ISBNPA 2013: Sustainable diet & environmental changes

Halfway through the Annual Meeting of the International Society for Behavioral Nutrition and Physical Activity (ISBNPA 2013), jotting down some impressions and ideas from the conference so far. A more thorough report later on.

• Individual behaviour change should never be the only goal. It’s not enough. We need to change the environment in order to have lasting effects. It’s a long process, but meanwhile, we can help people cope with the environment.
• Translational part in experience sampling and photography studies that examine environment-health relationships is missing. Most of the world doesn’t live in environments like this.
• Theory-based instead of theory-inspired: systematic process of linking theoretical basis to the actual implementation and evaluation. Too many intervention studies don’t use theory properly.
• Program adoption and maintenance is also an intervention: adopters and maintainers need to change their behaviour and be sufficiently motivated to do it.
• We’re all hypocrites in terms of sustainability. How can you advise anyone to eat fish? If all seven billion people on this planet eat sustainably caught fish, it will all be eaten within a year.
• As European consumers, food is the single biggest impact on ecosystem that we are responsible of. Need to think about the entire production chain.
• Autonomy-supporting approach is not a bag of tricks to make a person motivated. It’s a sincere interest and curiosity in the person, a sincere desire to help and support.
• Many say “we don’t want a nanny state, we don’t want government controlling food prices”. But right now we are controlled by big corporations and retailer chains. Is this better?
• We can change the system. And we can change the world.

There is a clear message that environmental changes should be the main focus and the food system needs to change. Climate change is a driver for a more sustainable lifestyle – which also means healthy AND sustainable diet.

This is also the most health-promoting conference I’ve been to. Encouragement to stand up for applauses, standing lunches, small portion sizes, 5-minute walking distance between two conference sites (and two such walks scheduled in the program every day), stair-climbing, fruit for dessert and at coffee breaks. Best attempt in “practice what you preach” so far in academia, although strawberries hardly are the most sustainable thing to eat in May.

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Choice architectures and role models

I recently read about the failure of physical activity interventions for children. It seems that well-intentioned and well-designed interventions succeed in increasing children’s daily physical activity by a meager five minutes – but this increase doesn’t last past the first few weeks. Clearly, we’re missing something.

Divide between exercise and everyday physical activity has become stark. People often wonder about my willingness to walk distances that are more than a mile. Sometimes, these are the same people who go for ten-mile runs every other day. I need both in order to feel good. I spend so much time in front of a computer that whenever there’s a chance to take a few extra steps, I’ll jump for it. Sometimes literally.

Are we missing the base of the pyramid?

The problem is that the Western environment and lifestyle has become extremely aversive towards everyday physical activity. Hotels are one of the clearest examples: I’ve noticed that the fancier the hotel, the more likely it is that it’s impossible to take the stairs. The doors are locked, only to be used in case of an emergency. What if my emergency is the urge to run up the stairs? Another thing are the lengthening commutes that even kids are having nowadays. The list goes on.

Ultimately, the choice architectures around us don’t favor walking or biking. Some cities have recognised this and really started trying to change things: sidewalks, bike lanes, bikeshare programs, free or extremely cheap public transportation.

Attitudes also need to change. This is from the NY Times article:

“Kids naturally love to run around and play,” Dr. Booth said. “But they’re just not doing it as much now. And we don’t know why. So what we really need to understand is, what’s happening to our kids that makes them quit wanting to play?”

Well, duh. They grow, start to think they they need to become adults, all serious and collected. Grown-ups don’t sprint, skip, wrestle, piggyback each other, do somersaults or anything that causes them to sweat and become out of breath, unless they are in the strictly specified context of exercise. That’s just plain silly. Fortunately there are exceptions, people who are self-confident and energetic enough to be active themselves, no matter what the context is. They’re the proper role models!

How to change choice architectures and role models? What kind of a role can technology play? I’ve started to think that its strength is in the ability to connect people, to help them become aware of other ideas and movements in real-time. The question that’s often asked, for a good reason, in my field is: “Will people who need wellness technologies use them?” The answer tends to be “couldn’t care less”.

