Workout without burn out for active women with with AI, Hashimotos and hypermobility with Dr. Emily Kiberd
This week on The Less Stressed Life Podcast, I am joined by Dr. Emily Kiberd. In this conversation, we discuss how women can work out without burnout.
- Why focus on feeding the muscle living with Hashimotos
- Clinical observation of hypermobility in women with autoimmune conditions, what this looks like, and how does this present?
- What is progressive overload & the importance of proper form for working out
GUEST SHARED HELPFUL TIPS ON:
- How to work out smarter, not harder
- Mistakes you’re making in your workout and what to do instead
- How to focus on feeding the muscle tissue living with Hashimotos
- Why your body composition is not changing, but you are working out
Dr. Emily Kiberd is a chiropractor with a practice in NYC and Boulder, Colorado, and a mama to Elvis and Brooklyn. She was diagnosed with Hashimoto's in 2016 and put herself into remission with changes in diet, lifestyle changes identifying root causes, and changing how she was exercising. She now helps women do the same with her online program Thyroid Strong, helping women learn how to work out without burnout. She's been featured in Vogue, Elle, Women's Health, Fortune Magazine, and Vice for her expertise in posture, ergonomics, and Hashimoto's background.
WHERE TO FIND :
5 strategies to lose weight with Hashimoto's
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Dr. Emily (00:00):
But you gotta do the basics like learn how to breathe, learn how to brace, learn how to stay stacked, learn, have movement flows for like neck pain, back pain, hip pain, shoulder pain that you do on your off days.
Stress is the inflammation that robs us of life, energy, and happiness. Our typical solutions for gut health and hormone balance have let a lot of us down we're overmedicated and underserved at the less trust life. We are a community of health savvy women exploring solutions outside of our traditional western medicine toolbox and training to raise the bar and change our stories. Each week our hope is that you leave our sessions inspired to learn, grow, and share these stories to raise the bar in your life and home.
Access to functional or specialized medicine testing and standard blood work is a big piece of personalizing care plans to help our clients succeed by getting accounts with multiple labs and ordering and tracking results from many different web portals slows efficiency by bogging us down in admin work. This is why I'm completely obsessed with our podcast sponsor at Rupa Health. It's a single portal that allows you to order from over 20 specialty labs in one incredibly simple dashboard. I'm talking less than 30 seconds to set up your free account and about 30 seconds to order the labs you need. All the results are in one place and I can securely send clients their results with a click of a button. A big advantage for our clients is that standard blood work can be ordered for almost two thirds less than other direct to consumer lab sites.
Rupa is a lab concierge, so they send the lab invoices on your behalf of a client, pays for their own labs. They help them get set up with a lab draw, navigate testing questions, and they provide the requisition forms. It's literally a dream. Go sign it for free to help streamline your practice and simplify ordering labs for your [email protected]. That's R U pa health.com. And let them know I sent you when you sign up. You can also check out the show notes for this episode for a short video walkthrough of how I use REBA Health in my own practice. All right, today on the less stress life I have Dr. Emily Kik, who is a chiropractor with a practice in both New York City and Boulder, Colorado. She's a mama to Elvis and Brooklyn or no talk about that name. That's great. She was diagnosed with Hashimo in 2016 and put herself into remission with changes in diet, lifestyle changes, identifying root causes and changing how she was exercising. She now helps women do the same with her online program with thyroid Strong, helping women learn how to work out without burnout. She's been featured in Vogue l, Women's Health, Fortune Magazine and Vice for her expertise and Posture Ergonomics and Hashimoto's background. Welcome Dr. Kieber.
Dr. Emily (02:48):
Thank you so much.
So let's start with the stories. We always like the stories. It helps us like you better, right? And also I, I mean I dunno what's not gonna be like with the kid named Elvis and I'd really like to know why you named your child Elvis. I think it's fantastic and wonderful, but also like would make me giggle all the time. So let's talk about that and tell me how you ended up with a practice in New York City in Boulder. Real quick. Just like pre-interview details that are not important, but I'm a curious person and then I wanna talk about the story. And hey, your story is partially mom and I'm guessing there's a reason you were practicing both places very different vibes in these places as well. Guessing that has something to do with guessing your healing journey has something to do with this.
Dr. Emily (03:29):
Totally. Where should we start? Should we start with Elvis or by coastal last? Yes.
Start, just start with Elvis.
Dr. Emily (03:34):
Where did that? Elvis is really the impetus for my autoimmune condition.
Thank you Elvis. I, it was just love you before this.
Dr. Emily (03:40):
I love you for it. So I've been a chiropractor since 2007. I had a practice in New York City right at 57th and sixth in the middle of Manhattan solo practice up to built a team of eight and was very multidisciplinary. It was other chiropractors, massage therapist, a trainer, podiatrist, acupuncture, and then a physiatrist who was doing p p injections and
Very progressive really.
Dr. Emily (04:03):
And, and then we would refer out to functional medicine docs to heal that piece. And so not that we wanted to be like a one stop shop, but you know, you learn something and you implement and it gets a certain percentage of people better. You're like, but I wanna get more people better. So then you integrate another piece of tool or knowledge or training and it was really, it was beautiful clinic. I built it out. We had a whole like corporate wellness division where we'd go in and do ergonomic assessments and nutrition talks and stress management. But it was really like how to leverage your stress to your advantage. And then there was the online piece. And when I had Elvis in 2016, as you can imagine, my candle was burning at both ends towards the middle, just totally burning myself out and you know, all the new mom symptoms, hair's falling out, can't lose the baby weight, exhausted.
