A.  Summary of complete team approach

A comprehensive sports medicine approach should include  1.) A team coach for the sport   2.)  A strength coach and/or Athletic Trainer
3.) A medical doctor who specializes in sports medicine and    4.) A Chiropractor/ Physical Therapist who is a certified ART® provider.   5.)
Proper Nutrition Counseling.  Get the best care you can by incorporating all these people into your team of Human Performance specialists.

It is important to note that the human frame and human performance physiology is far too complex for any one healthcare professional to be able to thoroughly detect, address, and resolve all issues that need attention.

The Need for a Tri-Prong Approach

Dynamic Neuromuscular Stabilization/Postural Restoration

-The need for soft tissue work such as Active Release Techniques to release overactive muscles.

-The need for joint manipulation to reduce joint compression and correct misalignment to restore proper  joint mobility.

-The need for rehab to restore mobility and stability to the muscles and joints of the body in order to ensure optimal body movement patterns.

A Tri-Pronged Approach

A. Manipulation and the Arthrokinetic Reflex

The most common question patients ask in clinic is “is my problem muscle related or joint related?”  Another common statement is “I think I have a pinched nerve”.  The simplest way to answer a very complex set of occurrences that surround muscle and joint pain syndromes is that most patients are dealing with a tri-factoral problem.   Barring acute trauma whereby fracture or dislocation is involved, it is important to give note that nerve involvement should take priority in a muscle and joint pain syndrome.  Let’s look at the nerve issue first.

Hilton’s Law states:

The principle that the nerve supplying a joint also supplies both the muscles that move the joint and the skin covering the articular insertion of those muscles.

Understanding the Arthrokinetic Reflex

Arthrokinetic reflex refers to the neurology of joints in which joint movement can  reflexively cause muscle activation or inhibition.^[1]

Arthrokinetic Reflex of the Knee

Leonard A. Cohen ¹ and Manfred L. Cohen ¹ From the Department of Physiology and Pharmacology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania

The prefix “Arthro-” means joint and  ”kinetic” signifies motion, and a reflex in humans refers to an involuntary movement in response to a given stimulus. Thus, the arthrokinetic reflex refers to the involuntary response that happens when a joint is moved, namely that relevant muscles fire reflexively.

The joints have nerve receptors called mechanoreceptors.  These mechanoreceptors are responsible for  transmitting movement impulses from the joint to the brain for interpretation.  Depending on the stimulus or lack thereof, these  Type I and II articular mechanoreceptors inhibit or facilitate muscle tone.  The neurology and physiology behind the arthrokinetic reflex is a main reason why manipulation is so effective at
treating chronic lower back and neck pain and also why it helps to improve sports and human performance.
A simple way to think about this is that “jammed joints” result in weaker muscles and mobile joints = strong muscles. Joints that are closed or compressed shut down muscles. They have joint dysfunction, either a joint has been strained or is locked up and fixed from  it’s normal motion.   Therefore, you must clear the joint motion in order to fully reflexively turn the muscle back on.

B.  Soft Tissue/ Fascia Release

They have a muscle problem, either the muscle has been “strained” or torn, or repetitively overloaded and has tightened and developed scar tissue over time.

The following link is an article by Dr. William Brady, an ART physician.  In it he discusses the importance of releasing scar tissue.  Hypoxic Fibrous Adhesion Pathway .

C. Functional Corrective Rehab

The need to retrain proper movement patterns.  3000-5000 repetitions to reprogram a movement so it becomes involuntary.
Only then can we “SAFELY” progress to strength training with proper movement and ensure optimal human performance.

This is the first in a series of articles that will detail a new paradigm in dealing with musculoskeletal injuries.  The first of which will deal with assessing human movement, and highlight the Functional Movement Screen™ and the Selective Functional Movement Assessment (SFMA), developed by Gray Cook and Lee Burton.  The Functional Movement Screen™ is an innovative system used to evaluate movement pattern quality for clients or athletes.

“It has also been recognized that the dysfunctions of muscles and joints are so closely related, the two should be considered a single, inseparable functional unit” Dr. Vladimir Janda

Our nervous system generates normal movement by integrating and orchestrating groups of muscles to produce fundamental movement patterns with an adequate balance of mobility and stability to meet the demands of the task at hand.

