3 Ways To take care of SI-Joint Pain Without Medication or Surgery

I have struggled with SI joint pain for many years, and short of an orthopedist, I have been to all kinds of healthcare professionals – physical medicine and rehab doctors, sports medicine doctors, osteopathic doctors, chiropractors, physical therapists, acupuncturists, massage therapists – you name it. Needless to say, my pain is chronic now, but I have come to figure out how to keep the pain in check, without medication.

Sacroiliac joint (aka SI joint) is the tiny joint that connects your pelvic bone to your spine with its main job to support the upper body. SI joint pain is a common cause of low back pain, and chronic pain. Almost all adults in the US will experience low back pain at least once in their life, and estimated 1/5 to 1/3 of those cases are caused by SI joint pain. People with SI joint pain usually have worsening pain with twisting or rotating motions. They often find that their pain gets better when they engage their abdominal muscles, which helps stabilize the pelvis. Standing up from a seated position or sitting up from a lying position is hard. Asymmetry in the pelvis from posture or scoliosis is one example. Personally I have both, and a fall a few years ago put me over the edge. A few other factors can worse SI joint pain – one is lack of flexibility, and increased tension in the surrounding muscles, and decreased stability of the muscles that keep the pelvis stable.

Treatments for SI joint pain can include anything from exercises, to massage, to oral pain medication to injectables. I am not one to shy away from these treatments for those who will not be harmed by them, and for those whose quality of life is crippled by pain. However, I really think the non-pharmacologic and non-invasive treatments – the treatments for issues that do not involve medicines or surgery -don’t get enough attention. I have a whole blog post on no-medicine/no-surgery ways of dealing with chronic pain, but sometimes you need just the right medicine for the cure. Heres a few golden nuggets of advice for fellow sufferers of SI joint pain.

  1. Try the below muscle energy techniques. Do each one for about 30 seconds 3 times. They can reset things pretty immediately.  

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If you don’t really feel like the pictures help, here is an awesome video

This particular one is hard to understand without a youtube video. Thankfully, this is only a 39 second video.

2. Try foam rolling! 

There is no good way to describe how to  describe how to foam roll, but it will make your life so much better. My pilates instructor Michele is so amazing, she put these videos together JUST for me. They are fabulous. Click on the images to go to the website where her videos are.

Foam-rolling hipsFoam-rolling legs

3. Try these stretches: 

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“Love Juice” Iron-rich Smoothie

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As Valentines day approaches, some of you may be wondering what would be a fun, creative and healthy way to take advantage of another American tradition that usually makes for fun cubicle decorating and themed parties. Well, do I have the answer for you – an iron-rich beet and apple smoothie! This smoothie is named after one of my favorite cafe owners in history – Drew, from the Namaste Cafe in New Brunswick, NJ. Drew no longer owns Namaste Cafe, but he came up with all the great recipes they ever served, and one of my favorite juices there was this apple, beet, lemon, ginger conconction called love juice. A search for iron-rich foods yielded this amazing recipe, which reminds me so much of the love juice at Namaste Cafe

love juice 2

Some caveats: If you have anemia, make sure you are evaluated by a doctor or healthcare professional. If you have moderate to severe anemia, you may need to take iron pills, or you might even need more significant intervention, such as a blood transfusion. This is not a substitute for necessary medical care (as is the case with anything else on this blog).

One thing about iron pills is that they are somewhat constipating. This smoothie is quite the opposite. No sense feeling bound up in addition to being sick! This is a great smoothie for those who are anemic or have a tendency for heavy monthly cycles, even if you are already on an iron pill for a short period of time.

Men have to be wary of having too much iron, but this does not have enough iron to cause iron overload in men (men need about 8mg of iron. This smoothie has about 2 mg. Pre-menopausal women need about 18mg per day)

Ingredients:

  • 2 small beets, cut into large chunks
  • 1 apple – large chunks
  • 4 dates
  • 1/2 cup kale
  • 1-1.5 cup water

Directions:

  1. Blend all ingredients in a blender until smooth. May need to add extra water to achieve desired consistency.
  2. Pour into a cup and enjoy!

