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Parkinson's disease

Why Parkinson’s Doesn’t Have To Win

An exercise management program specifically designed to attack Parkinson’s disease can help you reduce falls, improve energy, and restore function so you can live a normal, independent, and productive life.

Medical exercise and medical fitness professionals can guide you in using exercise to recover a happy, fulfilling, independent life with this condition.

I know this because I have witnessed exercise win. I have seen people claim victory. I have seen them take their life back from the thief called Parkinson’s (keep reading and I will share a story with a great ending)

The Condition

Parkinson's disease

Just to familiarize you, Parkinson’s is a progressive neurologic disorder that affects 1% of the population over 50. The condition progressively destroys cells in the brain that produce dopamine, a neurotransmitter controlling movement. Parkinson’s is characterized by tremors, postural instability, impaired movement, rigidity, a shuffling walk, difficulty moving the body, and speech impairment.

The Parkinson’s posture is characterized by an excessive forward head drop, rounded shoulders, forward trunk lean, and side to side shuffling. This posture is very taxing on the body and leaves its afflicted depleted of strength, energy, and confidence in their body.

Falls are a major concern with Parkinson’s disease as the body loses its ability to “catch” itself if it starts to fall. A person will experience decreased reaction time, and a feeling of “slowness”, making it very easy to fall and sustain serious injury.

If I just described your daily struggle, there is GOOD NEWS!

Medical Exercise

An exercise management program specifically designed to attack Parkinson’s disease can help you reduce falls, improve energy, and restore function so you can live a normal, independent, and productive life.

Let’s discuss the components of an effective exercise program for Parkinson’s and how it can benefit you or your loved one.

Range of Motion or Flexibility Training

Parkinson’s disease (PD), reduces the tone (or pull) of the extensor muscles (helps you stand upright). Consequently, when walking, the PD client takes shorter steps and his/her posture is stooped with bent arms, bent knees, and a forward falling head. Over time, this flexion posture (leaning forward) results in further weakening of the extensor muscles (helps you stand upright), and it becomes more difficult to fully stand upright. Joint and muscle stiffness discourages movement, and eventually, the tissue around the joint shortens and restricts movement. Flexibility training improves joint function, reduces stiffness, and improves mobility.

I recommend you focus on the following areas for stretching:

  • Ankle plantar flexion
  • Rotation & lateral flexion of the pelvis
  • Cervical & thoracic extension, rotation, lateral flexion
  • Outer hamstrings
  • Elbow extension and supination
  • Finger flexion and extension

Resistance Training

Gentle strengthening exercises for your extensor muscles (muscles that hold you upright) are super important because they counteract the flexion (forward lean) tendency seen in PD. Extensor muscles of the body include calf (gastrocnemius), anterior thigh (quadriceps), buttocks (gluteals), back (spinal extensors), back of the upper arm (triceps), mid-back (posterior shoulder girdle) and back of the neck (neck extensors). With this, the muscles included in hip extension, external rotation, and abduction are vitally important to improving balance and gait and preventing falls.

The benefits of improving your muscle strength and endurance include:

  • Increased ability to perform Activities of Daily Living
  • Increased independence and self-efficacy
  • Increased lean body mass
  • Maintained or increased bone mineral density
  • Counteraction of the Parkinson’s posture
  • Enabling you to feel better, stand taller, and function more effectively
  • Strengthening muscles and joints, helping you stand upright and move

Cardiorespiratory training

Rigidity can reduce your ability to inhale and exhale your breath. Additionally, PD may cause decreased chest expansion, slowed movements, fatigue, and poor endurance during prolonged activity. Aerobic activity has been shown to be extremely beneficial for improving cardiovascular and respiratory fitness, as well as the generalized health of the PD client. You want to perform aerobic (or cardiorespiratory) exercises involving large muscle groups to increase your heart rate, thereby improving cardiorespiratory function. Aerobic exercise is most beneficial when started early in the disease process.

