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FODMAPS Diet

low fodmap foods

FODMAP diets have been a hot topic lately! This diet was created by clinical researchers at Monash University in Australia. The diet was designed to treat Irritable Bowel Syndrome (IBS) as well as other bowel-related conditions. IBS is a very common gastrointestinal disorder that affects 1 in 7 people. FODMAPS are a collection of short-chain carbohydrates (sugars) that aren’t absorbed properly in the gut, which can trigger symptoms in people with IBS. 

FODMAP:

  • Fermentable: The process in which gut bacteria ferment shorts chain carbohydrates producing gases.
  • Oligosaccharides: Sugars including fructans and galactooligosaccharides (GOS) found in wheat, barley, onions, garlic, and legumes.
  • Disaccharides: Lactose, which is found in dairy products such as milk, soft cheeses, and yogurt.
  • Monosaccharides: Fructose, a simple sugar found in honey, apples, high fructose corn syrup, and agave.
  • Polyols: These include sorbitol and mannitol, which are found in some fruit and vegetables and are used in artificial sweeteners.

How do FODMAPs affect the gut?

When FODMAPs reach the small intestine, they move slowly, attracting water. When they pass into the large intestine, FODMAPs are fermented by gut bacteria, producing gas as a result. The extra gas and water cause the intestinal wall to stretch and expand. These characteristics may lead to bloating, gas, cramping, and diarrhea in certain individuals. In people with IBS, the ‘stretching’ of the intestinal wall causes sensations of pain and discomfort. Fermentation of FODMAPs in the colon produces carbon dioxide, methane hydrogen, and other gases. It slows colonic transit (time that it takes for a substance to move through your colon) and alters the microbiome. This may negatively impact tight junctions and activation of the mucosal immune system. 

How does low FODMAP diet help?

Researchers at Monash University have found that a low FODMAP diet has been shown to reduce abdominal pain and discomfort, reduce bloating and distension, improve bowel habits (reduce diarrhea or constipation), and improve the quality of life.

How is a low FODMAP diet used?

A FODMAP diet is meant to be undertaken in three phases. 

Phase 1: All high-FODMAP foods are eliminated from the diet for an extended period of time. 

Phase 2: Systematically reintroduce restricted foods, noting how well you tolerate increasing quantities of the foods you’re reintroducing. 

Phase 3: Only avoid foods in quantities that cause symptoms.

Is a Low FODMAP diet for everyone?

No, FODMAPs are found in a wide range of foods, and most people eat high FODMAP foods every day without digestive issues. Following a low FODMAP diet is a systematic dietary intervention that can be complex and requires substantial food knowledge. FODMAP ingestion is a great source of prebiotics (great source of food for the bacteria in our gut). Therefore it is not intended to be followed indefinitely, as this can lead to a reduction in beneficial microbes in the gut. 

Does the research support it? YES!

A meta-analysis of multiple studies showed that, compared to those on a standard IBS diet, patients on a low FODMAP diet enjoyed a significantly greater improvement in symptoms.  The authors conclude that a dietician-led low FODMAP diet could be a first-line approach to IBS management. Eliminating FODMAP foods and then slowly reintroducing them can help specify offending foods, leading to a less restrictive overall diet.

Can Low FODMAPS diets help athletes? YES!

A recent study published by the Journal of International Society of Sports Nutrition provided evidence showing that recreational athletes implementing a short-term LOW FODMAP diet under free-living conditions may experience benefits in exercise-related GI symptoms and perceived improvements in exercise intensity and frequency. However, authors advise caution when implementing the Low FODMAPS diet to minimize unnecessary reductions in total caloric and/or carbohydrate intake that may impact on nutritional quality. 

At Miami Spine + Performance, we use Functional Medicine to address the root cause of your gut symptoms. Every treatment is personalized to your needs. If you are interested in learning more about Low FODMAPS or other nutritional interventions, please give us a call!

 

Eswaran S, Farida JP, Green J, Miller JD, Chey WD. Nutrition in the management of gastrointestinal diseases and disorders: the evidence for the low FODMAP diet. Curr Opin Pharmacol. 2017;37:151-157. doi:1016/j.coph.2017.10.008.

Varjú P, Farkas N, Hegyi P, et al. Low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet improves symptoms in adults suffering from irritable bowel syndrome (IBS) compared to standard IBS diet: a meta-analysis of clinical studies. PLoS One. 2017;12(8):e0182942. doi:1371/journal.pone.0182942.

Dolan R, Chey WD, Eswaran S. The role of diet in the management of irritable bowel syndrome: a focus on FODMAPs. Expert Rev Gastroenterol Hepatol. 2018:1-9. doi:1080/17474124.2018.1476138.

