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I spoke to my new friend Jiang today and she informed me of something truly troubling. She felt horrible because she snatch deadlifted 100kg (220 lbs) today as her maximum instead of her programmed 140kg (308 lbs). Then I spoke to my cousin Drew today about four hours later and he was upset that he couldn’t beat his friend’s team on League of Legends despite having a significant advantage in terms of stats. Let’s get real—both of these children are 14 years old.

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Sea salt caramel is no kiddie flavor (although more discerning children may love it). In fact, sea salt caramel may be one of the most nuanced and decadent ice cream varieties out there…. Something about the caramel flavor feels richer than other ice creams. Something about the sea salt offers a bite that satisfies beyond taste imagination. It’s where sweet meets depth. And with this recipe, it’s an indulgence you can still revel in—even while keto, thanks to the magic of Swerve.

Pro tip: pour Mark’s cold-brew coffee over a scoop for the ultimate cool taste combo.

Servings: 6 half-cup servings

Time In the Kitchen: 45 minutes

 Chill Time: 8 hours

Ingredients:

• ¾ cup Brown Swerve
• 3 Tbsp water
• 2 cups heavy cream (room temperature)
• 1 cup unsweetened almond milk (room temperature)
• 1/8 tsp fine sea salt
• 6 large egg yolks (room temperature)
• 1 teaspoon flaky sea salt (such as Maldon)

Instructions:

In a medium pot over medium heat, melt 3/4 cup Brown Swerve sugar with 3 tablespoons water, swirling skillet frequently, until Swerve turns mahogany brown in color (it should be almost but not quite black). This should take around 10 minutes.

Add heavy cream, almond milk, 1/8 tsp salt, and simmer until cream mixture is completely smooth and warm. Remove pot from heat. In a separate bowl, whisk yolks. While whisking constantly, slowly pour about a third of the warm cream into the yolks, then whisk the yolk mixture back into the pot with the cream.

Return pot to medium-low heat and gently cook until mixture is thick enough to coat the back of a spoon (about 170 degrees on an instant-read thermometer). This should take between 25-30 minutes. You want to avoid cooking ice cream mixture too fast because the egg could curdle.

Cool mixture to room temperature. Cover and chill in refrigerator overnight or for 8 hours.

Strain through a fine-mesh sieve into ice cream machine. Churn in ice cream machine according to manufacturer’s instructions. Sprinkle flaky sea salt into base during the last 2 minutes of churning. Serve directly from the machine for soft serve, or store in freezer until needed. Enjoy!

Nutritional Information (per serving):

• Calories: 325
• Carbs: less than 1 gram
• Fat: 37 grams
• Protein: 3 grams

(For more information on how Swerve is metabolized, see this blog post.)

The post Keto Salted Caramel Ice Cream appeared first on Mark’s Daily Apple.

Originally Posted At: https://breakingmuscle.com/feed/rss

I’ll defend percentage-based training program’s efficacy for powerlifting and Olympic weightlifting until the bitter end, or when I’m muttering to myself on a park bench wearing a sleeping bag as a sport coat.

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Do you have a rumbling in your tummy that doesn’t seem to go away? If so, it is important to know what to eat to keep you full. Some foods can not only fill you up but also keep you satisfied for a long period. The reason for your hunger may very well be because […]

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We all need support to achieve greater health, build new health habits, and change a lifetime of health behaviors—and that’s where health coaching can play an important role.

The post How the ADAPT Health Coaching Model Can Help Us Fight Chronic Disease appeared first on Chris Kresser.

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Research of the Week

A very low carb high fat diet fails to impair exercise performance.

During immobility, heat treatment maintains muscle mitochondrial activity and staves off atrophy.

Lifting weights while you diet leads to almost exclusively body fat loss.

High maternal HbA1c linked to autism.

New Primal Blueprint Podcasts

Episode 355: Leland Conway: Host Elle Russ chats with the award-winning broadcaster who changed his life by following Primal principles.

Primal Health Coach Radio, Episode 18: Hosts Erin and Laura chat with Jonathan Posey, founder of an advocacy group that protects the rights of health coaches to practice.

Each week, select Mark’s Daily Apple blog posts are prepared as Primal Blueprint Podcasts. Need to catch up on reading, but don’t have the time? Prefer to listen to articles while on the go? Check out the new blog post podcasts below, and subscribe to the Primal Blueprint Podcast here so you never miss an episode.

Media, Schmedia

How youth basketball—and sport specialization in general—is threatening the health of young athletes.

Modern humans may have been in Europe 210,000 years ago.

Interesting Blog Posts

Jumiles, the edible wonder bugs of Mexico.

What’s the optimal exercise modality for mood boosting?

Social Notes

Interesting Twitter thread on the safety or toxicity of Bt corn.

Everything Else

Ah, camp season.

How are decisions made, if at all?

The fit young folks who ended up with bowel cancer.

Caffeine powder can kill.

As the permafrost melts, ancient organisms are waking up.