Some great ways to perform CV exercise include:

  • Walking
  • Stationary biking
  • Elliptical
  • Swimming (aqua aerobics)
  • Yoga
  • Pilates
  • Low-impact dance

Balance & Postural Training

Incorporating postural and balance training into your exercise program cannot be emphasized enough. Parkinson’s pain, stiffness, and lack of muscle strength disrupts your ability to perform efficient, controlled, and coordinated movements like walking. Awkward movement and postural patterns, like side shuffling, will require more energy and will increase your fatigue, resulting in decreased body stability and increased risk of falling.People with PD may develop new postural problems elicited by the disease, or the disease may exacerbate old postural problems. Poor posture fatigues the body. Injury can occur if proper body mechanics are not utilized. Therefore, it is very important that you learn what healthy posture is and how to maintain it throughout your daily activities and during exercise.

Postural training is highly beneficial as it:

  • conserves your energy
  • prevents falling
  • reconnects you with your body

trevor-parkinsons1Postural exercises should focus on increasing your awareness of proper posture and teaching you how to achieve and maintain correct body alignment with all exercise. Proper body mechanics should be a component of the total exercise program. Your program should emphasize sitting, standing, and walking tall. Include techniques for bed mobility tasks, getting in and out of chairs, descending and rising from the floor, and exercises involving proper use of the back muscles in tasks of daily living/lifting, etc.

Body awareness is another component of posture training. This means learning how to observe and listen to your body. People who are aware of their bodies are more likely to recognize incorrect positioning and movements that could unnecessarily stress a joint, increase muscle tension, or increase risk of falling. They are also better able to avoid overexertion.

Prior to activity, you should go through an alignment checklist from foot to neck focusing unloading your joints and using the right muscles to stand. You can practice this in front of a mirror to visually learn how to adjust your body.

Check out this great diagram (right) from the Mayo clinic that illustrates some postural checkpoints to focus on during walking.

Activities that enhance postural awareness go a long way toward improving your ability to recognize and correct postural problems.

Victory

As you read at the beginning of this article, Parkinson’s attempts to steal freedom people by overwhelming them with frustration, grief, or fear of living as a slave to a disease for the rest of their lives. However, as you can see, exercise can set you free. Exercise can teach your body to move right again, and exercise can teach you the tools you need to fight back and reclaim your freedom.


Trevor Wicken has been practicing as a Medical Exercise Practitioner for almost two decades and has a Bachelors degree in Sports Medicine and a Masters Degree in Exercise Science. He is certified as an elite trainer through NASM and has spent his entire career passionately helping people to use exercise and movement to reduce pain, prevent injury, and manage medical conditions. 

Seniors with trainer in gym at sport lifting barbell

4 Tips to Help Your Clients Reduce Their Risk of Falls

No matter how fit and healthy your older clients are, there is one thing that can change their lives forever: a bad fall. Every year, almost 1/3 of older adults fall and many cause injuries that will affect them the rest of their lives.

As a fitness professional, you need to be well-prepared to deliver the most effective fall prevention exercise programming to your clients. You can find excellent guidance on assessment and program design at www.mobilitymatters.fit. But you also should be providing advice to your clients on how to reduce their fall risk in other ways.

Have them do these and keep them on their feet!

1. Many falls happen outside where there are lots of potential hazards. Advise your clients to avoid walking on loose gravel, metallic/painted surfaces and cracked sidewalks and avoid being outdoors in bad weather (e.g., rain, sleet, snow). Appointments can always be rescheduled, but a trip to the ER should never be the reason!

2. Indoors, advise your clients to make sure that their path from the bedroom to the bathroom is free from obstructions (e.g., pet toys, rumpled rugs) prior to going to bed at night – that way a trip to the bathroom will not include a trip and a fall!

3. Advise your older female clients to never wear high heeled shoes outdoors. Put their heels in a canvas tote bag and walk outside in sneakers or flats instead. Nobody looks good falling, no matter how stylish the shoes!

4. In the bathroom, advise your older clients to line the floor of their shower/tub with textured adhesive strips. These are less likely to cause a slip or a trip than a rubber bath mat that might slip or bunch up. They also give a nice pedicure!

Are you a fitness professional interested in learning more on this topic? Check out Dr. Thompson’s 4 hour course with PTontheNet, Essentials of Older Adult Exercise Assessment and Program Design for Preventing Falls.


