Author Archives: Paul Jaminet - Page 79

How to Do Joint Mobility Drills

Posted by on July 26, 2011 22 comments

Todd Hargrove is probably familiar to many readers as a highly intelligent and good-humored commenter on Paleo blogs. He has a fantastic blog, Better Movement, which Mark Sisson calls one of the “18 Underrated Blogs You Should Be Reading”. Todd began his career as an attorney, but dealing with a chronic pain issue led him to become a therapist with “an obsessive interest in learning about how the body works and a strong empathy for others going through chronic pain”. He is now a rolfer and teacher of The Feldenkrais Method in Seattle.

I’ve noticed that the most sophisticated health and fitness practitioners place a heavy emphasis on brain and nerve function. Todd is one of these; as you’ll see, he offers a brain centered perspective on physical performance, pain and exercise.

Mobility is an extremely important part of good health, whatever one’s age or degree of athleticism. I’m therefore delighted to present this guest post by Todd on “How to Do Joint Mobility Drills.”

Mobility work is about the brain

Dynamic joint mobility drills are becoming very popular, and are starting to replace static stretching as a way to warm up, train healthy movement patterns, and (p)rehab injuries. Mobility work can be defined as deliberate movement through a defined pathway, done repetitively, usually without resistance. Examples include wall slides or arm swings for the shoulders, clam shells or leg circles for the hips, and cat/cows or rotations for the spine.

Joint mobility drills have several advantages over static stretching. First, they involve movement, which is good, because you probably want to get better at moving, not just staying still with your limbs splayed out. Second, most of the work in a static stretch is done at end ranges of motion that don’t get used very often. By contrast, joint mobility drills usually involve movements through the middle ranges of motion where most of life and sport occur. So they promise to have more applicability to real world tasks. Healthy athletic movement at most joints has far more to do with quality of motion than quantity of motion.

So the trend toward mobility drills is a very positive development. However, I believe that people often fail to obtain the full benefit of mobility exercises, mostly because they do not appreciate the neural mechanisms by which they work. The mainstream idea is that joint mobility drills work by making changes to the local muscular and connective tissues involved in the movement. In my opinion, mobility work has only a limited ability to cause significant adaptations in the mesoderm. Instead, it works by making changes to the virtual representations of those structures in the brain. In other words, mobility work is about function not structure, the brain not the body, the software not the hardware, the ectoderm not the mesoderm, the driver not the car.

OK, enough with the metaphorical distinctions. Here’s a detailed explanation what I mean.

Joint mobility drills are a weak stimulus to the mesoderm

There is little reason to believe that joint mobility drills have any notable effects on the local mesodermal tissues that are being mobilized.

Unlike weight training or endurance training, mobility work does not provide enough resistance or energetic demand to cause adaptations in the size or endurance of muscle cells. Unlike stretching, it does not involve enough time at the end ranges of motion to permanently add more muscle or connective tissue length. Unlike sports or other habitual physical activities, it does not create enough mechanical stress to the tendons and ligaments and joint capsules to cause any significant connective tissue remodeling (unless you did thousands of repetitions at a pretty good speed.) Joint mobility drills will provide circulation and warmth to the local tissues and synovial fluids, which is great and totally necessary for health. However, we would expect similar benefits from almost any repetitive motion in the same area.

So why would the specific form of a mobility exercise matter? Why not just move all your joints through all their ranges of motion in any old way? My answer is that mobility exercises work by communicating with the brain, and it will only communicate effectively when it sends the correct signals. Here is a discussion of some neural mechanisms by which mobility drills could improve coordination and reduce pain.

Joint mobility drills improve coordination by clarifying movement maps

Coordination happens in the brain not the body. Some key networks in the brain that sense and coordinate the muscles are called the body maps. The body maps are discrete parts of the brain that are organized in such a way as to represent the different body parts, just as lines on a map represent roads. Each part of the body has a separate area of the brain dedicated to moving and sensing that body part.[1]

Body parts that have greater sensory motor demands have bigger maps. Not surprisingly, the map for the hand is significantly larger than the map for the elbow. Thus, larger and more detailed maps means better coordination. The information necessary to maintain and build the maps is provided by proprioceptive signals from the body. Proprioception occurs when movement or touch stimulates nerve mechanoreceptors, which are located all over the body and primarily in joints.