Things I’m Up to and Interested In

Restaurant I’d try: The one where the waiters have dementia and there’s no guarantee you’ll get what you order.

I’m entirely unsurprised: Snack sales spike in states with legal cannabis.

I like this idea: What if you trained your cognitive skills like an athlete?

I enjoyed this article: What we can learn from shipwrecked “microsocieties.”

I agree: When considering the effects of “saturated fat,” you can’t ignore the food matrix.

Question I’m Asking

Do you ever train your learning/brain/cognitive skills like athletes train their bodies?

Recipe Corner

• Tuna poke bowls that rival Hawaii’s.
• Curry tuna salad in pepper boats.

Time Capsule

One year ago (Jul 7 – Jul 13)

• Keto for Women: 7 Tips to Make it Work – What should women watch out for?
• Ultimate Guide to Allulose Sweetener– All about allulose.

Comment of the Week

“I found the Ancestral Health lifestyle in late 2008, thanks in part to Mark’s Daily Apple. Turned 50 last year but feel like I’m in my 30s. I’m aiming for strongevity!”

– Always glad to have you along, Aaron. I like “strongevity”!

The post Weekly Link Love — Edition 37 appeared first on Mark’s Daily Apple.

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Mosquitoes are one of humanities greatest plagues. And in some regions, they are an even bigger problem due to the transmission of various diseases such as malaria, Dengue fever, and the Zika Virus. Are you that person who is eaten alive by mosquitoes anytime you brave the great outdoors (or even your backyard) while your […]

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“Do not go gentle into that good night.” That’s one of my favorite lines in all of literature, and it informs my outlook on health, life, wellness, and longevity.

Live long, drop dead. Compression of morbidity. Vitality to the end. All that good stuff.

But I’m sorry to report that Dylan Thomas imploring you to assail life with boldness is becoming harder for the average person to fulfill and embody. People more than ever before are heading into middle age with a head-start on the degenerative changes to body composition and function that used to only hit older folks. They may want to go boldly into that good night, but their bodies probably won’t be cooperating.

Ignore the standouts for a moment. I’m not talking about that awesome granny you saw deadlifting her bodyweight on Instagram or the centenarian sprinter smoking the competition. I’m not talking about the celebrities with personal trainers and access to the latest and greatest medical technologies. I’m referring to the general trend in the greater population. All signs point to average men and women alike having more fragile bones, weaker muscles, and worse postures at a younger age than their counterparts from previous eras.

What Signs Point This Way?

Low Bone Density

These days, more men than ever before are developing the signs of osteoporosis at an earlier age. In fact, one recent study found that among 35-50 year olds, men were more likely than women to have osteopenia—lower bone mineral density—at the neck.

Why?

Osteoporosis used to be a “woman’s disease,” lower estrogen after menopause being the primary cause. That’s rather understandable; estrogen is a powerful modulator of bone metabolism in women, and a natural decline in estrogen will lead to a natural decline in bone density. Men’s bone density has a similar relationship with testosterone; as a man’s testosterone declined, so does his bone density. As long as a man or woman entered the decline with high bone density, the decline wouldn’t be as destructive.

But here’s the thing: these days, both men and women are starting the decline with lower bone density. In women and men, peak bone mass attainment occurs during puberty. In girls, that’s about ages 11-13. In boys, it’s later. Puberty sets up our hormonal environment to accumulate healthy amounts of bone mineral density—but we have to take advantage of that window.

One of the main determinants of bone density accumulation is physical activity. If you’re an 11-year-old girl or a 16-year-old boy and you’re not engaging in regular physical activity—running, jumping, throwing, lifting, playing—you will fail to send the appropriate signals to your body to begin amassing bone mass. And once that developmental window closes, and you didn’t spend it engaging in lots of varied movement, it’s really hard to make up for all the bone mineral density you didn’t get.

But you can certainly improve bone mineral density at any age. Even the elderly can make big gains by lifting weights, walking frequently, or even doing something a simple as regular hopping exercises. The problem is that physical activity is down across all ages.

Children are spending more time indoors using devices than outdoors playing. They aren’t walking to school or roaming around outdoors with friends getting into trouble. If they’re active, they’re more likely to be shuttled from soccer practice to ballet to music lessons. Their movement is prescribed rather than freely chosen. Hour-long chunks of “training” rather than hours and hours of unstructured movement…

Not just kids, either. Sedentary living is up in everyone.

So there are two big issues:

1. Kids are squandering the developmental window where they should be making the biggest gains in bone density.
2. Adults are leading sedentary lives, squandering the lifelong window we all have to increase bone density.

Another reason men are having newfound problems with low bone mineral density is that a generational drop in testosterone has been observed. Twenty years go, men of all ages had higher testosterone levels than their counterparts today, meaning an average 50-year-old guy in 1999 had higher testosterone than an average 50-year-old guy in 2019. Testosterone will decline with age. That’s unavoidable. But something other than aging is also lowering testosterone—and bone density—across the board.

