Chiropractic Care and Working out

Autumn Leaves Signal it’s Time for a New Workout

Regular Chiropractic Care and a Healthy Lifestyle

In the 21st century, healthy living does not come for free. The primary difference between now and the good old days is the nature of our daily routine. Back then, men and women, and children too, performed rigorous physical work every day. Household chores, agricultural work, and work at a trade all involved ongoing physical labor. Transportation was via your own two feet or on a bicycle. Horseback riding, too, if you were lucky enough to own a horse, involved real exercise on the part of the rider. In the "modern" world, in stark contrast, the vast majority of our daily activities are sedentary. The long-term result is that most of us are seriously deconditioned. The solution to our lack of good physical health involves the costs of time and effort. We need to put in more than a few hours per week to gain the exercise we require. We need to spend time going shopping for healthy food and then preparing and cooking healthy meals for ourselves and our families. We need to make sure we're obtaining proper rest. Additionally, we need to make sure we're getting regular chiropractic care. Regular chiropractic care helps ensure our spines are aligned and our nerve systems are functioning properly. In this way, regular chiropractic care helps us get the most out of the valuable and precious time we're spending eating right and exercising. Regular chiropractic care helps us become healthier overall and enjoy higher levels of personal and family satisfaction and well-being.

Now that autumn is in the air, summertime recreational activities such as camping, going to the lake or beach, volleyball, and surfing begin to take a back seat and we look to focus on more prosaic forms of exercise. Strength training activities and cardiorespiratory-based exercise return to the forefront as we gear up for fitting fitness into our daily routines. On the other hand, many of us have taken the summer off as far as exercise is concerned, thinking we have put in a good nine months of activity and we deserve a break! Regardless of what we've been doing over the summer, for all of us the subtle changes in the weather are a reminder that it's time to get our exercise program organized again.
For those of us who admit to thinking, "Oh no, not more exercise!", it's useful to remember that exercise is not only very good for long-term health and well-being, it’s also very beneficial to your immediate health. Regular vigorous exercise helps us sleep better, look better, and feel better. For example, regular vigorous exercise helps people fall asleep. Additionally, the sleep we obtain when we're getting physical activity is much deeper and more restful than otherwise. We wake up refreshed and ready to take on the challenges of a new day. We have much more energy throughout the day and tend not to experience those mid-afternoon crashes. In terms of looking better, regular vigorous exercise makes your skin glow. Your face becomes brighter and shinier thanks to the increased oxygen supply you're getting. Regular activity also makes you taller owing to restoration of height within your intervertebral discs. As these discs make up approximately 25 percent of the length of your spinal column, you lose overall height if these structures are not fully hydrated. Regular vigorous exercise makes sure you're standing tall. Finally, we just feel better when we're exercising, a result of a regularly replenished supply of endorphins, your body's naturally occurring source of self-satisfaction and well-being.
How Much Exercise Should we be Doing to Reap These Benefits?
Guidelines consistently recommend at least 150 minutes of vigorous exercise each week, most typically obtained as 30 minutes of exercise done five days per week.¹ You're not restricted to 30 minutes per day of course. Thirty minutes is an acceptable baseline standard. Overall, people should perform both strength training and cardiorespiratory (aerobic) exercises on a regular basis.^2,3 You could do three days of strength training and two days of aerobic exercise some weeks, and two days of strength training and three days of aerobic exercise on alternate weeks. You'll be able to tell how things are going based on how you're feeling. Mostly, you should feel uplifted and invigorated in the hours following a workout. If at some point you begin to be slightly bored and are losing interest in your routines, those are signals to vary what you're doing. Fortunately, there is an abundance of exciting, captivating, compelling exercises and programs available across the spectrum of strength training and cardiorespiratory activities. The most important factor is be active and engaged in a consistent exercise program. The results will last a lifetime.

