Podcast 175: Why Modified Movement Works for Diabetes

Rebecca Scritchfield, RDN: 0:00

This episode is brought to you by Self Care for Diabetes, a virtual online program that's doing diabetes care differently.

Glenys Oyston, RDN: 0:08

We don't tell you to lose weight. Instead, we help you create positive and meaningful changes that make your life with diabetes better than before. Visit selfcarefordiabetes.com to learn more.

Rebecca Scritchfield, RDN: 0:20

Hey Glenys. Welcome to Episode Five.

Glenys Oyston, RDN: 0:24

Hey, Rebecca. It's good to see you, I'm super excited to talk about our subject today.

Rebecca Scritchfield, RDN: 0:30

Yeah, five is my favorite number.

Glenys Oyston, RDN: 0:34

Because you like the number five or because you like this topic.

Rebecca Scritchfield, RDN: 0:37

I seriously love the number five I always have. I've loved learning how to count by fives and multiply by fives using my hands anyway. It's always been my favorite number. And we can't say a nice round number, of course. But this is the fifth time we're kind of sitting down together and having a conversation about the intersection of self-care and diabetes concerns and a really cool topic, something that I care very deeply about just in my personal life because it helps me so much in many, many meaningful ways. And because I'm an exercise physiologist. So, we're going to talking about movement and modifying, why that's a good thing.

Glenys Oyston, RDN: 1:25

Yeah, I think this is a good one for us to talk about because you and I are, I think, either end of the spectrum of exercise. You love exercise, and I'm like, I sort of like it. But it really should be fun or should you know, I'm just a reluctant exerciser. So, I think this is a good one for us to talk about. Because I'm sure we're getting the spectrum of folks out there.

Rebecca Scritchfield, RDN: 1:50

You know, what's interesting is that exercise was one of the first things when I was nine, I remember feeling my heartbeat, and I was like, oh, how cool my heart's gonna beat. And I was like, until one day it doesn't, and it got morbid really fast. I did in my adult years learn that that's the age-appropriate age to kind of be like death and dying. But anyway, alas, it was this oh, kind of a positive body connection and a positive way of caring for my body. So I actually wasn't really that into sports when I was younger, I was very playful. You know, I love to dance and love music. I mostly had a positive connection to my body and movement. And then as I got older, and sort of diet culture did its diet culturally thing, right? You know, hula hoops, and jumping rope wasn't necessarily these fun, playtime, kid activities. And it was like, I was taught that it was about calorie burn, or intensity or whatnot. But even though when I became certified, it was like, I had this intention of let's have fun with the music. Let's make this fun. And, so even in the trainings, where I was getting my trainings, it was mostly a very positive health focus, it was definitely weight normative. But a lot of it was intended to be positive. And I think that's one of the reasons why I feel like I love exercise now is because of healing work, where I was able to get through to not make it be about earning food or changing my body, and to find moments of happiness and joy, and accomplishment around movement. And I think that's possible for everyone, no matter your interest in movement, or no matter your current fitness level that, the real problem is the industry and not necessarily you. So I really hope we can dive into all that cool stuff.

Glenys Oyston, RDN: 3:52

Well, this episode is for anyone who feels like what they can do with movement, or what's available to them right now is just not good enough. And I think that, you mentioned diet culture, and that, I think is where that comes from. Is this idea that whatever we're doing it's not good enough. You've got to go harder, faster, better, stronger. But this is for if you're a beginner or maybe you're just coming off an injury, or maybe you don't have the time or you feel left out in the fitness industry because it's all about intensity and pushing yourself over the limit. And I think, there a lot of folks out there like that.

Rebecca Scritchfield, RDN: 4:38

Even when we try to resist it, it just keeps showing up. A Facebook ad, a comment from somebody else. And I think what I would love to offer in this space is that we want to be encouraging of movement if you're interested in it, if you're curious about it. You want the fastest way to find and connect to your inner caregiver, you approach something with curiosity and interest. So, acknowledge and validate pain and negative emotions from the past, while you pause and ask yourself, is there a place to be open and curious and interested, and from that place see how you might be able to approach movement differently. And I think it's real important that we are here to help listeners understand why it can help with diabetes concerns. And if nothing else, if I had to have like one key wish, I really think that it's that feeling of body autonomy. So as a listener, by the end of this, you're saying, any positive or meaningful step that I can take toward a peaceful relationship to movement and my body is worth it. I think that's just so important to get to because from there, I think a lot of really positive and meaningful things can grow.

