Getting Your Period Back with hypothalamic Amenorrhea

Getting Your Period Back with hypothalamic Amenorrhea

Yep, you read that title right. Today we’re dropping the P bomb, that is, we’re talking about periods.

The glorious part of womanhood we love to hate. But when our reliable monthly guest stops visiting as often, it can cause some concern—and rightly so!

Not getting a period is not normal, sure it may seem convenient at the time, but that doesn’t make it good.

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What You Probably Don't Know about Chiropractors

As some of you might already know, my husband is a chiropractor. And as the wife of a chiropractor I am constantly explaining to people what he does. The questions usually arrive when I mention how much school he had to attend. Honestly, I think most people are surprised that chiropractors need 7.5 years of college, because they believe all they do is "crack people's backs" and give massages. 

I don't blame them for this. Honestly, I wasn't sure what else chiropractors did besides adjust before I married one (well he was an aspiring chiropractor at that point). I also didn't realize how much schooling and work it took to become one. So, in honor of Dwayne, excuse me, Dr. Golbek, starting his practice at Tensegrity Chiropractic this month I'm going to share some things that you might not know about chiropractors.

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Chiropractors are Doctors.

Maybe this one is obvious, but maybe not. Chiropractors receive a doctorate degree for all of their education. They are required to complete a bachelor's degree (4 years of college) and then 3.5 - 4.5 years of chiropractic school (depending on whether they attend summer semesters). During their schooling they complete an insane amount of credit hours (I think Dwayne was in 42 credit hours one semester--not sure how we survived, but it was crazy). They take classes in physiology, anatomy, biochemistry, microbiology, nutrition, etc. (all the human sciences). Then of course they take specialized classes like OBGYN, pharmacology, geriatrics, physical therapy, X-ray diagnosis, and the list goes on and on. 

On top of the classes, chiropractic students complete a year of clinicals, assessing, diagnosing and treating patients under the supervision of licensed doctors. Their education and training culminates in taking 4 different board examinations. Once they graduate and pass boards they receive a doctorate in chiropractic and from there, obtain state licensure before practicing.

They are Conservative Care Providers

Chiropractors practice conservative care, meaning they provide noninvasive treatment for pain and injury, a.k.a they do not prescribe medication or perform surgeries. Chiropractors utilize spinal manipulations (adjustments), soft tissue work, physical rehabilitative exercises, lifestyle counseling, eastern medicine, and other approaches to treat pain and injury. This is attractive for many people.  If you can find a way to heal and recover without medicine or surgery that's more money and time in your pocket, not to mention, it's easier on your body.

For example, during his clinicals, I remember Dwayne had a patient who was considering a major surgery for her injury. She was 10. Through conservative care she was able to regain complete function and forgo surgery -- definitely a win if I'm her parent. 

Not All Chiropractors are the same

Chiropractors are licensed and trained to do a lot of things. For instance, you can have your physical done by a chiropractor, x-rays taken and even labs drawn. That's not to say that every doctor does all of these things. Just like other medical professions, chiropractors specialize.

Different specialties include pediatric and pregnancy, sports rehabilitation, and geriatrics to name a few. Doctors who specialize might obtain a master's degree and/or attend classes and seminars (continuing education) throughout their career to obtain specialties. This is why when people tell me that, "chiropractic just doesn't work for me," I often encourage them to try a different doctor who specializes in their area of concern. 

They do a lot more than adjusting

Chiropractors are trained to assess patients, diagnose them and treat them--or refer them to the appropriate provider (this is a huge part of their education). As I've talked about above, they utilize several different techniques with many doctors specializing.

For example, Dwayne specializes in sports injuries and rehabilitation. He assesses his patients' movement patterns and muscular strengths and weaknesses and treats those movement patterns/muscles that are causing pain and injury. He uses joint adjustments, soft tissue work like cupping, taping, myofascial release, and trigger point therapy to get the patient out of pain and promote recovery. After getting their pain under control, he teaches patients how to move correctly through rehabilitative exercises so that the injury/pain doesn't reoccur. He also practices acupuncture and other eastern medicine techniques, because when it comes to getting a patient better different things work for different people.

(Dr!!) Dwayne Golbek - posing for his headshot at Tensegrity Chiropractic :)

(Dr!!) Dwayne Golbek - posing for his headshot at Tensegrity Chiropractic :)

Personally, I really fell in love with chiropractic treatment while pregnant (it helped that I didn't have to leave home to get it). If you've been pregnant chances are you've experienced some aches and pains and potentially some pretty sharp sciatic area pain. Most of the advice I got from other people was somewhere along the lines of "it'll go away when the baby comes, just wait it out" but seeing a chiropractor who was trained in treating pregnant women (the hubs) made a world of difference -- I'm talking from pain every time I moved my leg, down to no pain in a few treatments--not after the baby came. 

