You know it happens. You have that one TV show, or maybe even 2, 3 or 4 shows that you just can’t live without! You curl-up on the couch and enter another world of sex, drama, sports, horror, reality, comedy, or even educational learning. All of a sudden, hours have passed and you know you must continue on with your own daily life.
Athletes get injured. It’s part of the deal. Be it a torn ACL, Achilles tendonitis, or a pulled muscle, the questions arise: What can I eat to recover faster? Would more vitamins be helpful? What about collagen supplements? At this year’s virtual Food and Nutrition Conference and Expo (FNCE) of the Academy of Nutrition and Dietetics (AND, the nation’s largest group of nutrition professionals), several presentations offered updates on nutrition for injuries.
Are you working with any clients who have type 1 diabetes, type 2 diabetes, or even prediabetes? Well, you have a lot to learn if you don’t know the first thing about those conditions! There are over 100 million Americans currently have diabetes or prediabetes—some of them are, or will be, your clients.
Diabetes is a metabolic disorder that results in elevated levels of blood glucose (“blood sugar”) that can cause many health complications if not managed effectively. Although exercise is one of the three cornerstones of diabetes management, sometimes it can complicate keeping blood glucose levels under control, especially in people who have to replace the insulin that their bodies no longer make (or make enough of). How they respond to being active really depends on the type of exercise and diabetes.
In any case, on a basic level, it’s good to know more about how exercise affects people with diabetes. I have lived well with type 1 diabetes for nearly half a century at this point, and I have always known at some level that exercise did good things for my blood glucose, even before I had my first blood glucose meter (after going 18 years without one). How could I tell without a meter to test my levels? Honestly, it was because being active always made me feel better, physically and emotionally.
I earned a PhD in Exercise Physiology to better understand how exercising helped me. You don’t have to go that far with your education, but if you have diabetes or are going to work with clients or patients who have it, here are some basic things that you really need to know.
Sheri R. Colberg, PhD, FACSM, is a Professor Emerita of Exercise Science at Old Dominion University and a former Adjunct Professor of Internal Medicine at Eastern Virginia Medical School. She is an internationally recognized authority on diabetes and exercise. As a leading expert on diabetes and exercise, Sheri has put her extensive knowledge to use in founding Diabetes Motion (diabetesmotion.com), a website providing practical guidance about being active with diabetes. She also founded Diabetes Motion Academy (dmacademy.com), offering training and continuing education to fitness professionals.
According to studies, low back pain affects nearly 80% of all adults. Most low back injuries come from the following: wearing high heels (women), performing manual labor and people who sit for long periods of time (greater than 3 hrs.). Although these statistics are alarming, there are some simple steps one can take to make sure that they avoid current and future back pain or injury. These steps all involve simple exercises that can be performed from anywhere, including one’s office.
In order to prevent further injury or a relapse, the first thing to do is stretch common muscles that are tight and may have caused the lower back pain in the first place. Tight muscles are known to overwork and when this occurs, they become overactive and let us know through pain. These muscles include erector spinae, hip flexors, calves and the lats (the big back muscles).
For each stretch, you want to hold the stretch for 30-120 seconds and perform the movement for 1-2 repetitions 3-5x/week. (Watch Five Back Pain Stretches from WebMD.)
After you have stretched the tight muscles, now it is time to focus on strengthening the muscles that are weak or underactive. Typically, muscles become weak or underactive from lack of use or overuse by the muscles that assist or oppose the weak muscles. For example, if your hip flexor is tight, it could cause your glutes (butt) muscles to become weak. The muscles that tend to weaken with a lower back injury include certain core muscles, the butt and hamstrings.
For each strengthening exercise, you want to perform 1-2 sets of 10-15 repetitions 3-5x/week. (Watch Core Strength for Back Pain View and Good and Bad Exercises for Low Back Pain from WebMD).
Now that you have isolated the lower back with stretching and strengthening exercises, it’s time to focus on integrating your entire body back into exercising. Integrated exercises involve using as many muscles as possible in one given exercise. By performing integrated exercises, you will ensure that the your hip joint (which can be misaligned with low back injuries) starts and remains in the right position and the proper muscles are working as they should be.
