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The Power of Knowing Your Why

If you want to get fit or stay fit, you need a good motivator — a primary reason why you want to exercise, eat right, and live a healthy lifestyle.

I talk to people about this all the time. Active adults have powerful, compelling reasons why they lift weights, run, swim, take yoga, ride their bikes, and more. Here are just a few most often cited:

  • Playing with children/grandchildren
  • Reducing medication
  • Traveling
  • Sports and hobbies
  • Avoiding obesity, hypertension and falls
  • Social interaction
  • Better recovery from surgeries
  • Treatment of chronic conditions like Parkinson’s, diabetes and more
  • Being active without the risk of joint pain and hurting themselves
  • Do any of these strike a chord with you?

Any reason is a good reason. In fact, you don’t really even have to have one. Most people, however, need to remind themselves of what truly drives them to lead a healthy lifestyle. It can give you a boost when you’re not feeling motivated and it can guide your choices about how to spend your time and energy.

Knowing your deeper WHY leads to better results and a more vibrant life. Fully connecting with your why will motivate you to make better choices with how you eat and maintain your health. Many people are not aging well, but they are living longer, which means that their quality of life may be less than optimal. You have to ask yourself what’s more important to you right now. If you’re going to live a long life, you may as well live a healthy life.

Knowing your motivation is vital, but motivation can only get you so far. Your habits and daily routines are more powerful than motivation. Your motives for being healthy will help you get started on your goals, but your habits will get the results that you want. Think of it like this: You have to work regardless of whether you feel like it or not, right? You can apply the same reasoning with regards to your health. You must work towards good health and wellness regardless of how good or bad you’re feeling. When you discover the power of what good health, wellness and being fit can do for you, you’ll ask why you didn’t embark on your health journey sooner.

Bottom line, don’t let a lack of good health prevent you from living out your best years. Protect your brain health, improve your strength, lower your need for multiple medications. Good health leads to happiness and you deserve to happy. Find your motivation and strengthen your good habits as you eliminate the bad ones.


Ron Kusek is Transformational Wellness Coach & Holistic Chef. He is certified as a personal trainer through the National Strength & Conditioning Association, as well as holding certifications with the Institute of Transformational Nutrition as a Certified Transformational Nutrition Coach, and a Functional Aging Specialist with the Functional Aging Institute. Ron specializes in functional aging for mature adults; he runs a home-based wellness program for women 50+ called the Lean & Sexy Fitcamp. He’s working to change the lives of the community in the Antelope Valley in a positive, holistic way. 

Carbs-Bread

Sports Nutrition: Carbs in the News

Too many of today’s athletes believe carbohydrates are “bad.” If that’s true, what does the latest sports nutrition research say? The following studies, presented at the American College of Sports Medicine’s 66th Annual Meeting (Orlando FL, May 2019) indicate sports scientists agree that carbohydrates (grains, fruits, veggies; sugars, starches) can be health- and performance-enhancing sport foods. As you may (or may not) know, ACSM is a professional organization for sport science researchers, exercise physiologists, dietitians, doctors, and health-care providers for athletes (www.ACSM.org).  Here are some answers to questions posed by ACSM researchers.

Does sugar cause diabetes?

No. The problem is less about sugar, and more about lack of exercise. Most fit people can enjoy a little sugar without fear of health issues. Muscles in fit bodies burn the sugar for fuel. In unfit bodies, the sugar accumulates in the blood. Fitness reduces the risk of developing Type 2 diabetes.

In a 6-week training study to boost fitness, 35 middle-aged men with over-weight or obesity did either endurance cycling, weight lifting, or high-intensity interval training. Regardless of the kind of exercise, all types of training improved the bodies’ ability to utilize glucose with less insulin.

These subjects had blood glucose levels within the normal range at the start of the study; their glucose levels improved with exercise. While we need more research to fine-tune the types of exercise that best manage blood glucose, rest assured that living an active lifestyle is a promising way to reduce your risk of type 2 diabetes.

Can natural foods replace ultra-processed commercial sports drinks and foods?

Yes, standard (natural) foods can be fine alternatives to commercial sport fuels. Look no farther than bananas! In a study, trained cyclists who enjoyed bananas (for carbs) plus water (for fluid) during a 46 mile (75 km) bike ride performed just as well as those who consumed a sports drink with an equivalent amount of carbs plus water.

Natural foods offer far more than just fuel; they contain abundant bioactive compounds that have a positive impact on health and performance.  For example, after the ride with bananas, the cyclists had lower levels of oxylipins (bioactive compounds that increase with excessive inflammation) compared to the sports drink ride. Athletes who believe commercial sports foods and fuel are better than standard foods overlook the benefits from the plethora of bioactive compounds found in real foods.

Are potatoes—an easy-to-digest sports fuel—a viable alternative to commercial gels?

