
Boxing as therapy; role-playing games to help teens; running for fitness: Upstate Medical University's HealthLink on Air for Sunday, Aug. 25, 2024
Physical therapist Julie Lombardi, DPT, explains why boxing and other activities can be helpful for people with Parkinson's disease. Psychologist Robin Dean, PsyD, tells how she uses Dungeons and Dragons in teen therapy groups. Physical therapist Bethany Hudson, DPT, shares why she enjoys running and why it's a good form of exercise.
Transcript
Host Amber Smith: Coming up next on Upstate's "HealthLink on Air," a physical therapist explains why boxing and other activities can help people with Parkinson's disease.
Julie Lombardi, DPT: ... Something that is called BDNF, brain-derived neurotropic factor, is released with exercise and can help to protect those nerve cells, possibly slowing down the progression of the disease. ...
Host Amber Smith: A doctor of psychology tells how she uses Dungeons and Dragons in teen therapy sessions.
... You create a character that has a backstory, that has a history, that has a way of interaction, that has skills and abilities. And then, there's also this idea of chance, and the things that you can control and not control with what other characters do. ... And a runner shares how she trains and why she enjoys running.
Bethany Hudson, DPT: ... Being a physical therapist, seeing injuries, I try to practice what I preach. And so I do a lot of cross-training. ...
Host Amber Smith: All that, and a visit from The Healing Muse, coming up after the news.
This is Upstate Medical University's "HealthLink on Air," your chance to explore health, science and medicine with the experts from Central New York's only academic medical center. I'm your host, Amber Smith.
On this week's show, we'll hear how the fantasy role-playing game Dungeons and Dragons is helping troubled teens. Then we'll look at the benefits of running. But first, how people with Parkinson's disease are improving their symptoms through boxing and other activities.
From Upstate Medical University in Syracuse, New York, I'm Amber Smith. This is "HealthLink on Air."
Empower Parkinson Inc. is the charity that was selected by Upstate this year to receive volunteer support and up to $5,000 in funding through 2024. Today I am talking with Julie Lombardi. She's a doctor of physical therapy from Upstate who is also a board member of Empower Parkinson.
Welcome back to "HealthLink on Air," Dr. Lombardi.
Julie Lombardi, DPT: Thank you. Thank you for inviting me.
Host Amber Smith: Would you start by telling us what Empower Parkinson is?
Julie Lombardi, DPT: Sure. Empower Parkinson is an organization that's local to our community. It was originally started in about 2017. It started as just a class, a boxing class, for people with Parkinson's. We started this off very slowly, about 10 participants at the time, after the founder of this went and got training in a specific type of non-contact boxing for Parkinson's called Rock Steady Boxing.
And so this program started out slowly for about a year and then started to grow and then eventually needed new space. And as it grew into new space, there were more programs added besides boxing. And so there needed to be a new kind of umbrella term for this organization, which is where Empower Parkinson came from.
Really the whole goal of the organization is to empower people with Parkinson's and those that love them, so their caregivers.
Host Amber Smith: So did it start in a boxing gym?
Julie Lombardi, DPT: No. It started in an outpatient PT (physical therapy) practice.
Host Amber Smith: Oh, OK.
Julie Lombardi, DPT: It did move into a boxing gym at one point. And what's funny about that is when it had to move out of the PT practice because the space was being closed, we went around looking for a new space, and my personal opinion was like, "Our boxers are not going to want to be here in this gym. You know, it's so, like, hard-core, these boxing gyms." But they actually loved it. They loved the idea of walking in and seeing a ring and seeing all the heavy bags and all the speed bags. And it was a lot of fun to be there.
It has moved again since then and is in another boxing gym, a larger boxing gym. And that has allowed us to, again, expand what other programs are within the space since it's bigger.
Host Amber Smith: Now you said Rock Steady Boxing. Is that a different type of boxing?
Julie Lombardi, DPT: Rock Steady Boxing is an organization that started in Indianapolis. It was a boxing gym that some of the boxers there started working with people that had Parkinson's and realized how effective it was in improving their symptoms. So they then went on to learn more about Parkinson's disease and work with medical providers to learn more and develop it into, it's a class that is not specifically only boxing during the class -- it's about an hour long -- there are other components to it, so it's like a circuit-type class. It includes a lot of boxing within it, but it also includes other activities that may not be in a typical boxing program. So it's a non-contact boxing program specifically for people with Parkinson's disease because it targets their symptoms.
Host Amber Smith: Well, at this point in our community, how many people are involved with this?
Julie Lombardi, DPT: So the Empower Parkinson program has 150 participants in it at this time. There's about 125 of them that take part in the boxing classes, and then the other 25 are involved in some of the other classes.
