Tag: exercise

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From beginner’s yoga to more advanced practices, downward dog is one of the most popular poses. Physical therapist Dawn Lorring, PT, MPT @ClevelandClinic

Take a ‘Paws’ With Downward Dog

This transitional and restorative yoga pose provides a full-body stretch

Physical therapist Dawn Lorring, PT, MPT, walks through the steps of how to do downward dog correctly and shares its many benefits.

From beginner’s yoga to more advanced practices, downward dog is one of the most popular poses…with a few common misconceptions.

Rounding your back, placing your feet too far apart or putting too much weight into your wrists can all create a deeper stretch than intended — which increases your risk of injury.

Physical therapist Dawn Lorring, PT, MPT, walks through the steps of how to do downward dog correctly and shares its many benefits.

What is downward dog?

Downward dog (also known as downward facing dog, facing dog pose or Adho Mukha Svanasana in Sanskrit) is a foundational yoga pose. It’s often used as a transition between movements, like sun salutations. It’s also a form of active resting, active stretching and strengthening. This allows you to check in with yourself and re-evaluate your intentions during your practice.

You do downward facing dog by putting your body into an inverted V-shape (or pyramid), as if there were a straight line that runs through the top of your head up your spine and out of your butt toward the ceiling.

How to properly do downward facing dog

Facing dog pose won’t usually be your first movement when doing yoga. Before trying it, it’s best to loosen up your muscles and joints and find ways to work it into your overall yoga practice.

Once you’re warmed up and ready to go, follow these steps:

  1. Start on all fours with your hands shoulder-width apart and your knees in line directly behind your hips.
  2. Spreading your fingers wide, press down into your hands and tuck your toes (almost like you’re using them to grip the floor beneath you).
  3. As you exhale, bring your hips up and back, as if there’s a string pulling your butt toward the ceiling, so your body creates an inverted V-shape (or pyramid).
  4. Focus on straightening your back, not rounding it, so your head and neck are relaxed between your upper arms. It helps to focus on pressing through your arms to “push” the ground away from you and keep your arms active.
  5. Engage your core muscles and pull your tummy in.
  6. Keep your legs straight and, if it’s comfortable for you to do so, try to drop your heels down to the floor.
  7. Adjust your posture by shifting your weight between your hands and feet until you sink comfortably into the position.
  8. Hold this pose for 10 to 15 seconds at a time, making sure to breathe throughout.
  9. For a more relaxed stretch, bend your knees a little and readjust your posture as needed.
  10. When you’re done, exhale and move into your next pose or slowly lower yourself to the floor to enter child’s pose.

“Downward facing dog isn’t about keeping your heels on the ground or holding it for long periods of time,” clarifies Lorring. “It’s really about making sure you’re going to a place that’s comfortable for you, so you can adjust your body as often as you need in this pose.”

Facing dog pose variations

If you have a hard time getting down on your hands and knees, try this wall variation:

  1. Face the wall and place both your hands out in front of you so your palms are flat and your fingers are stretched out.
  2. Keeping your head and back straight and your hands on the wall in front of you, slowly walk your legs backward.
  3. As you move, walk your hands down the wall so you hinge at your hips and look directly at the floor.
  4. Keeping your head and neck relaxed, hold this pose for 10 to 15 seconds before slowly returning to stand.
  5. If you feel stress or discomfort in your wrists, you can modify by rolling up a towel or the edge of your yoga mat and placing the roll under the heels of your hands. This will decrease some of that pressure.

For a more challenging stretch that deeply engages your hips and hamstrings:

  1. While in the downward facing dog position, lift one leg up and stretch it toward the ceiling.
  2. For a deeper stretch, bend your outstretched leg back and over your body, so your knee is facing away from you.
  3. Repeat this process with the other leg, holding the pose for as long as you feel comfortable on either side.

Downward dog benefits

Downward facing dog provides a full body stretch, while also strengthening and working your:

Adho Mukha Svanasana helps improve your flexibility and control, and provides you a moment of active rest. It also increases blood flow to your head and upper body when you’re in the inverted V position. But because of this, you should talk to your yoga instructor, athletic trainer or healthcare provider before starting this position if you have:

“Facing dog pose tries to improve flexibility but also builds the strength to control that flexibility,” says Lorring. “If you’re feeling excessive stress to a certain part of your body, then you’re probably holding the pose for too long or you’re trying to go into a range that you’re not ready for. We can help you get there.”

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5 Ways to Boost Your Child’s Immune System for Life @ClevelandClinic Adriane Lioudis, MD.

We all want to protect our kids whether it be from falls, bumps and bruises — or avoidable infections and diseases. To help your child avoid illness, it’s important to encourage good habits and take steps to boost their immune system from an early age.

