SMI Newsletter — April, 2013

Spring Is In The Air

Greetings from SMI,

As the days get warmer and longer it is hard not to notice more people out walking, running, cycling and playing tennis. Hopefully YOU have been able to make the most of the nice spring weather as well.

We always see an increase in clients this time of year as the nicer weather results in more pulled muscles, sore joints and strained tendons. In order to reduce down time and maximize the time you spend working out, make sure that you are taking care of “the details.” Warm-up thoroughly before activity, stretch, roll and strengthen consistently to ensure that you minimize your risk of injury.

If you have questions about stretching, rolling or your own flexibility imbalances, please contact us today and one of our therapists can help address your specific needs with an individualized plan. In the meantime, enjoy the longer days and keep moving!


~The SMI Team

Announcing SMI in San Francisco!


Over the 17 years that SMI has been in business we have received numerous requests to open an office in San Francisco. While we haven’t gone quite that far, we are glad to offer our San Francisco clients an alternative to making the drive down the peninsula. SMI therapist, Eva Popper, is now available every other weekend in San Francisco. She will be working in the Alamo Square district at 425 Divisadero St, Suite 209.

You can schedule an appointment by calling the Palo Alto office at 650-322-2809.



Acupuncture For Allergies


Ease Allergy Symptoms with Acupuncture!


Allergy season is in full swing and millions of sufferers are looking for ways to find relief. A recent study out of Germany, published in the Annals of Internal Medicine,has found that acupuncture can help.(1) Allergy symptoms such sneezing, runny nose, itchy eyes, dry cough, crankiness and fatigue can be effectively diminished with acupuncture. Acupuncture decreases the body’s histamine response, opens swollen nasal passages, balances the immune system and helps you feel better! The German study consisted of 12 treatments over an 8 week period but most people see some improvement within 3 to 4 customized treatments.Stop feeling miserable – call for an appointment today!


Special for NEW acupuncture patients!


Your first treatment is free* when you purchase a 3 treatment package…a savings of $190!


*This offer is only valid for NEW acupuncture patients.

*Offer expires on June 15, 2013


read more about our acupuncturist Colleen Burke at

Comprehensive Nutrition Seminar On April 23rd



*click on link below

To Carb or Not to Carb: That is the Question

By Clyde Wilson, PhD

good nutrition


We have a love-hate relationship with carbohydrate. Athletes rely on them. Dieters try to limit or avoid them altogether. Many of us crave them and would love to eat them all the time! The Institute of Medicine sets the Recommended Dietary Allowance (RDA) at 130 grams (520 Cal) per day specifically to meet the needs of the brain. So what should YOU do?

Carbohydrate is one of the toughest parts to get right in a healthy diet. It is necessary to fuel the brain and for optimum athletic performance, but at the same time it does have the propensity to make us fat. The reason carbohydrate intake is so complicated is because muscle tissue is limited in how quickly it can absorb carbohydrate. If you eat 100 Cal of carbohydrate most will go to lean tissue, but if you double this to 200 Cal you will still only get 100 Cal or a bit more going to lean tissue. The rest goes to body fat. Up it to 300 Cal and you will likely get less than 100 Cal going to lean tissue, and at 400 Cal you might have none going to lean tissue. The exact cut-off is dependent on the individual but the “tipping point” is around 200 Cal. One dessert or cup of cereal, rice, pasta, potato or bread (2-3 slices) ranges from 200-300 Cal. Now think about how much rice or pasta you eat with bread on the side followed by dessert on a regular basis. Scary.

The key to carbohydrate absorption boils down to insulin. Insulin is the hormone that tells cells throughout your body that you have eaten and it is time for them to absorb calories. As you eat more and more carbohydrate, more insulin is released into your bloodstream, telling all your cells to absorb more calories. Some of the carbohydrate entering muscle is converted to a specialized form of glucosamine known as acetylated glucosamine.Acetylated glucosamine inhibit sinsulin signaling within muscle, reducing how much carbohydrate further enters the muscle. (2) With less carbohydrate going to muscle more ends up going to fat.

