Golf balls and the feet- a quick update

In August, I became fascinated with using golf balls to release the fascia in my feet.  I discussed it in my blog here.  I have been using a small ball on my foot every evening, and can officially say it has definitely improved the way my feet feel.  They aren't tender at all, the intrinsic muscles seem to engage more easily during movement, and, considering that I am on my feet for hours every day, they feel great.  More interestingly, however, is how this has affected my clients' movement patterns.

Before I get too far ahead of myself, it is worthwhile to note some of the discussions that are taking place in the movement/rehabilitation world, specifically in regard to trigger point therapy.  In a fascinating blog by Diane Jacobs, she theorizes trigger points are actually neural in nature, rather than a structural issue, either fascial or muscular.  As a result, trigger points provide temporary relief via the CNS, but it's short lived.  I can get behind all of this.  We aren't changing or lengthening the fascia when we perform SMR or trigger point work.  We are providing a short moment of neurological change.  During this window, I would argue it's possible to invoke potentially more permanent change if the trigger point is biomechanical in nature, not the result of an internal issue such as a cyst or tumor.  If, for instance, we do trigger point work on our foot, mobilize the ankle, and begin working on short foot and better movement patterns in the lower limb, I don't think the trigger point will repeatedly return, especially if we are diligent with our training.  This is the general theory behind the NASM CES course which, while it has its flaws, in my opinion has some merit.

Now, back to my clients.  I have a client I have been working with for years who has trouble with back spasms.  Her hamstrings and foot complex have always been incredibly tight, no matter what I tried (and I tried it all.  Hamstring SMR, activating the tibialis anterior to release the calves, PNF on the hamstrings, etc).  I began using the "golf ball trick," in addition to short foot activation, single leg stance  with short foot activation, and diaphragmatic breathing.  Supine leg flexion is close to 90 degrees and her foot is incredibly normal, not internally rotated and slightly plantar flexed like it has been.  You might argue this was related to the breathing, and I think that played a role, but she says the trigger points in her foot are almost completely gone.  She actually looks forward to our barefoot work,and sometimes requests it at the beginning of our sessions.  I have another client who had low back surgery 11 months ago for a disc repair.  He has had trouble with tightness in his calves and hamstrings since prior to the surgery.  Again, I utilized a variety of techniques to improve mobility and function, but it wasn't until we added the trigger point work to his feet that he noticed substantial improvement in hip flexion and mobility while walking and jogging.  Maybe these are outliers, or maybe other factors are at play, but I will continue to use the golf ball trick on clients with trigger points in their feet.  Even if relief is short term in nature, the more tools I have to help people move better, the more likely they are to move more.

Yours in health and wellness,
Jenn

Mastery, boredom, and how to accomplish proficiency

I am completely fascinated by the subjects of mastery and expertise, both what it takes to become a master of a given movement or craft and how one becomes an expert in coaching/teaching the movement or craft.  The former is mysterious to me; I get bored relatively easily and wonder if I will ever truly master anything.  The latter, of course, is my profession and the more I learn, the more I realize how little I know.

When it comes to what it actually takes to become an expert at one thing, the research seems to be pretty clear.  Ericsoon, Krampe, and Tesch Romer (1993) established that expertise occurs after 10 years of intense practice or 10,000 hours, whichever comes first (Magill, 2011).  Intense practice consists of practice that is deliberate, or designed by a coach or teacher to address aspects of performance through repetition and refinement.  This is very different than simply going through the motions and is done in a mindful way.  All of this practice and refinement allows experts to process information differently.  Experts of specific skills recognize patterns more quickly.  This allows them to anticipate and act more quickly than non-experts.  Daniel Coyle discusses the concept of focused practice in his book "Talent Code."  Deliberate practice, or deep practice, as he refers to it, is focused.  This is accomplished by performing practice where mistakes are made, tending to the mistakes, and practicing again until it is performed correctly.  This, of course, means working slightly outside of one's comfort zone and perfecting something before moving on (interestingly, Ashtanga Yoga works much this way.  It is traditionally taught so that the teacher only gives the student one pose at a time.  The student doesn't receive the next posture, or asana, until the current asana is perfected.  The founder of Ashtanga, Pattahbi Jois, is known for saying it takes 7 years to perfect the first series.  This would be approximately 4000 hours of practice, not including immersion weekends, weeks, or months where more deep practice typically occurs.  I understand many of the martial arts are taught the same way, with black belt status usually taking about 10 years to complete).  This also requires the person performing the deep practice to be passionate about the skill.  Last summer, during a graduate school presentation by legendary running coach Dr. Jack Daniels, he said the hardest athletes to coach were the ones with the most talent and low internal drive.  Because things come easily to these athletes, they don't feel the need to participate in deep practice, relying instead on their innate talent.  This, of course, eventually leads to a person "not reaching his potential," with the less talented person participating in much more deep practice, analyzing his mistakes, and eventually realizing a more favorable outcome.