Experts are now recommending that young men use night lights, avoid throw rugs on the floor, and do pre-emptive physical therapy—all to reduce the risk of tripping, falling, and breaking something. That is absolutely tragic. This shouldn’t be happening.

Text Neck

The smartphone is a great tool with incredible potential to transform lives, economies, and personal capacities. But it can wreck your posture if you’re not careful and mindful.

Try this. Pick up your phone and compose a text message. Do it without thinking. Now hold that position and go look at yourself in a mirror. What do you see?

Head jutting forward, tilted down.

Upper back rounded, almost hunched.

Shoulders internally rotated.

Now spend 6-8 hours a day in this position. Add a few more if you work on a computer. Add another 15-20 minutes if you take your phone into the bathroom with you. Add an hour if you’re the type to walk around staring at your phone.

It all starts to sound a little ridiculous, doesn’t it?

Not only are people spending their days sitting and standing with their spine contorted, they’re staring down at their phones while walking. This is particularly pernicious. They’re training their body to operate in motion with a suboptimal, subhuman spinal position. They’re making it the new normal, forcing the body to adapt. And it is subhuman. Humans are bipeds, hominids that tower over the grasslands, able to scan for miles in every direction, perceive oncoming threats, plot their approach, stand upright and hold the tools at the ready. What would a Pleistocene hunter-gatherer of 20,000 years ago make of the average 25-year-old hunchback shuffling along, nose pointed toward the ground? What would your grandfather make of it?

It used to be that the only person with a kyphotic, hunchback posture was pushing 70 or 80 years old. And even in that age group, it was relatively rare. Nowadays young adults, teens, and even kids have the posture.

Physical Weakness

Interest in effective fitness and healthy eating and CrossFit and paleo and keto and everything else we talk about is at an all-time high, and all your friends on Instagram seem to be drinking bone broth and doing squats, so you’d think that people are getting stronger and waking up from all the crazy conventional wisdom that society has foisted upon us over the years. They’re not, though. That’s the view from inside the Internet bubble. This explosion in ancestral health and fitness is a reaction to the physical ineptitude and torpor enveloping the modern world. A small but growing group of people are discovering the keys to true health and wellness because the world at large has become so backwards.

And no matter how many CrossFit gyms pop up or people you see walking around in yoga pants, the average adult today is weaker than the average adult from twenty years ago. That’s the real trend. It probably doesn’t apply to you, my regular reader, but it does apply to people you know, love, and work with. Here’s the reality:

Grip strength—one of the better predictors of mortality we have—of 20-34 year old men and women has declined since 1985, so much that they’re “updating the normative standards” for grip strength. Even 6-year-olds are weaker today.

New recruits in the military are weaker than recruits from previous eras. They’re even having trouble “throwing grenades.”

Everywhere you look—Lithuania, Portugal, Sweden, to name just a few—kids, teens, and adults of all ages are failing to hit the normative standards of strength and fitness established in older eras. People are getting weaker, softer, and less fit earlier than ever before.

Don’t let this happen to you. Don’t let it happen to the people you care about. You have the chance, the duty to your future self to go boldly into that good night, rather than wither and dwindle and fall apart. And it starts today, right now, right here. Do one thing today. What will it be?

How are you guys fighting the ravages of age and gravity? What are you going to do today to ensure you’ll go boldly into older age?

References:

Bass MA, Sharma A, Nahar VK, et al. Bone Mineral Density Among Men and Women Aged 35 to 50 Years. J Am Osteopath Assoc. 2019;119(6):357-363.

Fain E, Weatherford C. Comparative study of millennials’ (age 20-34 years) grip and lateral pinch with the norms. J Hand Ther. 2016;29(4):483-488.

Larson CC, Ye Z. Development of an updated normative data table for hand grip and pinch strength: A pilot study. Comput Biol Med. 2017;86:40-46.

Venckunas T, Emeljanovas A, Mieziene B, Volbekiene V. Secular trends in physical fitness and body size in Lithuanian children and adolescents between 1992 and 2012. J Epidemiol Community Health. 2017;71(2):181-187.

Marques EA, Baptista F, Santos R, et al. Normative functional fitness standards and trends of Portuguese older adults: cross-cultural comparisons. J Aging Phys Act. 2014;22(1):126-37.

Ekblom B, Engström LM, Ekblom O. Secular trends of physical fitness in Swedish adults. Scand J Med Sci Sports. 2007;17(3):267-73.

The post Is 50 the New 70? How the Modern Lifestyle Is Remaking Middle Age appeared first on Mark’s Daily Apple.

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As a pelvic health physiotherapist, I considered myself an expert in diastasis recti. After all, I’d been treating the condition for nearly 20 years in my patients.

Then, after my third pregnancy, I diagnosed the condition in myself.

Despite all my education and experience, my first reaction was fear. Because the conventional wisdom for so long has been to go slow to avoid anything that might make the diastasis recti worse, my instinct was to approach the condition conservatively.

