Keystone Behaviors

The concept of keystone behaviors may be the most important concept which you may read today. We live in a day and age in which the majority of people are dehydrated, sleep deprived, and simultaneously over-fed and malnourished. Imagine how impactful any of these factors, let alone the combination of all three, are on your health and the presence of your headaches.


When working with patients, many layers exist to an effective treatment plan. Perhaps the most powerful layers of any treatment plan are the behaviors we are performing in our daily lifestyle. Even more important are several keystone behaviors which are necessary for someone to maintain in their daily routine either as the primary intervention or the foundation for any additional treatments to be effective.

Your Top 2

With our thorough understanding of the importance of behavior, especially those keystone behaviors which have an unbelievable effect on how well the human body operates, we developed Your Top 2 to support an efficient and effective addition of behaviors which can have the highest level of impact on health. We direct our patients to read through a list of behaviors which have been shown to have high importance and impact on individual’s health. They are then instructed to choose two behaviors to add to their daily routine which are followed diligently for a set period of time. This time does not have to be equal to their calculated trial of therapy duration. Some patients rotate through several different combinations of behavioral change prior to determining their unique keystone behaviors.


Before embarking upon this process an important consideration is to have objective measurements (or objectifiable metrics) both before and after the behaviors are added to your lifestyle. This measurement is highly specific to what your goals in pursuing any level of treatment may be. Some common measurements assessed include:

  • headache frequency – daily, constant, occasional, time of the day
  • headache pain – 0-10 scale with 10 being the worst pain imaginable
  • sleep quality
  • overall energy
  • overall mood

Many other aspects can be measured, just make sure that it is what is important to you. Tracking on a chart is recommended.


The behaviors that we have identified for Your Top 2 Program have all been found to have a profound impact on many who follow through with the recommendation.  This is one reason why adding the appropriate behaviors before pursuing any other treatment is so very powerful. The changes that many experience end up being the entire treatment program or the foundation which a successful program is built. It is important to set a period of time in which you will fully implement the chosen behaviors on a daily basis. This doesn’t have to be months or even weeks, many times we are asking people to make the change for anywhere from 5 to 10 days.


5 Keystone Behaviors

We tend to have five top-level behaviors which we can add to our lives, if they are not already present, which can create truly dramatic results. These behaviors include:


9 Glasses of Water for 9 Days

Many people are spending the vast majority of their days fighting the effects of widespread and perhaps subtle dehydration and dealing with the severe performance compromises which are invariably present. The human body is mostly water. Maintaining this high proportion of water within our bodies is constant work. Drinking a couple glasses of water throughout the day unfortunately just doesn’t do the trick. An even bigger challenge is the fact that so many people are considering soft drink and diet soft drink consumption to count towards daily water intake needs, which unfortunately are likely moving you further towards dehydration. We like to see people commit a specified period of time such as nine days to drinking at least nine glasses of water per day. The cool thing about this level of water intake is that it many times decreases the desire for, or flat out takes the place of, the soft drinks that may have been such a large part of your previous daily routine.


9 Hours of Sleep for 9 Days

Modern life many times creates a situation in which we feel we need more hours in the day. Unfortunately the most common place we get these hours from is by sleeping less. Researchers have found that as we become sleep deprived, levels of productivity and quality in work and play drastically decrease. Additionally the long-term health effects are devastating. While optimal sleep levels can vary dramatically from person-to-person, it is important that when people are doing a trial focusing on increasing the amount of sleep we feel it’s best to aim for nine hours of sleep each and every night. It is also important to note that while many people might be in bed for nine hours the widespread use of multiple mobile devices and watching TV right up until the time you decide to call it a night has a powerful stimulating effect on the brain. This effect has been clearly shown to delay the onset of sleep and is so powerful that even once you are sleeping your brain waves have difficulty shifting to those necessary to benefit from the powerful restorative benefits of restful sleep. It is best to discontinue the use of screens at least 1 hour or more prior to going to bed.


Move Your Body and Sweat for 6 Days

The power of exercise cannot go unstated. Be sure to check with your healthcare practitioner to be sure you can tolerate the following behavior change. Realistically speaking it doesn’t even take that much time in order to make a big difference. If you haven’t exercised in the last 10 to 15 years, starting out with a brisk walk around the block might be the perfect level of intensity for you. If you have been walking for a long time maybe it’s time to add in some resistance activities. Lifting weights or just doing push-ups can have a dramatic effect on long-term health as researchers have demonstrated those with the most lean tissue mass (muscle) age the most gracefully, have dramatic risk reduction of nearly every disease, and are able to enjoy health throughout their golden years.