Glenys Oyston, RDN: 6:11

Yeah, absolutely. So, Rebecca, you're an exercise physiologist. What do you tell people about the benefits of movement?

Rebecca Scritchfield, RDN: 6:21

Anything that I could say that's not about weight loss or body. I love it when people have set those hopes aside, but almost always, when they're asking, there's these assumptions, it's about calorie burn et cetera, et cetera. So, I really tried to focus on mind and body benefits. And to really try to make it personal, that it depends on your approach to movement. And I'll kind of pose it as a question back, well, what's your why? What is your why for movement, not necessarily what you've been told. That's something really interesting to reflect on and think about. Who first told me what the meaning and purpose of movement was, and what was helpful and what was not helpful along in my journey?

Rebecca Scritchfield, RDN: 7:11

It is well documented that movement can help with sleep, anxiety, stress, generally balance out of your mood and emotions. All emotions are good, even the negative emotions, they help guide you to focus on the things you care about, right? But we don't love feeling stress and anxiety. But movement is something that can help complete the stress cycle, that can help you cope, and feel a little bit more grounded and able to pivot to go on the next important and meaningful things that you need to do as part of your day in your life.

Rebecca Scritchfield, RDN: 7:47

Very interesting, exercise can improve body image, but it's usually when you're not trying to lose weight. So, if you're not doing it because your body is a problem and you're trying to fix it, doing exercise can help enhance body image and what the research shows around there, it is more of a connection to the sense of accomplishment. So whether it's like, wow, that was really pretty hike today, I really love the view, the fresh air felt great. Or, oh my gosh, I had been working on being able to do knee pushups with good form and I did five, that feels great. When you have an interest or a desire, and you match that desire with some sense of accomplishment that you're validating, that can help improve a body connection. Where we can appreciate our body for all the things that it does for us during the movement that we're doing, but just, the things our body does without us having to think about it. I think that's a really valuable, physical and mental health connection that we can all make and cultivate.

Rebecca Scritchfield, RDN: 9:02

Movement really should not be punishing or shaming, which seems like common sense, right? Don't beat yourself up when you're doing that exercise. Always ask what you would tell a friend and it gets really clear. But I'll have a client be like, oh, you know, we'll do a workout together and they'll be kind of struggling with something and I'll ask for feedback and say, you know, I feel very demoralized right now. And I was like, gosh, you know, tell me what your mind is telling you. It's like, yeah, I'm just being really punishing, my mind is saying that I suck because I can't do this push up the way I want or something like that. So, it's not just because we all like being mean to ourselves, those thoughts are put there by the fitness industry that has certain body ideals and says that achievement is about hitting it hard or going to extremes or all these other things that really aren't true for health and well-being and are really not helpful for creating positive connections to movement.

Rebecca Scritchfield, RDN: 10:02

And now, more directly for diabetes concerns of the simple way I like to explain to people is muscles are amazing parts of your body, and they are thirsty for sugar. Because you use glucose for energy for every muscle contraction. So that's all your daily activities. But that also includes movement; so walking, swimming, chair, dancing, all of that. Any muscle contraction for that to happen, it recruits glucose as energy. And Glenys, I would love for you to add a little bit more to that concept for listeners.

Glenys Oyston, RDN: 10:46

The American Diabetes Association has some recommendations on their website, and I want to throw those out there first, but then talk about and really go a little bit deeper on that. They recommend the standard 150 minutes of moderate intensity exercise a week. And we've been hearing that for years, that's sort of been the general government recommendation. And that's great, but one I want to say if you're not there, if you're setting yourself up, I must do 150 minutes a week, and you're not there, I think that's just a recipe for, oh, I feel like I failed if I didn't do it. So, starting where you are, and starting a little bit at a time.

Glenys Oyston, RDN: 11:35

But, going back to you were talking about that sort of thirsty muscle situation. And there's the cardio, which is great. I went to a conference a few years ago, and they explained this wonderfully. And I was like, oh, this is so useful. This is such useful information. And they talked about cardio was great for using up blood sugar. And I think we've all just been told, diet culture, cardio, cardio, cardio, burn, burn, burn. And I think that things like resistance training that uses those muscles gets ignored in a way. But what I learned is that while the cardio burns up available sugar in your bloodstream, burns up, uses up, actually to use a more technical term. The resistance training actually helps improve insulin resistance. So it just makes yourself more thirsty for that blood sugar and more able to use it more readily.