-DS

 

Healthy Vegetarian & Gluten-Free Stuffed Peppers

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Stuffed peppers are a healthy and versatile dish because you can choose to put a variety of ingredients as the “stuffing”. Traditional stuffing is made usually with ground meat, cheese and some veggies but I like to make my own version that is both vegetarian and gluten-free. Another great thing about this stuffed pepper dish is that you can make it either on the stove or in a crockpot. IMG_0505

Ingredients: (serving size=6)

  • 6 bell peppers
  • 8 oz of organic frozen spinach (preferably whole leaf)
  • 6 oz of organic cottage cheese
  • 2 cups of cooked brown rice
  • 2 eggs
  • 4 mushrooms, diced
  • 1 cup of corn
  • 1 cup of carrots, diced
  • 1/4 cup of onions, diced
  • parsley, chopped
  • 4 cups of vegetable stock
  • salt and pepper
  • 2-3 tbsp of olive oil
  • 1 tbsp of pepper flakes
  • Options: parmesan cheese, grated

Crockpot Directions:

  1. Cook the brown rice either in a rice cooker or on the stove top. Do this few hours early or the night before (you can refrigerate the rice).
  2. Cut the tops off the bell pepper and removed all the seeds and ribs.
  3. Heat the olive oil in a large skillet, add the onions and carrots. Cook until the onions become translucent.
  4. Add the mushrooms, spinach and corn. Cover the skillet and let it cook in low-medium heat until the frozen spinach is melted (~3 min).
  5. Add the cooked rice and season with pepper flakes and salt
  6. Remove from heat. In a separate bowl, mix the 2 eggs, then add the mix into the rest of the stuffing.
  7. Add chopped parsley, cottage cheese. Blend and season the mix with pepper.
  8. Place the stuffed peppers (with the opening facing up) into the crock pot.
  9. Using a spoon fill each of the peppers with the “stuffing”.
  10. Add the vegetable stock to the base of the crockpot. Avoid adding any liquid to the inside of the pepper.
  11. Option: top each of the stuffed peppers with grated parmesean.
  12. Cook the stuffed peppers on high heat for 3 hours.
  13. Serve warm and enjoy!

Stop Top Directions:

  1. Cook the brown rice either in a rice cooker or on the stove top. Do this few hours early or the night before (you can refrigerate the rice).
  2. Cut the tops off the bell pepper and removed all the seeds and ribs. The split the peppers into half vertically.
  3. Heat the olive oil in a large skillet, add the onions and carrots. Cook until the onion becomes translucent.
  4. Add the mushrooms, spinach and corn. Cover the skillet and let it cook in low-medium heat until the frozen spinach is melted. (~3 min)
  5. Add the cooked rice and season with pepper flakes and salt
  6. Remove from heat. In a separate bowl, mix the 2 eggs, then add the mix into the rest of the stuffing.
  7. Add chopped parsley, cottage cheese. Blend and season the mix with pepper.
  8. In a separate skillet, add ~1 tbsp of olive oil and place the stuffed peppers the skillet. Let it cook in medium heat ~3 mins.
  9. Turn off the stove, and using a spoon fill each of the peppers with the “stuffing”.
  10. Add the vegetable stock to the base of the pan. Avoid adding any liquid to the inside of the pepper.
  11. Option: top each of the stuffed peppers with grated parmesean.
  12. Put a lid over the skillet and cook the stuffed peppers on low heat for  ~30 minutes or until the liquids are gone.
  13. Serve warm and enjoy!

-NZ

5 Easy Filling Snacks with Peanut Butter that Will Make You Ditch the Snickers: All Less than 5 Ingredients!

Today, I had a craving for one of my breakfast staples, which is super filling, and peanut butter is the major ingredient. For me, when trying to eat healthy, feeling full and satisfied is important. Peanut butter is one thing that consistently does a great job of filling my tummy, and over the years I have found some great recipes to fill my life with some rich, nutty flavor but still keep it healthy. Here are some examples.