Research also shows that how the practice is performed can affect the outcome of learning.  Massed practice, or practice with little rest between sessions or trials, is less effective than distributed practice, or practice that is much shorter in length.  This prevents both physical and cognitive fatigue, leading to faster acquisition of the skill.  I use this often when I train; I introduce a movement that is challenging for someone at the beginning of the session.  The person inevitably struggles because it is new and more complex than what we had previously been doing.  We perform one set and move on to something else, coming back to it 10 minutes later after doing other movements or exercises.  The second set is almost always better than the first, and it's always fun to watch the surprise on the client's face when he realizes he is more successful the second time around.  Usually, after 2-3 weeks of interspersing the difficult movement into the routine, the movement is no longer intimidating or threatening for the client and progression can occur, in terms of load/reps/sets.  Grooving a movement pattern is a rewarding feeling, both for the client and for the trainer.

Movement is something we should all want to master.  This doesn't mean performing complex gymnastics routines or being an elite level athlete.  It simply means having a sense of mastery over what our bodies can do and regularly challenging it to perform in ways that require focus and practice.  As I mentioned earlier, I am prone to boredom.  As a result, I will probably never be an expert at any one yoga practice, or any one movement system, for that matter.  I have been running for 17 years, more than half of my life, and I certainly don't feel like an expert runner.  I am, however, in tune with my body.  I regularly challenge it to do things that are hard, and I practice until I can perform these things with some level of ease.  I am currently training for the MovNat level I certification.  One of the requirements involves hanging from a bar and pulling the body up using a leg, elbows, and arms.  Two months ago, hanging from a bar for longer than 15 seconds was really challenging for me, let along actually performing the movement.  I began practicing the movement 4 times a week, sporadically throughout the day, about 10 minutes each day.  Now, I can get up easily with my right leg; my left leg isn't quite as smooth, but considering I couldn't get up using my left leg at all 8 weeks ago, I am pleased with the progress.  I think we are generally scared of things we can't do physically and instead of picking small challenges and working on them in a focused manner, we practice avoidance.  Instead of masters of our bodies, we are merely inhabiting them, allowing them to dictate what we "can" and "can't" do.  In order to maintain function and ability, we have to change the way we look at physical challenges and aspire to a sense of physical expertise.  Rather than shy away from physical challenges, we should embrace them, remembering that with deep practice, what is a physical challenge today won't be in a month.  And even if it still is in a month, that doesn't mean that one day, with focus and determination, it won't be accomplished.

Yours in health and wellness,
Jenn

Magill, R.A., (2011).  Motor Learning and Control, ninth edition.  McGraw-Hill: New York.
Coyle, D., (2009).  The Talent Code.  Bantam: New York.

