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3 Steps to Healthy, Happier Joints

Creating healthy joints in our bodies takes a multi-faceted approach. Do you know what the three most important factors are for joint health that we can influence with our own lifestyle behavior choices? The most significant impacts we have control over for our joints are diet, supplements, and exercise. The runner ups in fourth and fifth that also need to be mentioned here are our body weight and both the volume and intensity of movement we do daily. As an exercise specialist with twenty years’ experience working with knee and hip aches and joint replacement clients, I am going to share with you exercise tips for optimal joint health.

What is the best exercise for joint health?

The number one form of exercise for joint health that provides the most relief from stiff joints is cardiovascular exercise. When I say cardiovascular exercise, I am describing an activity that raises your heart rate with dynamic movement over a consistent period of time. Not just any aerobic exercise will do though, it is important you choose consciously for your conditioning and discomfort level. If you have knee or hip discomfort or aches in these joints, the best cardiovascular exercise options are ones that are non-weight bearing and that take the joint through a good range of motion. Stationary cycling, aquasize, rowing, and elliptical trainers are all good choices.

img_couple_walkingWalking is a fabulous exercise and if you love the outdoors, keep it up, but do pay attention to if the aches in your joints is limiting your distance or decreasing the time you can walk. Your joint aches and stiffness may also be slowing you down thereby decreasing your ability to get a great cardiovascular workout. One option, that I am a huge fan of that actually decreases the load on your joints while you walk, is pole walking. You can learn more here.

How Strength Exercise Helps Knee and Hip Joint Aches

It was a tough call to say cardiovascular exercise is number one as I have seen firsthand the incredible benefits strength exercises give to people with joint discomfort and how much improvement people have with everyday activities by simply doing a few of them. In fact the only reason cardiovascular exercise would take precedence, is it is usually easier for people to do on a daily basis.

Now when you hear strength, you may be thinking about some of those high intensity, hard strength exercises you see men do in the gym. The good news is those are not the type of strength exercises you need or what are recommended. Instead there are specific strength exercises that will actually help stabilize and absorb shock for the joint. The type of strength exercises that are best for anyone with joint aches and stiffness are muscular endurance exercises which is a strength exercise at an intensity that you can do at least 12 to 15 repetitions. Now the specific exercises you need depend on whether your focus is the knee or hip. The quadriceps muscle is absolutely the number one muscle to strengthen for knee aches and the gluteal or seat muscles are a focus for hip joint aches. The most important thing to realize here is that when you do strength exercises for your joints, you are building a fortress of support, stabilization, and protection around it which can decrease aches and increase functional ability in everyday activities. Below are a few exercises to strengthen the knee and hip joint:

The VMO Quadricep Muscle for Knee Strength & Extension:

  1. Use a Circle Foam Roller or hard couch pillows & a small squishy firm ball (kids or dollar store)
  2. Place the foam roller above your knee under both legs and the ball slightly above knee as well
  3. Flex one ankle of the active leg, toes up to ceiling and straighten the knee joint as you squeeze the ball and straighten the knee joint contracting the quadriceps muscle
  4. Hold this position for a count of 3 to 5 seconds maintaining the ball squeeze, lower, & repeat
  5. Do 12-15 repetitions each leg and 1-2 sets twice a week








Go here to see a Video of this exercise

Gluteus Medius Muscle Clam Shell Strength Exercise for Hip Aches and Discomfort:

  1. Lie on your side and line up your head, hips, and feet with knees bent in front at about 45 degrees, slightly tilt your body forward
  2. Place hand in front for balance or on hips, then draw your belly button to spine and lift top knee
  3. The trick here is to life from your hip, not push with your feet and to focus on feeling the muscle at the side of your hip
  4. Lift at a controlled speed, hold up for a count of three and lower gently, make sure your back does not roll back and the hips stay stacked and anchored so only the knee and hip move
  5. Do 12-15 repetitions and 1-2 sets each leg

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Go here to see a Video of this exercise:

You will notice that in both of the above strength exercises that they are non weight bearing which takes the load off of the joint; this is great for people with stiffness and discomfort in their knee and hip or experiencing aches in their joints as the low load still allows you to build strength and stability for your joint. Also, it is really important for people to work their joints through their greatest ache free range of motion. You will see in the above exercises, they both allow the joint to be move through its natural range.

Range of motion exercises are very important for people with stiffness and aches in their knee and hip.

The arthritic knee needs both flexion and extension range of motion exercises. You can view a sample of a knee flexion exercise in the video below that does wonders for loosening a stiff knee joint.