Note: I always use natural peanut butter with no added sugar, preferably organic, and preferably made with 100% from valencia peanuts.

  1. Peanut butter, chocolate chip and banana sandwich on cinnamon raisin bread: IMG_2431This is one of my go to quick meals, especially for breakfast. I am not a huge fan of Ezekiel bread, but I love the concept, and they really do knock it out of the park with the cinnamon raisin. Slather on a thick layer of peanut butter, sprinkle on a tablespoon of dark chocolate chips, and cover with slices of half of a large banana. Sprinkle with shredded coconut. This is about 400 calories, is SUPER filling and really delicious. Its a really sensory experience too because of the aroma of the cinnamon-raisin and the peanut butter.

 

2. Ants on a log:

This is a great kid-friendly snack that my friend Surbhee  (A co-founder of this blog) taught me. She spent years working as a nanny, and gave me this recipe when I had to work with some clients who had young children. I still use it as a staple and if you ate these when you were a kid its one of those get-in-touch-with-your-inner-child moments. Spread some peanut butter on a small celery stick, space out some raisins, and you are in business.

3. Grilled peanut butter and banana sandwich:

I have the edgy veg blog to thank for this one. I use trader-joes brand rustico bread instead of Ezekiel, but same concept.

4. Peanut Sauce:

Peanut sauce is a super easy condiment and all you need to whip it up is peanut butter, soy-sauce and sriracha. Maybe some sugar or honey. Check out our recipe here. This is great if you have a snack attack – whip this baby up and use it as a dip for carrot sticks, roasted or steamed broccoli, or as a topping for some spiralized veggies.grain_free_chocolate_chip_cookie_dough_bites1

5. Peanut-butter Cookie dough bites:

These grain-free, vegan little gems made primarily of chick-peas are super filling and super delicious. Just look at them! They have an incredibly short ingredient list, are FULL of protein, and taste amazing.

Goji Berry Tea

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Doing a detox or a cleanse in the new year? One great substitution for sugar and/or caffeine is the energy-boosting goji berry. Native to China, this reddish orange berry has long been used in Chinese medicine and food for its powerful nutritional benefits.

herbal20tea20with20goji20berriesA randomized, placebo-controlled study showed drinking goji juice significantly improved energy level, mental acuity and your sleep cycle.

Goji berries are sold in their dry form available at most health food stores. You can consume them either as is (like raisins), or brew them to make a tea. Since goji berries are naturally sweet, I don’t use any sweetener.

Goji berry tea Instructions:

  • Bring two cups of filtered water to a boil and pour the boiled water into a tea pot.
  • Add a half cup of goji berries and let the tea steep for 15 minutes.
  • To get all the goji juice into the tea, use a spoon to press on the goji berries.
  • Strain as you would a regular tea.
  • Option to add lemon slices to your tea if desired.
  • Serve the tea hot or chilled!

References:

Users Guide to Mung-Bean Sprouts

 

stock photo by dreamstime.com

First off, I want to apologize for being inactive for almost a month. The Practice Vitality writers have all had some personal issues they have had to deal with, and somehow all at the same time. It’s not easy to share issues of a personal nature over the internet, but we have always wanted Practice Vitality to be about a healing community, so once things simmer down, I will let my friends in the blogosphere know what has been happening with me (but not my co-contributors). I will say this – being a doctor and a patient at the same time has been an interesting experience.

With the new year coming, probably many of you will want to start the year off with a cleanse. Personally, I favor cleanses in the spring and the summer, when many of the fresh, cool, crisp foods used in a cleanse are better tolerated. Mung beans sprouts are a great cleansing food for the winter due to their easy digestibility. In Ayurveda, they are considered cooling, so adding some warming Indian spices and healthy oils can help make them more suitable for the winter.