For each integrated exercise, you want to perform 1-2 sets of 10-15 repetitions 3x/week. (View integrated exercises: http://www.allthingshealing.com/Chiropractic/Corrective-Exercise-for-Back-Pain/8558#.VIoTN74zf8E)
If you follow these three simple steps, you can avoid low back pain setbacks and ensure that your back is strong enough to handle your daily activities of life.
Maurice D. Williams is a personal trainer and owner of Move Well Fitness, as well as a fitness educator for Move Well Fit Academy With almost two decades in the industry, he’s worked with a wide range of clients, including those with health challenges like diabetes, osteoporosis, multiple sclerosis, hypertension, coronary artery disease, lower back pain, pulmonary issues, and pregnancy. Maurice is also an Assistant Professor of Health & Human Performance at Freed-Hardeman University.
Pain is a very personal and subjective experience. Modern pain science no longer views pain as a sensation; rather, pain is viewed as an experience that results from an amalgamation of inputs that are physical, psychological, emotional and social. These inputs must be viewed interdependently, because they all directly affect one another and the overall pain experience.
Researchers and clinicians have structured the bio-psycho-social (BPS) model of modern pain to better understand and treat chronic pain.
“Bio” represents biology, biomedical and/or biomechanical. This is the historical way chronic pain was treated—seeking disease, dysfunction or damage and then designing interventions that would address it.
“Pyscho” represents the current psychological characteristics of the chronic pain sufferer. This could include the individual’s beliefs about his or her situation, historical references related to past pain experiences, anxiety, depression and expectations about the future. Many of the psychological elements are influenced by family members and/or perceived experts or authorities (e.g., doctors, nurses, physical therapists and personal trainers).
“Social” represents the social implications of the pain experience. Social stressors relate to doubts that those around us don’t believe our pain is real and whether there is a social support structure in place. Additional stressors may be related to missing important social events, traveling or the inability to maintain employment or familial responsibilities.
The International Association for the Study of Pain defines pain “as an unpleasant and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” The word “potential” is significant in this definition because it describes pain even in the absence of tissue damage.
In a 2018 paper, the Centers for Disease Control and Prevention (CDC) noted that 50 million Americans suffer from chronic pain and 20 million suffer from high-impact chronic pain. High-impact chronic pain is chronic pain that “frequently limits life or work activities,” according to the report.
As a health and exercise professional, the likelihood of working with clients who have chronic and/or recurrent pain is high. These are clients who have been cleared for exercise by their physicians and who have either completed or are currently involved with treatment by a licensed medical provider such as a physical therapist or chiropractor. Understanding evidence-based strategies for exercise and maintaining professional scope of practice provide an important service to this population. Exercise programming to reduce mechanical stress and improve movement confidence and function are well within our professional role. But at no time should a health and exercise professional attempt to treat or diagnose any condition or provide medical advice.
The growing body of evidence around pain is reshaping treatment approaches by medical professionals. As a health and exercise professional who will very likely work with clients experiencing chronic pain, understanding the bio-psycho-social paradigm and what it means in reference to program design, communication and expectations are paramount.
One of the most effective strategies for introducing physical activity to clients with chronic pain is to establish rapport, which in turn, may help relieve anxiety and fear and set expectations. Here are three strategies to get you started:
Pain is a complex issue and it is neither helpful nor accurate to approach client communication and programming from an outdated paradigm. The current bio-psycho-social model contains elements of biology, psychology and sociology, of which all must be taken into account for lasting, pain-free movement.
Article reprinted with permission from Anthony Carey.
Anthony Carey holds a Master’s degree in biomechanics and athletic training and is the inventor of the Core-Tex™. Anthony is recognized internationally as a leading expert in biomechanics, corrective exercise, functional anatomy and motor control. He was named Personal Fitness Professional Magazine’s 2009 Personal Trainer of the Year and has received recognition for his work in the national media, including the New York Times, Time Magazine and Oprah’s “O” Magazine.
Anthony has authored two best-selling books: The Pain-Free Program: A Proven Method to Relieve Back, Neck, Shoulders and Joint Pain and Relationship and Referrals: A Personal Trainer’s Guide to Doing Business with the Medical Community, and consults for the San Diego Chargers as well as some of the largest equipment manufacturers and health clubs in the world.