Dr. Emily (04:52):
All my girlfriends were like, Yeah, yeah, yeah, you just had a baby. That's normal. 18 months later my kids one and a half like running around. I'm like, I am all the same symptoms. Like this cannot be my life. Like this is, you know, I also had some histamine symptoms, probably mass cell activation symptoms like eczema or on my mouth and my hand had to kill a couple parasites for that to go away. Mm-Hmm <affirmative> and saw the conventional medicine route. So primary care endo saw multiple functional medicine docs in New York is put on protocols, wasn't given a very clear diagnosis. And then I met my current functional medicine doc, Dr. Gabrielle Lion. And you know, she took a barrage of blood work and she's like, Has anyone else checked more than just your tsh? And I was like, I don't even know what you're talking about.
Dr. Emily (05:32):
Just make me feel better. And you know, she's like, you have Hashi monos, you have an autoimmune condition. It's great that we're picking it up early cuz we're gonna do all the things to try and put it into remission. And that's what we did. So changing up, you know, when I was pregnant I was pounding coffee and croissants probably to get me through that morning. Mm-Hmm. <affirmative> have fried chicken and an Arnold Palmer at night and that I was like, you know what, it's first time pregnant. Pregnant. I don't know how this is supposed to go down but I'm just gonna eat and you know mm-hmm <affirmative> gain 45 pounds and you know, all good. So we started to work on changing food, lifestyle changes. Was living a house in a condo with water damage and stacky bos, some parasites from some third world travel when I was in my twenties to India and Nepal. Just different protocols. And probably nine months into that journey started to feel better, which I know a lot of women are like nine months. Like that was,
You know, a long time.
Dr. Emily (06:28):
A long time. But like just the tip of the iceberg. And one of the things that I think a lot of moms do is they're like this body post baby. Like what is this body <laugh>? This is not my body. And they desire that pre-baby body. Mm-Hmm. <affirmative>. So I was like a lot of New Yorkers doing the double soul cycle. So 90 minutes of spinning or I would literally go to Soul Cycle and I'd walk across the street and go to a Barry's bootcamp. Mm. So you know, 45 minutes of spinning, 45 minutes of hit training and just like, you know, I'm already burning my candle at both ends, working 12 hour days, not seeing my kid breastfeeding in the middle of the night and trying to work out to lose the baby weight. And I had a trainer and he's like, Dude, you are doing this like you are exhausted and you look terrible.
Dr. Emily (07:13):
Why don't we do it better? And he had been a kettlebell trainer Matt Summer for 22 years, very knowledgeable injuries, you know, train for longevity, not to like kill it right now. And he's like, We're gonna dial it back and we're gonna do the basics. We're gonna do the basics consistently, we're gonna lift heavier. And the whole goal is to get like to feed your muscle. To get you a workout and to not have you dragging all day basically. Mm-Hmm. <affirmative>. And you know, he was in my clinic for a long time and we collaborated on every single patient and that was kind of like the birth of my fourth baby, which was thyroid strong <laugh>, which is a program to help women work out without the burnout. Mm-Hmm
<Affirmative>, thanks for sharing so many little pieces of that. And I think you quickly, but nicely went through a bit of your treatment pie that had to be thought of for Hashi Meadows cuz it's like we're gonna talk about one area of it that was a really big deal for you and honestly for others, but there were many other pieces that you've already handled. This is just the consistent, how do I do this for the, like you said, train for the longevity. Yeah. And not just in the short term. And that's a thing, it's like, you know, sometimes we complain about the way medicine is and it's such quick fix, but we kind of feed into it, you know, like we're just humans. I never blame us for being humans. I'm like, we're just humans. So we just want really quick fixes too. We're like, oh well so what? I just had a baby <laugh>. I would like to be better right now. Yeah. And it's like you get into it and we have a very toxic history of like exercise more, eat less. And someone just said it on the podcast the other day and I didn't correct her. I was like, well maybe. But you know, that's the thing. It's like with what you were doing who'd been hard to nourish through that. I wonder if you felt like just exhausted.
Dr. Emily (08:59):
I felt like a zombie, but I told myself this is how you're supposed to feel as a new mom because as a new mom you don't know. Mm-Hmm <affirmative> like everything's so new. You're like, is this normal? Am I supposed to feel this way? I don't know. And so I was just like, this is how it is as a new mom. Mm-Hmm. <affirmative> like that norm is now my new norm until it is like I can't do this. I
Want, it's a new my life. It's a new norm that you've been perpetuating for long enough where it's like becomes, you didn't realize that it, it grew over time. Yeah. Cause that it became the the
Dr. Emily (09:29):
Norm. Yeah. And to go back to Elvis, so my husband's a big Elvis fan, his dad was a big Elvis fan, he has like old records and I had a Homebirth and when you have a Homebirth you have a week to name your kid. Mm-Hmm <affirmative> like you can't like, you know at the hospital you have to like name him before you leave to send in the birth certificate. So it's like day three postpartum of pushing this eight pound mass out. And my husband's like, we have to name it. And we were literally pulling names out of the hat and like trying it on and seeing his reaction like two days old and you know, re and Elvis were two of the potential names and my husband was getting very anxious that he didn't have a name by day three of birth. And I was like, leave me alone.