So if they don’t care, do they really NEED the technologies, or are we just trying to create the need? The question should rather be formed in the following way: “What do people need and how can technology serve that need?” And that’s why it would be so extremely important to actually go to the people and figure out what their real needs and desires are.

Ride for Life

We did it! Hundred miles around serene Cayuga lake to raise awareness of AIDS and to raise funds for Southern Tier AIDS Program for continued prevention and support services. It was a wonderful ride.

I woke up at five on Saturday morning and zipped down Buffalo Street after a quick breakfast, my little LEDs shining in the dark and scaring a skunk who was puttering around minding its own business. Arrived to Stewart Park to wait for the ride to begin as the sky lightened, met friends with whom I’d be sharing the road. Watched more than 350 riders gather together. Before we were sent off, we were touchingly reminded of the purpose of the AIDS Ride for Life – the stories yet to be told, the lives yet to be saved, and the dreams yet to be realized.

Can’t quite describe the feelings I had at that moment. I think it was a mixture of sadness, joy and anticipation. I thought of Freddie Mercury and the songs he still kept on recording just days before his death. I thought of the book “Wisdom of Whores” I read last year, the theoretical ease and the practical difficulties of preventing HIV infections. I looked at people around me and I was glad to be one of them. They all cared.

Preparing for the ride

And then we started riding and I came back to the present moment and just enjoyed the cool morning air and the determined pedaling. I had tested the waters one week earlier on a 57-mile ride to Aurora and back, so I knew that the first hills would be steep and long, but not too bad. Pretty soon (well, after 1,5 hours) we were at King Ferry Winery, the first pit stop at 18-mile mark. Munched some protein-filled oatmeal with nuts and pumpkin seeds, filled my water bottle, chatted with friends, and soon we took off again.

Weather was absolutely perfect, half-cloudy, not too hot, not too cold. We sped past the second pit stop thinking that we would easily make it to the opposite end of the lake before having to stop. This theory would have held if I hadn’t started losing air from my backtire around 40-mile mark. It wasn’t a flat, but definitely a little bit of leakage was happening. Since it was less than ten miles to Verdi Signs pit stop, I wanted just to go as far as I could, and change the tube there with proper tools. (I had a spare tube and tire levers with me, but I had forgotten a wrench! My bike’s old-fashioned, it has real bolts to keep the tires on.) Well, had to stop to pump more air in a couple of times, but arrived to Verdi Signs without losing too much time on the way. And besides, it’s a ride, not a race.

Thanks to the repair crew, I soon had a new tube in and full of air. We continued through a lovely drumlin area and reached Seneca Falls after noon, having ridden 60 miles. I wasn’t feeling too tired, but definitely hungry. Enjoyed a good lunch with the team and got back on the bikes.

The 40 miles that we had left went by surprisingly fast. The wind that had been against us during the first half of the journey was now on our side (or, behind our backs). What’s more, the lovely volunteers had written and drawn encouraging messages on the road shoulder. We stopped once to fill our bottles and grab a handful of grapes before the last leg. Having eaten tons during the day, I actually felt quite energetic as we approached Ithaca. Crossing the finish line at Cass Park was awesome: a big crowd of people was there waving, cheering and applauding. Then we just relaxed and basked in the afternoon sun. After five we gathered for the victory ride through downtown to Stewart Park, where we had a nice dinner and celebrated the accomplishments.

Victory Ride!

The ride raised over $216,000. It’s an incredible sum and will go to a great cause. What’s more, the effect on raising AIDS awareness and strengthening people’s self-confidence goes even longer way. For me, 80 miles was the longest distance I’ve biked before this. It was wonderful to see that I could do it, and I didn’t even feel sore afterwards! And it was wonderful to see other people feel the same awe about themselves. Plus all the wonderful volunteers who took care of feeding and hydrating us and keeping us safe and smiling.

One girl actually rode a penny-farthing for 50 miles. Now, that’s a really amazing achievement!

Team Felicia – thanks everyone, you are wicked awesome!