Moral of the story, there is a great deal of work that goes into becoming a chiropractor, and there is much more that they do and treat than most people realize. Hopefully you learned something new! If you did, make sure to tell someone--knowledge  is power, plus I don't want to have to keep on explaining forever ;)

 

The Magic of Movement

the magic of movement

Happy New Year!!  So with tons of you setting goals to be more active in 2018, I wanted to explore the health benefits of regular movement, but this time from a new lens.

Before we do that, let’s talk about why I keep using the word movement and not exercise. I like the term movement, because it evokes pleasant thoughts of walking outside, playing with family, maybe even a little backyard football game or an in-home yoga session. Where as exercise draws up this image of forced, painful, drudgery for a lot of folks. This could be because “exercise” is often paired with “diet”  as a means to manipulate body size. Exercise is often prescribed by somebody other than ourselves, and as a result, rarely enjoyed. So—that brings us back to movement, my preferred term and why it’s awesome in all it's various forms.

While most people can tell you that, yes, movement is healthy, I think many would cite weight control as it’s primary health benefit—this is wrong for so, so many reasons.

First off, weight loss—or even forced weight maintenance—to achieve some arbitrary “ideal weight” does not equal health. But, that’s a whole separate post in and of itself, and I won’t be getting into it here. Weight aside, there are countless better health benefits of regular movement, and research shows that people of all body sizes can experience them.

When we use weight loss as our primary motivator for exercise, we’re usually left with low motivation and guilt around movement. No amount of movement is ever enough when weight loss is the goal, leading us to discount regular, less intense movements that might serve our bodies better. Plus, to the all-or-nothing thinker, missing one day of intense exercise is paramount to throwing in the towel, sitting on the couch for 10 days and binging on cookies and Netflix (not a healthy or helpful mindset if you ask me).

SO maybe you can list some non-weight related benefits of movement. It’s possible that you’re already aware of the cardiovascular benefits of regular aerobic exercise, but even these guidelines—to move 30 minutes a day—can seem like un-motivating drudgery when we don’t have the right mindset on movement.

The truth is that all movement, if done with the right motivation (to feel good and enjoy life a little more) can promote health. Beyond that, movement really can be quite magical. To illustrate this I’ve asked my hubby, Dwayne Golbek, to share some of his knowledge on the topic.

Dwayne is a Doctor of Chiropractic with a Masters in Sports Science and Rehabilitation. He’s also a Certified Strength and Conditioning Specialist (CSCS). Dwayne is a former Division I All-American high jumper and a current deadlift enthusiast and recreational climber. Moral of the story: this guy likes to move, and he’s also got a bunch of degrees and knowledge to back it up.

Dwayne doing his thing at Devils Den State Park in Arkansas.

Dwayne doing his thing at Devils Den State Park in Arkansas.

Luckily, since I’m married to him, I was able to steal some of his time (on our long road trip to Indiana) and ask him some questions about the magic of movement. Below is our “interview”.

Q (Me): What do you love most about movement?

A (Dwayne): My favorite part about movement is that it gives us the opportunity to really appreciate how amazing our bodies truly are.  I think a lot of people view themselves as fragile, incapable beings, scared of getting hurt, but also just trying to get by.  Movement makes us more comfortable with our bodies and more confident. It gives us a chance to discover that we aren’t fragile, but in fact, we were designed to adapt and thrive.

Q (Me): What are some health benefits of regular movement that don’t require hours of traditional exercise?

A (Dwayne): Regular movement improves our mood & sense of wellbeing, plus it’s a powerful pain reliever. It sounds simple, but the science behind it is pretty cool. Stick with me, I’ll explain. When you move your body, your joints are able to receive and send information to your brain about where you are in space (this is called proprioception). If your brain doesn’t get this information regularly, it sensitizes the area that isn’t moving. This sensitization bleeds over into the pain receptors. So while not moving can lead to over-sensitized pain receptors and an achy body, something as simple as a gentle full body stretch restores the brain-body connection, reduces pain, and allows the brain to focus on the areas in the body that truly need attention.

Besides this, movement has the ability to change how our DNA is expressed which may help slow the effects of aging (how cool). And the truth is, you don’t have to be a marathon runner or a professional lifter to receive those benefits, you just need to move your body regularly. 

Q(Aubrey) How do you view movement differently now compared to when you were a collegiate athlete?

A (Dwayne): When I was an athlete everything I did was so that I could jump higher. I wanted to outwork everyone everyday, thinking that it would make me perform better. At some point this mindset left me broken and burnt out, ready to move on to the next thing.  After my collegiate career ended, and when the pressure of performance was lifted, I started to get into other activities that I enjoyed like climbing and weight lifting. Over time I learned to listen to my body. I work hard when it’s right and take rest when I need to. Anyone that knows me knows I love to deadlift. If I were still the college version of myself, I’d probably do it everyday until I eventually got hurt. Today I take a different approach. Some days I lift, some days I climb, some days I go for a walk and overall I feel better. With this mindset, my lifts have improved significantly.  Ultimately it’s not pushing harder than someone else that matters, it’s just important to keep moving.