Dr. Emily (10:06):
I'm trying to heal. I'm like terrified to you know, have a bowel movement. And he goes, right, we're just gonna name him Elvis, read Stewart. I'm like, let's just get it done. And I'm like, let's just do re Elvis Stewart just in case he wants a corporate job. <Laugh>. Cause this is like me in Manhattan treating all these finance guys <laugh> just in case he wants that. Let's just give him a chance. And he goes fine. So his first name is actually Reid, his middle name's Elvis, but we've always called him Elvis. He actually thinks he's a reincarnation of Elvis. Like when he was three years old, maybe I was like four. He's like, yeah, remember that time I was on stage and I'd be like, <laugh>, I was singing to all the girls and I was like, when he's like, when I was Elvis, you know like,
And and you have dark, prominent, awesome hair. So I wonder, I just like have have to know. Does he also have dark gray hair?
Dr. Emily (10:56):
He does. Oh that's perfect. Thank goodness it worked out.
Dr. Emily (10:59):
<Laugh>. Yeah. Yeah. So that's the Elvis story.
Thanks. That was so necessary for this interview. Just can't stop my curiosity. Nobody need to get into how you exercise differently without autoimmune condition. Yeah I know it's our goal is today, but tell me about you were in this busy practice in the middle of Manhattan. I can only imagine what that looked like. And I often think this, when I see people it's like you want everything. It's like, oh wouldn't it be great to have this like multidisciplinary practice and we just solve almost all the problems and it's amazing. But it's like there's a lot of stuff there. So how is it now and why do you have a practice in Boulder?
Dr. Emily (11:33):
It was a beast with very high overhead. Mm-Hmm <affirmative> if you're seeing people. Mm-Hmm <affirmative>, you know, I was like the overhead doesn't matter, right? Mm-Hmm <affirmative> cause it's only a percentage of what you're making. But good old Covid came around and I remember shutting my doors in March and I was like, we're gonna open back up in two, two weeks. It's not if but when And June I had stepped back beginning of May I had started to see patients again cause I was like, rent's not gonna pay itself. Mm-Hmm <affirmative>. And my landlord was not giving a rent relief. He was giving a deferment. Mm-Hmm <affirmative> with interest was the, in the negotiations and it wasn't good for anybody. No. I was seeing like 10% of what I was seeing in May. Mm-Hmm. <affirmative> end of June 10%. No one was getting on a subway, No one was getting in a taxi.
Dr. Emily (12:28):
Everyone had fled the city. There's a statistics in the New York Times that the foot traffic in August of 2020. So six months what in midtown, which is where the practice was, was down 96% six months later. Oh Like a drive that would take me an hour, took me 15 minutes. I have videos of the Black Lives Matter marches going down six Avenue because there were no cars driving up at in June of 2020. So Covid decimated the practice. I closed my doors, I cried many, many tears still do. And nothing was holding us in New York. You know, we had a condo in Brooklyn, my husband worked from home. Our condo had this perpetual water leak that we could just not find the source of. And we kept coming up with stacky batters on our MO test after we remediated and before. And the condo was on a super fun site, like a block away from a Superfund site in Brooklyn.
Dr. Emily (13:24):
And I was like, nothing's holiness here. And if they locked down all the parks, cuz they literally chained the parks closed. And I was playing soccer on a rooftop with my, I was like if they do that another winter, I might throw myself off our condo rooftop cuz this is like insane. So we started to explore where else to live and I was like, I want somewhere sunny. I want somewhere dry where there's potentially less mold. So the things that came up were Boulder Austin was in there, but it's, I'm like a, I would die in the winter or in the summertime, just went like a little puppy and then San Diego and we chose Boulder, Colorado and all through the pandemic, I would fly back and forth every other week to see patients and you know, it went from every other week to once a month to six weeks.
Dr. Emily (14:06):
We were just in New York for the summertime and saw patients every other week again. And you know, I practiced in Boulder seeing patients from a chiropractic movement strength perspective, also some gate analysis. And you know, that's what I do in New York. Do I have the physical space that's multidisciplinary? No. Do I miss it like every single day? Yes. Is Boulder better for my kids' health and my health and my nervous system? Yes. So you know, just kind of going back to that like you know, new moms want it all. They want their bi baby body back. I think as entrepreneurial women, like I want Boulder and I want New York. So right now I make it work. It's not forever. Yeah, that's interesting. Was a recent change. Yeah and they each fill the soul in different ways. So it's funny cuz when people come in Boulder like, oh you came from New York? Like do you just love it here? And I'm like, I actually really love the energy of New York but I like Boulder and it's growing on me so.
Hmm. I have someone to introduce you too later. Okay.
I know they're a New Yorker's got all, all the love for that. That's fun. Very cool. Yeah. Okay, so we talked about this diagnosis and how it took you a few practitioners to get to this point because everyone else thinks that someone before you surely should have checked your thyroid. But unfortunately it's not that simple. It's like, did you check your thyroid? Oh did you check more than TSH and a reflex for t4? And that's the challenge for some reason, I have no idea why we don't check antibodies. I don't know. They charge a lot to the insurance company. I, it's $5 to me but I don't really get it. So anyway, so then you have this great guy, this trainer, kettlebell trainer I think is how you referenced him. I think his name was Matt didn't write his name. Yeah, yeah. All great.
