muscle pain

6 Ways to Quiet Muscle Pain

Written by FitRx on . Posted in Blog, Exercise

Peter Ellison, FitRx Physical Wellness Director

Muscle pain and soreness can really slow down your workouts.  Here are a few strategies you can use to help alleviate your soreness.

  1. Believe it or not, sometimes the best thing to reduce soreness is more exercise.  It sounds counterintuitive, but the increased blood flow to the muscle during exercise can speed up the process of alleviating soreness.
  2. Stretching before and after a workout can help to lessen the intensity of soreness. After a brief warm up, spend 5-8 minutes stretching before starting your workout session. Once you complete your workout, spend another 5-8 minutes of your cool down stretching as well.  Make sure your muscles are warmed up before you stretch, you never want to stretch a cold muscle.
  3. Switch up your workout! Trying something new may help to alleviate some of your regular soreness.  Try a Yoga or Pilates class at your local fitness facility.
  4. drinkwater


    Drink lots of water! Water can help to “flush” your system and help to reduce your soreness. Try to drink at least 64oz of water throughout the day, but the more active you are and the more you sweat the more water you will need. Staying hydrated can significantly help with soreness.

  5. Go get a massage! Getting a massage or kneading your muscles can significantly help to facilitate muscle recovery.
  6. Take a warm bath. Warm water can help to relax the muscles and stimulate the body to increase recovery.

Keep in mind that normal muscle soreness can last a few days. If your muscle pain persists or worsens with any of these tips consult your doctor.  Get out there, get moving and stay active!

Featured Photo: Journal of Muscle Activation Techniques

Image at Aofie Walley Wellness

Hello Middle Age Spread

Written by Dr. Ralph E. Carson on . Posted in Blog, From the Desk of Dr. Carson

Many of my clients … hit their late 30s, early 40s and suddenly they cannot shift those extra pounds. Especially around their middle, which used to easily disappear after a bit of dieting and exercise.  – Aofie Walley, Therapist, London, UK

Both obesity and aging are associated with the rewiring of a principal brain pathway that modulates energy balance. As we approach middle age, we typically become less active – maybe even lazy – and as a result, we should receive signals to eat less. This is made possible through the activity pro-opiomelanocortin (POMC) neurons within the arcuate nucleus of the hypothalamus (ARC).

The buildup of excess leptin stresses the manufacturing of the messenger that tells us to eat less and produces one that is useless… To put it simply: “obesity begets obesity.” – Dr. Ralph Carson on Visceral Belly Fat.

But in this modern age of unlimited food (energy) availability, the satiety neurons are reduced or misjudge how much food our body needs. Without the proper checks and balances, we can gain the “middle age spread” (the accumulation of intra-abdominal fat throughout adulthood until late middle-age). Hence, this belly fat correlates with the  increased incidence of cardiovascular disease, metabolic syndrome, diabetes, cancer and other inflammatory disease that manifest as we age.

Burke LK et al 5-HT obesity medication efficacy via POMC activation is maintained during aging Endocrinology (2014) 22:en20141223

Diet Soda: Widening the Waist

Written by Dr. Ralph E. Carson on . Posted in Blog, Etc, From the Desk of Dr. Carson, weight loss

Drink Diet Soda and Say Hello to 3 More Waist Inches


diet-soda-bellyAccording to a long-term study, just out, by Fowler, Williams and Hazuda, diet sodas are associated with an increase in weight circumference in older adults – in fact, this population measures over 3 inches more at the waist than non-soda drinkers (Fowler ’11; ’15). The study demonstrated this after 10 years of following individuals over the age of 65.


Belly fat increases the likelihood of chronic inflammation which leads to heart disease, stroke, and diabetes. An extra four inches of belly fat increases the likelihood of dying prematurely by 15% – 25%.  It has not been determined how drinking diet sodas increases belly fat, but it may have to do with its effect on the regulation of food intake. High doses of aspartame in mice in utero caused lesions in the area of the brain that receives the message to stop eating. Artificial sweeteners may have the same effect on people.


