the very first goal was to just walk comfortably and without pain again. The second goal was to be able to do one pushup! But my serious, overarching goal was to just feel strong, to not have any pain, and to become a better athlete by working on my full body conditioning. I am happy to say that I'm good on goals 1 and 2, and am very happy with my progress on 3.
  4. Now that you are training virtually, do you miss coming to your workouts in person?
    Personally, I do love being in person. However, I moved out west for a new job, and being virtual has allowed me not only to stay connected to Performance, but has also allowed me to continue working with Carter! While I do miss coming in and the routine of going to a physical location, I have found that remote working gets rid of any of my excuses to workout and instead has allowed me to really flourish in my space.
  5. How did training virtually impact or improve your journey or your goals?
    Initially it was challenging. Coming into the Performance location in Greenwich was so much fun, and I loved using the equipment. That said, Carter's expertise and ability to use what was available to me to achieve the same results was impressive! If anything, training remotely also helped me realize that I can be just as strong, just as productive in my home and that I can achieve physical success anywhere if I know how to look for it.

Carter Bushway

Carter Bushway

Carter Bushway, CPT, has channeled his passion for exercise into everything he does. Carter has a passion for basketball, balance and stability training, group fitness classes and working with older adults.

Meet Carter

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Revolutionizing physical therapy: the transformative role of AI in diagnosis, treatment, and patient care

Revolutionizing physical therapy: the transformative role of AI in diagnosis, treatment, and patient care

As we look into the future, the field of physical therapy stands on the brink of a profound revolution, driven by the potential of AI. Much like a skilled practitioner, AI can play a pivotal role in differential diagnosis, determining prognoses, developing personalized treatment plans, and in communication, monitoring and progression of treatment plans from afar.

December 7, 2023 | Shane Foley, PT, DPT, OCS, CSCS

physical therapy and AI

In the ever-evolving landscape of healthcare, the integration of artificial intelligence (AI) has already proven to be a transformative force. Many large hospital organizations are already utilizing this these technologies in things like reading x-rays and MRIs, and for pattern recognition in diagnosis disorders. As we look into the future, the field of physical therapy stands on the brink of a profound revolution, driven by the potential of AI. Much like a skilled practitioner, AI can play a pivotal role in differential diagnosis, determining prognoses, developing personalized treatment plans, and in communication, monitoring and progression of treatment plans from afar. AI is poised to elevate the practice of physical therapy into a more dynamic service offering, by improving precision and efficiency in diagnosis and treatment while fostering enhanced communication between therapists and patients.

One of the primary challenges in orthopedic physical therapy lies in consistency and accuracy of diagnosing a condition, and then developing the best treatment plan to return back to activity without pain and mitigate risk of injury recurrence. AI, with its ability to process vast datasets, synthesize research and identify patterns beyond human capacity, becomes a powerful tool in this regard. Physical therapists, Board Certified Orthopedic or Sports Clinical Specialists, those in Residency or Fellowship post-doctoral training, can all benefit from this tool. By analyzing patient history, imaging, and clinical data, AI algorithms can assist therapists in pinpointing the root cause of musculoskeletal issues with specific accuracy. With this, from the evaluation, patients can know that best guidelines are used to create the framework for the therapist to begin care. This then allows the experience and true artistry of the therapist’s manual therapy and patient specific rehab program design to come into play. This is the real differentiator!

The marriage of human expertise and AI prediction capabilities promises a more dynamic and responsive approach to patient care. This will allow both synchronous and asynchronous analysis of technique and form with prescribed exercises, communication, and the assimilating patient data, lifestyle factors, and treatment responses. AI models can help to forecast the likely trajectory of a condition in real time, providing foresight that enables therapists to proactively adapt treatment plans, optimize outcomes and potentially prevent the exacerbation of symptoms.

Personalization is the cornerstone of effective physical therapy and in high quality patient care. With the busy clinic environment in many physical therapy practices across the country, too often, a 16 y/o patient who tore their ACL and a 65 y/o patient with a knee replacement begin their treatment with the cookie-cutter “Knee Program.” AI helps to develop an evidence based framework for the patient, that the therapist can then use their creativity and expertise to tailor treatment plans to individual needs.

Continuous learning capabilities enable real-time adjustments to treatment plans based on patient progress. Although there is an expected timeline of recovery, as we have seen many times in professional sports, there are many specific and individualized factors which may cause someone to be on one side of the rehab timeline or the other. This iterative and adaptive approach ensures that therapy evolves dynamically, addressing the unique challenges each patient faces throughout their rehabilitation journey and that the determination of time to return to activity is appropriate.

Effective communication is integral to a successful therapeutic alliance between physical therapists and their patients. AI contributes to this aspect by facilitating seamless and personalized communication channels. AI-powered platforms can offer patients real-time guidance, support, and educational resources. These tools not only empower patients to actively participate in their rehabilitation, but also foster a continuous feedback loop between the therapist and the individual. The result is a collaborative and informed approach where patients feel engaged and motivated throughout the treatment process.

As we look toward the future of physical therapy, the symbiotic relationship between human expertise and artificial intelligence promises a paradigm shift in healthcare delivery. The integration of AI in differential diagnosis, prognosis determination, treatment plan development, and patient communication holds the potential to revolutionize the field, providing practitioners with unprecedented tools for precision and efficiency. Utilization of AI in physical therapy is the evolution of their field, a progression to a true hybrid-rehab model.

The hands-on manual artistry of a physical therapist will always be an irreplaceable skill to not just fact-check AI, but to help alleviate pain, decreased muscle tightness, improve mobility, provide tactile cuing for correct exercise performance, and build a trusting relationship between two human beings. It is my position that in the hands of a highly educated, experienced clinician, the utilization of AI is the future of best practice in clinical base healthcare. The utilization of AI across all levels and experiences of clinicians in the field of physical therapy helps to raise the floor, and overall quality of care that can be provided by anyone, anywhere. Thus, helping more people get better both completely and faster.


Shane Foley

Shane Foley

Shane Foley, PT, DPT, OCS, CSCS, is an orthopedic specialist who is certified in strength and conditioning, dry needling, and the Schroth Method. He has a deep passion for building relationships, helping people accomplish their goals and leading people to optimize their performance.

Meet Shane

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Food is primary care: the role of food in preventing and managing chronic diseases

Food is primary care: the role of food in preventing and managing chronic diseases

Long a blind spot of medicine, nutrition has stepped into focus in recent years. Yet it can be a powerful tool to promote a healthy life, if used correctly. "Food Is Medicine" is defined as the provision of healthy food resources to prevent, delay, manage, or treat specific clinical conditions in coordination with the health care system.

December 7, 2023 | Francine Blinten, MBA, MS, CCN, CNS

food is medicine

Long a blind spot of medicine, nutrition has stepped into focus in recent years. Yet it can be a powerful tool to promote a healthy life, if used correctly. "Food Is Medicine" is defined as the provision of healthy food resources to prevent, delay, manage, or treat specific clinical conditions in coordination with the health care system.

According to the Centers for Disease Control and Prevention, six out of every ten adults in the United States have at least one chronic disease, and about four in ten have two or more chronic diseases. Chronic diseases are conditions of long-term duration and require ongoing medical care; they include cardiovascular disease, atherosclerosis, hypertension, cancer, type 2 diabetes, Alzheimer’s disease, and osteoporosis, among others. Healthful nutrition practices are an essential component of efforts to prevent or control these diseases.

While nutrition cannot replace medicine, it can be an important part of a care plan; one the patient can control. Importantly, people are demanding it and if their healthcare providers are not incorporating therapeutic lifestyle options in their patient encounters, they will seek it out elsewhere, often from scientifically unsupported sources.

Fortunately, several organizations and associations are recommending guidelines, research, and funding for food as medicine programs. The American Heart Association (AHA) recently called for more research on integrating food and nutrition into healthcare. In September 2022, the AHA launched a Food Is Medicine research initiative designed to determine the impact of nutrition-based interventions on disease prevention and treatment, compared with standard medical care.

The National institute of Health published a study that showed preventable cancer burden is associated with poor diet in the United States, which means we can decrease our risk of cancer by maintaining a healthy diet.

Another example is preventing diabetes: the National Diabetes Prevention Program is the CDC-recognized lifestyle change program, a research-based program focusing on healthy eating and physical activity which showed that people with prediabetes who take part in a structured lifestyle change program can cut their risk of developing type 2 diabetes by 58% (71% for people over 60 years old).

Below are some examples of how your healthcare providers can integrate nutrition in their care, empowering clients to live a healthy lifestyle.

  • Providing educational materials such as handouts on diet related disease with sample meal plans and recipes.
  • Providing support for clients experiencing treatment related side effects. Dietary modifications can provide symptom relief so they can better tolerate treatment.
  • Appropriate referrals to dietitians or nutritionists. A feedback loop is crucial so providers can reinforce diet recommendations during patient visits.
  • Nutrition competency training for staff so everyone can participate in the effort and provide support.

Here's what you can do on a daily basis to improve your eating habits and lower your risk of chronic disease, or manage its symptoms:

  • Prioritize Plant-Based Foods
    • Increase the proportion of plant-based foods in your diet, such as vegetables, fruits, legumes, and nuts, which are rich in vitamins, minerals, and antioxidants.
  • Limit Processed Foods and Sugars
    • Reduce the intake of processed foods, sugary snacks, and beverages. Opt for whole, unprocessed foods to minimize added sugars and artificial ingredients.
  • Choose Healthy Cooking Methods
    • Opt for cooking methods such as baking, grilling, steaming, and sautéing instead of deep frying. These methods help retain the nutritional value of food.
  • Include Omega-3 Fatty Acids
    • Incorporate sources of omega-3 fatty acids, such as fatty fish (salmon, mackerel), flaxseeds, chia seeds, and walnuts, which are beneficial for heart and brain health.
  • Regular Physical Activity
    • Combine a healthy diet with regular physical activity for optimal health. Exercise contributes to overall well-being and can complement the benefits of a nutritious diet.
  • Consult with Healthcare Professionals
    • Seek advice from healthcare professionals, such as registered dietitians or nutritionists, for personalized guidance based on individual health needs and goals.
  • Cultivate Healthy Eating Habits
    • Aim for consistency in making healthy food choices, and view food as a form of self-care. Cultivate a positive relationship with food for long-term well-being.

