Happy November!
Here’s our monthly newsletter with a little health and wellness knowledge, some Asheville happenings, and other random interesting stuff we’ve come across.
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In this month’s Newsletter:
Building physiological reserve, good things take time, gratitude and “Ma,” movement snacks, two return-to-running stories, November in Asheville, dancing flamingos, fungal music, and a few other things we found interesting.
For Your Body
1. The cause of that side stitch might be your gut. Recent research points to digestion and the GI system as a possible cause. So if building capacity, improving mechanics, and specific strengthening aren’t resolving your symptoms—consult a dietitian or your PCP.
2. This is a great post on nutrition, supplements, and tendon health. The take home message: nutrition complements mechanical loading, it doesn’t replace it. And you can probably skip most of the supplements.
3. Aerobic exercise is a proven intervention for reducing pain. I’ve had many patients who are able to walk their back pain away.
4. A popular study on femoroacetabular impingement (FAI) is making the rounds in rehab circles, showing no difference between stretching and strengthening for overall quality of life. However, many are overlooking a key detail in the secondary outcomes: the strengthening group experienced a 20% greater reduction in pain compared to the stretching group.
5. Looking up without compensating elsewhere requires both thoracic extension and good cervical retraction.
6. Don’t have time for a post-meal walk? Research shows performing brief exercise (push-ups, squats, planks, stair climb, etc.) after eating can significantly reduce your glucose spikes.
7. EXERCISE OF THE MONTH: Dynamic Side Plank Sling
It’s reciprocal—which mimics most of our life activities
It works the frontal and transverse plane—which are often under trained
It works the slings—stretches the posterior oblique sling and strengthens the lateral sling
It’s low load—it won’t cause excessive muscle damage
Caution: if you can’t do a full side plank for 30 seconds you probably should not be doing this exercise
Things I wish my patients knew…
Physiological Reserve is how much “unused horsepower” you have after a task or at the end of the day. It is one of the most useful concepts for thinking about health, resilience, and independence as we age.
A larger reserve means more choices. You can carry the bag of mulch, you can take the stairs, you can do that house project yourself, you can recover from a spontaneous illness.
In engineering terms, you're increasing the factor of safety—building extra capacity so that normal life operates well below your limits.
That perspective shifts the goal from living longer to living with greater freedom throughout the years.
For Your Mind
8. Don't wait for the funeral to tell your friends and family what they mean to you. Gratitude is a bidirectional health and wellness practice.
9. You can’t bake a cake in 5 minutes. Good things take time. Most people overestimate what they can do in one year and underestimate what they can do in ten. Delayed gratification and finding enjoyment in the process will improve your life much more than focusing on the short term outcomes.
10. You don’t have to be “good” at your hobbies for hobbies to be good for you.
11. Empty space isn’t always a bad thing. Consider “Ma”—the Japanese concept of the intentional negative space, pause, or interval between elements—whether in time, space, art, or silence—that gives shape and meaning to the whole.
12. You don’t need a gratitude journal, just noticing one good thing before the day ends can help. At our family dinner table we ask our kids: “What was hard today? What was good today?”
13. Five minutes of meditation is enough. Researchers randomized 71 adults to 5 minutes, 20 minutes, or a control activity. The broader lesson from the research—many benefits were not strongly dependent on session length—consistency may matter more than doing long sessions.
Recovery Story
I met Amy Johnson at our Black Bear PT recovery tent at the Table Rock Ultra.
She had a remarkable recovery story:
A full-time working mom of two-year-old twins
Fractured her femur
Was non-weight bearing for 8 weeks
Consistently rehabbed her way back to her original form with strength training, patience, and grace
Never sacrificing her “more important roles” for running or recovery
It’s a wonderful story of a strong mother who put in consistent hard work to return to pain-free running better than she was before.
*I also love it because she gives away all my secrets for pain free running.
For Your Health
Medical-Literacy: When a headline says people who do X live longer, it doesn’t necessarily mean X caused the longer life. Those people may also exercise more, have higher incomes, sleep better, smoke less, have better access to healthcare—or simply be healthy enough to do X in the first place.
14. Get good by doing good. Among 2,856 participants, physical activity with volunteering was associated with less loneliness and mental distress and greater belonging, connectedness, and trust. Reach out to BeLoved Asheville to get involved in our community.