Q (Me): What are your suggestions for people who are scared to “exercise” or move because they feel they’re too out of shape?

My biggest suggestion is to start small with things that you enjoy doing and work your way up from there.  Don’t underestimate the power of any type of movement, whether you want to do a daily stretch program, walk around the block, or deadlift 500 pounds, the magic is in regularly moving your body.

I hope you guys enjoyed this conversation. I’m thinking about starting more regular posts on Monday focused on movement and fitness, and would love to hear your questions and ideas. Also, if you want to hear more from Dwayne, you can follow him on instagram at @movementcube .

Lessons on Running Slower and Faster

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I realize I haven't shared anything about fitness in a while. So, in true blog fashion--I'm just going to talk about what I've been up to.

I've been running...slower...and also faster. 

The Route66 Half Marathon was quite an eye-opener for me. Let's just say it was not an easy course (hello hills). But aside from that, it was the first race I ran in where I actually wanted to quit halfway through (somehow I didn't, but still). 

The reality of the situation was that I did not train consistently (maybe ran 2 or 3 days a week) or properly (longest run was 8 miles like 6 weeks before the race)---so was I surprised? Not really. After all, you can't reap what you did not sow.

The question remained: why wasn't I motivated to train consistently or properly? I started asking myself if I actually liked running, or if it was just a guise for maintaining a particular body type.

I know I used to love running, I loved training, pushing my pace, the experience of racing and the camaraderie of the running community. So I did some deep diving. I researched training styles -- I couldn't shut out the idea that I was just approaching training the wrong way--making recovery more difficult and running less enjoyable.

BY FAR the best part of running the Route66 race was getting to be a part of this relay team :) Thanks to Dr. Chris Barnes for this sweet jumping picture!

BY FAR the best part of running the Route66 race was getting to be a part of this relay team :) Thanks to Dr. Chris Barnes for this sweet jumping picture!

I looked into different low heart rate styles of training and came across the 80/20 method. This training philosophy involves training at an easy (low heart rate) pace 80% of the time and training at a higher intensity (race pace or faster) 20% of the time. Scientifically speaking this makes total sense and is evidence-based. But yet, I know I wasn't training this way.

Like most amateur runners, I was guilty of running most of my mileage somewhere in between an easy comfortable pace and my goal race pace. Which, if you're familiar with running training, means I was training too hard to recover well between runs, but too slow to get any faster.

So, I set out with my new, roomy altra running shoes (nothing motivates you to run more than a new pair of kicks) and went for an easy run, sans my tunes. I wanted to determine whether or not I actually enjoyed running. I determined that, yea, when I don't kill myself to stay at an uncomfortable pace for every single mile, I do in fact enjoy running, a lot. Once that was settled, I nerded out and drafted myself a flexible* training plan. 

*flexible because no one can say what life will bring. Whether it's holiday parties, sick kids, inclement weather, or just a change in what my body needs, it's important to be flexible and accommodating of changes with any exercise "plan". 

I planned my goal race and determined how many weeks I have from now until then. Next, I decided how many runs were realistic for me to do each week. From there, I planned for 80% of my runs to be at an easier pace (a pace where I could still talk, or if you like HR--where my HR is no higher than 75% of my max HR, using 220 - age to determine max HR). I also planned for 20% of my running to be at race pace or faster.

For me, this translated into including 1- 2 speed work days during the week, one long run day, and the 2-3 easy, recovery runs. Of course, like any endurance plan, mileage will have to increase (slowly) as the weeks go on. 

The results -- so far, so good. I haven't felt the need to stop training or take a 5 hour nap two days into the week, so that's progress.

I don't think that practicing gentle, respectful, intuitive movement and training for an athletic event are mutually exclusive. In fact, while it may feel like it's taking longer to build up my mileage and get to my goal pace with this method, research seems to show that it's a more effective method for performance improvement.  Training harder is not always better, and pushing past your body's signals for rest is not always healthy.

Whether you're a runner, a cross country skiier, or a self-proclaimed couch potato, listening to your body's need for movement AND it's signals for rest is a beneficial practice. Read more about it in this post.

I'm interested to hear from you guys--have you ever hit a rut in your exercise routine or sport? What did you do about it to turn things around? And to the runners: any tips on/experience with this training method?

Beating Winter Body Image Blues

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The week of Thanksgiving is when the chaos typically starts. Families in town, holiday get-togethers to attend, household chores and every day duties that refuse to be put on hold, and then someone inevitably gets a cold and you get it too. Suddenly the comfortable routine you set in the early fall months has gone right out the window. You look back and it’s been 3 weeks and you aren’t sure what you’ve actually accomplished.  Now it seems like the winter blues are knocking at the door just waiting to take up residence in your home until spring.

