Archive for the ‘Exercise’ Category

Closest Thing to a Wonder Drug? Try Exercise

October 25, 2016

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After I wrote last year that diet, not exercise, was the key to weight loss, I was troubled by how some readers took this to mean that exercise therefore had no value.

Nothing could be further from the truth. Of all the things we as physicians can recommend for health, few provide as much benefit as physical activity.

In 2015, the Academy of Medical Royal Colleges put out a report calling exercise a “miracle cure.” This isn’t a conclusion based simply on some cohort or case-control studies. There are many, many randomized controlled trials. A huge meta-analysis examined the effect of exercise therapy on outcomes in people with chronic diseases.

Let’s start with musculoskeletal diseases. Researchers found 32 trials looking specifically at the effect of exercise on pain and function of patients with osteoarthritis of the knee alone. That’s incredibly specific, and it’s impressive that so much research has focused on one topic.

Exercise improved those outcomes. Ten more studies showed, over all, that exercise therapy increases aerobic capacity and muscle strength in patients with rheumatoid arthritis. Other studies proved its benefits in other musculoskeletal conditions, like ankylosing spondylitis, and even some types of back pain.

For people (mostly middle-aged men) who had had a heart attack, exercise therapy reduced all causes of mortality by 27 percent and cardiac mortality by 31 percent. Fourteen additional controlled trials showed physiological benefits in those with heart failure. Exercise has also been shown to lower blood pressure in patients with hypertension, and improve cholesterol and triglyceride levels.

People with diabetes who exercise have lower HbA1c values, which is the marker of blood sugar control, low enough to probably reduce the risk of complications from the disease. Twenty randomized controlled trials have showed that patients with chronic obstructive pulmonary disease can walk farther and function better if they exercise.

Multiple studies have found that exercise improves physical function and health-related quality of life in people who have Parkinson’s disease. Six more studies showed that exercise improves muscle power and mobility-related activities in people with multiple sclerosis. It also appeared to improve those patients’ moods.

The overall results of 23 randomized controlled trials showed that exercise most likely improves the symptoms of depression. Five others appear to show that it improves symptoms in patients with chronic fatigue syndrome. In trials, exercise even lessened fatigue in patients who were having therapy for cancer.

What other intervention can claim results like these?

Even studies of older, hospitalized patients show a beneficial effect from multidisciplinary interventions that include exercise. Those randomized to such interventions in the hospital were more likely to be discharged to go home, and to spend less time in the hospital over all — and at a lower cost.

Although we don’t think of it this way, you can make a pretty good argument that exercise is as good as drugs for many conditions. A 2013 meta-analysis of meta-analyses (that’s how much data we have) combined and analyzed the results from 16 reviews of randomized controlled trials of drug and exercise interventions in reducing mortality. Collectively, these included 305 trials with almost 340,000 participants.

Diuretic drugs (but not all drugs) were shown to be superior to exercise in preventing death from heart failure. But exercise was found to be equally good as drugs in preventing mortality from coronary heart disease. Exercise was better than drugs in preventing death among patients from strokes.

Many people will be surprised at how little you need to do to achieve these results. Years ago, in an effort to get in shape, I tried the P90X routine. It proved too hard for me. Later, when I tried the Insanity workout, it beat me so badly that people at work kept asking me if I was ill. Two years ago, I tried P90X3. It was a bit more manageable, but I still couldn’t keep it up.

I have not been alone in thinking that physical activity to improve health should be hard. When I hear friends talk about exercising, they discuss running marathons, participating in CrossFit classes or sacrificing themselves on the altar of SoulCycle. That misses the point, unfortunately. All of these are much more than you need to do to get the benefits I’ve described.

The recommendations for exercise are 150 minutes per week of moderate intensity physical activity for adults, or about 30 minutes each weekday.

Moderate intensity is probably much less than you think. Walking briskly, at 3 to 4 miles per hour or so, qualifies. So does bicycling slower than 10 miles an hour. Anything that gets your heart rate somewhere between 110 and 140 beats per minute is enough. Even vacuuming, mowing the lawn or walking your dog might qualify.