One healthy way to consume carbohydrate is to only eat 100 Cal of carbs at a time. For most people, especially athletes and active individuals, this would mean eating at least 6 meals a day. Another way is to slow down the rate of carbohydrate digestion. Switching to whole grains such as brown rice, coarser breads and oatmeal slows digestion by 5-10%. The impact on weight loss and performance are therefore good but not great. The most effective way to slow the digestion of carbohydrate is to eat them with lots of vegetables. Vegetables take longer for the stomach to break down. Vegetables mix with the higher-calorie grains, and slow their digestion dramatically. Preliminary studies show that the effect is up to 10 times more powerful than switching from processed carbohydrates to whole grain carbohydrates. This enables the active person to increase their carbohydrate consumption to 300 or even 400 Cal in a meal as long as they consume enough vegetables with it to slow digestion. Vegetables can literally double the carbohydrate turning point before muscle shuts down.

What to do

· Eat between 100-200 Calories of carbohydrate in each of your meals, emphasizing whole grains like visually-coarse breads, brown rice, and plain oatmeal.

· If you need more carbohydrate, eat 2 cups of leafy greens or 1 cup of raw vegetables for every additional 100 Calories of carbohydrate.

· Cooked vegetables do not slow down digestion as much, so eat a little more of them than you would raw vegetables. Cook them el dente instead of to the point of mushiness.

· 100 Calories of carbohydrate = 1 slice of bread or 1/3-1/2 cup of cooked rice, pasta, potato, or most cereals

· Tomatoes and green peas are too soft to have much effect. Carrots and most fruits have too many calories to slow down the digestion of bread, rice, pasta and cereal.


*Read more about the upcoming seminar



Orthopedic Massage

The Problem with Plantar Fasciitis

Plantar Fasciitis

Some of you may have read the recent New York Times article entitled “No Consensus on a Common Cause of Foot Pain.” The article outlines how chronic plantar fasciitis is not a fasciitis at all but rather a fasciosis. The difference is meaningful. The suffix “itis” means inflammation whereas the suffix “osis” means degeneration. Biopsies of fascial tissue from subjects with chronic plantar fascia pain contained virtually no inflammatory cells at all but rather degenerative tissue.

For the entire article click here


What should you do if you have chronic plantar fascia pain?


The key to treating chronic plantar pain is two-fold. The first part is to promote healing of the damaged area. This can be achieved with a combination of massage, strengthening and stretching. Whereas light to moderate pressure has been found to have NO impact on repairing degenerative tissue, deep tissue massage has been shown to promote healing of damaged tissue (3). We recommend a combination of professional massage from a skilled therapist and self-massage at home. Eccentric strengthening and stretching exercises have also been found to to repair degenerative tissue (4). We recommend heal drops off the edge of a stair combined with a few theraband exercises.

The second part to treating chronic plantar pain is to undertake a thorough evaluation to discover why the plantar was injured in the first place. This is imperative to prevent the problem from returning. Possible underlying causes may include tight calves, tight hamstrings, joint restrictions of the foot and/or ankle or fallen arches just to name a few.


For more information or to schedule an appointment contact SMI today!


Mark Fadil
Executive Director
Sports Medicine Institute

(1) Benno Brinkhaus, Miriam Ortiz, Claudia M. Witt, Stephanie Roll, Klaus Linde, Florian Pfab, Bodo Niggemann, Josef Hummelsberger, András Treszl, Johannes Ring, Torsten Zuberbier, Karl Wegscheider, Stefan N. Willich; Acupuncture in Patients With Seasonal Allergic RhinitisA Randomized Trial. Annals of Internal Medicine. 2013 Feb;158(4):225-234.

(2) Gerald Heart and coworkers, Science, 23 March 2001

(3) Gale M. Gehlsen, “Fibroblast responses to variation in soft tissue mobilization pressure”, Medicine & Science in Sports & Exercise, Apr. 1999, Vol. 31, No. 4, pp. 531-535.

(4) Brett L Woodley, Richard J Newsham-West, G David Baxter. “Chronic tendinopathy: effectiveness of eccentric exercises,” Br J Sports Med. 2007 April; 41(4): 188-198.

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