Fowler SP, Williams K and Hazuda HP Diet Soda Intake Is Associated with Long-Term Increases in Waist Circumference in a Biethnic Cohort of Older Adults: The San Antonio Longitudinal Study of Aging J Am Geriatrics Soc (March 17, 2015)

Fowler SP et al Diet Soft Drink Consumption Is Associatdiet-soda-cans ed with Increased Waist Circumference in the San Antonio Longitudinal Study of Aging American Diabetic Association Abstract Number: 62-OR (2011).


Illustration: Roy Scott

6 Life-Changing Effects of Bariatric Surgery

Written by FitRx on . Posted in Blog, Etc, weight loss

After the Surgery: Nutrition Rules

(Featured illustration: Roy Scott)

Bariatric surgery has been getting a good bit of media attention lately. The thought of waking up with a smaller stomach or a smaller appetite may seem like miraculous relief to someone whose struggle with food has gone on so long it’s impacting their health. In a select few cases, these surgeries do provide miraculous relief.

But they also come with extreme, long-term commitments. So the decision to seek bariatric surgery should be made with the whole picture in mind. For example, one area that is not always fully considered in pre-op conversations about bariatric surgery is the area of nutrition. Individuals seeking surgery should understand the range of nutritional consequences that surgery will set in motion.

So what are the important nutritional implications of bariatric surgery?

#1 Less Nutrient Absorption

Surgical Weight LossFirst, when the stomach is surgically altered it cannot return to its original state. The stomach is responsible for all breakdown of food and nutrients so that they can later travel to the small and large intestine for absorption. When the stomach is bypassed or made smaller, the food loses the ability to be broken down for absorption resulting in lifelong nutrient deficiencies.

 #2 Vitamins Forever

The stomach also releases intrinsic factor which is necessary for the absorption of B12. Because this process is impaired by bariatric surgery, the individual who has bariatric surgery is recommended to take bariatric vitamins and minerals for the remainder of the lifespan. If supplements are not taken, it can result in hair loss; brittle bones, fingernails, and teeth; and perhaps more importantly, serious or chronic health issues.

#3 Diet: Eat Nutrient Rich Foods

Focusing on nutrient dense foods such as fruits, vegetables, healthy fats, lean proteins and complex carbohydrates becomes more important than ever due to the stomach’s very small intake capacity and limited ability to break intake down for absorption.

#4 Small Portions, Many Meals

The small stomach capacity will also require the individual to eat very small meals several times throughout the day. Individuals considering bariatric surgery should ask themselves if they could realistically sustain this eating pattern for the rest of their lives.

If supplements are not taken, it can result in hair loss; brittle bones, fingernails, and teeth; and perhaps more importantly, serious or chronic health issues.

#5 Eat Slowly, Chew Well

The mechanics of eating are forever changed as well. One with bariatric surgery must eat very slowly and chew food very well. If this is not practiced, the individual can become quite ill.

#6 Dumping Syndrome – Avoiding It Is an Individual Art

Dumping syndrome is another complication associated with the mechanics of eating and digestion. It is generally experienced after a simple carbohydrate or sugar meal is ingested and leads to intense vomiting or diarrhea. However, it is hard to predict with certainty how this complication will play out in each individual because different foods affect different people in different ways. So the prospect of dumping can make eating somewhat of a gamble across a whole range of palatable foods.

Surgery, Last Resort

Lap Band bariatric deviceIt is interesting to point out that FitRx works with clients to instill some of these same support systems.

  • Our clients practice “attuned eating,” which includes eating slowly and chewing food thoroughly.
  • We teach clients how to recognize, shop for, cook, and enjoy nutrient dense foods.
  • We also help clients to balance their food groups to make sure they obtain the full range of dietary nutrition

These practices will yield improved health, weight, and fitness. Though the dramatic results may take a lot longer without surgery, surgery itself is far from a simple weight loss toggle switch.

