Hot or Cold for Injuries?

How to Know Which is Best for You
Art Riggs
We all know that treating an injury immediately after it happens can help minimize the pain and damage as well as facilitate recovery. But after rolling your ankle in a soccer game, or hurting your back when lifting your toddler, or tweaking your knee when stepping out of your car, what's best? Should you ice it to try to control inflammation, or would heat be better to promote circulation?

While it's difficult to establish a fail-safe rule for when to apply ice or heat, the general directive is to use ice for the first forty-eight to seventy-two hours after an acute injury and then switch to heat.

It Depends

The reality is that many conditions are not necessarily the result of a specific injury. I call these conditions "recurrent acute" and find them by far the most common: sciatica that occurs when you drive a car, a back that flare up every time you garden, or tennis elbow from intense computer work. In these cases, consistent and frequent applications of ice may prove very helpful over long periods of time, particularly immediately after experiencing the event that causes problems.

Conversely, back or other muscle spasms caused by overexertion rather than injury may benefit greatly from heat immediately upon the onset of symptoms or immediately after exercise in order to relax the muscles and increase circulation. Also, muscle belly pain not resulting from acute and serious trauma generally responds well to heat, which can break the spasms and release the strain. On the other hand, nerve and tendon pain--regardless of the duration of symptoms, even if you've been experience them for months--benefit from ice.

What Works for You

The bottom line: different individuals will constitutionally vary greatly in their reactions. Some people are more prone to the types of inflammation exacerbated by heat, while others find their bodies contracting and tightening at the mere mention of ice. Try each option and pay close attention to how your body and mind respond, and let your gut be your guide. Ultimately, what works best for you is, well, what's best for you.

Moving Through Life

Yoga for exerciseFinding the Pleasure in Exercise
Sonia Osorio
We're busier than ever with longer workdays, less leisure time, shorter lunch hours, longer commutes, and more demands than ever before. We may even be in a job that doesn't fulfill us, yet we spend most of our time there. When the day ends, we have almost no energy left to do what we enjoy. How to find a healthy balance?

Plenty has been written about the therapeutic benefits of exercise. So, why aren't more people reaping those benefits and moving toward health and well-being? We need to reexamine our notion of what exercise and movement are and consider what we're moving toward or away from. Then we can begin to ask ourselves other questions: Not just are we fit, but are we physically, emotionally, and spiritually healthy? Are we happy? Do we enjoy how we're moving through life? How can we integrate more healing movement into our days?

Exercise as "Medicine"

We sometimes see more barriers than options to exercise. But what if we reoriented our point of view to notice where the opportunities lie? We can begin by simply redefining exercise (with its sometimes negative connotation of obligation) to movement. Already opportunities arise: How do we want to move in our bodies and in our lives? How can we have fun doing that? How can we move more (or maybe less, if we need to slow down)? How does it feel to be still? How can we make time to move into pleasure, to move with pleasure? Already, the notion of movement takes on a more healing expression. Rather than simply being another item on our to do list, it becomes a way for us to examine our lives, to see where we can move toward health, and use physical activity as a way to support this.

"When most people think of medicine, they visualize something material like a pill to be popped, a liquid to be swallowed, or an injection to be endured," writes Carol Krucoff, author of "Healing Moves: How to Cure, Relieve, and Prevent Common Ailments with Exercise" (Harmony Books, 2000). "Some might also consider surgery, tests, or procedures ... [But] simple physical activity can have profound healing effects."

Krucoff, who co-wrote the book with her husband, Mitchell, a Duke University cardiologist, advocates movement as preventive medicine, saying it's an ideal way to combat the increasing number of inactivity-related health conditions such as heart disease and obesity. This could actually be expanded to include stress-related conditions. In fact, it's often this combination of inactivity and increased stress that wreaks havoc on our immune system, endocrine system, and circulatory system. Every system in our body, in fact, responds to stress and inactivity. But, if this is true, then the inverse is also true: every system in our bodies will also respond to movement and pleasure. To make movement pleasurable and to use it as a way to reconnect with our bodies is, in many ways, the perfect antidote to the cycle of inactivity/hyperactivity and stress. As we move more in this way, we gain energy and health, we feel rejuvenated and relaxed, and we become more physically and emotionally aware.

