Resolution Research- Is it Physically Possible?

New.Year.Resolution
Many find the end of the holiday season to be a time of reflection upon the blessings of the past year and hopes and dreams for the upcoming year.  It is also a time typically associated with New Year’s resolutions, many of which are associated with weight loss.  However, according to the Franklin Covey time management firm, a staggering thirty percent of New Year’s resolutions are abandoned by February.  Is this solely a question of will power and commitment, or is there possibly a chemical connection to failed weight loss attempts?

A recent study in Cell Metabolism (December 29, 2016) explores a possible connection between obesity and dopamine.  Most people with a medial background automatically associate dopamine with a different disease, namely Parkinson’s Disease (PD).  PD is a chronic degenerative disorder on the central nervous system which affects motor function.

Ordinarily, cells in the substantia nigra (part of the midbrain) produce dopamine, a chemical that contributes to smooth and coordinated motor control.  Individuals with PD experience substantia nigra cell death which leads to decreased dopamine production.  This in turn results in slow movement, tremors, rigidity, difficulty initiating movement, depression, anxiety, and disordered sleep.  Symptoms often begin to appear after 60-80% of the substantia nigra cells have died.

Dr. Alexxai V. Kravitz, a researcher at National Institute of Health’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) with a heavy background in PD research, shifted gears several years ago and began obesity research.  Over time, he was surprised to discover that obese mice demonstrate similar behaviors to mice with PD.  Up until then, it was assumed that obese mice were inactive and lethargic due to excess body fat which made it difficult to be mobile.  However, Kravitz’s observations led him to hypothesize that perhaps obese mice were inactive due to an actual chemical dopamine deficit.

Kravitz explored his question through a randomized controlled trial.  In his study, he compared a group of mice which were fed a standard diet to a group of mice which were fed unhealthy fattening foods for eighteen weeks.  As early as the second week, mice in the unhealthy group weighed more than mice in the healthy group.  Interestingly enough, mice in the unhealthy group demonstrated decreased movement and activity well before they gained the majority of their weight.

This indicated that excess body weight wasn’t the culprit responsible for decreased activity.  Rather, six different aspects of the dopamine signaling system were observed, and it was discovered that obese mice demonstrated D2 dopamine receptor dysfunction.  According to Dr. Danielle Friend, “There are probably other factors involved as well, but the deficit in D2 is sufficient to explain the lack of activity.”  In order words, decreased activity in obese mice (and possibly humans?) is more connected to a chemical imbalance than to schlepping around excess weight.

The purpose if this blog is not intended to discourage people from their lofty New Year’s resolutions, nor to excuse those who fail by blaming it on possible dopamine deficits.  Studies are yet to be performed with humans, and many questions are yet to be answered.  Rather, the purpose of this blog is to validate and inspire.  Yes, it is difficult to make dietary and physical activity improvements.  In fact, there may even be chemical components contributing to the challenge.  That being said and in response to the blog title’s question …it IS physically possible!  Try as best as you can to stick to your guns and to take it day by day.  Find a friend to be your gym buddy.  Take the extra few minutes preparing that salad rather than the quick and convenient fast food route.  Mind over matter can accomplish tremendous accomplishments.

May we find the inner strength and resolve to commit ourselves to healthier lifestyle choices, and may we be kind to ourselves when we “slip up.”  I wish all of you, my dear readers, a happy and healthy 2017 filled with abundant blessing.

“Why Does it Feel Like My Insides are Falling Out?” (Part Two)

woman.afraid.pop
(Continued from Previous Blog:)

The symptoms of POP are uncomfortable and unpleasant.  One of the primary symptoms of POP is a feeling of heaviness in the uterus or pelvic floor, possibly even accompanied by the sensation of an organ descending or falling out.  Women may also experience pelvic pressure, low back pain, urinary urgency, urinary frequency, urinary incontinence, post-micturition dribble (leaking a small amount of urine after having just voided), straining with bowel movements, and incomplete emptying of the bladder and bowel.  The force of gravity works against the pelvic floor organs and further pulls them in a downward direction.  Therefore, symptoms are often worse after periods of prolonged standing or at night, after having been on one’s feet all day.

 

Fortunately, research has shown that pelvic floor physical therapy can help reduce POP.  POP is a condition that is similar to pelvic floor muscle weakness and incontinence in the sense that it too requires an uptraining program.  Pelvic floor exercises (Kegels) increase strength, endurance, and support of the pelvic floor.  Furthermore, a routine exercise program can prevent POP from worsening and can decrease the severity of symptoms.  Pelvic floor muscle training should first occur in a gravity assisted position (ex. with the buttocks resting atop pillows or a wedge pillow).   This position allows one to take advantage of the downward pull of gravity and to utilize it in one’s favor.  Performing Kegel exercises with the buttocks resting atop the elevated portion of the wedge helps pull the organs into a better position.

Image result for wedge hips elevated prolapse

 

Not only is the wedge a useful tool during exercises, but it is also a a helpful item that can be utilized for positional relief of prolapse symptoms. Women often report that their POP feels worse at the end of the day, after they have been standing on their feet and gravity has been pulling the organs down further.  By lying on the pillows or a wedge properly, gravity can be used in one’s favor to pull the organs superiorly (upward). Women who enjoy yoga may find the same relief from the downward facing dog position which also pull the organs into improved alignment.

 

In addition, certain lifestyle changes are important to reduce prolapse.  Education about avoiding Valsalva maneuver (exhaling with a closed windpipe) is crucial.  Instead, exhalation should be performed through the mouth during activities involving heavy lifting.  Furthermore, discussion about avoiding constipation and straining as well as proper muscle activation patterns while lifting or coughing (including inward abdominal contraction with upward pelvic floor muscle contraction) are important.

 

If exercise alone does not satisfactorily reduce POP symptoms, a pessary may be a helpful tool to successfully manage POP rather than resorting to surgery.  A pessary is an orthotic device that can be inserted (on a temporary or permanent basis, depending on the individual’s needs) to lift the POP.  There are many different shapes and sizes on the market, so practitioner guidance is extremely helpful to determine one’s needs and how to best address them.

 

A pessary is placed in the cervix, behind the pubic bone, in the same location as a contraceptive device.  An individual may prefer using a pessary only during specific activities (ex. during an exercise class), or they may choose to keep it inserted for longer periods of time.  In this case, it is recommended that one visit her doctor every three months for pessary removal and cleaning.  As with all other medical decisions, it is important to discuss options with one’s physician.

 

If you or someone you know can relate to the aforementioned POP symptoms, pelvic floor physical therapy might be the perfect solution for you.  We at Revitalize Physical Therapy are dedicated to helping you, and we would love the opportunity to do so.