Many individuals can be successful with bariatric surgery, but it requires lifelong support from behavioral health therapists, dietitians, exercise professionals, medical professionals and support groups. Individuals choosing bariatric surgery must realize they are committing to long-term engagement with the whole support community. Typically, when the post-surgery patient disconnects from any of these support sources, relapse occurs. At FitRx, we have provided this much-needed support for post-op bariatric patients, but we highly recommend that surgery always be viewed as a last option.


Long-Term Weight Maintenance: Science is Kinder than You Think

Written by Dr. Ralph E. Carson on . Posted in Blog, Etc, Exercise, From the Desk of Dr. Carson

In order to maintain our size we need to MOVE. (Hill ’13)

The moment we stop moving, increased deposition of fat can commence! With inactivity the metabolism slows and the appetite goes haywire. We talk about the desirability of having a “flexible metabolism,” but flexible metabolism is not about metabolic boosting so as to burn more calories while sitting. Flexible metabolism refers to the body’s ability to switch rapidly between the types of fuel we are feeding it (protein, carbohydrate, and fat). Flexible metabolism is about allowing your body to be more efficient at burning the types of food you eat.

Dr. James Hill heads up the National Weight Control Registry with a data base of more than 10,000 people who have dropped at least 30 pounds and maintained that loss for at least a year.  Dr. Hill recommends 70 minutes per day of moderate to intense exercise, six days per week.  The friendly word, here, is “moderate.” The entire 70 minutes can be carried out in a structured plan, but as we have eluded to previously, better to have a flexible plan combining structure with increased movement opportunities scattered through your daily life. Why is this?

Hill J, Aschwanden C, and Wyatt H State of Slim Rodale Books (2013). 

Exercise is best served in small doses, comfortable speed, and reasonable distances (Cool ’12; O’Keefe ’12)

fitrx5Developing a flexible metabolism doesn’t require endurance training or marathon running. In fact, the latter activities can push your heart to its limits causing acute problems such as arrhythmias, irregular heartbeats, diastolic dysfunction and lasting damage (calcification and scarring; larger artery wall stiffening). For older athletes (>35), the pleasure of intense physical exercise for long periods may take its toll on the body, causing it to age more quickly (musculoskeletal body trauma and cardiovascular stress).

Flexible metabolism is not about metabolic boosting so as to burn more calories while sitting…

Temperatures increase causing sweating, fluid and electrolyte loss, dehydration, muscle weakness and disorientation. Spikes in inflammation are a key concern in this type of exercise because they can cause permanent scarring of the ventricles. Sudden cardiac death occurs in 1 out of 15,000 joggers and 1 in 50,000 runners (Mohlenkamp ’00). More than 90% of sudden cardiac deaths occur during recreational sports (Marion ’11). The runners who were better trained over a longer period were less likely to experience heart damage, inflammation, swelling, and decreased heart perfusion.


Facing Fears – Starve a Fear; Nourish a Soul

Written by FitRx on . Posted in Blog, Etc

For you Fit Rx alumni, here is a refresher; for you newbies I hope this helps. We are all facing fear in various forms, and in case you’ve forgotten, here are some tips on how to move forward in spite of them. Let’s all agree that we have been slaves of fear far too long!

Fear is a distressing emotion aroused by impending danger, evil, pain, etc., whether the threat is real or imagined; it’s the feeling or condition of being afraid. Synonyms: foreboding, apprehension, consternation, dismay, dread, terror, fright, panic, horror, trepidation.

“Too many of us are not living our dreams because we are living our fears.”