Yes. In a study, trained cyclists ate breakfast and soon thereafter competed in a 2-hour cycling challenge that was then followed by a time trial. For fuel, the subjects consumed either potato puree, gels, or water. The results suggest 1) both emptied similarly from the gut, and 2) potatoes are as good as gels for supporting endurance performance.

The cyclists completed the time trial in about 33 minutes when they ate the potato or the gel. This is six minutes faster than with plain water. Any fuel is better than no fuel!

Is fruit juice a healthful choice for athletes?

Yes, fruit juice can be an excellent source of carbohydrate to fuel muscles. Colorful juices (such as grape, cherry, blueberry, orange) also offer anti-inflammatory phytochemicals called polyphenols. In a study, subjects did muscle-damaging exercise and then consumed a post-exercise and a bedtime protein recovery drink that included either pomegranate juice, tart cherry juice, or just sugar. The protein-polyphenol beverages boosted muscle recovery better than the sugar beverage.

Does carbohydrate intake trigger intestinal distress for ultra-marathoners?

Not always. During a 37 mile (60-kilometer) ultra-marathon, 33 runners reported their food and fluid intake. They consumed between 150 to 360 calories (37-90 g carb) per hour, with an average of 240 calories (60 g) per hour. This meets the recommendation for carbohydrate intake during extended exercise (240-360 calories; 60-90 g carb/hour). The majority (73%) of runners reported some type of gut issues. Of those, 20% of the complaints were ranked serious. Interestingly, the GI complaints were not linked to carbohydrate intake or to gut damage. In fact, a higher carbohydrate intake potentially reduced the risk of gut injury. (More research is needed to confirm this.) Unfortunately, runners cannot avoid all factors (such as jostling, dehydration, and nerves) that can trigger intestinal problems.

We know that consuming carb during extended exercise enhances performance, but does it matter if endurance athletes consume a slow-digesting or a fast-digesting carbohydrate prior to extended exercise?

Likely not, but this can depend on how long you are exercising, and how often you want to consume carbohydrate. Well-trained runners consumed 200 calories of carbohydrate in UCAN (slow-digesting) vs. Cytocarb (fast-digesting) prior to a 3-hour moderate run during which they consumed just water. At the end of the run, they did an intense sprint to fatigue. The sprint times were similar, regardless of the type of pre-run fuel.

That said, the slow digesting carb provided a more stable and consistent fuel source that maintained blood glucose concentration during the long run. Hence, endurance athletes want to experiment with a variety of beverages to determine which ones settle best and help them feel good during extended exercise. A slow-digesting carb can help maintain stable blood glucose levels without consuming fuel during the run. Fast-digesting carbs need carbohydrate supplementation throughout the exercise to maintain normal blood glucose.

Concluding comments: These studies indicate carbohydrate can help athletes perform well. To be sure your muscles are fully fueled, include some starchy food (wholesome cereal, grain, bread, etc.) as the foundation of each meal. Consuming carbs from just fruit or veggies will likely leave you with inadequately replenished muscle glycogen. Think twice before choosing a chicken Caesar salad for your recovery meal.


Nancy Clark, MS, RD counsels both casual and competitive athletes at her office in Newton, MA (617-795-1875). Her newly updated Sports Nutrition Guidebook is now available in a new sixth edition. For more information, visit NancyClarkRD.com. For her popular online workshop, visit NutritionSportsExerciseCEUs.com.

apple-scale-weight-loss

To Weigh or Not to Weigh

Do you want to lose weight?

You might be asking should I weigh or not to weigh, that is the question. Whether ’tis nobler in the mind to suffer the slings and arrows of knowing one’s outrageous weight, or to take arms against a sea of bulges by simply ignoring the scale and trying to eat less and exercise more. For some of us, the scale is a tool. For others, it’s the enemy.

So let’s say your plan is to lose 1lb a Week.

Some health and fitness professionals have made a compelling case for ignoring the scale, saying that measuring one’s percentage of body fat is the most accurate way to track one’s fitness level.

It indicates a healthy body composition, regardless of height and weight. I agree that you should know your body fat as a baseline for fitness.

Here are some body fat guidelines according to the American Council On Exercise

Body Fat Percentage for Women

  • Athlete: 14-20 percent
  • Fit: 21-24 percent
  • Average: 25-31 percent
  • Obese: > 32 percent

Body Fat Percentage for Men

  • Athlete: 6-13 percent
  • Fit: 14-17 percent
  • Average: 18-24 percent
  • Obese: > 25 percent

So why bother weighing yourself at all? When you’re trying to lose weight, it’s important to use any indication you can get that your efforts are paying off. It can take a couple of weeks before you see any difference in body fat. Your weight will change more quickly. Besides, there are relatively inexpensive scales that give you both your actual weight and your percentage of body fat.

My personal prejudice is to weigh yourself at least once every week or two. I do, and I find that facing my weight on a regular basis helps me stay motivated. Believe me, there have been times when I’ve dreaded getting on that scale. But I do it anyway because no matter what it says, I feel relief. I find it liberating. Why? Because now I know where I am and what I need to do next. It helps me maintain a healthy weight.