A part from the joy of the holidays, winter can be a kind of depressing time if you let it. The weather is cold and daylight is short. The stress of the holidays can run high and take a toll on your immunity. Colds, flus and other illnesses threaten to take all your time and energy. All of these things, combined with the very real physiological effects of cold weather and lack of sunlight, can contribute to low mood and even depression. In addition and related to this, body image is at an all time low for many people.

Even if you manage to make peace with food during the holidays, if you are able to enjoy all foods in moderation, honor your hunger and respect your fullness; If you’ve worked on replacing negative thoughts that say you’re good for eating one way and bad for eating another, winter time still puts you at risk for poor body image. And poor body image puts you at risk of falling for a quick-fix diet come January and a cycle of weight loss, gain, guilt and shame come February.  I’m guessing these things are not on your Christmas list…

But why is our body image so low in the winter months?? Aside from the increased rates of low mood and depression partially attributable to the lack of sunlight, we also have to contend with paler skin, natural weight fluctuations, and decreased physical activity.  Feeling a little down just reading this? Don’t worry, you can totally beat the winter body image blues, and I’ve got some tips on how below. But first, let’s address a couple of fallacies.

Fallacy # 1: People gain 7-10 lbs over the holidays

No. This is a random statistic the media came up with to scare people towards diets and weight loss products. Research published in the New England Journal of medicine looked at weight gain in America from before Thanksgiving until after the New Year (into March). The research actually found that the average weight gain was less than 1 lb.  So let’s just all take a deep breath and take that into perspective.

Fallacy # 2: Winter weight gain is unhealthy and you will keep the weight gained, forever.

Geeze people, let’s be a little more dramatic.  Okay but really, weight fluctuations are totally normal during the wintertime. According to a study done at Maastricht University in the Netherlands our metabolism increases during the colder months making us hungrier. Putting on a little weight or eating a little more is our body's way of making sure we have enough energy, considering it takes more energy to keep us warm. This doesn’t mean eat until you are stuffed because “Aubrey told me I use more energy in the winter”, no. It means continue eating when you are hungry and stopping when full – you can trust your appetite.

We’ve already mentioned the increased rate of colds/flus/yucky bugs during the winter months. Let’s not let the stress/fear of weight changes drag our immune system down.  Just rest and continue on your intuitive eating journey, trust the process.

Okay, so now that we’ve got that covered, what can we do to protect/improve our body image during the winter months? Here are 10 tips for just that:

10 Ways to Beat the Winter Body Image Blues

1. Buy winter clothes that fit and flatter you. Choose clothes that work for your body type and that you feel comfortable in right now. Beyond that, choose colors that flatter your skin tone (this is especially important in our ‘pastier’ months).

2. If you really don’t like being pale – try a sunless tanner. Here’ a list of 10 under $20 . You could also get a spray tan.

3. While we’re on the topic of sunlight, try to get some when you can, especially earlier in the day, but really whenever possible! Try going outside for a brisk walk during lunch for a double-punch of movement and vitamin D-soaked-rays.

4. About vitamin D – you knew I’d get there. You may consider taking a vitamin D supplement, especially if your levels are low. As I alluded to above, less sunshine means lower vitamin D levels and lower vitamin D may contribute to winter blues. I get mine from Trader Joes.

5.  Get up each morning, get dressed, and do your hair and/or makeup. There is truth to the saying “dress for success”.  Dressing up and just overall personal hygiene are surefire ways to make you feel better in your skin.

6. On that topic, for the ladies, try painting your nails. I don’t know why, but sometimes a little color on my fingernails makes me feel like a million bucks.

7.  Find an at-home workout video or program you love. I’ve mentioned these before, but I love Fitness Blender and Yoga with Adrienne (both free programs). You can also do paid programs as well (like beach body on demand and others, ask around). At-home workout videos are great to get you moving and feeling better in the wintertime. It can be hard to get outside and/or go to the gym in the dark and cold.

8. Try your hand at warm, nourishing soup and crockpot recipes. Warm foods are comforting and satisfying for the body and soul :) . Plus, learning how to prepare new recipes (or any new skill) increases self-confidence!

9. Take advantage of the increased in-doors time in the evenings to read a book, journal, start a Pinterest project, or just sip some warm tea and chat. The idea is to get your focus off of your body and onto new things, ideas and others.

10. Finally, go on coffee and lunch dates with friends or start a dinner club where you alternate host houses. Remember that other people are struggling with the winter blues too. Helping others is at the heart of getting our focus off of our body!

I'm interested to hear from you guys. How do you beat the winter body image blues??

Thoughts on Eating Style and Athletic Performance

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A couple weeks ago I wrote a post about intuitive eating and it’s potential to positively effect the health of female athletes and workout enthusiasts. Since then I’ve been deep diving into the topic of intuitive eating for athletes.