How DNS changed my yoga practice (and my running)

In November, I had the opportunity to take the second part of the DNS sport course.  I reviewed DNS I in an earlier post, and was thrilled to have the opportunity to not only learn from Zuzana again, but to take a private with her.  I was coming off of a self imposed 30 days of yoga, 1/2 marathon training, with some biking and weight training thrown in for good measure.  An old hamstring injury flared up in the midst of all of this and I was hoping Zuzana could provide some insight into changing my mechanics.  I, of course, thought I was in pretty good shape with perhaps some minor tweaking needed. During our private session, my tendency towards an inspiratory breathing pattern became quite apparent, along with my lack of lateral hip stability.  Both of these things were negatively affecting my spinal position during physical activity.  Over the course of the weekend, proper breathing patterns were continually emphasized during higher level positions, as well as eccentrically working the gluteus medius and integrating it with proper foot function (i.e. maintaining a short foot).  A video of Zuzana explaining proper breathing technique can be found here: http://www.youtube.com/watch?v=-7UJPm1hBEo

The fascinating thing about all of this was how much an inspiratory breathing position can affect spinal position and how much that affects pelvic position during movement.  Not only is spinal position impacted by breathing, the muscles of respiration, including the serratus anterior and transverse abdominis, are also important spinal stabilizers.  Blandine Calais-Germain points out in her book "Anatomy of Breathing" the serratus anterior is a powerful inspiratory muscle that does not involve the neck.  Rather, it has a strong rib cage posture which serves as the base for the neck region.  It is also an extremely important stabilizer of the scapula.  One of the rationales behind maintaining a good breathing position is this allows proper shoulder blade positioning and therefore proper shoulder stabilization.  Another important aspect of proper breathing which has strongly influenced how I move is the relationship between the diaphragm and the psoas.  In a review by Buchholz (1995), Elsa Gindler's work on the function of the diaphragm is discussed, including the fact that the diaphragm properly lowers only if both the psoas major and minor and the hip joints allow free leg-movement and low back flexibility.  Additionally, Page, Frank, and Lardnor (2010) point out spinal stabilization occurs if the transverse abdomens, multifidus, diaphragm, and pelvic floor co-activate for both trunk stability and force transmission.  Weakness in the pelvic chain can lead to dysfunction elsewhere, including low back pain, IT band syndrome, anterior knee pain, ACL tears, and ankle sprains.

So what does this all have to do with running gait and hamstring injuries?  By using primarily a chest breathing pattern, I was not properly stabilizing my pelvis.  To compensate for my lack of spinal stability, I learned to accomplish hip extension by anteriorly tilting my pelvis.  This, of course, shortened my psoas, turned off my poor gluteus maximus, and caused the rest of my posterior chain (calves and hamstrings) to go into overdrive leading to the appearance of the old hamstring injury.  Two fascinating things have happened since I have adopted a better breathing strategy.  The first is that my running stride has improved.  When I catch sight of myself in windows, I am no longer arching my back.  I am able to breathe into my belly as I run and my posture is much better.  The combination of better breathing, improved spine position, and active release therapy on my hamstring has resulted in no more hamstring pain.  The second thing that has happened is I no longer feel any lumbar spine compression when I practice yoga.  I have always had too much mobility in my lumbar spine.  My solution has always been to draw my belly button in to activate my transverse abdominis.  It turns out drawing in the naval doesn't activate the TrA, but breathing diaphragmatically does.  This has made a huge difference in how my back bends feel and I suddenly understand why the inhale always happens while moving away from the earth- to stabilize the spine.  Mark Stephens wrote a really interesting blog that discusses engagement of Uddiyana Bandha which can be found here: http://www.markstephensyoga.com/blog/mula-bandha-uddiyana-bandha.  He essentially says we want a relaxed belly during practice, not a contracted one.  While it has been really hard for me to throw out years of "engage Uddiyana Bandha.  Pull the navel towards the spine," the elimination of discomfort in the lower back and the improvement in my thoracic extension has been rather extraordinary.

One last note is much of the positioning of the spine and ribcage comes not from a pelvic tilt, but from a dropping of the ribcage.  This can be difficult to understand at first and, while it is a subtle distinction, it is an important one.  Dropping the ribs flattens the lumbar curve by using thoracic mobility, not lumbar mobility.  This allows spinal stabilization to occur and does not compress the lumbar vertebrae.  I do think this is what has made a huge difference in how my backbends feel and present themselves.  It is also what I focus on while running to maintain a proper pelvic positioning.  Years ago, when I read Chi Running by Danny Dryer, I couldn't figure out why he wanted people to pretend like they were hugging a big ball before they began running.  In retrospect, I see it accomplishes the same spinal position in a different way.

