Comment on this post about your experience with Gluten for others to read and comment on. Your experience may save another person from unnecessary suffering and help them understand the wide-reaching effects of gluten intolerance.

Thank you and can’t wait to hear about your experiences!

2 eggs

1 teaspoon GF vanilla extract

½ cup honey

¼ cup canola oil

¼ cup unsweetened applesauce

1 can (15 oz.) mashed pumpkin

2 cups whole grain sorghum flour or gluten-free all-purpose flour

2 teaspoons xantham gum or guar gum

1 teaspoon baking powder

1 teaspoon baking soda

½ teaspoon ground allspice

½ teaspoon ground cloves

½ teaspoon ground ginger

1 teaspoon ground cinnamon

¾ cup raisins

½ cup walnuts or pecans (optional)

Preheat oven to 350° F. Generously grease muffin cups or line with paper liners. Set aside. Beat wet ingredients—eggs, vanilla, honey, oil, applesauce, and pumpkin—together until well combined. In separate bowl, mix all dry ingredients together. Then stir in wet mixture above; fold in raisins and optional nuts until blended. Fill muffin cups 2/3 full. Bake at 350° for 12 to 15 minutes until done. Yields 24 two-ounce muffins.

**Recipe presented at the 2008 Healthy Kitchens, Healthy Lives conference (a collaboration between The Culinary Institute of America and Harvard Medical School)

Gluten-free eating is a bona fide trend these days.  As more people discover the benefits of a gluten-free  diet, major companies are investing in gluten-free products to boost their bottom line.  Products packaged as gluten-free alternatives are flooding the market, and while such products tend to be pricier, gluten-free eating can be as simple as eating lean meats, vegetables, and rice.

Some of our clients and even our staff have been diagnosed with problems with gluten.  Others have discovered problems on their own.  If you would like to blog about your experience, please do so at wholept.com/blog.  Your experience may save another person from unnecessary suffering and help them understand the wide-reaching effects of gluten intolerance.

People have asked: What is gluten?  Gluten itself is a protein–the composite of proteins gliadin and glutenin. This protein is what gives bread its chewy texture.   Gluten is the problem for people with celiac disease. Eating bread or any food containing wheat (including durum, spelt, triticale, and kamuten), oats, rye, and barley causes an immunologic reaction which damages the intestinal walls.  Elimination of gluten from the diet is the cure for celiac disease and the wide range of symptoms that result.  Classic symptoms include upset stomach, gas, bloating, diarrhea, abdominal pain and constipation. The list of potential symptoms is even longer.  See link to article  “The Trouble with Gluten:  Why Can’t I Eat Bread?” Testing for the celiac disease is done by biopsy of the large intestine to check for damage.  A blood test is also commonly done to check for antibodies in the blood and the genetic markers for the disease.

According to Dr. Fine, a leading researcher in gastroenterology, even those who don’t test positive for celiac disease may still have a sensitivity to gluten which can manifest itself in a variety of adverse ways.  A saliva or stool sample can reveal antibodies in the digestive tract.  Through his research, Dr. Fine has found that testing of the digestive tract is more sensitive test than testing the blood .  If antibodies are present in the digestive tract for gluten, elimination of gluten from the diet is recommended. https://www.enterolab.com/StaticPages/Faq.aspx#blood

Even without testing, if symptoms are noticed after consuming gluten, elimination is worth trying.  The impact on your day-to-day energy levels (and the elimination of symptoms you may not have even noticed) can be surprising.

-Lynn Batalden, PT, DPT

Join us for a class designed to improve quality of life for people with arthritis using Sun style Tai Chi. The Sun style is one of four major recognized styles of Tai Chi. It includes agile steps and exercises that improve mobility, breathing, and relaxation. The movements do not require deep bending or squatting, which makes it easier and more comfortable to perform. In this class you will learn basic Sun style posture, stepping, and movements. You will participate in warm up and cool down exercises and learn twelve specific Sun style Tai Chi movements. This program is designed for those who experience pain with movement due to arthritis, but enrollment is open to all. Studies have shown this program to be effective and safe for people with arthritis, and many arthritis organizations around the world support the program. Please wear comfortable, loose fitting clothing and shoes.