Today, my goals are much more modest. Trekking from my office to the clinic and back again gives me 30 minutes of exercise. Or, I walk to the supermarket from my office to grab lunch, at a mile each way. In colder weather, I spend half an hour on the elliptical machine. Doing this five days a week gets me the activity I need.

Although it feels as if there’s nothing we can do to change people’s behavior, there is evidence to the contrary. A systematic review and meta-analysis of advice and counseling by health professionals found that promotion of physical activity works.

Doctors and clinics that made efforts to promote exercise to patients needed to engage 12 adults on the subject to get one additional adult to meet recommended levels of activity one year later. That might not sound impressive, but it’s one of the better such results.

After the Academy of Medical Royal Colleges wrote its report, an editorial in the BMJ, a prominent medical journal, countered that exercise wasn’t a “miracle cure.” Instead, the authors argued it was “the best buy for public health.”

If that’s the best “counterpoint,” then physical activity seems like a no-brainer.

Article sourced here:
http://www.nytimes.com/2016/06/21/upshot/why-you-should-exercise-no-not-to-lose-weight.html

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Glen Barnett discusses Exercise as Medicine

August 2, 2016

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Here is a concept that I really want you to consider, I want you to view exercise and being active as medicine, a dose of goodness to manage your health, weight and wellness.  It has been proven over and over that as a preventative measure to ill health and as a ‘cure’ for a lot of ailments, exercise is the best medicine around.

So if we know that this ‘medicine’ called exercise can have such a positive effect on our well being then why isn’t everyone taking their daily dose?   Who knows maybe fear, laziness or indecision?  Here’s some help.

Start with a goal and see your goal as being your dessert – something you’re really looking forward to but you need to earn it.   Get to your goal in small bite size pieces. If your goal is to drop 20kg then plot some smaller increments in your calendar rather than the big figure down the track.

Make sure you get your exercise dosage correct so get some guidance.  It is important to know how much exercise should be ‘absorbed’ to give you the maximum benefit for your goal.  Exercise should be prescribed in a specific dose you know that works for you including type, intensity, frequency and duration.  Definitely sample different types of exercise medicine, until you’ve found what ‘medicinal remedy’ fits best with you or is easiest to swallow.   Basically make sure the exercise you ‘take’ is something you enjoy and something that is going to help you get to your goal.

Make a commitment to your health, yourself and your future. Taking a daily dose of exercise medicine in some way nearly every day will lead to a positive lifestyle change and a very healthy habit

So if you decide you want to get a dose of one of the best medicines for your health, call me, “Dr” Glen, at Coffs Coast Health Club on 66586222 and we can organise a FREE prescription to get you started.

 

Fitness starting with your Feet

November 29, 2015

Our feet and ankles are very important, considering we couldn’t stand, walk, run, or roundhouse kick someone in the face without them. Unfortunately, our lower limbs tend to be neglected unless something goes wrong.

Strong and flexible feet, ankles, and calves provide our base for stable movement, and are essential for performing our daily activities without pain or strain. In this article, I will give you a brief introduction to the the basic anatomy and movements in the ankle and foot (just enough for a good familiarity, but not enough for you to perform surgery…). Then, I’ll discuss the primary importance of working on this area, and finally, how to incorporate exercises for these areas into your training routine.

Your lower leg is made up of the bigger tibia on the inside and the smaller fibula on the outside, then connects lower down to the talus and the calcaneus (heel), then to the five small bones of the instep and the metatarsals and phalanges (your toes).

Lots of different sized ligaments connect the bones together for stability, along with various muscles from the big calf to the small muscles that move your toes.

Foot Anatomy

The ankle and foot is made to move in a great variety of angles to provide stability and dexterity, carrying us over all types of terrain from soft sand to rocky ground. Your ankle is not like a hinge on a door, and your foot isn’t just one big lump you slide your socks onto.

All the large and small joints in this area work together to provide this nimbleness, but only if we keep them moving like they are supposed to!