I worried.

Would I ever be able to do abdominal training again?
Would I be able to run long distances?
Would yoga no longer be safe?
What about Pilates?

Even for an expert like me, it was hard to figure out what having diastasis meant for my fitness. What exercises could I do? Could I fix the gap in my abdominal muscles? Was I “broken” in some way?

After working with another physiotherapist and a coach I finally began to separate the information from the misinformation about diastasis recti.

My physiotherapist and my coach helped me realize I wasn’t broken — with diastasis recti, my abdominal muscles simply couldn’t generate as much tension and intra-abdominal pressure as before. They also reminded me that there are still many exercise options available to someone who has diastasis recti.

Since that experience, I have been able to apply this deeper knowledge and understanding to help other women with diastasis recti feel and move better — without fear or limitation.

Here’s how to help a client with diastasis recti (or yourself) return to exercise safely.

First Things First: What Is Diastasis Recti?

If you or your client is diagnosed with diastasis recti, your first question is probably: what is that?

Here’s a quick explanation:

Diastasis recti has been historically defined by “the gap,” or the inter-rectus distance (the distance between the two sides of the abdominis rectus).

During pregnancy, the linea alba — the connective tissue that runs along the midline of the abdomen from the sternum to the pubic bone — softens and becomes more lax. The span of the connective tissue widens, and the rectus abdominis muscle bellies (the right and left sides of this muscle group) move wider apart to allow the abdominal wall to expand as the pregnancy develops.

This natural separation of the abdominal muscles commonly occurs during the third trimester and persists for some time after childbirth.

Most of the research on diastasis recti has been focused on closing the gap, and until recently, the goal of many postpartum exercise programs has also been to reduce or close the gap, as a means of recovery from diastasis recti. In the past, exercises have focused on physically bringing together the two sides of the abdominal muscles (using a band or literally crossing your arms over your abdomen and using your hands to bring both sides of the abdominal muscles together). The idea was to train both sides of the rectus abdominis to work next to each other again.

More recent research is finding that closing the gap is not as important as regaining tension in the linea alba, thus redefining what “healing” diastasis recti means.

Does everyone get diastasis recti during pregnancy?

Almost 100 percent of pregnant women will develop diastasis recti by the third trimester, and pretty much every woman will have a diastasis of greater than 16 millimeters by weeks 35 to 39 of her pregnancy.²² There is no clear way to identify who is most likely to have abdominal separation that persists months after pregnancy.

In the postnatal period, some women’s diastasis recti will “heal” without any intervention (assuming that no additional stress or aggravation of the separation exists). More than half still have a wide separation eight weeks after delivery, and although some recover by six months, many have not recovered at even one year.

A study in Norway found that almost one-third of women still had at least a mild separation at 12 months postpartum (and consequently that two-thirds didn’t — which, according to the study, means that the diastasis recti had “healed”).¹²

Many women seek help with their diastasis recti because they don’t feel strong and don’t like how their body looks after pregnancy.

Some women with diastasis recti struggle to feel their abdominal muscles in workouts and may tell you their belly feels hollow or disconnected. Sometimes you may notice the belly “cone” or push out through the gap.

You can assess your client’s diastasis recti — and you can teach clients to self-assess.

While ultrasound imaging has become the gold standard for accurate measurement of the inter-rectus distance, finger-width measurement remains the most commonly used screening method in clinical and training environments.

In this type of assessment, have your client lie supine, ask her to lift her head and shoulders slightly off the ground, and hold that position. You then use your fingers to assess both the gap distance above and below the umbilicus and the ability of the linea alba to create tension across the gap. You will also observe the depth of the gap and monitor your client’s breathing strategies during the slight sit-up movement.

The tautness that you can feel — or not — in your client’s tissues can indicate whether there’s good or poor tensioning of the linea alba. Activating the transversus abdominis before and during the maneuver can improve tensioning. To help your client activate her transversus abdominis, cue her to focus on her exhale as she performs the movement.

Can diastasis recti be prevented? Here’s what the research says.

Some of your pregnant clients will want to know how they can prevent diastasis recti or how they can “fix” it or make it go away after pregnancy.

Because there’s so much misinformation about diastasis recti readily available, trainers, coaches, and rehabilitation professionals must understand (and remind their clients) that there’s a lot still unknown.

Diastasis recti research is still very limited compared to other more mainstream concerns such as low back pain. However, it’s a growing area of research, and the quality of that research is steadily improving.

A client may blame herself, believing she actively caused her diastasis recti or is doing the wrong things to address it in postpartum. You may help her go a little easier on herself by explaining that in addition to the lack of evidence-based prevention protocols, one thing emerging from the research is that some factors influencing diastasis recti may not be beyond her control.

For example, one recent study found that the collagen make-up in the linea alba may play a key role in how diastasis recti develops.⁷ Some collagen types may not be as supportive or elastic, which can potentially influence depth and gap distance or the abdominal muscles’ ability to manage intra-abdominal pressure.