Christian Thompson, PhD is an Associate Professor in the Department of Kinesiology at the University of San Francisco and founder of Mobility Matters, an exercise assessment and program design platform designed to help fitness professionals and clinicians work with older adults. Christian has published scientific articles on exercise programming for older adults in peer-reviewed journals such as Medicine and Science in Sports and Exercise, Journal of Aging and Physical Activity, and Journal of Applied Research.

Pineapple-Paradise-Spinach-Smoothie-Culinary-Hill-square

The Naturopathic Chef: Jaeger Bomb Smoothie

This smoothie was created in honor of one of The Ageless Kitchen’s favorite Food and Fitness Lovers. Jaeger is a poster person for the life/work balance I speak of. This recipe is a big dose of oxygen, especially for a person who might sit in front of a screen all day. Our red blood cells go to sleep, and become stacked like poker chips, in our torso. We can’t process fat efficiently if we don’t fill our bodies with oxygen. Aerobic means “with usable oxygen.”

So, here’s to moving, even if you’re not moving. Burning fat, by increasing oxygen and reducing inflammation is The Jaeger Bomb’s mission.

Ingredients

  • ¾ cup frozen Pineapple
  • 1 cup Power Greens mix (produce section)
  • 1/3 cup Coconut water
  • 1/3 cup Almond milk
  • 1/3 Avocado, peeled and seeded
  • 2 tsps Chia
  • 2 tsps Hemp Hearts (seeds)
  • 1 tsp Vanilla

Place all ingredients in a blender, and process until smooth and light green. Stop and scrape the sides down 1 or 2 times. Our customers comment about how light and airy our smoothies are. We don’t add ice, and we blend an extra 1-2 minutes.

Phyte Bites

Pineapple is a very powerful anti-inflammatory food, due to the enzyme Bromelain. The highest concentration of Bromelain is found in the core of the Pineapple. When I cut up a Pineapple to freeze, I include the core. Slice it in coins and toss with the other fruit. When you blend it, you won’t even notice.

All of the different greens contain different phytonutrients. Change it up each week. Avocado, Chia, and Hemp provide essential fatty acids, and offer a host of other vitamins and minerals. This is a smoothie with serious Phyte!


Affectionately referred to as The Walking Encyclopedia of Human Wellness, Fitness Coach, Strength Competitor and Powerlifting pioneer, Tina “The Medicine Chef” Martini is an internationally recognized Naturopathic Chef and star of the cooking show, Tina’s Ageless Kitchen. Tina’s cooking and lifestyle show has reached millions of food and fitness lovers all over the globe. Over the last 30 years, Tina has assisted celebrities, gold-medal athletes and over-scheduled executives naturally achieve radiant health using The Pyramid of Power: balancing Healthy Nutrition and the healing power of food, with Active Fitness and Body Alignment techniques. Working with those who have late-stage cancer, advanced diabetes, cardiovascular and other illnesses, Tina’s clients are astounded at the ease and speed with which they are able to restore their radiant health. Tina believes that maintaining balance in our diet, physical activity, and in our work and spiritual life is the key to our good health, happiness and overall well being. Visit her website, themedicinechef.com

sarahcummings-sleeparticle

The Health Benefits of Better Sleep

The more that time goes on, the more evidence there is that sleep is our friend – possibly one of the best! Do you find that drifting off into sound slumber among today’s full-on society is something that is slightly out of reach for you in your life?

If you’re nodding your head as you read this, and you want to find out how sleep can have a positive impact on your life, then you’ve come to the right place.

Over the course of this article, we’re going to elaborate on the health benefits of sleep and how it can make a difference in your life!

Heart Health

Did you know that the chances of suffering a heart attack or stroke are higher in the early morning hours? [1] It’s thought that this is because of the way sleep interacts with our blood vessels.

If you are experiencing a lack of sleep, then you are considered among those who are more likely to be associated with issues surrounding blood pressure and cholesterol. These are defined as high-risk factors for both stroke and heart disease.

You’ll benefit from a healthier heart if sleep between seven and nine hours every evening, as recommended by health professionals.