“Most of what makes a child’s immune system strong is common sense,” says pediatrician Adriane Lioudis, MD. If you keep these five tips in mind, you’ll stack the deck in your child’s favor for a healthier life.

1. For newborns, consider breastfeeding

While it’s a very personal decision (that isn’t always possible), if you are able to exclusively breastfeed your child for at least six months, it may have benefits. Some research shows that breastfeeding your child might possibly reduce allergies, Dr. Lioudis says.

2. Promote regular hand washing

Eighty percent of infections are spread by touch. Teach your little one to take the time to wash their hands after sneezing, coughing and going to the bathroom. Washing hands with warm water and soap for at least 20 seconds can remove bacteria and viruses and can reduce the chance of lung infections by up to 45%.

3. Don’t skip immunizations

Follow your pediatrician’s advice when it comes to the childhood vaccination schedule. Immunizations start in infancy and continue to adulthood and prevent measles, mumps, chickenpox, rotavirus and other infections.

“Get the flu shot for your child yearly, as well,” Dr. Lioudis says. This is particularly important for children with asthma and other chronic health conditions.

Also, if your family will be traveling internationally, it’s important to seek advice from your child’s healthcare provider about any needed vaccinations.

4. Make sleep a priority

To maximize immunity, children must get enough sleep.

Sleep requirements for each night vary by age:

  • Babies between 0 and 3 months need 14 to 17 hours of sleep. Those between 4 and 12 months need 12 to 16 hours of sleep.
  • Children between the ages of 1 and 2 need between 11 and 14 hours.
  • Kids between the ages of 3 and 5 should get from10 to 13 hours.
  • Children ages 6 to 12 should get between 9 and 12 hours.
  • Teens between the ages of 13 to 18 need 8 to 10 hours.

Not getting enough sleep limits the body’s ability to produce proteins called cytokines that help fight infection and reduce inflammation.

5. Encourage a healthy diet

A healthy diet is also important for your child’s immune system.

Dr. Lioudis recommends encouraging your child to “eat the rainbow” when it comes to fruits and vegetables. A good selection of whole grains should be part of their diet as well. Keep processed foods to a minimum. Proper food choices can help ensure that your child gets enough vitamins — such as vitamin A and E. These vitamins are needed to maintain good health and a strong immune system.

You can’t avoid all illness, but some kids need extra protection

“Even if you follow these tips, your child might still get between seven and 11 colds each year,” says Dr. Lioudis. She adds that you can expect each one to last up to two weeks.

Also, keep in mind that some things billed as common “remedies” aren’t effective in boosting immunity. For example, there’s no definitive proof that large amounts of vitamin C or echinacea help prevent colds or shorten them, she says.

However, if your child has a compromised immune system, work closely with your pediatrician to find ways to improve his or her immunity. Each child needs a personalized approach because their individual immune system varies, Dr. Lioudis says.

“There’s generally a different protocol with immunocompromised children. There are some vaccines we have to add in on top of what most children have, but it’s something that we must determine on a case-by-case basis.

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Vitamin D is one of the most powerful nutrients for supporting the immune system @ClevelandClinic  🌞

Who doesn’t want a healthy immune system? (Raise your hand. No one?) But did you know the role your diet plays in keeping it in top shape to protect you from toxins and infections?
Sadly, too many of us don’t eat enough of the fresh fruits, vegetables and other foods we need to keep ourselves healthy year-round. Healthy foods provide many substances including vitamins and minerals to keep us strong and healthy. You can’t just eat an orange or grapefruit or pop a vitamin pill and expect one quick burst of vitamin C to prevent a cold and to boost your immune system.
“A truly healthy immune system depends on a balanced healthy diet over time,” says registered dietitian Maxine Smith. “It’s like training for a battle and preparing your body ahead of time so it can through a good punch when attacked by viruses, bacteria and toxins. Other lifestyle practices such as regular exercise and good sleep will better prepare you for the battle.” 
With some exceptions, it’s best to get your vitamins and minerals from your food rather than in pill form. Smith shares some tips for some of the top vitamins and minerals your immune system needs to perform:

1. Vitamin C
Vitamin C may help prevent infections or shorten their stay. Citrus fruits are a standout, but did you know there are other good sources? It’s true! Smith recommends the following:
Spinach.
Kale.
Bell peppers.
Brussels sprouts.
Strawberries.
Papaya. 
Fun fact: vitamin C is in so many foods that most people may not need to take supplements unless a doctor advises it. Consult with your doctor before taking any vitamin C supplements

2. Vitamin E
Like vitamin C, vitamin E can be a powerful antioxidant that helps your body fight off infection. This important vitamin — part of nearly 200 biochemical reactions in your body — is critical in how your immune system functions. To get your vitamin E, think high-fat plant foods such as:
Almonds.
Peanuts/peanut butter.
Sunflower seeds. 
Oils such as sunflower, safflower, and soybean oil.
Hazelnuts.