Francine Blinten

Francine Blinten

Francine Blinten, MBA, MS, CCN, CNS, specializes in disease prevention, management of chronic disease, weight management, gastrointestinal disorders and bone support. She also has a subspecialty in oncology nutrition.

Meet Francine

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Unleashing the power of wearable technology in healthcare

Unleashing the power of wearable technology in healthcare

Wearable technology aids in improving healthcare outcomes in various ways. What sets these apart from your standard blood pressure cuff monitors, pulse oximeter, or other devices you see in a doctor's office or other medical setting, is the fact that these are devices you can wear every day. Here's how to make the most of them.

December 7, 2023 | Robert Mahlman, PT, DPT, OCS

wearables

Healthcare is a rapidly evolving landscape in which wearable technology has emerged as a game changer by offering individuals, an unprecedented opportunity to take control of their well-being. Wearables provide continuous monitoring and personalized insights which aid in exercise performance, recovery, nutrition, and overall stress management.

Wearable technology aids in improving healthcare outcomes in various ways. What sets these apart from your standard blood pressure cuff monitors, pulse oximeter, or other devices you see in a doctor's office or other medical setting, is the fact that these are devices you can wear every day. From Apple Watches to Oura Rings, FitBits to Whoop Straps, there are plenty of options for everyone.

When it comes to exercise, we are all used to wearables that will track steps, calories burned, and even heart rate while exercising. But with the current wearable technology, your average heart rate and current heart rate, heart rate variability, respiratory rate, stress levels, and even an EKG can be provided to you pre, during and post workout. This information is important with exercise as it allows the individual to see how their body responds to a specific program during the activity, and after. You can personally determine how hard the workout is, not only by a subjective feel, but also by the metrics your wearable provides.

Something that has become more important in optimizing your health and exercise is how you recover. While there are various ways you can promote recovery, such as getting appropriate sleep, mindfulness and massage therapy, wearable technology provides insight on how well those recovery tactics work on your body specifically. For example, after a stressful day or difficult workout, you may notice certain metrics will be out of their usual range. Then, by using certain recovery techniques, you can see how long and how effectively they return to baseline. This is important as it can help with managing injury risk, and overall optimization of an exercise program.

The use of wearable technology allows the average person to gain insight on their bodies, response to activities or stress, and then make an educated decision with objective data on how to recover best from that stress and build a program around it. With wearable technology, you are able to monitor your overall health regularly and watch for trends. This is some thing that when used appropriately can help decrease risk of injury across all ages, improve overall quality of life and health, and decrease stress on the healthcare system by promoting more accountability from the individual.


Robert Mahlman

Robert Mahlman

Robert Mahlman, PT, DPT, OCS, is a board certified orthopedic clinical specialist and certified Schroth therapist who specializes in the treatment of various orthopedic injuries, along with scoliosis and concussion management.

Meet Rob

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Understanding metabolic health through key biomarkers

Understanding Metabolic Health Through Key Biomarkers

Metabolic health is all about having ideal levels of certain biomarkers, such as obesity, elevated triglycerides, HDL levels, insulin resistance, and blood pressure, among others. These markers are like checkpoints on the road to a healthy metabolism — here's what you need to know.

November 1, 2023 | Claire Petri, CPT

metabolic panel

In the fast-paced world we live in, it's easy to overlook the intricate processes that keep our bodies running smoothly. One such vital process is metabolism, responsible for converting the food and beverages we consume into the energy we need to function. But how do you know if your metabolism is healthy and operating efficiently? In this article, we'll delve into the world of metabolic health and the essential biomarkers you should be keeping an eye on.

Metabolism at a glance

The metabolism is the engine that drives our bodies, determining how efficiently we burn and utilize calories. It's a complex network of chemical reactions that allows us to harness the energy we get from our diet. But just like any engine, it can experience hiccups. That's where metabolic health comes into play.

Metabolic health and biomarkers

Metabolic health is all about having ideal levels of certain biomarkers. These markers are like checkpoints on the road to a healthy metabolism. They include:

  1. Obesity: This can be measured using waist circumference or Body Mass Index (BMI), with waist circumference often being a more accurate reflection of your health. This is because abdominal fat is strongly associated with increased health risks, particularly metabolic and cardiovascular issues.
  2. Elevated triglycerides: Triglycerides are fats found in the blood and are a significant component of body fat. Elevated levels can be a sign of metabolic issues, as they are linked to an increased risk of heart disease and can indicate an imbalance in the body's energy storage and utilization.
  3. HDL Levels (cholesterol): High-density lipoprotein (HDL) cholesterol is often referred to as "good" cholesterol. Maintaining healthy HDL levels is crucial for metabolic health because it helps remove excess cholesterol from the bloodstream, reducing the risk of plaque buildup in arteries and promoting overall cardiovascular well-being.
  4. Insulin resistance: This condition can impede your body's ability to process and store sugar efficiently, potentially leading to various health problems, such as type II diabetes.
  5. Blood pressure: High blood pressure is another important indicator of metabolic health; it can reflect the body's ability to regulate blood flow and energy utilization, and it is often linked to metabolic syndrome and related conditions.

Assessing your metabolic health

You might be wondering how you can assess your metabolic health. The most comprehensive tests are typically done in a medical setting, where a Comprehensive Metabolic Blood Panel (CMP) can provide a detailed look at these biomarkers, as well as other critical information about your health, such as fluid balance, electrolyte levels, kidney function, and more.

But did you know that there are also at-home metabolism tests available? These can give you a basic idea of your metabolic health and are a convenient option if you'd like to monitor your progress regularly. These at-home metabolism tests include options like metabolic rate calculators, home blood sugar monitors, and wearable fitness trackers that provide insights into your daily activity and calorie expenditure.

Improving your metabolic health

Once you have the results of your metabolic tests, what can you do to enhance your metabolic health? Let's break it down by the key biomarkers:

  1. Obesity: Combat obesity by adopting a healthy lifestyle. Both proper nutrition and regular exercise and physical activity can help you maintain a healthy weight and boost the efficiency of your metabolism. In other words, your body will process and use calories more effectively.
  2. HDL & triglycerides: The power of exercise and nutrition shines here. Just 60 minutes of moderate-intensity aerobic activity per week, combined with a diet rich in healthy fats like olive oil and nuts, can increase your HDL levels while reducing triglycerides.
  3. Insulin resistance: Exercise, once again, is your best ally in the fight against insulin resistance. Regular physical activity helps your body process and store sugar correctly, with muscles playing a crucial role in this process. By ensuring your muscles are actively taking in glucose, you can prevent the accumulation of excess sugar in your body, which can lead to conditions like diabetes, PCOS, non-alcoholic fatty liver disease, and stroke.
  4. Blood pressure: Stress management is a key player in maintaining healthy blood pressure. By finding effective ways to manage and reduce stress, you can significantly lower your blood pressure. Techniques like good sleep hygiene, regular massages, and meditation can be invaluable in improving your metabolic health and overall well-being.

In conclusion, keeping an eye on your metabolic health is essential for maintaining a healthy and vibrant life. By monitoring key biomarkers and making positive lifestyle choices, you can ensure that your metabolism is working optimally, keeping you energized and ready to face life's challenges. So, remember, it's not just what you eat, but how your body metabolizes it that truly counts!


Claire Petri

Claire Petri

Claire Petri, CPT, is a personal trainer based in Greenwich and Darien who specializes in strength training and functional fitness. She enjoys working with both athletes and general population clients, and has experience with Pilates techniques, weight loss and pain management, helping clients overcome gym anxieties and learning proper movement patterns.

Meet Claire

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Serendipity Magazine’s Medical Leader: Danielle Pasquale

Serendipity Magazine's Medical Leader: Danielle Pasquale

Redefining healthcare

Fall/Winter 2023 | Serendipity Magazine

Physical Therapist Danielle Pasquale PT, DPT was honored as a medical leader by Serendipity Magazine for her outstanding work creating a bridge between the highest clinical standards and exceptional levels of care. Check out her feature below.

Serendipity Magazine featured Danielle Pasquale


Danielle Pasquale

Danielle Pasquale

Danielle Pasquale, PT, DPT, is a physical therapist certified in dry needling, women's pelvic health, and pre/post-natal fitness. She has always had a passion for helping people, and decided to funnel that drive into physical therapy and teaching others how to live their healthiest life.

Meet Danielle

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The effects of body composition and insulin resistance on the heart

The effects of body composition and insulin resistance on the heart

There are ways to prevent and manage cardiovascular disease through the lens of body composition and insulin resistance. Here's what you need to know.

November 1, 2023 | Optimal Health Uncovered

heart health and insulin

Dr. Alon Gitig joined host and physical therapist Michael Beecher to provide evidence-based insights into preventing and managing cardiovascular disease through a unique perspective. They emphasize that maintaining optimal muscle mass is not only beneficial for strength and mobility but also plays a significant role in reducing the risk of cardiovascular issues. In fact, studies show that individuals with higher muscle mass have a 30% lower risk of developing cardiovascular disease.

Furthermore, they highlight the alarming fact that insulin resistance, which isi often overlooked, is a hidden contributor to the development of cardiovascular disease and dementia, making it a critical aspect of overall health to address. Recent statistics indicate that approximately 34% of adults in the United States have some level of insulin resistance, underscoring the importance of addressing this silent epidemic. Join us in gaining a deeper understanding of these connections and the factual basis for better cardiovascular well-being.

Dr. Alon Gitig, MD, is a cardiologist based in Yonkers, New York who has been practicing for over two decades. He is affiliated with Mount Sinai Hospital.

Listen here, or wherever you get your podcasts.

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What constitutes a healthy metabolism?

What constitutes a healthy metabolism?

While genetics play a role in determining metabolic rates, there are several ways to optimize your metabolism for better overall health.