The human system will compensate normal patterns of movement in response to pain or in the presence of weakness, tightness, or structural abnormality. Over time, pain alters normal movement patterns, often causing compensation such as limping or guarding to protective injured joints or muscles.   The pain associated with movement often results in as decreased ROM, muscle length changes, and decreased strength.

Gray Cook has said that a limp is visual representation of the body giving up it’s core stability in order to prevent the loading of a painful joint.  Sometimes the body compensates in a less dramatic fashion and the altered movement patterns are more subtle.

The traditional sports medicine model is to look to the pain.  Typical RICE(rest, ice, compression, and elevation) is helpful to control inflammation.  However, using an isolated or regional approach to either evaluation or treatment will not accurately detect the issues that caused the pain, nor restore function. Gray Cook has said repeatedly that functional restoration requires a map of dysfunctional patterns and a working knowledge of functional patterns to gain clinical perspective and design an effective treatment strategy.

Pain-free functional movement for participation in occupation and lifestyle activities is desirable. In order for our body to create proper pain-free functional movements during sport or activities requires adequate posture, full unimpeded range of motion, proper muscle and fascial gliding between soft tissue structures, motor control, and balance reactions.  Impairments in  any of these areas can alter functional movement resulting in or as a consequence of pain.

Utilising the Functional Movement Screen™ and the Selective Functional Movement Assessment (SFMA) allows healthcare professionals to assess key functional movement patterns the body performs and allows the detection of faulty movement, muscle imbalances, and lack of joint mobility and stability.  This information is essential to identify dysfunctional movement. Traditional muscle length, strength, and special tests can be used to help the clinician identify the impairments, which are associated with dysfunctional movement.

By using the Selective Functional Movement Assessment (SFMA) as an approach designed to complement existing exam the practitioner can better detect faulty movement patterns and be much more specific in devising a program therapeutic exercise to help correct the problem or issues. The Functional Movement Screen™ and the Selective Functional Movement Assessment (SFMA) serve as a model to efficiently integrate the concepts of posture, muscle balance and the fundamental patterns of the movement system into musculoskeletal practice. It should also serve as a feedback system for the effectiveness of the therapeutic exercise program, which should target the dysfunctional movement pattern as well as the impairments that have been identified.

Part two will address the approach that should be utilized to properly evaluate and manage muscle and joint pain syndromes.

…. How to Talk with Your Doctor

This is the first article in a series on How to talk with your doctor.

Have you ever gone to your doctor and completely drawn a blank and forgot what questions you wanted to ask?   A good game plan and a few simple questions can help you make the most of your next visit.  Asking questions will help you get a better sense of what your doctor is
thinking, and why he or she is recommending a certain treatment or diagnostic procedure.  And most importantly, it will
better enable you to be a partner in your healthcare.  But you need to know what to ask.  Here is a good start…

1.  When you see the doctor, say “ The most important things I want to talk about today are this, this ,and that”  and list them according to
priority.

2.  Once your doctor makes a diagnoses, ask him or her  “what else do you think it could be?”  and “How sure are you?”

3.  “What are my options?   Ask whatcould you have done to cause it, and what can you do to remedy it and prevent it from reoccurring.

4.  If medication is necessary, ask “Why am I getting that drug?”

5.  What are the side effects?

6.  Should I get a second opinion?

Most doctors do not take it personally, but they view it as though you are taking your health seriously.

Perfect Synergy for Diagnosing and Resolving Muscle and Joint Pain Syndromes

This is the second article in a series of articles on a new paradigm in dealing with musculoskeletal injuries.   Read the first article here.

In the series I will detail the secret to resolving muscle and joint pain syndromes.  What makes a “sports Chiropractor” different from other chiropractic physicians?  Many of the chiropractic physicians who practice sports medicine are certified Active Release Techniques® providers.  And of those, most are full body certified, which means they have spent a great deal of time invested in learning and mastering their skill and craft at detecting and resolving soft tissue injuries.

I have never heard of Active Release Techniques® or ( ART) before,  What is it?

Active Release Techniques ® is a patented, state of the ART soft tissue movement based treatment that is used to locate and break down scar tissue that results from soft tissue injuries to muscles, tendons, ligaments, fascia, and nerves.