Some of those other classes are -- there's so many -- there's spin, so it's like a cycling for Parkinson's. There's nutrition classes, which this is a really cool concept. There's classes where a registered dietician comes in and teaches people how to cook and make meals that are nutritious and kind of brain-healthy. There's also pole-walking classes that occur in the park during the appropriate months, and yoga and tai chi and singing. And one of the newer classes that's available is this form of martial arts called aikido, and they're teaching participants how to fall safely, which I am just so excited about that class.
So there's a lot of programming within Empower Parkinson for people that have different things that they enjoy as well as just to fit their different needs to meet them where they're at.
Host Amber Smith: And is there a charge?
Julie Lombardi, DPT: There is a membership fee that is, I believe, around $75 a month. However, nobody is turned away based on costs.
They want this program to be available to anyone who needs it. And so there are scholarships available. And even the members of the organization, the other people who are members believe so strongly in it, some of them even pay double membership dues to cover another boxer. And there's grant funding. So there are creative ways to help people be a part of this organization if they can't afford it.
Host Amber Smith: Let me ask you, if you would, to give us a description of what Parkinson's is and what percent of the population has it or will develop it.
Julie Lombardi, DPT: Parkinson's is what we call a neurodegenerative disease. It is a disease of the brain in which the cells that produce dopamine start to die off. And it is pretty common in terms of neurodegenerative diseases. It's the second leading neurodegenerative disease site behind Alzheimer's.
There's about, I think, 1.5 million people living in the United States with it, about 90,000 new cases a year. About 1% to 2% of people over the age of 65 do develop this disease. So it's one of the more common neurodegenerative diseases that we experience.
Host Amber Smith: How does somebody know that it's developing in them? Are there symptoms to be aware of?
Julie Lombardi, DPT: There are symptoms that are considered the cardinal signs, and those are tremor, so you'll often see a specific type of tremor in the hand, although tremors can occur in other areas of the body; rigidity, which just means like a stiffness; there's slowness of movement, which we call bradykinesia; and then postural instability, which is like difficulties with balance. And if somebody's experiencing some of those, they may then end up being diagnosed with Parkinson's disease. Although having those symptoms doesn't mean you definitely have a typical idiopathic Parkinson's disease. It might be something else. So obviously seeing a provider that's well versed in the disease is how somebody would get diagnosed with this.
So those are the cardinal signs. And again, you don't have to have all of them to be diagnosed. But there are signs that show up somewhat before that. People that eventually go on to have Parkinson's disease, many of them have something called REM sleep disorder. So typically when you're sleeping, and you're dreaming, your body should kind of be paralyzed. These folks are known to act out their dreams, so they're punching their partners in their bed, maybe rolling out of bed, falling out of bed. So that's something to talk to a medical provider about if you're experiencing that, as well as one of the interesting things is loss of smell can sometimes occur well before some of the other symptoms show up.
Host Amber Smith: This is Upstate's "HealthLink on Air" with your host, Amber Smith. I'm talking with doctor of physical therapy Julie Lombardi from Upstate's College of Health Professions about Parkinson's disease.
We don't know what causes this though, right?
Julie Lombardi, DPT: It's one of those disorders where we think genetics kind of contributes to it in terms of some people may have a genetic predisposition, and then environmental factors can come into play. There have been some environmental toxins that have been identified, pesticides and herbicides. The one that comes to mind is paraquat, as well as some metals that are toxic. So exposure to some specific chemicals has been linked to Parkinson's.
The disease process is often a misfolding of some proteins that we naturally have in our brain. And so these proteins misfold and deposit, as well as some of the powerhouses of our brain cells, the mitochondria, start to become dysfunctional. And so all of those things combined contribute to the disease process.
Host Amber Smith: What is done for treatment?
Julie Lombardi, DPT: There is no cure. And, there are several organizations that are working towards a cure, which is great.
Right now treatment is, and has been for a while, targeted at symptoms. And so there are medications that people often go on that can be very helpful with their symptoms. And one of the most common ones that people hear about is carbidopa levodopa, which helps to increase the ability for the brain to use dopamine.
And then exercise. Exercise is treatment. It also can help to kind of protect the brain cells because of the release of some chemicals within the brain, something that is called BDNF, brain-derived neurotropic factor is released with exercise and can help to protect those nerve cells, possibly slowing down the progression of the disease. So medication, exercise, there are some surgeries and other treatments that are a little bit more invasive that can also be helpful.
Host Amber Smith: Have you seen people improve their Parkinson's symptoms after exercise?
Julie Lombardi, DPT: Absolutely. So as a PT (physical therapist) it's one of the most exciting things, one of the things that I really enjoy about working with people with Parkinson's. If they haven't had therapy before, they come into it thinking that they just can't improve because they have this disorder that's progressive. But it's so not the case.