Mung bean sprouts are a childhood food for me, but they have been considered a healthy food for thousands of years such as in ancient health systems like Ayurveda. For more info, check out this post by Joyful Belly Ayurveda – one of my favorite websites for ayurvedic nutrition. It’s a very user-friendly and approachable resource for ayurvedic and integrative nutrition. Mung beans are high in one of my favorite compounds – resistant starch, which has shown some evidence that it can be helpful for colon health and for the gut microbiome.

How to Make Mung Bean Sprouts:

Mung bean sprouts take a little planning, but very little time or preparation. Usually, I make mine over 2 nights.

  1. Soak your mung beans. I soak them at least for 12 hours. I change out the water after a day if I don’t end up going to the next step.
  2. Drain out the water, and cover the bowl of mung beans with a lid. Place a tissue on the bottom of the bowl to collect the excess water.
  3. Wait a few hours – as few as 3 hours but can be as long as 12hrs.

Tips:

  • The sprouts need a moist environment but they should not be wet.
  • Alternately, you can put the beans in a moist cloth and gather the cloth tightly in a ball which you can let hang in the kitchen. You can also just put the mung beans in a nut-milk bag and let them hang.
  • If you live in a cold climate, you may want to put the sprouts in the oven with the pilot light on to help them along.
  • Cooking sprouts thoroughly can prevent illness from sprouts
  • Wash sprouts thoroughly before eating them or cooking with them
  • Wash seeds in peroxide preheated to 140 degrees fahrenheit to help minimize bacteria. Peroxide is not a harmful chemical in these small amounts.
  • The longer you wait for the seeds to sprout the more likely you are to have bacteria on the sprouts.
  • Refrigerate sprouts once you have made them.

Now, you should all know that I love sprouts for the health benefits, but there are risks, just as for anything. Sprouts have to grow in warmer, more humid temperatures, which bacteria also love and so there is a risk of food poisoning with E. Coli. Making sprouts at home actually has more risk than buying sprouts outside because the sprouts makers work with the FDA to minimize the risk. Here is a website from UC Davis the has some suggestions on how to minimize the risk of food poisoning. Pregnant women, young children and elderly, and people who could have a compromised immune system should not eat home-made sprouts. 

Here are some other posts to use as references to help you get a good idea on how to make mung bean sprouts:

Serving:

  • Serve Mung bean sprouts plain as a snack, or with a couple of squeezes lemon, 1/2 tsp salt and a pinch of  chili powder and turmeric. Chopped cilantro is a nice garnish. You can also add carrots and grated fresh coconut.
  • Add warming indian tempering spices, such as in this short youtube video. Sesame oil and ghee are great options, but keep in mind that in Ayurveda sesame oil is heating and if you have heavy periods they can get worse if you use sesame.

gluten free fridays

checkout gluten free fridays at http://vegetarianmamma.com/gluten-free-fridays/


  

Holiday Eater Forgive Thyself

The holidays can often be a binge fest for many of us. Everywhere we go, we are surrounded by sugar and fat. Whether it be a work-related holiday party or a family gathering with (sometimes unhealthy) traditional food that evokes warm memories, the holidays can feel like a constant attack on the senses for the health savvy.

Tis the season of love and forgiveness, they say, and in that holiday spirit, its important to forgive the most important person of all – you!

Have you ever had a huge meal and then felt regret about eating too much? Does that regret then degenerate into self-hatred, which then makes you give up on your goal, or eat more in order to punish yourself? I’m thinking of the cartoon Cathy, who millions of women have identified with over the years, and more recently, Mindy Lahiri of the Mindy Project. If these pop-culture phenomena strike a nerve with you, you are not alone in your self-loathing. However, it may not be helpful.


A study at the University of Canterbury gives us a few reasons why forgiving yourself is a positive when it comes to health habits during the holiday season:

  1. People who associate food with guilt are less likely to lose weight in the short term compared to those who associate it with celebration
  2. People who associate guilt with food are more likely to have less control over their eating
  3. Those who associate guilt with food are less likely to maintain their weight.