Your Lower Legs Work Hard for You – Here’s What They Do

Jump RopeOur calves (the bigger gastrocnemius and smaller, deeper soleus muscles) point the foot down, giving us the power to rise up on our toes and assist with running and jumping. But even with the foot flat on the ground, our calves provide stability in squatting, lunging, and other big movements.

On the front and sides of the shin are the anterior tibialis, posterior tibialis, and peronei muscles, which provide stability like stirrups and slings, and also the fine motor control that keeps us balanced and steady.

Down into the foot are many small muscles that control our arches and toes. These foot intrinsic muscles are the most at risk for atrophy from disuse when we don’t actively get out of our shoes and move our feet as we’re meant to do.

What Can Go Wrong in the Foot and Ankle

With all this considered, it’s easy to see the complexity of large and small muscles and joints working together to keep us upright and walking, as well as running, jumping, and balancing.

The coordination and differentiation of all these possible movements is key to foot and ankle control, and to moving freely and gracefully through your feet.

It’s also likely why we hear so many complaints about stiff ankles and feet.

If the smaller muscles are too weak to support your foot and ankle, your body reacts by increasing the tension where it can, in the bigger muscles. The tightness in the calf and ankle is then a protective mechanism that stretching may help a bit, but improved control and strength in the foot would solve.

Another common issue people experience is collapse arches in the feet. This is caused by poor mobility in the midfoot, along with weak posterior tibialis and intrinsic muscles. With improved mobility and strength in these areas, the arches should correct themselves over time.

Below we’ll discuss a variety of exercises with an emphasis on coordination and dexterity to wake up dormant muscles and restore proper mobility and control over this important area.

8 Exercises for Building Strength and Motor Control in the Feet and Ankles

The exercises we show here have an emphasis on active movement in various angles and ranges of motion.

A lot of people don’t fully explore the movement our feet and ankles are capable of, and this results in stiffness and weakness. The first step is knowing that it is actually possible to move this way, and the next and best step is to practice!

 

Below, we’ll look at each of these exercises in detail so you can understand the mechanics and benefits of each exercise, as well as programming recommendations.

1. Foot Circles with Toes Flexed (Curled)

Foot 1This movement concentrates on the small muscles in the arch of the foot. These foot intrinsicssupport the foot, and control over them means improved control and dexterity, which is so important in graceful and athletic movement.

It’s a simple movement – it’s just making a circle! – but the addition of flexing your toes makes this surprisingly difficult and can lead to muscle cramping in the beginning. Start off by not flexing your toes strongly and do the circles slowly.

Do 10-15 reps in each direction for 2-3 sets.

2. Toe and Ankle Movement Coordination

Foot 2Here is another simple movement that works on coordinating the use of the muscles of the lower leg and foot. Simply lift your foot up and down through your full range of motion and add the toe movements with it as well.

The coordination is toe extension (lifting toes upward) as you lift your foot upward, and toe flexion (curling in) as you point your foot down. And the other variation is then flexing your toes down as you lift your foot upward, and extending your toes as you point your foot down.

Do 10 repetitions of both variations for 2 sets.

3. Diagonal Patterns

Foot 3These are combined motion patterns of either your foot lifting up and rolling inward and then pointing down and outward; or your foot lifting up and rolling outward and then pointing down and inward. You are essentially tracing an X with your foot as you work on the coordination of ankle and foot motions.

This can be another surprisingly difficult exercise and is extremely useful for learning how your ankle can move.

Do 10-20 reps for 2-3 sets.

4. Rolling up Onto the Toes

Foot 4This is the first exercise where we are putting weight onto our feet.

The goal here is to combine a loaded active stretch to the ankle and foot together. It’s a dynamic move, so don’t hold too long in any position, instead go slowly through the full range and back again to encourage active movement through all the positions.

Do 5-8 reps for 3 sets.

5. Squats with Ankle Rotation

Foot 5In this exercise, don’t worry if you can’t drop down into the full deep squat position. The purpose of this exercise is to practice rolling on the inside and outside of your feet while weightbearing in a “compromising” position.