We got Matt kettlebell guy, he's got a lot of experience and he looks at you and he's like, this is not okay. Like what you were doing is not working for you. Yeah. So I wanna talk about that. Like let's talk about it from your professional hat and then or personal hat maybe personal hat first. Maybe let's start with like Matt's like this isn't working, we're gonna change this and you lightly talked about that. Let's like clearly tell me what you did differently cuz before doing cardio, cardio hit okay. Cardio, cardio, cardio essentially like lots of cardio and burning the candle at both ends, aka dumping all the minerals, killing the cells in your adrenals, et cetera. And I have never seen, so just for context that you know, but maybe listeners don't know very likely to have a thyroid issue during pregnancy and postpartum.
I don't know what the increased stats are but we've got episodes about it <laugh>, where you need more nutrients for your thyroid during pregnancy and postpartum. It's easy to have happen And then it's kind of like a perfect storm of I am managing this stress x, y, Z way and now it's like too much and you had stuff, you know, the history was there. It was just like you needed a straw to break the camels back type situation. So nothing about this is a surprise except for any woman. It's a surprise until you get the actual diagnosis or it's still like you're still getting gaslighted to like, oh I'm, you know, just tired cuz I'm a mom. Which I'm like that's just not we can we just not make that normal anymore? Like can we just have energy <laugh> at some point, at some point postpartum. So now we're standing here with math kettlebell guy and he's like, this is not working for you. Let's talk about what you did differently at that time. Like just tactically and then let's back up and talk about it from the professional hat status on how you need to work out a bit differently with an autoimmune condition.
Dr. Emily (17:22):
Yeah, it was a little bit of the conversation with Matt. It was also like Gabrielle Lion, my functional medicine doc. Mm-Hmm <affirmative> is all about like you lift heavy shit and that's what you do. So it was also a little bit from her in terms of just putting that message in my head. So you know, I dialed back all that cardio and hit. So he's like, listen, you're going like four or five days a week to Soul Cycle, do one cuz it fills your soul and I'm gonna write you a program and it's gonna be three days a week. If you don't want us do soul cycle at all, just do my program and we'll make it kettlebell based. Cuz kettlebells are very forgiving when you're learning form. I knew form but like when you're in the fog brain fog of Hashimotos, you just like your mind is not there.
Dr. Emily (18:08):
So yeah, it was kettlebell based and it was functional compound movements which are a hinge, like a deadlift, a squat, some sort of push pull lunge, which are very, is very challenging for the Hashi ladies. And we can talk about why carry, like you're carrying your groceries, which is very good to do in New York. You need to know how to do that without like killing, without being like a crazy bag lady and killing your shoulders. And then some sort of like controlling rotation. So we call that anti-rotation. So we just build a program. It was like nothing over six reps but I was picking up heavier weight and he would give me a long enough rest break to bring my heart rate down. So I wasn't gasping for wind like when I was at Barry's bootcamp and they're like transition off the treadmill and go to the floor and now we're gonna do 50 squats for the next two minutes, you know?
Dr. Emily (18:59):
Mm-Hmm. <affirmative>. So, and it was just really basic and any good trainer will know it's a good written program and we do the basics consistently. The general population, I think we need to think it looks sexy and challenging and something needs to be like swinging around our head and mm-hmm <affirmative> transition to that. And actually he would like train me in the morning before we would start clinic and I felt so much better. I was also doing all the things, the functional medicine pieces. But you know for me it wasn't so much like I need to lose weight even though that was probably in the subconscious like lose the baby weight. It was like I just need to not feel like I'm dragging all day. Especially seeing patients all day and then trying to see my kid at night. So that was the dialogue. And from a professional clinical perspective, you know, I'm seeing those women who are doing the double soul cycles and seeing them over years. Like their body composition is not changing. Hmm. And watching them actually waste away or like, especially if they're in their fifties, like their skin is starting to sag but they don't wanna touch the weight. So I saw a lot of different, you know, I saw some Pilates instructors with pelvic prolapse and diastasis and wondering, okay, there seems to be some tendencies that are coming up and how can I do this better? Not only for my own body but also for the patients that I was treating. Mm.
There's a lot there. My first thought was when Matt says this is what we're gonna do three days per week, six reps do it. Right. Do it consistently. That was like a version of relaxation for a person who was like going 90 miles per hour.
Dr. Emily (20:38):
But yet still moving and not just being like, well just sit. Okay I'm not gonna do that Matt. Yeah. I still like to do Thanks. That's
Dr. Emily (20:45):
Like a child's pose for Uhhuh.
Dr. Emily (20:47):
For someone who's doing double cell cycles.
Right, exactly. Like a child. So love it. Yeah. So there are so many pieces there and you felt a lot better. And I actually, the first thing I wanna know cuz I'm kind of using this in context of your story of course is you've talked about the rest of the treatment pie and taking nine months to change. But then you just talked about you started doing this workout and you felt a lot better and at first you were quite motivated to change your body. Like working, you were really working against your body, right? Yes. Like you were working against it and then now you went to working with it. And I think that's just a simple way to say like a different way to look at it and that's what it sounds like. So what month in your journey did Matt write you this program and you started doing that?
Dr. Emily (21:26):
Probably six months in.
Okay, got it. Yeah. Yeah. So we're feeling better at that point. We're not like crazy exhausted zombie stuff. So we've got some things that are actually happening. So you brought up so many things about body composition not changing when people are doing all of this. Like how we perceive a workout to be like it must make me out of breath and all these things. And it's probably, honestly I think this might be where like I wonder if this is where some aversion exercise comes from and I just am wondering even for myself cuz like I did not grow up with fitness, I really embraced it in the last 10 years and still feel like I've got a lifetime to go. Like and I've changed my comprehension and integration of it and we were just talking offline about like yeah I want it to be written a different way now. And not just to be like, I don't wanna just be exhausted after Barry's bootcamp where he is like drop and give me 25 lunges per minute or whatever. Right. So I wanna talk about body composition not changing. I wanna talk about lunges being challenging for Hashimotos. Let's start with body compositions a little more broad of a term, right? Why when your clients come in, they're doing all these things, is their body composition not changing? And why are women afraid of weights?