Unfortunately it feels like I’m deep diving straight into the abyss – I’m anticipating an attack from giant squids, 20,000 League’s under the sea style, anytime now. Because the truth is, while there is some research regarding the psychological effects of intuitive eating among current and former female athletes, there’s pretty much ZILCH on how normal/intuitive eating effects sport performance, rates of injury, etc.  If you know of some such research CONTACT ME. And if you are in a place to perform a research study, please CONTACT ME!

But, regardless, at this point what I’m about to write is mainly extrapolation from what I do know to be true based of research but also a little conjecture based off of my own experiences and observations as an athlete. Mainly it’s a compilation of thoughts from my crazy, curious brain. But hopefully it’ll help raise a few thoughts of your own.

Let’s start with some observations:

  1. Athletes are told that in order to perform at their best they need to really focus on good nutrition: pre, during and post workout fueling, along with an overall balanced, health promoting diet.
  2. Many athletes are encouraged to lose weight in the name of improving performance: i.e. runners, swimmers, divers, high jumpers, dancers, gymnasts, wrestlers. Weight loss goals permeate nutrition discussions in each of these sports
  3. Athletes, both female and male, are at a higher risk for eating disorders and disordered eating
  4. Characteristically, elite athletes are high performing, perfectionistic, rigid, earn what you work for types

Taken together, these form a perfect storm for athletes to be what we term ‘controlled eaters’. Controlled eaters are individuals who eat based off of a set of rules, utilizing willpower to decide what, when, and how much to eat. This includes athletes who count calories, follow a strict meal plan, eat only certain foods that they deem ‘clean’ and those that restrict foods in the name of weight loss or ‘performance’.

A recent research article published in the Eating Disorders: The Journal of Treatment and Prevention surveyed former collegiate athletes, asking whether their eating habits had changed since college, and if so, how.  Participants reported increased freedom and decreased anxiety with eating since stopping their sport. They reported eating based off of their hunger and satiety cues as opposed to the rigid format with which they ate as athletes. Beyond this, they reported decreased binging and feelings of being out of control with eating (1).

In essence, the female athletes in this study, who by the way were all former gymnasts or swimmers/divers (both weight conscious sports), were experiencing binges and ‘out of control’ eating while they were collegiate athletes. Also during their time as collegiate athletes, they were eating in a controlled, rigid manner that resulted in higher rates of anxiety.  This doesn’t really come as a surprise. It’s well known that rigid eating and diets often lead to disordered eating, binges, and feelings of anxiety and being out of control around food.

This information alone should be enough motivation to stop the controlled eating amongst athletes, but as a former collegiate swimmer, I know that it’s not. We need to be able to say that normal/intuitive eating results in better sport performance than controlled eating. Because sadly, for many of these kids long-term health isn’t really on their mind, but performance definitely is.

Until we have research to definitively support that intuitive eating athletes perform better, have decreased rates of injury, recover better, etc. than controlled eaters we have stories, case studies and hypotheses. But just because these things aren’t double blind randomized control trial (RCT) studies, doesn’t mean we shouldn’t take them into consideration. So, here are some things to think about in the mean time:

We tend to believe that a lower body weight will translate to better performance in certain sports (running, high jump, swimming to name a few).  But what are we basing these beliefs on?

Let’s take high jump for example. My husband was an All-American high jumper, so I’ve watched my fair share of ‘Fosbury flops’ over the years.  It is true that many of the elite college high jumpers were tall and skinny. Because people with this body type tended to perform well at high jump, the athletes who weren’t already naturally tall and skinny did everything to get there and the ones who had this body type tended to did all they could to prevent weight gain. In essence, there was a lot of restricting calories among high jumpers in an effort to emulate the best athletes in the sport. But this thinking has a major flaw. Correlation between lower bodyweight and performance is not the same as a lower bodyweight causing good performance.

In fact, I remember one athlete who jumped around the same time as my husband. He was a fair bit bigger than the ‘typical’ high jumper. And by bigger I mean he met normal weight standards for a man his height while most high jumpers toed the line between underweight and normal weight. But you know what, that kid’s name was Erik Kynard and he ended up winning silver in the high jump at the 2012 Olympic Games in London.

Although one example does not make a case, there are countless similar examples out there of athletes who don’t follow the expected strict weight and diet rules or their sport and yet succeed. I mean look at Rich Frohning, four time CrossFit Games champion. While most of the sport of CrossFit restricts foods that don’t fit into the ‘paleo’ framework, Rich Frohning is famous for eating what he wants (sounds like an intuitive eater to me). What if we didn’t force our bodies or our athletes ‘bodies to be something they weren’t designed to be by means of restricting calories and overworking? What if instead we fueled them well, eating when hungry stopping when satisfied, giving permission to enjoy food and discover foods that make us feel good? What if instead we had well fueled athletes who used their unique strengths to excel at sport in their own way?