If you were to run and unexpectedly roll onto the side of your foot, you’d likely get a nasty ankle sprain. The exercise shown here is a progressive way to practice these common stresses to your feet and ankles. You can control the pressure and stress of the movement and use it to strengthen these positions to make it less likely to be severely injured when it unexpectedly happens.

Do 5-8 reps for 3 sets.

6. Ankle Rolling Side-to-Side

Ankle RollingHere we move to standing and up on the ball of the foot as we practice rolling our ankle from side to side.

Again, it’s better to do this while we are controlling the forces so we can strengthen them, rather than having it happen randomly and possibly causing injury.

Do 5-8 reps for 3 sets.

7. Weightbearing Ankle Circles on the Heel/Ball of Foot

Foot 7Continuing in standing, we’ll now practice ankle circles while placing as much weight as we are comfortable with on either our heels or on the ball of the foot.

There are different forces and strains involved in the two variations, so it’s good to familiarize yourself with both.

Do 10 reps in each direction for 2 sets.

8. Calf Raises

Calf RaisesAnother classic exercise, this is the most direct way of strengthening the calf muscles in their full range of motion from a full stretch to a full contraction. You can adjust your intensity by how much you hold on with your hands and by eventually adding weight to your body through a backpack or holding dumbbells.

If this is too much for you, then work both feet at the same time or start on a flat floor versus a step to reduce the range of motion until you get stronger and can handle strengthening from the full stretch.

Do 8-12 reps for 3 sets.

Fundamental Calf Stretches for Flexible Lower Legs

Calf StretchA very common complaint we hear from people is their lack of ankle flexibility.

Many bodyweight exercise moves, especially as you move into intermediate and advanced work, such as the pistol squat and various locomotive patterns, require good ankle flexibility.

The calf muscles are a very dense muscle group because we use them constantly – even just in standing and walking. And the ankle joints,  because of the lack of variety of motion throughout the day, tend to be stiff and immobile. This can require aggressive stretching, in terms of load, not intensity, to achieve improvements in range of motion.

A classic and effective exercise is using a step or sturdy block for your foot so you can drop your heel down to stretch.

It’s simple, not fancy, but works extremely well if you are consistent and approach it the right way. I recommend doing this in shoes, in this way you can place the middle of your foot on the edge of the step comfortably for the stretch. This is protective of your foot arch and allows you to put more weight into the stretch.

 

The variations are with your knee locked out straight and with your knee bent. The straight leg version emphasizes more of a gastrocnemius stretch, and the bent knee version gives the calf muscles a bit of slack and thus puts more of a stretch in the ankle joint.

The calf responds well to long holds of stretching, so 1 to 2 minutes for 3 sets should be a minimum goal. Stretch before active movement such as the strength and motor control exercises above so that your body learns to adjust and retain the new range of motion from the stretching.

Self-Massage Techniques for Healthy Feet, Ankles, and Calves

Self MassageA bit of self massage work is very useful in the lower leg and foot to loosen some tension prior to stretching and exercise.

The massage itself doesn’t make you more flexible, but it does temporarily help you feel less tight and gives you a window of opportunity to stretch further with less discomfort.

Just make sure not to overdo it, the trick is to apply just enough pressure to ease tension, not push as hard as you can to force it to happen!

 

Starting at the foot, work along the sole along the contours of the bones and feel the small muscles in you feet, keep the pressure light at first then gradually increase the pressure. If you are doing it correctly you’ll notice an easing off of tension in the muscles. You can then add more pressure and continue if you feel you need it, or move on to the next area.

Move on to the sides of your shin, into the calf and the front of your shin. The calf can be especially sore to massage deeply, so be aware of this and go gradually until you get accustomed to the pressure.

You can also use a ball to change the pressure and get into the muscles from a different angle.

Along with being mindful of gradually increasing pressure, you should limit your time on self massage to no more than 5 minutes. Too much of a good thing is still too much. And it is much more valuable to spend the majority of your time on active exercise.