I wrote this post two years ago and still have people with diabetes write to tell me how much it has meant to them. How they printed it off and showed it to their family and friends. How people seemed to finally understand the difficulty of what they live with.
Here is the new Fall Slaw with apple and fennel that I’m serving at the winery. 🍂🍁 Guests order extra to-go, every day!
Make no mistake: sitting less time overall is a good idea for myriad health reasons, but is sitting as bad for you as some would suggest? Is it really the new smoking? In 2017 alone, a slew of new research studies has looked at various health detriments associated with prolonged sitting, even in adults who exercise regularly.
For adults with type 2 diabetes, bouts of either light walking or simple resistance activities benefit not only their glycemic responses to meals (4; 5), but also markers of cardiovascular risk. Both types of interrupting activities are associated with reductions in inflammatory lipids, increases in antioxidant capacity of other lipids, and changes in platelet activation (6).
What is good for one may not be as beneficial for all, though. For example, in adults with low levels of frailty, sedentary time is not predictive of mortality, regardless of physical activity level (1). Sitting more if you are already frail likely just increases frailty and mortality risk, which is not surprising. Along the same lines, being less fit matters in how you respond to breaking up sedentary time. Middle-aged adults with low levels of cardiorespiratory fitness gained the most metabolic benefit from breaking prolonged sitting with regular bouts of light walking, which included five minutes of light walking every 30 minutes over a 7-hour research period (2). If you’re already very fit, adding in some light walking breaks during the day is not going to have as much of an effect—again not surprising.
For in adolescents in school, reducing their sitting time (both in total time and length of bouts) has been shown to improve their blood lipid profiles and cognitive function. A “typical” day (65% of the time spent sitting with two sitting bouts >20 minutes) was compared with a simulated “reduced sitting” day (sitting 50% less with no bouts >20 minutes (3). Can teens stand to improve their health this week? Again, it cannot hurt to break up sedentary time, so why not do it? More recess breaks for teens would be good—and for everyone else for that matter.
All is not lost for people with limited mobility or no ability to engage in weight-bearing activities. Including short bouts of arm ergometry (five minutes of upper body work only every 30 minutes) during prolonged sitting attenuates postprandial glycemia (following two separate meals) when done by obese individuals at high risk of developing type 2 diabetes, even though they remain seated (7). People who cannot walk or stand can, therefore, break up their sedentary time in other ways that can also be metabolically beneficial.
As for other health benefits, breaking up sedentary time is associated with a lower risk of certain types of cancer. In a recent meta-analysis, prolonged television viewing, occupational sitting time, and total sitting time were all associated with increased risks of colorectal cancer in adults (8), which is the most common type after breast/prostate and lung cancers. That study reported a dose-response effect as well, suggesting that both prolonged total sitting time and greater total daily sitting time (2 hours) were associated with a significantly higher risk of colorectal cancer.
In summary, even just the most recent evidence is convincing enough that prolonged sitting is bad for you, and many more studies published similar results in prior years. Is sitting as bad as smoking, though? That remains to be proven. However, you really cannot argue with a recent international consensus statement on sedentary time in older people (9). It states, “Sedentary time is a modifiable determinant of poor health, and in older adults, reducing sedentary time may be an important first step in adopting and maintaining a more active lifestyle.” In fact, the best advice may simply be to consider the whole spectrum of physical activity, from sedentary behavior through to structured exercise (10). Putting yourself anywhere onto that spectrum is definitely better than sitting through the rest of your (shortened) life.
Reprinted with permission from Sheri Colberg.
Sheri R. Colberg, PhD, FACSM, is a Professor Emerita of Exercise Science at Old Dominion University and a former Adjunct Professor of Internal Medicine at Eastern Virginia Medical School. She is an internationally recognized authority on diabetes and exercise. As a leading expert on diabetes and exercise, Sheri has put her extensive knowledge to use in founding Diabetes Motion (diabetesmotion.com), a website providing practical guidance about being active with diabetes. She also founded Diabetes Motion Academy (dmacademy.com), offering training and continuing education to fitness professionals.
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Humans are neurobiologically wired to seek out safety, convenience, and familiarity in our day to day choices. The repetition of these choices create our behavioral patterns.
Behaviors serve two purposes; first, to get something. Second, to avoid something.
Our behaviors cannot change until we become consciously aware of what environment and/or triggers are creating them.