The AIDS Ride is not a unique fundraising effort here, although it’s perhaps the largest event in terms of duration and organizing. There’s something going on almost every weekend. For example, in August, women swam one mile across Cayuga Lake to raise funds for hospice care. Tomorrow, there’s a Food Justice Summit walkathon (5 miles) with the aim to build a sustainable food system. Community is activated to do good voluntarily, and have fun and be physically active at the same time.

We have similar things in Finland too, but somehow I’ve never managed to hear of them, and I think they tend to be smaller scale. For example, there was a “Kävele naiselle ammatti” (“walk an occupation for a woman”) event in Tampere two weeks ago. Perhaps Pirkan Kierros could be re-focused as a charity event? (Could be that some of the money is already being donated somewhere, but if that’s the case, they’re not really advertising it.) Let me know which events you know of!

So now I’m listening to Queen’s last album, Made in Heaven, and thinking how people in welfare nations are more likely to engage in voluntary work, because they are safe and secure and can spare their time and resources on helping others. When a mind is not occupied with basic survival, it can reach out to the world and respect every life as valuable.

This year has been one hell of a ride so far. Ups and downs, but much more ups than downs. It’s a beautiful world that we have, and beautiful people in it. Let’s strive to make it even better.

SNEB 2012

I attended the Society for Nutrition Education and Behavior Annual Conference in Washington DC July 13-17. This is a brief summary about the conference in general and the main themes that stuck with me, even two months after the conference. The summary of the conference proceedings and many of the presentations are available here.

The garden behind the hotel was a place for quiet, relaxing moments.

As a sidenote: it’s somewhat embarrassing how it’s taken me ages to get this done. Reuniting with my significant other and having a summer vacation right after the conference was wonderful, but it caused this to get stuck midway in the priority pile. Still, better late than never.

Conference

Almost 600 people participated in the conference this year, making the attendance the highest in the past ten years. I might be biased, but I’m inclined to think that one of the reasons was the current president, no other than Brian Wansink. He has the skill to breathe energy and enthusiasm into anything he touches. And based on the talks I had with various conference attendees, the research that Food & Brand Lab does is generally considered not only quirky, but very interesting, original and practically useful as well.

Interest in practical usefulness was apparent in the audience demographics: in addition to researchers, a lot of dieticians, cooperative extension people, and health promotion program planners were present. Exhibition booths included potato and wheat promoters, developers of engaging educational materials, cancer researchers and so on.

Exposing kids to oranges and cantaloupes!

All in all, everyone’s focus was on practical and actionable things in nutrition education and behavior change. The overall theme of the conference was synergy, which encouraged people to find ways to collaborate and benefit from each other’s expertise. I think that the most inspiring thing for me was just talking with all sorts of people and feeling the empathy, enthusiasm, and the drive to learn and to make real changes. Feeling that others genuinely cared about people’s well-being and wanted to make a difference.

Community partnerships

Building partnerships was the focus of several sessions and talks. Not only partnerships between researchers and health professionals, but engaging the entire community: universities, schools, community organizations; researchers, students, activists, educators, parents, farmers, daycare centers, chefs, churches… the list goes on. Two centers, one from west and one from east coast, presented their visions and modes of operation.

• Center for Nutrition and Activity Promotion bridges disciplines to help people eat healthier and be more active.
• Center for Health & Risk Communication works with communities to promote health and social justice.

Both centers started by collecting the resources that were already available and expanded from that. They develop, implement, and evaluate health promoting services, using a lot of students to do the practical work. This is great for everyone: students get practical experience and a taste for civic engagement, researchers are able to focus on coordinating and evaluating, and community members are approached from many directions.

I participated in an exercise to create a network of partners in local community to achieve the objective of a given project. We were encouraged to think outside the box to identify organizations and companies that could be involved, such as grocery stores, environmental activists and so on.

It would be really great to get students more involved in Finland as well, to create actual health promotion projects. Small-scale, of course (at least at first), but it would have been awesome to do something real instead of just writing essays when I was a student.