Additionally, factors such as your client’s gender, the presence of a hernia, her history of abdominal surgery or C-section, the number of pregnancies and births she’s had, and the condition of her skin all may potentially play a role her diastasis recti diagnosis.¹

Many commercial training programs focus on strategies to control activity-related intra-abdominal pressure before and during pregnancy — including the Valsalva maneuver with weight lifting and chronic straining with toileting. However, these programs and strategies need further research to show their efficacy in preventing DRA.

Five Ways You Can Help Clients With Diastasis Recti

Being diagnosed with diastasis recti can be stressful and confusing. Luckily, as a coach, you’re in an excellent position to help your clients return to exercise safely, while also feeling strong, healthy, and empowered.

Here are five ways you can help.

1. Dispel myths and reduce fear.

Myths about diastasis recti abound, and some of your clients may tell you they feel broken. Clients who feel scared and avoid exercise will continue to lose strength. You’re in a great position to help them.

Your client may have read or heard myths such as:

• That diastasis recti is preventable (it’s not!)
• That if she doesn’t have it after her first delivery, she won’t have it later (that’s not the case).
• That diastasis recti only occurs after pregnancy (in fact, it’s present in almost every pregnancy by the third trimester — it’s just harder to notice because the pregnancy makes the abdomen firm and the skin pulls taut over the belly.)

First and foremost, reassure a client with diastasis recti that she is not broken. Use your coaching expertise not only to help her focus on reestablishing efficient control of intra-abdominal pressure and improving abdominal strength, but also to help her feel strong and confident in her body again.

2. Provide realistic, progressive exercise programs.

Your client’s post-pregnancy training should focus on helping her regain strength and confidence in her body. With evidence-based program design and good, ongoing communication, you can help your postpartum clients achieve these goals.

Should clients with diastasis recti avoid certain exercises?

Increasingly, it seems like no exercise is off limits, across the board, for all women with diastasis recti.

The more we learn about diastasis recti and the factors involved, and the more we see many women continue to participate in challenging sports and activities without worsening symptoms, the more encouraging — and necessary— it becomes to keep looking for new and better answers.

As research and evidence continue to progress, there are now fewer limitations on the types of exercise women with diastasis recti can do.

That said…

We recommend avoiding the following categories of exercise in early postpartum (when she is least likely to be able to control intra-abdominal pressure effectively):

• Advanced abdominal exercises that put a lot of stress on the abdominal wall
• Plyometric exercises
• Intense exercises or exercise classes

Advanced Abdominal Exercises

This category includes the abdominal exercises we believe should be avoided in early post-pregnancy and possibly added to the later stages of a postnatal rehabilitation program:

• Exercises in which the belly/lower pelvic region is bulging up or out (e.g., crunches and sit-ups, leg raises, bicycles, knee tucks, jackknives).
• Exercises in which the belly is hanging down toward the floor and the hands are a farther distance from the feet or knees (e.g., front planks and variations, pushups, renegade rows).

This is not to say that these exercises are “bad” and must always be avoided, but in our experience, postnatal women should gradually progress toward these exercises, rather than start with them. Make sure that you avoid exercises that cause the abdominal wall to bulge outward (especially at the midline), cause any stress to her C-section incision, or cause leaking of urine.

In exercises where the belly may be hanging toward the floor, your client may feel like her insides are “spilling out” of her belly if she can’t feel tension in her abdominals. For example, if she’s doing a front plank directly on the floor and she never feels it in her abs, but she feels a ton of tension in her shoulders and upper back or some discomfort in her lower back, you should modify the exercise. Try a different variation, such as the incline front plank or a regression to a hands-and-knees position.

What the research says about abdominal exercises…

Recent research has compared the effect of the curl-up and the drawing-in maneuvers on gap “closure.” (The drawing-in maneuver is typically considered a contraction of the transverse abdominals, the deepest of the abdominal muscles.) Several studies have noted that the curl-up maneuver reduces inter-rectus distance and the drawing-in maneuver increases it.^{2,6,11,13,15,16}

It’s easy to see how things can get confusing, right?

So, are crunches OK then? And if avoiding exercises that could increase the gap or prevent it from healing is one of the biggest concerns for people with diastasis recti, what should we do about deep abdominal training? What about rotation exercises and exercises that train the obliques?

Another study identified that compared to women without diastasis recti, women with diastasis recti “demonstrated significantly lower trunk muscle rotation torque and scored lower on the sit-up test.”³ In the context of the idea that there’s less ability to translate forces across, with the understanding that a larger gap or un-tensioned linea alba has a decreased ability to translate forces,¹³ it makes sense that trunk muscle rotation torque would be diminished.

No research specifically states that crossover crunches, bicycle crunches, planks, or sit-ups are bad and should be avoided at all costs.

