PT 360 - May 2020

Getting you back to the life you want to live.


M ay 2020

In Touch

T he S paces I n B etween ...


Shelly Coffman

baking fool because that’s my daughter’s love language — cooking together (and sugar, apparently). Our amazing PT 360 team member Kristi gave me the incredible gift of a clean desk, and not having to manage paper piles is the BEST. PRESENT. EVER. What I came to realize, that I already knew but didn’t think was ever possible to experience, was that removing the static of ALL THE THINGS left quite a lot of peace in the spaces in between. Every member of our PT 360 family brought that extra bit of peace to our work world— anchored, stable, and grounded with all the warmth for each other and our patients flowing forth in all the questionable days. We leaned on each other, we muddled through together, and we gave each other all of the support that 6 feet of distance allowed us. We are a stronger team for it. We are, at our core, helpers. We have helped each other, and it has helped us be able to continue helping our folks whether in the clinic or virtually (which has been a fun newmedium!). Having the space to step back, recalibrate, and reassess what really fills our buckets and helps us fill others’ buckets — that’s a gift at any time, but a high-value gift in a time of uncertainty. My wish for you is that you have had the opportunity to look at the spaces in between and feel the comfort of not automatically filling those spaces, but sitting quietly and filtering down to the things that really matter. It may not be “Tiger King” (I know I’m going to get a little backlash for that one), but the time spent curling up with your loved ones, even virtually, will go in the big bucket. –-Shelly Coffman

Last month’s newsletter topic (written before COVID-19 hit Oregon) seemed a world away. In early April, we received our in-clinic copies with sweet Nova’s face on the front, and of course, I think Nova is an excellent dose of Xanax for anyone who needs it in these anxiety-inducing times. And I reread my article, hoping the tone wasn’t too off- putting for our current life experience. These days of no contact are full of stuff we wish we had (hello grocery store quick trips, the gym, or even more importantly, hugs and jobs), stuff we’re glad we have (family time, sleep, the sun, a roof over our heads, and jobs), and what I am personally currently grateful for: stuff I am now clear that I don’t need. Last month I was talking about being laser-focused on goals and what we can accomplish just given the time and attention. We all are short on time. It’s only gotten worse with the onset of the digital age — always available, always bringing new information, and most importantly, always distracting from our focus. In this time of staying at home, “digital-ness”has most certainly ramped up for most of us. Netflix stopped asking us if we were still watching, because, duh! What I have become so appreciative of is time. Y’all stopped wanting early morning appointments about 10 days into this thing because 10 a.m. became the new 8 a.m. I got to have early morning deep conversations with my daughter while taking leisurely walks with the dog. I started running to the park to keep my lungs and cardiovascular health up, and I love hearing the birds and the quietness of the streets. I became a

H ow R egular W orkouts C ould H elp P revent A lzheimer ' s

Imagine if you spent a day standing outside your local gym and asking everyone who went in the same question: “Why are you working out today?” What kind of responses do you think you’d get? Some answers, like “I want to lose weight” or “I want to build muscle,” are obvious, but there’s another contender that might rise to the top: “I want to clear my head.” Anecdotally, most of us know that a hard run or a challenging weightlifting session can help declutter our minds and push petty worries and stressors away. But according to one study, it’s possible that exercise can literally clear up messy nerve cells to restore and improve our memories. For the more than 50 million people diagnosed with Alzheimer’s, this simple treatment could prove revolutionary. In a 2018 article, Scientific American describes the brains of people with Alzheimer’s as “harsh place[s] filled with buildups of harmful nerve cell junk,” including amyloid plaques and neurofibrillary tangles. This complex neural web makes the disease difficult to treat, but an experiment conducted by scientists from Harvard Medical School, The Salk Institute for Biological Studies,