Sources

1. Colak TK, et al: Association between the physical activity level and the quality of life of patients with type 2 diabetes mellitus. J Phys Ther Sci 28(1):142-7, 2016
2. Carlson JA, et al: Walking mediates associations between neighborhood activity supportiveness and BMI in the Women's Health Initiative San Diego cohort. Health Place 38:48-53, 2016
3. Wojan TR, Hamrick KS: Can Walking or Biking to Work Really Make a Difference? Compact Development, Observed Commuter Choice and Body Mass Index. PLoS One. 2015 Jul 8;10(7):e0130903. doi: 10.1371/journal.pone.0130903. eCollection 2015
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A Spring in Your Step

A Spring in Your Step

Regular Chiropractic Care and Freedom of Motion

Efficient and effective mobility is key to good spinal health and good health overall. Spinal mobility depends on interactions between adjacent vertebras, a complex array of small and large muscles, and ligaments that bind the vertebras together. Nerve irritation and soft tissue inflammation may disrupt the smooth biomechanics of normal spinal motion. Left uncorrected nerve irritation and soft tissue inflammation result in a vicious cycle of increasing biomechanical dysfunction, further loss of freedom of motion, and increasing pain. Regular chiropractic care helps restore spinal mobility by focusing on the causes of biomechanical dysfunction. By analyzing sources of nerve interference and correcting spinal misalignments, regular chiropractic care optimizes spinal activities such as efficient mobility and weight-bearing. The resulting increased function reduces soft tissue inflammation and pain. Thus, regular chiropractic care helps reduce physiological stress. The overall benefits include improved freedom of motion, freedom of choice, and freedom of action.

We all know people who are light on their feet. Fred Astaire comes immediately to mind, as do tennis star Andy Roddick, the great Yankee shortstop Derek Jeter, and WNBA star Candace Parker. Closer to home, we may recognize similar combinations of grace and athleticism in a family member or friend. We may believe that such qualities are inborn and represent natural abilities. But each of us can develop comparable qualities of fluidity and ease of motion. We may not achieve the skill levels possessed by professional athletes, but we can acquire improved posture, greater balance, and heightened skills in day-to-day tasks requiring dexterity and coordination. In other words, we can all develop a spring in our step.
Such a springiness and lightness are the direct result of efficient biomechanical functioning of the spinal column and weight-bearing bones and joints including the pelvis and hips, knees, and ankles.^1,2 Such efficient biomechanical functioning is innate, but these abilities are gradually lost as we grow up, encounter the stresses of life, and become more and more sedentary. Over time, our musculoskeletal system loses flexibility, dynamism, quickness, and the ability to respond to sudden changes in the environment. The overall result is an impression of stiffness and heaviness. Gracefulness is lost as soon as physical motion becomes conscious and planned, rather than instinctive and spontaneous. But these losses are not necessarily the inevitable accompaniment to growing up and getting older. The good news is that such lightness can be recovered. We can restore that spring to our step and, in fact, learn to turn back the clock.³
The great benefit is that the processes involved in reacquiring gracefulness, lightness, and springiness also lead directly to improved health and well-being. The primary action is to engage in regular, vigorous exercise. Any form of exercise, done consistently, will enhance biomechanical functioning. Your muscles learn how to dynamically support increasingly heavier loads against gravity. Proprioceptors, specialized nerve endings located in weight-bearing joints throughout the body, learn to rapidly respond to mechanical alterations in three-dimensional space. Your heart and lungs become more efficient as your body learns to adapt and respond to increasing physiological demands. You begin to lose weight as your daily desire for excess calories naturally decreases in response to a more physical lifestyle. In many ways, your body becomes much smarter and you soon find yourself noticing a certain ease, a certain economy of physical movement, as you go through your day.
The innate grace that begins to be recovered is the wellspring of the newfound spring in your step. As you continue to exercise and achieve your optimal weight, such physical ease perpetuates and becomes an integral component of your overall enhanced health and well-being.

1. Iorio JA, et al: Biomechanics of Degenerative Spinal Disorders. Asian Spine J 10(2):377-384, 2016
2. Du CF, et al: Biomechanical response of lumbar facet joints under follower preload: a finite element study. BMC Musculoskelet Disord. 2016 Mar 15;17(1):126. doi: 10.1186/s12891-016-0980-4
3.  Huang ZY, et al: The location of Modic changes in the lumbar spine: a meta-analysis. Eur Spine J. 2016 Feb 25. [Epub ahead of print]

Regular Chiropractic Care and Healthy Exercise

Taking Care of Business

Regular Chiropractic Care and Healthy Exercise

Whether you are just starting an exercise program or someone who has been exercising regularly for many years, chiropractic care is an important component of your fitness activities. Just as regular exercise increases a person's flexibility and stamina, so too does exercise require a certain baseline level of flexibility and stretchability. All types of exercise involve range of motion maneuvers of the spine and other weight-bearing joints such as the hips, knees, and ankles. Biomechanical limitations or restrictions within these structures, especially those of the spine, may cause muscle irritation, inflammation, and even injury. Regular chiropractic care, by detecting and correcting sources of nerve interference, helps to reduce and resolve biomechanical dysfunction in the spine. The result is increased spinal mobility, greater overall freedom of movement, and an enhanced ability to successfully perform a wide range of exercise activities. Regular chiropractic care helps you get the most out of your exercise and supports your long-term goals of health and well-being.