Glenys Oyston, RDN: 12:35

And so, of course you're going to think about what your interests are, and that kind of thing. But I think it's just useful to know that there's a lot of different movement available that you can do. And then of course, you want to just be mindful when you see that whole manage weight or lose weight, as they often will say is this expected outcome of exercise because I think that's another way to tank your motivation around one to do any of that. You hear cardio and weight training and you're like, oh my god, I don't want to do any of that because what if I don't get the expected result? But as opposed to just focusing on exercise as a beneficial thing, regardless of any weight change. So, there's a lot of good reasons to get into movement for blood sugar, in addition to all the things that you said, which I attest to. Managing stress, anxiety, getting better sleep. I do think it does improve our body image because we're kind of feeling our bodies from the inside. And I think that as opposed to that self-objectification phase we can be in, we just feel what it's like to have a body and so there's kind of no downside to thinking about movement.

Rebecca Scritchfield, RDN: 13:52

Yeah, and I just think kind of validating that. Anytime you're doing something for the first time there's uncertainty, it feels awkward, you don't know yet, you don't have the experiences yet. Or maybe you're starting over so you have some negative memories, right? But it is that sort of beginning again, right? It's like the nerves on the first day kindergarten or whatever, right? So, to pause and think about an intention. What is it that I hope to get out of this and because perhaps, maybe the intention is about trying something and see how it feels in your body or see what you think. And maybe it's a song that already know you love to listen to, and you just want to move your body in space and feel your body, and take more of a gentle movement, stretching type of approach and validating, okay, look, that is movement, and that counts as movement. And, that part of me that thinks that has to be long, intense, hard and extreme, that is a message I'm looking to unlearn and so validating that something like that is good enough and I'm interested in, and I'd like to try something like that again, or I'd like to try something else next time.

Rebecca Scritchfield, RDN: 15:09

I would love it if everything we approached with movement was just easy, and we didn't feel anything. But actually, you can feel things that can feel quite challenging when you're doing movement. And when we feel that difficulty, and then say, oh, it's because I suck that, just like you said, tanks motivation. But, as you were saying earlier, we do want to think outside of the cardio box, if you will when you think of movement and physical fitness, it's really the blend of cardio, strength and flexibility. And something I learned early on in my training was about research on people who were aging, and Tufts University did some great studies showing that you could be 90-100 years old. That was the age group of the study participants and literally, from a bed lift a one-pound weight, one-pound weight bicep curl, one-pound weight overhead. And there was substantial muscle strength and endurance improvement, and they saw remission of sarcopenia, which is muscle loss. So, I really want to encourage you to think about strength training with a total reframe, like, Glenys, we were talking about earlier. You can use it with as low weights that are good for you, resistance bands, even cans of soup. When I was young growing up in Ohio, I would go in the cupboard and get cans of soup, and it was me and the chicken noodle soup or something. You know, it was equipment. And you can do anything from a chair, right, you could start on upper body and core from a chair. You don't have to spend a lot of money; you don't have to join a gym to start strength training.

Glenys Oyston, RDN: 16:50

I love hearing you talk about that because it's something you can do at home if you want to. And one of the things I kind of like go, oh, I can't believe this was true, darn it. Is that as somebody caught in diet culture for a long time, and on that hamster wheel kind of burnin, burnin, burnin. And I gave some thought to weights, but I don't think I knew why I was doing it. And I certainly was not getting enough food in to build any muscle strength and it was very discouraging to do any kind of weight training in that situation. But, years later when I'm figuring out my exercise stuff, which I will be for a lifetime, I've realized. I started kind of one of those places that were a little too high intensity, quite frankly. But if you go in and decide you're not going to do the intensity they're prescribing, it can be a bit better. But doing a lot more weight training my back pain disappeared, my leg pain disappeared. And I was kind of like, darn it, they were right. This actually is really useful for my body. And the other thing is, my A1C went down a little bit and I was like, ah, they're really right about this exercise stuff. In some ways, I was like, oh, now, I have to do it. But then when I realized, oh, actually, I'm getting more fit, this is getting easier. Oh, this actually feels good. I really like feeling stronger. And it was all detached from weight, nothing was happening with my weight, which is great. It just felt very, kind of wonderfully empowering to do that. To do that level of exercise it wasn't about weight, it was about being stronger, and feeling better.