We often are able to just get people moving and thinking about movement differently and working intensely. One of the keys is that moderate to vigorous intensity exercise is really helpful. So pushing people to a limit that they didn't think they could move at, within tolerance, can be extremely helpful in getting people to move better. And so it can help with their movement, it can help with their mood.
Parkinson's is not just a movement disorder. I mean, it's considered a movement disorder, but there are these non-motor symptoms that can actually impact their quality of life even more than the movement issues. And so exercise for anybody can improve mood, it can improve sleep, improve digestion. So all of those things also happen in a person that has Parkinson's disease, which is why exercise is just kind of like that silver bullet that hits everything and helps improve quality of life and mobility.
Host Amber Smith: I've heard that boxing is a really good workout. Is that why that was chosen first, looking at the connection with Parkinson's?
Julie Lombardi, DPT: Boxing is an incredible workout. And so when we were first getting the Rock Steady Boxing program started in 2017, those of us that were a part of it went and also got certified to deliver that type of exercise, but also started to work with an amateur boxer ourselves to really, like, learn more about what is boxing. And it is hard. It is really hard. There's so many things about it. You are pushing. You're kind of being cued to hit as hard as you can. And so with people with Parkinson's disease, they often have this, like, change in their sensory awareness of how much effort has to go into their movements. And so when you have a coach telling you "Go harder," you put more effort behind your movements, and you're able to move differently. So there's that.
There's the cognitive component. With Parkinson's, cognitive processes can slow down. So the ability to think can kind of slow down and become more challenging. And especially when you're trying to think and move. That doing two things at once can be really challenging. And so boxing targets that. So it might be certain combinations of punches. So you're going to hit with your left hand first, then your right. And then you're going to squat down and duck. And then you're going to come back with a right hook. And so, having to remember that sequence, with also moving fast and hard, all of those things together are specifically targeting the areas that people with Parkinson's have difficulty with.
On top of that, it's challenging your balance. If you're having to hit something hard, move out of the way -- nobody's ever hitting the participants; it's non-contact -- but we'll do things like swing an arm over their head, telling them we're going to be doing this as part of the drill, so that they have to duck or dodge a punch. Obviously we would never actually land a punch. But getting people to move quickly, that agility piece, is a part of it as well.
Host Amber Smith: Is this something that needs to be done every day, this kind of workout? It seems pretty intense.
Julie Lombardi, DPT: It is pretty intense. And so there have been guidelines that have been published for exercise for people with Parkinson's disease. The goal is to achieve at least 150 minutes per week of aerobic exercise, and then at least two times a week of strengthening exercise and balance. And then some flexibility exercises should be completed at least three times a week. Every day would be best. The intense exercise can be those two to three times a week, trying to get to that goal of 150 minutes.
That being said, any exercise is better than no exercise. So if it's taking everything out of you just to do it one time a week to start, then that's where you start. And so, that's what I was saying earlier: We kind of meet people where they're at. So whatever it is for that person, wherever that person's at, that's new to the gym, it's completely acceptable. It's a really supportive environment there. And I'll say that that's been one of the barriers for some of the patients that I've seen in the past.
When patients finish with physical therapy, we often want them to continue with some type of exercise because this is a progressive disease. And so you have to stay on top of your symptoms and stay on top of your fitness. And so I would often recommend, "I would like you to go to a community exercise program." Community exercise programs are great because that social aspect keeps people involved and gets them exercising longer, as well as it helps with mood. And so people would be interested but often afraid to go that first time because it's something new, and you're telling me I'm going to go box. This all sounds really scary, you know?
And so just getting somebody there the first time to kind of see what it's all about and even just to observe a class, meet some people, see what a supportive environment it is, that can break that barrier. And then knowing that, hey, you know, some people are standing in this class, some people are sitting, everyone's just doing things to their level. I think that can break down some of the fear in joining.
Host Amber Smith: How would a family get involved if they have a loved one they think would benefit from these classes?
Julie Lombardi, DPT: To get involved, the first step is to just show up, or call, or visit the website. So all of the information is on their website. It's empowerparkinson.org, and that's Parkinson without an S at the end. So empowerparkinson.org. If you go onto that website, you'll find all the information about classes, signing up, or again, you can just call the phone number on there -- 315-729-7178 -- figure out a time to go there and meet up to learn more about it. Everyone is really welcome to just even pop in at any point where there's classes and it's open.
Host Amber Smith: Dr. Lombardi, thank you so much for making time to tell us about Empower Parkinson.
Julie Lombardi, DPT: Thank you again for inviting me.
Host Amber Smith: My guest has been doctor of physical therapy, Julie Lombardi from Upstate's College of Health Professions, and from the organization Empower Parkinson. I'm Amber Smith for Upstate's "HealthLink on Air."