Knee Range of Motion Exercise for Flexion:

The arthritic hip needs extension and abduction exercises and depending on aches, where the incision will be during surgery, and muscle tightness, it may also require flexion and adduction exercises. Below you can view a sample hip extension exercise which feels great.

Hip Range of Motion Exercise Bridge Lift:

Lastly it is crucial you know that volume or the amount of activity you do can be detrimental to your joint health. Ironically, the adverse effects of the volume of activity you do fall on both ends of the spectrum; this means that if you do too little activity, your joint will remain stiff, weak, and will also lack flow of nutrients required for healing. On the other hand, if you do too much not just in one workout, but for the entire day, it will increase inflammation and discomfort. Make sure to find the right balance for your body and to not overdo it. You will need rest days!

There you have the exercise tips for healthy joints, now you can combine them with your diet and supplements to keep moving freely and living your best quality of life.

To learn more about hip and knee exercises or to receive a complete exercise program for hip and knee replacement pre and post operation visit or


Jody Kennett is an ACE Certified Medical Exercise Specialist with a diploma in Kinesiology from SFU. She is the creator of the Hip Replacement and Knee Replacement Exercise Programs which were developed from teaching the ‘gold standard’ Joint Replacement Class for 15 years. The unique class helped hundreds of clients prepare and recover from knee and hip replacement and improve their quality of life. She packaged the successful exercise program into an online Ebook & Video for people around the world to benefit from the proven system they developed and it has now circled the globe making stronger joints around the world! For more information and to learn about the complete exercise program visit: and

Italy 5-0, Adventure Travel at Any Age

Cheryl and TerryI just recently finished a two-week trip to Italy – it was my “wish” for my 50th birthday, and what a birthday it was!

It was what they call a “Self guided” Walking tour and four of us set off for a wonderful adventure in a beautiful country.

Four days in Rome and then eight days hiking the Amalfi coast, visiting Mt Vesuvius and the ruins of Pompeii…it was incredible!

On the plane home my husband and I were re-living the adventure, chatting about the people we met on foot walking from town to town, and the exercise we got and how great we felt even though we had enjoyed all the food and wine that Italy is famous for. And it hit me that pretty much 90% of my vacations are what I call “fitness vacations”, hiking, biking, walking and more often then not, coming home feeling better than I did when I left.

And when I look back and really I am not sure which came first…the importance of fitness and the ability to pursue physically active trips or the desire to do those types of trips prompted me to maintain a certain level of fitness in my life.

But either way, I cannot imagine a holiday without the physical aspect of being able to walk for hours on end, explore villages, immerse myself in the culture, take time to understand the history, meet the local people along the way and stop as long as I like to take in the incredible scenery and be “in the moment”.

In Rome we chose guided “walking tours”. They were 4-5 hours a day, exploring Rome, discovering the hidden gems, walking up to the coliseum, Pantheon, Vatican city and the Spanish steps.

Then we headed to the Amalfi coast, where we trekked from town to town. We started in the town of Amalfi then onto Praiano, Santa Agata, & Sorrento.

We covered 85 Km in distance and almost 14,000 feet in elevation gain – there is lots of “up” on the Amalfi Coast, plus wild mountains – old fishing towns tumbling down to the water’s edge. Spectacular paths with views for miles. Bathing in little coves. This was a truly multigraded walk for the hardy strider.

Our route shows both faces of the peninsula – the craggy scenery of the eastern (Amalfi) end and the more accessible charms of the western tip.

Cheryl hikingOur final day was spent hiking a stretch to the top of Mt Vesuvius and wandering thru the ruins of Pompeii.

This is the best of both worlds…enjoying all the opportunities that come my way, and at the same time improving my fitness, immersing myself in the culture, seeing first hand the historic sites and just exploring this world – on foot, because I am able to.

So even though a big part of my job these days involves sitting in a booth as an analyst with TSN covering curling– I will work hard to maintain my fitness while I am on the road. I have multiple yoga apps on my iPad, I try to stay in hotels with a gym, and I continue to take the supplement that will allow me to maintain my joint health and mobility – SierraSil Joint Formula 14.

Well, time to get back to researching the best hikes in the world and my next adventure for 2017!

Happy Trails!

The Benefits of Exercise on Joint Health

If you suffer from joint pain, exercising can be difficult. Some think exercising increases pain and it’s best to avoid putting any additional pressure on the joints. But the opposite is true. If you don’t use it, you lose it. Exercising can help ease stiffness, improve joint movement, strengthen muscles and maintain bone density. Even slight movements can help pump the blood to the joints, lubricate the joints and strengthen the muscles to protect the joints. When you don’t work out, that is when the pain increases and arthritis worsens. However, keep in mind that prolonged and intense workouts may worsen the pain and inflammation.