3. Vitamin A#

Vitamin A is an infection-fighter and comes in two forms: preformed such as in animal foods such as fish, meat and dairy or from plant carotenoids. Tuna is a great source of preformed vitamin A. When it comes to carotenoids, go colorful: 
Carrots.
Sweet potatoes.
Pumpkin.
Butternut squash.
Cantaloupe.
Dark green leafy vegetables.

4. Vitamin D
Known as the sunshine vitamin, it’s one of the most important and powerful nutrients for supporting the immune system. Food sources are limited but include:  
Salmon. 
Mackerel.
Tuna.
Sardines.
Vitamin D fortified like milk, orange juice and cereals. 
In general, it’s best to get most of your vitamins from food, but vitamin D may be the exception to that rule. Talk with your doctor to find out if you need a supplement. 

5. Folate/folic acid
Folate is the natural form and folic acid is the synthetic form, often added to foods because of its health benefits. To get more folate, add more beans and lentils to your plate on a regular basis, as well as leafy green vegetables. Avocado is another tasty source. You can also get folic acid in fortified foods (check the label first).
Enriched pasta.
Enriched bread.
Enriched rice.

6. Iron
Iron, which helps your body carry oxygen to cells, plays a part in many of the immune system processes. It comes in different forms. Your body can more easily absorb heme iron (aka iron from animal products), which is abundant in:
Red meat (limit to smaller amounts and less often).
Chicken.
Turkey.
Canned sardines.
Oysters.
Clams.
Mussels.
Canned light tuna.
If you’re a vegetarian, have no fear. You can still find iron in:
Beans.
Broccoli.
Kale.
Iron-fortified cereals.

7. Selenium
Selenium seems to have a powerful effect on the immune system being important for preventing infections. Animal foods are the best sources, with the exception of Brazil nuts, that offer a whopping greater than 100% daily value in one nut. However, too much can be a problem, so keep to no more than one to two of these in a day. Look for selenium in: 
Seafood (tuna, halibut, sardines).
Meat and liver.
Poultry.
Cottage cheese.

8. Zinc
Zinc is needed for the production of new immune system cells. It’s found primarily in animal foods but can be also found in some vegetarian food like.  
Oysters.
Crab.
Lean meats and poultry.
Baked beans.
Yogurt.
Chickpeas.
Choose frozen when you can’t get fresh
Depending on where you live and what time of year it is, you can’t always get your hands on high-quality fresh produce. Keep in mind that buying frozen is a good option and can be quite convenient in our time-crunched world. Frozen food can still boost your immune system. 
“Manufacturers freeze frozen fruits and veggies at ‘peak’ ripeness, which means they’ll pack a similar nutritional value as their fresh counterparts,” she says. “Just choose plain frozen foods rather than those with added sugars or sodium.”​


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This fresh English Pea Pasta recipe is loaded with healthful pea protein and flavored with garlic, mint and grated Parmigiano Reggiano.@ClevelandClinic

There is something special about using fresh peas straight out of the pod. This recipe was inspired by our root-to-stem philosophy of cooking: It always seems like such a waste to throw away the pea pods, but they are relatively inedible. To make use of the pods, we’ve pureed them into a spring-fresh pasta sauce. Remember: Pasta for breakfast is a great choice, especially when it’s loaded with healthful pea protein.

Ingredients

Kosher salt
1 pound fresh English peas in pods (yields about 1 cup shelled peas and about 3 ½ cups pods)
½ cup water
¼ cup extra-virgin olive oil
2 small spring onions or 2 large shallots, chopped
2 small spring garlic (whites) or 3 garlic cloves, minced
2 tablespoons Greek yogurt (optional)
12 ounces whole grain pasta, such as linguine, rigatoni or small shells
Freshly ground black pepper
¼ cup fresh mint (peppermint preferred), thinly sliced
Espelette pepper to taste (optional)
Grated Parmigiano Reggiano cheese (optional)