Dr. Emily (22:34):
Well I think women are afraid of weights because when do we ever learn, right? Mm-Hmm. <affirmative>, if you went to the weight room high school, the bros are a little intimidating. I know for college I lived on a StairMaster or an elliptical machine and you know, maybe you hire a trainer but you know, it takes three days to be certified. Mm-Hmm <affirmative> to like take a test and be certified. So, you know, for a trainer to be able to train an autoimmune population, I would say would be very niche in terms of reps and sets and rest breaks and you know, I mean it's an art to program a workout very specific for someone. So, you know, the fear around weight I think makes sense because we never, it would be great if in high school they had like women's weight lifting <laugh>. Mm-Hmm <affirmative>, you know, and yeah.
Dr. Emily (23:19):
So you know, I have conversations with women, some of them it's like six weeks long and they're going back and forth. They're like, oh I'm so afraid to injure myself. Which I get. But if the goal is not to never feel pain, right? Yes. We don't wanna get injured. Injury is probably inevitable. And if you're not feeling, like if you're not pushing yourself hard enough, you're not gonna get changes in the muscle. So for me the goal is for my women, the goal is not to never feel pain or muscle soreness. Yes. We don't want like, you know, sciatica, numbness, tingling, stabbing pain. We don't want that. And I'm gonna give you the form on how not to experience that. But you should feel like you challenge yourself. And I don't know from a societal perspective if that is a commonly accepted mindset. You know, we can get any food any time of year.
Dr. Emily (24:09):
Right. You know, we're a little soft in that aspect of like day to day is not that cha, we're not like, you know, hiking three miles to get our water out of a well. You know. So I think there's a fear because from a day to day perspective we're not challenging ourselves. I know that's scary for Hashi ladies cuz they're scared of like pushing themselves into a flare up or experiencing symptoms worse if they overdo it In terms of body composition, I think a lot of women fear getting bulky lifting weights. And I just had someone drop in the Facebook group. Like it's not about the number on the scale. Like she was taking measurements every week and she was noticing her pants were fitting better, her measurements were changing and you know, the number on the scale was going up because she was building more muscle and muscle weigh more than fat.
Dr. Emily (24:57):
So I think, you know, I like to frame working out and you know a lot of women with how shemos really focused on weight loss. Instead of focusing on like let's lose the fat, which can be kind of a downward spiral and a very negative shaming blaming spiral. Like let's just focus on our muscle like building up our muscle, right? Our metabolic engine disposal for excess glucose will help change our body composition will help contribute to longevity. Like the more muscle we have if we get sick in the icu, it's like the only determinant with whether we're gonna get out of the icu. So let's focus on the muscle tissue, feeding it with resistance training, feeding it with optimal protein. And you say body composition, women are like, I don't know what that means. It's like, okay, do your pants fit better cuz you're shifting the ratio of percentage of body fat to muscle composition. So that's how I like to frame working out. Cause I feel it's empowering versus oh I gotta like lose this love handle. It's like so shaming, you know? Right.
Yeah. I like framing it from that's my like new set of frame is empowering versus disempowering. Right? Yeah. People use different versions of that but if it's not fitting under the empowering version, it's not not a good fit. You brought something up, you know, women are afraid of you with auto immunity causing a flare from overdoing it. Has that ever happened to you? Because this started in 2016 so there's a lot of opportunity there for and then big stressors a couple of years ago.
Dr. Emily (26:26):
Yeah. I have definitely been in a flare up where I work out immediately need to take a nap and I'm dragging for like the next three days. Joint pain, brain foggy. Mm-Hmm <affirmative>, all those symptoms have come up. What
Do you do with that? I mean you recognized it. That's what you first did. Yeah.
Dr. Emily (26:46):
What did you I well I texted my functional medicine back <laugh> and I prioritized the foundational basics. I was also like not sleeping and Netflix binging and mourning the closing of my first baby, my clinic in New York. So that was probably part of it. But you know, so I usually resistance train three to four days a week. And then on my quote unquote off days, I do movement reset patterns for about 15, 20 minutes. Like I just kind of like being in my body and trying different things. Cause I like, I like to encourage women to like stay curious. Mm-Hmm. <affirmative> especially in their body and in their healing journey. So I'll do these movement patterns that are similar to how we learned our movement patterns as babies and usually with a cattle bell, but it's not like trying to be creating progressive overload. And then the other thing I do is I try to hit my 10,000 steps a day. So when I overdo it, I try to reign it in and kind of go back to the basics.
Mm. Okay. You stay curious. I stay you go back to, you go back to walking. Mm-Hmm. Being active is basically part of your life. I'm guessing it's part of how you kind of went into
Dr. Emily (27:58):
Yeah. I mean it's kind of hard to promote health as a chiropractor and like living with joint, like chronic joint pain kind of isn't an option as a chiropractor.
Dr. Emily (28:10):
<Affirmative>. Yeah. So yeah, I think moving, you know, it's like walk your talk.