Plyometric Exercises

These include:

• Running, sprinting, jogging
• Jumping, box jump, jumping rope
• Burpees, squat thrusts, and other similar conditioning exercises

Your postnatal client may not yet have sufficient abdominal muscle or pelvic floor muscle strength and coordination to control intra-abdominal pressure as well as support the internal organs.

If her body isn’t quite ready yet, she could be setting herself up for issues such as pelvic organ prolapse, urinary incontinence, or low back and pelvic pain.

Intense Exercises

Your client’s body has experienced some major changes over the past nine months. Now it’s important to re-train it, which requires taking just a couple of steps back to teach the core and pelvic floor muscles how to function at their best again.

Keep your sights on the long-term gains, and encourage your clients to do the same. If a client wants to jump right back into heavy resistance training or abdominal and plyometric exercises, intense cardiovascular workouts, or something like a typical “mom and baby bootcamp” class (with lots of running, jumping, crunches, etc.), she could be risking injury or long-term pelvic floor dysfunction.

It’s your job to explain why those options may not be best for her right now, and to help her exercise in a way that helps her achieve those goals over time.

Explain to your client that it’s more effective to stick to exercises and a workout schedule that will rebuild her strength slowly and steadily, rather than hold steadfast to an idea of where she “should” be or where she left off before pregnancy. The idea is to help your clients be able to continue exercising and enjoying their activity over the long term, with minimal risk for injury and burnout.

Whose Decision Is It?

At the end of the day, it’s important to remember that your client has full autonomy over her body and her decisions.

Sometimes, a client may have symptoms and be OK with that. While you can warn her that continuing what she’s doing could make her condition worse, remember that she’s the one in charge of deciding — your role there is to educate her. Make sure to document that you have made an explicit recommendation.

Remember… every client’s postpartum healing experience is different.

Proceed cautiously as your client progresses beyond early postpartum and can start doing more challenging movements. Monitor her diastasis, try different exercises, and scale the workouts based on what you observe and how she tells you she’s feeling.

There are many breathing strategies that may work for your client, depending on the exercise, load, position, and even the day. You can recommend she exhale on exertion, inhale on exertion, hold her breath gently during exertion, exhale slightly right before exertion and hold her breath for the remainder of exertion. Experiment to find what works best for your client in the moment.

Collaborate with a physiotherapist or rehabilitation professional skilled in rehabilitative ultrasound imaging. Find practitioners who use imaging to help their patients improve muscle activation strategies and learn how to use their breath to assist in abdominal activation in different contexts.

If you choose not to program certain exercises with your client, try to use supportive language to explain your choice rather than language that evokes fear. Avoid catastrophizing how they’re feeling or what their body is doing as they perform exercises.

3. Be aware of warning signs.

To help your client heal and continue to make progress, be on the lookout for symptoms that could indicate potential or existing pelvic dysfunction. Always encourage her to listen to her body and trust the signals her body is sending.

When to Proceed With Caution

Abdominal doming or coning is often mentioned in articles about pre- and postnatal exercise, cited as something to be avoided, an indicator that an exercise is too challenging and may lead to negative consequences. But so far, the research hasn’t concluded that doming is harmful.

Uncontrolled outward pressure forming a central dome or cone on your client’s abdomen, which is not a danger, but can be a potential indicator that she’s not able to control intra-abdominal pressure efficiently, or that an exercise may need to be scaled down. You can help your client test different breathing strategies — including the core-pelvic floor connection breath — and find what works for her in that exercise on that day.

Planks, crunches, and other high-load exercises in a front-loading position often cause doming, but so can simple dumbbell exercises. You can monitor your client’s abdominal wall and adjust or remove exercises if you notice doming along her linea alba.

When to Stop Exercise and Refer Out

If something doesn’t feel right during an exercise, it’s probably not. If your client just “knows” that what she’s feeling in her body isn’t comfortable, have her stop.

Sometimes exercises will feel a bit awkward after pregnancy, and that’s OK. As a reminder, your client should stop an exercise if:

• It is causing her any pain.
• There’s a pulling sensation through a C-section scar.
• She feels pressure in her bladder or rectum.
• She’s leaking urine during or after a workout.
• She can’t breathe easily.

Remember: regain function first, before doing any intense exercise.

Diastasis recti is not directly correlated with low back pain, pelvic organ prolapse, or incontinence. However, postpartum women often experience one or more of these conditions, and though they may be common, they’re certainly not ideal. Always be on the lookout for these symptoms, and make sure your client follows up with her doctor if she’s experiencing any of them.

Pressure or a feeling of heaviness at the perineum may indicate pelvic organ prolapse, requiring an assessment from OB-GYN or physiotherapist. Pain in the abdomen, pelvis or perineum are not common with diastasis recti and require medical assessment as well.

4. Cultivate a referral network.

If you have a referral network, you’ll always have support from a team of health professionals.

Postpartum women may work with various healthcare professionals of different disciplines, and understanding what each professional does is very important, so you know when to refer your client to another professional.