-Les Brown

Strategies to Face and Move through Fear

  1. Find out what the fear behind the fear is! For example, the root of most performance fears, the fear behind the fear, is often “I’m not good enough” or “They won’t like me.”  Identifying the true fear creates awareness, the first step in creating change.
  1. Ask “what is really true?” F.E.A.R. = “False Expectations Appearing Real.” It’s a great reminder that our minds think the threat is real.  If I ask myself what is really true, then, as with public speaking, I can admit that I am good enough, know enough – maybe more than my audience.  The truth is I am capable of speaking in front of anyone when I’m in my most confident state.
  1. Play the “what if” game. What is the worst that could happen?”  To play the game, ask yourself “What if my fear happens, then what? And what if THAT happens, then what?”  By the time you follow this path a few times, the possible outcomes start to seem preposterous and the real risk is put into a new, less threatening perspective.  You also start to calmly prepare for reasonable unexpected events.

(Note – be mindful that “worst case scenario” thinking usually cripples us and doesn’t benefit us. Despair expects horrible things around the corner. Hope expects good things around the corner.)

  “Fear makes the wolf bigger than he is.”

-German Proverb

  1. Make sure you are spiritually and emotionally grounded. I use deep breathing, prayer, inspiring quotes, YouTube videos, movie scenes, and positive present-tense affirmations to get myself centered and calm.  I return to my confident state of mind by reviewing my successes and my belief in myself no matter WHAT happens.
  1. Ask for help. Turn to someone you trust, with whom you feel safe, who you know cares about you and ask them to go with you, help you, hold you accountable to facing your fear. Verbalize your fear and commit to facing it. When we verbalize our fears it can help to disempower them.

Bite into a Healthy Lifestyle with Asparagus Salad

Written by FitRx on . Posted in Blog, Recipe

March is National Nutrition Month® ! This year’s theme is “Bite into a Healthy Lifestyle,” which encourages everyone to adopt eating and physical activity plans that are focused on pairing nutrient dense foods with daily body movement. In general, this one-two combination is a powerful way to reduce the risk of chronic disease. Hopefully, this bite into a healthy lifestyle can inspire you adopt sustainable practices for overall health and wellness. Don’t forget to thank your dietitian on March 11, which is National Registered Dietitian Nutritionist Day!

 Tip: look for the freshest, most tender asparagus spears you can find and slice them into very thin rounds.

Green Salad with Asparagus and Peas

Eating Well

Photo: cherie at

Choose tender asparagus. (Photo: cherie at

Makes: 8 servings

Start to Finish: 35 minutes


2 teaspoons freshly grated lemon zest

¼ cup lemon juice

¼ cup canola oil, or extra-virgin olive oil

1 teaspoon sugar

½ teaspoon salt

¼ teaspoon freshly ground pepper

2 heads Boston or Bibb lettuce, torn into bite-size pieces

2 cups very thinly sliced fresh asparagus, (about 1 bunch)

2 cups shelled fresh peas, (about 3 pounds unshelled)

1 pint grape or cherry tomatoes, halved

2 tablespoons minced fresh chives, or scallion greens


  1. Combine lemon zest and juice, oil, sugar, salt, and pepper in a large salad bowl.
  2. Add lettuce, asparagus, peas, tomatoes, and chives (or scallion greens).
  3. Toss to coat.

Nutrition Information:

Per serving: 113 cal, 7 g total fat, 152 mg sodium, 10 g carb, 3 g fiber, 3 g protein

This salad combines two stars of the spring garden, asparagus and peas, which provide a healthy dose of Vitamin A and C and folate. Tip: look for the freshest, most tender asparagus spears you can find and slice them into very thin rounds. Bite into this recipe and into a healthy lifestyle!


More Troubles with Sitting – and What Won’t Help

Written by Dr. Ralph E. Carson on . Posted in Blog, Exercise, From the Desk of Dr. Carson

In his first of two articles, Dr. Carson presented evidence showing that sitting for long, uninterrupted periods has serious health risks. And he followed that with some techniques for mitigating or avoiding those risks. Here is a brief addendum to underscore both the risks and the ways to counteract too much sitting.