Mm-Hmm. <affirmative>. Yeah, for sure. So,
Dr. Emily (28:16):
Okay. No one wants to, you know, like visit a sickly functional medicine doc. We like bags under the eyes. Right, right.
Yeah, yeah, yeah, yeah, yeah. Okay. So you, I liked how you said this. You're like, I do these movements similar to patterns we learned as babies. Interesting. And then walking, I actually want you to define progressive overload cuz I think we're gonna have to go back to some basics on like, hey we don't know what you're talking, I've heard of this term. Yeah. but let's go ahead and define that.
Dr. Emily (28:40):
I mean if we break it down really simple, it's if you did the same workout with the same amount of weight, right? There's gonna be a point where you've created muscle tissue and your body is not gonna respond to the stimulus. Mm-Hmm <affirmative>. So you need to either increase the reps, increase the weight, or really at the end of the day, increase the volume so that the stimulus to the muscle is more and it's challenging.
Awesome. So let you brought up lunges being challenging for Hashimotos and then just in general that may bring us to changes in the body with autoimmunity that are not the same for everybody else. So let's talk about big umbrella. I think that's, yeah.
Dr. Emily (29:20):
Most important. So lunges, lunges and squats. So there's certain injuries that in clinical practice I notice women are like, like I just <laugh> please don't program squats and lunches <laugh>. And there is a slower tendon turnover. So all of our tissue is regenerating and replenishing. Typically with a hypoactive thyroid, it is a slower process because we need thyroid hormone for every metabolic process in the body. And that tendon, that inro patella tendon that goes from your quad around the kneecap inserts into your lower leg gets super cranky. Especially if we've been sitting all day sedentary is like a desk jockey. So you know, the pressure in the knee increases exponentially. For example, in a squat or lunge once your seat drops below your knees. And I've had women come and be like, I don't wanna get on the floor with my grandkids or my kids cuz I'm afraid I won't get back up cuz my knees hurt so bad so I avoid it.
Dr. Emily (30:22):
It's like you avoid playing with your kids is basically what you're saying or grandkids really is more the narrative that I've heard. Mm-Hmm <affirmative>. And so I was like, okay, well let's train it in a slow controlled movement so that when you do it on the subconscious and it's body weight, like getting off the floor after playing with your grandkids, you don't even have to think about it. There is a subconscious motor control like muscle memory of that movement. And then let's, once you own the form, let's add weight because you heal the tendons by loading them and we're gonna give you long rest breaks in between your sets so you don't feel like you're getting, you're giving yourself an overuse injury when you're lifting. And if you're doing kind of like the boutique fitness in New York, you know you gotta rest break at like the 50 minutes after class.
Dr. Emily (31:08):
Professional lifters give themselves a one to three to five minute rest break in between their sets. You know when you actually experience that, you're like, do, do do. You're like walk around, you know you're, you take a walk, you shake it out, you're like, oh my god, that was only 10 seconds. Like a long rest break is much longer than <laugh> what we perceive. Mm-Hmm <affirmative>. But it's important. So that's what I do for the knees and it's maybe squat to a chair body weight now squat, holding a kettle belt your chest to the chair so your, your seat is not going below your knees for a lunge. You know a lot of people cue, okay tap your back knee down, chest up. If you do that you will be lunging with a big sway back like a banana back in your low back. And you are now giving yourself no core pressurization less spinal stability. You are giving yourself an extension compression compensation in your low back. So IQ like lean a little bit forward, not rounded but a little bit forward so that your ribs stay over your pelvis and you're stacked and you're giving yourself optimal pressurization in your core and optimal spinal stability. I
Feel like we need this to be a visual podcast.
Dr. Emily (32:20):
I know I like we need like a little core diagram thing. I know
You brought up form a bit ago and we talked about, you know, the injury can happen and obviously form is the, I think the, the answer to trying to prevent injury. But it's, we slip out of that sometimes. So we just talked about the lunges and et cetera and I know I wanna talk about form a little bit and I think you, you mostly that was a bit of a form conversation but you said from an autoimmune perspective with working out there's changes with the tissue and so you should be picking up a weight versus yoga. So maybe let's talk about that.
Dr. Emily (32:54):
Yeah, yeah. So you know I was looking at the autoimmune women coming into my clinic with co-treating them with functional medicine doctors and the things that were coming up were low muscle mass, right? Low muscle tone, slow deep tendon reflexes which were all hypothyroid component. Kind of like a skinny fat look appearance. And then you start to take 'em through a movement screen. So what is moving too much? What is not moving enough? Most practitioners focus on what's not moving enough, like what's tight, stiff, but what is moving too much like elements of hyper-mobility, tissue laxity, ligamentous laxity was coming up and there's a test to do, it's called a BATTON score where you check 10 points in the body and if there is joint laxity to a certain aspect, then you go refer out earlier down low for like a genetic hyper mobility. Mm-Hmm <affirmative> and I like movement so I like to check what's moving too much, what's not moving enough.
Dr. Emily (33:53):
It's good to direct where your treatment is cuz you don't wanna just like massage your muscle that's weakened tight but not firing but you know what I mean? Mm-Hmm <affirmative> or that's surrounding a hyper mobile joint. Like you go and release that you're gonna make someone feel like they can't walk. So I was checking all my hashi women for this and I was like wow. Like they have all these bait and score signs. So knees hyperextending back behind the ankles, the elbow hyperextending the thumb, able to push down towards a soft part of their forearm. Pinky being able to hyper extend backwards past 90 degrees. And then the last checkpoint is if you stand knee straight and touch the floor you can palm the floor. Which is not normal. It's like every yogi's dream, but it's actually too much laxity, too much flexibility, especially in the hamstrings.