For example, a physiotherapist trained to work with athletes and active individuals who have diastasis recti can work with your client to identify strategies that help her improve intra-abdominal pressure control.

One thing: make sure you’re all on the same page with the message that having diastasis recti doesn’t mean your client has to stop movement altogether.

5. Practice compassion.

Be sensitive and compassionate with your clients and recognize that everyone is different.

For many women, their postpartum body may feel foreign, and in many cases, they may be looking for the quickest way back to how they looked and felt before pregnancy.

Your clients’ expectations may range from acceptance of the changes they’re experiencing to complete rejection of a body that rose to the enormous challenge of growing a small human in nine months. Social media has intensified postpartum messaging, causing many women to feel inadequate or implying they’re to blame for the separation of their abdominal muscles.

Harness this opportunity to re-examine your beliefs about diastasis recti, to work collaboratively with your clients to understand their fears regarding exercise and movement, and to provide reliable evidence-based guidance as they work to heal, regain strength, and feel good in their own skin again.

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The post How to Train Clients With Diastasis Recti appeared first on Girls Gone Strong.

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A criticism often leveled against the keto diet is that it’s more expensive than a “regular” (read: SAD) diet. There’s some truth to that. It does cost more to buy meat than ramen and beans. I personally spend more on groceries now than I did before finding Primal. Not only did I shift to buying different types of food, I also came to care more about food quality. I started choosing more pasture-raised meat and eggs, and more pesticide-free and organic produce and dairy.

However, my grocery bills haven’t changed noticeably since going keto. If you’re already eating Primally, your daily foods don’t have to change that much if you decide to try keto. You’ll remove some (okay, most) of the fruits and root veggies, and sub in more above-ground veggies and probably some healthy fats. It’s not a substantial overhaul. However, if you’re coming from a standard high-carb, lots-of-cheap-packaged-foods diet straight into Primal+keto, it can be a shock to the wallet.

Sure, I can tell you that this is an investment in your long-term health and spending more on food now means spending less on medical care later. I believe that. I also know that doesn’t help you today if you’re looking at your food budget and your fridge, now mostly empty after purging it of non-Primal, higher-carb foods.

If you’re committed to making Primal+keto work on limited funds, it can be done. Here are some tips for making it happen.

1) Buy What You Can Afford

With Primal+keto, there are ideals when it comes to food quality, and then there’s what fits your budget. Now is the time to call on the saying, “Don’t let the perfect be the enemy of the good.” Don’t stress about buying the best quality everything. Don’t forgo eating vegetables because you can’t always fit organic options into your budget. Non-pastured eggs still have more to offer nutrient-wise than a bagel for breakfast.

In terms of priorities, aim for better quality meat. (I’ll include tips for finding less expensive meat choices below.) Check the Monterey Bay Aquarium’s Seafood Watch to see which types of seafood are worth your money and which should be avoided altogether; don’t spend money on the latter.

For produce, check out the Environmental Working Group’s Dirty Dozen—the vegetables and fruits they recommend buying organic—and the Clean Fifteen that are safer to buy conventional. Of note to keto eaters, spinach and kale should be organic, but many of our keto-friendly faves make the clean list. Don’t stress if you need to choose conventional avocados, cauliflower, and broccoli.

Remember, too, that it’s not always necessary to look for the organic label even for the “dirty dozen.” If you’re buying from local farmers, ask about their practices. Many small farmers are pesticide-free or use organic practices but simply can’t afford the process of becoming organic certified (it’s quite expensive and arduous). The same goes for meat.

2) Don’t Menu Plan

I’m going against the grain here. Most articles on budgeting tell you to make and stick to a strict plan. I find, however, that it’s more cost-effective to let sales be my guide. I’d rather check out my local grocery stores and farmer’s markets, buy what’s cheapest, and make it work. Use apps that tell you where the sales are and buy accordingly. Sign up for the customer loyalty cards at the stores you frequent so they can send you deals and coupons.

I realize that this might sound stressful if you don’t feel confident in the kitchen. If you’re beholden to recipes, this doesn’t always work. (Of course, you can always look up recipes on your phone in the grocery store—I’ve done it a million times.) Remember that you can always default to making a Big-Ass Salad or an omelet or scramble.

3) Shop Around

Get to know the various supermarkets, specialty stores, and farmer’s markets in your area. Learn what’s the freshest, cheapest, and most likely to be available at each. While it’s convenient to do one-stop shopping, it might be worth the extra time it takes to make two or three different trips during the week to hit up different stores.

Think outside the traditional grocery store box. In many smaller communities, a “big box” store may have the largest selection of meat and veggies, including organic, and a wide variety of specialty products. In my town, Grocery Outlet is the best place to buy organic coconut oil and olive oil, and they carry lots of other keto-friendly staples like nut butters, grass-fed meat, and cheese at low prices.

If you have access to a farmer’s market, definitely make sure you check it out. Sometimes farmers will mark down their remaining items at the end of the day so they don’t have to pack it up. You won’t have the same selection, but you might score some deals.