Helping teens adjust socially through Dungeons and Dragons -- next on Upstate's "HealthLink on Air."
From Upstate Medical University in Syracuse, New York, I'm Amber Smith. This is "HealthLink on Air."
Teenagers with social adjustment issues can learn to better understand and relate to others through the fantasy role-playing game Dungeons and Dragons. Here to explain how this works is Dr. Robin Dean. She's a doctor of psychology and an assistant professor of psychiatry and behavioral sciences at Upstate.
Welcome to "HealthLink on Air," Dr. Dean.
Robin Dean, PsyD: Thank you for having me. I'm excited to talk.
Host Amber Smith: You heard about using fantasy games in therapy for young people at a psychotherapy conference, is that right?
Robin Dean, PsyD: Yes. I am a member of the American Group Psychotherapy Association, and they hold a conference every year that's focused on group psychotherapy options for children, adults, private practice -- kind of across the spectrum.
Host Amber Smith: Well, can you describe what fantasy games are in general?
Robin Dean, PsyD: So usually we talk about, in this area, tabletop role-play games, which is folks sitting around a table working together to create a story. And so in most of these situations there is a leader most often known as the Dungeon Master who creates the fantasy world and who establishes the main objective for the group and characters that they interact with along the way, and then with the other players -- each one taking on a persona or personas in the game -- they create a story of folks working together, maybe sometimes even in opposition, toward this main objective.
Host Amber Smith: So it's not on a TV screen or a computer screen, it's not on telephones or cellphones. It's played in person, sitting around looking at each other.
Robin Dean, PsyD: It can be. With COVID, a lot of things moved online, and so there are definitely virtual games. And when you want to connect with folks that are farther away, that can also be done virtually. But for the most part, it's played in your mind and your imagination. And so however it is that you want to connect with others and build that story together, you can use multiple platforms.
Host Amber Smith: So what can you tell us about Dungeons and Dragons, for someone who's never played that game? What's important to know before you get started?
Robin Dean, PsyD: Dungeons and Dragons is really just one example of these tabletop games. Different games have slightly different rules, but in the end it really kind of boils down to a group of folks working together toward that, I guess, mission or adventure.
Some specific things that may come into play that could be of interest, so there are different types of characters, warlocks or rangers, gnomes. And different characters have different skill sets. And so for example, as the DM (dungeon master) currently, I've created a non-player character, somebody that's joined the game in order to facilitate, who is a forest gnome. And in his backstory that I've given him in my head, he was a guy of the world. And gnomes are small and kind of don't really get considered a lot in the human world, or amongst the bigger monsters. And so he's moved out to the forest to just kind of live a simpler life.
And so when our players come to interact with him, he's a tinkerer, and he's really into, like, gnome culture and heritage, and he is helping to put on a basically a gnome culture fest. And they're helping with this party. And so, him as a character, he would be really good at things that require some level of intelligence because he's a builder, and he's creative. And so, he's more likely to have skills in those things.
In addition to the skills that come inherent with the character's race and class, there's also a level of chance. And so, although he might be really good at building stuff, when we get to a point where he says he wants to build something, there are the dice which add a little bit of chance. And so rolling the dice,then adds in, like, possibly an epic fail. So maybe he says, "Well, I want to build a crane in order to help the team reach high places as we're decorating." And you roll the dice, and he just gets a really bad roll. And so he builds it, sets it up, and everything just crumbles.
Because in life, even if you do have skills and are generally more successful in stuff, sometimes the roll of the dice or the luck of the draw means that things don't go well for you. And so it's also interesting to kind of think about, like, that aspect. And so in playing the game you create a character that has a backstory that has a history, that has a way of interaction, that has skills and abilities. And then there's also this idea of chance, and the things that you can control and not control with what other characters do or just the roll of the dice.
Host Amber Smith: Is there any dressing up or props that come about with this?
Robin Dean, PsyD: There can be. It's not necessary, because as I said, the game is played in your imagination. But a lot of times people do like to dress up in order to get into the persona of their character.
I keep a dragon puppet in my office. And every once in a while when I need a little inspiration, he and I will walk through the building, in order to really get into the dragon feel. It helps with the mood of the game.
Host Amber Smith: Now, before we get into this anymore, I wanted to ask you how teens are traditionally treated for social adjustment issues, because traditionally it wasn't by playing Dungeons and Dragons. What has it been before?
Robin Dean, PsyD: Usually treatment within the child and adolescent clinic is focused on individual interventions. So what that may look like, typically, is talking to your therapist about some struggle you had with the world outside, and processing through how you feel about that, and getting support or techniques on ways in which to do that better going forward.
And so your therapist may say, "OK, so you're in an argument with your friend. Why don't you try looking at their perspective, and what would their perspective look like?" And so from their perspective, what could they be looking for from you? And so now what can you do now might be to try to explain your feelings to them and apologize for the parts that you've played, and this is what you can do going forward.