Body Repairs

Sleep is your body’s time to be at its most relaxed. This is also the period in which the body busies itself repairing any damage developed from a range of factors, including stress.

When you’re asleep, notably deeper stages of sleep, [2] your body works to repair muscle, organs, and other cells. Chemicals that operate to strengthen your immune system begin to circulate in your blood.

Your body’s cells are able to produce more protein, and these protein molecules are at the root of the repairs your body needs to overcome daily stressors.

Less Stress

When you don’t receive adequate amounts of sleep, your body moves into a state of stress. This means that your body’s functions are put into ‘high alert mode’, with the effects of this ranging from high blood pressure to the increased production of stress-related hormones.

Avoiding high blood pressure is important, because high blood pressure can increase your heart attack and stroke risk. What’s more, when we factor in stress hormones and how they make it harder to fall asleep, it soon becomes clear that sleep is vital to stay for health.

More Energy

High-quality rest gives will make you feel energized and more alert the following day. You’ll be more active and use up the energy you’ve rewarded yourself with, which subsequently opens the door for a good night’s sleep that evening, too.

This knock-on effect creates a healthy cycle that is hard to not enjoy, especially when you are waking up feeling refreshed and ‘full of beans’ to accomplish whatever lies ahead each day.

Enhanced Memory

During sleep, as your body is resting and repairing itself, your brain is hard at work processing the things you have learned that day.

It’s like a filing process, whereby your brain is sorting all the things in their rightful place, creating connections between events, memories and feelings, for example.

The ability to move into a deep sleep is absolutely essential for your brain to form links and memories, and the better quality of sleep you experience, the better your memory will become.

Weight Loss

Some experts believe people who sleep under seven hours each evening, are more likely to be classified as overweight or obese. Researchers believe that this is due to the balance of bodily hormones that affect the appetite of sleep-deprived individuals. [3]

The body’s hormones leptin and ghrelin are both responsible for the regulation of your appetite, and when sleep isn’t at a suitable level, these hormones become disrupted.

The result of the disruption with these hormones is that you will eat more than necessary, and when you eat more than you need to, losing weight – and even maintaining it – becomes a difficult task.

Conclusion

As you may have realized throughout this article, sleep has the ability to have a bearing on many of the chemicals and processes that help your body to function. This is what makes sleep such an important function in all of our lives.


Sarah Cummings writes for The Sleep Advisor (sleepadvisor.org), a site dedicated to helping people improve their sleep habits. Her love of exercise has always been a big part of how she leads her life, and finds that her keen approach to a healthy diet, daily yoga and dedication to high-quality sleep helps her offer sound advice to others all over the world!

References

  1. https://www.nhs.uk/news/heart-and-lungs/heart-attacks-worse-in-the-morning/
  2. https://www.huffingtonpost.co.uk/2014/03/07/your-body-does-incredible_n_4914577.html
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3519150/

 

quitting as self care

Quitting as Self-Care

A few years ago the term self-care appeared as a means of describing anything that a person does to take care of themselves, like getting a massage, meditating, going for a walk in nature, or taking a relaxing bath in essential oils. All of the above are great ways to improve your physical and emotional health; however, they are often used not as a way to improve health, but to undo the damage caused by underlying stresses and simply restore one’s previous level of health.

Take meditation. It’s a practice that has been used for millennia as a means of trying to reach an enlightened state. But what do we often use it for now? As a means to calm ourselves down after an argument with a significant other or a way to gain a glimpse of equanimity before what we know will be a tough day at work.

In the above instances, meditation isn’t being used to take us to a higher place, it’s being used to get us back to baseline. And then the next day, when our job or our toxic relationships drag us back into sadness or anxiety, we use it again to bring us back up.

This is akin to using Tylenol to treat cancer. Cancer causes pain, so we take Tylenol to relieve the pain. This treats only the symptoms and ensures that we’re going to have to take Tylenol again and again each time the pain arises.

How would we stop that cycle? By curing the cancer.

Similarly, you can’t massage away a bad job and you can’t journal away a toxic relationship. In both instances, you’re merely treating the symptoms.

What’s the cure? Quitting.