In my practice, I have helped hundreds of people lose weight. And many of them initially fight me about getting on the scale, and I understand this because I know that terror. Part of the process of losing weight is to prepare oneself to do it. If you are not psychologically ready to lose, stepping on the scale can be a real turnoff and actually deter you from losing weight. But once you’re ready, facing that number can jump-start your weight-loss program and keep you going.

I give my clients a baseline of their body fat percentage and get them to use the scale. Then we set up a diet and exercise plan. You can lose weight by diet alone. But dieting can reduce muscle mass along with fat. This becomes ever more important as we age. We can lose as much as 6 pounds of muscle tissue per decade as we age. And metabolism can slow down as much as 3 percent per decade. You can see that if left unchecked, you’re on a slow boat to obesity. Adding an exercise program may be all you need to turn this process around. Cardio exercise burns calories, and strength training raises your metabolism and builds lean muscle mass while you are losing. Losing about 1 percent body fat a month and one to two pounds a week is considered safe and realistic. Here’s the winning combination. Reduce calorie intake with diet, do cardio most days to burn calories, and strength train at least a couple of days a week to build muscle mass and increase metabolism.

So, I’ve made my case for using the scale as a tool, and I hope you’ll try it when you are ready. Regardless, to be or not to be at a healthy weight should not be in question.


Mirabai Holland MFA, EP-C, CHC is one of the foremost authorities is the health and fitness industry. Her customer top rated exercise videos for Age-Onset health issues like Osteoporosis, Arthritis, Heart Disease, Diabetes & more are available at www.mirabaiholland.com. Mirabai also offers one-on-on Health Coaching on Skype or Phone. Contact her at askmirabai@movingfree.com.

Instructor And Elderly Patient Undergoing Water Therapy

5 Simple Exercises To Help Symptoms Of Rheumatoid Arthritis

When left unchecked, rheumatoid arthritis can be majorly debilitating and cause real and continued pain. However, if you’re willing to do the research and put in the work, you can do certain exercises which can majorly reduce the symptoms, improve your overall mood and actually make you that much physically healthier, generally speaking, which can only be a good thing. The real question then is, what sort of exercises ought you be doing to try and achieve this. Well, let’s take a look at five ways to help improve those symptoms.

Start Stretching

Stretching is actually something which we all ought to do and can be a great way to start anyone’s day. Daily stretching reinforces a healthy sense in which the muscles are able to become increasingly limber and flexible across time. Stretching is a personal thing, and it will depend a bit on where most of your arthritis pain is concentrated. When you stretch you want to go slowly and thoroughly. Warm up for a few minutes and then stretch each of the muscles you want slowly, pushing yourself further in tiny intervals. To guarantee success, track down a physical therapist with an understanding of rheumatoid arthritis.

A Focus On The Hands

“It’s all too common that rheumatoid arthritis has an adverse and painful effect on the hands, meaning this is an area which ought to be focused on in terms of exercises that can be done”, advises Charles Tevesham, health writer at LastMinuteWriting and Writinity. There are only a limited number of ways in which one can move one’s hands, so you ought to do your best to try and explore the full range of stretches available. Using a stress ball and a small roller can help to achieve this as well.

Go For Walks

Sometimes when you are in pain, having to get up and go on a walk can be the last thing that you want to do. But, it’s hugely beneficial. The act of walking involves so many of the different muscle groups and makes it so easy to do something that will be beneficial for your arthritis. It is also a great way to boost your mood, since it is exercise and involves being outdoors. Make sure you drink water and try to slowly increase your speed across the duration of your walk.

Water-Based Exercises

Completing exercises, stretches and other forms of aerobics in a pool is a wonderfully forgiving way of going about your pain reduction routine. Being in water helps to reduce the impact of your body weight so it makes it very easy to do exercises without fearing that you are going to injure yourself. Furthermore, the act of swimming is actually a really good exercise that involves using all o the muscle types in your body in a way which is actually deeply therapeutic and relaxing. If the water is warm, that’s an even better way to soothe pain.

Get On Your Bike

Cycling is another good exercise option. “Cycling is definitely one of the more strenuous options available to you, but it’s one that will really help ensure that the increase in the risk of cardiovascular problems that rheumatoid arthritis involves, doesn’t get the better of you”, says Mary Simmons, health blogger at DraftBeyond and ResearchPapersUK. You ought to make sure that you have stretched thoroughly before you get onto a bike as the intense locational nature of the workout, in other words the amount of pressure it puts your leg muscles under, can cause you an injury. That said, it’s an incredibly good way to exercise the muscles in the lower half of your body and has long term benefits to flexibility and pain reduction.

Conclusion

Overall, stretching and various other exercises are actually vitally important to giving yourself the best chance of avoiding unnecessary and difficult to deal with pain. Rheumatoid arthritis is never going to be pleasant, but if you really commit to a routine of exercise you can be sure that the way you feel, physically and mentally, is going to improve and that steps towards managing the symptoms will be moved through quickly.