Directions

  1. Bring a large pot of water to boil and add enough salt to make it salty like the sea.
  2. Meanwhile, wash the peas. Pull off the stem ends: remove the peas and place in a small bowl. Reserve the pods.
  3. Fill a bowl with cold water. Set aside. Add the empty pea pods to the pot of boiling water and cook for 5 minutes. Using a slotted spoon or spider, remove the pods from the boiling water and transfer to the bowl of cold water to cool quickly. Drain the pea pods and add to a Vitamix or high-speed blender. Add ½ cup water. Puree for 2 to 3 minutes.
  4. Place a fine strainer over a bowl and add the pea pod puree to the strainer, pressing on the solids to release as much puree as possible into the bowl. Discard the solids in the strainer. Reserve the puree in the bowl; season to taste with salt and pepper.
  5. Cook the pasta in the pot of boiling water until al dente, stirring occasionally.
  6. Meanwhile, in a large skillet, heat the olive oil over medium heat. Add the onions and garlic and sauté until softened, 3 to 4 minutes. Add the peas and cook 2 minutes. Stir in the reserved pea pod puree and Greek yogurt, if using, and cook just until heated through. (Don’t overcook the peas or puree as the sauce will turn brown).
  7. Using tongs or a spider, transfer the pasta to the sauce in the skillet. Toss until combined. Season to taste with salt and pepper. Transfer the pasta to the serving bowl. Add the basil and mint. Serve with Espelette pepper and grated Parmigiano Reggiano cheese, if using.

Nutritional info (per serving)

Makes 4 servings.

Calories: 554 kcal
Total fiber: 12 g
Soluble fiber: 0.1 g
Protein: 15.5 g
Total fat: 16.7 g
Saturated fat: 2.0 g
Healthy fats: 12.1 g
Carbohydrates: 84 g
Sugars: 7.7 g
Added sugars: 0 g
Sodium: 178 mg
Potassium: 433 mg
Magnesium: 14 mg
Calcium: 134 mg

Source: The What to Eat When Cookbook by Michael F. Roizen, MD, Michael Crupain, MD, MPH and Jim Perko, Sr, CEC, AAC.

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Morning back pain waking you up? Try these simple fixes. @ClevelandClinic. Pain relief from experienced Physical Therapists

Why Your Lower Back Pain Is Worse in the Morning (and What To Do About It)

Your sleep position, immobility, mattress and underlying conditions can all cause morning back pain

There’s nothing worse than waking up on the wrong side of the bed. But it can be hard to avoid when you wake with lower back pain in the morning. A back that throbs, aches or sends shooting pain down your legs can quickly set the tone for your day.

Most people experience lower back pain at some point, and more than 20% have chronic lower back discomfort. It’s the second most common reason people in the U.S. visit their primary care provider — behind colds and flu.

Whether you experience lower back pain all day or only in the morning, understanding what’s contributing to the pain may help you fix it. Pain management specialist Tara-Lin Hollins, MD, shares what might be behind your morning back pain and offers tips to help you wake up pain-free.

4 causes of lower back pain in the morning

Back pain and sleep have a complicated relationship. Pain can disrupt your sleep, and poor sleep can make you more likely to have higher pain. Getting to the bottom of your pain may help end the cycle.

Dr. Hollins says several factors can contribute to morning back pain.

1. The wrong sleep position

You spend a third of your life sleeping or resting, so if your spine is out of alignment while you sleep, it can have a significant impact on your body. Your sleep position affects your alignment and may (or may not) support the natural curvature of your spine.

“It’s common to be so tired at bedtime that you fall into bed and sleep however you hit the bed,” Dr. Hollins says. “But you may not be sleeping in the best position for your spine.”

The most beneficial sleep positions for your back are on your:

  • Side, with your knees partially bent
  • Back, as long as you don’t have sleep apnea (which worsens when sleeping on your back)

Sleeping on your stomach makes you more likely to twist your neck to the side — a quick way to throw your neck and spine out of alignment.

2. Lying down for hours

When you sit all day at your desk without moving, it can make you stiff. Similarly, when you sleep, you’re not moving much for seven to eight hours. Lying immobile for a long period could cause you to wake up with back or hip pain.

“Our bodies are not supposed to be stagnant for multiple hours,” Dr. Hollins explains. “Stiffness can settle in, and inflammation can build up. Then, when you try to move in the morning, releasing the inflammation can be painful.”

Tricky, right? After all, you want a good night’s sleep, and lying immobile while you doze is often a sign that you got all of your ZZZs. But to avoid lower back pain, Dr. Hollins advises taking some time to stretch before you jump out of bed.

3. An unsupportive mattress or pillow

Your mattress is your main source of back support while you sleep. And your pillow ensures proper neck alignment. A mattress that’s damaged, too soft or sagging can cause your lower abdomen to sink deeper than the rest of the spine, pulling your back out of alignment.

“All too often, people opt for a soft mattress, thinking it will be more comfortable,” Dr. Hollins notes. “You don’t want a hard mattress, but it should feel firm and supportive. You shouldn’t sink into it.”