You can sense the effects of mechanoreception on your maps instantly by doing a simple experiment. Try to imagine or sense the exact shape and position of your ears. Now rub just the left ear for a few seconds and then compare your ability to sense the left ear and the right. You will note that it is much easier to form a clear picture of the left ear. The simple reason is that touching the ear activated its mechanoreceptors, which sent a signal to the brain, which excited the neurons in the map for that area. Of course, the additional clarity in the map is only temporary, and after a minute your ears will feel the same.

In order to make long term changes in the maps, you need to place demands on them consistently over a long period of time. When a certain movement is used repeatedly in a coordinated and mindful fashion, there are actual physical and observable changes in the part of the brain that controls that movement. For example, the finger maps in a braille reader’s brain are observably larger than the counterpart of the average person.[2]

While movement will clarify maps, lack of movement will tend to blur them. In a famous experiment, researchers found that sewing a monkey’s fingers together for a few weeks caused its brain to map the fingers as one unit, not as two separate parts capable of individual movements.[3] We would expect similar map blurring to occur when any joint movement is neglected for a certain period of time. This loss of control over previously accessible movements is the neural version of the “use it or lose it” principle, and is sometimes called sensory motor amnesia.

A common area for sensory motor amnesia is the thoracic vertebrae. Most people probably have one or two vertebrae in their upper back that haven’t moved in a certain direction with respect to its neighbor in years. The movement isn’t physically impossible, it’s just not part of the brain’s current movement programs due to neglect. A good analogy might be a language that you could once speak fluently that you haven’t spoken for years. The knowledge is in there somewhere, but a good portion of it is not readily accessible without some brushing up.

The right mobility drill would be structured to require the brain to brush up on its thoracic movement skills and reactivate some rusty movement programs. If the brain remembers how to move a currently static vertebra, the result is an immediate qualitative change in the movement of the entire spine. The decisive change is not to the physical tissues of the vertebral joint, but to the way that the brain maps the vertebrae for sensation and movement.

Blurred maps can create pain

Accurate maps also have important consequences for how we feel. Phantom limb pain is a dramatic example. Many people with an amputated limb experience pain in the missing body part. This is because even though the arm is gone, the virtual arm in the brain lives on, and can be stimulated by cross talk from nearby neural activity. When this occurs, the brain creates a sensation of the missing arm that is incredibly realistic and often excruciatingly painful.

Some pain researchers believe that less severe instances of mapping errors may be involved in many chronic pain conditions. Numerous studies have shown that sensory motor illusions caused by mirrors or other tricks can cause pain. For example, if you immerse your index and ring fingers in warm water and the middle finger in cold water, this will often cause your middle finger to feel painfully hot. Other studies have shown that pain from these illusions can be alleviated with proprioceptive input that corrects distortions in the maps.[4] For example, an amazing treatment for phantom limb pain involves placing the remaining limb in a mirror box in such a way that it fools the brain into thinking the missing limb is alive and well! Based on these and other studies, many pain researchers believe that clarifying the maps is a promising treatment for many forms of chronic pain.[5]

Movement creates sensory gating

Mobility drills can also reduce pain by sensory gating. Sensory gating means that the processing and perception of sense information is reduced by the presence of competing sense information. If your nervous system is busy trying to process signals resulting from movement or touching, it has less ability process signals caused by tissue damage (nociception). Most people will instinctively take advantage of sensory gating by rubbing an area that has just been injured. The rubbing sends sensory signals to the brain which compete with the damage signals. If you feel temporarily better after a massage, exercise, or yoga, sensory gating is probably a major reason why.

How to maximize the benefit of mobility exercises

Based on the foregoing, there is good reason to believe that the brain should be the primary target for joint mobility work. With this in mind, here is a quick list of rules to keep in mind when doing mobility work.

1. Avoid pain and threat. If you create pain while doing joint mobility drills, the brain will attend to the pain and ignore the potentially interesting proprioceptive information.  Further, the brain is not interested in adopting a new movement pattern that is threatening. Make sure the movement does not cause too much discomfort or create other signs of threat such as holding the breath, grimacing, collapsing your posture, or using unnecessary tension.

