Category: THE-BEAUTY

Experiencing discrimination in the workplace — where many adults spend one-third of their time, on average — may be harmful to your heart health.

A 2023 study in the Journal of the American Heart Association found that people who reported high levels of discrimination on the job were more likely to develop high blood pressure than those who reported low levels of workplace discrimination.

Workplace discrimination refers to unfair conditions or unpleasant treatment because of personal characteristics — particularly race, sex, or age.

How can discrimination affect our health?

“The daily hassles and indignities people experience from discrimination are a specific type of stress that is not always included in traditional measures of stress and adversity,” says sociologist David R. Williams, professor of public health at the Harvard T.H. Chan School of Public Health.

Yet multiple studies have documented that experiencing discrimination increases risk for developing a broad range of factors linked to heart disease. Along with high blood pressure, this can also include chronic low-grade inflammation, obesity, and type 2 diabetes.

More than 25 years ago, Williams created the Everyday Discrimination Scale. This is the most widely used measure of discrimination’s effects on health.

Who participated in the study of workplace discrimination?

The study followed a nationwide sample of 1,246 adults across a broad range of occupations and education levels, with roughly equal numbers of men and women.

Most were middle-aged, white, and married. They were mostly nonsmokers, drank low to moderate amounts of alcohol, and did moderate to high levels of exercise. None had high blood pressure at the baseline measurements.

How was discrimination measured and what did the study find?

The study is the first to show that discrimination in the workplace can raise blood pressure.

To measure discrimination levels, researchers used a test that included these six questions:

• How often do you think you are unfairly given tasks that no one else wanted to do?
• How often are you watched more closely than other workers?
• How often does your supervisor or boss use ethnic, racial, or sexual slurs or jokes?
• How often do your coworkers use ethnic, racial, or sexual slurs or jokes?
• How often do you feel that you are ignored or not taken seriously by your boss?
• How often has a coworker with less experience and qualifications gotten promoted before you?

Based on the responses, researchers calculated discrimination scores and divided participants into groups with low, intermediate, and high scores.

• After a follow-up of roughly eight years, about 26% of all participants reported developing high blood pressure.
• Compared to people who scored low on workplace discrimination at the start of the study, those with intermediate or high scores were 22% and 54% more likely, respectively, to report high blood pressure during the follow-up.

How could discrimination affect blood pressure?

Discrimination can cause emotional stress, which activates the body’s fight-or-flight response. The resulting surge of hormones makes the heart beat faster and blood vessels narrow, which causes blood pressure to rise temporarily. But if the stress response is triggered repeatedly, blood pressure may remain consistently high.

Discrimination may arise from unfair treatment based on a range of factors, including race, gender, religious affiliation, or sexual orientation. The specific attribution doesn’t seem to matter, says Williams. “Broadly speaking, the effects of discrimination on health are similar, regardless of the attribution,” he says, noting that the Everyday Discrimination Scale was specifically designed to capture a range of different forms of discrimination.

What are the limitations of this study?

One limitation of this recent study is that only 6% of the participants were nonwhite, and these individuals were less likely to take part in the follow-up session of the study. As a result, the study may not have fully or accurately captured workplace discrimination among people from different racial groups. In addition, blood pressure was self-reported, which may be less reliable than measurements directly documented by medical professionals.

What may limit the health impact of workplace discrimination?

At the organizational level, no studies have directly addressed this issue. Preliminary evidence suggests that improving working conditions, such as decreasing job demands and increasing job control, may help lower blood pressure, according to the study authors. In addition, the American Heart Association recently released a report, Driving Health Equity in the Workplace, that aims to address drivers of health inequities in the workplace.

Encouraging greater awareness of implicit bias may be one way to help reduce discrimination in the workplace. Implicit bias refers to the unconscious assumptions and prejudgments people have about groups of people that may underlie some discriminatory behaviors. You can explore implicit biases with these tests, which were developed at Harvard and other universities.

On an individual level, stress management training can reduce blood pressure. A range of stress-relieving strategies may offer similar benefits. Regularly practicing relaxation techniques or brief mindfulness reflections, learning ways to cope with negative thoughts, and getting sufficient exercise can help.

About the Author

Julie Corliss, Executive Editor, Harvard Heart Letter

Julie Corliss is the executive editor of the Harvard Heart Letter. Before working at Harvard, she was a medical writer and editor at HealthNews, a consumer newsletter affiliated with The New England Journal of Medicine. She … See Full Bio View all posts by Julie Corliss

About the Reviewer

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio View all posts by Howard E. LeWine, MD

The first thing to know about ringworm is that there are no worms involved.

This generally harmless skin infection is caused by a fungus. The fungus causes a raised rash usually shaped like a ring, almost as if a worm was curled up under the skin (but again: no worms are involved).