Harry Conley is a content editor at LuckyAssignments and GumEssays. He develops training procedures and manages the workflow to give writers supplemental support instruction. A man of many interests, Harry also works in providing supplementary materials and instructional support for contributors.

 

References

Charles Tevesham, health writer, LastMinuteWriting and Writinity.
Mary Simmons, health blogger,  DraftBeyond and ResearchPapersUK

Health, fitness, wellness

Living Well with Arthritis

Although arthritis today is considered one of the leaders of the pack in the epidemic of chronic illness, millions of those affected are living fulfilling lives and living them well.

According to The Institute of Medicine’s New Report on Living Well With Chronic Illness, 8.6 million Americans are living with disabilities related to arthritis. The Arthritis Foundation reports it as “striking one in every five adults, 300,000 children and as the leading cause of disability in the United States.” Arthritis is a chronic illness that impacts many.

Depositphotos_39763765_xs(1)Those living with arthritis can live well and have a good quality of life by employing lifestyle interventions as medicine, in conjunction with, prevention, joint protection, weight management, physical activity, wise food choices, stress management and a good medical regimen. By combining all these necessary recommendations into a personalized Wellness Strategy and Plan, a coach can assist an arthritis patient in organizing what is important for them to live life well. The Wellness Plan then becomes a map by which to navigate toward managing and maximizing the patient’s best life possible.

A common factor also influencing quality of life for those challenged by arthritis or any chronic illness is what is called “adherence” or “medical compliance”. Lack of adherence to medical and lifestyle improvements is a large piece of the cost of healthcare today and contributes to the epidemic of chronic illness. Average patient adherence rates for prescribed medications are about 50 percent, and for lifestyle changes they are below 10 percent.

The World Health Organization reports “improving adherence also enhances patients’ safety because most of the care needed for chronic conditions is based on patient self-management, use of medical technology for monitoring, and changes in the patient’s lifestyle.” A coach assists in supporting patient compliance and self-accountability and works with the patient to forward the action toward their goals.

The same report goes on to say “patient-tailored interventions are required and must be customized to the particular illness-related demands experienced by the patient. There is no single intervention strategy that has been shown to be effective across all patients.” Therefore, working with individuals one on one is of primary importance for enhancing their quality of life. Coaches work with clients on a one on one basis assisting them in creating a wellness plan that is personalized to them.

Dr. Bennett and team’s article Health Coaching for Patients with Chronic Illness states “it is critical that those with arthritis understand, agree with and participate in the management of their chronic condition. Health coaching is one way to accomplish this function.”

A long-term study done at Stanford University indicates that interactions with a coach can significantly increase the health of people with chronic illness. Stanford’s Chronic Disease Self-Management Program brought patients (including those with arthritis) together with a coach. “Subjects who took the Program, when compared to those who did not, demonstrated significant improvements in exercise, cognitive symptom management, communication with physicians, self-reported general health, health distress, fatigue, disability, and social/role activities limitations. They also spent fewer days in the hospital, and there was also a trend toward fewer outpatient visits and hospitalizations.”

Young Couple Jogging in Park

It was found “This type of self-management, through coaching, is so effective it has been endorsed by the Surgeon General of the United States.”

“Give a man a fish, and he eats for a day. Teach a man to fish, and he eats for a lifetime.” Health & Wellness coaches work with a client to tailor-make a wellness plan that includes self-management, coordinating their medical regimen, and forwarding lasting lifestyle changes. Working together with a coach, a patient can successfully manage their condition and create a strategy to living life well with arthritis.

What Can Health & Wellness Coaches Do for You?

► Work with you to take an inventory of your current wellness status

► Guide and facilitate your personal well-life vision toward the life you would like to live

► Work with you to develop a personalized Wellness Plan that is tailored to your needs. The wellness plan becomes the map that integrates your important areas of focus including: self-management support, the medical regimen, and lifestyle improvements.

  • Self-management support:
    • Promote healthy behaviors
    • Impart problem-solving skills
    • Assist with the emotional impact of chronic illness
    • Provide regular follow-up and accountability
    • Encourage people to be active participants in their care
    • Assist in patient self-advocacy
  • The medical regimen – facilitation of a patient-directed approach
    • Scheduling and attending medical appointments
    • Asking your medical team the right questions
    • Following through on daily prescribed medications
    • Tracking your regimen to support success
  • Lifestyle improvements
    • Physical activity
    • Healthy eating
    • Eliminating risk factors
    • Promoting healthy behaviors

► Bridging the gap between clinician and patient.