Emotional Fitness
We often focus on physical fitness, but any movement toward health must also include emotional and spiritual fitness. Psychologist Nancy Mramor, PhD, author of "Spiritual Fitness" (Llewellyn Publications, 2004), ties emotional fitness with our physical health and with our heart's expression. "There is evidence that the largest number of heart attacks occurs on Monday morning between 8 and 9 a.m.," she says. "This occurrence is related to the experience called joyless striving. It applies to feelings of having to force yourself to go to a job that you have no interest in, or even truly dislike. Clearly these feelings suggest a lack of emotional fitness in the match between the employee and the job." When we're emotionally connected to our work in a healthy way and to one another, we not only survive, we thrive.

Personal Health
Interpersonal relationships, in fact, are one of the three major causes of life stress, along with environmental events/conditions and personal attitudes and beliefs. In his book, "Love and Survival" (Harper Collins, 1998), renowned physician Dean Ornish, who first proved that heart disease was reversible through lifestyle changes, says that in order to survive, we need not only care for our lives, but the lives of others. Individuals with supportive relationships get sick less, heal faster, and live longer.

Our health and well-being are not about being hyper-active or inactive. They're about finding a balance, making our actions conscious, and learning to move in ways that are both healthy and appropriate in our own lives, then moving this healing energy out toward others. So, rather than exhausting or limiting our energy, we learn to expand it. Then we can begin exercising in a whole new way--exercising our right to choose and to better understand our body, our life, and what we want to be doing with it.

Begin by checking in with yourself as you're moving through your day: How does your body feel right now? How are you breathing? Where is this movement taking you? Do you feel good? Are you satisfied? Are you happy? If not, then change something. Change how you're moving, where you're moving toward, or look at what you're moving away from.

"Become the change you seek in the world," Mahatma Ghandi said. This isn't about a temporary quick fix to end a bad habit, lose some weight, or fill our time. This is about long-term change--making more conscious use of our time and of our life. It's about moving though life in healthy and healing ways, and expanding our idea of who we can be. Then our view of the world widens, our heart grows, our spirit soars, and our body moves toward true change. This is the healing power of movement.

How to Protect Your Skin in the Dry, Cold Months

How to Protect Your Skin in the Dry, Cold Months
Barbara Hey

Winter can be tough on skin, but there's much you can do to defend against the assaults of the season. The skin's primary role -- to protect the body -- is ever more important in extreme weather, and in most locations, that means extreme cold outside and dry, over-heated air inside during the winter. Your epidermis must "weather" these drastic fluctuations in temperature, and often the result is chapped, scaly, flaky skin.

Facing the Frost

The biggest wintertime concern is dehydration. In colder climates, you definitely need to increase the protection quotient. "You must over-treat skin to keep it hydrated," says Barbara Schumann-Ortega, vice president of Wilma Schumann Skin Care in Coral Gables, Florida. That means a shift from lighter skin care products used during warmer months to winter-weight products, such as thicker, cream-based cleansers and moisturizers. These will provide stronger barriers against the harsh environment of winter months. And this is especially important for the face. And if much time is spent outdoors skiing, snowboarding, or walking, for example, your complexion needs heavy-duty protection from brisk wind and winter sun as well.

"People often forget about sunscreen in the winter," says Schumann-Ortega. For regular outdoor time -- a few hours a day -- a sunscreen with an SPF of 20 should be sufficient. But if a winter trip on the slopes or shore is part of the plan, sunscreen with a higher protective factor is needed, even if your time is spent beneath an umbrella. "Both snow and sand reflect the sun," she says, so don't be caught unprepared. Double your efforts to protect the parts of the face particularly prone to display the effects of dryness: The lips and the area around the eyes need a continual shield against the elements. Ask your skin care professional which products are appropriate for your skin type and effective, seasonal moisturizers and sunscreens.