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and other notable institutions found that exercise helps clear up the tangles and improve learning and memory in mice with Alzheimer’s. The scientists even went a step further, identifying a particularly helpful molecule called BDNF that gets a boost from exercise. Now, pharmaceutical companies can use that insight to formulate drugs for Alzheimer’s that raise BDNF. Until those drugs arrive, though, exercise alone might help prevent or heal memory loss. As Dr. Jonathan Graff-Radford puts it in an article for the Mayo Clinic, “Studies show that people who are physically active are less likely to experience a decline in their mental function, have a lowered risk of developing Alzheimer’s disease, and possibly have improved thinking among people with vascular cognitive impairment.” Multiple studies have found that exercise even helps the brain grow, adding volume to the prefrontal cortex and the medial temporal cortex, which control thinking and memory. To get these benefits, you need to make exercise a regular part of your routine, although you don’t necessarily need to sweat every day. One study found that women who walked briskly for just one hour twice a week achieved increased brain volume over six months to a year. If you can’t spare whole hours, you can break that time up into shorter sessions to get results. In an article for Harvard Medical School, Heidi Godman writes that just about any moderate-level exercise will do. She recommends swimming, stair climbing, tennis, dancing, or even chores like mopping floors or raking leaves — pretty much anything that gets your heart pumping. To hold yourself

accountable, try partnering up with a friend, keeping a journal of your progress, or hiring a personal trainer.

“Whatever exercise and motivators you choose, commit to establishing exercise as a habit, like taking a prescription medication,” Godman writes. “After all, they say that exercise is medicine, and that can go on the top of anyone’s list of reasons to work out.” The next time you find yourself struggling with brain fog or worrying about your memory declining in old age, instead of focusing on those negatives, try packing a bag and hitting the gym. If it works for the mice, it just might work for you, too!

U nlock Y our S pice P otential ! T he T echniques B ehind M aking E xcellent I ndian F ood

into it. This technique jazzes up any Indian dish, and getting creative with spice combinations is half the fun!

Indian food is a dream cuisine for many plant- based, vegetarian, and vegan eaters, but it can seem very intimidating to cook at home. That’s only because you may not be familiar with the cooking

Bhunao (Sautéing and Roasting) In order to understand how to bhunao, you need to be familiar with masala, an Indian spice mixture that has been ground into a powder or paste. Most commonly, masalas are a combination of onion, garlic, ginger, tomatoes, and spices. However, masala ingredients can vary according to region and personal preference, but you can find some version of it on the spice aisle of most grocery stores. To bhunao, start by heating oil. Then you add your masala and cook over medium-high heat. As the water in the masala evaporates, it’ll stick to the pan; use splashes of water, yogurt, or stock to loosen it and prevent burning. Do not let your masala burn! Your masala has been “bhunaoed” once it’s thick and shiny and you can see the oil has separated. Finally, add meat and vegetables and cook down to your liking. This is the most important technique for recreating Indian curries, such as tikka masala and korma. Now that you know a few Indian cooking techniques, be creative in the kitchen! When you’re not following a recipe, you can have fun and explore different flavor combinations while still knowing exactly what to do.

techniques used to make it. How do you make the most of your spices? How do you combine vegetables (and/or meat) with the spices? Here are two techniques to get your favorite Indian dishes tasting as authentic as those served at a restaurant.

Baghar/Tarka (Tempering) Add whole spices (cumin, cloves, cardamom, peppercorns, curry leaves, dried pepper, etc.) to oil

and fry until fragrant. That’s it! The spices infuse the oil with flavor, and the roasting further develops the spice. You can temper spices at the beginning of a recipe, like a curry, before adding other ingredients, or you can stir it into a dish right at the end, like dal or stew.

Every Indian household has a different version of tarka dal, which is essentially prepared lentils with a tempered oil and spice mixture stirred

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S hould Y ou S kip Y our W orkout if Y ou D on ' t F eel W ell ? W hy S ome E xercise I s B eneficial W hen Y ou ' re S ick