  • Health coaches can bridge wellness-coachthese gaps between the medical team and patient by following up with patients and guiding a patient-centered approach, asking about needs and addressing obstacles, addressing health literacy, cultural issues and social-class barriers.
  • Health Coaches help patients become self-directed in navigating the health care system. Coaches can help with patient self-advocacy and coordination of care

► Provide accountability & support for you to be successful

  • Offer emotional support
  • Coping with illness is emotionally challenging. Coaches can offer emotional support and help patients cope with their illnesses. They also assist patients in seeking out additional emotional support that will help them achieve and maintain success.

► Provide ongoing evaluation of progress toward your goals

  • Re-evaluating success
  • Resetting goals & action steps as necessary
  • Provide acknowledgement & support of successes
  • Assist in maintaining forward momentum toward goals

► Serve as a continuity figure

  • Coaches travel with the patient as an ally and assist them with staying the course while implementing their wellness plan.

► Assist in patient-directed achievement of successful lifestyle behavioral change

  • Be your ally and walk shoulder to shoulder with you

Dr. Linda Gogl is a Doctor of Physical Therapy with Board Certification in Orthopaedic’s with over 20 years in healthcare. She currently serves as Director of Development and Team Member for Real Balance Global Wellness Services. Her professional experience includes outpatient Clinical Director, Developer/Director of an APTA Credentialed Orthopaedic Residency Program, Director of Quality Assurance for the largest physical therapy private practice in California, Credentialed Clinical Instructor, Adjunct Professor of Anatomy & Physiology, Research mentor and Clinical Coordinator for University affiliations. More recently she also served as National Director of Training and Implementation for OptimisPT, a physical therapy software system.

References

  • Arthritis Foundation. Arthritistoday.org
  • Bennett et al, Health Coaching for Patients With Chronic Illness. Fam Pract Manag. 2010 Sep-Oct;17(5):24-29.
  • Harris et al. The Institute of Medicines’s New Report on Living Well With Chronic Illness. Centers for Disease Control and Prevention. Volume 9 – September 20, 2012.
  • Lorig et al. Chronic Disease Self-Management Program, 2-year Health Status and Health Care Utilization Outcomes. Medical Care. Volume 39, Number 11, pp 1217-1223.2001
  • National Prevention Strategy, Clinical and Community Preventive Services, National Prevention Council 2010. www.surgeongeneral.gov/initiatives/prevention/strategy/preventive-services.pdf
  • National Prevention Council Action Plan: Implementing the National Prevention Strategy www.surgeongeneral.gov/initiatives/prevention/2012-npc-action-plan.pdf
  • World Health Organization. Adherence to Long-Term Therapies. Evidence for Action. 2003.
Breast Cancer Survivor

Breast Cancer and Exercise

The most common issues that plague post-mastectomy patients are upper-crossed syndrome and range of motion limitations in the affected shoulder. Upper cross syndrome is the combination of protracted (rounded) shoulders, forward head, cervical lordosis, winged-scapula, and thoracic kyphosis. As a result of these postural deviations, mastectomy, lymph node dissection, and/or radiation, the chest muscles may become tight, shortened and spastic. This not only exacerbates the postural deviations, but may limit the ability of the patient to move their arm/shoulder through flexion, extension, abduction, and external rotation. While this is a general statement, the majority of patients will present with these symptoms. This is compounded even more if the woman undergoes reconstructive surgery. Not only with it further exacerbate upper-crossed syndrome, it will create a muscle imbalance in the area of surgery, if either the rectus abdominis or latissimus muscle are used for reconstruction.

a trainer helping a senior woman doing fitnessThe most important factor in the safety and efficacy of the exercise program is the initial assessment. At the very least this should include a comprehensive postural assessment as well as shoulder range of motion measurements taken with a goniometer. The well-trained fitness professional will be able to deduce, from the results, which muscles need to be stretched and which need to be strengthened. By selecting the wrong combinations of exercises, the results may not only be undesirable, they may in fact be detrimental. For example, if a client presents with moderate to severe upper-crossed syndrome, performing any kind of “pushing” exercise that would involve the chest muscles (chest press), could make the syndrome even more pronounced by causing the pectoral muscles to tighten and contract. Instead, the goal need to be on stretching the chest wall and strengthening the opposing muscles in the back; particularly the scapular stabilizers.

Prior to adding a load (resistance) of any kind, the patient should have close to full range of motion through the particular plane of motion. Without correcting the range of motion first, the patient will reinforce the negative movement pattern by performing strength training exercises throughout a limited pattern of movement. Therefore, initially the focus should be on range of motion exercises. These may include very basic exercises that the patient can do on their own; front wall walks, side wall walks, pendulum swings, and corner stretch, or active isolated stretching that can be executed with the assistance of a professional. The combination of both will increase the speed of improvement in most cases.

Once close to full range of motion is achieved, the emphasis can be on strength training. Not only will this help to correct the postural and range of motion deviations, it will help increase bone density and lean muscle mass. Many women will either be of menopausal age, or thrown into menopause from their cancer treatment. With estrogen no longer being produced, the risk of osteoporosis increases. To make things even more complicated, the long-term side-effects of chemotherapy include osteoporosis, diabetes, and damage to the heart and lungs; all of which can be avoided or improved through proper exercise recommendations.