November 1, 2023 | Ashley Jerry, MS

clock with food

The metabolism, often associated with weight management and energy levels, is the complex process of maintaining homeostasis by regulating energy balance, nutrient availability, and cellular functions necessary for survival and proper function. While genetics play a role in determining metabolic rates, there are several ways to optimize your metabolism for better overall health.

First, it is important to understand the signs of a healthy metabolism. Individuals with a well-functioning metabolism tend to maintain weight without excessive fluctuations. They have consistent energy levels throughout the day and experience minimal fatigue. Additionally, their digestion is efficient, leading to regular bowel movements and optimal nutrient absorption.

Physical Activity

One important factor in optimizing your metabolism is physical activity. Engaging in regular exercise not only helps burn calories, but also improves muscle mass. Since muscles require more energy than fat cells even at rest, having more lean muscle leads to an increased metabolic rate. Incorporating both cardiovascular exercises like running or swimming and strength training activities such as weightlifting can contribute to an active and healthy metabolism. Additionally, High-Intensity Interval Training (HIIT) workouts involving short bursts of intense activity followed by brief rest periods can boost your metabolic rate and increase calorie burn even after the session is over.

Nutrition & Hydration

Following a well-balanced diet also significantly impacts metabolic health. It is important to incorporate whole foods like fruits, vegetables, whole grains, lean proteins, and high-quality fats. Avoiding excessive consumption of processed foods high in added sugars and low-quality fats is key, as they can negatively impact your health and metabolism.

On the other hand, consuming more protein-rich foods, which have a higher thermic effect compared to carbohydrates or fats, leads to a higher metabolic rate. Protein also helps build and maintain muscle mass. Aim for lean sources such as chicken breast, fish, Greek yogurt, and legumes. Additionally, incorporating adequate fiber from sources like whole grains, fruits, vegetables, and legumes can support a healthy metabolism. Fiber aids digestion and helps regulate blood sugar levels.

Another way to optimize your metabolism is through proper hydration. Drinking enough water helps maintain cellular function and supports various metabolic processes within the body. Dehydration can temporarily slow down your metabolism; therefore, it is important to focus on water and electrolyte intake.

Stress Management

Adequate sleep is often overlooked, but it plays a crucial role in metabolic health. Sleep deprivation can disrupt hormone production, leading to increased appetite and cravings for high-calorie foods. It also affects the body's ability to regulate blood sugar levels properly. Aim for seven to nine hours of quality sleep each night to promote optimal metabolic function.

Lastly, stress management is essential for maintaining a healthy metabolism. When we experience chronic stress, our bodies release cortisol, a hormone that can lead to weight gain and hinder metabolic processes. Engaging in relaxation techniques such as meditation, deep breathing exercises, or hobbies that bring joy can help reduce stress levels and support a well-functioning metabolism.

To summarize: A healthy metabolism exhibits stable weight maintenance, consistent energy levels, efficient digestion, and regular bowel movements. Optimizing your metabolism involves incorporating regular physical activity into your routine, consuming balanced meals with an emphasis on protein, staying hydrated, prioritizing adequate sleep, and managing stress effectively. By adopting these lifestyle changes, you can enhance your metabolic health and overall well-being.


Ashley Jerry

Ashley Jerry

Ashley Jerry, MS, is a nutritionist who specializes in a variety of fields, including food sensitivities, medical conditions, and sports nutrition. Her expertise includes gut health issues, weight loss, self-image and an overall understanding of nutrition, as well as treating a diverse range of medical conditions such as high cholesterol, high blood glucose levels, obesity, pregnancy, gastrointestinal function, anxiety, depression, and overall health.

Meet Ashley

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How menopause affects the metabolism

How menopause affects the metabolism

Among the many changes that occur during menopause, including hot flashes, night sweats, and changes in mood, a shift in metabolism also occurs which can lead to further issues as a direct result of the decrease in estrogen production. Here's what to expect.

November 1, 2023 | Ashley Moriarty, PT, DPT, OCS

woman looking out the window

Among the many changes that occur during menopause, including hot flashes, night sweats, and changes in mood, a shift in metabolism also occurs which can lead to further issues as a direct result of the decrease in estrogen production. Some of these changes include:

Slower basal metabolic rate

Basal metabolic rate is the rate at which your body burns calories at rest. If BMR slows down, which some studies suggest it does by 100 kcal/day, but energy intake (food consumption) does not decrease in a similar way, then you may be at risk of increased fat mass.

Changes in lipid profile

Menopause causes an imbalance of cholesterol, low-density lipoprotein cholesterol, (LDL), triglycerides, and high-density lipoprotein (HDL) due to a sharp decrease in estrogen. This imbalance, termed dyslipidemia, is a risk factor for cardiovascular disease.

Changes in fat distribution and insulin resistance

This is a shift in which weight is distributed throughout the body, causing more fat to accumulate in the abdomen. Abdominal fat can increase the risk of metabolic disorders, cardiovascular disease, hypertension, and diabetes due to changes in insulin resistance. The accumulation of abdominal fat in women during menopause is associated with a decline in the production of the protein adiponectin. Adiponectin is important for the metabolism of glucose, as it makes the cells muscles and the liver more sensitive to the actions of insulin. Low adiponectin levels are associated with insulin resistance and thus higher levels of glucose.

Decreased muscle mass

Other hormonal changes the occur during menopause can lead to sarcopenia, or loss of muscle mass. This decrease in muscle mass can also contribute to a slower metabolism as muscle burns more calories than fat. As you already know, there is a higher risk of increasing fat mass in the postmenopausal stage, which accompanied by a decrease in muscle mass, can put you at increased risk of musculoskeletal injury.

Recommendations

In addition to consulting with a doctor who specializes in menopause and hormone replacement therapy, you can benefit from meeting with an optimal health provider who can assess and intervene with exercise, nutrition recommendations, and help create a comprehensive plan to minimize the effects of these changes.


Ashley Jerry

Ashley Moriarty

Ashley Moriarty, PT, DPT, OCS, is a board certified orthopedic clinical specialist who is certified in dry needling and pre- and post-natal fitness.

Meet Ashley

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A comprehensive recipe for weight loss: it’s not just about exercise

A comprehensive recipe for weight loss: it's not just about exercise

When it comes to weight loss, the two commonly discussed factors include exercise and nutrition. But can someone lose weight by changing their exercise habits, but not their nutrition? Research says no: to lose weight, it is necessary to both increase physical activity and adopt a healthy, balanced diet.

October 6, 2023 | Ashley Jerry, MS

food and measuring tape

When it comes to weight loss, the two commonly discussed factors include exercise and nutrition. But can someone lose weight by changing their exercise habits, but not their nutrition? Many believe that to lose weight, it is necessary to both increase physical activity and adopt a healthy, balanced diet.

To fully identify the potential outcome of only adjusting exercise habits, one must first understand the relationship between exercise and weight loss. Exercise plays a pivotal role in burning calories and increasing metabolism. It also builds lean muscle mass, which contributes to a higher basal metabolic rate. Simply stated, the more muscle one has, the more calories they burn even at rest. Additionally, exercise helps improve cardiovascular health, boosts mood, and increases overall energy levels. Exercise is undeniably a fundamental component of any weight loss journey.

However, relying solely on exercise to lose weight poses several challenges. The first challenge includes the caloric deficit equation. An hour of moderate-intensity exercise may burn around 300-500 calories, depending on various factors such as body weight, duration, and intensity. Additionally, exercise can also stimulate hunger and increase appetite, making it more challenging to resist unhealthy food choices. Research has demonstrated that intense exercise can lead to an increase in the hunger hormone, ghrelin, while simultaneously reducing the level of the hormone responsible for suppressing appetite, leptin. This hormonal response can create a vicious cycle, making it difficult to adhere to a calorie deficit solely through exercise, without controlling nutrition habits.

Some people believe that if one were to increase the intensity and duration of their workouts, they will burn enough calories to create a calorie deficit, resulting in weight loss. While this may be true to some extent, it is important to note that relying solely on exercise to achieve weight loss goals can be a challenging and unsustainable approach. Additionally, the body is highly efficient at adapting to increased physical activity. Over time, the body becomes more efficient at performing the exercise routine, which means fewer calories are burned for the same effort. This is known as exercise adaptation, which can further impede weight loss efforts if nutrition is not addressed.

Studies have consistently shown that diet plays a more significant role in weight loss than exercise alone. In fact, numerous studies strongly support the view that changing dietary habits is fundamental for long term successful and sustainable weight loss. This is because it is much easier to consume calories than it is to burn them through physical activity.

Incorporating a balanced diet consisting of lean proteins, carbohydrates, and healthy fats (macronutrients) and one that is limited in calories will create a caloric deficit, ultimately leading to weight loss. Individuals can support their overall exercise performance and recovery by consuming nutrient-rich foods such as fruits, vegetables, nuts, whole grains, and lean proteins which promotes satiety and prevents overeating.

Another important factor to consider is the importance of post-exercise nutrition. After a workout, the body requires proper nourishment to replenish glycogen stores, repair muscles, and support recovery. Consuming a balanced meal or snack that includes adequate protein and carbohydrates can enhance the benefits of exercise and maximize weight loss. Protein consumption is particularly crucial, as it promotes muscle synthesis and boosts metabolism, helping to sustain weight loss efforts in the long run.

While it is possible for some individuals to lose weight solely by changing their exercise habits. It is often more efficient to address both exercise and nutrition simultaneously to achieve sustainable weight loss and optimize overall well-being.

It is essential to recognize that no one-size-fits-all approach exists and it is best to consult with a qualified nutritionist or healthcare provider who can provide personalized guidance for sustainable weight loss.


Ashley Jerry

Ashley Jerry

Ashley Jerry, MS, is a nutritionist who specializes in a variety of fields, including food sensitivities, medical conditions, and sports nutrition. Her expertise includes gut health issues, weight loss, self-image and an overall understanding of nutrition, as well as treating a diverse range of medical conditions such as high cholesterol, high blood glucose levels, obesity, pregnancy, gastrointestinal function, anxiety, depression, and overall health.