Dr. Emily (34:41):
So there's a genetic component, there's a biomechanical component where if you're yogi you're giving yourself, you know, overstretch hamstrings. And then I was noticing in my autoimmune population that a very high percentage had this hypermobility and these women, because they have joint aches must pain. They're like, can you just like crack my back, give me a massage and then tell me how to foam roll. And I was like that like yes I know I'm a chiropractor but what you need is to create joint integrity, you know, more muscle mass stability. And I know like it's gonna feel tight at first cuz we're kind of tightening everything down but you will feel so much better. So a lot of the women I was like hey no more yoga for like the next eight weeks. I felt like I was like tearing out their soul but
Oh this is so different than usually what we talk about here.
Dr. Emily (35:31):
Right, Right. And you like even conventional medicine and then even like my functional medicine doc friends, some of them are like the common exercise recommendation is low impact yoga, Pilates, things that are going to feed that parasympathetic aspect of your nervous system, foam rolling, stretching, you know chair yoga. But all of those are great for the parasympathetic and there's a time and place. Mm-Hmm <affirmative>, but none of those feed the muscle tissue and none of that is gonna help a hyper mobile woman or someone who has tissue laxity like NOA amount yoga is gonna help her stabilize her joints. No amount of chungs is gonna help put muscle mass on to kind of stoke her metabolic engine. Yeah. So I was like listen, let's take out the yoga if you wanna do it in eight weeks, but like let's try resistance training and we're gonna work up to three times a week we're gonna do kettlebells.
Dr. Emily (36:22):
Cuz you can kind of like mess up your form a little bit and not totally tweak your back. Whereas like Barb Bell deadlifting, like you don't get that spot on, you can throw out your back very easily or give yourself a dis herniation and like dumbbells are kind of like bounce around on the legs and stuff and you can use the offset weight of a kettlebell to stimulate those. Going back to those movements we did as babies stimulate certain parts of the body to stabilize properly. If that makes sense. So I'll just give you an example of that Please. You go to physical therapy and they go, oh you need to have better posture, pinch your shoulder blades together. And you're like, Yeah I can do that for like five seconds and then I'm exhausted. Right. They're like, lift your chest, squeeze your shoulder blades.
Dr. Emily (37:05):
Oh we gotta work on that. You know, you're gonna do three sets of 15 every day twice a day. You never see a baby as they start to get upright. Like learning to stand and walk, squeeze your shoulder blades together for Right cuz they're getting upright. Mm-Hmm <affirmative> to pot, to <laugh> get their eyes on the horizon. You see a baby get long through their neck, soft chin eyes on the horizon and their shoulder blades actually kind of go down and wide and are flush to the ribs. They're not pinching and squeezing and over activating your OIDs. So if when we learned our D neurodevelopmental milestone at 10 months to come up to stand, why would we cue it in a way that's pathological as an adult? Does that make sense? Yeah. But I feel like this is the first time I've ever heard any of these concepts.
Dr. Emily (37:58):
<Laugh>. Okay, so this, let me give you like the backstory. So this comes out of the Check Republic called the Prague School. It was started by Pavel Collage. They literally look at babies and how they move and you know, Yda was there, he's a very famous name in the movement world and you know, 30% of kids don't hit their milestones. Like they don't develop properly. So for example, there's a certain point where a baby should disassociate the eyes from the head. So if you go, okay, follow my finger. Mm-Hmm <affirmative> a baby will first use their whole head and their eyes and then at a certain age, a certain milestone they can move their eyes but not their head. Mm-Hmm. <affirmative>, if you have a four year old who can't disassociate is like moving their head and their eyes to track something. That kid when they're reading is gonna be doing that and is gonna have a really hard time reading.
Dr. Emily (38:50):
Right. So that's an example of who would go to the Prague school to rehab, something like that. But you can take those movement patterns and apply them to lifting. For example, when a baby fatigues, they go into an extension pattern. When a CrossFitter fatigues doing muscle ups, like let's say they do the first 10 and they're like stacked, like their ribs are right over their pelvis and they're creating good intra abdominal pressure. But oh, they start to fatigue by, you know, CrossFits like rep 40, 45. That CrossFitter will go into an extension pattern, which is a primitive reflex strategy. So when you fatigue, when you're weight lifting, you'll notice on a squat someone coming out of the hole will drive up into extension, like will drive their hips and their chest will go forward and then their like that's when everything should lift together. That's you're literally triggering a primitive reflex, a pathological stabilization strategy. Does that make sense?
Yeah. It's just, I'm glad you gave us the context of where it came from cause I'm
Dr. Emily (40:02):
Like, sorry. Sorry that No, it's great for the
Audience. No, that's good. I think like someone's listening to this and they say, Oh okay I was doing a bunch of cardio, it's not serving me. I want to exercise the right way. I feel like Dr. Criber, this feels really specific and nuanced and my trainer doesn't know anything about this. <Laugh> doesn't know how to help me exercise for auto immunity. Where does someone start like trying to, cuz we'd brought this up earlier. Where did you learn how to lift weights? Nowhere. Nowhere. And the injuries ensued.