Dates: August 12-September 30, 2010
Day: Thursdays
Time: 9:00-10:00 am
Cost: $50
Instructor: Elizabeth Stephenson, PT
PRE-REGISTRATION IS REQUIRED.

Liz Stephenson is a physical therapist who is also a certified instructor in Tai Chi for Arthritis classes.

By Elizabeth Stephenson, PT

Nancy has been working in an office since her college graduation.  She truly enjoys her job and recently received a promotion. However, lately she has been experiencing headaches, neck pain, and a burning sensation between her shoulder blades, usually beginning mid-morning and worsening throughout the day.  This cycle repeats itself daily and has started to take its toll.  She is finding it difficult to concentrate at work due to the pain, and feels exhausted by the end of the day.  She has even begun to notice the burning sensation in her upper back while cooking supper in the evening.

Nancy mentioned these painful sensations to her friend Marge, who is a physical therapist.  Marge explained to Nancy that what she is experiencing is likely muscle tension and fatigue resulting from her sitting in one position throughout the day. Marge decided to give Nancy a few pointers on things she can do throughout the day to ease her muscle pain and discomfort.

Marge helped Nancy to understand why she was having this pain by telling her that muscles burn energy when they do their job.  This burning of energy requires fuel (oxygen and nutrition) and creates waste products, much like a burning log produces energy but leaves ash behind that needs to be cleaned from the fireplace.   Muscles are designed to move, tighten and relax throughout the day.  However, many of us have jobs which require us to sit in the same position for long periods of time.  When we ask our muscles to hold us in one position they are not going through their natural tightening and relaxing cycle.  The relaxing of the muscles helps to bring in a fresh blood supply with oxygen and nutrients.  The tightening cycle, in addition to helping us move, squeezes waste products and deoxygenated blood out of the tissues.  Without this natural tightening and relaxing, waste products can build up in the muscle and new blood supply is compromised.  This may cause pain and encourage the muscles to tighten up even more to protect themselves.  We need to move in order to break this cycle.

Marge explained to Nancy that changing position and even getting out of her chair more frequently and moving around, about every 15 minutes, would be helpful.  In addition, Nancy should perform the following stretches and exercises throughout her work day in order to help her muscles feel better and decrease her pain.

• Shoulder Circles- gently roll your shoulders forward in circles, and then reverse the motion rolling shoulders in backward circles. Repeat 3-5 times each direction.
• Shoulder Airplanes- roll one shoulder in forward circles while the other shoulder is rolling in backward circles. Repeat 3-5 times then reverse directions.
• Shoulder Blade Squeezes- Squeeze your shoulder blades toward each other, imagining that they are being pulled gently but firmly toward your spine.  Try not to pull your shoulders up toward your ears.  Repeat 5-10 times holding the squeeze for 2-3 seconds.
• Chin Tuck and Stretch- With your head up on shoulders, gently tuck your chin then bring your chin down toward your chest until a stretch is felt in the back of your neck.  There should be NO PAIN.    Hold the stretch for 10-30 seconds and repeat 3-5 times.
• Forward Arm Stretches- Intertwine your fingers and turn palms out in front of you as you stretch arms forward.  Keep your head up on top of your shoulders.  Hold for 2-3 deep breath cycles.  Notice how deep breathing enhances the stretch through your arms, shoulders, and rib cage.
• Overhead Arm Stretches- Intertwine fingers, turn palms forward, reach out and up over your head.  Keep head up on shoulders and do not arch through your back.  Hold for 2-3 deep breath cycles as in previous stretch.

The next thing that Marge wanted Nancy to understand was that her posture during the day also plays into her feelings of pain and discomfort.  Nancy’s forward slumped head and shoulders were really putting a strain on her upper back and neck muscles.  Marge suggested that Nancy periodically think of her posture and perform the following check list:

• Sit up on your “sit bones,” the two bones on either side of your pelvis, instead of slumping back on your tailbone.
• Picture your spine as a strand of pearls and from the top/back of your head pull your strand of pearls up toward the ceiling.  (Are you able to feel how this action makes it easier to sit on your sit bones and how this brings your head up on top of your shoulders?)
• Imagine that you have cords or wings coming out of the sides of each of your shoulders and pull them gently out more toward the side.  (Do you feel how this brings your shoulder blades back toward your spine?)
• Now take a few nice deep breaths. Begin by filling your lungs from the bottom of your rib cage and up.  Each time you breathe in think of your strand of pearls elongating just a little bit more.