If you are interested in more reading on this topic, "Anatomy of Breathing" does a really nice job explaining the breath in a not overly technical way.  Sue Falsone's Movement Lecture on the thoracic spine also does an excellent job explaining the role of breathing in spinal stability.

Yours in health and wellness,
Jenn

Calais-Germain, B., (2006).  Anatomy of Breathing, Eastland Press: Seattle.
Buccholz, I., (1994).  Breathing, voice, and movement therapy: applications to breathing disorders.  Biofeedback Self Regulation, 19(2), pp. 141-153.
Page, P., Frank, C.C., & Lardner, R., (2010).  Assessment and Treatment of Muscle Imbalance.  Human Kinetics: Illinois.

V-Core instructor training and why runners should do things barefoot

Last week, I had the privilege of taking a V-Core certification class with Dr. Emily Splichal. Dr. Emily is a podiatrist in NY who introduced me to the golf ball technique I discussed here and whose guest blog can be found here.  She advocates barefoot training as a way to improve foot stability, mobility, and integrate hip and foot function.  She believes in an evidence based approach to programming and selects exercises based on their proven effectiveness, rather than simply because it "looks" cool.  She is an excellent teacher and a thorough lecturer.  By the end of the 6 hour workshop when we were reviewing anatomy, I found myself thinking, "of course the gastrocnemius and the peroneals concentrically evert and plantarflex while the soleus and its best friend the posterior tibialis plantar flex and invert and it only makes sense that at initial contact the foot is rigid, becomes flexible (pronates) and then becomes rigid ago for toe off.  Why didn't anyone else ever explain it this way?"  The workout was challenging, and by the second workout, I noticed some other participants fighting fatigue (lack of gluteus medius control during dynamic balance exercises, difficulty balancing as effectively), but that's to be expected at the end of a long day.  The sequencing was well thought out.  I found myself repeatedly thinking how good this style of training would be for runners.  Not only was the workout performed barefoot without socks to optimize feedback from the ground, the movements are sequenced so that there is a gradual build in difficulty without some of the masochism often found in a group exercise setting (the "we will do this until we are all dying" approach).  If I were teaching this to runners, I would integrate diaphragmatic breath with an emphasis on neutral pelvic alignment to bring a little more awareness to the LPHC, but this was a foot workshop focusing on foot mechanics, so that is simply a personal preference.

There is this fascinating thing that runners do when they take up exercise programs.  They exercise with shoes on and they often choose exercises that are done in a seated position or on 2 legs.  Running, of course, is an activity that takes place entirely while standing and on one leg; as a result, I have always felt it is important for runners to incorporate single leg training into their routines.  An interesting journal article by Barr and Harrast (2005) points out 40-50% of all running injuries take place below the knee and foot problems are the most common injuries reported by marathon runners.  What this says to me is that runners need to strengthen the foot and ankle complex as part of their movement regimen.  Performing exercises while maintaining a short foot, for example, is a great way to begin to re-establish the neuromuscular control necessary for proper gait mechanics.  This, along with improving ankle dorsiflexion, can begin to combat the risk of plantar fasciitis; Barr and Harrast state runners with ankle dorsiflexion of 6-10 degrees have a 2.9 odds ratio of developing plantar fasciitis while runners who had 0 degrees or less of ankle dorsiflexion have an odds ratio of 23.3.  This is a substantial difference, and one that should be considered when developing strength and mobility programs for runners.  Further up the kinetic chain, these factors can contribute to anterior pelvic tilt, lack of hip control, and excessive knee movement in the frontal plane.  Runners need to perform movements that integrate foot and hip function and emphasize proper mechanics all of the way up into the pelvis and lumbar spine.  Another point Dr. Emily made during the V-Core workshop which also applies to running gait is there needs to be a focus on eccentric control, rather than simply focusing on concentric contraction.  Functionally, decelerating motion is critical for proper stabilization patterns during gait mechanics.  This is why things such as hopping can be so good for runners- proper landing technique requires eccentric control of the lower limb muscles.  She integrated some single leg hops and plie hops that were low impact and felt safe, even in a group setting.  Runners would benefit greatly from integrating some of these gentle plyometrics into their programs.