Meet Ashley

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Best approaches to treat your low back pain

Best approaches to treat your low back pain

Low back pain is one of the most common conditions someone will experience at some point in their life. The good news is that majority of individuals with low back pain will experience complete recovery, especially when utilizing various conservative treatment approaches.

October 6, 2023 | Renee Lascarides, PT, DPT

man clutching his chest

Low back pain is one of the most common conditions someone will experience at some point in their life. Studies have found lifetime prevalence rates for experiencing low back pain range from 70-84%. While low back pain initially may be scary, there is no reason to worry. The good news is that majority of individuals with low back pain will experience complete recovery, especially when utilizing various conservative treatment approaches that can be customized to fit someone’s needs and interests. These treatments will help control pain, improve disability, and improve quality of life. Surgery is usually only indicated for a small percentage of people with low back pain, and is not the go-to treatment option.

Stay on the move

The spine is built to be strong and resilient. When someone is experiencing low back pain, the first thought is usually to stay in bed and let it rest. However, he best thing to do when low back pain starts up is to modify, not restrict, activity, and keep moving. Avoiding painful movements or activities is okay, but bedrest is going to prolong pain and limitation of daily activities. Motion is lotion for our joints. The more we move, the better our bodies will feel. This is why exercise is the best treatment for low back pain. It may initially seem scary to exercise while you are in pain, but it will not cause any damage or further the injury, especially when it is under the guidance of a trained professional, such as a physical therapist.

Use hands on techniques

Utilizing physical therapy and massage therapy can also drastically reduce pain levels. In the early phases, hands on techniques in physical therapy can help improve how the joints in the low back move and reduce pain levels. It can also help mobilize tight and restricted muscles. Exercises can include gentle and progressive strengthening of the core, hip musculature, trunk, and legs. Aerobic exercise has been found to be one of the most effective treatments for patients who have been experiencing chronic low back pain. This can include walking, swimming, or riding a bicycle.

Other exercise methods that help people with low back pain include Pilates and yoga. Building strength will help reduce pain, restore disability, and improve robustness of the spine. Exercising also allows the body to release pain alleviating chemicals, which reduces the amount of medication needed to control pain.
Another very important aspect of recovering from low back pain is sleep.

Encourage good sleep hygiene

Good quality sleep will allow the body to heal and recover. Good sleep hygiene is crucial for us to function at our highest capacity. There are things we can modify to set us up for success; a cold, dark room along with a consistent sleep and wake time are ideal for good quality sleep.Creating a routine before bed can help signal to our body that it is time to start winding down. Taking a hot shower or bath, stretching, meditating, or doing breathe work are all good activities that will help prime our bodies for sleep and reduce low back pain. Performing this routine at or around the same time every night also helps create a regular sleep schedule. Try to avoid caffeine four to six hours before bed and avoid eating a late dinner. All these tips can help prime our body to reach REM sleep and deep sleep, where our muscles repair and grow and our body and mind recover. This is why good quality sleep will optimize recovery from low back pain.

Overall, there are a variety of methods you can use to decrease your back pain without resorting to surgery unless necessary. Remembering to stay mobile and avoiding bed rest is crucial, as well as getting a good night’s sleep and using hands on recovery methods such as massage or physical therapy.


Renee Lascarides

Renee Lascarides

Renee Lascarides, PT, DPT, is a physical therapist in the Hamden office, as well as an adjunct faculty member at Sacred Heart University. As a youth athlete, Renee was constantly active and played soccer and participated in cheerleading and gymnastics.

Meet Renee

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Should you stretch before or after a workout?

Should you stretch before or after a workout?

Warming up effectively will increase blood flow to muscles, prime joints and tendons, and lower the risk for injury. So, let’s settle the debate: what’s the best way to accomplish this, dynamic or static stretching?

October 6, 2023 | Claire Petri, CPT

woman stretching

Why limber up? A proper warm up will signal to your muscles that they are about to be called into action. Warming up effectively will increase blood flow to muscles, prime joints and tendons, and lower the risk for injury. So, let’s settle the debate: what’s the best way to accomplish this, dynamic or static stretching?

The difference between dynamic and static stretching is all about movement. Dynamic stretching is controlled movement, with the goal of taking the body through its full range of motion. These maneuvers often mimic the functional movements that will be performed during the workout. Some benefits of dynamic stretching include an increased range of motion in muscles and joints, improved blood flow, and mind-muscle connection. When a proper dynamic warm up is implemented, we also see superior muscle engagement and strength gains.

A noteworthy example is the World’s Greatest Stretch. When performed correctly, this movement effectively mobilizes the thoracic spine, hips and ankles!

woman performing the World's Greatest Stretch
Image courtesy of MindBodyGreen.

Static stretching is also extremely beneficial! However, this is best used in the cool down portion of the workout. For this style of stretching, muscles are held in an elongated position for 30 seconds or longer. Static stretching will increase flexibility, help prevent muscular soreness in the days following a workout, and will have long term effectiveness in reducing the risk of muscle strain injuries. When paired with breathwork, static stretching at the end of a workout will signal a physiological cool down response in the body, allowing heart rate to slow and blood pressure to return to pre-exercise levels. Talk about effective movement from start to finish!

References

  1. https://www.hss.edu/article_static_dynamic_stretching.asp
  2. https://news.hss.edu/9-of-the-best-dynamic-stretches-to-warm-up-with-before-a-workout-according-to-personal-trainers/
  3. https://www.physio-pedia.com/Impact_of_Static_Stretching_on_Performance#:~:text=Static%20stretching%20has%20a%20relaxation,postural%20awareness%20and%20body%20alignment.
  4. https://www.uhhospitals.org/blog/articles/2023/07/dynamic-stretching-how-to-properly-warm-up-for-exercise#:~:text=%E2%80%9CStatic%20stretching%20takes%20your%20body,University%20Hospitals%20TriPoint%20Medical%20Center

Claire Petri

Claire Petri

Claire Petri, CPT, is a personal trainer based in Greenwich and Darien who specializes in strength training and functional fitness. She enjoys working with both athletes and general population clients, and has experience with Pilates techniques, weight loss and pain management, helping clients overcome gym anxieties and learning proper movement patterns.

Meet Claire

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Are men more susceptible to heart disease?

Are women more susceptible to heart disease?

There is a common misconception that men have an increased risk of cardiovascular disease (CVD) compared to women. Recent studies have refuted this claim, stating that aging women have an increased incidence and severity of CVD compared to men.

October 6, 2023 | Chris Donato, PT, DPT

man clutching his chest

There is a common misconception that men have an increased risk of cardiovascular disease (CVD) compared to women. Recent studies have refuted this claim, stating that aging women have an increased incidence and severity of CVD compared to men.

The American Heart Association (AHA) reported in 2019 that males ages 60-79 had a 77.2% incidence of CVD, while females in the same respective age range had 78.2% incidence of CVD. In adults over 80 years of age, AHA reported females also had an increased incidence of CVD (91.8%) compared to males (89.3%). AHA also stated that from 2014-2017, 77.8% of women and 70.8% of men were diagnosed with high blood pressure or hypertension (HTN). The incidence of HTN in adults over 75 years old was 85.6% in females and 80% in men.

In women with diabetes, the risk of heart failure and risk of mortality due to CVD is increased compared to diabetic men. It was reported that incidence of mortality due to diabetic cardiomyopathy is higher in women than men, as diabetes is believed to negatively impact the protective effect of estrogen against CVD in premenopausal women.

The decline in sex hormones is also shown to increase the risk for CVD with onset of increasing age in both genders. While both genders experience a decrease in sex hormones, the decline is more significant in women following the onset of menopause. Estrogen is correlated with a lower overall incidence of CVD in premenopausal women. This further supports the indication that the steep decline in estrogen following menopause leads to an increased risk for CVD in aging women by 2-4x. Menopause also leads to increased incidence of high LDL cholesterol, HTN, diabetes, and obesity, which further elevates the risk for CVD in aging females.

However, men also experience an increased risk for CVD following a decline in the production of sex hormones. For example, studies report an increased risk for CVD in aging adult men associated with hypogonadism. This decrease in testosterone has an independent association with increased risk for acute MI in males with type 2 diabetes, as well as an overall increased incidence of CVD in men. In aging men, low testosterone levels have been linked to a higher risk for stroke. At 40 years old, men with serum testosterone levels below the recommended threshold have a higher risk of mortality due to CVD.

Other risk factors that put women at an increased risk for CVD include the steeper increase in systolic blood pressure in aging women. In adults over 75 years of age, hypertension is 14% more prevalent in females, leading to an increased risk for left ventricular hypertrophy, heart failure, and stroke. Also, women with a history of hypertensive disease during pregnancy also have an increased incidence of CVD later in life.

As mentioned earlier, although the risk of CVD in females is slightly higher than in men, increasing age has been found to have a significant correlation with the increased incidence of CVD in both genders. Therefore, it is essential to promote physical activity and lead a healthy lifestyle in order to minimize the modifiable risk factors and comorbidities associated with cardiovascular disease.

References

  1. Rodgers JL, Jones J, Bolleddu SI, Vanthenapalli S, Rodgers LE, Shah K, Karia K, Panguluri SK. Cardiovascular Risks Associated with Gender and Aging. Journal of Cardiovascular Development and Disease. 2019; 6(2):19. https://doi.org/10.3390/jcdd6020019
  2. Maas AH, Appelman YE. Gender differences in coronary heart disease. Neth Heart J. 2010 Dec;18(12):598-602. doi: 10.1007/s12471-010-0841-y. PMID: 21301622; PMCID: PMC3018605.

Chris Donato

Chris Donato

Chris Donato, PT, DPT, is a physical therapist based in New Canaan who enjoys working with all populations. He specializes in working with athletes, especially overhead athletes, drawing from his time playing five years of club baseball at Sacred Heart University.

Meet Chris

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Marathon Mondays: Make it to the start healthy

Marathon Mondays: Get to the start healthy

In the final episode of our Marathon Monday mini-series, 5x Boston Marathon Division Winner Heather Pech joins the podcast to talk about her training process and how she keeps winning gold.