Wiffin, M., Smith, L., Antonio, J., Johnstone, J., Beasley, L., & Roberts, J. (2019). Effect of a short-term low fermentable oligiosaccharide, disaccharide, monosaccharide and polyol (FODMAP) diet on exercise-related gastrointestinal symptoms. Journal of the International Society of Sports Nutrition, 16(1), 1. https://doi.org/10.1186/s12970-019-0268-9

https://www.monashfodmap.com/

Breaking Down Weightlifting Movements: The Snatch

Athlete Performing a Snatch

The Olympic Snatch is one of the most complicated and effective weightlifting movements that is frequently used in sports performance, CrossFit, and barbell sport.

The Snatch itself involves Lifted a barbell from the ground to the overhead position in one motion. Traditionally, the snatch is caught deep in a squat position requiring a significant amount of upper-body stability and lower body mobility.

Part of what makes the snatch such a unique lift is that any small deviation from proper technique and mechanics can result in a missed lift. For other major lifts in the super total such as the deadlift, Clean and Jerk, and Squat, small deviations can be compensated for by strength and grit. This is why the Snatch is called by some “the most athletic movement in Olympic Sport”

 

The snatch itself is typically broken down into three primary phases; the first pull, the second pull, and the catch

 

The First Pull:

During the first pull, the barbell is lifted off of the ground up to the crease of the hip. Within the first pull, the knees are pulled back to make room the barbell around the knees and then return forwards as the bar is brought towards the crease of the hip.

The physical demands of this position include primarily proper thoracic (upper/middle back) extension, foot stability, and the ability to appropriately load the hamstrings

While there is much debate as to the appropriate torso height for the liftoff phase of the snatch, most coaches will agree that a rounded upper back is an efficient position to pull from, which means that some level of thoracic extension, without composing the neck or lower back is ideal.

Additionally, the ability to stabilize the arch of the foot is critical for the liftoff phase as the foot is to be in full contact with the ground and any deviation away from the balanced position can result in a missed lift or injury, particularly when the weight increases relatively to your max. Most lifters also use an Olympic weightlifting shoe designed to improve dorsiflexion capacity of the ankle, though at times at the expense of a properly centered foot and stabilized arch.

The initial lift of the bar during the snatching from the ground up to the top of the knee requires a proper hip hinge during which the hamstrings and posterior chain are adequately loaded to produce maximal force and reduced the compressive load on the spine while lifting the bar. Likewise, the bar is taught to be kept very close to the body to reduce strain place on the lower back during the lift.

 

The Second Pull:

Once the bar has reached the top of the thigh or hip crease, the second pull is initiated in which the body uses triple extension (hip, knee, ankle) to propel the bar vertically. Once the bar has reached the maximal height, the lifter descends into the catch position to receive the barbell.

Athletes vary in at which point they initiate the second pull. Some athletes chose to extend just before the bar reaches the crease or the hip but the majority of weightlifting coaches teach the lifter to be patient during the first pull and explosively triple-extend once the bar reaches the hips in the snatch. An early second pull can result in an inefficient bar bath and potentially a leak of potential vertical force to propel the bar upwards.

Important characteristics for the second pull are more related to training athletic qualities and synchronizing extension of the hip, knee, and ankle. From a mobility and motor control standpoint, however, the ability to properly extend the hip while stabilizing the spine is arguably the most important physical characteristic for executing an efficient and safe second pull.

Hip Extension is not only an important motion for the snatch, but also a variety of fitness movements including the deadlift, running, bridging, and lunging. Often individuals possess very little hip extension and use their lumbar spine (lower back) to extend during a lift or athletic movement. When we can effectively address pure hip extension, through manual therapy and specific exercises, we can expand your force capacity as well as significantly reduce the likelihood of a lower back injury.

 

The Catch:

After the lifting drops under the barbell following the second pull, the catch position requires the lifter to have two feet planted on the floor and the arms locked out overhead. Once the lifter catches in a stable position and stands up to the standing position.

The “catch” phase of the lift is by far the most physically demanding in that it requires a tremendous ability to sit into a deep squat with an upright posture and lock the arms out overhead. The squat itself has numerous prerequisites that we will cover in a later installment of this series, but the difference during this lift is that the squat is required with a barbell locked out overhead. A traditional powerlifting squat has very little upper body mobility requirements beyond enough shoulder rotation to hold the bar. The front squat does require a relatively upright torso as well as upper body extensibility for the front-rack. However, neither of these compare to the demands of the overhead squat.