When implementing a regular exercise regimen, avoid strenuous activity, listen to your body and incorporate light activities. If you are just starting out, aquatic exercises may be a great place to start. Aquatic workouts help relieve pressure of your body’s weight on the affected joints, while providing resistance for your muscles to get stronger. You can even do aquatic exercise if you don’t know how to swim. Other light activities may include jogging, walking, light weights and stretching (yoga, Pilates, or Tai Chi). If you are uncertain which type of exercise is best for you, consult with your health care provider.

How to Stay Motivated

When choosing an exercise routine, focus on activities that you find enjoyable. This could include walking to the grocery store, biking in the park or gardening. If you don’t know what you might enjoy, start small and try a variety of activities.

If you find it hard to stay motivated, make exercising a social activity. Joining an aquatic fitness program or going for a walk with a friend can motivate you to stick to your exercise routine.

Another way to stay motivated is to set realistic goals. Schedule exercise when you are at your highest energy level for 20-30 minutes, 3 times a week. If you are just starting, plan a 10 to 15 minute workout and gradually increase the length of time once you’ve become accustom to your routine.

Supplementing for Joint Health

Taking health supplements for joint health is just as important as exercising. As you age, joints and muscles are not as resilient and may require more time for recovery post-workout. For your muscles to work efficiently and to replenish the loss of minerals during your work out, certain nutrients are vital. SierraSil, a Kosher certified and active ingredient in SierraSil Joint Formula14, contains minerals in a rich clay structure that eases joint and muscles aches, reduces stiffness and helps prevent cartilage breakdown associate with exercise and movement. Many professional athletes have reported increased performance and decreased recovery times using SierraSil.

Other benefits of exercise

Exercising has proven mental and emotional benefits from reducing the impact of stress to regulating your sleep patterns to boosting your immune system. Even after a short burst of exercise, you’ll feel more confident and energized.

With the right exercise program, you can conquer your joint pain and inflammation one workout at a time. It is never too late to incorporate a little movement in your daily routine for a more thriving and pain free life.

By: Justyna Zarzeczny. For more health and wellness articles by Justyna please visit her blog at

Video Blog: Caroline Berry on why anti-inflammatory diets are great for joint health and mobility

Video Transcript

Hi, my name is Carolyn Berry and I’m a registered dietitian here in Vancouver BC. I am passionate about being a dietitian because I feel there is so much information going around about nutrition.  There’s lots of myths and I really like to debunk those myths. I think that’s really important.

I do work in a hospital. I work in a private clinic and I also have my own private practice called Berry Nourished. My website is I feature lots of different recipes on my website, so really easy to make, simple ingredients. I’m also very active. I run marathons and I like to help people basically learn how to eat and be fit at the same time. When it comes to eating organic foods we really need to weigh out the costs versus the health benefit of the organic food.

We do know that organic foods have a lower amount of pesticides than non organic foods. However, they are quite expensive. A rule that I like to go by is the dirty dozen versus the clean 15. That’s something that you can look up to see the entire list but just to give you an example, the dirty dozen would include apples, nectarines, grapes, spinach. Those are things if you are going to buy organic, I would spend your money on the more pesticide dirty dozen. The clean 15 would include things like onions, cabbage, cantaloupe. If you think about cantaloupe, it has a really thick skin so you’re not eating the skin, right, so that’s a bit of a cleaner fruit in terms of pesticides.

Inflammation is at the root of a lot of illnesses and there’s things that we can do in our diets to help. One of the things would be increasing Omega 3 fats. Omega 3 fats are found in cold water fatty fish, so examples would be salmon, trout, herring, mackerel, sardines. Plant sources of Omega 3 would be ground flax seeds, chia seeds, walnuts, canola oil. We really want to increase our intake of these Omega 3 fats. They are anti-inflammatory. On the other hand, we have Omega 6 fats and Omega 6 fats are found in a lot of those really light tasting oils that are used in a lot of processed foods. For example, sunflower oil, safflower oil, soy bean oil. Companies are using those oils because they’re cheap to produce. They’re putting them in cookies, crackers, baked goods. A lot of those processed foods that we’re eating so as a result, in our North American diets, we get a lot of Omega 6 fats. We actually want to be achieving a ratio of Omega 6 to Omega 3 of 4 to 1. 4 Omega 6 to one Omega 3. Unfortunately in North America our ratio is more like 15 to 1 so we have a lot of Omega 6 in our diets. We want to work on cutting down the Omega 6 and replacing those with more Omega 3 fats.