Also look into local CSAs, farm stands, and meat purveyors who sell direct to customers. Again, you can often find ones that offer sustainable practices and high-quality products without the expensive organic label. Check out Eat Wild and Local Harvest to find farmers near you. I’m a fan of CSAs that sell “ugly produce”—the items that aren’t pretty enough for grocery stores but that are still tasty and nutritious—so it doesn’t go to waste.

Finally, check Facebook marketplace, Craigslist, and so on for people looking to sell backyard eggs for cheaper than the store. If you live in an area where people hunt, you might be able to score some meat this way during hunting season, too.

4) Skip the MCT Oil and Exogenous Ketone Products

Unless you have a medical reason to have very elevated ketones, these expensive products aren’t a priority. You don’t need them to do keto “right.”

5) Reconsider the Keto-fied Baking

Almond flour, coconut flour, arrowroot powder, erythritol, and so on can also be pricey. From a nutrient perspective, there are better ways to invest your grocery dollars. You don’t have to give it up entirely, but consider how big a chunk it’s taking out of your budget and whether it’s worth it.

6) Eat the Stuff that Other People Don’t Want

I’m talking organ meat, bone-in chicken thighs and drumsticks, sardines, and the like. The great irony is that these are some of the most nutrient-packed foods in the store, and you can often get them for cheap because the average consumer is looking for boneless, skinless chicken breasts. Good news for you!

Ask the butcher at your grocery store if they have organ meats or cuts that they aren’t going to put in the case because they aren’t popular enough. You might be able to snag cheap (or even free) bones for bone broth that way too—although probably less so now that bone broth has become such a trendy item.

If you’re squeamish about organ meat, remember that almost anything can be ground up in a food processor and mixed with ground beef for burgers or meatballs, or to be hidden in chili or meat sauce. Heart is an excellent place to start. It doesn’t have the distinctive strong flavor of liver or kidney, and it’s very affordable.

7) Your Freezer is Your Friend

Many items are less expensive if you buy them frozen—vegetables (especially off-season), berries, seafood—and they’re just as nutritious. Freezing also allows you to buy in bulk and freeze the extras, or prepare big batches of food and freeze smaller portions for later. If you have a chest freezer, look into splitting a cow or a pig with friends. This can sometimes land you a great deal on a pasture-raised animal.

Throwing away food is throwing away money. There’s no reason to waste food if you have a freezer. Most leftovers can be frozen if you’re not going to consume them immediately (though some things, like mashed cauliflower, don’t reheat well). If your avocados are on the verge of going bad, slice and freeze them. Blend fresh herbs with your oil of choice and freeze them in ice cube trays to add to soups and sauces later. Strain leftover bacon grease into a jar and freeze that, too.

My favorite freezer trick is to keep a large zip-top bag to which I add vegetable trimmings like the ends of carrots, celery, onions, and beets, and broccoli stems. I also keep the bones from all the delicious bone-in meat I’m cooking. (I always buy bone-in when I can—it’s one of Dr. Cate Shanahan’s Four Pillars of health.) This allows me to…

8) Make Your Own Bone Broth (and Nut Milk)

Bone broth is a hot commodity nowadays—no pun intended—and you can spend a pretty penny on it at the store… or you can just make it yourself out of stuff that other people are throwing away.

Whenever I cook a whole chicken (which is usually more cost-effective than buying just breasts or thighs), or when my aforementioned freezer bags fill up, I make a batch of bone broth in my slow cooker or Instant Pot. To store it, I freeze it in mason jars or silicone muffin cups. The latter makes broth “pucks” that are uber convenient for adding to dishes later.

Nut milk isn’t necessary for keto obviously. However, if you’re dairy-free and buying nut milk, you really have to try making your own. It couldn’t be easier, and I strongly prefer my homemade nut milk (a blend of almond, hazelnut, and Brazil nut) to anything I can find in the store. As a bonus, I use the leftover nut pulp to make pancakes, bread, and rolls. (See the recipe in The Keto Reset Diet.)  It’s a double bang for my buck, and no waste.

The Good News…

Despite the naysaying, it’s not only possible to do keto on a budget, but sometimes going keto actually saves you money. First, many people are able to reduce or eliminate certain medications—insulin, blood pressure meds—which can be a significant monthly savings. Second, once you’ve become keto-adapted, you might find that you’re eating fewer calories overall for the same amount of energy. Mark touts this benefit all the time.

Also, your “non-essentials” budget usually goes down. I’m talking things like frappuccinos, restaurant desserts, and alcohol. The cost of a night on the town decreases significantly when you’re fully buzzed off a glass and a half of wine once you go keto! (And when you’re not ordering 2 a.m. pizza.)   

So, let me turn it over to you: Do you have other tips for making Primal+keto easier on the wallet? Share them below, and have a great week, everybody.

The post 8 Tips For Keto on a Budget appeared first on Mark’s Daily Apple.