Every year several thousand athletes visit the Active Release Techniques® (ART) tent at the Ironman races. It’s always just about the most popular place at the race second to the finish line of course. They know that if there is a physical problem or if they just want to race better they can get instant results.

Well, now you can get the same care. The ART providers shown below at the IRONMAN Provider Network are race tested. They know your concerns and they know how to keep you training at your best.

Many people, even athletes active in sports clubs have not heard of ART, yet nearly every MLB, NHL, NFL, NBA teams use Certified  ART providers.   Active Release Techniques® providers have worked on athletes in the Olympic games and in Mixed Martial Arts.  ART providers play a major role in PBR, Professional Bull Riding, as well as the PGA.  All these athletes share the common bond of repetitive stress, overuse injuries, and sports related trauma.  If ART can help them get back in the game, it can surely work for you.

Active Release Techniques® is even offered as part of the comprehensive approach to training and rehabilitating some of the world’s top athletes at Athletes’ Performance.  A true refuge for the elite athlete, Athletes’ Performance attracts athletes from around the globe.   Many of the top champions in sports make Athletes’ Performance their off-season home.

What is causing your pain?

Specific, detailed diagnosis allows for more effective treatment.

Many of our patients come in and ask us “is it the muscle or the joint that is injured?”.  This is such a common questions it comes up almost daily.  The reality is this,  according to Dr. Vladimir Janda  ” It has been recognized that the dysfunctions of muscles and joints are so closely related, the two should be considered a single, inseparable functional unit.

Active Release Techniques® combined with Chiropractic Manipulative Therapy =  A More comprehensive treatment for injuries.

For most musculoskeletal conditions and sports injuries, there are two equal parts in play, the joints and the surrounding soft tissues.  As I mentioned above, nearly all injuries involve a joint and the surrounding soft tissue.  Soft tissue includes, muscles, tendons, ligaments, nerves, and, more importantly, all the fascia that surrounds and intertwines throughout these tissues.  Traditional methods in sports medicine is based on an acute trauma based model.  For example, an acute ankle sprain or fracture or dislocation.  Many times a medical workup is completely based on joint integrity.  If X-rays reveal a fracture or dislocation, the fracture is set and cast or a dislocated joint is reduced and maybe placed in a sling.  But what about all the soft tissues that are injured in the process.  They are often ignored unless there is a compete tear of a muscle or tendon.

In chronic overuse injuries, downplaying of the importance of soft tissue injuries is even more critical.  Many physicians make the mistake of telling patients “you just have a soft tissue injury and need to rest”.  Well rest can be very helpful, it allows the inflammation to reduce and pain often gets better.  But what happens when you resume your sport or activity?  Most often, the pain comes back because rest will not and cannot resolve soft tissue injury. Thankfully there is a solution: Active Release Techniques®

Fascia, when healthy forms a free gliding interface between and within muscles, allowing free movement to occur.  When fascia, muscles, tendons, and ligaments get mechanically overloaded, injury can occur resulting in fibrosis and adhesions that disrupt the “sliding and gliding” of tissues.

Active Release Techniques ® is a patented, state of the ART soft tissue movement based treatment that is used to locate and break down scar tissue that results from soft tissue injuries to muscles, tendons, ligaments, fascia, and nerves.

So Does ART Help to Speed Recovery from Injury?

ART works by effectively detecting and resolving soft tissue restrictions, adhesions, scar tissue and restoring proper gliding between muscle and fascial layers.  By doing so, the muscle tissue no longer should be restricting joint motion.  However, many times joints can become “locked” due to adhesions in the joint capsules and from wear and tear and chronic overload over time.  Manipulation is very helpful at restoring joint motion and breaking up adhesions that restrict joint movement.

How Long Until I Feel Results?

In about 4-6 visits, the pain should be substantially better.  This does not mean the issue has resolved, but you are on your way.  If in about 4-6 visits you are not experiencing significant pain relief, you should be referred out for further imaging or consult with another health care provider.  We do not waste your time or your money.

Capitol Rehab Sports Care is all about combining the best in soft tissue treatment, manipulation, along with a Functional Movement Screen™ which allows us to detect faulty movement patterns and then devise a comprehensive corrective exercise plan to retrain movement and improve mobility and stability where needed in order to optimize performance for sport and for life.