The medical name for ringworm is tinea corporis.

Are there other types of tinea infections?

There are many different kinds of tinea skin infections, named in Latin for the part of the body they affect, such as the

• scalp (tinea capitis)
• groin (tinea cruris)
• feet (tinea pedis)
• body (tinea corporis).

Tinea infections can look a bit different depending on what part of the body they affect, but they are usually pink or red and scaly.

How do you get ringworm?

Tinea infections, particularly ringworm (tinea corporis), are very common. People catch them from other infected people and also from infected animals, particularly dogs and cats. They can also spread from one part of the body to another.

What does ringworm look like?

It usually starts as a pink scaly patch that then spreads out into a ring. The ring (which is not necessarily perfectly round) usually spreads wider with time. It can sometimes be itchy, but most of the time doesn’t cause any discomfort.

There are other rashes that can have a ringlike shape, so it’s always important to check in with your doctor, especially if the ring isn’t scaly. But most ringlike rashes are tinea.

How is ringworm treated?

Luckily, tinea corporis and the other kinds of tinea are very treatable. Most of the time, an antifungal cream does the trick.

When the rash is extensive (which is rare) or doesn’t respond to an antifungal cream (also rare), an antifungal medication can be taken by mouth.

As is the case with many other germs these days, there are some drug-resistant cases of tinea related to overuse of antifungal medications. But the vast majority of fungal infections go away with medication.

What should you do if you think a family member — or a pet — has ringworm?

If you think someone in your family has ringworm, call your doctor. The sooner you get started on treatment, the better.

If someone in the family has been diagnosed with ringworm, make sure that others don’t share clothing, towels, or sheets. Have everyone wash their hands frequently and well.

If your pet has a scaly rash, call the vet. Vacuum the areas your pet frequents, and have everyone wash their hands after touching the pet.

Can you prevent ringworm?

To prevent tinea corporis and other kinds of tinea:

• Keep skin clean and dry.
• Change clothes (particularly socks and underwear) regularly.
• Wash your hands regularly (this helps prevent all sorts of infections).
• If your child plays contact sports, make sure they shower after practice, keep their uniform and gear clean, and don’t share gear with other players.

To learn more about ringworm, visit the website of the Centers for Disease and Prevention.

Follow me on Twitter @drClaire

About the Author

Claire McCarthy, MD, Senior Faculty Editor, Harvard Health Publishing

Claire McCarthy, MD, is a primary care pediatrician at Boston Children’s Hospital, and an assistant professor of pediatrics at Harvard Medical School. In addition to being a senior faculty editor for Harvard Health Publishing, Dr. McCarthy … See Full Bio View all posts by Claire McCarthy, MD

The notion that hurting yourself can make you feel better seems like a contradiction. But that’s exactly what drives skin cutting and similar forms of self-harm among adolescents, says Matthew Nock, chair of the department of psychology at Harvard University.

If you’re a parent, you may have heard about cutting or be wondering about red flags. Here are the basics on what to know, and how you can respond if you’re concerned about this form of self-harm.

What is self-harm?

“Self-harm is the intentional destruction of body tissue in the absence of any intent to die,” explains Nock, who specializes in treating self-injury behaviors in childhood to young adulthood. “Most often it happens on the arms and takes the form of cutting with some type of sharp object, such as a razor blade, pencil, or pocket knife. It might also include burning the skin or inserting objects under the skin, such as paper clips.”

How many teens engage in self-harm?

About 17% of teenagers engage in self-harm at least once, according to the American Psychological Association.

Many who do so begin between ages 12 and 14, when adolescence can deliver a one-two punch: combining a new mental health disorder with greater risk-taking behaviors, explains Nock.

What leads some teens to engage in cutting?

Cutting appears to affect all genders of adolescents equally, Nock notes. But what factors make teens more likely to do it? In addition to experiencing depression, anxiety, or other mental health issues, teens who cut themselves may be more apt to use drugs or alcohol.

A 2022 study in Child and Adolescent Mental Health suggests additional contributing factors, including family problems, school or job challenges, and struggling relationships with friends. Ultimately, cutting appears to have three contributing components, Nock says: psychological, biological, and social.

“Kids who engage in self-injury have difficulty tolerating emotional distress and are more likely to try to escape from those feelings,” he says. “It might be that their pain demands attention, and when they’re really upset, cutting themselves focuses on their physical pain and reduces their psychological pain.”

The sense of relief or release after cutting reinforces the behavior, leading teens to cut themselves again and again. “An adult who’s feeling upset may have a drink, go for a run, or engage in yoga to decrease their distress. When they feel better afterward, that behavior gets reinforced,” Nock says. “We think the same is true with self-injury: if you feel really bad and cut yourself, the feeling goes away.”