As someone who’s complete 4 marathons I do think that eating an anti-inflammatory diet is really really important, because we put so much strain on our joints and anti-inflammatory foods can really help with that. One of the things would be eating lots of fruits and veggies. I know that this is something that we’re always preaching about but it’s so so important. Fruits and vegetables have a high amount of antioxidants which can help combat inflammation. Another big one would be minimizing those refined carbohydrates, so the white pastas, the white rice. We want to try and switch those to the whole grain version. Whole wheat pasta, whole grain rice, quinoa, etc.

Another big one would be saturated fats and trans fats. Saturated fats and trans fats start the promotion of the inflammatory process in the body. It’s okay to have some saturated fats but we want to do is try and eat more of the healthy unsaturated fats. When it comes to choosing meats, minimize your red meat intake a little bit. Choose more poultry, skinless poultry, fish, high in Omega 3s. Those are better choices. Also the pulses, so the dried beans, peas and lentils. Choose more of those vegetarian proteins as well, incorporate that into your diet. Another big one is stay away from those sugar sweetened beverages. It’s okay to have them once in a while but they spike your blood sugars and that causes inflammation. Bottom line, try and eat fresh foods and minimize any processed foods, always go for the fresh whole food.

When it comes to supplementation, as a dietitian, I’m all about foods before supplements. That being said, there are some nutrients that we don’t always get enough of in our diets. One big one would be vitamin D. We do get vitamin D from the sun. We also get it from milk products, from fish, from eggs, but we tend to not get quite as much as we need. Vitamin D is anti-inflammatory. I recommend taking an additional supplement. That would be about a 1,000 IU per day. Then Omega 3s would be another supplement that you might want to consider taking. If you’re not getting those 2 servings of fatty fish a week, so your salmon, your trout, your sardines, if you’re not getting 2 servings a week, I would suggest an additional Omega 3 supplement, about 500 mg of Omega 3 per day.

Video Blog: Dr. Jack Taunton talks sports medicine

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The passion that I have for sports medicine has been there for a long time. As a young child, grade one, I had polio and I went through extensive rehabilitation. Then just as I was getting over that into junior high school, I got hit by a car and had a fractured dislocation of an ankle and I was in a cast for 32 weeks and went through a lot of rehabilitation. My friends were athletes. My friends were successful. I equated being an athlete and being successful as one and I was neither, so that I had a passion to get better, to thank the people that helped me and to be able to get into a running program, getting into a cycling program, a program that would allow me to catch up to my friends and get better than them.

My big passion was to make a major games which most people would laugh about. The question is in terms of the work with sports medicine and how much work does an athlete require. Sports medicine is now been recognized as a true specialty in sports medicine that’s just been … They’ve gone through a whole process. They’ve just now started to announce the ones in Canada that have now got this specialty and I was very, very lucky to get one of the early ones a month ago. What sports medicine is it’s basically taking that science of human movement that you understand from kinesiology and then applying that to a diseased state. That diseased state may be arthritis, it may be an ankle sprain. It may be a spinal cord injury.

We need to be able to diagnose that. Most important, we have to know what we’re dealing with, to diagnose it and utilize the most up to date, current, and we want to be up to date and current, that’s why we do research, to be up to date and current and to give that athlete, young or old. It’s got nothing to do with age, and it’s got nothing to do with ability. Young or old to get them the best chance to recover and get back to doing the activity that they want to do. When you run 62 marathons, you get injured. Yes, you do. Particularly you have to look at somebody as old as myself. I mean I co-founded the Vancouver Marathon and started the first running club in Canada.

It was only 6 of us and we put on the first Vancouver Marathon and there was 32 of us, but all those 32 were hard core runners. Nowadays we have many, many more, obviously tens of hundreds more but are they any better than the group that I first started with? No, but the important thing is for the people that are now, they now are doing it much safer. They don’t go through the same number of injuries that we went through because it was trial and error. We didn’t know what a stress fracture. As soon as we know that somebody’s got pain in their foot or pain in their hip and it hurts to hop on, you got a stress fracture until proven otherwise. Because if you continue to push, let’s say you’ve got groin pain and you’re continuing to push in your marathon training and it hurts to hop but the next day you get out and do it again.