Find a local ART Ironman Provider in your area at:

http://ironman.activerelease.com/

References:

1.  http://www.fasciacongress.org/2009/

2.  Leon Chaitow Talks about the Explosion of Fascial Research

http://tricoretherapy.com/blog/?p=177

http://chaitowschat-leon.blogspot.com/2011/02/explosion-of-fascia-research.html

3. Fontaine, M.  The Secret To Resolving Muscle and Joint Pain Syndromes

4.  Fontaine, M.  Athletes and Active Individuals Share A Common Bond..Soft Tissue Injuries

5.  Hammer,W.  The Pathology and Healing of Tendinosis

6.   Chaitow, L.   New Research Explains Why Manipulation Is Effective

7.  Cramer, G.  Evaluating the relationship among cavitation, zygapophyseal joint gapping, and spinal manipulation: an exploratory case series. J Manipulative Physiol Ther. 2011 Jan;34(1):2-14.

8.  Cramer, G.   Zygopophyseal joint adhesions after induced hypomobility.  J Manipulative Physiol Ther. 2010 Sep;334(7):508-18.

WE HEARD YOU LOUD AND CLEAR!!! We have extended our hours at Capitol Rehab!!

2011 was the year of the beating! That’s right, I took a beating from the beloved patients of Capitol Rehab, as I was reminded, (repeatedly I might add), that it has gotten difficult to schedule appointments during some of our business hours. And maybe worse still, during some of our hours, the wait has become unusually long.

So in an effort to answer the call, we have added a highly skilled chiropractor to our team and are now offering extended office hours.

Beginning January 2, 2012, Capitol Rehab of Arlington will:

-Opening at 7 am Mondays, Wednesdays, and Fridays.
-Open till 3pm on Saturdays.
-We will have TWO doctors available to see patients during our busiest evening hours of 4-6 PM, Monday, Tuesday, Wednesday and Friday.

2012 is going to a big year with big additions to Capitol Rehab-Arlington. First, allow me to introduce Dr. Matt Fontaine. Dr. Fontaine is a Full Body Certified Active Release Technique provider who brings a wealth of experience and knowledge to Capitol Rehab. (Click here to meet Dr. Fontaine) His addition, plus the extension of our treatment hours, will allow us to better serve the loving and loyal patients of Capitol Rehab.

So speaking of BIG ADDITIONS, what are yours? If you are anything like me, the New Year sparks the inner fire to make a change. Sometimes the change is earth changing, but more commonly it is one of those small internal adjustments. This year I am asking all of us to table the annual “Lose 20 Pounds” campaigns, and instead, look inward.

Losing 20 pounds is a good step, but self improvement should be the ultimate goal.

Allow me to share. This past summer I had the opportunity to visit Barcelona, Spain. It was my first visit overseas, so understandably, I was full of naive expectations. As a blue blooded, home-grown American, I figured I would do like most tourists and politely tolerate the simple ways of a “less sophisticated” country. After all, its all about American Exceptionalism, isn’t it?

One thing is certain, whoever came up with the term “American Exceptionism”, didn’t spend time in Barcelona, Spain, because if Barcelona were in the United States, it would easily be a TOP 5 destination.

Barcelona has:

-Beaches to Rival Miami
-Shopping to Rival Rodeo Drive
-Hotels to Rival Vegas
-Restaurants to Rival New York City
-History to Rival Paris

And best of all, people that are without rival! And that’s my New Years Eve Challenge to You!!

Try to be more like the people of Barcelona.

If you have never been to Barcelona and you have no idea what it looks like to be a Barcelonian, here is all you have to do:

1. Do whatever you already do, just do it with more passion and maybe do it a little better.
2. Remember that every day you live, is one less day you have left to live. So live this day to its fullest.
3. Be a better person…ALWAYS!!

With all that Barcelona has to offer, why aren’t the people more like,.. well… Americans? Certainly the people are proud, and there most assuredly is a sense of National Pride, but its not at all similar to running into the New Yorker who brashly announces where he is from by yelling “UPTOWN!!!” to everyone within earshot.