To catch the barbell in a stable enough position to stand up and maintain a successful lift, the shoulder complex must have a tremendous degree of overhead stability coupled with adequate upper back extension to take the strain off of the shoulder joint itself. 

Additionally, a physical capacity that is not talked about frequency is the ability of the wrist to radially deviate (bend towards the thumb side). Generally, at higher levels of Olympic weightlifting, lifters will grip very wide on the bar to both meet the hip crease during the second pull and reduce the overhead mobility requirement during the catch. Because the wrist is a small and complex joint, we mustn’t place the wrist in a vulnerable position during the snatch.

 

Common Injuries Seen in the Snatch

If you are a Crossfitter, Olympic weightlifter, or other athlete and would like a joint-by-joint injury risk assessment as well as therapy to correct these findings, please reach out to us at 754-231-8338, we would love to help you!

Third-Party Testing

 

There is no shortage of supplements in today’s society. You can find multivitamins, fish oil, probiotics, herbal blends, protein powders, etc online or at your local health food store. The use of supplements to fill “dietary gaps” or enhance your diet can very useful. For example, if you live in areas where you do not get sufficient sun exposure, it is useful to supplement with Vitamin D to avoid nutritional deficiencies. 

However, how can we be sure that the supplement(s) we are consuming are contributing to our health goals? Ideally, nutrient supplementation is informed by advanced nutrient testing to cover any nutritional gaps. We can test our nutritional status, supplement adequately, and retest to ensure we achieved our nutritional goals. Third-party testing can also help us as consumers make informed decisions about the quality of the supplements we are purchasing.

 

Supplements Are Not Created Equal

The Food and Drug Administration (FDA) states “.. manufacturers of dietary supplements are responsible for making sure their products are safe before they go to market. Dietary supplement products are not reviewed by the government before they are marketed, but FDA has the responsibility to take action against any unsafe dietary supplement product that reaches the market”1. According to the U.S Food and Drug Administration, the FDA does not keep a list of manufacturers, distributors, or the dietary supplement products the supplement companies sell. The manufacturer or distributor of a particular supplement must be contacted by the consumer for detailed information.2 

The supplement manufacturer is responsible for ensuring that the “Supplement Facts” label and ingredient list are accurate, dietary ingredients are safe, and that the content matches the amount declared on the label. As of June 2007, supplement manufacturers are required to comply with the FDA mandated Current Good Manufacturing Practice (CGMP) guidelines. These guidelines are considered the baseline to “ensure the quality of the dietary supplement and ensure that the dietary supplement is packaged and labeled as specified in the master manufacturing record”. Beyond CGMP, many supplement manufacturers may opt to apply voluntary third-party certification to their manufacturing or ingredient sourcing standards.3

What is a Third-Party Certification?

Third-party certification means that an independent organization has reviewed the manufacturing, sourcing, and distribution processes of a product and has determined that the final product complies with specific standards for safety, quality, or performance. The product review includes formulation/material reviews, testing, and facility inspections. Supplement companies may opt into third-party certification processes to provide labeling transparency for consumers. This helps to improve confidence that the supplement being sold has been validated for quality by independent auditors that screen the supplement development process of that product or prove that product claims are true. 

Most certified products bear the certifier’s mark on their packaging to help consumers and other buyers make educated purchasing decisions. Some companies like Metagenics go above and beyond to ensure the quality and consumer transparency. Metagenics offers an online platform called “TruQuality” that offers full visibility to testing information for every single product they create. 

Takeaways

This is not to say that all supplement companies lacking third-party certifications are unreliable, but independent validation of sourcing, manufacturing, and distribution processes, as well as labeling claims, provides added assurance of supplement quality.  Before using a supplement it is important to consult with your doctor. Dietary supplements may not be risk-free under certain circumstances. If you are pregnant, nursing a baby, or have a chronic medical condition, such as diabetes, hypertension, or heart disease, be sure to consult your doctor or pharmacist before purchasing or taking any supplement.

Next time you are shopping for supplements look for third party certifications in the chart below. You can also visit the company’s website and find information regarding their product’s quality, potency, and purity. 

 

Get the scoop on POOP!

“What does my stool have to do with my health?! ”

Patients in my practice are often surprised when I ask about their bowel movements. Let’s face it, talking about our pooping habits can be embarrassing. We may feel shy or uncomfortable talking about something so private and as a result, we may choose not to discuss our symptoms with our healthcare provider. Sometimes we may not be aware that our pooping habits are irregular at all. We may be accustomed to bothersome symptoms like gas, bloating, constipation, and accepted them as part of our “norm”. Addressing our gastrointestinal (GI) symptoms can have favorable effects on our health. 