Quit the job that’s taken your sanity day after day. Quit the relationships that have led you to the negative self-talk that requires hours of journaling and meditation to sort out.

Because all of the above self-care tools are amazing in their own rights, but are so much more helpful in improving your physical and mental health if you’re starting from a more stable baseline — which requires taking a good look (often through journaling!) at what is disturbing your peace.

So next time something has you anxious or depressed, grab that journal and write down what led to that feeling. Then start analyzing whether the cause can be quit. You may need a job-ectomy, or to have some toxic friends surgically removed from your friend circle.

And after you do, be sure to light some candles, throw some essential oils in a bathtub, and meditate your way to enlightenment — free of whatever was holding you back!

Learn more about strategic quitting for your health… register for Dr. Morski’s upcoming webinar:


Article reprinted with permission from Lynn Marie Morski.

Dr. Lynn Marie Morski is a Quitting Evangelist. She helps people to and through their quits through her book “Quitting by Design” and her podcast Quit Happens, along with speaking and coaching. She is also a board-certified physician in family medicine and sports medicine, currently working at the Veterans Administration. In addition, she is an attorney and former adjunct law professor at Thomas Jefferson School of Law. Visit her website, quittingbydesign.com

Surgery word cloud

Can I Avoid Surgery?

Did the title of this article capture your attention?  It should because surgery, no matter how big or small, is serious business. The type of surgery this article is speaking to is orthopedic surgery. This means surgery due to pain, disease, and dysfunction in your muscles, tendons, ligaments, bones, and joints.

Maybe you, or someone you care about, have been told that surgery is necessary.  You have done what the doctor suggested.  You tried Physical Therapy.  You went beyond that, and tried massage, acupuncture, chiropractic, drugs, and other alternative interventions. Why would avoiding a surgery even come into your mind? You are in pain, the doctor said you need it and that should be the end of the discussion right?

It’s a tough decision with uncertain consequences. Second and third opinions are recommended.

There might be several reasons why you want to avoid it; the thought of someone going in and “cutting you” (surgery is really a controlled injury), the risks associated with being put under anesthesia, the long recovery time and disruption to your life routine post surgery, you know someone that had surgery and months later are still not feeling much better, or they may be suffering complications from the surgery itself.

You have doubts.

Maybe you have read the recent research that concluded that a very common surgical procedure on knees actually showed more long term harm than good. (1)

Have you read the research that shows that there are many individuals with a diagnosable orthopedic disease that don’t report pain?  And there is research that shows that some report pain and nothing can be found wrong that directly explains the pain. (2) (3)

Maybe you will need the surgery. But is there one more conservative non-surgical alternative that you haven’t tried yet?

There is… Exercise.

But wait, you already did exercises at the physical therapy clinic. Even the chiropractor gave you some stretches and rubber bands to tug on and that didn’t work.

Here is the problem. All exercise is not created equal. What may work for one person doesn’t work for another.  Why is that?

Because every pain situation, just like people, is unique.

Pain is a word. When you choose to use the word pain to describe a sensation in your body you are clearly elevating the level of concern you have for the sensation.

Pain is not a thing like a brick, cat, glove, or car. Pain is the brain’s conclusion about all of the information it is receiving and processing from within the body moment-to-moment.

If you are considering surgery because you are experiencing a sensation that you choose to use the word pain to describe, then in a sense you are having surgery to remove the pain right? Which is weird because pain isn’t a thing to be removed, as it is simply a word chosen to describe a subjective conclusion based on bodily information. So a surgeon doesn’t remove pain with a scalpel, they remove the body part that they think is causing the pain. Sometimes this works great. Sometimes it doesn’t. See previous references.

What the surgeon is doing, what the drugs are doing, what the spinal manipulations are doing, are changing, or at least trying to change, the information that the body is producing to see if changing the information that way will lead to a new conclusion of the brain.

Change the information and possibly change the conclusion.

Back to the exercise thing.

What is exercise? It is stimulation to, and of, the body that changes the information within it. Sometimes those changes are short term and sometimes they can be of a longer term.

But you tried exercise in physical therapy and with the chiropractor and it didn’t help.