2. Be mindful and attentive to what you are doing. Attention enables neuroplasticity, which is the goal. The brain receives massive amounts of sensory information each second and will ignore any inputs it deems irrelevant, uninteresting or redundant. If you pay careful attention to what you are doing during mobility drills, the brain will place a higher value on the resulting proprioceptive information and be far more likely to make changes to your movement maps.

3. Use novel movements. The brain is more likely to pay attention to a stimulus that is novel. Most joint mobility drills incorporate novelty already and that is why they work. However, endlessly repeating the same drill will have diminishing returns. So you might want to change things up from time to time to keep the brain interested.

4. Easy does it. The benefits of moving slowly and gently to improve coordination have been recognized by martial artists, elite athletes and musicians for a long time. The scientific explanation for why slow and easy works requires a post of its own, but here is a start. Slow and easy movement works because it: is inherently non threatening; is less likely to cause pain; allows you to find movement angles that would be missed at higher speeds; improves the proprioceptive signal to noise ratio; allows greater opportunity to focus on the subtle differences in joint movements; and, under the Weber Fechner rule, less force equals greater ability to discriminate in the amount of force used.[6]

5. Be curious, exploratory and playful. Motor learning is greatly facilitated by a curious playful attitude. All animals engage in the most play during the times of their lives when the educational demands are the highest. This means that play is the best solution to difficult education problems that evolution has found. With this in mind, use mobility work as a way to experiment with subtle variations of how to move and figure out which ones work best.

Conclusion

Next time you do some joint mobility drills, move slowly and carefully, completely avoiding any discomfort. Reduce speed and range of motion as necessary. Use the minimum amount of force and effort to get the job done. Pay careful attention to exactly what you are doing and play with subtle variations to assess which are most efficient and comfortable. Try a few repetitions at the slowest speed you can possibly move. Then see how you are moving. I think you will see some improvements. Good luck!

Endnotes

1. http://en.wikipedia.org/wiki/Cortical_homunculus

2. http://www.sciencedirect.com/science/article/pii/S1364661398011723

3. http://jn.physiology.org/content/66/3/1048.abstract

4. http://www.cell.com/current-biology/abstract/S0960-9822%2810%2901060-2

5. http://www.ncbi.nlm.nih.gov/pubmed/12909433.

6. http://en.wikipedia.org/wiki/Weber%E2%80%93Fechner_law

Chocolate Chip Cookies

Posted by on July 24, 2011 28 comments

We have little baking experience, so we’re just beginning to learn how to make Perfect Health Diet compliant doughs and baked goods. This recipe turned out very well — unexpectedly well considering it was our first try. And it’s so easy; it takes less than half an hour.

Ingredients

Dry ingredients:

  • Rice flour 1 cup (optional: sticky rice flour)
  • Tapioca flour 1/3 cup
  • Baking soda 1/2 tsp
  • (optional) Beef gelatin 1 tablespoon

Wet ingredients:

  • Butter ½ cup (1 stick)
  • Egg yolks 3
  • Rice syrup 1/4 to 1/3 cup
  • Vanilla ¼ tsp

Flavorings

  • Chocolate chips
  • (optional) pistachios
  • (optional) raisins
  • (optional) pomegranate seeds

Preparation

Melt the butter (we used the microwave, about 20 seconds) in a mixing bowl. Add the other wet ingredients and mix thoroughly.

Mix in the dry ingredients until the dough has an even consistency. It will look like this:

Then fold in some flavorings. We broke up some bulk dark chocolate and included pistachios:

In another batch we tried chocolate covered raisins:

Place cookie-sized batches on an aluminum foil lined baking sheet:

The aluminum foil prevents the bottom of the cookies from burning.

Bake at 375 F for 10-12 minutes. Remove the cookies and let them cool for at least half an hour; after they are cooled, refrigerate them.

This was the chocolate and pistachio batch:

The chocolate covered raisins melted and produced brown cookies:

Post-eatem

The cookies were good – we were surprised how well they came out on our first attempt.

Shou-Ching really loved them, and so did our guests, but I thought the texture was drier and more crumbly than I would like. (Of course, I used to prefer uncooked dough to cookies, so I like things chewy.) This is a general issue with rice flour – it doesn’t hold together as well as gluten-containing flours. We tried both sticky rice flour and regular rice flour; I think the sticky rice flour might be very slightly better but it was difficult to detect a difference.