Will asking about cutting put ideas in a teenager’s head?

Parents often worry about this. But it’s safe to assume kids in middle school and high school are well aware of what self-harm involves, from social media and interactions with peers and others. “Asking kids about it isn’t going to give them the idea to do it — all of the data we have suggests that’s not the case,” Nock says.

What are key signs of cutting in teenagers?

Be alert for

• fresh cuts on a teen’s skin, or evidence that skin has been cut, burned, or had objects placed under it
• covering body areas — whether arms or legs — they didn’t tend to cover before.

Is there a connection between cutting and suicide?

While teens who engage in cutting don’t intend to end their lives that way, their willingness to hurt themselves might indicate a greater risk that they may attempt suicide. More than 50% of children and adolescents who die by suicide have previously self-harmed, according to the 2022 study described above.

“The more you intentionally hurt your body — which takes some amount of courage to do — the more likely you’ll target yourself in the future,” Nock says. “We also think there’s a self-hatred component to this — you’ll hurt your body when in distress rather than do something productive like go for a run. There’s a sort of self-criticism that leads people to hurt themselves and ultimately try to kill themselves.”

How can parents respond if they notice signs of cutting?

If they confide in anyone at all, teens who self-harm tend to tell their friends, not their parents or other adults. But parents can break through the secrecy and offer support with a calm, steadfast approach.

“Encourage them to talk to you about what they’re experiencing, knowing that you’re an open ear and will be as nonjudgmental as possible,” Nock says. “It’s not realistic that we’re going to root out all risky behaviors that kids engage in. But when death is a potential outcome, encourage friends and family not to honor that secrecy and to try to intervene to keep the person safe.”

Seeking appropriate resources can help:

• Take your child to a primary care doctor who can refer to a mental health professional, or go directly to a psychiatrist, psychologist, or social worker for evaluation.
• Ask your doctor or a mental health professional about local or telehealth options for cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT). Both approaches can help teens learn healthier strategies to cope with emotional distress.
• If your child’s self-injury seems severe or you’re concerned about the possibility of suicide, go to a hospital emergency room. “If our kids fall and suffer a break or accidental injury that needs medical attention, we go to the ER — and the same should happen for injuries that are self-inflicted,” Nock says.

About the Author

Maureen Salamon, Executive Editor, Harvard Women's Health Watch

Maureen Salamon is executive editor of Harvard Women’s Health Watch. She began her career as a newspaper reporter and later covered health and medicine for a wide variety of websites, magazines, and hospitals. Her work has … See Full Bio View all posts by Maureen Salamon

About the Reviewer

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio View all posts by Howard E. LeWine, MD

I recently saw a car vanity plate that read “LBODOC” (as in elbow doc). The driver — probably an orthopedic doctor or arthritis specialist — was clearly a fan of the elbow, an unassuming joint and a surprisingly central player in many daily tasks. I could relate: throughout my medical career, the elbow has been my favorite joint.

Here’s why we should give praise to elbows and do all we can to protect them.

What if we didn’t have elbows?

Let’s face it: the human experience would be quite different without elbows.

Imagine your arm without a joint that bends at the elbow. You’d be unable to easily feed yourself, put on makeup, shave your face, or brush your teeth. It’d be tough to get dressed or throw a ball without elbows. And, importantly, wiping yourself after using the bathroom would be nearly impossible.

Yet, when it comes to joints and joint disease, we hear little about elbows; hips and knees get most of the attention. So, let’s consider for a moment what the lowly elbow does and why it deserves more credit.

How do your elbows work?

Three bones come together at the elbow joint: the humerus, which is in the upper arm, and two long bones called the ulna and radius in the lower arm.

Your elbow has two main motions:

• Flexing and straightening. Flexing your arm allows you to bring your hand toward your body (flexion), which you do when bringing food to your mouth or putting your hands on your hips. Straightening your arm (extension) allows such motions as putting your arm in a shirt sleeve or reaching your toes.
• Turning up and down. You can also flip your palms from facing the ceiling (supination) to facing the floor (pronation). These motions are important for many common movements, such as turning a key or a doorknob.

Bumping your elbow: Why is it called the funny bone?

Probably for two reasons:

• The humerus in the upper arm sounds just like the word humorous, meaning funny.
• Bumping your elbow often puts pressure on the ulnar nerve, since it’s located between the bones of the joint. Pressure on this nerve can cause a funny tingling sensation that runs down your arm.