That hip can break right through. You can lose the blood supply to it. You could end up having to have an artificial hip at the age of 20 which you would rather not have since the artificial hips only last 15 to 20 years. Prevention is everything that we’re trying to do now is by looking at the strength, looking at flexibility and balance because all of those factors are so critical, particularly as you start to fatigue in whatever sport you’re doing. We want to be able to prevent those injuries because some of those injuries can be very significant. Inflammation early on is important because it attracts the white cells which help the healing process. The problem becomes when you continue to aggravate it. You get more and more inflammation.

Now it’s not just localized attracting these white cells to come and heal that small muscle injury, but it becomes a massive inflammation which can create … People can get autoimmune conditions where you can get inflammation in other joints not related at all to the calf strain that you had. It prevents at a certain level the actual healing process to occur. You need some inflammation to attract cells, but then the cells have to be able to do their job, turn on the fibroblast, lay down the type one collagen and heal that tear. If it’s all inflammatory cells, that’s where the process stops and the healing stops. There are certain conditions. Tennis players get chronic tennis elbow because ll that inflammation there, it stimulates the laying down of what’s called type 3 collagen.

It’s weak, it’s haphazard. It continues to re-tear. If you get rid of the inflammation, you stimulate that fibroblast to lay down type one  collagen. You get strong collagen. It heals and we follow you up one, two, three years that 80 or 90% of those people are healed. We wanted to see whether we could enhance athletes, not aerobic capacity, could you run faster, run further but could we enhance your anaerobic power. These are power sports, so we selected 10 football players. Then we put them on 3 weeks of either the supplement or SierraSil. Then they were off 3 weeks to clear it out and then they got the opposite. We wanted to see because when you do an anaerobic work, you create anaerobic products which impair your performance.

Lactic acid, people would understand. What the actual mechanism of action of of SierraSil is, is it clears and removes information. It removes the lactic acid and then allows you to train that much harder. We train these athletes. These are top, top athletes. We wanted to see if sure could we do it with individuals that were neophytes but we wanted to take top athletes. We wanted to train them incredibly hard and to create one of the most painful exercise test called the Wingate test and to really stress them and could we improve their anaerobic power. Yes, we could. We improve their power 3% and people say, “Well 3%. That’s not very much.” Well, you take a look at our power sport, let’s say it’s a cyclist. In that sprint 3%, 3 seconds.

You look at Dawn is our coach for our national kayak and canoe team. He coaches world champion and he’s got all these athletes. Boy, if they could get 3% on him, that would be a huge, huge difference.

Video Blog: Dr. Kam Shojania on lifestyle factors to maintain joint health

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My career has been most at UBC. I’ve trained at UBC in medicine and internal medicine, rheumatology, and then I became faculty whereupon I became head of rheumatology at UBC and also St. Paul’s and VGH. My career is mainly seeing patients, but also teaching and doing research at the Arthritis Research Canada, which is our largest freestanding arthritis center in Canada.

We have an aging population, and that impacts one type of arthritis. The most common type is osteoarthritis, which gets worse as we get older, and it affects many of us. The other types, however, like lupus and rheumatoid don’t change with age and actually affect younger people, so younger women and men. With one type of arthritis, osteoarthritis, it is going to be a tsunami with the aging population. If we want to keep active and mobile into our 80’s and 90’s and even 100’s, then there need to be some changes in our lifestyle.

Sometimes, when a patient sees me for arthritis, they will preface it by saying they aren’t really keen on taking a medication. After assessing them, I may say, “You know, your type of arthritis is best managed by lifestyle measures,” and then I go through the exercise and the weight loss and the lifestyle changes they need to make, and, at the end, some of them will say, “Isn’t there just a pill I can take?” While that’s an amusing anecdote, it does hold true for a number of patients that I see. Lifestyle measures are particularly difficult to change.

With regards to weight, a 10-pound weight loss for overweight people can translate into a 25% reduction in the need for a total knee replacement. That’s huge both for the patient, but also for our system. If we could reduce the number of knee replacements, we can save a lot of money.

Sometimes, we talk about a cure for arthritis, but I think the important thing is there are many types of arthritis, some in fact we can cure. One of the common types of arthritis in men is gout, which is totally preventable now, so there’s one down.

If we look at rheumatoid arthritis, we have amazing new treatments over the past 15 years that basically can put it into remission and using old treatments early can actually put it into remission, older, less expensive treatments, so not two down yet, but getting there. If we look at osteoarthritis, however, we are not that close to preventing it yet.