September 11, 2023 | Britt Gunsser, PT, DPT, OCS, CSCS | Brendan Copley, CSCS, ATC

Get to the start healthy

Hosts physical therapist Britt Gunsser and personal trainer Brendan Copley, who are marathoners themselves, discussed what exactly makes Heather such a successful runner — from her nutrition to mentality, Heather breaks down everything that makes her a world record holder.

During the interview, Heather shares her running journey, highlighting the importance of paying attention to the finer details in training that can set athletes apart, as well as the crucial role of community and support in her running life and how she has cultivated a network over the years.

The hosts delve into Heather's approach to optimal health, touching on the four pillars of exercise, stress management, recovery, and nutrition. Heather shares insights into how she has evolved her recovery and rest strategies throughout her running career and provides valuable advice on balancing running with other life commitments. She also discusses the significance of cross-training to prevent burnout and shares her mental resilience strategies.

Heather wraps up the interview by recommending resources for aspiring runners, sharing her upcoming running goals, and reflecting on memorable races that have shaped her remarkable running career.

Listen here, or wherever you get your podcasts.


Britt Gunsser

Britt Gunsser

Britt Gunsser, PT, DPT, OCS, CSCS, is a board certified orthopedic clinical specialist, certified Schroth therapist and dry needling specialist. She has completed extensive work on running rehabilitation and is an RRCA Running Coach.

Meet Britt

Brendan Copley

Brendan Copley

Brendan Copley, CSCS, ATC, is a personal trainer who specializes in working with endurance athletes and post-rehab clients. Brendan is a marathoner and former cross-country runner and has worked as an athletic trainer for Quinnipiac University’s cross-country and track teams.

Meet Brendan

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Marathon Mondays: Listen to your “foot brain”

Marathon Mondays: Listen to your "foot brain"

Megan Searfoss, owner of Ridgefield and Darien Running Company, joins Britt and Brendan to dive into the rigorous running shoe fitting process that includes a 3D scanner, detailing why the brand and type of shoe matters for the wearer. The trio also discuss the latest trends in footwear, including carbon plating, as well shoe life expectancy and how to deal with companies updating your favorite pair of running shoes.

August 21, 2023 | Britt Gunsser, PT, DPT, OCS, CSCS | Brendan Copley, CSCS, ATC

Listen to your

On this episode of Marathon Mondays hosted by physical therapist and RRCA Running Coach Britt Gunsser and personal trainer Brendan Copley engage in a discussion about running footwear with Megan Searfoss, the owner of Ridgefield and Darien Running Company.

Megan dives into the rigorous running shoe fitting process that includes a 3D scanner, detailing why the brand and type of shoe matters for the wearer. The trio also discuss the latest trends in footwear, including carbon plating, as well shoe life expectancy and how to deal with companies updating your favorite pair of running shoes.

They dive into the advantages of visiting a running store over buying shoes online, emphasizing the importance of a personalized fitting process, such as using a 3D scanner to determine arch height, size and width, as well pressure points, pronation, supination, and foot flexibility while walking. The purpose of the shoe is also evaluated during the fitting process to determine whether road, trail, cross-training, or walking shoes are right for the customer based on their different needs.

No one shoe will work for everyone, and depends on personal style preference (traditional vs. minimalist vs. maximalist shoes), how they run (forefoot running vs. heel striking) and how much support their feet require. Megan discusses the purpose of shoe rotation, wear and tear considerations, and recovery time for shoes, as well as her specific recommendations for marathoners.

Near the end, Megan touches on the phenomenon of "super shoes," or high-tech sneakers that claim to make their users run faster, explaining who they benefit and their key differences from regular training shoes. She also goes over common myths and misconceptions about running shoes, finally answering the question, "which brand or shoe is the best?"

Finally, the hosts address common myths about running shoes and seek Megan's response to the age-old question of what constitutes the best shoe or brand. The episode concludes with a fun question about pump-up songs for races, offering a well-rounded and informative exploration of the world of running footwear.

Listen here, or wherever you get your podcasts.


Britt Gunsser

Britt Gunsser

Britt Gunsser, PT, DPT, OCS, CSCS, is a board certified orthopedic clinical specialist, certified Schroth therapist and dry needling specialist. She has completed extensive work on running rehabilitation and is an RRCA Running Coach.

Meet Britt

Brendan Copley

Brendan Copley

Brendan Copley, CSCS, ATC, is a personal trainer who specializes in working with endurance athletes and post-rehab clients. Brendan is a marathoner and former cross-country runner and has worked as an athletic trainer for Quinnipiac University’s cross-country and track teams.

Meet Brendan

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Marathon Mondays: Mental strategies to help you the finish line

Marathon Mondays: Mental strategies to help you the finish line

Hosts Britt Gunsser, physical therapist and RRCA Running Coach, and Brendan Copley, personal trainer, are joined by mental performance consultant Arianna Martignetti as they dive into the realm of sports psychology, aiming to unravel the mental aspects of training and racing. They explore the often-quoted sentiment that running is primarily a mental endeavor, and seek insights into how athletes can enhance their mental strategies to complement their physical preparation..

July 3, 2023 | Britt Gunsser, PT, DPT, OCS, CSCS | Brendan Copley, CSCS, ATC | Arianna Martignetti, Ed.D

Mental strategies to help you the finish line

Hosts Britt Gunsser, physical therapist and RRCA Running Coach, and Brendan Copley, personal trainer, are joined by mental performance consultant Arianna Martignetti as they dive into the realm of sports psychology, aiming to unravel the mental aspects of training and racing. They explore the often-quoted sentiment that running is primarily a mental endeavor, and seek insights into how athletes can enhance their mental strategies to complement their physical preparation.

The group explores methods to cope with challenging moments in training, handle negative self-talk, and prevent the cascade effect of bad days or weeks in a training cycle. The conversation extends to race-specific strategies, including pace management, setting realistic expectations, and dealing with race-day jitters. Arianna sheds light on the physiological aspects of these mental strategies and discusses how they impact performance. She also touches on scenarios involving unfamiliar races or returning to training after injury or time off.

Arianna provides insights into daily mental strategies for promoting peak performance using techniques such as visualization and offers
guidance on overcoming common mental traps that can hinder an athlete's progress. She finished with a discussion on how to work through negative self-talk and how to implement daily mental strategies to promote peak performance, among other topics.

Listen here, or wherever you get your podcasts.


Arianna Martignetti

Arianna Martignetti

Arianna Martignetti, Ed.D., is a mental performance consultant who works with individual athletes, weekend warriors and teams at all levels, including competitive youth, high school, and collegiate levels, as well as recreational athletes.

Meet Arianna

Britt Gunsser

Britt Gunsser

Britt Gunsser, PT, DPT, OCS, CSCS, is a board certified orthopedic clinical specialist, certified Schroth therapist and dry needling specialist. She has completed extensive work on running rehabilitation and is an RRCA Running Coach.

Meet Britt

Brendan Copley

Brendan Copley

Brendan Copley, CSCS, ATC, is a personal trainer who specializes in working with endurance athletes and post-rehab clients. Brendan is a marathoner and former cross-country runner and has worked as an athletic trainer for Quinnipiac University’s cross-country and track teams.

Meet Brendan

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Marathon Mondays: Nutrition and hydration for the long distance runner

Marathon Mondays: Nutrition and hydration for the long distance runner

On this episode of Marathon Mondays, hosts Britt Gunsser and Brendan Copley bring in nutritionist Ashley Jerry to discuss essential fueling strategies for long-distance runners. They cover the importance of macronutrients, hydration, and carbohydrate intake, providing practical tips to manage GI distress, optimize nutrition during taper phases, and make informed choices regarding supplements, all aimed at helping runners enhance their performance and recovery.

June 5, 2023 | Britt Gunsser, PT, DPT, OCS, CSCS | Brendan Copley, CSCS, ATC | Ashley Jerry, MS

Nutrition and hydration for the long distance runner

On this episode of Marathon Mondays hosted by physical therapist and RRCA Running Coach Britt Gunsser and personal trainer Brendan Copley invite nutritionist Ashley Jerry to share insights on fueling strategies for long-distance runners. The episode kicks off by emphasizing the importance of proper nutrition throughout the entire training plan, and especially as training intensity and duration increase. Ashley underscores the essential role of macronutrients — carbohydrates, fats, and proteins — in meeting a runner's energy needs. Additionally, she offers practical advice on maintaining proper hydration, especially in hot weather, and ensuring an adequate intake of electrolytes.

The discussion deepens into the significance of carbohydrates in sustaining energy levels during long runs, and they discuss recommendations based on the timing and types of carbohydrates that runners should consume. Ashley also provides examples of pre and post-meal options for marathon runners and explores strategies to manage gastrointestinal distress during and after runs, shedding light on common triggers for such issues and how to prevent them.

Over the course of the episode, Ashley, Brendan and Britt cover a range of topics related to running nutrition, including fueling on days involving both running and weightlifting, the use of supplements like BCAAs and green powders, recognizing signs of under-recovery, and the importance of incorporating rest days into a training regimen.

Listen here, or wherever you get your podcasts.


Ashley Jerry

Ashley Jerry

Ashley Jerry, MS, is a nutritionist who specializes in a variety of fields, including food sensitivities, medical conditions, and sports nutrition. Ashley specializes in sports-specific nutrition guidance, including for sports such as running, powerlifting, bodybuilding, crew, football, and more.

Meet Ashley

Britt Gunsser

Britt Gunsser

Britt Gunsser, PT, DPT, OCS, CSCS, is a board certified orthopedic clinical specialist, certified Schroth therapist and dry needling specialist. She has completed extensive work on running rehabilitation and is an RRCA Running Coach.

Meet Britt

Brendan Copley

Brendan Copley

Brendan Copley, CSCS, ATC, is a personal trainer who specializes in working with endurance athletes and post-rehab clients. Brendan is a marathoner and former cross-country runner and has worked as an athletic trainer for Quinnipiac University’s cross-country and track teams.