So in 2012, let’s take a small step sideways, and lets learn from Barcelonians:

1. Eat a little less, and walk a little more. This has to be the reason I didn’t see any obese Barcelonians.
2. Spend less time in front of your computer and more time in front of people. Conversation builds connections. This must be why Barcelonians take 2 hour lunches.
3. Celebrate something. This must be why the parties don’t start until after midnight…every night.
4. Embrace similarities and welcome differences. This explains why despite my inability to speak 5 solid words of Spainish, Barcelonians always went out of their way to make me feel welcome.
5. Count lives blessings, and the n count them again. You only go around once, you should start NOW trying to make the best of it.

Get Busy Living Or Get Busy Dying.

Dr. Booker

When studying cultures that have successfully achieved longer than average lifespans, diet plays an obvious and important role. The first lesson we can learn is that trying to diet NEVER works!! What does work is having a better understanding of how to eat.

The lesson to learn is this: The successful cultures are able to reduce their caloric intake by 20% by simply eating until they are 80% full.

This simple, yet powerful restriction results in caloric reduction, the same essential goal of most traditional diets. The difference is this form of restriction doesn’t require any uncomfortable changes in food choices and is therefore far more successful.

Scientists have studied the benefits of caloric restriction.

-Reduced cellular damage from free radicals.
-Weight loss
-Lowered blood pressure and cholesterol
-Reduced heart disease

So how do we reduce our caloric intake without creating additional inconveniences? The strategies are remarkably simple and therefore achievable. Here are some tips:

1. Use Smaller Vessels-Discard the large dinner plates and big glasses for smaller plates and tall, narrow glasses. You are likely to eat significantly less.

2. Eat Early-Accross the board, cultures of who eat their biggest meals earlier in the day live longer than culture who pack it on towards the end of the day.

3. Eat More Slowly- Eating faster usually results in eating more. Slowing down allows time to sense and react to cues telling us we are no longer hungry.

4. Use Your Bathroom Scale- Weighing yourself on a daily basis is one of the most surefire ways to reduce your weight and keep it off.

5. Make Food Look Bigger-People who ate a quarter pounder topped with lettuce, tomatoes and onions felt as full as people who ate the half pound burger, but they ingested significantly fewer calories.

6. Focus on food and Have a Seat-When its time to eat…EAT! Stop working on the computer, texting, eating on the run, etc. When you sit to eat you consume less, eat more slowly, and feel more nourished.

Now in my 40′s, the tones of vanity have given way to cries for survival!

“Why is this happening to my body?”
“Will I ever be able to do that again?”
“Why is it taking me so long to heal?”

And my personal favorite, “Do you have any secrets for living longer?”

Well luckily, I do advice in the area of longevity, but I have to warn you, be careful for what you wish for, because when pressed on the subject, most honest people are able to admit, its not living longer that we most desire, its living more quality years.

So before I dive into the first lesson for longevity a few Rules We Must All Agree On:

1. Anti Aging is QUACKERY! I will tell you that real scientists agree that they cannot do such a thing, so anyone making those claims is a con artist and a charlatan.
2. Our Goal is more quality years NOT more total years.
3. Longevity is more than just your physical being, it is the health of your mind and spirit.
4. I am not sharing any Rules or hidden secrets, I am sharing lessons learned from the most successful cultures on this planet. Cultures that seem to have fooled the clock, or the science books, about the concept of living a long and happy life. Many of these lessons were taken from studies done in the book “The Blue Zones.”

Without further delay:

RULE NUMBER ONE: Move Naturally

Considering I just completed a marathon, this first rule may surprise you. The research suggests that longevity isn’t about running marathons and triathlons, and it isn’t about being the weekend warrior. Worse still, it isn’t about the 90 day P90x or Insanity workouts, its about making regular, low-itensity physical activity, part of a daily routine. Cultures that spent their lives gardening, or working as shepherds; doing daily yoga or taking regular nature walks, did the best.

Remembering that “LIFE” is the marathon, so don’t approach it as a sprint. All of the longevity cultures studied incorporated some form of regular, low-intensity activity that satisfies each of the following:

-A large emphasis on core strength at least twice a week,
-Daily balance exercises
-Aerobic exercise 5 times a week.