The last part of the equation is the risk of lymphedema of the affected arm/shoulder. Lymphedema is the swelling of the extremity following the removal of, or radiation to the lymph nodes on that side. Even if someone has undergone a sentinel node biopsy, and only had one node removed, they can still get lymphedema. Lymphedema is progressive if untreated and can be very painful and disfiguring. It can happen at ANY time after surgery; one hour or fifty years. The risk doesn’t increase or decrease with time, however a higher percentage of body fat, infection, age, and poor nutrition can all increase the risk once someone is at risk. In my sixteen years of working with cancer patients, I would say this is the number one “overlooked” issue amongst cancer patients. More often than not, they will not even be told about lymphedema. Following lymph node dissection and/or radiation, the lymphatic pathways do not operate with the same efficacy that they did previously. Therefore, we no longer know what the individuals exercise threshold is. It is critical to START and PROGRESS SLOWLY. This allows for a gradual increase in frequency, intensity, and duration of the exercise program. If at any point there is swelling, the patient should be advised to stop exercising and see their doctor immediately to determine if, in fact, they do have the onset of lymphedema. They should come back with a medical clearance form and the exercise instructor should take a step back with the frequency, intensity, and duration to the point prior to the onset of swelling.

Putting all of these pieces together is very much like solving a mathematical equation. If you are missing any of the information, you will never solve the problem. A typical exercise session should begin with cardiovascular exercise. This too should be gradually increased at a rate that the client is comfortable with and their body responds favorably to. They should stay well-hydrated, they should not wear tight-fitting or restrictive clothing on their upper body, and they should not overheat (all of these factors can increase the risk of lymphedema). Following the warm-up they should be instructed to do a series of lymph drainage exercise to open up the lymphatic pathways and prepare the body for exercise. I reference these exercises in CETI’s Cancer Exercise Specialist Handbook and Breast Cancer Recovery with the BOSU® Balance Trainer Book.

Meta Slider - HTML Overlay - Women wearing pink tops and ribbons for breast cancer on white backgroundFollowing the warm-up and lymph drainage exercises, the exercise specialist should determine what the areas of “need” are for the client. Remember to begin with stretching and range of motion exercises until they have close to “normal” range of motion. At that point the goal becomes strength training and choosing exercises that will strengthen the weaker muscles and stretch the tight and shortened muscles. Weight/resistance should also be very gradually increased and attention paid to any potential swelling of the extremity. Typically I chose exercises that will stretch the chest (chest fly, corner or door stretch, assisted stretching) and will strengthen the back (low/high rows, reverse flies, lat pulldown). They often [present with winged scapula following a node dissection. If this is the case, I will incorporate exercises that will strengthen the serratus anterior. If they have undergone an abdominal TRAM procedure, core work will be of the greatest importance in preventing, or minimizing, low back pain.

Because every muscle in the body works synergistically, an imbalance in the shoulder can lead to a multitude of imbalances from the hips to the knees to the ankles etc… Choose your exercises carefully. Put emphasis on the areas of need. This is not and can never be a cookie-cutter workout. No two breast cancer patients are the same. Not only are you taking into consideration their surgery, reconstruction, and treatment, you have to also factor in the remainder of their health history and any additional orthopedic concerns. I urge anyone who wants to work with cancer patients to undergo specialized training. It is very complex and the untrained professional can end up doing more harm than good.


Andrea Leonard is the Founder and President of the Cancer Exercise Training Institute. She is a certified as a corrective exercise specialist by The National Academy of Sports Medicine (NASM), as a personal trainer by The American College of Sports Medicine (ACSM), the National Academy of Sports Medicine (NASM), the American Council on Exercise (ACE), and as a Special Populations Expert by The Cooper Institute. She is also a continuing education provider for the National Academy of Sports Medicine and The American Council on Exercise.

 

Physio assisting elderly woman during exercise with power band a

The Importance of Exercise Following A Stroke

According to the American Heart Association, 700,000 people annually in the United States suffer a stroke.(1)  The incidence of stroke is likely to continue to escalate because of an expanding population of elderly Americans; a growing epidemic of diabetes, obesity, and physical inactivity among the general population; and a greater prevalence of heart failure patients.(2)

Following a stroke, survivors will often work with Physical and Occupational Therapists to restore strength and control through exercise programs. However, most insurance companies only pay for a certain number of therapy sessions per calendar year which can leave a gap in the rehabilitation process. It’s important to continue the exercises that a physical therapist has prescribed and progress safely through an exercise program to regain strength and functional movement. This is where a certified personal trainer with experience in rehabilitative exercises can come in. A certified personal trainer can be part of the healthcare team and can design a program which is both safe and functional.  Walking, flexibility exercises, and light strength training can help a stroke survivor continue on the path of rehabilitation. Swimming is also another beneficial form of exercise if a pool is available.