Simple and cheap

One of the recurring themes was the need for simple and cheap tools to promote healthy choices, as well as the need for healthy choices themselves to be simple and cheap. The first person to talk about this was Sam Kass, the White House chef and advisor in Michelle Obama’s Let’s Move! initiative, which has the goal to reverse childhood obesity. One of the aims is to give parents easy, understandable tools that help them make healthy choices for their kids.

Another example that stuck in my mind was Leon T. Andrews’ “Healthy Cities for a Healthy Future” talk where he showed a series of pictures of a gradual transformation of a cross-section in a city: starting from a barren scene with no sidewalks or biking lanes, ending with a charming pedestrian-friendly cross-section with trees, flower beds, wide sidewalks, crosswalks, clear traffic signs and an entire street devoted to pedestrians. The point was that not everything has to be done at once, it can start from just adding a crosswalk and pedestrian traffic lights, and slowly become so that the entire environment encourages walking and biking instead of driving.

Besides, it makes sense to keep children active and give them nutritious food.

• Healthy kids = better students
• Better students = healthy communities
• Healthy communities = healthy future

The advantages of synergy and partnerships are clear from this perspective as well: what is simple and cheap for one person can be very difficult and expensive for another. That’s why it is crucially important to find the right person to work with. Sharing tips, tricks, experiences, and best practices is equally important. That’s really what education is also about. Technology can help a lot if it’s done right for the target group’s needs and fits into existing routines reasonably well.

Leon T. Andrews is from ChangeLab Solutions, who have collected lots of tools and policies on their website. For example, they have a toolkit for advocates who want to work with city planners to create healthier cities. Maybe something like this could be made more interactive to make it easier for ordinary people to figure out some basic things they could also do to help a little?

International perspective

I met several other international participants in an evening reception and in the International Division meeting. No one else from Europe, though. There was a wonderful woman from Argentina who had started her own initiative to develop educational materials and programs for schools to promote healthier eating and physical activity. She was extremely interested in how to leverage technology to lessen the need for people to travel around teaching, but the problem in Argentina is that schools don’t usually have Internet connections or computers for children. We came to a conclusion that the best way to start would be to develop a DVD for those schools which at least have computers on-site.

Other interesting perspectives included an energetic South Korean woman’s story of the country’s journey of advancing from malnourishment and poverty after the Korean war to being the 11th strongest economy in the world, and a woman from New Zealand who was doing her PhD in food literacy and how to measure it. Food policies in different countries and the sustainability of the entire food systems were also discussed critically.

And I just love hearing different accents from around the world!

Talking about weight

Rebecca Puhl from Yale Rudd Center and Dianne Neumark-Sztainer from University of Minnesota made compelling cases against dieting and weight stigma. Puhl presented research results that demonstrated how obese children are 63% more likely to be bullied, largely because overweight characters are always portrayed in a negative way in children’s media. It’s an awfully big problem because weight-based teasing easily leads to social isolation, lower performance at school, depression or anxiety, and less physical activity. Also, teachers and parents look at obese children more negatively. All this obviously results in increased emotional eating, which makes the original problem worse, which leads into more emotional eating and… you get the picture.

Neumark-Sztainer talked about dieting in adolescence and presented findings from longitudinal studies which showed that dieting predicted binge eating. Stopping a diet was not associated with greater weight gain than persistent dieting. So, diets don’t really work. Instead, I think that helping people form new small habits is the way to go. Figure out what the person can do and how s/he could do it.

We need to be able to communicate with anyone in a sensitive, respectful manner. Health at Every Size approach makes a lot of sense, especially since exercise really should be fun, stress-relieving, energizing activity instead of a dreary obligation.

My posters & technology

I presented two posters about predictors of adherence and water intake advice. Dieticians were more interested in water, researchers more in adherence. I discussed the importance of self-efficacy and mental well-being with a couple of people and got a reference to Ellyn Satter’s Eating Competence approach, which focuses on two aspects in healthy eating, which make a lot of sense:

• The permission to choose enjoyable food and eat it in satisfying amounts.
• The discipline to have regular and reliable meals and snacks and to pay attention when eating them.