STRATEGIES TO INCORPORATING LESSON ONE

1. Inconvenience Yourself-Use the stairs not the elevator, get up to change the channel, get rid of the electric can opener/snow blower/garage opener.
2. Have Fun. Keep Moving.-Rather than exercising for exercise sake, make your lifestyle active. Take walk breaks instead of coffee breaks, don’t join a gym if you hate it, do things that keep you active that you enjoy.
3. Walk.- Its easier on the joints, always accessible and invites company.
4. Make a Date.-Getting out and about can be more fun with other people. Knowing someone else is counting on you will motivate you to keep at it.
5. Plant a Garden.-Working a garden requires frequent, low-intensity, full Range of Motion activity, and you have the benefit of fresh vegetables!
6. Enroll in a yoga class.-Just be sure to practice it 2 times a week.

Barrier #1: Too Busy
It’s unlikely that you’re too busy to exercise. You probably just need to use a little creativity to get the most out of your time.

Get up 30 minutes earlier. If your days are packed and the evening hours are just as hectic, get up 30 minutes earlier twice a week to exercise. Once you’ve adjusted to early-morning workouts, you can add another day or two to the routine.

Rethink your weekend rituals. Your Saturday matinee could be reborn as a Saturday bike ride, a trip to the pool or a hike.

Squeeze in a few 10-minute walks throughout the day. If you don’t have time for a full workout, don’t sweat it. Shorter spurts of exercise spaced throughout the day offer benefits as well.

Park in the back row of the parking lot. Or park a few blocks away — and then walk quickly to your destination.

Barrier #2: Boredom
It’s natural to grow weary with a repetitive workout, especially when you’re going it alone. But exercise doesn’t have to be boring.

Exercise with a partner. Enjoy the camaraderie, and offer encouragement to one another when the going gets tough.

Vary the routine. Rotate among several activities — such as swimming, walking and cycling — to make things more interesting.

Check out sports leagues or exercise classes. You’ll learn new skills while getting a great workout.

Barrier #3: Fear
If you’re nervous about injuring yourself, try the following techniques.

Try an exercise class for beginners. Focus on the basics, and don’t worry about the hard stuff.

Consider working with a personal trainer. Get a customized fitness tutorial from a certified expert who can monitor your movements and point you in the right direction.

Keep the exercise simple. Start with a simple walking program. As you become more confident in your abilities, add new activities to your routine.

Barrier #4: Lack of Money
You don’t need a gym membership to get a great workout. Consider these alternatives.

Try the community center. Exercise classes offered through a local recreation department or a community fitness group might fit your budget better than an annual gym membership.

Take the stairs. Skip the elevator when you can. And try to make climbing stairs a workout in itself.

Do strengthening exercises at home. If you can’t afford weights, try inexpensive resistance bands. Or do squats or push-ups using your body weight to gain strength.

Watch exercise videos. Try videos on cardio kickboxing, aerobics, tai chi, yoga or other techniques.

Start a walking group. Round up friends, co-workers or neighbors for regular group walks. Plan routes through your neighborhood, near your workplace, or at local parks.

Barrier #5: Lack of Support
Remind those close to you how beneficial exercise can be — and ask them to join you.

Suggest a new adventure. For example, invite a friend to go to an indoor climbing wall or rent a tandem bicycle.

Exercise and play with your kids. Sign up for a parent-child exercise class. Take your family to the park for a game of tag or kickball. Swim with the kids in the pool instead of watching from your chair.

In the end, there’s no obstacle to fitness that can’t be overcome. Just put your mind to it, take it a step at a time, and you’ll be surprised how easy exercise becomes over time.

Diet Tweak #1: Don’t eat after 6pm
This is such a simple and effective way to lose fat. Late night eating is the most damaging to your waistline, so cut it out completely.

Brush your teeth immediately following dinner. Once your teeth are brushed, you’ve put a period to the end of your consumption for the day.
Change your evening routine. If you’ve always ended your day watching your favorite shows with your hand in the snack bowl, then now is the time to change things up. Find activities that don’t revolve around food and stick with those.
Make it a habit. The first few weeks will be the hardest, but soon your new no-food-after-6pm routine will feel normal.

Diet Tweak #2: Cut back on carbs
Notice I didn’t say to cut out all carbs, but rather to cut back on carbs. These diet tweaks are meant as lifestyle changes that you stick with long term. Cutting back on carbs is a realistic and very effective way to lose weight.