Here are some tweaks we’ll try next time:

  • Add more egg yolks. A little more fat might give a moister texture.
  • Try potato starch in place of tapioca flour.
  • Experiment with the protein. Most recipes either have no protein or use egg whites. We like the idea of a balanced mix of macronutrients, so we wanted to include a bit of protein. We tried the beef gelatin, partly because we have some around, and partly because gelatin mixed with water makes a good glue. We wondered if this might help the rice dough cohere. As yet we haven’t tested enough variations to know whether this was a good or bad idea.

We’d love to hear tips from more experienced cookie chefs – and reviews from the most honest critics, young children!

About the Meet-up at Plum Island

Posted by on July 22, 2011 12 comments

Update: We’ve moved to the beach at the entrance to the wildlife refuge parking at parking lot 1 because the parking lot area at Sandy Point was full. Paul is wearing a green shirt and Shou-Ching is wearing a red shirt. We’ll be near where the board walk from parking lot 1 enters the beach.

Just a reminder: today (Saturday) is the day of our meet-up. We’ll be on the beach at the south end of Plum Island between 4:30 and 6:30, and will share food, chat, walk, wade in the ocean, read, and play with whoever cares to join us.

If you come and are looking for us, feel free to call my cell phone: 617-576-1753.

It’s a nice place to spend a summer Saturday. The beach is located within a wildlife refuge that has walking trails through salt marshes and dunes. (We’ll do some walking before heading over to the beach at 4:30.) Nearby is Newburyport, a scenic town with an abundance of restaurants, art galleries, and shops.

What It Looks Like

We visit Plum Island about 3 times a year to walk in the wildlife refuge and picnic on the beach. Here are a few pictures from past trips.

Here’s the beach:

The water is a bit cold for swimming but fine for wading.

There are hiking trails, some of them boardwalked, through dunes and salt marsh:

They have facilities for aerobic exercise:

And resistance exercise:

There is wildlife:

If you care to you can hunt for clams:

Directions

The easiest way is to take exit 57 from I-95, which is Rte 113, and proceed through Newburyport onto Rte 1A south. Near the Newbury town line turn left onto Rolfes Lane; there will be a sign for Plum Island. At the end of the road turn right; when you’re on the island turn right again. You’ll have to pay $5 to enter the Parker River Wildlife Refuge. Proceed south on the refuge road; the beach is in Sandy Point State Reservation on the south end of the island.

How to Recognize and Fix a Brain Infection

Posted by on July 20, 2011 195 comments

I thought I’d pull up an interesting tale from the comments. It is a great illustration of what we’re trying to accomplish on this blog.

Thomas first commented here on December 31:

I just got your book from a relative for Christmas (I told them to buy me it!) and am reading through it now. Very interesting, although some of it is beyond a simple layman like me.

The part of this blog post that starts “Thus common symptoms of a bacterial infection of the brain are those of cognitive hypoglycemia and serotonin deficiency” and continues for several paragraphs describes precisely the mysterious changes I have experience over the last decade of life (I am now 33), with the one variation being that I suffer extreme fatigue rather than insomnia or restlessness. Every other sympton, including the odd mental state you mention, is a perfect match, and I experience them all to a marked degree….

I have been diagnosed with general anxiety but never depression. I do not feel sad ever, just irritable and anhedonia-ac, if I may coin a word. Anti-depressants, and I’ve tried a bunch, do absolutely nothing for me.

Brain infections are widespread – I wouldn’t be surprised if 20% of the adult population has a brain infection of mild severity – but they are hardly ever diagnosed or treated.

Fortunately, there are some symptoms that are almost universally generated by brain infections, so it’s not necessarily that difficult to diagnose them. But I think no one knows the symptoms. Infections are generally allowed to progress for decades.

One of my crucial steps forward was when I recognized that I had the cognitive symptoms of hypoglycemia when my blood sugar was normal. I could relieve the symptoms if my blood sugar became highly elevated. Thinking about why that might be led me toward the idea of bacterial infections.

Thomas went on to describe the origin of his symptoms:

I began to decline after suffering the second subdural hematoma of my life at age 20 when I was in Italy, followed by a 5 year binge on alcohol.