Keep Your Feet Healthy for a Lifetime

Our ankles and feet are too often under-exercised and taken for granted considering how much we rely on them everyday. It’s no surprise that this neglect of their full range of motion and total potential for coordinated movement can lead to stiffness and weakness, and perhaps even pain.

This article focused on simple, yet effective exercises that not only lessen the chances of potential injury, but may also reverse some damage that has already been done (barring any true injuries in need of surgery or more intensive therapy).

Spend 5-10 minutes on these exercises every day, and you’re likely to feel your feet getting stronger, more flexible, and more able to handle variations in movement.

 

Article Sourced from: https://gmb.io/feet/

 

Top tips for getting fit (if you’re not much of an athlete)

September 13, 2015

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If you’re not much of an athlete right now, here are some ideas to help you get in shape.

Your running shoes/tennis racquet/softball glove/high-school sports trophy collection are tucked into the back of some closet, quietly gathering dust. Nowadays your main form of exercise is walking between the couch and the fridge. You’re handier with the remote than you are with a racquet.

And yet … you’d like to be in better shape. Maybe even train in a particular sport. Maybe even compete in the Senior Games. Crazy, right — at your age?

Nope. You’re never too old for physical activity, said Mary Frances Visser, a professor of human performance at Mankato State University who researches the effects of exercise on older adults.

“Physiologically there are no real limits,” said Visser, an associate editor for the Journal of Aging and Physical Activity. “You’re limited by your own physiology in certain ways, but in terms of saying ‘Nobody over the age of 60 should ever do X’ — that’s nuts.”

Aging itself can bring upon a desire for better health, said Gary Westlund, founder and president of Charities Challenge, a nonprofit that sponsors races focusing on health issues.

“It’s a very common experience that people, when they get into their 60s and even 70s, one of their motivations is, ‘I want to be a better man this year than I was last year,’ That includes, of course, ‘I want to be healthier, fitter, I want to run faster, row faster,’” said Westlund, who is certified as a health and fitness specialist by the American College of Sports Medicine (ACSM).

Exercise is especially important as you get older because physically fit people are better able to cope with, and heal from, health challenges that accompany aging.

Even if you’re already experiencing some of those challenges — even if you basically haven’t risen from the couch since George Bush Sr. was president — it is possible to get back what you have lost.

Visser knows a woman who “was a total couch potato all of her life” until, at 55, she decided to compete in the Senior Games in the 50-yard dash. She spent a year training and eventually “wound up medaling in the 100-yard dash in the National Senior Games.”

Westlund met an 85-year-old runner at his organization’s Challenge Aging 5K race last fall.

“It was his first road race I believe, or one of his first road races. He had taken up running at 83. He had the fastest 5K time in Minnesota last year — at any 5K — for a man 85 or older.”

This year’s Minnesota Senior Games are May 28 to 31 — probably too tight a deadline if you’re just now lacing up a new pair of sneakers. But you could start training for next year, Visser said. (And next year’s state games are qualifiers for the nationals.)

If you have a medical condition — high blood pressure, diabetes, heart history problems, joint disease — check with your doctor, Westlund said. Otherwise, women up to age 55 and men up to 45 can probably start doing light to moderate exercise without the doctor’s green light. Information about aging and physical activity is available at the ACSM’s website (www.acsm.org), the National Institutes of Health’s Senior Health site (www.nihseniorhealth.gov/exerciseforolderadult) and the National Institute on Aging’s site (www.nia.nih.gov/health/publication/exercise-physical-activity/introduction).

When you first start, don’t expect to whip yourself into shape in a week. “The human body at 20 and the human body at 50 are very different,” Visser said. “You can really, really hurt yourself if you do too much too soon.”

Visser recommends starting with five minutes of activity and working up to eight, then 10 and on up to at least 30. Add weightlifting, stretching and so on to regain muscle mass, flexibility and balance.

Article sourced here:  http://www.startribune.com/lifestyle/goodlife/300831881.html