Elbow trouble: Four well-known problems — and a surprising fifth

Like so many overlooked and underappreciated things, most people think little about their elbows until something goes wrong. Here are some of the most common elbow problems:

• Arthritis. Several types of arthritis can affect the elbow, including rheumatoid arthritis, psoriatic arthritis, and gout. Interestingly, the most common type of arthritis, osteoarthritis, doesn’t usually affect the elbow unless there’s been prior damage to the joint.
• Bursitis. The bursa is a saclike structure that surrounds the tip of the elbow. Bursitis develops when it becomes swollen or inflamed, due to infection, gout, or bleeding.
• Tendonitis. Tendon inflammation (tendonitis) may develop on the inside part of the elbow (called “golfer’s elbow”) or the outside (called “tennis elbow”). Despite these names, you don’t have to play any particular sport to develop elbow tendonitis.
• Trauma. Everyday activities and athletic pursuits put the elbow at risk. A bike accident, falling off a skateboard, or just tripping on a curb and falling onto your arm can cause significant elbow injuries. These include ligament damage, broken bones, or bursitis.

And the surprising fifth problem? Cell phone-induced nerve irritation: holding your elbow bent for a long time can lead to “cell phone elbow” due to pressure on the ulnar nerve. This can cause numbness and pain down the arm. The solution? Put the phone down — or at least go hands-free.

How can you protect your elbows?

Considering all our elbows do for us, we need to do our best to protect them. That means:

• Wear elbow protectors when engaging in activities likely to injure the elbows (like skateboarding or roller blading).
• Learn proper technique for activities that can stress the elbow like racquet sports, baseball, weight training, or repetitive motions in carpentry and other types of work. For example, a trainer or coach can help you improve your tennis stroke to avoid overstressing the elbow joint and its tendons or ligaments.
• Use appropriate equipment. For example, avoid using a tennis racquet that’s too heavy for you.
• Train well. Strengthening forearm muscles and stretching can help avoid golfer’s elbow.

The bottom line

As the junction between hand and shoulder, our elbows play a pivotal role in everyday function. It’s high time we recognized them for what they do for us. Even if the elbow isn’t your favorite joint — as it is for me — perhaps it should be in your top five. After all, think of all the things you couldn’t do without them.

About the Author

Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School. … See Full Bio View all posts by Robert H. Shmerling, MD

Editor’s note: in honor of Pride Month, we’re re-publishing a 2019 post by Dr. Cecil Webster.

Generally speaking, discussing what happens in our bedrooms outside of the bedroom can be anxiety-provoking. Let’s try to make your doctor’s office an exception. Why is this important? People in the LGBTQ+ community contend not only with a full range of health needs, but also with environments that may lead to unique mental and physical health challenges. Whether or not you have come out in general, doing so with your doctor may prove critical in managing your health. Sexual experiences, with their impact on identity, varied emotional significance, and disease risk, are a keystone for helping your doctor understand how to personalize your healthcare.

Admittedly, talking about your intimate sexual experiences or your gender identity may feel uncomfortable. Many LGBTQ+ patients worry that their clinicians may not be knowledgeable about their needs, or that they’ll to have to educate them. Finding a LGBTQ+ adept doctor, preparing ahead of time for your next appointment, and courageously asking tough questions can give you and your health the best shot.

Finding a skilled clinician who is LGBTQ+ adept

Many large cities have healthcare institutions whose mission centers on care for LGBTQ+ peoples. However, these organizations may prove inaccessible to many for a variety of reasons. Regardless of your location, asking friends, family, or others to recommend a clinician may be a game changer. If your trans friend had a relatively painless experience visiting an area gynecologist, perhaps your Pap smear may go smoothly there as well. If your coworker has a psychiatrist who regularly asks him about his Grindr use, perhaps it may be easier to navigate your gay relationship questions with her.

Word of mouth is often an undervalued method of finding someone skilled and attentive to the needs of LGBTQ+ individuals. Online, many clinicians offer a short bio with their areas of expertise, and there are provider directories featuring trusted clinicians. Further, some doctors regularly write articles and give talks that may offer clues about desired knowledge. A simple Google search of your provider may yield a bounty.

Next, give your doctor or healthcare organization a call. Don’t be shy about requesting someone whose practice matches your specific needs. Your health information is protected, and generally, physicians hold your clinical privacy dear. Keep in mind that not all clinics will know or share whether or not your doctor is, for example, also a lesbian, but they may pair you with someone well suited to your request or point you in the right direction.

Preparing for your appointment

Let’s say you are nervous about coming out to your doctor. A little preparation may ease this burden. Here are some quick tips:

• Let them know you’re nervous at the start of the conversation.
• Be as bold as you can tolerate.
• Write down what you are excited about, nervous about, and/or curious about.
• Go in with a few goals and start with what’s most important.
• Maximize your comfort. If your partner is calming, bring them. If Beyoncé soothes what ails you, bring her along too.
• Lightly correct or update your clinician if they get something wrong.