Osteoarthritis is the most common type of arthritis that we often get. Many of us will get it, and it happens more as we get older. Younger people get it if they’ve had a traumatic injury to a knee, for example, or a back. However, one of the big factors for osteoarthritis is obesity and muscle deconditioning.

In treating osteoarthritis, we don’t have a pill that’s going to slow it down. The pain medications for osteoarthritis leave a lot to be desired. The best way to manage it is by lifestyle measures. This is particularly hard, but, on the plus side, these lifestyles measures of exercise, achieving appropriate weight, help other conditions as well like diabetes, cardiovascular risks, cancer even. I think that, in the hopes of improving their joint symptoms through lifestyle measure, we are going to achieve a lot of other benefits.

Other tips in preventing joint diseases, I think one of the biggest factors in rheumatoid arthritis, which, remember, these are all different types of arthritis, but rheumatoid arthritis, if you can quit smoking, it reduces the risk of even developing rheumatoid arthritis significantly.

Here’s another one for rheumatoid arthritis that most people don’t know about, but gingivitis or inflammation of the gums is associated with more with the onset and severity of rheumatoid arthritis. Flossing your teeth and having good dental care, also, smoking makes gingivitis worse, too, but good dental care reduces the risk of rheumatoid arthritis.

Going to gout, which is another type of arthritis, completely separate from these other two I’ve mentioned, high fructose corn syrup makes it worse or increases gout, so sugary sodas and even fruit juices with high … supplemented with high fructose corn syrup are not good for gout. Preventing gout is, again, no fast foods, reducing sugary drinks. Cherries, for example, are good for gout, so these little tips as you said that can help different types of arthritis.

In the Arthritis Research Canada, we have a number of outstanding research projects looking at ways for people to cope better with their arthritis, reduce symptoms and even prevent arthritis, also looking at ways of getting the inflammation out. We call that knowledge transfer, because there’s lots of great research, but how do we get that knowledge to people? If people are interested, they can go to the website, and look for information or ways to help.

One other tip I forgot to mention was a BC government website called HealthLink BC. Now, if people are interested in looking at lifestyle measures, up on the left, there’s weight loss, diet and exercise, and there’s … They have them for different age groups and different conditions, so I urge people to go there. It’s free. It’s our provincial program, and it’s very useful.

Video Blog: Kevin O’Connor talks about goal setting and training with a team

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You need realistic goals. I’ll be turning fifty in a year and a year and half time and I’m already looking at trying to break the Canadian records of fifty. I think with realistic goals it’s much easier to do, and the fact is I have a good training group that I run with and we have a good comradery. It’s just slightly easier to look forward than to look back. You never want to look back at what you’ve done. You want to look forward to what you do. You just have to adjust your goals.

I think you have to look after your body and then I was lucky enough to get on with Sierrasil, maybe, four years ago and taking the product, especially the formula-14, which is really good. It really speeds up the recovery so I can train just as hard as I did before, but you have to train smarter. The recovery is actually more important than the actual training. Taking the product, I like the topical spray as well, it really helps you. You know that with them products and looking after yourself, it’s going to be much easier to recover. I’ve been very fortunate. I’ve had no major injuries at all.

Training through the winter months, I think it’s very important to find a group. If you can’t find a group then just try and find a training partner so you know what when it’s cold, wet, miserable, rain, snow that someone’s going to be there and you’re accountable, and then, especially good clothing, nice, dry, warm clothing, keep you warm. Then you have some sort of smaller goals. We’re all training for the winter for a major spring marathon. If you find a smaller few races, like in January February, it helps you keep it motivated and gets you through them horrible days.

I need to do hard workouts with a group, just know my teammates are going to be there through really hard workouts. For steady running you can do it by yourself, especially if you limit it to time. I can’t always be where my teammates are going to be on a Wednesday when I’m doing a steady run, so I think it balances itself out. Some people prefer to train with a group. Some people train by themselves. For me, and I think for most people, there’s a bit of both. It really helps.

I found the benefits for training with a group is that not only do you have great training partners and we’re all accountable for each other, but that we’ve all become very good friends. Some are like my coach, he’s become my lifelong friend. In my own group that we train with, Super K Run, we started off with four people that were trying to qualify for Boston and now we’ve got up to between thirty and forty athletes that come and go, and we’ve stayed friends ever since. We’ve had a few Christmas parties and we hung out on New Years. To me, the friendship is just as important as the training.

Some of the benchmarks for success with my own athletes is that I will give them realistic goals. I don’t like to sugar coat anything. I’m quite realistic, because otherwise they’ll just become disappointed and I don’t think that’s really a good thing to do as a coach. We’ll assess their fitness. We’ll know what they’re capable of and then we’ll set a target and hope they will achieve it. When they do, it’s better for everybody. We’re so much more happier.

