Having a sugar crash? Keep fruit on hand! I carried bananas with me everywhere during my Whole30. It’s not great for weight loss to eat too much fruit; however, you’re already removing so much sugar and simple carbs from your diet that some fruit won’t ruin it for you. Especially if it means avoiding soda ice cream!

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Eating out is one of the hardest things during the Whole30. Go into it knowing you’re going to have to ask your server for modifications and extra information. Also, don’t go to places you know you can’t eat Whole30! Just don’t! I make ONE caveat: I stop at McDonald’s all the time to get one item, and it is Whole30 approved. Unsweet iced tea!

If you go to an American restaurant, a good option is always a burger without the bun. Also make sure to specify no ketchup, mayo or mustard. But there’s nothing wrong with some delicious ground beef with pickles, tomato, onions, and lettuce on top. If you order french fries or sweet potato fries, make sure to ask what kind of fat they’re cooked in and (for SPF) whether there’s sugar added.

Asian restaurants are great! Yummy stir frys are my go-to here. Often Thai restaurants will cook their stir frys in coconut milk, yum! Ask for no rice; sometimes (Ginger Thai in Carytown) they’ll sub extra veggies! Again, ask about the fats used for cooking.

At Mexican restaurants, I order fajitas without the tortilla. Then it’s just a stir fry with guacamole! Make sure you ask for no cheese or sour cream. Lots of things are Whole30 friendly here. Read the ingredients and make sure you’re not getting dairy, corn, bread, or beans.

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Dr. Gregory may have had you lie on your back during the exam and hold your head slightly up form the table. This is the second test described in the following abstract. We only use the first test (CCFT) when we need to objectively document neck injury for court etc.

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Unless we die prematurely, we all get older and experience the effects of aging, but most of us are aging too fast and poorly.   Most people have large gaps in their planning, if they have a plan at all.  

Public health and medicine provide a misleading perspective when they inform the public using risk of death or illness related to behavior.  Risk factors are useful when performing research but leaves out the ongoing damaging process.  Risk implies that you will feel healthy until you suddenly fall over with a heart attack. It omits that you will feel like crap for a decade first. How many people do you know who felt bad and looked bad for many years before they were diagnosed as diabetic?

For example, diabetes creates a risk of kidney failure but a high A1C (http://diabetes.niddk.nih.gov/dm/pubs/A1CTest/) causes ongoing cumulative vascular damage effecting not only your kidneys but retina, nerves etc.  You are losing vision and balance well before you ever become diabetic.

A1C is actually a measure of glycation which damages your proteins including enzymes and stiffens the collagen fibers that hold you together. Glycation adds to the low level inflammation that increases your pain and the rate your joints degenerate. Look at the document below for more information.
 
The point is, when we view the effects of our behavior as risks, even if they are risks of death, we eventually dismiss them.  “Familiarity breads contempt.”  The cat continues to cross the road because he has never been hit by a car... yet.  

What we miss is the ongoing damage that cruds up what should otherwise be a good life with graceful aging.  

We need to live as good cultural examples for our grandchildren by making good choices today. 
In our office we work with nutrition to an extent but refer to others for the more time-consuming training.

At RCS, we focus strongly on pain relief and function with accurate diagnosis, manipulation and corrective exercise.

If you don’t want to be bent over with a hump, unable to stand straight with neck, back and hip/knee pain; fix your posture now.  You need to work on joint range of motion, alignment and stability / balance.  

What most people think of posture is good static alignment of all the joints.  You are standing or sitting straight, maybe walking.  There is more to it than that.  You need stability, which means having a controlled base or core to move from.  You also need to maintain good balance and proprioception so that you know where you are along with your relation to all your parts.

When all of this is not working right you can be injured traumatically but definitely will be over-stressed with more fatigue, aches/pains, and repetitive stress injuries like tendinitis.  If you are an athlete you will not recover and be able to train as well.  Athletes are particularly difficult in that they have learned to compete with a particular posture and form even if it is not perfect.  Improvements will change technique and temporarily impair performance, which is discouraging to someone who’s image depends on performance. 

If your head and shoulders are forward and your chest is down, you not only look old but your joints are degenerating, you fatigue faster and have more aches/pains (this postural imbalance is often referred to as upper crossed by PTs and chiropractors).

If your hips are flexed when you stand, your lumbar spine has to arch and extend for you to stand up.  Your hip flexors will be short along with your low back muscles and the opposing abdominals and gluteus will be weakened.  This is often referred to as a lower crossed posture.  People often have both upper and lower crossed postures.  Computer work and driving promote these.