Ask tough questions, give clear answers

As a psychiatrist who works with kids and adults, I often hear questions like, “I don’t know really how to say this, but I started experimenting with other guys. Does this mean I’m gay?” I may start by asking if you’ve enjoyed it. My colleagues in health care might begin with the same question.

Pleasurable experiences come in all sorts of constellations, and healthy exploration is part of being human. Additionally, clinicians need to assess and address your safety. Many LGBTQ+ people are at higher risk of intimate partner violence. We may ask about your use of condoms, how many partners you’ve had recently, your use of substances during sex, and how these experiences may shift how you see yourself. Give clear answers if possible, but don’t fret if you’re uncertain. Your doctor will not likely provide a label or pry unnecessarily. They may offer constructive information on the use of condoms, reasons to consider using PrEP (which can effectively prevent HIV), and places you can go for more guidance. Physicians enjoy giving personalized information so that you may make informed healthcare decisions.

There is no end to what is on people’s minds. Be bold. Will tucking reduce my sperm count? Maybe. Does binding my breasts come with risk? Likely. Was Shangela robbed of her RuPaul’s Drag Race: All Stars 3 crown? Utterly, but let’s get back to your cholesterol, shall we?

Remember that it is often impossible to squeeze everything into one appointment. Afterward, take time to catch your breath, reflect on what you’ve learned, and come up with more questions for next time. We’re here for that.

About the Author

Cecil R. Webster, Jr., MD, Contributor

Dr. Cecil R. Webster, Jr. is a child, adolescent, and adult psychiatrist in Boston. He is a lecturer in psychiatry at McLean Hospital and Harvard Medical School, and consultant for diversity health outreach programs at the … See Full Bio View all posts by Cecil R. Webster, Jr., MD

Remember childhood summers when you climbed monkey bars, swung from ropes, and jumped over streams? Rain just added to the fun, leaving you soaked and muddy.

You can relive those adventures by signing up for a mud run. These outdoor team events focus on navigating through military-inspired obstacle courses and getting good and dirty in the process.

Tough Mudder and Spartan races are the most well-known mud races. But similar mud runs are available in most states. Some offer shorter distances and levels of difficulty. Others are designed just for women, kids, or families.

How do mud runs work?

Usually these events follow the same basic concept: participants traverse a course that covers anywhere from three to 10 miles (or longer), and tackle 10 to 25 obstacles.

While some mud races can be done solo, most are designed as team-oriented events. Teams are often coed and consist of five to 10 people. There is no time limit, but depending on the distance and number of obstacles, most teams complete the course in anywhere from less than an hour to three-plus hours.

The obstacles are challenging enough that most people need help — physically and emotionally — to navigate over, under, and across them. This is where a “we’re-all-in-this-together” comradery comes into play.

What sort of obstacles are featured in mud runs?

Common obstacles include

• climbing over spider web-like cargo nets
• scaling walls of various heights
• swinging from ropes with handles
• keeping your balance while walking across beams or logs
• carrying logs or sandbags
• slithering under barbed wire.

And then there’s all the mud. Be prepared to trudge through sticky mud pits, crawl through muddy tunnels, and shoot down mud-slick slides.

What are the health benefits of a mud run?

According to Dr. Aaron Baggish, founder of the Cardiovascular Performance Center at Harvard-affiliated Massachusetts General Hospital, the benefits of these events come from how they are constructed.

“Obstacle racing combines large-muscle, whole-body resistance exercises superimposed on a long-distance endurance race,” he says. “They are a snapshot of all-around conditioning, as you need strength, stamina, and mobility.”

Besides the physical benefits, mud races offer psychological challenges, and the emotional rewards, of conquering tasks that require planning, coordination, and strategy.

How can you prepare for a mud run?

Mud races require strenuous exercise, so discuss your safety and capabilities with your doctor before signing up for an event. While almost anyone of any age can participate in these events, they require a certain level of conditioning to complete and to reduce the risk of experiencing injury.

“Training for obstacle races incorporates many aspects of fitness and performance,” says Dr. Baggish. “So it’s best to prepare with a coach or trainer who understands the fundamental skills needed to complete these races.”

Whether or not you work with a trainer, you’ll want to focus on:

• Aerobic fitness. While you won’t consistently run as you do in a traditional road race, such as a 5K or a half marathon, you do have to hustle from obstacle to obstacle. “Optimal training for such obstacle races involves a combination of steady-state aerobic base training like jogging or cycling, coupled with interval work that simulates the start-and-stop nature of competition,” says Dr. Baggish.
• Grip strength. You will have to grab, hold, and pull yourself against gravity. Exercises that can help include pull-ups and farmer carries (where you hold dumbbells or kettlebells in each hand while you walk back and forth). Good form is essential during these exercises to help you avoid injury. Remember to start low when working with weights and go slow.
• Plyometrics. Many obstacles require explosive jumps and quick movements. Exercises like box jumps, burpees, and jump squats can help replicate these moves.