At various times, all of us are occupied to a greater or lesser extent with activities of daily living that require physical exertion. If we live in a suburb, when we've completed our shopping at the local mall we place filled grocery bags into the trunks of our cars and haul them out of those trunks when we get home. If we live in a city, we may carry similarly filled shopping bags for several blocks or even farther to cover the distance between the supermarket and our home. Once we're home, we may need to store some of the products we've purchased on the top shelves of kitchen cabinets, closets, and (again, if we live outside the city) the storage space in our garage. Other typical daily or periodic home-based activities include cleaning, doing the laundry, gardening, and taking out and bringing in trashcans or carrying trash to the disposal unit.

All such exertions require appropriate amounts of strength and flexibility for effective maneuverability. For example, an intact and functioning rotator cuff and sufficient shoulder range of motion are needed to be able to reach up and store on a top-level shelf grocery items that won't be used for a while. As well, sufficient flexibility and strength in our hips, knees, and ankles are needed to effectively perform a wide range of household functions. Typically, we take all such abilities for granted. We usually don't consider what's required from a biomechanical point of view as we go through our day, doing things automatically that we've done in the same way for many years. But many of us have friends or family members who have undergone shoulder surgery as a result of an injury sustained while performing a common activity around the house. Many of us also have friends or family members who have had knee or hip replacement surgery, even though they seemed too young at the time to have required such a major procedure.

These surgeries are usually done to fix problems resulting from what is described as osteoarthritis.^1,2 Osteoarthritis, that is, inflammation of bones and joints, causes painful and restricted joint motion and places unbalanced stresses on muscles, tendons, and joint cartilage. Osteoarthritis of the shoulder, hip, or knee may make it very difficult to perform activities of daily living. Left unattended, osteoarthritis may certainly require surgery sooner or later. However, for most people there is a much better long-term solution. Regular exercise begun early in life is highly effective in preventing osteoarthritis from developing in the first place.³ If a person is older, regular exercise is also highly effective in providing protection from an osteoarthritic process that may have already begun. With regular exercise, joints and other biomechanical structures are trained to go through their entire available range of motion. Joints are lubricated and muscles are stressed effectively. The resulting activity improves biomechanical function and diminishes the likelihood of developing osteoarthritis. Not only do we gain an improved ability to "take care of business", that is, to perform our activities of daily living, we also gain long-term health and well-being.
1Reed D, et al: Does load influence shoulder muscle recruitment patterns during scapular plane abduction? J Sci Med Sport 2015 Nov 5. pii: S1440-2440(15)00207-8. doi: 10.1016/j.jsams.2015.10.007. [Epub ahead of print]


2Sampath KK, et al: The effects of manual therapy or exercise therapy or both in people with hip osteoarthritis: A systematic review and meta-analysis. Clin Rehabil  2015 Dec 22. pii: 0269215515622670. [Epub ahead of print]


3Kim D, et al: Effect of an exercise program for posture correction on musculoskeletal pain. J Phys Ther Sci 27(6):1791-1794, 2015

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Riding the Brakes

Regular Exercise and Regular Chiropractic Care

Whether you run or walk, play tennis or play basketball, lift weights or work-out with medicine balls, regular chiropractic care is an essential component of your exercise method of choice. We exercise because we want to, because we want to be healthy and well for all the years of our lives. Importantly, regular chiropractic care helps us achieve these health and wellness goals. Regular exercise makes demands on many of our physiological systems, especially on the musculoskeletal, cardiorespiratory, and endocrine systems. In order for these systems to respond properly, your nerve system must be operating at peak efficiency. By detecting and correcting areas of spinal nerve interference, your chiropractor helps your nerve system — your body's master system — coordinate the activities of all your body's other systems. As a result, regular chiropractic care helps you get the most out of your exercise time and helps you obtain high levels of health and well being.

