Ask Dr. Bob: The Best Kind of Milk, Preventing Muscle Knots, Smarter Carbs

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Loosen up
What is a muscle knot, really? And how do I get rid of one?

First, they’re not knots. Those tender, sometimes painful spots are actually contracted muscles that feel hard to the touch. They show up most frequently in the neck, shoulders, spine, and lower back — often because of the tense, hunched-over posture caused by long hours at a desk. The best way to treat a knot is with aggressive, targeted pressure from a massage. (I tell my masseuse to “kill me” when she asks about pressure; that’s the level you need to force the fibers to release — think of it as good pain.) An easy DIY method to address knots is to buy a few pliable therapy balls to help knead muscles against a wall or on the ground.

(Bigger balls are best for the large muscles of the back and hips, smaller ones for the neck and shoulders.) This solution works as prevention, too. Spend a few minutes at night massaging tight muscles, and they’ll be less likely to knot up the next day. Last, good posture goes a long way to prevent knots. Whenever I catch myself slumping in my chair, I throw my shoulders back and down, like a Marine.

A New Diet Strategy
Nutrition-wise, I know white bread is worthless. But I love eating it. Do I really have to give it up?

Here’s a concept I’ve put into practice for years: Eat refined carbs like white bread sparingly — and when you do, eat them at the very end of a meal. Why? Think of your metabolism as a fire that needs fuel to burn. If the first thing you toss in your stomach is carbs with a high glucose load — say, a dinner roll — you can expect your blood sugar to spike immediately. It’s like throwing newspaper into a fire. Now think of feeding the flames with a dense piece of oak. That’s what you’re doing when you eat protein or nutrient-rich veggies first. Even if you then add fast-burning sugars to the blaze, like a bagel, the effect is muted. This notion is borne out by a new study from Cornell: When the subjects ate carbs last versus first, their blood sugar was 28 percent lower. The other added benefit is that if you fill up on protein and produce at the start of a meal, you won’t be as tempted to go overboard on the bread basket.

Fitness Matters
How fast can you fall out of shape?

It can happen more quickly than you may think. Recently, Danish researchers studied a group of fit, active men who’d had a leg injury that left them immobile. They found that in just two weeks the men’s muscle strength diminished by a third. Even though this is an extreme example — you may stop going to the gym, but you’re unlikely to lie on the couch for two weeks straight — it shows how valuable it is to be consistent with your fitness. If time is the issue, do a 20-minute session of jumping jacks, push-ups, squats, lunges, and planks. That alone will help you maintain strength.

RELATED: More Questions Answered, from Dr. Bob Arnot

Nutrition Update
What’s the healthiest kind of milk?

In my opinion, your best bet isn’t even the real thing: It’s almond milk. Cow’s milk, whether whole, 2 percent, or skim, has 12 or more grams of sugar per eight-ounce serving. (Use it in a 24-ounce smoothie and you’re drinking the sugar equivalent of a Snickers bar.) Nut milks, on the other hand, have zero sugar and a quarter of the calories of regular milk, and they still pack plenty of calcium and vitamin D. That’s why I switched to using almond milk over my cereal and in my morning coffee. Just be sure that when you buy a carton at the store, you go for the unsweetened version.