How to stay safe in the mud

While being physically prepared can help reduce the risk of injury, you should take other precautions to stay safe. For instance:

• Choose your race depending on level of fitness. Be sure you know what you’re getting into before you go.
• Wear lightweight, moisture-wicking clothing. Avoid cotton, which gets heavy with mud and sweat.
• Wear a headband, protective eyewear, or visor to keep mud out of the eyes.
• Wear long shorts or pants that cover your knees to prevent scraping, or opt for knee pads.
• Consider gloves to protect your hands and provide extra grip.
• Cover your feet with petroleum jelly or an anti-chafing cream before putting on socks to protect wet feet from chafing and blisters.
• Tie shoelaces tightly (but not so tight that they cut off circulation). Mud creates suction and you can quickly lose a shoe.
• Pace yourself. Walk or take a break when needed.

Where can you find a mud run?

It depends on the level of challenge that you seek. Are you ready for a Tough Mudder or Spartan race? Looking for a family first mud run, or a Muddy Princess or Muddy Kids event?

These additional sites also can help you find mud races in your area:

• Mud Run Finder (US)
• Run Guides (Canada and the US)
• Savage Race (US)

About the Author

Matthew Solan, Executive Editor, Harvard Men's Health Watch

Matthew Solan is the executive editor of Harvard Men’s Health Watch. He previously served as executive editor for UCLA Health’s Healthy Years and as a contributor to Duke Medicine’s Health News and Weill Cornell Medical College’s … See Full Bio View all posts by Matthew Solan

About the Reviewer

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio View all posts by Howard E. LeWine, MD

As wildfires become more frequent due to climate change and drier conditions, more of us and more of our communities are at risk for harm. Here is information to help you prepare and protect yourself and your family.

How does wildfire smoke affect air quality?

Wildfire smoke contributes greatly to poor air quality. Just like fossil fuel pollution from burning coal, oil, and gas, wildfires create hazardous gases and tiny particles of varying sizes (known as particulate matter, or PM10, PM2.5, PM0.1) that are harmful to breathe. Wildfire smoke also contains other toxins that come from burning buildings and chemical storage.

The smoke can travel to distant regions, carried by weather patterns and jet streams.

How does wildfire smoke affect our health?

The small particles in wildfire smoke are the most worrisome to our health. When we breathe them in, these particles can travel deep into the lungs and sometimes into the bloodstream.

The health effects of wildfire smoke include eye irritation, coughing, wheezing, and difficulty breathing. The smoke may also increase risk for respiratory infections like COVID-19. Other possible serious health effects include heart failure, heart attacks, and strokes.

Who needs to be especially careful?

Those most at risk from wildfire smoke include children, older adults, outdoor workers, and anyone who is pregnant or who has heart or lung conditions.

If you have a chronic health condition, talk to your doctor about how the smoke might affect you. Find out what symptoms should prompt medical attention or adjustment of your medications. This is especially important if you have lung problems or heart problems.

What can you do to prepare for wildfire emergencies?

If you live in an area threatened by wildfires, or where heat and dry conditions make them more likely to occur:

• Create an evacuation plan for your family before a wildfire occurs.
• Make sure that you have several days on hand of medications, water, and food that doesn't need to be cooked. This will help if you need to leave suddenly due to a wildfire or another natural disaster.
• Regularly check this fire and smoke map, which shows current wildfire conditions and has links to state advisories.
• Follow alerts from local officials if you are in the region of an active fire.

What steps can you take to lower health risks during poor air quality days?

These six tips can help you stay healthy during wildfire smoke advisories and at other times when air quality is poor:

• Stay aware of air quality. AirNow.gov shares real-time air quality risk category for your area accompanied by activity guidance. When recommended, stay indoors, close doors, windows, and any outdoor air intake vents.
• Consider buying an air purifier. This is also important even when there are no regional wildfires if you live in a building that is in poor condition. See my prior post for tips about pollution and air purifiers. The EPA recommends avoiding air cleaners that generate ozone, which is also a pollutant.
• Understand your HVAC system if you have one. The quality and cleanliness of your filters counts, so choose high-efficiency filters if possible, and replace these as needed. It's also important to know if your system has outdoor air intake vents.
• Avoid creating indoor pollution. That means no smoking, no vacuuming, and no burning of products like candles or incense. Avoid frying foods or using gas stoves, especially if your stove is not well ventilated.
• Make a "clean room." Choose a room with fewer doors and windows. Run an air purifier that is the appropriate size for this room, especially if you are not using central AC to keep cool.
• Minimize outdoor time and wear a mask outside. Again, ensuring that you have several days of medications and food that doesn't need to be cooked will help. If you must go outdoors, minimize time and level of activity. A well-fitted N95 or KN95 mask or P100 respirator can help keep you from breathing in small particles floating in smoky air (note: automatic PDF download).