Need tips for choosing the best mattress for your back? We can help.

4. An underlying condition or pregnancy

Some conditions or chronic diseases may put you at higher risk for morning back pain. Chronic conditions that affect both sleep and morning back pain include:

Pregnancy can also bring back pain in the morning due to:

  • Additional strain on your lower back muscles
  • Shifting center of gravity
  • Increased weight

How to stop waking up with lower back pain

Lifestyle changes, like achieving a healthy weight and exercising every day, are always helpful for back pain. But Dr. Hollins also recommends actions related to sleeping that may additionally help reduce or eliminate your morning back pain.

Add supportive pillows

Pillows are a great way to support your back’s alignment. Your typical sleep position should guide the pillows you use:

  • Back sleepers. Choose a head pillow that supports your neck and lets your head sink in. Place a pillow under your knees to support your spine’s natural curvature.
  • Side sleepers. For your head, choose a thick pillow that keeps the top portion of your spine straight and parallel to the mattress. Place a small pillow between your knees to help even out your hips.
  • Stomach sleepers. Don’t use a pillow for your head, or choose a very thin one. Put a thin pillow under your lower abdomen to keep your spine aligned.

“Look for pillows that are specific to your sleep position,” Dr. Hollins advises. “But no matter which position you use, adding pillows strategically around your body can support your spine and reduce morning pain.”

Adjust your sleep position

If you’re used to sleeping in the same position every night, it can be challenging to change it. But small adjustments may help:

  • Place both arms in the same position if you sleep on your back — instead of flinging one arm over your head — to keep your spine aligned.
  • Bend your knees when sleeping on your side to help balance your body and reduce any pressure on your lower spine.
  • Put pillows in front of you if you sleep on your side so you don’t roll onto your stomach.
  • Sleep on your left side whenever possible to take pressure off your internal organs.

“You want to be as comfortable as possible when you go to sleep,” Dr. Hollins says. “That way, you’ll be more likely to stay in a supportive sleep position.”

Replace your mattress regularly

According to the Sleep Foundation, the general guideline is to replace your mattress every six to eight years. But you may need a new mattress sooner if yours is:

  • Making noise (if it’s an innerspring mattress)
  • Noticeably sagging or damaged
  • Causing muscle or joint stiffness, especially if you don’t have the same stiffness when you sleep at hotels or other homes

When choosing a new mattress, choose a “medium firm” mattress — level 6 out of 10 on the mattress firmness scale. It may reduce your back pain symptoms by nearly half.

Pause before you get up

Most people get out of bed as soon as they wake up, Dr. Hollins points out. But taking a few minutes to prepare your back for transitioning to sitting, standing and walking can help with morning back pain.

  • Stretch while you’re still in bed. While on your back, bring one knee to your chest. Hold it for three seconds, let it go and then, switch to the other leg.
  • Warm your muscles. Slide a heating pad under your back to warm your muscles. Use one that’s designated as safe for use in the bed and has an auto shut-off. Keep the sheet or your shirt between the pad and your skin.
  • Take your time getting up. First, sit on the edge of the bed and let your back adjust. Then, use your legs — not your back — to stand up.

See your healthcare provider if your back pain worsens or occurs most mornings for two or three months. They can check for underlying back issues and may prescribe physical therapy.

“Don’t wait six or eight months to see your provider,” Dr. Hollins urges. “They can provide guidance about the best stretches to do, and your back will thank you.”

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Tired of plain fruit? Add some tang with this yogurt dressing. This dish is not only colorful, bright and fun, but also high in potassium, an important nutrient! @ClevelandClinic

Recipe: Pineapple Yogurt Fruit Salad

Make fruit more fun for kids — and adults!

Ingredients

  • 1 tablespoon sugar free lemonade drink powder mix
  • 1 cup fat-free plain Greek yogurt
  • 15-ounce can of pineapple tidbits, in juice, drained
  • 1 medium granny smith or other green apple, cut into small chunks
  • 1 cup red grapes, each cut in half
  • 2 medium bananas, sliced into coin shapes
  • 1/4 teaspoon cinnamon

Directions

  1. Combine lemonade powder mix and yogurt in medium bowl.
  2. Add all fruit and stir until well-combined.
  3. Sprinkle cinnamon on top.
  4. Refrigerate. Serve chilled.

Nutrition information (per serving)

Makes 6 servings

Calories: 140
Fat: 0 g
Saturated fat: 0 g
Sodium: 15 mg
Protein: 4 g
Carbohydrates: 32 g
Sugars: 24 g
Dietary fiber: 3 g