"When it's cold, you lose blood flow to the skin," says Schumann-Ortega. The result is a dry, dull tone. Facial treatments can increase circulation and rejuvenate a healthy glow. But, Schumann-Ortega cautions, be careful with peels and resurfacing treatments during the winter, as they can do more damage than good with skin that's already taxed from the harsh environmental conditions.

Winterizing the Body
It's not just the face that suffers in the winter. Skin everywhere dries out, and gets that flaky look and uncomfortable winter itch. Hot baths -- a delightful antidote to the chill -- can further exacerbate dry skin. The solution? Add 10 drops of an aromatic essential oil to the bath to moisturize as you soak. (Lavender is particularly soothing to dry skin.) Then apply an emollient moisturizer -- a product that feels particularly thick and creamy to the touch, like a body butter -- geared for extra dry, rough, chapped, or cracked skin. Apply it immediately after drying off, when the skin can most readily absorb the lotion and restore its barrier. If dryness is still bothersome, indulge in a salt rub and full-body conditioning wrap to re-moisturize.

And don't forget feet and hands. The feet, hidden by socks and boots all winter long, often go neglected this time of year and need attention, but the most obvious casualties of winter are the hands. Exposed to the elements and the subject of frequent hand-washing during the cold and flu season, hands can turn to rawhide just as holiday parties go into full swing -- not an elegant look for holding onto a champagne flute.

This is the season to slather hands with heavy, oil-rich cream at night and cover them with gloves. And don't forget feet: they also require the same special care. Consider a moisturizer for them in the evenings and sleep with socks on. In the morning, your feet and hands will feel soft and moisturized. Your skin care professional can recommend appropriate gloves, socks, and a home-care routine for this process. In addition, treat hands and feet to regular spa treatments to exfoliate dead skin cells, and paraffin treatments to replenish and moisturize.

Relax and Enjoy It
In winter, and all seasons, stress can disrupt even the best skin. "We always ask clients what's going on in life, since adrenaline, holiday pressures, and even joy can have an effect on body chemistry," says Schumann-Ortega. The skin reflects it all. "Some clients may come in after four weeks and they look like a train wreck," she says. So do your best to minimize the effects of stress with exercise, meditation, and proper diet. And don't skimp on the self-care. Schedule time for pampering, relaxing treatments.

Some final tips:

  • Drink water. Even when there's a chill in the air and thirst isn't overwhelming, water consumption needs to be high to combat the dry air.
  • Avoid products with a high percentage of synthetic ingredients (propylene glycol, petroleum), chemical detergents (sodium laurel sulfates), and artificial colors and fragrances.
  • Employ quality skin care products suited to your skin type.
  • Check your medications. Illness and ongoing pharmaceuticals can upset pH balance.
  • Incorporate nutritional supplements into your skin health regimen, such as essential fatty acids, zinc, magnesium, vitamin A, and B vitamins.

Winter doesn't have to take its long, hard toll on your skin. Ask your skin care professional about hydrating products and circulation-enhancing treatments to ease the long, dry months of winter. After all, spring is just around the corner.

The Importance of Proper Posture

Proper postureCorrect Alignment Leads to Better Health
Hope Bentley
Talk of good posture often generates images of women walking in a circle with books balanced on their heads or soldiers standing at attention. But good posture does not have to be rigid or ridiculous. In fact, far from ridiculous, it may be the key to good health.

According to Patrick Wroblewski, a Boulder, Colorado-based structural integration practitioner, "Good posture is a dynamic, working awareness of how gravity is coming down through the body." In other words, just as the body moves and changes throughout the day, so should posture.

Wroblewski explains that many people come in to his practice with complaints of lower back pain, and stiff necks and shoulders, most of which have a direct correlation to poor posture. If a person sits hunched in front of a computer screen all day, it's likely the head hovers towards the screen, the lower back has collapsed and the tail bone is supporting the weight, and legs are crossed or splayed. Bad standing posture includes the same hunching or lateral misalignment, like standing with a hip cocked to one side. These common forms of less-than-perfect posture mean less-than-healthy consequences for the body.