 Troubles with Sitting – Orthopedic Health Problems attributed to too much sitting

(Mathews ’12; Ford ’12; Berkowitz; Hamilton ’07; George ‘13)

Muscle degeneration (Back problems)too-much-sitting-back-pain

  • Slumped muscles go unused — tight back and weak abdominal muscles combined to cause serious back pain due to extreme lower curvature (lordosis)
  • Sore back: inflexible spine movement causes soft disc dehydrated and brittle. This can lead to a herniated disc. Typically the disc between vertebrae expand and contract like a sponge soaking up fresh blood and nutrients with activity.
  • Collagen hardens around supporting tendons and ligaments with extended inactivity

Tight hips: decreased hip mobility due to tight hip flexors (short and tight) limit range of motion and produce falls

Limp gluts (buttocks): hurt stability and stride

Strained neck: Craning neck forward over key board or tilting head to cradle phone

Sore Shoulders

Soft bones: Weight bearing exercises cause bone to grow thicker and lack thereof causes osteoporosis


Sitting can reduce life expectancy

Standing could increase your life span. The more time on your feet strengthens the bits of DNA called telomeres (Sjogren ’14). Telomeres protect the ends of chromosomes (like the tips that keep shoelaces from fraying). Telomeres tend to get shorter and shorter until they can shorten anymore and cause cell death.

Women who spend too much time sitting around (>11 hours/d) had a 12% risk of premature death (13% more cardiovascular disease; 21% more cancer; 27% more coronary artery disease) than those who were inactive for <4 hours (Sequin ’14).


Can scheduled exercise sessions offset the negative effects of sitting?

Adults spend 50% – 70% of their waking hours sitting or approximately 8 hours per day. Sitting for extended periods of time can harm even those that exercise (Craft ’12; Wilmot ’12). The increased risk of sitting is not offset by moderate to vigorous exercise or meeting the recommended physical guidelines. Regular exercise does not reduce the risk of an otherwise sedentary life style as one remains susceptible to just as great a risk of diabetes, cardiovascular disease, obesity and premature death. Short but frequent walks or alternative activity sparks (short term episodes of movement lasting 5 – 10 minutes) can counteract the harm caused by sitting long periods.



Craft LL et al Evidence that women meeting physical activity guidelines do not sit less: An observational inclinometry study Int J Behav Nutr Phys Act (2012) 9: 122.

Ford ES and Caspersen CJ Sedentary behaviour and cardiovascular disease: a review of prospective studies Int J Epidemiol (2012) 41: 1338 – 1353.

George ES et al Chronic disease and sitting time in middle-aged Australian males: findings from the 45 and Up Study Int J Behav Nutr Phys Act (2013) 10:20.

Hamilton MT et al Role of Low Energy Expenditure and Sitting in Obesity, Metabolic Syndrome, Type 2 Diabetes, and Cardiovascular Disease Diabetes (2007) 56: 2655 – 2667.

Matthews CE et al Amount of time spent in sedentary behaviors and cause-specific mortality in US adults AJCN (2012) 95: 437 – 445.

Sjogren P et al Stand up for health–avoiding sedentary behaviour might lengthen your telomeres: secondary outcomes from a physical activity RCT in older people Br J Sports Med (2014) 48: 1407 – 1409.

Wilmot EG et al Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis Dibaetologia (2012) 55: 2895 – 2905.


15 Tricks to Avoid Sitting Risks

Written by Dr. Ralph E. Carson on . Posted in Blog, Exercise, From the Desk of Dr. Carson

Don’t just sit theretry these

(Ekblom-Bak ’12; Loprinzi ’13; Yancy ’10; Healy ’08)

Last week, we learned of many possible health risks caused by habitual, uninterrupted sitting over long periods. Since it’s not how much but how often you exercise that matters, you can counteract the harmful effects of sitting with small lifestyle adjustments. The following activities may do just as much good as formal exercise to reduce chronic disease such as heart attacks, stroke, cancer, and diabetes (Ekblom-Bak ‘13).