As stated earlier not all exercise is equal. Often exercises are just given to work on the area of the body that hurts. This might not be the best way to change the information. Exercise has very specific influences on the body depending on HOW you do it. The old adage “Just Do It” is painfully inaccurate advice. We need to know the quantity but also need to know the quality of your experience with different exercises.

Pain is a subjective experience that, at least right now, does not have an objective measurement like temperature, pressure, and distance. Your pain is totally unique to you and cannot be experienced by anyone else. Pain has a component of quality associated with it. It certainly can have a cause like when you break a bone, cut of your skin, tear a muscle, or sprain a ligament. But sometimes the cause is not so clear-cut.

So what am I proposing? What could be the thing that you haven’t tried yet?

A different approach. A totally different strategy. A more precise HOW.

I am talking about exercise that is highly catered and highly specific to your unique body.

Your body has its own unique history, a unique genetic profile, a unique combination of diseases and dysfunction, all of which confluence towards a unique problem. This requires a completely unique solution. A completely unique HOW.

This unique strategy and HOW is based on some simple concepts.

  1. All physical exercise uses the Muscular System in some form or another.
  2. The Muscular System receives and produces information form the nervous system.
  3. Muscles control you in three primary ways:
    • By contracting to maintain your joint positions,
    • By contracting to change your joint positions by lengthening,
    • By contracting to change your joint positions by shortening.
  4. Your body is a system that by definition means that all of the body parts are interconnected, interacting, and interdependent.
  5. A system’s control over information, and the stability of that information, can be assessed by perturbing it – by knocking it off course a bit – to see if it can make the necessary course corrections in order to stay in control.
  6. You should be the center of attention – not the exercise. You should not be made to conform to the exercise – the exercise should be made to conform to you.

If number 4 is true then it stands to reason that any part of your body’s information generation and processing can affect any other part’s information.  You may good at contraction shortening but are not so good at contraction lengthening.

If number 5 is true then a good way to see if you actually have control and assess the information control is my assessing your ability to do number 3.

Given the fact that your body is completely unique from any other body, this means that any strategy and HOW must be created to explore your unique information control system and any influences between parts. See number 6.

This is what Muscle System Specialists are trained to do. To systematically explore your information control by assessing your muscles’ ability to hold joint positions and change joint positions via lengthening or shortening contractions. This tells us about the quality of you information generation and processing.

The challenge is to find those places and conditions. You have roughly 600+ muscles and are capable of being in a dizzying array of positions and motions.

It’s okay – we have a process to explore your unique body’s abilities and start discovering the solutions it needs in order to change its control, to change the quality of information within it that just might lead to a change a reduction in pain.

Can you avoid surgery? Maybe. You have to decide if it’s worth some time and effort to exhaust conservative non-surgical options. Always speak with your doctors regarding this important decision.


Greg Mack is a gold-certified ACE Medical Exercise Specialist and an ACE Certified Personal Trainer. He is the founder and CEO of the corporation Fitness Opportunities. Inc. dba as Physicians Fitness and Exercise Professional Education. He is also a founding partner in the Muscle System Consortia. Greg has operated out of chiropractic clinics, outpatient physical therapy clinics, a community hospital, large gyms, and health clubs, as well operating private studios. His experience in working in such diverse venues enhanced his awareness of the wide gulf that exists between the medical community and fitness facilities, particularly for those individuals trying to recover from, and manage, a diagnosed disease. 

Charlie Rowe, CMSS joined Physicians Fitness in the fall of 2007 after spending 9 years as the Senior Personal Trainer at Oak Hill Country Club in Rochester, New York. He has also worked within an outpatient Physical Therapy Clinic coordinating care with the Physical Therapist since joining Physicians Fitness. Charlie has earned the Cooper Clinic’s Certified Personal Trainer, the NSCA’s Certified Strength and Conditioning Specialist, the American College of Sports Medicine Certified Health Fitness Specialist, Resistance Training Specialist Master Level, and American Council on Exercise Certified Orthopedic Exercise Specialist Certifications. 