I would highly recommend taking one of Dr. Emily's workshops if you are at all interested in gait mechanics, integrated barefoot training, and understanding the impact of the foot on the rest of the kinetic chain.  If you are a runner and there is a V-Core class near you, it would be highly worth your time to incorporate this into your training program.  I strongly believe that runners need to do more than just run (especially if they are sitting most of the day) to maintain joint mobility and prevent injury.  If there isn't a V-Core class near you, take your shoes off and, if you are without an arch, try to activate the muscles that lift the arch of the foot away from the floor.  Try to perform some exercises in this position, such as lunging, single leg squats, single leg deadlifts, etc.  Notice how this makes your hips feel and focus on using perfect form with each repetition.  Your running stride will thank you for it.

Yours in health and wellness,
Jenn

Barr, K. P., & Harrast, M.A., (2005).  Evidence-based treatment of foot and ankle injuries in runners.  Physical Medicine and and Rehabilitation Clinics in North America, 16, pp. 779-799.

Running, hip mobility, and the importance of stabilization

One aspect of running gait which has been getting quite a bit of attention lately is the hips, specifically what role they play in sending a person forward.  There are many muscles in the hip, a mobile joint designed to move in the sagittal, frontal, and transverse planes.  The hip and shoulder are designed to function similarly (internally and externally rotate, flex and extend) and the anatomy of the two joints is also similar.  The hip has 6 muscles that function much like the rotator cuff.  The deep 6 muscles of the hip (piriformis, gemellus superior, gemellus inferior, obturator internus, obturator externus, and quadratus femoris) are considered part of the local muscle system, which stabilizes the hip in the femoracetabular joint (Osar, 2012).  The psoas major, minor, pelvic floor, and deep fibers of the gluteus maximus also contribute to hip stabilization, although the deep 6 function primarily to maintain joint centration during rotation.  As we move superficially, the global muscle system, or the muscles that are primarily responsible for movement, can be found.  These include the superficial fibers of the gluteus maximus, gluteus medius, hamstring complex, quadriceps, TFL, adductor complex, and sartorius.  The fibers from the TFL and gluteus maximus joint together to form the IT band, which assists in abduction and internal rotation (Behnke, 2006).  While we consider the hip joint a "mobile" joint, a lot has to happen to maintain stability and throughout movement and gait mechanics.  For instance, if the gluteus medius, which functionally controls hip adduction, isn't firing properly during gait mechanics, the IT band picks up the slack.  This leads to increased knee adduction during running gait and can be a source of knee pain.  In a study performed by Wilson, Kernozek, Arndt, Reznichek, and Straker (2011), the running gait of 20 females without patellofemoral pain (PFP) was compared to the running gait of 20 females with patellofemoral pain (PFP).    EMG analysis revealed gluteus medius activation was delayed and shorter in the PFP group.  Late gluteus medius and maximus onset also correlated to increased hip adduction and internal rotation.  Runners with tight hip flexors have an extremely difficult time extending the hip with a neutral back (Dicharry, 2012).  This not only limits hip mobility, it leads to inhibition of the gluteus maximus which, as seen above can lead to knee instability.

So, what does all of this mean and what can we do about it?  Designing a focused strength and mobility program that emphasizes maintaining knee control during movement in multiple planes and hip mobility while strengthening the hip external rotators and gluteus maximus is a great place to start.  When designing a program, either for yourself or someone, it is important to look at the person's current form during movement, then choose movements to improve function where there is dysfunction, and finally, make sure the movement is executed with quality.  These three things, form, function, and quality, are the pillars of improving moving patterns and enhancing movement function.