We're all familiar with the highway driving experience of being behind a person who is continually braking for no apparent reason. This is especially problematic if you're in the left-hand lane. You're zipping along at the posted speed limit and suddenly the brake lights of the car in front go on. You have to immediately react and hit your brakes. If this happens more than a couple of times, you look for the first opportunity to pass this unskilled driver. The person riding their brakes may thoughtlessly cause a serious traffic problem or worse. Metaphorically, you may be physiologically "riding the brakes" without knowing it, creating ongoing problems for your long-term wellness and well-being.
For example, many of us are not aware that lack of regular vigorous exercise results in a slowing down of our metabolism. Without such exercise, our daily metabolic processes simply do not operate at peak levels. In the absence of critical energy demands imposed by regular vigorous exercise, a low level steady state takes over. Fat cells accumulate, reflexes dull, and our overall sense of awareness deteriorates. But your body is a finely crafted machine and it is designed to fulfill very high performance metrics. The aphorism, "what you don't use, you lose" applies specifically to human physiological performance. Without regular vigorous exercise, you're riding your physiological brakes and your body systems will degrade accordingly.

The good news is that these entropic effects can be reversed. Our bodies are dynamic and remarkably adaptive. Beginning or renewing an exercise program will quickly result in noticeable benefits. Many people will begin observe such benefits within four to six weeks. The important health benefits derived from regular vigorous exercise include slowing of the heart rate, increased capacity of the heart to pump blood, increased capacity of the lungs to take in oxygen, accumulation of lean muscle mass, increased creative abilities, increased ability to focus and perform useful work, and improved restful sleep.

These benefits all derive from any basic exercise program that includes some form of strength training and some form of cardiovascular exercise. Thirty minutes per day, five days a week, is the recommended standard. A program that incorporates three days of cardiovascular exercise and two days of strength training, or three days of strength training and two days of cardiovascular exercise, will be sufficient to derive maximum results. Cardiovascular exercise includes walking, running, swimming, bicycling, cross-country skiing, and sports such as basketball and lacrosse. Strength training should comprise routines including exercises for the chest, back, shoulders, arms, and legs. Certain forms of exercise such as yoga simultaneously incorporate strength training and cardiovascular exercise.

Most important is the consistency of exercise. What works for one person may not work for another. Find the types of exercise that you like to do and want to do and keep going. There will be times when you need to take a break for a week or two. Trust your instincts and return to your exercise program as appropriate. Encourage your family members to participate so that everyone can achieve peak performance, health, and wellness.
Dr. Parrish Skrien is a licensed Chiropractor serving the Mankato community.
Dr. Parrish Skrien has been freeing people from pain in the clinic in Mankato, MN. As a Chiropractor with experience, Dr. Skrien is committed to promoting optimal health and well being of  patients.
Be sure to Like us on Facebook, here is our link https://www.facebook.com/#!/pages/Skrien-Chiropractic-Clinic/332196071132
Dr. Skrien uses a "whole person approach". This approach to wellness means looking for underlying causes of any disturbance or disruption (which may or may not be causing symptoms at the time) and make whatever interventions and lifestyle adjustments that would optimize the conditions for normal function. Using this unique approach, Dr. Skrien is able to help you to accelerate and/or maintain your journey to good health.
Dr. Skrien has been in practice since 1993, and is a graduate of Palmer College of Chiropractic. He is a Certified Medical Examiner for DOT Exams #3288071785, and specialises in the Gonstead Technique.  He has been in the Mankato area since 1996, and in his current location since 2005. He is dedicated to helping his patients reach their optimum health in a drug free manner. He treats patients of all ages from newborns as young as a day old to patients in their 90's. He has a number of athletes under care ranging from grade school, high school, college, and the weekend warriors. He has helped some of them get to their personal best including  try outs for the Olympic games, and pro baseball

Zeno, Achilles, and the Tortoise

Regular Chiropractic Care and Long-Term Wellness

When you are engaged in the process of enhancing your overall health and well-being, it's important to pay attention to the details. This implies taking care of what's going on beneath the surface as well as what you may easily notice and observe. As most of us know, when we finally become aware of symptoms, that particular disease process has been going on for quite a while. For example, dizziness and nausea in a person over the age of 50 may likely represent undetected, and therefore unmanaged, high blood pressure. Similarly, the onset of sciatica usually represents the final outcome of a longstanding process of spinal nerve irritation and spinal joint dysfunction. Chiropractic care is a unique method of health care that investigates the causes of a person's biomechanical symptoms, analyzing and detecting the spinal nerve and joint progenitors of such problems. Regular chiropractic care helps reduce nerve interference and restore spinal function, thus helping you and your family attain greater levels of health and well-being.