Does Posture Matter?
Ever feel low on energy? Get sick often? Experience headaches or digestive upset, like constipation or diarrhea? Feel less agile than you used to be? Your postural habits may be behind these symptoms.

Proper posture means the body is aligned so that all the muscles work as they were designed to. On the other hand, poor posture leads to inefficient movement, causing the muscles to have to do extra work. For instance, if the head isn't resting correctly on top of the neck and spine but hovers over the chest instead, the muscles at the back of the neck have to remain contracted to hold the head up. The results? Circulation becomes hindered, and oxygen and nutrients have a hard time flowing through the body. Contracted muscles are less able to receive hydration and energy, and the tissue eventually becomes hard and fibrous. Eventually, muscles can pull bones out of alignment and cause serious problems and discomfort.

The bottom line is, poor posture can lead to muscular stress and fatigue, which can in turn lead to deficient circulation, compromised immunity, and poor lymph flow--which brings us back to low energy, frequent illness, headaches, digestive issues, and waning agility. So to answer our earlier question, yes, posture matters.

Perfecting Posture
Correcting poor posture requires undoing the hardening, or fibrosis, of the muscles that have been habitually contracted, allowing them to relax and the bones to move back into place. Perhaps a simple concept, but not an easy task.

Wroblewski uses a combination of techniques to help correct posture: Swedish massage can help increase circulation and release chronically held areas. Deep tissue massage helps wake up the body and reverse some of the fibrosis in the tissue. And other bodywork techniques can further precipitate postural adjustments. He says, "Any kind of manipulation--craniosacral, acupressure--can cause an unwinding of tension and allow the body to release to the position in which it belongs."

Wroblewski also recommends movement education, an umbrella term that includes many types of bodywork, such as Alexander Technique, Feldenkrais Method, Hellerwork, and Trager Approach. Movement education advocates that one's body structure and movements can get stuck in habitual, unhealthy patterns. Movement education unwinds the patterns and teaches the body, as well as the mind, anew. This is done through a series of sessions where practitioners may use hands-on manipulation to teach the student different, more efficient ways to move, sit, stand, reach, bend, lift and walk. Ultimately, this balances the body and allows energy to move freely.

Movement education techniques may be especially beneficial for people suffering from chronic difficulties, but also for anyone trying to achieve higher levels of physical and mental wellness.

According to Wroblewski, bodywork can induce a "neutral reprogramming," so that people can start from scratch and learn to recognize when good posture is breaking down. Then the necessary adjustments can be made.

What's a Body To Do?
Desk jobs are notorious for wreaking havoc and causing postural impairments. Sitting for hours on end staring at a computer screen is likely one of the worst things you can do to your body. If you spend a lot of time sitting, make sure both feet are flat on the ground to give yourself a "tripod" of stability for the spine to rest on. Also, be sure to take frequent breaks, even if it just means walking to the window for a moment, or getting a glass of water. And when standing, distribute weight evenly between both feet, and don't lock the knees or ankles.

Good posture takes practice, practice, practice and constant reminding. Wroblewski suggests leaving reminders in places where you will run into them throughout your day.

Old habits die hard, and this is true for muscular habits too. Be sure to schedule a series of massage treatments to help retrain the body. And talk to your practitioner about stretches and posture tips that can enhance your massage sessions. As you progress, you will notice less joint and muscle pain, fewer headaches, more energy, and possibly even stronger immunity and better digestion. Finally, you will develop a stronger awareness of your body and an increased sense of well being.

Safe Fun in the Sun

Nutrition Offers UV Shield
Sharron Leonard
Because sunlight activates the synthesis of vitamin D, a nutrient that works with vitamin A to build strong bones and good eyesight it is essential for health. Furthermore, bright light, specifically sunshine, can improve your mood and help ward off depression. But all things in moderation. Overexposure to UV rays can cause potentially extensive damage to the skin, an all-too-common occurrence. "Skin cancer is now considered epidemic throughout the nation", according to The Centers for Disease Control Prevention. "Over one million residents in the United States are expected to get skin cancer this year more people than the collective total of all who will get cancers of the breast, prostate, lung and colon. Exposure to ultraviolet (UV) rays in sunlight causes 90 percent of the skin cancer cases." And this overexposure may double the risk of melanoma, a type of skin cancer that causes more than 80 percent of skin cancer deaths.