Below is a sequence I frequently use to work hip mobility and strength.  If you try it, focus on maintaining proper knee alignment by not letting it collapse.  Also, think about maintaining a neutral spine and letting all of the movement come from the hips.  I usually do 10 per side and switch.  It's a great dynamic primer for more complex movements.

Yours in health and wellness,
Jenn

Osar, E., (2012).  Corrective Exercise Solutions to Common Hip and Shoulder Dysfunction.  On Target Publications: Santa Cruz.
Behnke, R.S., (2006).  Kinetic Anatomy, Second Edition.  Human Kinetics: Champaign.
Wilson, J.D., Kernozek, T.W., Arndt, R.L., Reznichek, D.A., Straker, S., (2011).  Gluteal muscle activation in females with and without patellofemoral pain syndrome.  Clinical Biomechanics, 26(7), pp. 735-740.
Dicharry, J., (2012).  Anatomy for Runners.  Skyhorse Publishing: New York.

Foot Function & Kinetic Transfer- a guest blog by Dr. Emily Splichal

I am excited to share that this week's post is written by educator, podiatrist, and founder of the Evidence Based Fitness Academy (EBFA) Dr. Emily Splichal.  Dr. Emily is also the creator of both the internationally recognized Barefoot Training Specialist Certification and the V-Core certification, a barefoot training workout that emphasizes functionally training the core with specific exercises.  To find out more about Dr. Emily or to check out some of her workshops, visit her website at http://evidencebasedfitnessacademy.com.  Enjoy!

Foot Function & Kinetic Transfer:

With foot fitness and barefoot training concepts at the forefront of athletic performance and fitness programming – how often do you assess your client’s feet?   

One of the most important roles the human foot plays in human movement is in the transfer or unloading of kinetic energy and power!   

The secret to the unleashing of this kinetic energy and power – is supination & pronation. 

When it comes to foot function – or shall I say dysfunction – over-pronation gets the most attention.  Excess mobility or lack of foot strength can lead to excess strain on tendons and ligaments of the foot, knees and hips, leading to over-recruitment of large global muscles to stabilize.   

Let’s take a moment and look at the opposite – lack of foot mobility or over-supination.

Can this be just as harmful?  

If a foot has a limited ability to pronate (or load) how does this impact kinetic transfer and power output?

To fully understand kinetic transfer in the foot, we must also understand that the foot is greatly influenced by the hips – and therefore we cannot address foot dysfunction without integrating hip mobilization!

How is the foot influenced by the hip?

Formed by the femur proximally, the movements of the hip that impact the foot the greatest are in the transverse plane – these are internal rotation & external rotation.   

These transverse plane movements of the hip are transferred distally through the tibia which will influence the foot in the frontal plane.   Tibial movements are able to influence the foot through its direct contact with the talus.  

Talar movements are then translated plantarly to the heel bone (calcaneus) and distally to the midfoot (navicular), causing the foot to either supinate or pronate.   When assessing for integrated foot mechanics, just remember that hip internal rotation is associated with foot pronation – and hip external rotation is associated with footsupination.  

Hip mobility and foot function

If you have a client or athlete with an over-supinated or inverted foot type, you will want to assess their ability to internally rotate the hips.   Often times, I find athletes with a history of stress fractures, plantar fasciitis and tendonitis have restricted hip mobility.   

If this is the case, hip mobilization is key to achieving optimal foot function, foot mobilization and kinetic transfer with each step!   I integrate piriformis, glutes, TFL, lateral hamstrings, and adductor stretces in all planes.  

Empowered YOUth- a book review

I was contacted recently by the Youth Wellness Network to review a book written by its founder, Michael Eisen, and his father, Jeffrey Eisen.  While I feel strongly about youth wellness, it's not my normal area of expertise.  After reading about the organization and Michael, I decided it would both be fun and potentially informative (more information about the Youth Wellness Network can be found here: http://youthwellnessnetwork.ca).  I was pleasantly surprised by a book that, while written primarily for young adults and their parents, should be read by anyone wanting to make changes in their lives.