Personally, I think we’d have a lot less injury and a lot less burnout. Beyond that I know we’d have less eating disorders and healthier, stronger people who would be able to leave their sport behind and step into a nourished life with a few less scars and a better relationship with food.

 

Reference:

1. Carolyn R. Plateau, Trent A. Petrie & Anthony Papathomas (2017) Learning to eat again: Intuitive eating practices among retired female collegiate athletes, Eating Disorders, 25:1, 92-98, DOI: 10.1080/10640266.2016.1219185

Intuitive Eating for the Female Athlete

Intuitive eating for the female athlete

Singling out the LADIES this week to talk about intuitive eating in the face of one of my favorite topics - low energy availability in female athletes! Now before you opt out because a.) you're a guy or b.) you aren't an "athlete", know this: there is a lot of overlap here between the effects of low energy availability on women and men. Also, in today's fitness fanatic, weekend warrior culture the line between athlete and everyday Jane gets blurred, a lot. In other words, you might find a nugget here that's worth your time.

I get fired up about this topic for a few reasons. First off, I'm inspired to share by my own experiences with low energy availability as a collegiate athlete and beyond.  Secondly, I'm constantly encountering adult women who struggle with the ramifications of under fueling and overexercising. Athlete or not, these women typically have a couple things in common: they are frustrated that their weight won't budge no matter how hard they work, they have a belief that there is just "something wrong" with them, and finally, they think that all of the resultant health issues of under-fueling are either completely unrelated to their food intake or just the norm.

There is this huge misconception out there that "as long as you are maintaining or gaining weight, you are taking in enough energy." Forget the fact that you don't have a period anymore, you have terrible digestive health, low energy, poor mood, decreased sleep quality and maybe even poor bone density. Forget the fact that you can't make it through a whole week or even a day's worth of workouts like you used to. And what about that nagging cold that never seems to go away? There's no way it's related to under-eating if the number on the scale hasn't budged....right?

PSA: You CAN chronically under-fuel and STILL maintain your bodyweight. Our bodies are smart. We were designed to adapt and conserve, and sometimes that means stealing energy from certain body systems - like your reproductive system for example - in order to fuel a workout.

It's so, so common for female athletes and workout enthusiasts to have irregular or completely absent menstrual cycles. A lot of athletes just accept this as par for the course, but they shouldn't. No, irregular periods are a warning sign that the body is not receiving enough energy to carry out it's normal functions. When this is the case, recovery and overall health are negatively affected and performance and quality of life are sure to take a hit. We used to only be concerned with the complete absence of menstruation in athletes in the context of anorexia and osteoporosis, but then we go smart. We realized we needed to take a look at the at the downward trend that led to these conditions. We had to look at the full spectrum of inadequate nutrition in female athletes.

ahhh the "graysuit" -  just a  fond memory of my chiche wardrobe as a college  athlete

ahhh the "graysuit" -  just a  fond memory of my chiche wardrobe as a college  athlete

Enter the concept of energy availability. I know I've been throwing that term around a lot here. Let me finally get around to defining it. Energy Availability (EA) is the amount of energy left over or available for your body's normal functions  (i.e. reproduction, digestion, immune function, muscle repair, etc.) after the energy expended for exercise is subtracted from the total energy consumed from food.

If you're a math person, EA is your total daily energy (food/calorie) intake minus the amount of energy you burn during exercise activities. Even though I kind of hate talking about calories, I'll give you an example so you can better understand:

Let's say Sally eats 2000 calories, but burns 750 calories working out. She would have 1250 calories left to use to fuel the normal functions of her body. Now take this 1250 calories and divide it by Sally's fat free mass (FFM) in kg and you have EA. Why do we do this step? Because FFM (muscle, bone, organ tissue) requires more energy than fat tissue - the more FFM you have, the more energy required to keep all body systems running properly. So in this example, what is Sally's FFM? Well, if we assume Sally is 60 kg and 24% body fat, that means she has 51.6 kg FFM (86% of her total bodyweight). Therefore her EA would be 24.2 kcal/kg FFM/day. Optimal health is associated with EAs of 40 - 45 kcal/kg FFM/day in athletes.

Confused yet? Don't worry, the numbers aren't super important for this post - just know that Sally has a low energy availability and that can cause some issues, including missed or completely absent periods, poor bone density, poor performance, increased risk of injury, poor mood, etc.  So where's the good news for Sally?

The good news is that Sally and other women with this issue can increase the food they consume, and thereby increase energy availability. This restoration of energy availability often leads to the return of a normal menstrual cycle without medication (woot woot). Possibly even more exciting, intuitive eating, in combination with some strategic pre and post workout fueling, can help female athletes meet their energy requirements without calculating a dang thing (yay, because I'm sure your brain is fried from all that math up above)!