The above study does not mean that people who feel less guilt around food are skinnier, nor does it definitely say there is overall no benefit to using guilt to help you with a diet, but it is food for thought, but it makes you think twice about the self-hatred many of us engage in during the holidays.

 

Golden Milk

Fall is in full swing! The days are getting shorter, the air is crisp, and finding a cuddle buddy feels like a necessity. There is an urgent feeling of having to be indoors and get everything done before it’s dark, which can be as early as 5p these days!

I have been enjoying this simple cup of comfort I want to share as an alternative to the age old warm milk at night. Growing up on the East Coast, I use to love having hot milk during the Fall and Winter months. I also had pretty severe eczema and later came to discover I needed to eliminate wheat and dairy completely. With so many dairy alternatives on the market these days, (including easy homemade nut milk recipes!) replicating this nourishing beverage has been easy.  In addition, this simple nurturing hot beverage includes Turmeric and Ginger which are loaded with healing benefits and aid in keeping a strong immune system during cold- catching winter months.

Recipe for Golden Milk:

Time: 3-5 minutes

-1 cup Almond Milk (or your favorite dairy alternative)

-1 tbsp. Turmeric

-1 small piece crushed Ginger

-1 tbsp. Raw organic Honey

Directions:

Start by bringing the Almond milk to a boil in a saucepan. Reduce to low heat and add crushed ginger. Turn off heat and let sit for a minute. Pour into your favortie mug and add Turmeric and Honey.(more/less depending on your liking). Sip and enjoy this nourishing warming beverage as you let go of your day.

-SM

Vegan Potato Salad

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Potatoes are probably one of the most readily available produce out there. They are available all year long, and when prepared correctly, can be nutritious as well. They contain vitamin B6, potassium and vitamin C. Generally, nutrition and taste vary depending on the type of potatoes: from russet to red to purple potatoes, potatoes come in a lot of different varieties.

While everyone have their own concept of the ideal potato salad, I like my potatoes to be a little on the firm side with skins intact (more nutritious). I prefer to use red potatoes, purple potatoes or fingerling potatoes, but feel free to sub the recipe with your favorite potatoes. Be sure to pick organic potatoes, to avoid GMOs.FullSizeRender

Here is my vegan potato recipe:

  • 1 lbs. organic potatoes
  • 1 cup of vegan mayonnaise (I use Grapeseed Oil Vegenaise®)
  • 2 tbsp. pickle brine
  • 1 1/2 tsp. sea salt
  • 1/2 tsp paprika
  • 11/2 tbsp. Swiss sweet mustard
  • 1/4 tsp. ground black pepper
  • 1 cup thinly chopped celery
  • 1/2 cup peas (frozen or fresh)

DIRECTIONS:

  1. The best way is to steam whole potatoes, as it retains more of its water soluble vitamins (such as vitamin C) than boiling. But, you can also boil them as an alternative.
    1. To steam: steam potatoes in a large pot ~10 minutes
    2. To boil: cook whole potatoes with water in a pot in medium heat until the water boils. Reduce heat to low and simmer until potatoes are tender, about 10 minutes.
  2. Cool the potatoes.
  3. If you are using frozen peas, make sure to boil or steam the peas first (~3 minutes).
  4. Cut the potatoes into bite size cubes.
  5. Add the cut potatoes along with celery and peas in a mixing bowl. Season with salt and mix.
  6. Add the rest of the ingredients and toss gently.
  7. Cover and refrigerate the potato salad for at least an hour. Serve chilled or at room temperature.

-NZ

Top 6 Vegan Products to Buy at Trader Joes

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Top 6 Vegan Products to Buy at Trader Joes

First, want to thank Deborah of Urban Naturale for featuring us on her Plant-based postluck party! Our fall root-vegetable vegan black-bean burger was featured.