Empowered YOUth tells the story of two very different individuals.  Jeffrey was born in the 1950s and desperately sought his father's approval.  He was driven, closed off emotionally, and goal oriented.  The stress he placed on himself to succeed led to anxiety, GI issues, and pent up emotions.  As he began to achieve major successes in the business world, he focused solely on his next major accomplishment, never appreciating what he had already achieved or being present for his three children.  This lead to physical problems (he continued to suffer from both GI problems as well as Crohn's disease), and a tumultuous relationship with his youngest son, Michael.

Michael, unlike his father, was an extremely sensitive child who was rather uninterested in pleasing the adults in his life.  As a young child, he earned the reputation of being "spirited" and "challenging."  He never really fit in as an adolescent until he discovered his love of basketball could also be a way to be accepted by others.  However, rather than continuing to enjoy the sense of being in the moment basketball originally gave him, he became fixated on earning the most points each game and proving his prowess on the court.  This eventually takes away from the magic the game once held for him and results in the game becoming a goal oriented, rather than process oriented, endeavor.  One of the themes that runs throughout Michael's first 20 years of life is his need to blame others for things that happened to him, instead of focusing on how he chose to respond to difficult situations.

When Jeffrey is in his mid-fifties, he realized his business successes weren't fulfilling him.  He felt something was missing, and stumbled upon life coaching as a way to both give back and improve himself.  During this time, Michael floundered at University, attempting to figure out his path.  Through the suggestion of Allan, Michael's older brother, Michael began to be coached by his dad.  As their previously strained relationship begins to improve, both Michael and Jeffrey experience important changes in their outlooks, goals, and attitudes towards life.

One of the themes that ran continuously throughout the book as a way to become empowered was the concept of mindfulness.  Mindfulness, as defined by www.psychologytoday.com, is "a state of active, open attention on the present.  When you're mindful, you observe your thoughts and feelings from a distance, without judging them good or bad."  This is an extremely valuable tool and one which can be difficult as a young person to grasp.  When I was an adolescent, one of the adults in my life (I can't remember which one) gave me the copy of a speech entitled "Attitude."  I read it often and while I couldn't always fully grasp the meaning behind the author's words, the last line impacted me greatly.  It stated, "I am convinced that life is 10% what happens to me and 90% how I react to it.  And so it is with you...we are in charge of our attitudes," (Charles Swindoll).  Though I didn't realize it at the time, this tool of simply recognizing my reactions helped me deal in a much more positive way with difficult issues in my life.  Being a teenager is a very self absorbed time, where everything that happens is viewed from the eyes of "how does this impact me."  That tends to be the place we react from, which leads to much more emotional responses as a young person than is necessary.  Those who learn to internalize their responses often end up sick, as represented by Jeffrey in the book.  Being in the moment and understanding the control we have over how we respond enables us to both deal with the difficult situation at hand and not over react.  One of the things that helps tremendously with this is exercise.  Sports is such a wonderful outlet for emotion and allows us to be calmer in the moment.  Dr. John Ratey's book "Spark" does an excellent job explaining the psychological benefits of exercise, particularly on mood.  One point he makes which is also made by the Eisens, is that exercise should be mindful.  We need to be present while we exercise, aware of what we are doing, focused on how we are feeling in that instant, rather than putting on headphones, watching TV, and going through the motions.  Viewing exercise as a skill is helpful with this, and finding a type of exercise that one actually enjoys is also helpful, rather than perceiving it as a chore, a drudgery that must be done because it is "good for me."  Yoga, martial arts, learning a sport, powerlifting, running, a well designed complex functional training program, all of these are movement skills that can and should be performed with a level of mindfulness and attention that have benefits reaching far beyond just the physical.

I would highly recommend Empowered Youth not just to adolescents and young adults, but to their parents, teachers, and people who want a better understanding of how their actions impact themselves and others.  Empowered Youth can be purchased at Amazon (follow link here).

Yours in health and wellness,
Jenn