Our poop can offer us valuable insight into our health status. It can inform us about the health of our digestion, absorption, inflammation, gut health, brain health, and many other systems in our bodies. The gut is the gateway to our health. It’s the home of 80% of your immune system and powerful neurotransmitters are made there as well.1 Trillions of microflora work together to ensure proper digestive function. They aid in the production of essential vitamins such as B vitamins and act as a protective barrier for the immune system. The bacterial balance in our gut also discourages the growth of unfavorable bacterial, parasitic, and/or fungal infections from compromising our gut function. Because our stool is formed in our GI tract we investigate the integrity of our gut to understand it’s a contribution to our signs and symptoms. 

The Bristol Stool Chart is otherwise known as the “poop chart” is a very helpful tool used to characterize our stool. This chart was devised by doctors in the Bristol Royal Infirmary in England and it is used by doctors around the world to help characterize different types of stool.  

  • Type 1–2 indicate constipation
  • Type 3–4 are ideal stools as they are easier to pass
  • Type 5–7 may indicate diarrhea and urgency.

Every person will have different bowel habits, but there are a few important characteristics to consider when discussing our stool. Ideally, poop should be soft, well-formed, and easily passed within a few minutes of sitting down on the toilet. The bowel movement should pass without pain or straining, and you should experience complete emptying of the bowels.

 

The following situations may suggest that it’s time to get your poop checked:

  • You’re not pooping every day or not pooping enough. 
  • You see undigested foods in your stool except for some fibrous foods like beans, corn, grains, such as quinoa, peas, seeds, sunflower seeds, flax seeds, sesame seeds, or skins of vegetables, such as bell peppers or tomatoes.
  • You’re exhibiting some other type of digestive discomforts such as consistently loose bowel movements, stomach cramping, bloating, gas, indigestion, and hemorrhoids.
  • You’ve been diagnosed with an autoimmune condition. Scientific evidence shows that imbalances in our gastrointestinal bacteria are related to inflammation and autoimmune conditions. 2
  • Gut imbalances can also present as chronic fatigue, brain fog, skin-related symptoms, and other symptoms.3

 

Testing our poop can give us valuable information about our symptoms. Stool testing can help you and your doctor identify the types of bacteria that live in your GI and any potential bacterial, yeast or parasitic infections in the gut. A comprehensive stool test also looks at how well you break your food down into fiber, screens your immune system, determines your level of digestive enzymes, and how well you are digesting and absorbing your fats.

I want to encourage you to speak to your healthcare provider about your bowel habits and gut health. Get comfortable sharing information about your poop and don’t allow embarrassment to discourage you! At Miami Spine + Performance we offer comprehensive stool testing via Doctor’s Data Lab, to understand your unique digestive system. If you are interested in learning more about stool testing, please give us a call.

 

*If you’re getting gut symptoms regularly and experiencing any of the following symptoms, make sure to see your doctor immediately: unexplained weight loss, changes in bowel habits, such as loss of bowel control, persistent diarrhea, persistent constipation, blood in the stool.

How to Build a Bulletproof body for Jiu-Jitsu

Chiropractor Hallandale Beach Jiu Jitsu

Essential exercises to keep you healthy and performing at a high level consistently in Brazilian Jiu-Jitsu.

 

Jiu-Jitsu is a particularly unique martial art and sport in which the majority of a match is played with one or both competitors on the ground either on their back, on their behind, half kneeling or full kneeling positions.

What makes a jiu-jitsu athlete unique is that throughout their training they will learn to be comfortable in several positions and be able to both simultaneously attack their opponent and defend themselves from each of these positions.

To build a perfect body for longevity in jiu-jitsu, we must break down each position and the mobility and stability requirements from each position to be healthy and effective in the sport:

The Importance of Mobility in Jiu-Jitsu

Mobility can be defined as the ability for one joint to express a full range of motion independent of other motion in the body. An example of this in jiu-jitsu that most can relate to is the hips. At some point in your jiu-jitsu training, you have likely encountered an individual who has a near-impossible guard to pass due to his hips being extremely flexible as well as good speed to pummel their legs and recover guard. This is a prime example of using mobility to your advantage to improve your jiu-jitsu. In other cases, you have likely encountered an individual who is very prone to be “stacked” in the guard due to hip immobility. Even if an individual is taught the proper technique to retain and attack from the guard position, if their hips cannot keep up with the position or passing of their opponent, they leave themselves vulnerable to both being passed and being injured.