The Eleatic philosopher Zeno, writing almost 2500 years ago, famously propounded several paradoxes purportedly proving that various conceptions of the physical universe were false. The most famous of these involves the Greek hero Achilles and a tortoise, stating that if the tortoise started ahead of Achilles in a race, the fleet-footed Achaean warrior could never catch the plodding turtle. Zeno also claimed to prove that a moving arrow is actually at rest. His main purpose was to defend the philosophy of the "one" of his great teacher, Parmenides, as against the "many" of competing philosophies such as those of Empedocles, Anaxagoras, and Democritus. Parmenides wished to demonstrate that reality is a unity, and that the world as interpreted by the senses is unreal. Zeno's paradoxes have stumped many thinkers over the ensuing millennia. The main flaw in his brilliant puzzles is that he blurred the distinction between "discrete" and "continuous" phenomena. We can put the solutions to Zeno's paradoxes to work in our understanding of the best method by which to approach our philosophy of exercise.

Many of us prevent ourselves from beginning an exercise program by focusing on the daunting perspective of the necessity of doing exercise for one's entire life. We allow the enormity of the ongoing, continuous nature of such an enterprise to deflate our resolve. The result of this flawed point of view is that we stop ourselves before we can even get started. But if we radically modify our interpretation of the "continuous" nature of the work to be done and instead approach our exercise activities from the "discrete" standpoint, we would then be able to take each exercise session on its own merits. Whole and complete in itself, today's exercise only needs to be done today. Tomorrow's exercise, which when it arrives is now "today's" exercise, is done similarly. Do today's work today. Over time, the discrete method results in a continuum of results. We accomplish our long-term goals step-by-step, giving our full attention, focus, and concentration to what needs to be done right now, today.^1,2

Once we become willing to take on this deeper understanding of the nature of the process of exercise, the next step is to investigate and choose our preferred types of exercise activities. The good news is that, other than making sure we're doing both cardiovascular and strength training exercises, the specific type of exercise doesn't matter. As long as we're doing some form of cardiovascular exercise on a regular basis, whether we run, walk, swim, bike, or cross-country ski is up to us. Similarly, as long as we're doing some form of strength training on a regular basis, whether we use kettle bells, medicine balls, or a combination of free weights and stationary equipment is our choice. The key, overall, is to avoid Zeno's critical error, and be well aware of the distinction between "discrete" and "continuous" events. This empowering distinction will be of value, not only in terms of exercise, but in all aspects of life.³


1Innes KE, Selfe TK: Yoga for Adults with Type 2 Diabetes: A Systematic Review of Controlled Trials. J Diabetes Res 2016;2016:6979370. doi: 10.1155/2016/6979370. Epub 2015 Dec 14.


2Skórkowska-Telichowska K, et al: Nordic walking in the second half of life. Aging Clin Exp Res 2016 Jan 23. [Epub ahead of print]


3Haider T, et al: Yoga as an Alternative and Complementary Therapy for Cardiovascular Disease: A Systematic Review. J Evid Based Complementary Altern Med 2016 Jan 19. pii: 2156587215627390. [Epub ahead of print]

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The Platonic Ideal

Regular Chiropractic Care and Ongoing Wellness

Regular chiropractic care is an important component of any health, fitness, and wellness program. Whether you're engaged in upgrading your diet, beginning or enhancing a program of regular, vigorous exercise, or launching a meditation or awareness practice, regular chiropractic care helps provide the physiologic framework by which you can achieve the greatest benefit from your wellness activities. In order to derive optimum benefit from your diet, fitness, and wellness programs, your nerve system must be functioning at peak capacity. Your nerve system is your body's master system. Accurate and timely flow of information is required between your nerve system and other systems, such as your digestive, hormonal, and cardiorespiratory systems. Interruptions in the flow of these signals or miscommunications will prevent you from obtaining maximum value from your healthy diet and exercise activities. By detecting and correcting spinal misalignments that cause nerve irritation, regular chiropractic care helps ensure that all your body systems are working together in harmony. As a result, regular chiropractic care helps you and your family achieve long-term health and well-being.