Host Amber Smith: This is Upstate's "HealthLink on Air" with your host, Amber Smith. I'm talking with doctor of psychology, Robin Dean, about using Dungeons and Dragons to help teens in therapy at Upstate.
Robin Dean, PsyD: Now, what made you interested in trying D and D with teens at Upstate? The short answer is that it sounded fun. I am not much of a gamer. And I think that's partially because it's not the way I was told or that you're supposed to behave. Gaming is a thing for geeks and nerds. And so growing up I never really got into it, although I think I was always kind of interested. And so when, as an adult, I found out that there is the possibility of doing good therapy and also getting into something that for the longest time I was told, oh, maybe you shouldn't do that because then you're a bit of an outcast or kicked aside.
During the conference we played a little. And you could really see how this could be effective for clients. And, it was fun.
Host Amber Smith: So how did you introduce the game? Did you already have a group of teens that you thought this would work with, or did you assemble them?
Robin Dean, PsyD: Because it is a very new idea and an untraditional approach, I needed to get permission in order to run the game. And so we started with a little bit of research in terms of the effectiveness, and we needed to make sure that it would be paid for by insurance.
And then I got referrals from other therapists within the clinic for kids, specifically teenagers, that had some interpersonal difficulties who would benefit from being able to practice their skills in the moment with the support of a therapist.
Host Amber Smith: How long does the game last?
Robin Dean, PsyD: The game can last as long as you like. And so, in just playing D and D, you can do a one-shot game, which is, a random group of people get together, you have an objective that you want to accomplish, and you spend an hour or two accomplishing that objective.
Robin Dean, PsyD: Or, the game can last for years. Depending on the complexity of the story or what happens after you accomplish one objective, you can always add on another. So the story line that we are playing currently is the youth have all been recruited into a government organization, and the goal of the government is to help the various factions within the community to live better in harmony and peace and to have the resources that they need and order to thrive.
And so we've been doing this particular game for three campaigns. Each of our campaigns last about eight weeks, and so 20-something weeks approximately -- and still going strong. We managed, oh, there's been a shift where in the current campaign, the previous government administration has been ousted, and now there's a new government administration that does things differently.
Host Amber Smith: How many teens are in this group?
Robin Dean, PsyD: There are currently seven in the group.
Host Amber Smith: And is it male and female?
Robin Dean, PsyD: Male, female and other. So we have some kids who identify as non-binary. I don't think we currently have any folks who identify as trans.
Host Amber Smith: Now, what were you hoping to see through the use of D and D? Because I imagine the teens enjoy it, or they wouldn't stick with it, and maybe they've sort of bonded. Is that what you were looking for?
Robin Dean, PsyD: Really what we're looking for, mostly, is that they see the value of therapy, and that they have a space to practice skills that they wouldn't be able to do otherwise.
Probably the best example of, like, real progress is ... we had a kid who the very first day came in, put his head down and couldn't introduce himself because he was experiencing so much anxiety. The only times where he did speak on that first day were about his character. And so he could say one or two things about the character.
And so now, a few months later, he is probably one of the most active and engaged folks. And periodically we have someone come in that'll observe, and in the last session where there was an observer, he outwardly introduced himself and greeted the person, which is coming a long way from where he started in terms of the level of anxiety. And he is able to talk about some of that and what's been helpful. And part of that is feeling comfortable in the environment, that it's OK for him to be him.
Host Amber Smith: So you are able to track progress among the individuals?
Robin Dean, PsyD: Yes. So some of it is subjective, things that we see in the environment. We also use a social skills assessment inventory to track progress a little bit more objectively. Every eight weeks or so we take a break, and during that break we reassess in order to have the children and their parents complete a rating scale so that we can keep track of things like the kids' level of engagement or cooperation or assertiveness and how they're progressing as the group has continued.
Host Amber Smith: Have you seen any negative effects from this game?
Robin Dean, PsyD: One of the things that we did struggle with ... when we first started to run the game, we were doing it in just the eight weeks. We would recruit a group of kids, we would run the eight-week session, and then they would be discharged.
And I wanted to run a long-term group. And so we went from two months to four, in order to see what would a long-term group would look like. And, a couple things came up from that: 1., the group of kids that were in it all had been in the group before, and so there were dynamics that ended up getting a little muddled because you come in knowing some folks but not others, and you have this idea of what the group is supposed to be like because you've run it before, but each person has a different idea of what the group's supposed to be like. So there was some of those dynamics.
And because we didn't have a built-in way to really do more processing -- because we do spend a lot of time in game play and not so much kind of actually thinking about the feelings and talking about specific things that happened -- there wasn't enough opportunity to really delve into disagreements and really explore some of that, which is another reason why we run, now, eight weeks and take a break, because then we can check in with the individual group members about what's going on and how they're feeling and give natural points for people to transition out, or for new people to transition in.