Coaching has impacted my own training because I think I’ve seen a lot more from what I’ve gained from my own coaches and how much more respect I actually have for them. A lot of time is voluntary time, a lot of their own free time. For my own athletes, if I am not really working out really hard that day I’ll actually run with them. It’s, for me, the hardest thing is whether or not I actually want to run with them because I’m already doing my own training. If I have an easy run one morning, I might be able to do it with them. That way I can actually run with them, give them a few tips rather than just being on the sidelines. If it’s on a track day then I’d rather be in the middle shouting out times and advice from the middle. It’s slightly longer than I’ll run with them.

I’ve been able to avoid any serious injuries for many years now. A lot of it is down to the way I look after myself, my body. I do very good with nutrition. I train very well. I train very smart. I have a chiropractor. I have physio. I have message. I have cold water baths which aren’t that much fun, but necessary after a hard workout. I also take a product from Sierrasil called Formula-14 and the topical spray which really helps me for recovery days.

Video Blog: Dr. Bal Pawa discusses women’s health as we age

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Video Transcript

Hello, I’m Dr. Bal Pawa. I’m the co-founder of Westcoast Women’s Clinic, an integrative medical clinic, specializing in hormonal health. We have a reputation in this community for about fifteen years. We pioneered the clinic, we were one of the first in BC. Women come to us because we are MDs who look at healthcare in a very holistic way. We look at wellness rather than the illness model. We offer a personalized health approach. We look at lifestyle, we look at diet, mind-body medicine. We look at sleep. Sleep is a crucial part of health, as well. We look at investigations and state-of-the-art testing for hormones.

Women come to our clinic for many reasons. They often are looking for answers that they have not found at any of their other healthcare providers. They’re often feeling depressed, they’re having hot flashes, fatigue is a big one. Insomnia is a big one. Women age differently in their lifespan. You can get a thirty-year old who is reaching premature menopause, for example, or you can get a fifty-five year old who is still having periods. Across their reproductive life span, they’ll present differently and have many symptoms, and they find that going to walk-in clinics is not meeting their needs.

They’re looking for a clinic that is offering integrative approach to hormonal health. Somebody who’s credible. As you know, hormones are very controversial issue. They’re looking for doctors that are medically trained and have special expertise in this area.

When we look at holistic, or integrative medicine, as it’s called, we’re looking at medicine through a wellness model, not just an illness model. An illness model is where a patient goes into a doctor and they have a symptom, and they say, “Okay, I have heartburn,” and the doctor prescribes a drug. We’re looking at causes of that symptom, we’re looking at the body as a whole. That’s how usually the human body works, as a system, not fragmented parts. We look at through lifestyle, stress, sleep, nutrition, and also we do prescribe. Going to a drug or a medication is not our first go-to.

How do we create perfect health is what I’d like to address. I think it’s a partnership. When you get a patient who is advocating for their health, they’re motivated, they want to make difference, and then they find a doctor who has expertise in that area and who’s passionate about making a difference. I think that’s a winning combination. When we create a partnership, we’re actually creating a health plan that is personalized. We look at how motivated the patient is, and we’re willing to go the full ante to find out what’s causing their symptoms, how we can best help them, and create a personalized health plan.

Creating health means creating knowledge, creating good habits and routines, and creating a database of credible information. We offer seminars, one-on-one meeting with the nurse, with the doctor, with the team … We’re looking at ways that we can educate the patient, and that helps their journey and sustain their compliance.

As women age, they’re often very concerned about bones and joints. These are two different disease process. Bone is a live tissue, and as bones age, they often get softer with age. That’s called a disease, osteoporosis. Joint disease is a disease of aging where it’s wear and tear. It’s often accompanied by tendons and ligaments and bone-on-bone surfaces, like a ball and socket. That’s a wear and tear, and that’s called osteoarthritis, so two different processes.

Both do involve inflammation, so our principles for looking at joint and bone health are, one is to promote exercise: movement, agility, weight-bearing is especially good for bones, but movement such as swimming and cycling is great for joints. Looking at lifestyle such as smoking, alcohol, or caffeine intake. Those three factors impact how the joints are working, and also how bone tissue responds to these toxins. Looking at diet, for example, having things that are anti-inflammatories in your diet, such as omega-3. Vitamin D is a crucial part of bone health, and vitamin D is also great for absorption of calcium. It’s very important to get calcium in your diet. When we’re talking about bone and joint health, we often tell women to look at cross-training. We often tell them to look at a very whole diet, and of course you have to recognize that genetics play a role, as well.