15. The medical world loves diagnoses and labels. But often, finding the mechanism is much more important.
16. On the flip side, don’t let the mechanistic story limit the possibilities. Outcomes are not always proof of a mechanistic narrative.
Comedy
“I used to play sports. Then I realized you can buy trophies. Now I am good at everything.” -Demetri Martin
Local Asheville Cartoonist, Mary Lawton, was featured in the New York Times. Congratulations Mary!
For Our Asheville Community
Nov 11-12 — Dorrance Dance
MacArthur Fellow Michelle Dorrance's acclaimed company turns tap dance into something halfway between dance, percussion and improvisational music.
Nov 14-15 — RADFest
The River Arts District's big two-day celebration includes local artists, live music, studio tours, food, a molten metal pour, block printing and other demonstrations. It was created in the aftermath of Helene and now celebrates the RAD's recovery and creative community.
Nov 20 — Cold Mountain Wolf Howl
A 21+ nighttime tour of the red and gray wolves paired with Highland Brewing's Cold Mountain beer at Friends of Western North Carolina Nature Center.
Nov 21 11am-3pm — Free PT @ Jus’ Running
Aaron will be at Jus’ Running the Saturday before the Turkey Trot offering free PT, manual therapy/stretching, running analysis and personal Q&A.
Thanksgiving Day Nov 26 (9:15am start-time) — Downtown Asheville Turkey Trot 5K
Burn off those Thanksgiving calories before you even sit down to dinner! Sign up for Asheville’s Original Turkey Trot—the biggest 5K of the year and a beloved local tradition. Don’t forget to dress up: we're awarding prizes for "Best Turkey" and "Best Group Costume"!
Etc.
17. Living Labyrinths brings together fungal biology, art, sound and cultural history—including Beatrix Potter's remarkably serious mycological work and a sound installation by musician Jason Singh made by recording electrical activity from fungi with biofeedback sensors and mapping those signals into sound.
18. Ants perform life saving amputations on each other? In the study, 13 of 17 ants with injuries to the femur underwent amputation. Our approach to femur injuries is a little more gentle…
19. Check out Biblio & Corian Concept’s new album Answers. It’s a “warmly melodic union of folk, electronica, and ambient.” Shame and Lichen Trip are stand outs for me. The whole album can also be used as a background to decorate time.
20. Why do flamingos dance while they eat? Scientists studied the ridiculous-looking foot stomping and head movements flamingos use around shallow water—and found the movements actually help stir up the small prey they're trying to capture. Sometimes evolution looks like choreography.
21. Sudden Shower over Shin-Ōhashi Bridge and Atake by Utagawa Hiroshige (1857) is a masterclass in capturing atmosphere, weather, and fleeting motion. Vincent van Gogh was so mesmerized by this specific print's striking composition and dynamic weather that he painted an exact copy in oil, Japonaiserie: Bridge in the Rain, in 1887.
Patient Success Story
Overcoming a Hamstring Injury Weeks Before a Race
Stacey sustained a hamstring injury weeks before her race.
Luckily, as a skilled yoga teacher, she already understood the mechanics of the injury. She modified her practice, avoided stretching, and stayed active. This was an essential part of her quick recovery.
She was feeling better after the evaluation. The specific hamstring loading and manual therapy had reduced the pain.
But it wasn’t until the second session when we discovered that activating her core abolished her hamstring pain with hip flexion.
Maybe this lack of core stability was “destabilizing” her pelvis and causing her synergistic core muscles (hamstrings) to have to work harder to compensate?
Regardless of the narrative—integrating core exercises into her hamstring exercises and hip flexion exercises led to an improvement of her movement and her symptoms.
With Stacey’s hard work and PT plan she was able to finish 3rd in her group at the race!
Congratulations Stacey!
And if you are looking for a yoga practitioner that understands injury, go to one of Stacey’s classes.
*from the first Recovery Story…there are no secrets to pain free running. It’s hard work, patience, persistence, and constantly showing up to do the boring things over and over again.
If you need any help with your pain, movement, or health, don’t hesitate to reach out.
Stay healthy,
Gaelyn and Aaron
Black Bear Physical Therapy
Email: bbearpt@gmail.com
Instagram: @bbearpt
Facebook: Black Bear PT