Meet Brendan

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Marathon Mondays: Building a marathon training plan

Marathon Mondays: Building a marathon training plan

In this introductory episode, Britt and Brendan dig into what you should be looking for in a thorough training program, answer frequently asked questions, and debunk common myths. They cover developing a personalized training plan, the importance of different types of runs, how to incorporate strength training, and more.

May 8, 2023 | Britt Gunsser, PT, DPT, OCS, CSCS | Brendan Copley, CSCS, ATC

Building a marathon training plan

The inaugural episode of the Marathon Monday podcast, hosted by physical therapist Britt Gunsser and personal trainer Brendan Copley, sets the stage aimed to prepare runners at all experience levels for their next race, hosted by marathoners themselves. Their goal is to be as helpful as a post-race banana, offering insights into topics like personalized training plans, types of runs, strength training, and more. They discuss various options for training programs, including pre-formulated online plans, hiring a coach, or going the DIY route, each with its pros and cons. They also touch on how to find the right coach, emphasizing factors like experience, coaching platform, and finding the right personality match.

The episode delves into the five main workout categories in a training plan: long runs, interval training, easy runs, cross training, and recovery runs. They discuss the importance of not overemphasizing the long run, debunking the myth that the long run is the only critical workout. Britt and Brendan also discuss interval training, easy run percentages, and the purpose of recovery runs and cross training.

For those who are just starting out, Britt and Brendan also provide insights into what a typical beginner's strength and conditioning program for runners might look like, stressing the importance of starting with bodyweight or light weights for those new to strength training. They also touch on how strength training requirements might change when training for a marathon, including adjusting to busy schedules or integrating running into other fitness classes effectively.

Listen here, or wherever you get your podcasts.


Britt Gunsser

Britt Gunsser

Britt Gunsser, PT, DPT, OCS, CSCS, is a board certified orthopedic clinical specialist, certified Schroth therapist and dry needling specialist. She has completed extensive work on running rehabilitation and is an RRCA Running Coach.

Meet Britt

Brendan Copley

Brendan Copley

Brendan Copley, CSCS, ATC, is a personal trainer who specializes in working with endurance athletes and post-rehab clients. Brendan is a marathoner and former cross-country runner and has worked as an athletic trainer for Quinnipiac University’s cross-country and track teams.

Meet Brendan

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The missing link to successful rehab and return to sport

The missing link to successful rehab and return to sport

While much is understood about the importance of physical therapy when rehabilitating from an injury and returning to sport, there is less focus on the role of mental performance. Overall, psychological readiness has been undervalued and underassessed when determining if an athlete is ready to return to sport at their previous competitive level.

August 1, 2023 | Ashley Moriarty, PT, DPT, OCS

woman with an injured thigh

While much is understood about the importance of physical therapy when rehabilitating from an injury and returning to sport, there is less focus on the role of mental performance. Overall, psychological readiness has been undervalued and underassessed when determining if an athlete is ready to return to sport at their previous competitive level.

While research continues to emerge regarding the importance of incorporating mental performance to all injuries, there is a strong body of evidence related specifically to anterior cruciate ligament reconstruction (ACLR). It has been suggested that the single most important factor influencing return to pre-injury sport participation is psychological readiness, and current data suggests that only 50% of people who have undergone ACLR return to their previous level of activity. Of those that do return, up to 30% sustain a second injury within two years.

In order to return to sport after ACLR, there are a battery of physical tests that are usually administered to assess strength, power, and range of motion, among other things. However, it is speculated that the primary reason that half of injured athletes fail to return to sport is because of psychological barriers, not physical barriers, yet this area of recovery is overlooked. Despite a strong link between fear of reinjury and failure to return to sport, many rehab programs fail to include a formal assessment of psychological readiness, namely the Tampa Scale of Kinesiophobia (TSK-11). The TSK-11 assesses pain related fear of movement and fear of reinjury, using a grading scale of 11-44, with higher scores being associated with more fear, and a score of greater than 17 falling into a “high fear” category. In one study by Paterno et al, those who reported high fear were four times more likely to report lower levels of activity, indicating they may not return to their sport. Additionally, those who did return to cutting and pivoting sports with high fear were at an increased risk of reinjury within the first 2 years. successful rehab and returning to full participation in sport.

Psychological readiness should be an integral part of an athlete’s rehab process. Objectively, assessing fear of movement and fear of reinjury should happen in a similar vein as assessment of strength and range of motion. It should be addressed early and continuously in the rehab process, as the athlete progresses toward running, cutting, pivoting, and return to contact. Mental performance consultants should be involved in every athlete’s return to sport journey to address fear of reinjury, improve confidence in their movement abilities, and help implement strategies to cope with possible setbacks. Concerns about return to sport should be addressed well before the time comes to make a decision so we can eliminate or minimize fear before return to the field or court.

Despite the growing body of literature that emphasizes the importance of mental performance training for injured athletes, there are large gaps in its implementation. This is the missing link between traditional rehab and return to sport at pre-injury levels, which is the ultimate goal for these athletes.

Citations:

Paterno MV, Flynn K, Thomas S, Schmitt LC. Self-Reported Fear Predicts Functional Performance and Second ACL Injury After ACL Reconstruction and Return to Sport: A Pilot Study. Sports Health. 2018 May/Jun;10(3):228-233. doi: 10.1177/1941738117745806. Epub 2017 Dec 22. PMID: 29272209; PMCID: PMC5958451.

Baez SE, Hoch MC, Hoch JM. Psychological factors are associated with return to pre-injury levels of sport and physical activity after ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 2020 Feb;28(2):495-501. doi: 10.1007/s00167-019-05696-9. Epub 2019 Sep 5. PMID: 31486916.


Ashley Moriarty

Ashley Moriarty

Ashley Moriarty, PT, DPT, OCS, is a board certified orthopedic clinical specialist who is certified in dry needling and pre- and post-natal fitness.

Meet Ashley

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golfer near a hole

Mental performance: the key to unlocking your golfing potential

Mental performance: the key to unlocking your golfing potential

Golf is a sport that demands both physical and mental prowess. While the significance of physical fitness in golf is well-established, the importance of mental performance cannot be overlooked.

August 1, 2023 | Patrick Vierengel, CPT, TPI-F1

golfer on the green

The relationship between mental performance and the game of golf is a topic of great importance and interest in the field of sports science. As an avid golfer and a professional in the field, I believe this discussion holds tremendous value for both players and researchers alike.

Golf is a sport that demands both physical and mental prowess. While the significance of physical fitness in golf is well-established, the importance of mental performance cannot be overlooked. The ability to think strategically, maintain focus, manage emotions, and handle pressure are all crucial elements that can greatly impact a golfer's performance on the course.

Countless studies have highlighted the link between mental performance and golfing success: researchers have found that golfers who possess strong mental skills, such as concentration, visualization, and self-confidence, exhibit superior performance compared to those who neglect their mental game. Furthermore, mental performance has been shown to directly influence a golfer's ability to make effective decisions, execute shots with precision, and recover from setbacks.

Understanding the intricate relationship between mental performance and golf is essential for improving training programs, enhancing coaching strategies, and maximizing player performance. By comprehending the mental challenges faced by golfers and implementing appropriate interventions, we can potentially unlock untapped potential and elevate the overall standard of the game.

One of the most important aspects of mental performance in golf is the ability to stay present, focused, and in the moment. Golf is a game that requires players to make precise shots, and any distraction or loss of focus can lead to disastrous results. Professional golfers have mastered the art of staying present, shutting out the noise and pressure around them, and fully committing to each shot. They understand that one bad shot should not define their round, and as a result have the ability to bounce back quickly from any setbacks.

Visualization

Visualization is another key component of mental performance in golf. Professional golfers spend time visualizing each shot before they even step up to the ball. They see the trajectory, the landing spot, and the roll of the ball in their mind's eye. By visualizing the shot, they are able to execute it with more confidence and precision. This technique not only helps with performance on the course, but also aids in managing nerves and anxiety during high-pressure situations.

Mental toughness

Mental toughness is a trait that distinguishes the great golfers from the good ones. Professional golfers have learned to cope with the pressures of the game and bounce back from adversity. They understand that golf is a game of highs and lows, and a bad shot or round does not define their career. Developing mental toughness takes time and practice, but it is essential for success in golf. Golfers with strong mental toughness are able to maintain a positive attitude, stay composed under pressure, and make smart decisions — even when the game is not going their way.

Goal setting

Lastly, goal setting is a crucial aspect of mental performance in golf. Professional golfers set both long-term and short-term goals to keep them motivated and focused. Long-term goals help them stay on track and provide a sense of direction, while short-term goals give them something to strive for in the immediate future. By setting specific and achievable goals, golfers can stay motivated and track their progress over time.

In conclusion, mental performance plays a vital role in the game of golf. Professional golfers understand that success on the course is not solely determined by physical skill but also by mental resilience and performance. Staying present, visualizing shots, developing mental toughness, and setting goals are all strategies that professional golfers employ to unlock their full potential. So, the next time you hit the golf course, remember that the key to success lies not only in the swing, but also in your mental game.


Patrick Vierengel

Patrick Vierengel

Patrick Vierengel, CPT, TPI-F1, is a certified personal trainer and golf trainer who trains clients out of Greenwich and New Canaan. Patrick specializes in working with golfers, using his golf knowledge as a golf trainer and Titleist Professional Institute Level 1 Certified Golf Fitness Professional. He is currently studying to achieve the TPI Level 2 Fitness certification.

Meet Patrick

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woman meditating with her son

Avoiding parental burnout

Avoiding parental burnout

Parenting is a rewarding, stressful, fulfilling, and challenging endeavor. Parental stress is normal and common, but there may come a time when a parent’s stress becomes severe or long-lasting, which can affect their ability to cope; this can manifest into parental burnout. Here's what you can do about it.

August 1, 2023 | Arianna Martignetti, Ed.D.

mom meditating with her son on the couch

Parenting is a rewarding, stressful, fulfilling, and challenging endeavor. Parental stress is normal and common, but there may come a time when a parent’s stress becomes severe or long-lasting, which can affect their ability to cope(1); this can manifest into parental burnout.