UV rays cause oxidative damage and can actually change the skin's DNA cellular structure, creating highly unstable and toxic molecules. These are known as free radicals and can lead to malignancies. Sunscreen, adequate coverage and sunglasses have long been recommended to avoid this damage, but diverse studies now suggest some promising supplemental strategies for UV protection from the inside out. Certain nutrients and a low-fat diet have shown specific anti-cancer properties.

Free Radical Control

Antioxidants have long been known to neutralize free radicals and render them inactive, protecting cellular structure. Powerful antioxidants include vitamin C (citrus fruits, strawberries, broccoli, tomatoes), vitamin E (asparagus, raw nuts and seeds, spinach), beta-carotene (yellow and orange vegetables) as well as the minerals zinc (shell fish, legumes, whole-grain foods) and selenium (nuts, whole-wheat bread, oatmeal). A recent study published in the Journal of Investigative Dermatology demonstrates that lutein and zeaxanthin, plant pigments found in predominately green leafy vegetables, also have strong antioxidant properties that diminish the effects of UV irradiation by reducing the acute inflammatory responses. Lutein- and zeaxanthin-rich foods include green, leafy vegetables such as spinach, kale, broccoli and turnips as well as corn and egg yolks.

As long ago as 1991, studies have shown green tea consumption and topical application afford protection against skin tumors. More recent research corroborates these results and points to the polyphenols in green tea, which contain antioxidant and anti-inflammatory properties. In addition, one major element in green tea, epigallocatechin-3-gallate (EGCG), is thought to stop production of an enzyme required for cancer cell growth. Several cups of green tea might be a worthwhile addition to your daily routine.

Avoiding fatty foods may also provide benefit. Studies suggest that a low-fat diet can reduce the incidence of premalignant lesions called actinic keratosis. To maintain a low-fat diet, the U.S. Department of Agriculture recommends that you get most of your calories from organic, whole foods such as grains, fruits, and vegetables and to avoid foods high in saturated fats. For more information, visit their website.

Know the Index
Even though it is helpful to counteract damage to your skin through nutrition, it remains vital to shield yourself from the sun's invisible UV rays and avoid them when they're at their most intense. The UV Index, a measurement of ultra-violet sun radiation, can assist in protecting you from potentially harmful exposure. This forecast of UV intensity ranges from a nighttime low of 0 to a very sunny 10-plus. It is greatest when the sun hits its apex (noon), then rapidly decreases as the sun moves across the afternoon sky. The higher the UV Index, the shorter the time for skin damage to occur. To determine the UV Index in your area, check your local newspaper, TV and radio news broadcasts, or you can visit the U.S. Environmental Protection Agency's website. This rating allows you to determine your geographic risk and, in turn, the level of adequate sun protection needed.

Regardless of your sun-screening defenses, always be vigilant about checking your skin for possible signs of melanoma. "When melanoma is detected in its early stage, surgical removal cures the disease in most cases," according to the American Academy of Dermatology. "If the disease has spread to lymph nodes, the 5-year survival rate is 30-40 percent. If the disease has spread to distant organs, the 5-year survival rate is 12 percent."

Melanoma appears as a pre-existing mole that changes, or as a new mole on previously unaffected/clear skin. Performing skin self-exams every few months and knowing the characteristics to look for in any mole identified will enhance early detection and reduce risk. For more information on early detection, visit

And don't forget common sense practices:
  • Avoid long-term sun exposure and wear a hat, sunglasses, and protective clothing
  • Apply sunscreen with SPF of 30 or above
  • Avoid artificial tanning devices
  • And be aware of sun exposure year-round
With a few protective measures, you can continue to enjoy fun in the sun safely. Wear your sunscreen--in the winter months as well as the summer--seek shade, cover up with sleeves and pants, and don't forget your hat!

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