Host Amber Smith: What has the response been from your colleagues and from the staff in psychiatry and behavioral sciences?
Robin Dean, PsyD: They love it. We have a wait list currently because all of the clinicians are like, "I've got a kid for you." And it tends to be the ones that are anxious or depressed. A lot of times we get children that are diagnosed with autism spectrum disorder, that have just this social awkwardness, and they really need a space where it's OK to be a little nerdy, a little geeky, and where they can practice those interpersonal techniques with extra support.
Host Amber Smith: Do you think using Dungeons and Dragons would have an application with adults?
Robin Dean, PsyD: Well, so when it was initially introduced in the AGPA conference, it was introduced by a practitioner that uses it with adults. So yes, absolutely.
Host Amber Smith: Well, Dr. Dean, thank you so much for making time to tell us about this.
Robin Dean, PsyD: Absolutely. It was a pleasure to be here. Hopefully, people are excited and interested, and maybe other people will start to think about integrating this as well.
Host Amber Smith: My guest has been doctor of psychology Robin Dean. She's an assistant professor of psychiatry and behavioral sciences at Upstate. I'm Amber Smith for Upstate's "HealthLink on Air."
Next on Upstate's "HealthLink on Air," meet a physical therapist who almost every day makes time to go running.
From Upstate Medical University in Syracuse, New York. I'm Amber Smith. This is "HealthLink on Air."
Upstate physical therapist Bethany Hudson was the fastest of the Upstate runners in the Syracuse WorkForce Run this year. It's a 5K race, which she finished in 19 minutes, 5 seconds, placing 26th out of a field of more than 2,200 runners. And she was 10 seconds faster than the year before. So today I am talking with her about running, which she does pretty much every day.
Welcome to "HealthLink on Air," Ms. Hudson.
Bethany Hudson, DPT: Thank you so much for having me.
Host Amber Smith: Do you run a lot of competitive races?
Bethany Hudson, DPT: I wouldn't say competitive. I run several races a year. I'm never in, like, the top leader board normally, or anything like that. I just run mostly for myself and to see if I can be better than the previous year, kind of like this race.
Host Amber Smith: Do you have a favorite distance that you like to run?
Bethany Hudson, DPT: Well, I like marathons just because I feel like that takes a lot of my time and energy to train for, and I have a goal, but they're kind of grueling. So I don't know if I could say favorite. But, longer distance is where I thrive, because I don't tend to be fast for short distance often.
Host Amber Smith: But the WorkForce run, it's a little more than three miles. You finished first among the 45 runners from Upstate. How'd you do it?
Bethany Hudson, DPT: Well, I train quite a bit. I do run, like I said, I kind of just run for my own health and mental stability. So I don't really ever think about my speed. But I also run with Fleet Feet quite a bit, so I do train with them. And I do speed work, sometimes, with them to help push myself since I don't really like to challenge that side of running. So I'm sure that helps quite a bit.
Host Amber Smith: Do you have any secret way of preparing for a race? Is there something you do the night before, as a ritual?
Bethany Hudson, DPT: For a marathon, yes. For any short distance, because you never know what it's going to be like. You can't plan for the weather. It's such a short distance that I don't feel like I have to prepare quite as much because it'll be over, even if it's very painful, it'll be over quickly.
With a marathon, though, I do tend to have more rituals. And I think I tend to be a little bit more superstitious too, because it's so long being out there that if I don't do those things, I feel like the pain's going to start sooner. And I think a lot of it is probably in my head. But I do eat a very specific meal before a marathon. I always eat pasta with pesto, and then I eat a side of bread and cheese and garlic. And then the day of, I always wake up like two hours early and have a cup of coffee and a bagel. That's pretty much my ritual. Try to sleep if I can, but I'm always nervous.
Host Amber Smith: So let's talk about your training. If you do run every day, what is that like? Do you run before work, after work?
Bethany Hudson, DPT: I wish I could be someone that gets up early and works out and conquers the day. Unfortunately, I am not. So I normally run after work, depending on when I get out, when I'm done with everything.
Like I said, I do train with Fleet Feet, so I run with them on Wednesdays and Sundays.
I tend to run, like, five to six times a week. I do build in rest times, especially as I've been getting older. I'm trying not to wear down my body, and being a physical therapist, seeing injuries, I try to practice what I preach. And so I do a lot of cross-training and some days are super easy. I just go for a nice short jog. Some days I set aside a lot more time and if I know I'm going to get out on time from work, I maybe, the weather's depending, those things all play a role in how long I'll be outside.