References

  • Thorlund, J., et al, Arthroscopic surgery for degenerative knee: systematic review and meta-analysis of benefits and harms, BMJ 2015;350:h2747 doi: 10.1136/bmj.h2747
  • Ave Marie, L., Why Most People Are Wrong About Injuries and Pain – SimpliFaster Blog, 12/24/2018
  • Brinjikji, W., et al, Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations, Apr 2015 www.ajnr.org
Kama-Squat-article

Gait and Alignment

Many times when I run in Central Park, I see some elite runners. They look like gazelles. However, sometimes, I will see runners who have knees turned in, toes turned the opposite way, or simply just POUNDING on their feet.

When I teach Yoga, or even strength training, I advocate aligning the hip bone (asis joint) with the knee, and the 2nd toe.

i.e., Squats.

Often trainers will tell students to “bring their feet hip width apart” and perhaps, having read too many magazines with models who are super thin, they bring their feet so wide that they are BEYOND the alignment they could possible sit in or walk in. Imagine the MANSPREAD on the subway. Over time, if clients keep doing “squats” with their feet so beyond the width of their hips, it puts undo strain on the ACL, ankles, and causes many muscle imbalances.

In a squat, the goal is NOT to “go lower”.

A member once wrote a nasty comment via the gym website that “I didn’t go low enough” in my squat. What is “low enough”? If you are compromising form, or bending your back over more to make up for the fact that knees can only bend so much, then this is counterproductive.

When squatting, you should “crease” the hip joint (hip flexors) and imagine a chair being pulled out for you. Reach for the chair with your butt while bending your knees. The chest may tilt slightly forward, but the movement is NOT initiated by bending the upper body into forward flexion. Imagine if you were wearing all white, dry clean only clothing, and were carrying a tray of martinis (or red sauce). You would have a mess if you bent forward with your upper body. Therefore, keep your chest high, hold the platter high, and only angle forward as needed. This way all the work goes into the quads and glutes, and not into the back.

Exercise Samples (L to R): One leg step up; one leg dead lift; squat to one leg

Another drill I like to teach is a step-to 1 leg squat. Take a step to your right, balance on the right leg, and perform 1-3 squats. Then repeat by stepping left. To advance this, take a little hop, and then do 1-3 1 legged squats.

1 leg step ups (pictured above): place 1 foot on a bench laterally. The step should have 2 risers on each side if you are between 5’ and 5’4, and maybe 3 risers if you are above 5’6, and 4 risers if above 6’ tall. Press the weight into the foot that is on the bench and full stand up on this 1 leg. Then sit back down into the squat stance with both knees bent (one will be on the floor).

1 leg dead lifts  (pictured above): based on warrior 3: 1 leg is very straight without locking. Like a seesaw, pitch forward by lifting the free leg as high as it can go, but do not round the back, or drop the chest. I also look forward and keep my chest slightly lifted. Recover to upright by raising the gaze. Repeat 4-8 reps per leg.

Sit, stand, raise lower…this is a combination 1 leg squat into 1 leg deadlift (warrior 3). Repeat 4-8 reps.

Practicing 1 legged drills will make it so that when you perform drills such as squats on 2 legs, you will remember that if you were to take 1 leg off the ground, your stance/width should be based on this idea.

This will give you better form for running, and even walking.

The hip, knee, and 2nd toe should always REMAIN FRIENDS in every exercise for better alignment, and pain-free workouts.


Kama Linden has been teaching fitness for over 2 decades. She has taught strength, step, pilates, vinyasa yoga, senior fitness, and has worked with clients and students of all ages and fitness levels. She is certified by AFAA Group Exercise and NASM CPT, as well as 200 hour Yoga. She has a BFA in Dance from University of the ARTS.  Her new book, “Healthy Things You Can Do In Front of the TV” is now on sale on amazon.com, BN.com, and Kindle. Visit Kama’s website, bodyfriendlyoga.com, and kamalinden.com.

healthy-food-assortment

Aging Well By Eating Well

Our health and how we age are not only dependent on our genes, exercise and a positive attitude. What we eat has a major influence on how well we look and feel as we head into our golden years. Simple changes to the choices made on a daily basis can make aging well something to look forward to.

One vitamin (really a type of hormone) that most of us are deficient in, but is essential to optimal health is vitamin D (specifically, vitamin D3 or Cholecalciferol), and many longevity experts call it the miracle anti-aging vitamin.