Parental burnout consists of an exhaustion that can feel overwhelming, an ineffectiveness or lack of fulfillment in your role as a parent and feeling a sense of emotional distance from your child or children(2). It may also feel like you are not the parent that you want to be or used to be. Despite formal clinical interviews needing to occur to determine parental burnout, some risk factors include, but are not limited to, perfectionism, a lack of stress management skills, or a lack of co-parent support and/or emotional support(1).

With the summer winding down and the school year approaching, I encourage you to reflect on what might have caused you to feel burned out, or what is contributing to your stress. With those in mind, the following may be helpful in mediating parental stress:

  • Take a brief vacation(3) – It might not be possible to take an actual vacation whenever you want to, right? Taken from dialectic behavior therapy, the brief vacation approach is an attempt to slow down and re-energize yourself. Taking a brief vacation means finding a 15-minute (or more, if time permits) activity that will bring you some peace, grounding, or enjoyment. Some examples include taking a mindful shower, going to get yourself a cup of coffee or tea, reading an article, going for a walk, listening to a few songs alone, or practicing meditation. Consider implementing a brief vacation when you know your kids are safely engaged in their own activities. Shifting your mindset to perceiving a brief activity as a momentary vacation can help induce relaxation to address your needs at a particular time. The flexibility and spontaneity of doing so may also be a sense of relief or reward for parents that tend to be more rigid.
  • Evaluate your expectations – Reflect on whether you had expectations for this past summer, and whether those expectations were met. Why were they met, or what got in the way? What are your expectations for the upcoming school year? Additionally, where are your expectations coming from: the kids? Your spouse? Yourself? Recognizing what your expectations are and where they are coming from can help address whether they are realistic, manageable, or adjustable; this can help mediate stress, offer a clearer perspective, and possibly result in communication with those that are inducing expectations.
  • Effective communication – After becoming aware of your stressors, you may realize that some stress can be alleviated through conversations with others. For example, perhaps you had high expectations for your kids to enjoy their summer. Have you considered what your kids’ expectations were? What about for the upcoming school year? By communicating in a way that works for your family unit, you can understand each other’s expectations and whether they are realistic or need to be adjusted. Sometimes those that cause us stress are unaware of the effect they are having on us. Finding ways to effectively communicate with those closest to you can help others become more accountable and assist in setting boundaries for yourself (which may lead to a few more brief vacations).
  • Keep it simple – Remind yourself that things do not have to be perfect, and some things can be simple without compromising quality. If perfectionism tends to be your norm and simplifying feels difficult, then consider assessing your priorities and simplifying your lower ones. Chances are, you have had to adjust, pivot, or adapt numerous times in your journey as a parent already; you can do it again. Committing to keep things simple can mean carrying less “stuff” (literally and figuratively), spending less time getting out of the house (potentially resulting in more time to do things you can enjoy), and minimizing worry or stress.

References

1 Mikolajczak, M. & Roskam, I. (2020). Parental burnout: Moving the focus from children to parents. Child & Adolescent Development, 7-13.
2 Mikolajczak, M., Gross, J. J., & Roskam, I. (2019). Parental burnout: What is it, and why does it matter? Clinical Psychological Science, 7(6),
3 Cerula, S. (2023, February 9). Taking a Brief Vacation. The Behavioral Wellness Group.


Arianna Martignetti

Arianna Martignetti

Arianna Martignetti, Ed.D., is a mental performance consultant who works with individual athletes, weekend warriors and teams at all levels. She works with her clients to fine-tune their mental skills or increase their self-awareness to create the change that they want and achieve their goals — and more.

Meet Arianna

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confident soccer player

Mindfulness for the student athlete

Mindfulness for the student athlete

Student-athletes are subjected to a fast-paced, competitive lifestyle. Balancing academic and athletic demands are a natural source of stress for young athletes; developing mindfulness skills can moderate mental clutter and help maximize academic and athletic achievement.

August 1, 2023 | Ben Leibowitz

confident soccer player

We all experience our own stressors, anxieties, fears, confidence issues, and other mental struggles. Carrying a sense of mindfulness through our day-to-day lives, practicing thorough attention to the present moment, and sustaining a conscious awareness of our thoughts, sensations, and environment, can be beneficial in our abilities to work through the “noise” that we tend to experience in our minds.

Mindfulness is a process of entering into a state of mind, without judgment, which can be difficult to accomplish. Developing a strong sense of presence and attentiveness to the nature of our minds, bodies, and surroundings takes practice and commitment. For student-athletes in particular, practice and devotion are pertinent in the accomplishment of their goals; it is essential that the drive towards success extends beyond efforts left on the field, court, ice, or pool. It is equally important to tend to the mind and apply objectives and intentions towards mindfulness.

Student-athletes are subjected to a fast-paced, competitive lifestyle. Balancing academic and athletic demands are a natural source of stress for young athletes; developing mindfulness skills can moderate mental clutter and help maximize academic and athletic achievement.(1) As a former student-athlete, through practice I’ve learned that mindfulness is key in affecting stress, anxiety, confidence, motivation, and other mental challenges that can impact academic and athletic execution. Below are two strategies that student-athletes can utilize to work towards a greater sense of mindfulness and reduce the impacts of mental struggles on performance.

Attentiveness to the Breath

Breathing meditation is a way to begin engaging with mindfulness. Even if practiced for a short period of your day, learning to focus on your breath has been shown to quiet the mind, reduce stress, and increase relaxation.(2) Outlined are steps for a breathing meditation:

  • First, find a comfortable position with your spine erect.
  • Shift your attention to your breath and bodily sensations. Relax your jaw, shoulders, abdomen, and other areas of tension. Feel your body relax while sitting comfortably in your position.
  • Inhale, feeling the air fill your body. On the exhale, feel the release of all tension. Allow your breath to function on its own, without controlling or timing it, following the natural, cyclical flow of the breath.
  • Allow all thoughts that enter your mind to pass over, gently returning attention to your breath.

This breathing technique is key to accomplishing a sense of mindfulness and relieving mental clutter. These exercises have been extensively researched and prevalent across cultures, traditions, and philosophies. Mastering these techniques is a skill and is difficult. Just like a sport, or training a muscle, it takes practice and attention.

Beginning The Day: Imagining Success

Another effective way to relieve symptoms of mental obstacles is through imagery. Engaging in visualization has been shown to improve relaxation and an ability to cope with stress and anxiety, and increase emotional wellness, self-confidence, and athletic performance. We can engage in imagery in a multitude of ways, including the visualization of colors, loved ones, tension in the body, and environments. For student-athletes, visualization can serve as a beneficial tool. In pursuit of academic and athletic consistency, visualizing our goals can be an especially productive mode.

To visualize our goals, follow these steps in a comfortable and relaxed environment:

  • Begin with the breathing technique above.
  • Hold a specific goal in your mind (e.g., winning a competition, acquiring a skill, or engaging in a behavior).
  • Create a scene in your mind, as vivid and detailed as possible, in which you succeed at this goal. Imagine the environment where it occurs and the feelings that accompany the accomplishment Although difficult, try to minimize overthinking or forcing the creation of the image.
  • With the intention set, allow whatever arises and let the quieted mind take over without expectation.
  • If doubts arise, meet them with a believable affirmation: “I can do this,” “I am okay,” “I am confident,” “I am in control.”
  • Continue remaining attentive to the breath as you visualize.
  • Allow yourself the time and space to fully engage in this imagery. Performing this before you begin your day can be effective in setting yourself up for success.(3)

Overall, mindfulness is an essential apparatus for learning to live in the present moment. Although transforming one’s relationship with their thoughts is a complex, in doing so, we can become better equipped to understand and cope with our thoughts, stress, anxiety, and more. Being mindful is a key element in self-acceptance, presence, enjoyment of life, and mental clarity. For student-athletes: practice mindfulness like you practice your sport. Experience the difference!

Learn more about mental performance consulting

References

1 Anderson, S. A., Haraldsdottir, K., & Watson, D. (2021). Mindfulness in athletes. American College of Sports Medicine, 20(12), 655-660.
2 https://www.health.harvard.edu/mind-and-mood/breath-meditation-a-great-way-to-relieve-stress
3 https://www.healthline.com/health/visualization-meditation

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Maximize recovery with innovative treatments: blood flow restriction therapy

The vital role of physical therapy after regenerative medicine procedures: exploring the benefits of blood flow restrictive therapy

Regenerative medicine procedures have revolutionized the field of healthcare, offering innovative treatments for various conditions. While these procedures hold tremendous potential for tissue repair and regeneration, it is important to understand the critical role of physical therapy in optimizing outcomes and facilitating a successful recovery.

July 5, 2023 | Ashley Moriarty, PT, DPT, OCS

Man lifting weights with blood flow restriction cuffs on

Regenerative medicine procedures have revolutionized the field of healthcare, offering innovative treatments for various conditions. While these procedures hold tremendous potential for tissue repair and regeneration, it is important to understand the critical role of physical therapy in optimizing outcomes and facilitating a successful recovery. In recent years, emerging research has highlighted the benefits of incorporating blood flow restrictive therapy into the aftercare following regenerative medicine procedures. In this article, as a physical therapist, I will emphasize the importance of physical therapy after regenerative medicine procedures and shed light on the evidence supporting blood flow restrictive therapy.

The significance of physical therapy after regenerative medicine procedures:

Physical therapy plays a vital role in maximizing the benefits of regenerative medicine procedures. These procedures, such as stem cell therapy and platelet-rich plasma (PRP) treatments, aim to promote tissue healing and regeneration. However, without proper rehabilitation, the potential benefits may not be fully realized. Physical therapy helps optimize the healing process, prevent complications, and enhance overall function and mobility. In addition, a comprehensive physical therapy evaluation will help to identify the root cause of tissue breakdown in the first place. Mobility restrictions, muscle imbalances, and poor neuromuscular control all can lead to poor movement patterns which result in excessive stress to certain structures. It is these structures that break down and may require regenerative medicine procedures. However, without addressing the source of the problem these treatments may only lead to transient relief. When combined with physical therapy, a lasting outcome and full resolution is more likely.