About the Author

Wynne Armand, MD, Contributor

Dr. Wynne Armand is a physician at Massachusetts General Hospital (MGH), where she provides primary care; an assistant professor in medicine at Harvard Medical School; and associate director of the MGH Center for the Environment and … See Full Bio View all posts by Wynne Armand, MD

Health guidelines recommend adults get at least 150 minutes per week of moderate-intensity aerobic exercise, or at least 75 minutes of vigorous exercise. Which activities you choose don’t matter as long as they get you moving.

But what if an injury, illness, health condition, disability, or even normal aging makes being active hard for you? In those cases, adaptive sports could lend a much-needed hand.

What are adaptive sports?

Adaptive sports are competitive or recreational sports or activities for people with disabilities or physical limitations. They often run parallel to traditional endeavors, but are modified to support people’s specific physical abilities.

“Eventually, almost everyone will experience some kind of disability that impedes regular exercise, whether it’s mild arthritis, requiring a knee or hip replacement, limited vision, or a more significant physical disability,” says Dr. Cheri Blauwet, an associate professor in physical medicine and rehabilitation at Harvard Medical School, and a former wheelchair racer who is a seven-time Paralympic medalist and two-time winner of both the Boston and New York City Marathons. “But today, because of advanced technology and supportive infrastructure, people can find almost any kind of sport or activity that takes into account their abilities and helps them stay active.”

Why is it important to stay active?

Not getting sufficient regular exercise increases the risk of heart disease, stroke, obesity, diabetes, and cancer. It also affects mood. And people with disabilities are especially vulnerable because of the challenges of staying active, says Dr. Blauwet. “Adaptive sports are a way for us to continue to exercise regularly and support our health and well-being going forward.”

Research backs this up. According to one study, people participating in adaptive sports and activities report better overall health, quality of life, and social life.

How can you learn about options for adaptive activities near you?

You can find state and local adaptive sports programs and accessible activities through the websites of the National Center on Health, Physical Activity and Disability and the Challenged Athletes Foundation. “These programs also can help you find mentors, coaches, and the support system that you need to be successful,” says Dr. Blauwet.

What kind of sport or activity you choose ultimately depends on your interests and level of function, but many options are available.

Build on strengths and consider new activities

Dr. Blauwet shares other strategies that can help you transition to adaptive activities.

Look at your current form of exercise. “Almost any kind of sport or activity can be adjusted to accommodate people with disabilities, so there is a good chance you can continue with a favorite endeavor,” says Dr. Blauwet.

For instance, as part of her ongoing therapy, former Arizona representative Gabby Giffords, an avid cyclist who lives with a brain injury after an assassination attempt, now rides a recumbent bike because of paralysis on her right side and balance issues. (A recumbent bike is a three-wheel bicycle that places the rider in a seated or laid-back reclining position.)

Other sports and activities can be altered similarly. For example, specialized golf carts can help you stand and stabilize your body while swinging the club. Sledge hockey uses sleds to skate across the ice.

Focus on your strengths. Don’t dwell on what you can’t do, but focus on what you can. Running no longer an option? How about power walking using walking poles for support? Can’t use your legs? Focus on upper body activities like swimming or kayaking. Low vision? Guides are available to help you walk, run, and cycle.

Join a team. Many adaptive sports have organized team leagues with adjusted rules and formats, like wheelchair basketball and tennis, and “beep” baseball and kickball for individuals with low vision. “These are a great way to build more awareness about your new endeavor and build a community with other peers with similar disabilities,” says Dr. Blauwet. “Plus, a little competition provides extra motivation.”

Try something new. Use your new functional status as an opportunity to attempt a different sport or activity. “Test the waters and try something that has always interested you,” says Dr. Blauwet. “Now might be the ideal time to explore waterskiing, windsurfing, horseback riding, or rock wall climbing.”

It may be mentally and emotionally tough to embrace adaptive sports and activities, as it can feel like your disability has become magnified. But don’t let that dissuade you, adds Dr. Blauwet. “Staying committed to being active and investing in your health can help reduce and eliminate any negative stigma you feel. Participation in adaptive sports is not a lesser way of living, but a way to live better.”

About the Author

Matthew Solan, Executive Editor, Harvard Men's Health Watch

Matthew Solan is the executive editor of Harvard Men’s Health Watch. He previously served as executive editor for UCLA Health’s Healthy Years and as a contributor to Duke Medicine’s Health News and Weill Cornell Medical College’s … See Full Bio View all posts by Matthew Solan

It’s hard to care about anything when you feel exhausted, burned out, or ragged around the edges. Your once-fiery enthusiasm may seem more like charred rubble due to overwhelming family responsibilities, a job that drains you, or financial struggles. Or maybe an illness, the uncertainty and disruptions of the age we live in, or a combination of factors has left you feeling as if you have precious little to give.