Technology had a relatively small role amidst policies, education programs, partnerships and environmental influences. That is perfectly fine, I think. Nevertheless, a couple of posters focused on mobile applications and tablet games aimed for children. There was also a session about enhancing your presence in social media – how to best use Pinterest, Facebook, Twitter, LinkedIn and blogs. It seems to be pretty essential nowadays to have social media presence, but sometimes I wonder how fragmented our time (at least mine) becomes when we start following all these things.

—–

Recreation

It was so hot that I couldn’t really spend a lot of time outside without melting into a puddle. Nevertheless, we managed to get some walks in. The main attraction nearby was the National Zoo, which held animals from almost all parts of the world. Still, it just doesn’t feel quite right to keep living things imprisoned, even though giant pandas would probably be extinct without zoos by now. What affected me the most was seeing gorillas that were munching on snacks looking bored, orangutans trying to make their beds more comfortable by fluffing up the pile of hay, and other primates leading quiet family lives. Those guys looked just like humans, and I wondered why I was on this side of the bars and they on the other side.

Father’s taking a nap while mother’s nursing the baby.

We also went to see an eating disorder play called “Breaking Up With ED” with a colleague. ED is this nasty fellow who barges in uninvited and generally makes everyone miserable. The play was touching and funny, with monologues from various different characters, either suffering from eating disorders themselves or watching someone else’s suffering.

Next year

Next year’s conference will be held in Portland, Oregon, the healthiest and greenest city in the United States. Apparently, the founders of Portland were cunning fellows who wanted to attract more businesses, so they decided to make downtown blocks only half of the length of standard city blocks. As a result, the city is very pedestrian-friendly.

23½ Hours

A quick question: can we limit our sitting and lying to just 23½ hours a day?

What are we doing to our world?

I am worried about climate change. Extreme weather conditions, spreading diseases. Arctic ice cap melting, rise in the sea level, flooded homes and nuclear plants on the coastline.

And yet, I still book flights to places where I necessarily wouldn’t have to go. I sometimes accept car ride offers or yield into group pressure of taking a cab. I don’t usually turn my mobile phones off for the night, and I turn the lights on when it gets dark. Sometimes, I take an elevator because the stairway is inaccessible, or because I simply forget or I feel I’m in a rush. And one big sin I didn’t even realize at first – out of convenience, I’ve taken a towel from the fitness hall when I’ve gone swimming, which means that the towel is used only once before being washed.

But I feel guilty about these choices, this unnecessary waste of energy. I don’t really want to save time on the planet’s expense. I don’t think my time is more valuable than the health of nature and the survival of human race.

Climate is changing. There’s more than enough solid evidence on that nowadays, even though some still try to deny it. Frankly, I don’t care if you don’t believe that climate change is caused by human actions. Even if you think that mother nature is just getting hot and bothered as a natural part of her cycle, you still should try to stop making it worse. We shouldn’t foul our own nests. Clean air and water are becoming rarities with the amount of carbon, microparticles and other nasty by-products and chemicals that our way of living pumps into our environment.

Quote from Bill McKibben’s new introduction to his book End of Nature:

The elder President Bush was facing a reelection battle against Bill Clinton, and so advisers persuaded him to attend the world environmental summit in Rio de Janeiro, possibly the most optimistic moment in recent history. Before he went, however, he told a press conference that “the American way of life is not up for negotiation.”

Behavioral economists might say that this is a great example of valuing short-term pleasures over long-term consequences. We just want more and more with as little effort as possible. Larger houses, larger cars, larger breasts, larger portions of food delivered faster, more and more travelling to snap pictures we can share on Facebook to show that we are not boring. Are we really so simple? Do these things really make us satisfied with our lives?

Incidentally, what is good for environment is almost always good for health too. Switching from a car to other means of transportation. Eating locally grown vegetables and fruits, lean meats, ditching processed junk. Turning off electronics to focus on friends and family. Getting involved in community efforts to increase green areas, sidewalks, bike lanes and public transportation. Recognizing that coveting material possessions is not the way to true happiness.