We very commonly hear from people that they don’t have enough time to consistently exercise. They’ve got kids, careers, responsibilities, and many other excuses. The great part is you really don’t need that much time to benefit from exercise when you do it the right way. The concept of intervals has been around for many years but unfortunately most don’t understand how to properly leverage the massive results which can be seen from shorter periods of time committed. We know that one minute of intense exercise, as generally seen during interval exercises, may yield the same benefit as 45 minutes of aerobic activity.


When we recommend interval style exercise the entire workout including warm-up and cool down, takes about 20 minutes. It consists of a five minute warm-up performing the activity of your choice – it can be biking, running, swimming, jumping jacks, rowing, or anything else your heart desires. You then follow with up to six sets in which you perform the activity for 30 seconds at 100% effort and follow it up with 60 seconds of active rest (preferably continuing to do the activity you’ve chosen but if you need to completely stop that’s okay too). After you have repeated the 30 seconds of 100% effort followed by 60 seconds of rest six times you then do the same activity for a cool down period of five minutes. This little exercise routine only takes 19 minutes and we can promise you that regardless of your level of fitness, you will be challenged. If you can’t do all six sets but still get your heart pumping, that’s a good start. The great thing about this approach is that 100% effort is purely subjective to you, not your neighbor, not a professional athlete, but you. As your fitness increases, your 100% effort will increase as well, but it will still be based on 30 seconds of work followed by 60 seconds of rest.


10 Minutes of Meditation for 10 Days

Every day we’re learning more and more about the power of meditation. The benefits of meditation are widespread but include things such as:

  • improved focus
  • less anxiety, stress, depression
  • improved overall emotional well-being
  • cardiovascular health


The aforementioned areas have widespread powerful impact on the health of the human body, so considering the addition of a meditative practice to your daily routine should not be an afterthought. There are many ways one can pursue a meditative practice. The methods to meditate vary tremendously and are numerous, so unless you already have comfort with meditation and have found something you like, it is important to have a good resource to guide you as you try something new. The people over at Headspace have a great tool for those looking for a bit of guidance while meditating. The way we like to test if this is going to bring you benefit is by having a commitment to daily meditation of 10 minutes for 10 days in a row.


Be Social 7 Days in a Row

This is an important behavior that a lot of people don’t think about. When researchers do epidemiological studies on communities, they find high levels of social interaction by the members’ community were most common amongst the populations with the highest level of health and happiness. In a day and age where most people’s social interaction is via text message, social media, email, or a quick phone call, it is important to remember that humans need personal interaction within their communities. Attending a local parade, getting all of your local friends together for that morning cup of coffee at the local coffee shop, going to your neighborhood picnic, or the many other opportunities which allow you to directly interact with your peers is something we feel is slowly going away in today’s society. If you look at yourself as a homebody or someone who is generally just communicating with everybody via electronic means, we challenge you to commit 1 hour each and every day for 1 week to social interaction with those closest to you in your community.


When determining which behaviors you are going to implement it is best to survey your current lifestyle to understand which are lacking the most. Once you have identified Your Top 2 you would like to implement, it is time to commit to the recommended timeline in order to fully vet how much impact your chosen behaviors may have on your life. After you have taken time to do Your Top 2, you can evaluate the effects of those behaviors. As noted earlier our four favorite aspects of health to monitor are pain levels, energy, mood, and sleep quality. We have even included a handy little chart for tracking the impact on them and any additional aspects you wish to monitor. If you don’t notice dramatic changes with your first trial of Your Top 2 don’t fret. Most people test a couple different combinations before they’ve determined what works best for them. However, at times there may be additional underlying metabolic health concerns which need more intensive treatment than behavior and lifestyle change alone. If this is the case for you, we’ve got some great stuff in store in the pages that lie ahead which will build upon the incorporation of your newfound healthy behaviors.


If you take the time to understand the behaviors which are the most important for helping you feel healthy and vibrant, the long term effect on your life is unimaginable. These simple behaviors are things you can do from the comfort of your own home, so why are you waiting? Today is the best time to start making a difference in tomorrow!

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