Now that Nancy had a pretty good idea of how to help herself feel better, Marge gave Nancy the following pointers for arranging her work station so that her body is in good alignment and there is as little strain as possible on her muscles:

• Sit with your buttocks all the way back in the chair so that the backrest of the chair helps to support your spine.  Then move the chair forward to your desk (instead of sitting on the edge of the chair to reach your work station).
• Feet should be flat on the floor with knees and hips at a 90 degree angle.  If you are small you may need to use a foot rest (old phone books work for this).
• Shoulders should be relaxed and arm rests should support your forearms when your shoulders are in a relaxed position.
• Elbows should be at 90 degrees and wrists should rest on a pad in a neutral position, neither bent up or down.
• Your monitor should be directly in front of you and at eye level.  Again, old phone books can work well for this.
• Try to avoid holding the telephone between your shoulder and your ear.  If you need to talk on the telephone while performing other tasks, consider getting a headset.

Nancy was happy that she had confided in her friend about her pain and very pleased to see that making the work station changes and performing the simple exercises very quickly began to make a difference in her pain and fatigue level.  Nancy began to feel an increase in her concentration and a renewed enjoyment in her job tasks.  She realized that a small commitment to these strategies, and a few minutes per day spent focusing on her body really paid off.

Some phones that can download applications, such as the iPhone, have a program for strengthening your pelvic muscles with Kiegel exercises.  The applicationallows you to set a timer for number of repetitions, holds and periods of rest.  It’s like your own personal coach!

Scar tissue, also called adhesions, forms with any injury that disrupts the skin or deeper layers of tissue including surgery.  The scar “sews up” the torn fabric through cells by depositing fibrin.  Any time there is a cut, it is replaced by scar tissue.  Depending on the type of tear or cut the scar may be more or less “organized” or neat.  A scar that forms along the grain of the tissue, much like cutting a fabric on the grain, will be a less visible scar—a fact that plastic surgeons employ for their surgeries. In researching scar tissue adhesions after abdominal surgery, it appears that it’s common knowledge among surgeons that bowel adhesions are a significant consequence of any bowel surgery.  A repeat abdominal surgery can involve up to 20 minutes or more of cutting through adhesions.

Living with these scars may be painless, but abdominal adhesions may have something to do with your back or pelvic pain, or even contribute to problems with urinary incontinence. Scar tissue can affect how well the abdominal muscles heal, and it can also make these muscles weaker and less efficient. Abdominal and back muscles work together to properly support the spine, and when scar tissue limits the function of the abdominals, it can create back and/or pelvic pain. Scar tissue not only affects the outer layer of skin, but also penetrates deep into the inner-most layer of the epidermis, including connective tissue and muscles.

Approximately 18 years ago, Becky Rogers, PTA and Clinic Director at Creative Therapeutics, was working with a woman in her sixties who had been complaining about back pain for almost 40 years.  She had been to specialists regarding her pain and had received treatment with physical therapists before with minimal success. In starting to treat the patient, Becky uncovered a 40 year old c-section scar.  It was so tight that it created a vertical valley in her abdomen.  Becky worked on releasing the scar and every step along the way the patient’s back pain decreased.

Scars can also affect areas other than the abdomen and pelvic floor. Elizabeth Stephenson, PT, was called in to assist with the treatment of a woman who was experiencing tingling and pain in her right arm. Her primary therapist had employed all conventional treatment in an attempt to alleviate the woman’s pain, but these attempts were unsuccessful. Liz noticed a small scar on the front of the woman’s neck and decided to try scar manipulation, hoping it would give the patient relief in her arm. Sure enough, after using the technique in several treatments, the woman’s arm pain and tingling were resolved.