A woman should get her hormone levels checked when she’s having symptoms. The first hallmark of perimenopause is when she’s missing periods. Around age forty, forty-five, she may notice that her periods are becoming irregular. She may have two periods in one month, or she might have two or three months of no periods. That is the first hallmark that menopause is approaching. If you define menopause, that’s a milestone that women reach. It’s not something they go through. The average age is fifty-one in North America.

Perimenopause is the few years leading up to menopause. Hormone testing at that point is very limited, because your hormones are changing every month. There is some more comprehensive testing that we do send away, and we’re looking at stress hormones, and we’re looking at thyroid, and we’re looking at other hormones that we can do locally, and some that we send to the states. The menopause testing is done here in Canada and it’s very easy to do. You can do an FSH, and you can go to your doctor and get an FSH done when you stop your periods. When you’ve had a few months with no periods, you can go and get an FSH level done and that will determine whether you have crossed over into menopause.

Natural supplements, and whether we should consider them or not has been an ongoing question. One of the most important things to know is that our nutrition, which is a vital piece of health, is changing. If you look at broccoli from 1960 to broccoli now, and you analyse the selenium content, it’s very different. We are very depleted in our trace minerals. Twenty-five years ago doctors were told, “You don’t need to supplement vitamins for your patients if they eat a healthy diet.”

Now we say “Well you know, you want the patient to have a very healthy diet, full of phytonutrients from vegetables, of having whole foods and not processed foods, and good source protein, of course; but we have to recognize that we are still depleted in certain trace minerals, and also vitamin D is something that you just don’t find in your diet readily.” There are some things that you will need to supplement. Vitamin D is a big one. That would be about a thousand to two thousand units a day. I would want patients to have omega-3. I would want now, with the new research, also looking at fermented foods in our diet, to improve our micro-biome and to improve our health of the gut. Having foods that have variety of pre-biotics and pro-biotics in them, that would be things that you could supplement with. Along with a very healthy diet.

Then there are patients that are special cases, who have compromised absorption. Inflammatory bowel disease, for example; or you can get patients that are elderly, or they’ve gone through some medical problems. Even vegans, they may need extra supplementation with B12 or iron, as well.

The most important thing that women have to realize, there is so much information out there. They should know what information applies to them. Having good, credible information is key. I feel that having good resources of websites … You can go to Westcoast Women’s website, we offer websites for osteoporosis, for menopause. We also offer seminars through the clinic, with physicians. We just want patients to get good, credible information so we can empower women to make their own decisions and be informed about their health.

The other important feature for creating health is a woman who advocates for herself. She puts herself as a priority, and makes health a very top priority in her life. We love the ripple effect. That means that when we get a woman back on her feet and she’s healthy, then she creates health for others. Women are great at networking, and they’ll tell their friends what they did differently for their exercise or for their vitamins. Then they’ll tell their friends, and their family. We find such a ripple effect with getting women back on their feet. We love that, and that’s what keeps us as doctors passionate about this healthcare in women’s health.

Another critical component for women and men as well, is the management of stress, and how the mind-body connection is so powerful. I’ve done a lot of research in this in the last fifteen years, and it is profound. Stress hormones are the big players in the body. They contribute to inflammation, they contribute to gut health. The gut is so vital. If you have a healthy gut, eighty percent of your immune system is made in the gut. Seventy percent of your serotonin, which is your happy hormone, is made in the gut. Keeping your gut healthy is so vital to health.

If you look at the father of medicine, Hippocrates, “Let food be thy medicine.” That was such a profound statement, because we’re not paying enough attention to what we’re putting in our mouth. The micronutrients that we want to absorb, first of all the choices we make in food are very important, but then keeping the gut healthy. Why is our gut not healthy as it used to be? Why is our micro-biome different than it was? We look at the processed food we’re consuming, we look at the toxins in our diet, we look at the GMO foods we’re consuming. We look at the stress that our body is facing, the schedules that we keep. All of that contributes to gut health.

There’s a lot of research now, looking at gut health and how it impacts the brain, as well. In our lifetime as physicians, I never thought that we would see probiotics being recommended for mood disorders. A psychiatrist, a very prominent psychiatrist, feels that if we were able to correct the micro-biome, we could actually impact diseases such as autism and inflammatory diseases of the brain, and depression and mood disorders. That is a huge area of research and I’m fascinated by it.

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