Glenys Oyston, RDN: 18:41

I think this idea that you have to do like, going back to the 150 minutes, this idea that you have to do that right away. It's like no, if you could maybe do something once a week and that's where you're starting, or if you could get up from your desk a few times a day and just have a little stroll or something like that. Start sort of there and go forward without thinking you have to accomplish everything right away. I think maybe we could put it in the show notes to have an article that showed that, we've always said even just 10 minutes of exercise is helpful. Well, it turns out that even something as little as two minutes of exercise at a time is really helpful for heart health. And it was a great article to show that there's no amount of exercise that's too little to start with. And I think that's how I came at it in my mind. I'm just going to do a little bit and see how it goes and build from there. And that's, I think more useful than just coming at it and think we have to be perfect. But the other thing is there's so much other stuff. I had a client who took up gardening, he's like I'm hauling around, I got a little garden plot in a community garden I'm hauling around bags of soil and hoeing. And yeah, you're getting a lot of good strengthening exercises. So again, just sort of thinking about water exercises, water dancing pedal from the desk, I've seen those. So there's so much stuff to do that can fit for you.

Rebecca Scritchfield, RDN: 20:24

Almost like experimenting, you know.

Glenys Oyston, RDN: 20:27

Experimenting, yeah. What else is there besides cardio strength?

Rebecca Scritchfield, RDN: 20:35

So, that third piece, flexibility. Real important part of movement, it's the most ignored, including by me for a very long time. In fact, it was interesting when you were talking about feeling some improvements after finally doing some strength training that worked for you. I also had low back pain. And thinking it was all these things, and what really ended up helping was gentle and restorative yoga. And it took maybe about a month, I really gave my body some rest and I did this gentle restorative yoga, and here it was, the low back pain was related to tight hamstrings, and I also worked on my posture.

Rebecca Scritchfield, RDN: 21:22

But it is going to be the idea of flexibility, that's just stretching, but in reality, it's most likely to help you have good form and listen, walking is very natural, but there's a form to walking, there's a foot strike and all that stuff. Flexibility also can really be helpful in preventing injuries. So it's not just stretching, stretching is part of our flexibility. But get it out of your mind that, oh, that's not hard enough, or that's not good enough, or that's just a waste of time. Because it cannot be further from the truth. Many people don't realize that flexibility can really help their posture, can help their muscles to reach high to pick up a dish in the cupboard, that they can help their body feel better. And then when it comes to doing purposeful movement, like we talked about, it can help you have better form and things like that.

Rebecca Scritchfield, RDN: 22:26

And if you are listening it's like, you know what, I wonder if my hamstrings are tight, you just try to bend out slowly lean and bend over forward. And if you feel that in the back of your legs, you probably have some tight hamstrings and you could benefit from a short, gentle, flexibility program, whether you follow yoga or stretches for walking type videos, or whatnot. There's all types of resources out there. But I really just want to encourage calm and gentle stretches, they can feel good, they can feel relaxing, they could be stress relievers. And I mentioned restorative yoga. Either you could search on the internet or YouTube, or something for chair yoga postures and just find some things that you could try out and start. And again, I know we themed this modified movement is meaningful and that's really what we want to help you focus on. Listen, being able to do some yoga stretches from a chair, right, as opposed to not doing anything from a chair, right? It is better, and it's better if it feels like something you could be curious about and open to and this idea of practicing, right? So notice maybe a short-term benefit, like I feel a sense of accomplishment, or I'm glad I took that moment to have some breath. You know, let me go on with my day. But what happens a week later, a month later, right? It can take a while before you notice maybe some unexpected longer-term benefits of movement. So I also want to encourage people to, you know, stick with it.

Glenys Oyston, RDN: 24:00

I think the great thing about something like yoga, stretching flexibility is that it supports all the other movements that you're going to want to do. Or you might want to do at some point. So definitely useful. So to sum it up, why does modified movement matter?

Rebecca Scritchfield, RDN: 24:23

It's interesting, because as much as we're like let's focus on modifying, I got to thinking, what are we modifying from? It's almost like, oh, well, there's a norm and you're not it so here's a modification. So I even find myself dancing around this idea of we are kind of making this assumption, the cultural way, that this is where everyone starts, and then there's deviations. So even just challenging, what if we took this definition, to don't assume that there's a target and then the modification is just something else. But it's more like, I want to approach something in movement that sounds interesting to me, and I want to find a way in it, that feels like a good fit. That it feels like it's connected to my body, that it feels like it's a good fit and doing something beneficial. I think the most compassionate way we can approach movement is to be thinking about feeling good in the long term, what feels good immediately kind of physically in the body, and just start there and build. And certainly really challenge the idea that being hard on yourself, it's important to continue. So, we can't control our thoughts and feelings, right? When you hear that negative criticism, oh, you didn't do it again today, you better do it tomorrow. Okay, wait a minute, how could I say that differently? This is something that I'm working on establishing and I have time to do it tomorrow, so I will go ahead and try tomorrow. But I don't want to beat myself up about the fact that it did not happen for me today.