Always choose whole grain bread and pasta over white. Whole grains are less likely to be stored as fat than processed grains.
Eat half of the carbs you normally do. Eat your sandwich open-faced and reduce the size of your pasta serving.
Avoid carb-filled snacks between meals. Instead of crackers or chips, have fresh fruit and veggies.

Diet Tweak #3: Eat more fiber
Most people simply do not get enough fiber in their diets. Fiber is essential when it comes to getting lean since it is low calorie while filling you up.

Instead of seeing salad just as a side item, make salads into meals. Add protein to a large pile of greens for a guiltless meal. *Try the recipe for Grilled Salmon and Peach Salad below.
Make veggies a part of every meal. The benefits of eating more vegetables are too numerous to list, just know that your body will become healthier and leaner with each fibrous bite.
Fruits are a delicious source of fiber. Incorporate fresh, seasonal fruits into your daily diet.

Diet Tweak #4: Drink tons of water
Drinking plenty of water is another extremely simple way to promote weight loss. Chronic dehydration leads to false hunger signals and unnecessary calorie consumption.

Drink a large glass of water before each meal. This will prevent overeating.
Choose water instead of sugar-filled sodas and juices. Sugar-filled drinks are a huge weight-gain trap.
Carry a water bottle with you throughout your day. Keep water in the car and at your desk for constant hydration.

Diet Tweak #5: Enjoy natural sweets
Traditional sugar-filled sweets will quickly add up around your waistline. Instead of going for sugary sweets, enjoy natural sweets.

Fruit is nature’s candy. Reach for sweet, seasonal fruit for dessert.
Avoid foods that contain white sugar or high fructose corn syrup. Consider these items ‘anti-flat-abs’.
Use wholesome sweeteners such as pure maple syrup, brown rice syrup or dates in your recipes instead of white sugar. Eliminate white sugar from your kitchen.
Eating right, coupled with challenging exercise, is the formula for a toned, lean body.

•chicken or turkey: white meat without the skin
•beef: tenderloin, porterhouse, top loin, flank steak, 90 percent lean ground beef
•pork: tenderloin or chop
•veal: any cut
•lamb: look for the term “loin”
•game: bison, rabbit, buffalo
•other healthy protein choices: fish, nuts, tofu, lentils, beans
Aim for three- to four-ounce portions, and complement the meal with whole grains, fruits and veggies.

Here are five ideas for protein-rich, healthy meals to get you started:

Idea #1: HamburgerUse 90 percent lean ground beef to create portion-controlled, three- to four-ounce patties. Serve on a whole wheat bun or pita, and pile the burgers high with veggies like lettuce, tomatoes and onions. Watch those condiments — you don’t want to overload on calories, sugar or sodium. Serve with a side of steamed broccoli and cauliflower.

Protein alternatives: ground turkey, ostrich, salmon

Idea #2: Chicken ChiliChili is a hearty favorite that can be modified into a healthy dinner. Use skinless chicken pieces. Experiment with different types of beans, such as kidney, black and pinto. Toss in delicious veggies like peppers, mushrooms, onions and peas.

Protein alternatives: Diced lean steak, 90-95 percent lean ground beef, turkey breast

Idea #3: Fish TacosFor a fun alternative, make it a fish taco night. Shrimp, tilapia, and mahi mahi are low in calories and make a delicious taco. Add grilled vegetables such as peppers and onions. Top with salsa (1/2 cup for 30 calories) and two tablespoons of one high-fat topper like guacamole, reduced-fat sour cream or grated cheese.

Protein alternatives: chicken breast, strips of lean steak, rice and beans

Idea #4: Pork TenderloinUse fruits such as plums, pears, apples or mangoes to create a mouth-watering marinade or chutney for pork tenderloin. Serve with a side of green beans and baked new potatoes.

Protein alternatives: chicken breast, mahi-mahi, tilapia

Idea #5: Tofu Stir-FryFor a meatless alternative, cook up a quick and easy stir-fry. Heat a teaspoon or two of oil in a wok; toss in cubes of marinated firm tofu; add vegetables such as broccoli, onions, peppers and carrots; serve over 3/4 to 1 cup of cooked brown rice.

Protein alternatives: skinless chicken, turkey, shrimp, pork tenderloin