Ask a Tahoe Health Professional | TahoeDailyTribune.com

Ask a Tahoe Health Professional

Question: I have had a hard time finding energy lately. What are some ways to jump start my body and get me out of this rut?

Answer: Your experience of lack of energy may be correlated to your adrenal glands. The adrenal glands are located at the top of each kidney and are responsible for producing hormones like cortisol and aldosterone. Your adrenal glands help the body control blood sugar, burn fat and protein, and serve as a reactor to stressors, including illness and injury. A common symptom of adrenal insufficiency is fatigue. The insufficiency usually occurs when the glands aren't able to make enough cortisol. Cortisol is also known as the "stress hormone" as it relates to how we regulate and process stress.

When it comes to getting your energy back, and potentially even more than you had in the past, a great place to start is with "de-stressing" to harmonize your hormone levels. A new and proven method to harmonize cortisol levels is through "heart breathing." Heart breathing is a technique that was developed by Heart Math Institute, and it is the simple practice of taking deep breaths with your attention on your heart space. Instead of imagining breathing into your lungs, imagine breathing into your heart. Do this at least twice a day for five minutes or more.

In addition, take an inventory of your mental patterns. Your fatigue is likely caused by stress, which could include external stress and life experiences, as well as the stress that is experienced internally within your mind. Have your thoughts been all over the place lately? Have you been experiencing increased anxiety or negative self talk? It is a good idea to approach the resolution of your fatigue by decreasing the things that "tire you out," whether they be internal or external.

The "jump start" you are looking for can actually be found with more of a "re-booting." Take time to relax, and let your adrenal glands know that they don't need to be in survival mode. Only then will they naturally harmonize the regulation of hormones that are important to your health.

Question: When it comes to skiing related injuries, what types of physical therapy are generally recommended? And do I need a physician referral for it?

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Answer: Skiing inherently increases your risk of an "internal knee derangement" by 10x versus snowboarding which increases risk of wrist injury by 10x. So as a skier you need to protect your knees. The best way to do that is by strengthening your core and your hips. Skiing is not performed purely in the sagittal plane i.e. forward and backward, but rather from a semi-squat position with rotation and side bending. To prepare your body I suggest squats on unstable surfaces such as standing on a BOSU or on a pillow. If that is easy try single leg squats. For full body preparation I like working out in an indoor pool. Most physical therapy clinics have a warm indoor pool, and working out with a licensed PT is covered by your insurance. You can practice the side bending and rotation you would experience skiing. This limits your risk of injury because of the buoyancy provided by the water. Aqua therapy still strengthens you in the motions of skiing without excessive risks placed on your knees. And its fun! Direct access to physical therapy is legal in all 50 states which means that you can see a physical therapist without a physician referral. However, you should see a physician at least once a year and your PT may contact your physician to coordinate care depending on the severity of your injury.

Question: How long do typical physical therapy sessions last and are they painful?

Answer: Who said physical therapy was painful? Well, sometimes it can be, but only if it is absolutely necessary. For example, after somebody has a total knee replacement and their knee is very stiff then we may push it to the limit. For the most part physical therapy is therapeutic, which means it may be uncomfortable or difficult but avoids causing pain. PT visits are typically 1 to 1.5 hours long. At my clinics we provide 30-45 minutes of 1:1 hands on therapy by licensed PTs or PTAs. We then provide 30 minutes of 1:1 personal training by aides under the guidance of PTs. Following these treatments we may ice or hot pack the patient for 15 minutes to decrease swelling and pain. Aquatic Therapy is 1 hour long in the pool. I believe that the hands on treatments followed by personalized exercise programs are what make physical therapy so effective. Don't settle for the group class. You deserve to see a practitioner who is paying attention to you.

Ask a Tahoe Health Professional is part of the Tahoe Daily Tribune's Healthy Tahoe initiative. You can email questions to health@tahoedailytribune.com. From there questions are anonymously sent to our health professionals.

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