Loss of balance, stability and strength have been implicated in falls in the elderly.  If you want to spend the remainder of a short life in a nursing home, just fall down a lot until you are sufficiently injured. A hip fracture is a serious injury, especially if you are elderly. If you are falling or not stable or strong, work on it!

Most of us have learned to ride a bike or play a sport.  Just because you are out of shape does not mean that you can’t relearn and retrain.  You may have to work around some painful damaged parts, but it is still doable; you just need to begin, persist and not become discouraged.  You may need outside help but you have to remain responsible and in control.


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I recently insisted that a friend provide peer reviewed evidence supporting the use of a multilevel nutritional product she is involved with.

I frequently use this to discourage multilevel sales pitches, stating that I will not be involved unless they can be demonstrated to be better than placebo, alternative products and that the difference is great enough to warrant the cost and any risks.

It occurred to me that I should be able to do the same for the services in my office.

In our office we use the functional movement screen and the more extensive Selective Functional Movement Assessment (SFMA) which was developed by the same group. They allow us to determine what basic movement patterns are limited; impairing performance, draining energy, creating overstress injury and risk of traumatic injury.

The assessment can be used to direct appropriate corrective exercise selection.

The following was written by Dr. Rob Butler and is available on the web at: http://www.functionalmovement.com/

Hi, blog readers! I’m Tania, the office manager at RCS. Over the next couple weeks I’m going share a bunch of tips at you from my experience with the Whole30!

I did my Whole30 in January. I lost ten pounds in 30 days and felt much healthier by the end of it. I also developed good habits that keep me healthy in the long term.

I recommend the Whole30 to anyone interested in kickstarting their Paleo diet. If you’re strict with yourself for an entire month and take it seriously, you end up with good habits and resources for your new lifestyle.

The biggest challenge I faced was avoiding non-Whole30 foods when I forgot to cook or pack a lunch. Meal planning will be your friend! Figure out what you want to eat for breakfast, lunch, dinner, and snacks for a week. Try to choose things that have ingredients that much up so you don’t end up with spoiled veggies. For instance, if you’re buying carrots you have to buy a pound minimum. Therefore you need two dishes that involve carrots for this week - perhaps beef stew and chicken stir fry!

I also had to plan WHEN to cook. Since I wasn’t used to cooking, I didn’t realize how much time it consumes! Now I put cooking on my calendar. I usually make two dishes at a time twice a week, and I make enough for lots of leftovers.

The Whole30 meal plans by the author of the “Well Fed” cookbooks are a good starting point. She has great recipes and even has a grocery list! If you are only cooking for one person or you’re not used to cooking a lot, careful when following her advice. I found everything took me twice as long to prepare as she suggested (I had a lot of learning to do). Also, it was too much food for me. I recommend starting with half of the dishes she suggests.

Runner's World has some excellent online training resources and I recommend the magazine as well. People have been requesting examples of active warm up exercises as evidence demonstrates that they are preferable to static stretching or no warm up at all. 
Here are a few available at their online site. Nothing is perfect but these are well performed and good representatives.

http://www.runnersworld.com/race-training/the-perfect-warmup

http://www.runnersworld.com/stretching/body-shop-turn-your-heat

http://www.runnersworld.com/workouts/weekly-workout-butt-kicks

http://www.runnersworld.com/stretching/dynamic-warmup-runners

http://www.runnersworld.com/workouts/fully-fit-active-warmup

How to rehydrate between runs:
http://www.runnersworld.com/sweat-science/drinking-between-workouts

As promised, here are some publications on gut biome and autoimmune aspects of birth.

These papers go over why it is important to avoid unnecessary antibiotics and antibiotics in your food, eat a variety of fresh and fermented fruits, vegetables and, if tolerated, dairy.

Also, there is good information here about why breast feeding is important and some downsides to Cesarean section.

While reviewing the connection between pregnancy and low back pain in my patients, I ran across some recent papers that I thought would be of interest.

My main concern with pregnancy, vaginal delivery or cesarean section is that the abdominals and pelvic floor muscles are stretched and possibly injured to the point where they can’t optimally stabilize the core.  Also the body develops compensations and learns new stabilization strategies that don't involve the abdominals.  Instead, we use the psoas erector spinae and quadratus lumborum muscles which can cause chronic back pain and predispose to injury.

It is important after pregnancy to get your muscles retrained to control your movement without compensations that will lead to pain. 

We use corrective exercises in our clinic and often refer out to specialist PTs for pelvic floor aspects since not all problems are due to underactivity of the pelvic floor muscles but may be due to inappropriate coordination or differences between deep and superficial muscle activity.


I ran accross some papers on gut biome and autoimmune aspects that are not yet being addressed well by many in the medical community. I will post these soon!

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