Dr. Emily (40:37):
<Laugh>, Right? So the first thing I treat every single woman is how to engage their core. Like how many times you've been in a fitness class and they're like engage your core. You're like, what are you talking about? How do I
Do that? You know,
Dr. Emily (40:50):
You're like, okay, am I doing it now? How about now? How about now? So it starts with the breath, right? So if we're doing superficial shallow breath, a sympathetic breath, the diaphragm is not going to be pushing down on the contents. We're not gonna be getting intra abdominal pressure. So I teach every woman to breathe down and wide. So to the fronts of the inside of the hips wide and into the low back, which actually pushes a spine out of extension. So you're creating this like little tank of strength in your tummy. So we learn how to breathe, then we learn how to brace. So if the listeners put their hands, like if they feel the tops of their hips, the tops of their iliac crest and they put their hands in the soft part, if you take a breath in, you should feel your hands expand forward wide and into the back.
Dr. Emily (41:37):
So you take a breath in. Okay. And now you're going to just let out an exhale and you'll feel your tummy go back to soft. Right? Well you don't wanna do that when you pick up a weight you'll blow your back out. So you take a breath in. Okay. And now this is gonna be audible. You're gonna go, Okay, so what did you feel in your hands? You should oh your like a little pew like Yeah, exactly. Yeah. That is bracing your core. That's what should happen. So when trainers are like, suck your belly and pick up that weight, that's not what should happen. Like that's a Pilates cue. So suck your belly in, pull your belly to your spine. That's a pathological cue that you're literally training someone to not move their body properly. <Laugh>. Mm-hmm <affirmative>. Like how that 30% of babies don't develop properly.
Dr. Emily (42:25):
So that brace, what you felt when you went ch on the exhale should match the load. So if you're gonna pick up a pen, you're not gonna do that, right? You might just like, mm-hmm <affirmative>, if you're picking up double body weight deadlift, you need it to be like really braced. Mm-Hmm <affirmative>. So we teach 'em how to brace cuz most women are sucking their bellies in which will put them into that extension and then compress the joints and then they're injured. I'm like, oh my god I just picked it up once. Why didn? I injure myself. Well you didn't breathe. Embrace properly. And then the last piece is stacked, which is we talked about a little bit ribs over pelvis so that you're not going into that extension compression compensation. So you'll see this with like, this is more like CrossFitters. They're doing deadlifts for reps and they're starting to fatigue and at the top of their deadlift there's this huge arch in their back cuz they're driving through their hips and they're flaring their ribs.
Dr. Emily (43:19):
That is not stacked. That is, you need to put the weight down and <laugh> you're injuring your low back and si joints. But I understand you're driving through your hips to get the barb bell up. But like keep your ribs down so that you keep that good intra abdominal pressure. Hmm. Course stabilization. I sure hope you teach this. I do. So this is insight thyroid strong. Except I like dial it down to like super, super basic. So like, it's so funny cuz people join Thyroid Strong, my online course and they're like where's the workout? And I'm like, well workout comes next Monday, next week. But you gotta do the basics like learn how to breathe, learn how to brace, learn how to stay stacked, learn, have movement flows for like neck pain, back pain, hip pain, shoulder pain that you do on your off days.
Dr. Emily (44:04):
You just choose one. Mm-Hmm <affirmative>, it's called move out of pain videos. And then the week after you get workout videos and written programs, people can, I just love the workout. I'm like, no, Like you into yourself. Like just do the basics. You must walk before you can run <laugh>. Yes. Yes. Totally. So this is like for my chiropractic movement brain that I usually don't talk about cuz no one's like, Oh I wanna move like a baby. Everyone's like, can you just gimme some more energy and like have me lose weight. So I don't talk about this, but I think this is kind of of what sets it apart from a Pilates program for Hashimotos or another exercise program for Hashimotos is getting the form dialed down properly so that you can start to pick hip, have your weight without injuring yourself. Mm-Hmm
<Affirmative>. Well and I, you know, you talked about the hyper mobile population and you made it seem like this is so much more prevalent than maybe I was thinking
Dr. Emily (44:55):
It is. And you know how many people are looking for it, right? Like, you know, it's kind of like everyone is checking TSH but they're not checking antibodies. It's like how many people are going underdiagnosed? You know, the hyper mobile population is also walking around in a big sway back and rip flare, kind of giving a little kick to their adrenals into the sympathetic mm-hmm <affirmative> not feeling grounded cuz none of their joints are stable. Yeah. So there's an emotional component too. So it's so nice to use weights to ground yourself, to feel connected to the earth, to, you know, I don't know if you've met like the Hashi ladies sometimes with like super anxious and they're like all up here. Maybe that's like you got like, let's bring the energy down. Yeah. And
No, that's a unique concept. Waits for grounding. Literally
Dr. Emily (45:38):
<Laugh>. Yeah. Like it's one thing to be like, let's put you into a child's pose and calm. Okay, let's like have you do 10 heavy deadlifts and like literally like physically ground you into your joints. Yeah.
Well we covered so much I was not expecting to today, which is all good. I'm just like, oh, sometimes you think you know something and then you're like, I know nothing about this <laugh> about proper exercise for autoimmunity if there's tissue laxity and hypermobility. So Dr. Emily, where can people find you online?
Dr. Emily (46:08):
Dr. Emily Hybrid. Everywhere. Instagram, Facebook, TikTok, believe it or not. Mm. And on my website is Thyroid Strong. And then I also have a podcast where we talk about all those things called Thyroid Strong podcast.
Perfect. Thanks so much for coming on today.
Dr. Emily (46:24):
Thanks so much for having me.
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