Here's the how and why:

  1.  Our energy needs are constantly changing. Workouts differ in intensity and duration every single day. If that isn't enough, let's consider some of the countless other factors that affect energy requirements: hot and cold weather, anxiety, stress, lack or sleep, certain medications, caffeine intake, injury, sickness, I could go on... The point is we are not able to calculate exactly how much energy we need on a given day, but our bodies know. Intuitive eating focuses on honoring your cravings, eating when hungry and stoping when full.  Athletes who give themselves permission to eat in this way are more likely to meet energy needs instead of stopping early based on a "prescribed plan".
  2. One caveat that is important for college/elite athletes with large energy requirements to consider is meal and snack timing / spacing throughout the day. Sometimes eating to hunger can feel like an out of control experience for athletes who aren't fueling adequately over the course of the day. Because these athletes have such an energy debt built up by meal time, they're more likely to eat until uncomfortable to meet energy needs. This can be avoided with a little planning. Try eating a meal or snack at least every 3 to 4 hours throughout the day. On top of this, utilize pre and post workout snacks to help meet energy needs. Using these strategies will make it easier to eat based off hunger and satiety without the all-encompassing HANGER monster taking over.

  3. Switch your focus from weight loss to energy, health and performance. Focusing on weight loss has this nasty way of making us more dissatisfied with ourselves. It tricks us into believing that self-abuse is just a way of life and what do we get for it? Nothing. Concerted efforts at energy restriction do not work long term, and often they just result in weight regain and psychological unrest. Instead, focus on fueling regularly to have more energy. Focus on performing your best whether it's in your sport at work or as a mom.  Confidence, strength and energy, these are healthy, obsession with weight and food, these are not.

The truth is that low energy availability and its resulting health effects might be "the norm" among active women, but it certainly isn't normal and it's not the abundant life you were meant to lead. 

 

 

Intuitive Movement for Couch Potatoes and Athletes

Today was one of those days. You know the one where you head out for a long run with all the things: water, shoes, fanny pack with some yummy electrolyte goo, brand new pretty neon run top, but you forget one thing... your phone and headphones are still sitting on the kitchen counter top at home. Now you have to face a long run without tunes, might as well be the end of the world...or so I used to think.

Okay so some of you have no idea what I'm talking about, but some of you runners totally do. I'm not crazy, I promise. The point is I used to NEED music to zone out on runs and push past all of my internal signals, so that I could complete whatever mileage and pace I had planned for the day. Oftentimes, the next day I would be so sore and tired that I'd end up taking the rest of the week off, and if I'm being honest, I would feel a little dejected afterwards. This is not how movement is supposed to feel. Movement should be energizing, stress relieving and even exhilarating at times. It should be sustainable and enjoyable, and it can be. 

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If you aren't a runner or even someone who works out regularly, let's consider another example. Can you remember a time back when you thought trendy diets and mass produced exercise plans held the key to health? Did you set out to lose X  number of lbs (maybe starting on January 1st, or a Monday, definitely a Monday), with a diet plan in one hand and a strict exercise regimen or video in another? You started the program, but after a few days when you were too sore to get off the couch, you told yourself, "I hate exercising" and quickly threw the diet plan and video out the window.  Have you ever considered that maybe its not exercise that you hate, but just forced activities with weight loss as the primary motivator? 

Enter intuitive movement. Just like eating, we can learn how to make peace with exercise by listening to our bodies and being mindful during workouts and regular daily activity. We can learn to move in a way that is enjoyable and rewarding to us as individuals. It may sound like intuitive movement is about EASY exercise, but that's not necessarily true. Instead, it's about paying attention to your body and being mentally involved in your workout (i.e. unplugging from that podcast or playlist for your run). When you do this you start to notice things. You may notice a certain activity is challenging.  You may also notice you feel amazing after it's over. Remember this positive feeling, it's far more motivating than a number on the scale or the time at the end of a race. Alternatively, you might notice that you really don't like certain activities allowing you to continue finding what works best for you!

Intuitive movement can make a huge difference in the way you enjoy exercise (movement)  regardless of whether you currently consider yourself a couch potato or an elite athlete. No matter where you are on the exercise spectrum,  here are 4 ways you can start practicing intuitive movement and begin reaping the benefits.

1. Do what you enjoy!

This one is a no brainer, yet I see so many people who don't follow it. The form of movement that you do is really not that important. What IS important is that you enjoy what you do enough to continue doing it regularly.

For those who aren't elite athletes and are just looking to start moving more often, listen up -- If you hate running, PLEASE stop/ do not start running. And if you do not like working out in the gym - stop forcing yourself. Find something you do enjoy - it could be the traditional walking, biking, swimming, running, etc., or it could be intramural sports, group exercise classes or dancing. It could be as simple as cleaning your house, gardening, going to the mall, playing with your kids. Whatever it is, do it with joy, remember how it makes you feel and don't ever let anyone convince you it's not enough. Not sure what you enjoy? Start trying things out! Search for local group workouts like yoga in the park, group runs/bikes, outdoor bootcamps, local gyms and give them a try. If you are in a larger city try out Class Pass or search Meetup for ideas. More of a social butterfly than a lone wolf? Find a buddy and try doing something with them, combine movement and quality time.