I want to start this post with a caveat – I am a huge fan of the plant-based lifestyle and I have tried to go vegan many times, but I have not yet fully succeeded. My last attempt floundered when I was doing a 2-week night-shift around the holiday season. Trust me when I say ICU nurses and Emergency Department nurses ALWAYS have access to candy and dessert, ESPECIALLY around christmas time! And then there was the candy drawer in the family medicine office – let’s just say nurses will always make sure there is some candy around. Maybe it’s because of their motherly nature, or due to their stressful jobs, or because their patients are so grateful to them and bring them candy. Probably a combination. I love my nurses though – couldn’t have survived residency without them!

Despite my unsuccessful vegan attempts at being vegan, my fridge and pantry is almost completely vegan, and I rely on certain products to make the majority of my diet pretty close to plant-based. Trader-joes has been a life-saver. My favorite story about trader joes is that the first voluntarily organic thing my husband ever bought was from Trader Joes! Pretty cool, huh?

I got the idea for this post because I saw this one from A Dash of Soul about the best vegan items at TJs, and after I got myself some of that strawberry coconut dessert, I decided the world needed to know how Trader Joes helps me be practically vegan. Here goes!

  1. Mildly Spiced Organic Vegetable Burritos: These guys are awesome. You get two burritos for $3.29! Way cheaper than the other frozen burrito alternatives out there – Amys black bean vegetable burritos for example, are generally $3.00 for one burrito. And they are quite delicious. A lot of vegan burritos have a ton of rice, and this decreases the nutrient density of the burritos. These burritos are big on vegetable and bean content. I usually take off some of the tortilla to further improve on the nutrient density.
  2. Trader Joes Creamy Valencia Peanut Butter – This peanut butter is one of the best peanut butter finds ever! Valencia peanuts are super low in sugar and starch, and have 3g of fiber per 2 tbsp serving. Valencia peanuts are less likely to have aflatoxin, which is something found mostly in peanuts grown in humid climates. Although the government monitors how much aflatoxin is allowed in peanut butter, it’s always good to minimize the possible susceptibility to liver cancer. Valencia peanuts are also generally sweeter. This means they really don’t need any extra sugar to sweeten the peanut butter.
  3. Trader Joes Goddess Dressing: For those who love creamy dressings, this one comes as a salad-rescue. This dressing has a tahini base and is one of my favorites, next to just using lemon, salt, pepper and olive oil. The tahini flavor isn’t over-bearing either. Beware the fat content though! 18% of your daily recommended intake!
  4. Trader Joes Cruciferous Crunch Collection Salad Mix: The easiest salad you will ever make is using a small handful of this salad mix, and combining it with a bigger handful of any other salad green (eg. Arugula, Spring Mix, Mache) and adding a small handful of nuts. Toss with the above dressing, and voila! You have a salad that is crunchy and flavorful, and of course, packed with immune-boosting, cancer-fighting cruciferous vegetables.
  5. Trader Joes Organic Oats and Flax Seed Oatmeal: Flax seeds pack lots of nutrition. They are high in fiber and omega 3 fatty acids. Flax seeds and oats are both particularly high in soluble fiber, which is really good for decreasing your cholesterol (soluble fiber binds to bad cholesterol and fat). Soluble fiber also is particularly helpful for improving your gut flora as it has prebiotic properties (helps build a favorable environment for good bacteria to grow). Thats why this product is a staple in our house. Beware – it does have some sugar – 1 packet has 11g to be precise. That’s about 2.5 tsp. I’m willing to live with that.
  6. Trader Joes Dark Chocolate Chips – I know, they are a dime a dozen – most dark chocolate chips are vegan, too. However, a lot of dark chocolate chips are kind of hard and you might as well be biting into very sweet cacao nibs. The way these are formulated, they are super deliciously easy to bite into. Throw them in your oatmeal, eat them on a peanut butter sandwich with some toasted coconut, blend them in your smoothies – these are magnesium containing, anti-oxidant rich, pure decadent, deliciousness. 1 tablespoon of these contains 8g of sugar, so something to watch out for.

Do you have any TJs favorites? Would love to hear yours!

-DS

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