Getting sick is terrible, especially if you’re trying to stick to a consistent workout routine. You may think sickness means more rest days — but in fact, depending on your symptoms, continuing to exercise could be a good thing. While it may seem like common sense to avoid exerting yourself too much when you’re feeling under the weather, the effects of exercising while you’re sick are a bit more nuanced than you think. If you’re sick and trying to decide if you should try to get a workout in, assess where you feel your symptoms. Are they only above the neck? Or are they above and below the neck? Symptoms of a head cold, such as a runny nose, a mildly sore throat, and some congestion, shouldn’t keep you from exercising. At the very worst, you might just have to cut back the intensity of your workout. If you usually go for a run, try decreasing the time of your run or going for a walk instead. There’s actually evidence that exercise can help alleviate symptoms located above the neck when you’re sick. For instance, walking and jogging can help clear up congested nasal passages. Many runners will attest to the fact that their workout actually helps them feel better when they’re sick. There’s also evidence that yoga can boost your immune system and ease aches related to sinus issues. Saying “om”might even help too, as one study found humming could actually aid in opening clogged sinuses.

seem to exacerbate your sickness, take a break until the sickness subsides. That said, it’s nice to know that it takes more than a little case of the sniffles to throw off your workout routine!

R hubarb C ake

If you have a fever or any type of stomach problem, however, you should skip your workout altogether. And if your workouts

Nature’s favorite tart vegetable — yes, rhubarb is a vegetable! — is in season once again. Celebrate rhubarb season with this simple, delicious cake.


• 2 eggs, beaten • 1 cup sour cream • 3 cups rhubarb stalks, diced • 1/4 cup butter, softened

• 2 1/4 cups white sugar, divided • 1 tsp baking soda • 1/2 tsp salt • 2 1/4 cups all-purpose flour, divided Directions 1. Heat oven to 350 F. Grease and flour a 9x13- inch baking dish. 2. In a large bowl, combine 1 1/4 cups sugar, baking soda, salt, and 2 cups flour. 3. Stir in eggs and sour cream until smooth. 4. Fold in rhubarb and add mixture to the prepared baking dish.

5. In a small bowl, combine 1 cup sugar and butter until smooth. 6. Stir in 1/4 cup flour until mixture is crumbly. 7. Sprinkle mixture on top of cake batter and bake for 45 minutes. 8. Let cake cool for 5–10 minutes and serve. 3


1215 SE 8th Ave., Ste. D Portland, OR 97214

I nside T his I ssue

The Spaces In Between ... Can Exercise Jog Your Memory? Page 1 The Secrets of Indian Food Page 2 Should You Skip Your Workout if You're Sick?

Rhubarb Cake Page 3

A New Way to Treat Lower Back Pain Page 4

M edicare N ow C overs A cupuncture A N ew O ption to T reat L ower B ack P ain

of Physicians found moderate evidence that acupuncture is effective at treating lower back pain and may be a viable option for you if other methods of pain relief aren’t working. What will Medicare cover? For those with Original Medicare (parts A and B), your plan will cover up to 12 acupuncture treatments over 90 days. These have to be administered by a licensed acupuncturist to treat chronic lower back pain. If you see noticeable improvements in your condition after your treatment, an additional eight sessions may be covered. What’s the big picture? The CMS’ decision to cover acupuncture marks the first time Medicare has expanded to an area of alternative medicine. The decision came in response to the opioid crisis, which

Good news for Medicare beneficiaries! In a landmark decision, the Centers for Medicare and Medicaid Services (CMS) has opted to cover acupuncture treatments for those suffering from chronic lower back pain. This new treatment option opens more possibilities for those seeking pain relief and hints at more choices becoming available to beneficiaries in the future. If you’ve been wanting to try acupuncture for your chronic lower back pain, then there are some things you should know before seeking treatment. Can acupuncture help? Acupuncture is an ancient form of medicine, with roots as far back as 100 B.C. Today, many patients in the United States have found the treatment effective — though clinical trials have proven inconclusive. However, in 2017, guidelines published by the American College

has unfortunately highlighted the extremely harmful effects of painkillers on individuals and families. As more alternative medicine treatments are studied, Medicare beneficiaries faced with other forms of chronic pain may have new treatment options opened to them. If you feel that your chronic pain isn’t responding well to physical therapy alone, don’t be afraid to incorporate treatments like acupuncture in conjunction with exercises like yoga. These typically work well as a supplement to physical therapy. If you’ve been suffering from chronic pain and would like an alternative to opioids or surgery, talk to your physical therapist and see what options work with your current treatment.

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