For the athlete, I understand that sometimes we can get in a rut with our sport and may not always feel like we enjoy doing it. But I would argue that if you once loved the sport you're doing, you can love it again, like a little kid. Try remembering what you love about your sport. You might also consider working with a sports psychologist - such an amazing resource for helping athletes find joy in their sport. Additionally, mindful exercise can be huge for bringing enjoyment to your workouts -- this leads me to my next point.

2. Practice mindful movement

Like my running example above, being mindful during exercise can be a game changer when it comes to reaping the rewards of regular movement. Research suggests that mindful exercisers are more likely to reduce their stress and improve health outcomes than mindless exercisers. So what is mindful exercise? Simply put, it boils down to body awareness and being engaged in the here and now. When you are working out or active in your day to day life are you zoned out thinking about your to do list? OR, are you paying attention to your surroundings, to the task at hand, noticing what is in front of you right now? Are you noticing how you feel, where you're engaging muscles and what movements you're doing? Mentally engaging in the activity you're presently doing is the key to mindfulness. Try this - next time you're doing something active, don't look at your phone. Every time your thoughts wander to something that's not happening in the present, bring them back. If you want to go further than just focusing on the present moment, try meditating on good things during your workout: the benefits of exercising, or maybe what you're thankful for, etc. You might be able to do this for 10 minutes the first time, 15 minutes the next time, and so on. Mindfulness is like a muscle, it needs training, but remember the more you practice it, the better you will become at it. 

3. Respect your body's signals for rest

This one is so so important, and at the same time it's the hardest to convince people to do. REST. We as Americans are pretty much allergic to this concept. Even when we are quote on quote "resting" we're usually engaging in some sort of technology addiction, always keeping busy. So it shouldn't be surprising that when I tell people they have to rest in order to develop a consistent healthy relationship with movement, they usually stutter and stare in disbelief. Typically, I hear something like, "well, if I stop now or skip a day, I'll just completely fall off the band wagon," this fear is accompanied by concerns about gaining weight in one day (really that fast?). And herein lies the issue, exercise, when done with weight loss as the sole motivator, is not sustainable and rarely enjoyable. But I digress. 

Because of our obsession with "doing", our belief that exercise should mostly be painful, and our aversion to resting, many of us are out of touch our body's signals. If you have super low energy, you're a straight grouch, or you're relying on extra caffeine to get through the day, you might need a rest day. If you are constantly sore and stiff or you're getting the sniffles all the time, you might need a rest day. If you just don't want to do something you normally love doing, you might need a rest day! Just try it - take a day off and give yourself permission to relax and recharge, see how much better your relationship with exercise becomes. 

If you are an athlete, I strongly encourage taking rest days if you can. This topic is so so close to my heart as I am fairly certain looking back on my college swimming career that I spent a large portion of my freshman and sophomore years overtrained and overtired due my own mentality that rest was for the weak and slow. I was convinced that pushing through would solve all my performance problems, but it usually left me sick and in a bad place.  If you aren't able to take a day off, be extra careful to get rest outside of your workouts when you notice these signals. Another way you can tell if you need some rest is through monitoring resting heart rate. You can take your heart rate immediately upon waking (and while still lying in bed) for a week or two and figure your baseline or average resting heart rate. If you not a sudden spike in your resting heart rate or rising trend, this is a sign you might need to back off.

4.Ditch the Pressure to ALWAYS follow a plan & just move

My final tip for practicing intuitive movement is to just move! Well, Doi. But seriously, just like my diatribes about throwing out the diet plans and just eating. It's just as refreshing to realize that you don't have to follow a strict exercise plan with perfect mileage or strength training periodization, or set workouts. Just like diets, this often results to all or nothing thinking. It can leave you feeling like, "if I didn't run X miles or I don't have time to do Y strength training workout might as well just sit on the couch all day, and then for the rest of the week and feel yucky. Forget that. Instead, can't do your planned workout? Just move, anyway you can. It all counts! Go for a walk with the dog, or on your lunch break. Do some squats with your kiddo or a few pushups on a commercial break. Do half of your planned workout. And then enjoy the energizing health giving feeling of moving, however you can! Movement is incredibly important, it's what we were designed to do and it's rejuvenating. It would be a shame to let the pressure of being perfect stop you from experiencing the blessings of regular movement. 

Think about it, what's one thing you can do today that'll  take you away from an all or nothing exercise mindset to practicing intuitive movement??

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As for myself, I'll be chasing this man down the gravel driveway -- but it'll be phone free this time ;)