Scar tissue can also impact bladder and bowel function. If the bladder cannot fill or empty like it should because of a restrictive scar, this can create urinary urgency, frequency and leakage. The bowel function can also be impaired, causing constipation and symptoms of irritable bowel syndrome. Physical therapy can be an effective tool to minimize the effects of scar tissue. At Creative Therapeutics we utilize a hands-on approach to treat this problem and teach you ways to keep the scar mobile.

If you are experiencing pain and think scar mobilization would help, call us today to schedule a free consultation, or talk to your doctor about a referral.

Thursday 9:00 – 10:00 AM | June 3 – July 22, 2010 | 8 Sessions

Join us for a class designed to improve the quality of life for people with arthritis using Sun style Tai Chi.  The Sun style is one of four major recognized styles of Tai Chi.  It includes agile steps and exercises that may improve mobility, breathing, and relaxation.  The movements do not require deep bending or squatting, which makes it easier and more comfortable to learn.  In this class you will learn basic Sun style posture, stepping, and movements.  You will participate in warm up and cool down exercises and 12 specific Sun style Tai Chi movements.  This program is designed of those who experience pain with movement due to arthritis.  However, enrollment is open to all.  Please wear comfortable, loose fitting clothing and shoes.

Studies have shown this program to be effective and safe for people with arthritis.  Many arthritis organizations around the world support this program including the United States, United Kingdom, Australia, Korea, and Norway.

Cost: $50. Pre-registration is required.
Instructor: Liz Stephenson is a physical Therapist who is a certified instructor in Tai Chi for Arthritis classes.

Welcome our new Pelvic Floor Therapist Laurie Drake who has been working with the pelvic floor since 1991. The Pelvic Floor dysfunction is actually a collective term for a wide variety of problems that can occur with your pelvic floor muscles. It can mean weakness, disuse, incoordination, pain or holding too much tension. When weakness is the problem, the normal support the pelvic floor provides to our pelvic organs is lax, making prolapse worse. Also, when these muscles are weak it can lead to urinary leakage not only when we cough, sneeze or laugh, but also with strong urgency or not being able to make it to the bathroom in time.

Many people fear back pain. They worry about becoming disabled, of having to have surgery, or being physically limited from the things they want to do. Back pain is alarming and a dysfunctional back impacts the most basic everyday activities. Not to mention, it hurts.
In my clinical experience, people feel the pain, and if it goes in longer than 2 weeks in treatment, wonder why an MRI has not been ordered. As you hobble, bent over into your physical therapy appointment, those thoughts come naturally. Low back pain is a simple non-serious condition in 95% of cases. That doesn’t always mean you don’t have to work hard to improve it.
Education helps, in my opinion, to alleviate concern and to know if your problem is following the course that it should. Any medical evaluation starts with a good clinical exam. “Taking a history”, is what medical people call it when they sit and ask you questions. A good history leads the practitioner to understand the nature of the problem and what the condition is likely to be, as well as what types of tests to do. With back pain, it is important to “rule out” any other type of problem such as infection, or disease of internal organs. This will come from the history and blood tests. In patients going to the doctor for low back pain, .7% have metastatic cancer, .01% have spinal infection, and 4% have bone breaks (fracture) from osteoporosis. (Jarvik, 2002 )
Clinical tests are then added to the picture and allow the practitioner to know when further tests should be ordered. In back pain, the most important thing to rule out is serious involvement of the nerves or spinal cord. The tests that give you that information is testing the reflexes at the knee and the ankle, testing for loss of sensation at the foot (ie. Can you feel warm water on your foot when taking a shower), and strength of the legs and especially the foot and toes. If your foot is dragging when you walk, if you can’t raise on your toes, and if your big toe can be easily pushed down when you lift it up, these are signs of more serious nerve involvement. Another important sign that is asked in the history, is if you are losing control of bowel or bladder function.
Experienced doctors often do these tests quickly and sometimes their lack of explanation about the importance of these simple tests leads you to believe you weren’t checked out thoroughly.
What has been your experience with low back pain? How do you manage it when it happens? I’m looking forward to hearing from you. Next month I’ll blog about herniatied discs and MRI.
Lynn Batalden PT