Host Amber Smith: So you've mentioned Fleet Feet. That's a local athletic shoe store. They have training programs that you're a part of?
Bethany Hudson, DPT: Yeah. They have distance programs, so anything from a half marathon up. Then they also have a No Boundaries program, which is for a walk to 5K. And then they have an in-between. So if people are kind of, maybe you don't want to train for a marathon, but they do want to get something a little bit more, they can help guide that. But they do distance. So some days that'll be long workouts where they have a program built into it, so maybe you run two of the miles a little faster. And then on Wednesdays, we do speed workouts, which is short bursts of fast running, which is what I would never do on my own without them because I do not like to do that.
Host Amber Smith: Now when you're training on your own, do you ever use a treadmill?
Bethany Hudson, DPT: Yes, I do. I don't despise treadmills like a lot of people. I don't prefer it, but I have one in my basement, and if the weather's not perfect, then I'll go into the basement, watch something and run. The snow, the cold, I am not a big fan, so I would much prefer being on a treadmill, warm and comfortable.
Host Amber Smith: If you are running outdoors, do you run with headphones? I know there's kind of a big debate between runners, whether it's safe to do that, but whether it's beneficial, too.
Bethany Hudson, DPT: Yeah, I know. They have a lot of different things now where you can also, like, hear your surroundings and listen to music. I should probably use something like that. I always run in a pretty safe place where I'm not near a lot of cars too. But no, I always am listening to something -- podcast, stand-up comedy, music, something, audiobooks.
Host Amber Smith: How do you stay hydrated or fueled during the long runs, particularly when you're training for a marathon?
Bethany Hudson, DPT: I carry a handheld water bottle. This is something that I did not use to do very well, and they gave me a lot of instructions with the different people that I would run with and the coaches at Fleet Feet. I don't like having something in my hand. It felt, like, kind of like more resistance, more work, but when you're getting out there and you're doing a lot more miles, it was really important for fueling myself, having not only just the hydration, but nutrition.
And then, typically during a race, there's always so much that I hydrate every mile if I can, if they have water stops. Shorter distance, I don't because hopefully I won't be out there long enough, and I'll just hydrate after.
Host Amber Smith: This is Upstate's "HealthLink on Air" with your host Amber Smith. I'm talking with physical therapist Bethany Hudson about running. She was the fastest among runners from Upstate Medical University at the Syracuse WorkForce run this year.
So how did you get started or interested in running?
Bethany Hudson, DPT: I never ran when I was younger. I just would go to the gym and run recreationally, just for fitness. And then when I was in college, I had a lot more time on my hands because I was, there was all these days that I didn't have structure, so I started running a lot more. And then it also was a way for me to reduce anxiety at that time, too.
So I started building miles, and then I kind of was like, I need a goal to have. So then I started signing up for half marathons, and then eventually that grew to marathon goals. But I never really ran competitively, never in high school, never in college. It was just something I did more as fitness, and then it became good structure for my day and kept me busy.
Host Amber Smith: You mentioned as a physical therapist you've seen patients who have injuries from running. What are the most common running injuries, and do you have any advice for avoiding those?
Bethany Hudson, DPT: Yeah. I see a lot of injuries with the feet. There's different types, like plantar fasciitis, post-tib (posterior tibial) tendinitis, things where your arch is hurting. Then I also see a lot of hip pain and sometimes knee pain. Those are probably the most common, anything for the lower body really. I do think I treat a lot more people with foot and ankle pain. That's kind of what I do, mostly, at Upstate.
As far as staying injury free, trying to build slowly, train appropriately. I think a lot of the times a lot of people are overtraining, not taking enough of those rest breaks, not doing enough cross-training, I think, even more than rest breaks. Myself included.
I like running. That's kind of therapeutic for me. That's what I enjoy the most. The cross-training doesn't come as naturally, so I don't do it as often, but there is so much importance to it that if we're not keeping our muscles strong and everything around all the structures that we're using so much, then you'll see kind of wear and tear, and those injuries happen. So definitely taking appropriate rest breaks, cross-training.
And then I think, also, like when something is wrong, listening to the body and seeking help, right? It could be an easy fix. It could just be you need to implement stretching, you need to maybe add in a few exercises before or after you run.
So, hopefully trying to build slowly and manage that well will help.
Host Amber Smith: Now, you mentioned cross-training. If you have found your perfect running shoe, is it OK to use that same shoe when you're cross-training, or if you're working -- and you've got to wear shoes while you're working -- or do you need to have a separate shoe that's just for running?
Bethany Hudson, DPT: I think it depends. I don't typically wear my actual running shoes working or cross-training. You could. It would just wear the shoe out a little bit faster, because you have more time and miles on it.