Plato's Ideas were perfect templates, of which everything we perceive are tangible representations. But the Ideas were not to be found in the world around us. Rather, they were conceptions of rational thought, transcendental objects of knowledge existing in a realm beyond our own. And yet, Plato's Ideas continue to be a source of inspiration and wonder, more than 2400 years after he first described them. These ethereal notions continue to function as critical guideposts, significant markers along our various life journeys, standing for ideal outcomes we are striving for and hope to achieve.
For example, we all have our own ideal image of what physical fitness is supposed to look like. These ideal images may vary from person to person, but each image ultimately derives from a Platonic Idea of physical human beauty, strength, and musculoskeletal proportion. Our conundrum, if we care about health, wellness, and fitness, is how we're going to go about achieving our ideal. As we proceed along our path to optimal physical fitness, it's very important to keep in mind that the Idea, as such, is not an actual part of our world. We will fail if we seek to achieve such perfection. A reasonable goal is to do what needs to be done and continue to do our best in all such endeavors.
A primary major access to physical fitness is starting and maintaining a healthy, nutritious diet. Such a diet involves making consistent choices from all of the five food groups, that is, fruits, vegetables, grains, protein foods, and dairy products. Each of us has our own specific preferences, and some of us may have specific requirements, such as being gluten-free or lactose-free, but the requirement for variety and obtaining the nutrition provided by each group remains the same for everyone. Importantly, international health agencies strongly recommend eating five portions of fresh fruits and vegetables every day. In the United States, this recommendation has been termed, "Five to Stay Alive".
A healthy diet, maintained over months and years, provides across-the-board benefits for fitness and wellness. When combined with a program of regular vigorous exercise, healthy eating results in conversion of unneeded fat to lean muscle mass, weight loss, and an enhanced sense of well-being. Research consistently demonstrates that a healthy diet reduces the risk of high blood pressure, heart attack, and stroke.¹ A healthy diet reduces the risk of cancer, diabetes, and obesity.² Thus, a healthy diet not only helps us achieve our own representation of the Platonic Idea of physical fitness. A healthy diet helps us achieve our own demonstration of other important Platonic Ideas, those of happiness and harmony.^3
1Koutsos A, et al: Apples and cardiovascular health--is the gut microbiota a core consideration? Nutrients 7(6):3959-3998, 2015
²Esposito K, et al: A journey into a Mediterranean diet and type 2 diabetes: a systematic review with meta-analyses. BMJ Open 2015 Aug 10;5(8):e008222. doi: 10.1136/bmjopen-2015-008222
³Richard A, et al: Associations between fruit and vegetable consumption and psychological distress: results from a population-based study. BMC Psychiatry 2015 Oct 1;15(1):213. doi: 10.1186/s12888-015-0597-4

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Dr. Parrish Skrien has been freeing people from pain in the clinic in Mankato, MN. As a Chiropractor with experience, Dr. Skrien is committed to promoting optimal health and well being of  patients.
Be sure to Like us on Facebook, here is our link https://www.facebook.com/#!/pages/Skrien-Chiropractic-Clinic/332196071132
Dr. Skrien uses a "whole person approach". This approach to wellness means looking for underlying causes of any disturbance or disruption (which may or may not be causing symptoms at the time) and make whatever interventions and lifestyle adjustments that would optimize the conditions for normal function. Using this unique approach, Dr. Skrien is able to help you to accelerate and/or maintain your journey to good health.
Dr. Skrien has been in practice since 1993, and is a graduate of Palmer College of Chiropractic. He is a Certified Medical Examiner for DOT Exams #3288071785, and specialises in the Gonstead Technique.  He has been in the Mankato area since 1996, and in his current location since 2005. He is dedicated to helping his patients reach their optimum health in a drug free manner. He treats patients of all ages from newborns as young as a day old to patients in their 90's. He has a number of athletes under care ranging from grade school, high school, college, and the weekend warriors. He has helped some of them get to their personal best including  try outs for the Olympic games, and pro baseball.