Another benefit of exercise for stroke survivors is prevention of recurrent stroke or heart attack, which occurs frequently in people who have had a stroke.(3)  Reducing risk factors can decrease the incidence of recurrent strokes and coronary events. An aerobic conditioning program can enhance glucose regulation and promote decreases in body weight and fat stores, blood pressure, C-reactive protein, and levels of total blood cholesterol, serum triglycerides, and low-density lipoprotein cholesterol.(4) Exercise also increases high-density lipoprotein cholesterol and improves blood rheology, hemostatic variables, and coronary endothelial function.(5)

It is very important that a personal trainer communicate with healthcare professionals about their client after a stroke, including the physician and physical & occupational therapists to best help the client. Safety should always come first when exercising. Overexertion and pain should always be avoided. Decrease in balance, spasticity(6), memory, and fatigue is common after a stroke. Like everyone else, stroke survivors will have good days and bad days. However, modification of exercises can help after a stroke to get individuals on the path to better physical health.


Kris Pritchett Cameron is the owner of ReNu Your Life Fitness & Neuro Wellness in Cedar Rapids, Iowa and a certified personal trainer through the American Council on Exercise. Kris has dedicated over 20 years to the health and fitness of others. Kris has worked with all ages from children to the elderly, but her specialty is medical fitness and working with older adults. With a background in healthcare and physical rehabilitation, Kris has experience working with clients who have orthopedic injuries, arthritis, Multiple Sclerosis, Parkinson’s Disease, Alzheimer’s, cancer, diabetes, heart disease, osteoporosis, bariatric surgery, mental disorders, and stroke. 

References

  • American Heart Association. Heart Disease and Stroke Statistics-2003 Update, Dallas TX
  • Gillum RF, Sempos CT. The end of the long-term decline in stroke mortality in the United States? Stroke 1997; 28:1527-1529
  • Mol VJ, Baker CA, Activity intolerance in the geriatric stroke patient, Rehabil Nurs. 1991; 16:337-343
  • Franklin BA, Sanders W. Reducing the risk of heart disease and stroke. Physician Sports Med. 2000; 28: 19-26
  • Hambrecht R, Wolf A, Gielen S, et al. Effect of exercise on coronary endothelial function in patients with coronary artery disease. N Engl J Med. 2000; 342: 454-460
  • Spasticity is a condition where muscles are stiff and resist being stretched. It can be found throughout the body, but is common in the arms, fingers, or legs. Hope: The Stroke Recovery Guide. 2010 National Stroke Association
doctor chart

What I did when I was diagnosed with Multiple Sclerosis

The road to a diagnosis of multiple sclerosis may have come in a whirlwind of a day or at the end of long, agonizing years. The destination is all the same – a mysterious, unpredictable and unseen disease.

When I received my diagnosis Thursday, July 7, 2016, I didn’t know a thing about multiple sclerosis.

I knew about diabetes, cancer and heart disease. Why wasn’t I familiar with MS? Isn’t that the “wheelchair disease?”

The questions ransacked my mind.

  • What’s going to happen to my body?
  • What had already happened to my body?
  • What caused it?
  • Did I do something to bring this on?

Like it or not, MS was now part of my world.

I felt like I just booked a plane ticket for an undisclosed destination. No trip planner. No time for online reviews. No travel agent recommendations. Nada. Just signed, sealed and delivered. I knew, however, I needed to hit the road with the best possible plan to restore and maintain my health.

I wanted MS to know that I was in charge.

MS was not going to determine my health or my future.

So, I had the right mindset, but not a clue where to begin.

According to my neurologist, I needed to start on a disease modifying drug. These drugs are designed to reduce the MS attacks and slow down the damage to the central nervous system (the brain and spinal cord – the place of attack for this autoimmune disease).

Personally, I believe there is an incredibly valuable place in this world for medicine and in my opinion, this was one of those places. However, I also knew from my years of studying nutrition and wellness strategies I needed more than what the medicine cabinet could offer to truly conquer this disease. I needed the best of both worlds – the main medication to address the disease and a highly personalized, research-based nutrition plan.

My gut told me two things:

  1. My body had sustained an immense level of chronic stress over the recent years – I changed careers, completed a triathlon, attended culinary school in NYC, helped to care for my mother during cancer treatments and ultimately grieved her passing. These intense years not only drove me into extreme adrenaline fatigue but likely created a firestorm of other stress-induced damage I was just beginning to discover. Based on my research, stress was actually powerful enough to “turn on” an autoimmune disease like MS. I would never know what actually turned MS on in my body, but I knew I needed to arm myself with as much ammo as possible to stabilize this disease.I was onboard with taking the disease modifying drug based on the recommendation of my neurologist. However, all medications have risks and benefits and sometimes the risks don’t outweigh the benefits. For me, the symptom-management medications were not compelling enough for my current state of health. I didn’t have extreme symptoms, and I didn’t want to start popping pills like movie theatre popcorn. Outside of the main medication, I wanted to begin healing my body through diet and lifestyle first. I knew the research and experienced the body’s healing abilities in the past.
  2. I needed to pursue my own healing plan as if it was my only path to restore my health. The reality is my body didn’t get MS because it was deficient in a disease modifying drug. The medicine would help, but it’s not addressing the root cause. There was something on a much deeper level that allowed this gene to turn on. Through reading and research and discovering the profound work of Dr. Terry Wahls, I learned about a new path to stopping the progression of this disease. Dr. Wahls – a medical doctor diagnosed with MS – had the food prescriptive plan to reversing MS through paleo principles and the science to back it up. Step aside Beyonce, you may slay a dance floor like no other, but Dr. Wahls is my new hero. She’s slayin up some serious healing in the kitchen. I knew if I didn’t get to the root cause of what turned the disease on in my body, the medication would only take me so far. For the best chance of truly stopping the progression of this disease, I needed to get to the root of it.

Here’s what I did when I left my neurologist’s office and invite you to do the same.

Eat.

Deep healing starts in the kitchen. Hippocrates said it himself, “Let food be thy medicine and medicine be thy food.” Food – real whole food – has the nutrients our cells need to thrive and heal. I needed to ensure that my body was receiving the proper nutrients to stand up to MS; and equally as important I needed to ensure my body was digesting and absorbing the nutrients I was giving it. The latter half is the most overlooked yet essential part of the equation.

Thanks to the clinical research of Dr. Terry Wahls, the science was already done to show not only the nutrients my body needed to heal from MS but also the prescriptive menu to achieve it. And so it began… eliminating gluten, dairy, soy and eggs, and fueling up on my nine cups of veggies a day. Healing my gut. Healing my cells. Healing my life.

Start Now: How many veggies do you eat in a day? When was the last time you had a veggie? (Unlike our school cafeterias French fries and ketchup don’t count!) Add one at your next meal… even at breakfast. Toss some veggies in an omelet or spinach in your smoothie.

Sleep.

The importance of sleep goes far beyond the beauty benefits. When we sleep our body doesn’t have to move, digest food or think critically. That enables our body to use its energy to remove toxins, manufacture hormones and fight infection. Sleep may seem passive, but it’s prime time hours for the body to detox and repair – essential components to anybody, especially those suffering from an autoimmune disease like MS.

At the time of my diagnosis, I had an incredibly demanding schedule. As a personal trainer, I lead a weight loss class that began at 6 am. And some nights I have been at the gym as late as 10 pm, so sleep was a luxury. However, if I was serious about standing up to MS and doing everything in my power to support the healing process, I needed to prioritize sleep. I couldn’t change the time of my morning alarm but I did become more efficient with getting to bed and getting off the electronics an hour prior to snuggling in.

Start Now: Aim for 7-8 hours of sleep a night in a dark, cool room. If you’re completely off the mark for this now, shoot for 30 minutes earlier than your current bedtime. Once that becomes an easy habit, progress with another 30-minute increment until you reach your goal.

Chillax.

Stress is part of life. Work/life balance is a myth. It’s time to get a grip on what’s stressing you out, set realistic expectations in all areas of your life and prioritize a little chill-axation.

This was by far the greatest challenge for me. Veggies – I got them. Earlier bed time – it’s not easy, but I can deal. Chill on the couch? There might as well have been needles poking out of the couch cushions, it was straight up torture. The idea of doing “nothing,” was actually stressful to me. I wasn’t being productive! There were so many other things to do.

I always circled back to my “why.” Why does this matter? What’s the risk if I don’t change my habits? What’s the payoff if I do? Remembering my why – standing up to MS – got me through the ick of learning to deal with it. My body needed “active rest,” time outside of my sleeping hours to unwind and relax.

Start Now: What’s one expectation you’ve put on yourself or your life that if you let go of, could free you from guilt? Do it! (Cue Free Your Mind for a little En Vogue action!)

This became my starting point of a very long, very rewarding road to healing. Everyone’s path is as unique, but if given the chance, the body will heal itself.

Let’s give your body that chance, shall we?

This post originally appeared on alenebrennan.com. Reprinted with permission.


Alene Brennan has been featured in USA Today, Philadelphia Inquirer, Huffington Post and Mind Body Green. Alene overcame debilitating migraine headaches through diet and lifestyle and is now once again using a “Less Pharm, More Table” approach is managing her diagnosis of Multiple Sclerosis. Alene holds four certifications: Nutrition Coach, Yoga Instructor, Personal Trainer and Natural Food Chef. She also completed specialized training in nutrition for autoimmune disease specifically the Wahls Protocol and the Autoimmune Protocol. Since receiving her MS diagnosis and seeing first-hand the power of using diet and lifestyle to create a healing environment in the body, she dedicated her virtual nutrition coaching practice to helping people with MS and autoimmune diseases take back control of their health. Visit her website, alenebrennan.com.