Evidence supporting blood flow restrictive therapy:

One particular physical therapy technique that has gained attention in the realm of regenerative medicine aftercare is blood flow restrictive therapy (BFRT). BFRT, also known as occlusion training or KAATSU training, involves the use of specialized cuffs or bands to partially restrict blood flow to a specific limb or muscle group during exercise.

Research studies have demonstrated the benefits of incorporating BFR into the rehabilitation process after regenerative medicine procedures. A study published in the Journal of Orthopaedic & Sports Physical Therapy in 2019 revealed that BFR, combined with traditional rehabilitation exercises, led to significant improvements in muscle strength and function after ACL reconstruction surgery, a common regenerative procedure. The study reported greater quadriceps muscle size, improved knee function, and reduced muscle atrophy compared to traditional rehabilitation alone. Furthermore, a systematic review published in the Journal of Science and Medicine in Sport in 2020 examined the effects of BFR on muscle strength, hypertrophy, and endurance. The review included studies on both healthy individuals and patients with musculoskeletal injuries. The findings suggested that BFR, when properly implemented, can enhance muscle strength, size, and endurance even at lower exercise intensities, making it a valuable tool in the post-regenerative procedure rehabilitation process.

The benefits of BFRT can be attributed to the unique physiological response it elicits. Partial blood flow restriction during exercise creates a hypoxic environment, triggering metabolic and hormonal responses that promote muscle hypertrophy, increased capillarization, and improved muscle fiber recruitment. A study in the Journal of Applied Physiology also found that circulating hematopoietic stem/progenitor cells (HSPC) were increased following BFR compared with control, which may enhance outcomes after regenerative medicine procedures.

Incorporating blood flow restrictive therapy into aftercare:

To incorporate BFR into the aftercare following regenerative medicine procedures, it is crucial to work with a qualified physical therapist who is experienced in this specialized technique. They will assess your condition, develop an individualized rehabilitation plan, and guide you through the appropriate exercises while monitoring your progress and ensuring safety.  It is important to note that BFR should only be performed under the guidance of a trained professional, as improper use or excessive pressure can lead to complications. The appropriate pressure and exercise intensity will be determined based on your unique circumstances, ensuring optimal benefits without compromising your safety.

Physical therapy is an indispensable component of the aftercare process following regenerative medicine procedures. It helps maximize the benefits of these treatments, promoting tissue healing, and restoring function. Incorporating blood flow restrictive therapy into the rehabilitation process has shown promising results in optimizing muscle strength, hypertrophy, and endurance. Preliminary evidence indicates BFR leads to enhanced stem cell migration which may enhance outcomes after regenerative medicine procedures. As always, it is crucial to consult with a qualified physical therapist who can develop a tailored rehabilitation plan to ensure a safe and successful recovery.


Michael Beecher

Ashley Moriarty

Ashley Moriarty, PT, DPT, OCS, is a board certified orthopedic clinical specialist who is certified in dry needling and pre- and post-natal fitness. She has a passion for helping people move better and stay active, especially new moms.

Meet Ashley

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Decoding stem cell treatments: sources, contrasts, and PRP in regenerative medicine

A stem cell is not a stem sell: understanding the different types of stem cell treatments, sources, and platelet-rich plasma

In recent years, stem cell treatments have emerged as a promising field in regenerative medicine, offering potential solutions for various health conditions. In this article, we will explore the contrasts between different stem cell treatments, their sources, and the role of PRP.

July 5, 2023 | Shane Foley, PT, DPT, OCS, CSCS

Stem cells

In recent years, stem cell treatments have emerged as a promising field in regenerative medicine, offering potential solutions for various health conditions. However, with numerous types of stem cell therapies and different sources of stem cells available, it's crucial to understand the key differences and make informed decisions based on the best medical evidence. Additionally, platelet-rich plasma (PRP) has gained popularity as a therapeutic approach. In this article, we will explore the contrasts between different stem cell treatments, their sources, and the role of PRP.

Embryonic stem cells (ESCs):

Embryonic stem cells are derived from human embryos. They possess remarkable pluripotency, meaning they can differentiate into any cell type in the human body. ESCs have immense potential for regenerative medicine, but their use is highly controversial due to ethical concerns surrounding the destruction of embryos. Currently, their clinical applications are limited.

Adult Stem Cells:

Adult stem cells are found in various tissues, such as bone marrow, adipose tissue, and blood. They are more specialized than ESCs and have a more limited differentiation capacity. However, they can still differentiate into multiple cell types, aiding in tissue repair and regeneration. Adult stem cell therapies have shown promising results in the treatment of conditions like orthopedic injuries, cardiovascular diseases, and autoimmune disorders.

Induced pluripotent stem cells (iPSCs):

iPSCs are adult cells that have been reprogrammed to revert to a pluripotent state, similar to ESCs. This breakthrough discovery has enabled the generation of patient-specific stem cells, avoiding the ethical concerns associated with ESCs. iPSCs have the potential to revolutionize personalized medicine, providing tailored treatments for individuals.

Cord blood stem cells:

Cord blood, obtained from the umbilical cord and placenta after childbirth, contains a rich source of stem cells. These stem cells are similar to adult stem cells and can differentiate into various cell types. Cord blood stem cells are commonly used in the treatment of blood disorders, immune deficiencies, and certain cancers. The collection of cord blood is non-invasive and poses no risk to the mother or baby.

Platelet-rich plasma (PRP):

PRP is a therapy that involves using the patient's own blood, specifically the platelet-rich portion, to promote healing. Platelets contain growth factors that facilitate tissue regeneration and repair. PRP is commonly used in orthopedics, dermatology, and sports medicine to treat conditions such as osteoarthritis, tendon injuries, and skin rejuvenation. Although PRP has shown promising results, more research is needed to establish its efficacy and determine the ideal application protocols.

Understanding the different types of stem cell treatments and their sources is crucial for making informed decisions about potential therapies. While ESCs possess immense potential, their use is limited due to ethical concerns. Adult stem cells, iPSCs, and cord blood stem cells offer more practical alternatives with promising therapeutic applications. Additionally, PRP has gained popularity as a regenerative treatment option, harnessing the body's natural healing capabilities.

It is important to note that the field of stem cell research and regenerative medicine is still evolving. As more evidence and clinical trials emerge, the efficacy and safety of these treatments will become clearer. It is recommended to consult with healthcare professionals who specialize in regenerative medicine to explore the most appropriate options for your specific condition. Being educated on the sourcing and type of stem cell is vitally important.


Michael Beecher

Shane Foley

Shane Foley, PT, DPT, OCS, CSCS, is an orthopedic specialist who is certified in strength and conditioning, dry needling, and the Schroth Method. He has a deep passion for building relationships, helping people accomplish their goals and leading people to optimize their performance.

Meet Shane

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How to prepare for spine surgery

How to prepare for spine surgery

How to prepare for spine surgery

Back surgery can potentially be a very scary and stressful procedure, but there are a variety of ways to ensure you have the best recovery possible.

May 26, 2023 | Larry Piretra, PT, DPT, OCS, SCS

Doctor looking at a spine diorama

Back surgery can potentially be a very scary and stressful procedure, but there are a variety of ways to ensure you have the best recovery possible. Some common back surgeries within the cervical, thoracic, and lumbar spine include diskectomies, laminectomies, fusions, scoliotic surgery, and kyphoplasty. The steps leading up to your surgery and after are vital to successful long-term outcomes.

The actions you take prior to surgery can help set up success immediately post-operation. Simply speaking, the better shape your body is prior to surgery, the better shape your body will be after surgery. Through the prehab process, your physical therapist can help discuss what the process following surgery and what motions will be beneficial vs potentially harmful. It is extremely important to follow your physician’s instructions as certain surgeries have restriction with movement (e.g. no bending, lifting, or twisting for six weeks).

Your body will be undergoing some trauma through the surgical process; therefore, aiding in the recovery is imperative to positive surgical outcomes. Cryotherapy is a great treatment to help naturally aid in your body’s own healing process. Benefits from cryotherapy include reduction in pain from inflammation, reduced muscle tenderness, immune system boost, and renewed skin/blood cells. Infrared sauna may also be a potentially useful tool post-surgery to aid in healing through improved circulation, stress reduction/improved sleep, detoxification, improved immunity, and natural wound healing. Both cryotherapy and sauna are great options, but they should both be cleared by a medical professional prior to utilization.

Proper nutrition should be at the forefront of every healthy individual’s mind, especially when recovering from a spinal surgery. One’s activity levels may be temporarily limited after surgery which makes the nutritional component that much more important. You will likely need to increase protein intake following spinal surgery, as it is one of the keystones within your diet that builds and repairs your body. Foods with high protein amounts include fish, poultry, beans, eggs, lentils, and nuts. Appropriate hydration is also imperative to healing process after spinal surgery, as this helps nutrients disperse throughout your body and support healthy joints and musculature surround the spine.

Spinal surgery can take a toll on one’s mental health just as much as their physical health, but there are plenty of strategies to help overcome this obstacle. Education and not being afraid to ask questions are key to understand the full process from surgery through recovery. This includes speaking with your physician, physician assistants, physical therapist, and friends/family who may have undergone a similar procedure. The best thing you can do leading to spinal surgery is prepare and plan the first weeks following, understand the timeline of recovery, and practice relaxation techniques. Your outlook can have a major influence on your recovery, as those with lower levels of stress/pain catastrophizing can have better surgical outcomes.
Always ensure you have your support system when undergoing spinal surgery, which can include your friends/family, physical therapists, physician, or even a support group. With these tips, you will set yourself up for success and ensure you have the best possible outcomes.


Larry Piretra

Larry Piretra

Larry Piretra, PT, DPT, CSCS, TPI-M2, is a physical therapist and strength and conditioning specialist who serves as the Naples Site Lead. As a Titleist Medical and Fitness Professional, Larry also serves as the Golf Programming Lead for Performance.

Meet Larry