A lack of D3 is thought to be a factor in many health problems, from increased cancer risk to inflammation and osteoporosis. Our bodies make vitamin D when our skin is exposed to sunlight. Ten to fifteen minutes per day between the hours of 10am and 3pm on unprotected skin is all you need. However, increased time is necessary for those who are older, have darker skin or are obese. By using sunscreen to prevent the risk of skin cancer after a thirty-minute sunbathe, not to mention wrinkles, or if you happen to live in northern regions (37 degrees above the equator or basically north of Atlanta, GA) during the winter months, you are unlikely to get sufficient sun exposure to produce enough. Since our vitamin D level decreases with age, and it can be difficult to get adequate amounts from the food and beverages we consume, the majority of individuals take it in the form of a supplement. A simple blood test can determine if your vitamin D3 level is within the recommended healthy range; ideally between 30 and 60 ng/ml. In the meantime, you can eat more fatty fish, mushrooms, and fortified dairy, juice and cereal products.

We also tend to become deficient in B vitamins as we age, especially B6. Thankfully, this vitamin is one you can easily get through food by choosing poultry and other meats, as well as fish including cod, salmon, halibut and tuna. Fruits and vegetables such as avocados, red bell peppers, spinach, yams and potatoes with the skin on, asparagus and green peas are also excellent sources of this essential vitamin. Snacking on unsalted sunflower seeds, chestnuts and pistachios will supply a good dose of B6 too.

If you want to age well, there’s no better strategy than loading up on the veggies. They provide essential minerals and vitamins. Plus, they are chock full of natural antioxidants. Strive to eat a “rainbow” of colors, as the darker the pigment in the food, the more minerals and vitamins it contains. Choose dark green leafy greens including kale and Swiss chard, orange and red foods such as carrots and tomatoes, purple fruits and veggies similar to blueberries and beets, as well as yellow foods like peppers and squash.

Fat is not the enemy when it comes to aging well. Good fat from omega-3 fatty acids, that is. Two crucial ones – EPA and DHA – are primarily found in certain fish. Two to three servings of fish a week is adequate, since so many types are contaminated by mercury, PCBs, dioxin or other toxins, so more is not necessarily better. This warning about fish is true especially for children and pregnant women. Another omega-3 fatty acid, ALA (alpha-linolenic acid), is found in plant sources such as nuts and seeds like walnuts, chia and oils from flaxseed. These all support heart health and brain cell function, among other anti-aging benefits. They are also thought to be important for cancer prevention and reducing the risk of autoimmune disease, which can increase as we age.

An additional strategy for nutritionally aging well is to increase your fiber consumption. Although we need a little less as we get older, most of us never reach the recommended 21-38 grams per day. Aim for two servings of fruit, three vegetables and three to four portions of whole grains daily. Remember to gradually increase your fiber intake, as well as your water to prevent any gastro-intestinal discomfort.

Most everyone can drink more water. It is essential to cellular function and organ health, including adequate digestion and glowing skin. Who doesn’t want that? Increasing your water intake gradually is the key to establishing a new habit. Start by drinking one glass for every caffeinated beverage you consume. Then slowly begin to replace other liquids like diet drinks, fruit juices or sugary beverages to work up to a minimum of eight glasses a day. Be sure to consult your physician or a Registered Dietitian Nutritionist if you have a heart, kidney or lung disease as your fluid intake may need to be limited.

Last, but not least, don’t skip breakfast. It is the most important meal of the day for fueling your body and maintaining your metabolism. Choosing your breakfast foods wisely will give you the energy needed to start your day on the right track. Reserve fast food, high-fat options, pastries, and high-sugar cereals to infrequent emergency situations.

Hopefully, by implementing the suggestions offered you will begin aging well by eating well.

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Regina Saxton is a Registered Dietitian Nutritionist specializing in intuitive eating behaviors helping women develop a healthy relationship with food and their bodies while managing weight and disease for optimum health. She has a private practice out of Georgia and offers virtual nutrition coaching nationally. Visit her website for more information, reginasaxton.com