The Importance of Stability in Jiu-Jitsu

Stability can be defined as our body’s’ ability to keep certain areas of your body still and balanced while moving or being moved in other areas of your body. A great example of this is passing the guard. As a jiu-jitsu player, you have likely encountered the individual who has such a great base that they seem impossible to sweep or control from the bottom position. Even when controlling one of these individuals’ legs or having a deep grip on their collar, there is something about this individual that makes them an immovable object. Having excellent stability, particularly in your “core”, will allow you to move quickly, powerfully and efficiently on the mat, all while significantly reducing your chance of injury.

At Miami Spine and Performance we work with many jiu-jitsu athletes, both recreational enthusiasts, and high-level competitors throughout Hallandale, Aventura, and Hollywood. We have found that many of our jiu-jitsu athletes present to the clinic with neck and lower back pain that is ultimately a result of poor respiration, core stability, and hip control during training. In our Jiu-Jitsu Injury Prevention video series, we are going to share 3 of the primary exercises we use with our jiu-jitsu athletes to keep them healthy on the mats and performing at a high level in competitions. We will cover the basics of proper respiration, as well as how to properly train your hip for both stability and mobility.

For exclusive access to our Jiu-Jitsu Performance and Injury Prevention series please sign up below!

 

Jiu-Jitsu Injury Prevention Series: Breathing

Proper Respiration is the foundation of any good athletic movement but is particularly important for Jiu-Jitsu because of the dynamic nature of the sport and the regular transition between positions. To smoothly transition between positions, maintain cardiovascular performance and maintain a strong base is contingent upon your ability to use your respiratory and stability diaphragm muscle in sync.

Not only does proper diaphragm function and intra-abdominal pressure improve your performance, but it also protects your spine from injury during training. The actual strength of the core muscles does not prevent injury, but rather your ability to generate pressure in your abdomen to create stability around your spine and prevent bucking of the vertebrae.

Our goal with training the diaphragm is to produce pressure in the abdomen in 360 degrees with each inhale and to be able to maintain 20-30% of that pressure during exhalation. Once you can accomplish this task lying on your back with your legs elevated, challenge your breathing in different positions! (Example: Face down, side-lying, half kneeling, in guard)

Watch the video below for instructions on how to begin training your breathing and core stability for Jiu-Jitsu!

 

 

Jiu-Jitsu Injury Prevention Series: Hip Stability

Once you have established your intra-abdominal pressure, you have already successfully built the foundation for good stability in jiu-jitsu.

In addition to intra-abdominal pressure, it is also crucial that you have good centration and stability in your hips. This will allow you to sit back into your hips and use them explosively when shooting for a takedown. Hip stability means more than just strength, there are plenty of individuals with an impressive leg press but no hip stability.

Hip stability is a product of proper hip centration and the ability to produce force from all different angles. Not only will it strengthen your standing position, but also is beneficial in both the top and bottom position on the ground. When passing guard at higher levels, most individuals are standing and must have an excellent base to not be off-balanced by their opponent.

It is important to note that strength does not equal balance. Balance starts with centration. Many individuals are shocked when they can put up large numbers in the weight room on exercises like squat, lunge and leg press but are unable to properly bridge with their hip. A lot of the stability demands required for Jiu-Jitsu fall on the small musculature of the hip.

Watch the video link below for how to train hip centration and stability properly for Jiu-Jitsu!

 

Jiu-Jitsu Injury Prevention Series: Hip Mobility

Before we dive into the importance of hip mobility for jiu-jitsu and how to train it, let’s first discuss the difference between mobility and flexibility. Flexibility is the ability to passively stretch muscular, tendon and ligament tissue beyond its resting length. Mobility, on the other hand, is the ability to control soft tissues in their end range of motion. This means that flexibility is a prerequisite for mobility.

For example, If an opponent can push your feet behind your head and you feel a very little stretch in your back or hips, this would be an example of excellent flexibility, but this doesn’t necessarily mean that this position is safe or ideal for your body. However, if you can bring your feet behind your head on your own without compromising other areas of your body, this would demonstrate excellent mobility and means that you can safely control this position and use it as part of your game.

In addition to improving your jiu-jitsu game and giving you more options on the mat, having great hip mobility also reduces the strain on your lower back when training. The large majority of lower back injuries are the result of overloading on the joints of the lower back due to inadequate movement of the thoracic spine (middle back) and the hips. Therefore, improving the movement quality of your hips can greatly reduce your incidence of lower back pain and prevent injury in the long term.

Most individuals mistake flexibility training for mobility training. Holding stretches or rocking back-and-forth are not adequate means of improving mobility, particularly if your goal is to build strong and efficient hips to use in a contact sport such as jiu-jitsu. To improve hip mobility and create lasting changes that impact the long-term, it must be trained just like any other physical capacity.

Learn how to train your hip mobility by clicking the link below!

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