An active lifestyle is an effective way to provide health benefits such as preventing high blood pressure, high cholesterol, and metabolic syndrome. Despite not exercising according to the recommendations, as many as 40% of adults may be achieving the exercise guidelines by making movement part of their life (Loprinzi ’13).

If your lifestyle requires a lot of sitting, try breaking up the stasis with some of these healthy movement activities:

  1. Standing with computer on top of the filing cabinet
  2. Sitting on exercise (stability) ball instead of desk chair
  3. Dance about, wiggle around, take a few steps back and forth, fidget
  4. Standing during meetings
  5. Standing talking on the telephone
  6. Walking during lunch breaks
  7. Gardening and lawn care
  8. Housework (vacuuming and mopping floors)
  9. Stand folding laundry or ironing
  10. Do-it-yourself projects
  11. Marching in place during TV commercials
  12. Getting up from your desk and doing jumping jacks, knee lifts and bends
  13. Purchase an activity monitor
  14. Set a timer for to go off once per hour
  15. Move printer farther away
  16. Sit up straight
  17. Take water breaks
Photocredit: Cat York, from "Get up and Stretch"

Photocredit: Cat York, from “Get up and Stretch”


Ekblom-Bak E et al The importance of non-exercise physical activity for cardiovascular health and longevity Br J Sports Med (2013) 092038.

Healy GN et al Breaks in sedentary time: beneficial associations with metabolic risk Diabetes Care (2008) 31: 661 – 666.

Loprinzi PD and Cardinal BJ Association between biologic outcomes and objectively measured physical activity accumulated in ≥ 10-minute bouts and <10-minute bouts Am J Health Promotion (2013) 27: 143 – 151.


Love at Three G’s

Written by Marianne Messina on . Posted in Blog, Etc

Three Tips to the Lovelorn from FitRx Therapist Jonathan Rios

“Envy is the art of counting the other fellow’s blessings instead of your own.” – Harold Coffin

For many, the month around Valentine’s Day is a reminder of lost loves, longing for love, or even love not yet experienced. We can all agree, ours is a culture obsessed with fairy tale lovers and happily ever afters.

When these expectations aren’t met, our hearts are easily wounded. Those of us who don’t have a current love often turn to thoughts of our “lack” and become intensely critical of love itself. In fact, we may even find ourselves bitter towards those around us who seem to have found that “true love.” Does this sound like you?

Photo Credit:

Photo Credit:

How about any of these:

  • Are you unable to be happy for the love others have found?
  • Is it hard to congratulate others on their relationships?
  • Do you secretly rejoice when others experience heartbreak?

If you found yourself answering even the tiniest “yes,” let these three g’s help you avoid the trap of becoming embittered:

Gratitude – Write down all the romantic and platonic relationships (past and current) that have been a blessing in your life. (What lessons did you learn about yourself?). Instead of meditating on all the “misfires” and “heartache,” flip your focus to that of thanksgiving.

Generosity – Realize there’s someone in your immediate community who is “heartbroken” this year and could use a dose of love themselves. (Get the focus off of you and onto others.) Bring them a gift. Offer to babysit. Write them a note. Take them out for dinner. Actually verbalize how important they are to you.

Grace – Give yourself an unmerited treat. See a movie that inspires you. Spend time with people who care about you. Watch YouTube clips of your favorite comedian.  Visit your favorite museum. Go hiking. Go on a road trip. Call out sick. Declare a “self-enrichment day.”

It’s virtually impossible to be both jealous and grateful at the same time. Our internal world is one of constant tensions and we must do the hard work of choosing which thoughts and emotions will steer the ship.

This month of Valentine’s, I implore you to choose love in the truest sense by loving yourself and giving yourself away to the people around you. Someone nearby needs what you have to offer.