I am worried about climate change. We are already suffering the consequences all around the world and we need to start acting and changing. We simply cannot afford the consequences of continuing on this path. Reducing waste is one good way to start.

The Weight of the Nation

HBO’s new mini-series, The Weight of the Nation, is tough to watch in the beginning. The health consequences of obesity are dire and so are the numbers: 68% of US adults and 18% of children are overweight or obese. But there’s hope as well: people are able to change their habits and environments, if they commit to it, have realistic goals and social support, and figure out which changes they can do in their lives.

Incidentally, the CEO of Weight Watchers, David Kirchhoff, just published a book called Weight Loss Boss about his own personal journey in weight loss and, even more importantly, weight maintenance. I got a free copy at Mobile Health conference and I have to say, it’s actually a very good book (despite the obvious promotion of Weight Watchers). He is totally honest about his own failures and bad habits, and there are no magic tricks: it’s just portion control, physical activity, staying away from unhealthy food, and arranging your environment to support healthy eating. Basically:

1. Eat vegetables, fruits, lean proteins, whole grains, and low-fat dairy
2. Avoid junk food
3. Watch portion size
4. Exercise daily
5. Repeat

Kirchhoff talks a lot about environmental influences and he’s been heavily inspired by the research results of Food & Brand Lab. In his book and in his presentation at Mobile Health, he praised a certain Dr. Brian Wansink and his lab of their clever research several times! It’s great that Weight Watchers have incorporated this into their program.

It’s habit and lifestyle change, not willpower or temporary dieting. Small habit changes was really what Mobile Health was also all about – I’ll soon write more about key insights from the conference.

Apps ad nauseam

This is some sort of a Sunday-evening rant. Be warned.

I’ve spent several hours browsing all sorts of apps and devices for health-related goals, and right now I don’t want to see or try out any of them. I guess I reached the saturation point. Who are the intended users of these thingamabobs? Surely not the ones whose need for intervention would be the highest.

Mothers who struggle with budget and time constraints, trying to do their best to keep themselves sane while preparing food for their families and working two jobs. Businessmen and -women whose days are filled with one meeting after another, sitting in cars and airplanes, grabbing food where it’s available and entertaining clients over one drink too many. And lonely, depressed teenagers and adults who try to fill their emotional voids with food and end up feeling even worse, triggering another binge to relieve their self-disgust.

It is difficult to understand the worlds that other people live in, let alone design fancy gadgets that could help them change their behaviors (if they could afford them or be bothered to try them out). Unhealthy diet and lack of exercise are often just symptoms of deeper-lying issues. Somehow, the simple idea of eating food has become incredibly complicated.

Let’s say that the (obese or at-risk) population can be split into three groups: first group lacks awareness of healthy habits, the second lacks the abilities, and the third one just isn’t motivated. All groups can to some extent be nudged with upstream interventions that make healthy options more available, appealing, and affordable than unhealthy ones. However, downstream interventions that target individuals need to be tailored to their personal needs. And those needs can be really complex. (For instance, the need for cognition. Mine is pretty high, which works against me sometimes – I usually want explanations, it’s not so easy for me to just go with the flow and intuitively follow suggestions or hunches.)

I’m looking for solutions that could work in the real world and actually reach people in need. I think that one channel really can be social media – probably not Facebook, but other online communities which provide a tight social group with similar goals, intimate understanding of problems, and emotional support. We are herd animals and like to flock together. Now, lot of people just lurk on online forums, taking information in but not posting anything themselves. If we would advertise suitable applications among these communities, perhaps we could reach a part of the lurker population. These suitable applications should obviously be effortless to use, somewhat entertaining, and emotionally engaging. Stories are powerful persuaders, and social support is something almost everyone craves.

Not saying that trackers and self-monitoring apps don’t have their place. Of course, a part of the population benefits from habit trackers that serve to increase their awareness of their nutritional intake, activity level, sleep quality and so on. However, most applications assume that people are rational and can change their behavior based on this new self-awareness. For some people, calorie counting and tracking may just feed their obsessions about their diet and weight, when they would in reality need to become more aware of what’s going on in their mind.