Rebecca Scritchfield, RDN: 26:11

I do want to address challenges too. There are going to be lots of different things that can show up as challenging for you during a workout. It could be mentally challenging, physically challenging, a bit of both. And there will be times where you might want to approach kind of kicking it up a notch or approach a challenge. For example, we could say that swim aerobics class can feel easier on the joints, right. But it's still challenging to move through the water. So I wouldn't say that there's any good reason to look at that activity as say, less than running or, you might have heard of HIIT or High Intensity Interval Training and that if you can't get to the pool, but you can chair dance or you could hula hoop, do something from home, walk up and down your stairs. Maybe you've got five minutes, 10 minutes, but any effort that you could do now is good. And there's a way to feel the challenge and find the challenge and let that challenge just be what it is. A body response and not a judgment or not a decision. You should be able to breathe while you're doing activity and you can always stop and take a rest. So to know that you have some basic kind of tools and skills to approach movement, how to approach a challenge, and if it's feeling like too much what to pivot back down from, I think is all really good. So that way as we go through the what ifs, well, what if about this and that before you start, go through that checklist and then you should feel a lot more relief about going ahead and approaching modify movement. And remember, like we said in the beginning, it really is good for you in the long term as part of your self-care for diabetes plan.

Glenys Oyston, RDN: 28:09

I think one of the most useful sort of framings of modifying movement I've heard, it was from Marc Settembrino of Fat Kid Yoga Club, and he talked about adapting the posture rather than, like you said, there's no norm that we have to be starting from, right. So we're really adapting everything to our own bodies. And I think it is so important to go at the pace that feels right for you. And I don't necessarily mean easy, but your level of challenge is going to be different from someone else's level of challenge, and that's okay. And you can decide what level of challenge that you want to go to. I think if you're feeling reluctant around movement, look at, are you putting a lot of pressure on yourself? Are you sort of thinking, oh, I failed in the past, and it was all connected to weight loss. It was unenjoyable. And how do you bring the fun back to that?

Rebecca Scritchfield, RDN: 29:14

I want to close with a suggested reflection for movement, and I'll have the words for this in the show notes as well. But, if you could take a couple minutes to take, bring some thought to these questions. And I encourage you to take just a deep calm, relaxing, inhale and exhale breath. And ask yourself to approach these questions with curiosity and compassion. And the first question I would like you to ask is, who first taught me what to think about movement? And what was said? And this could be a specific scenario that's just coming, just boom popped in your mind. Or it could be a general thread of where you kind of first come to know about movement, but who first taught me what to think about movement? What was said? And give yourself as much time as you need to answer that. I think the second question that would be so good to reflect on is ask yourself, what is one thing that I would like to unlearn about movement, from my well-being? So what is one thing I would like to unlearn about movement for my well-being? And the third question is, what is my why? And I'd like you to find just one positive, uplifting, intentional, beneficial, open minded, aspirational, inspirational, something that feels good, what is my why for movement? And I think you'll find something important and meaningful, it could be a gut reaction response, and then you might take a little bit more time and journal on that and expand on that. But I think if you ask yourself those questions, it's going to help reveal a starting point to approach taking meaningful action. And I feel like if there's one thing that we've kind of, narrowed in on through our conversation is about, we do have a lot of healing to do around movement in our body. But we kind of need to look at things differently, more flexibly, more about finding a personal fit and open minded and our own personal reasons and interests and curiosities. And do what we can to care for ourselves throughout the process. But when it comes to self-care for diabetes, and something that we do in all of our group work is really just help to find something that's personally meaningful, in an approach that that makes it feel less scary and more optimistic. And I think if you get there, you can't go wrong. And you are really going to do what you need to do to create a healing space for yourself.

Glenys Oyston, RDN: 32:27

I think those reflections are really lovely, and really useful and helpful. Thank you.

Rebecca Scritchfield, RDN: 32:32

Yeah, no problem. And hopefully if you guys are ready to join our group you will consider doing that. We have monthly live calls and 14 modules as soon as you sign up, bam, you get all the modules at once, but we coach you every week by email for the first three months of your membership, and we got a great group of folks, so we'd love to see you there.

Rebecca Scritchfield, RDN: 33:01

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