I tend to wear a very similar type of shoe when I work. I wear a stability-like supportive shoe. I also wear inserts, and I do wear those all throughout my workday. I wear them when I do strength train and when I stretch and stuff like that. But I tend to rotate different shoes just to kind of keep the longevity of them.
Host Amber Smith: What would you say to someone who wants to start a running routine?
Bethany Hudson, DPT: Just start slow. One of the things that we implement at Upstate with our running program for people that are recovering from injuries is a return-to-running protocol. So it's intervals where you're building in a walk/run, so you're building that up very slowly. There's levels at which you have to progress each one, and we would monitor that as the therapist.
So I think the same kind of principle starts if you're going from no running to running. That's kind of the best way, I think, to reduce injury. And I think just getting started, some people are different. I prefer probably running on my own a little bit more, just because it's my time to kind of decompress. But my mom didn't start running until she was 55, and she signed up for a run/walk program and met great people that now she runs with three times a week. And that's kind of her motivation. So I think finding what works for people too. Some people don't like that. Some people like to do it themselves.
I do like the mix. It gets to be redundant to do the same thing by myself. So I like seeing and chatting with different people on my longer runs with Fleet Feet. So I think getting out there and meeting a group, there's tons ofgroups in this area. Just to shout out, there's the Syracuse Track Club, there's the Lake Effect Run Club, there's the Y, there's Elevate (Fitness), Fleet Feet. So there's so many. They meet in different parts of town. There's people of all ages. It is just a good way to meet the community. So I think just getting out, starting small, so you don't lose steam and get burnt out too. And then, find your people.
Host Amber Smith: And what about someone who's been running for a while and wants to ramp it up, maybe do a longer distance, or maybe start competing for time? Are there ways to do that without putting yourself at risk of injury?
Bethany Hudson, DPT: So there is a, it's a 10% rule is kind of like a well known rule that you shouldn't really increase your mileage more than 10% in a week, at a time. So every week should be slowly building. And a lot of training programs, when you are working toward a longer distance, will incorporate that. So they'll have like one day that's a little longer, but maybe they'll cut back some of the others so that total mileage isn't exceeding that 10% increase.
So there's definitely safe ways to do it. As far as speed work, following different speed programs, there's a lot of interval training out there that can help you get that aerobic endurance back.
Host Amber Smith: Why do you think running makes such a good exercise?
Bethany Hudson, DPT: I think it's great because you can pretty much do it anywhere. You know, if I'm traveling, I can bring sneakers and run and see a place. You don't need to have a lot of equipment or spend a lot of money on it. You can meet different people. You can do it alone. So I think there's a lot of different aspects for everyone. And you can do it at your own speed, you know. I run with a lot of different groups, and I run at a lot of different paces, and it's all fun and everything is different.
Host Amber Smith: Well, I appreciate you making time for this interview, Ms. Hudson. Thank you.
Bethany Hudson, DPT: Of course. Thank you so much.
Host Amber Smith: My guest has been runner and Upstate physical therapist Bethany Hudson. I'm Amber Smith for Upstate's "HealthLink on Air."
And now, Deirdre Neilen, editor of Upstate Medical University's literary and visual arts journal, The Healing Muse, with this week's selection.
Deirdre Neilen, PhD: Claire Scott's work has appeared in Atlantic Review and Bellevue Literary Review, among many others. She puts a modern spin on the myth of Pandora in her poem "Musings on Hope."
Cynicism is winning ladies and gentlemen
odds are on Sixth Extinction
favored ten to one
over Bright Morning
but we cheer for Morning
as we drive SUVs and gobble steak
vote no on affordable housing
and take 20-minute showers
Perhaps we should go back and back
to where we first left Hope behind
the moment our boyfriend furled his fist
the second the doctor said I'm so sorry
we might find Hope soaked and shivering
by the side of a six-lane highway
or perhaps sealed in the bottom of a jar
after all the evil spirits had eloped
Don't open it some people warn
Hope is disappointment in disguise
leading to craving and suffering
splitting time into today and tomorrow
when the only real moment is now
others believe there is room
for a Hope that includes all beings
like a prayer from the center of the earth
Why not settle Hope on the green cushion by the fire
you know, the one your grandmother gave you
when you graduated from Wilson High
embroidered with The World is Yours
feed her ambrosia and play
wordless tunes on a lyre
until she is ready to lift again
wearing a cape of white feathers
Host Amber Smith: This has been Upstate's "HealthLink on Air," brought to you each week by Upstate Medical University in Syracuse, New York.
Next week on "HealthLink on Air," Upstate ranks nationally in a study of female neurosurgeons.
If you missed any of today's show, or for more information on a variety of health, science and medical topics, visit our website at healthlinkonair.org.
Upstate's "HealthLink on Air" is produced by Jim Howe, with sound engineering by Bill Broeckel.
This is your host, Amber Smith, thanking you for listening.