I’m not a mental health expert. I’m just someone who’s experienced her share of stress, loneliness and anxiety, and also struggled with sensible eating at some point. And I would like to understand why human beings make their lives so difficult sometimes.

Tale of stubbornness

There’s this girl who’s extremely pig-headed and has a tendency to push herself too hard, ignoring the warning signs of her mind and body. Who wants to be strong for others rather than admit that she might need help too.

But then there comes a time when even half a mile feels like crossing a desert, and a friendly workmate who happens to be driving past and offers a ride for the last few hundred yards feels like a life-savior. Perhaps the girl will learn that it’s okay to accept sincere offers for help, and ask for it too.

She is really grateful for all the friendliness, generosity and caring people have given her – not just during the past few weeks, but throughout her life. And she needs to tell that to them, face-to-face, in more words than just a “thank you”. She’s afraid that some people may have taken her stubbornness as ungratefulness, when she’s just wanted to not be a bother.

***

“I don’t want you to do anything that hurts.”

After two and a half weeks of limping on a hurting foot and generally not giving it enough rest, I finally had to hear it from a doctor to understand that pain is a signal that something’s not right. Good news: no plantar fascitis anymore. Bad news: stress fracture in the heel. At least that’s the current diagnosis, since stress fractures don’t show clearly in x-rays until they start healing. My bone had a certain unhealthy fluffiness in it.

No weight-bearing for the next 2-4 weeks, depending on how eagerly the bone starts to heal once I’m not stomping on it constantly. I’m on crutches the first time in my life. Well, I did want new experiences, right?

I worried about not being able to exercise, but hobbling with crutches is actually quite good upper-body training. I felt pretty exhausted after lugging myself around campus. Just hoping the weather stays pleasant.

***

My  experience is not at all unique, although stress fractures usually happen to real athletes and runners. The pattern is the same: too much exercise, not enough time to rest and adjust. Injury develops gradually and healing takes a long time; pain is the last thing to come and the first thing to go. If exercise continues despite the fracture, the bone may break so badly that it never fully recovers.

Come to think of it, the effects of physical and mental stress are pretty similar. Some amount of stress is good, but chronic stress and insufficient recovery from it lead to trouble. Stubborn overachievers who don’t let themselves rest and take it easy every once in a while may end up in the work disability statistics.

Barriers into opportunities

Time for confessions. I have plantar fasciitis.

Didn’t even make it three weeks before breaking something. Fortunately, it’s not lethal, dementing or contagious, just pretty damn painful and limits my freedom.

In layman’s terms, plantar fasciitis is heel pain caused by inflammation of the tissue that connects the heel bone to the toes. That’s what you get for overusing your feet and not giving them proper care. Frankly, I blame last weekend’s beautiful weather which tempted me to a long jog on too hard surfaces. This week, I’ve been limping around with gradually worsening pain, still stubbornly walking to campus and back. For those who know me, it probably says something about the level of the pain that I decided to go to a doctor already today.

The people at Cornell’s Gannett healthcare center confirmed my self-diagnosis. They were also extremely friendly and projected the feeling of caring. Still, I find it kinda funny that the nurse measured my temperature and blood pressure, also asking when I had my last period. Some kind of screenings probably, but hey, it’s just my heel that’s hurting!

Anyway, the remedy is ibuprofen, stretching and rest for at least a couple of weeks. A concrete barrier to the types of physical activity that I’m used to doing – basically anything that involves being on your feet. It’s slightly frustrating, but it actually makes it easier to try out something new, since there are plenty of opportunities in Ithaca. Not sure if I’d have gone to that yoga class tonight if I would have had the option to just go for a jog whenever I felt like it. I’m glad I went: got some exercise with a dose of mindfulness, and felt relaxed and better connected with myself afterwards.

And being temporarily lame justifies accepting a ride home from a social gathering, providing a chance to chat a little bit more on the way.

Some barriers are, of course, stronger and more permanent. Even then, one can always decide how to look at them. Could there be some golden opportunity lurking nearby?