“What you’re experiencing is burnout. It’s real and it can lead to depression, anxiety, relationship damage, and an inability to function at home or at work,” says Dr. Marni Chanoff, an integrative psychiatrist with Harvard-affiliated McLean Hospital.

Take heart: With time and effort, you can refill your cup, slowly adding back a bit of the energy and joie de vivre you’ve been missing. Here are three ways to start.

1. Carve out time for yourself

Taking time for yourself isn’t a luxury; it’s essential to self-care. “You need to slow down and give yourself the opportunity to rest and rejuvenate,” Dr. Chanoff says, “Schedule it if you have to, starting with 10 or 15 minutes, a couple of times a day.”

How can you reclaim precious minutes in an overly full schedule? “Look at your day, week, or month, and be discerning about how many things you say ‘yes’ to in one period of time. Give yourself permission to say ‘no thank you’ to things that deplete you or don’t serve you,” Dr. Chanoff says.

Make small moments count: choose what makes you feel at peace. For example, have a cup of tea, or simply lay a blanket or mat on the floor at home or work and lie on your back. Don’t look at your phone or email. “You want to tell your body to take a break. It helps you reset and back away when stress draws you in,” Dr. Chanoff explains.

2. Commit to better health

A strong body helps balance the stressful situations that have caused your burnout. The basic recipe for good health includes:

• Exercise. Moderate intensity exercise, the kind that works the heart and lungs, releases important chemicals that help regulate mood, sleep, and many body systems. Aim for at least 150 minutes of exercise per week, which amounts to about 22 minutes a day. Start with just a few minutes a day if it’s all you can do. It doesn’t have to be fancy. “It can be any movement that brings you joy, like dancing, yoga, or brisk walking,” Dr. Chanoff suggests.
• A good diet. Eating lots of junk food (typically full of sugar, salt, and unhealthy saturated fat) fuels chronic stress, fatigue, depression, and anxiety. Choose more unprocessed foods such as vegetables, fruits, whole grains, legumes, lean proteins (fish or poultry), and unsaturated fats (such as avocados or olive oil). If time is an issue, Chanoff suggests batch-cooking simple, healthy foods you can have several days of the week. (Lentil or bean soup is a good one-pot meal. Throw in as many vegetables as you can.)
• Sleep. Insufficient sleep affects overall health, concentration, and mood. Try to sleep seven to nine hours per night. “It helps to wind down an hour or two before you fall asleep. And practice good sleep hygiene: turn off your phone, keep your room cool and dark, and go to sleep and wake up at the same time each day,” Dr. Chanoff advises.

3. Surround yourself with comfort

Hygge (pronounced HOO-ga) is the Danish concept of cozy comfort that brings happiness and contentment. Folks in Denmark know a thing or two about finding sunshine in cold dark months.

To practice hygge, surround yourself with people, activities, and things that make you feel cozy, loved, happy, or content. Go simple: spend time with your favorite people, add a small vase of flowers to your space, don fuzzy slippers once home, eat a treasured comfort food, or listen to a favorite song.

More ideas to try:

• Light a candle.
• Get under a heated blanket.
• Frame a photo of a happy time.
• Have breakfast in bed.
• Use pretty table linens.
• Indulge in art (check out various works at museums online).
• Stand still outside to listen to the sounds of nature.
• Curl up in a cozy chair.
• Window-shop in your favorite store.
• Wear a soft sweater that feels good on your skin.
• Use a silk or satin pillowcase on your bed pillow.
• Take a warm bath.
• Get an oil diffuser with a scent that reminds you of a place you love, like the beach or a pine forest.

Turn up the effect by savoring cozy comfort. How does it feel, taste, smell, or sound? “Engaging the senses with soothing stimulation can be nourishing. It counteracts ongoing stress that the nervous system endures, and may help to elicit the relaxation response — the opposite of the fight or flight [stress] response,” Dr. Chanoff explains. Breathing deeply will help, too.

Eventually, these bits of hygge, health, and personal time will give you something you probably haven’t allowed yourself in a while, and that’s compassion. Be gentle with yourself. Pamper your soul and replenish your cup, so you can continue being there for the important people and tasks in your life.

About the Author

Heidi Godman, Executive Editor, Harvard Health Letter

Heidi Godman is the executive editor of the Harvard Health Letter. Before coming to the Health Letter, she was an award-winning television news anchor and medical reporter for 25 years. Heidi was named a journalism fellow … See Full Bio View all posts by Heidi Godman