This was another clue. Traumatic brain injuries, such as hematomas, often initiate brain infections, because they breach the blood-brain barrier. Alcohol is also a risk factor, as I pointed out in my reply to Thomas:

Alcohol abuse depresses bacterial immunity and would be a risk factor for a brain infection: http://www.ncbi.nlm.nih.gov/pubmed/16413723, http://www.ncbi.nlm.nih.gov/pubmed/20161709. Subdural hematomas frequently show infections, e.g. http://www.ncbi.nlm.nih.gov/pubmed/20430901.

We next heard from Thomas on February 22, when he had been on our diet for 7 weeks and had just tried his first ketogenic fast:

I’ve been doing PHD for about 7 weeks now, and tried a ketogenic fast this past weekend. I ended up going 33 hours with some coconut oil and cream. It was a bit tough having to eat a bunch of oil on an empty stomach, but nothing too bad.

I can’t say there was any improvement cognitively or with anhedonia, but there seemed to me to be a pronounced calming effect after about 24 hours of fasting. I often stutter or stumble over words (again, for about 10 years now), which usually goes away only with two or three alcoholic drinks. But the speech problems stopped almost completely during the fast, which makes me thing that there is some link to anxiety and stuttering.

Positive changes in brain function during ketosis suggest that the brain isn’t functioning normally when it relies on glucose as a fuel. There are several possible causes of this, but one is a bacterial infection. Another clue.

I generally recommend getting on our diet and supplement regimen, and reaching a stable health condition, before starting antibiotics. There are several reasons for this, which I’ll elaborate on later, but briefly:

  • Antibiotics work well on a good diet but may fail on a bad diet.
  • Pathogen die-off toxins can cause significant neurological damage and this toxicity may be substantially increased on a bad diet.
  • There is considerable diagnostic value in being able to clearly discern the reaction to antibiotics. Rarely is it certain that a brain infection is bacterial, or that the antibiotic in question is the correct one. To judge whether the antibiotic is working, it’s important that health be stable and as good as possible.

I therefore recommend being on our diet and supplement regimen for 3-4 months before starting antibiotics.

Thomas seems to have followed this advice, since he has just reported starting antibiotics:

I’ve been on PHD for a few months, and about a month ago went to the low-carb therapeutic ketogenic version of the PHD. After reading some of Paul’s posts, I believe that I might have a brain infection as a result of a head injury from more than a decade ago (Paul, if you recall, my condition has a lot of similarities to the one you once had). I started taking doxycycline a few days ago, and I have already noticed pronounced improvement (whether due to the diet or the antibiotic or both) in controlling the irritability and anxiety that have plagued me for years….

I definitely feel great since making the diet changes. My blood pressure, which has been creeping upwards over the last few years to 135/80 or so, is back down to 110/70. My testosterone is 824, and I am pleased to see that I maintaining my strength in the gym despite being on a ketogenic diet.

Pronounced improvement in the first days of doxycycline is quite possible, because doxy acts as a protein synthesis inhibitor. It essentially blocks bacterial functions and switches them into a state of hibernation. The bacteria are still there, but they are not interfering with brain function as much as before.

This improvement is confirmation that Thomas has a bacterial infection of the brain. If there were no infection, he wouldn’t notice an effect from the antibiotics.

Over a period of months, the doxycycline plus ketogenic dieting should help his innate immune defenses clear the brain of most bacteria. Combination antibiotic protocols may be even more effective.

In a follow-up comment, Thomas mentioned Ben Franklin and the blessing of good health:

Thanks for the response Paul, as well as all your help. If this works, I owe you my first-born child and then some! Ben Franklin (I think it was him) might have been right about health being the greatest blessing. The improvements I’ve seen recently have done more for my well-being than anything in the last decade, and I am profoundly grateful to you for all your excellent advice.

It’s comments like this that make blogging and book writing worthwhile.

It’s probably hard for those who have never had ill health to appreciate how enjoyable it can be for those with chronic diseases to recover good health. I’ve blogged on this before (Of Recovery, Hope, and Happiness, July 13, 2010 – don’t miss Ladybug’s painting).

Thomas, antibiotics and ketogenic dieting will work, I’m pretty sure. May you come to perfect health, and always remain grateful for the many blessings that are yours.