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What You Need to Know about Exercise and Diabetes

Sheri Colberg, Ph.D./21 November 2017/ All MFN blog, Conditions/

Do you have type 1 diabetes, type 2 diabetes, or prediabetes? Then you need to know that exercise is a cornerstone in the management of all of these conditions, and it can benefit your health in so many ways.

diabetes old Sometimes, being active can actually make it more challenging for you to manage your blood glucose (“blood sugar”) levels, unless you learn more about its effects. I have always known at some level that exercise generally did good things for my blood glucose, even before I had my first blood glucose meter (after going 18 years without access to one). How could I tell without a blood glucose meter?

Being active always made me feel better, physically and emotionally, so much so that I earned a PhD in Exercise Physiology to understand why. You don’t need to go that far with your education, but there are some basics about being physically active with diabetes or prediabetes that you really need to know.

Here are some things that I know about exercise now that I wish someone had told me years ago.

#1: Exercise can help erase your blood glucose “mistakes”

Exercise acts kind of like an extra dose of insulin.
At rest, insulin is the main mechanism your body has to get glucose into muscle cells.
During exercise, glucose goes your muscles without needing any insulin (via muscle contractions)
Being regularly active makes your muscles more sensitive to insulin, so it takes less to have the same effect when you eat during or after exercise.
What better way to help erase a little overeating of carbs (or some insulin resistance) than a moderate dose of exercise to lower your blood glucose?

#2: Exercise doesn’t always make your blood glucose go down

It doesn’t always make your blood glucose come down, at least not right away.
During intense exercise, the excess glucose-raising hormones your body releases can raise your blood glucose.
Over a longer period of time (2-3 hours), it usually comes back down, but who wants to wait that long?
If you take insulin, you’ll need to take less than normal to correct a post-workout high or your blood glucose will likely be crashing low a few hours later.
A cool-down of less intense exercise (like walking) can help bring it back to normal, so do an easy, active cool-down after intense workouts or activities.

#3: Your muscles are critical to managing your blood glucose levels

Exercise also helps you build and retain your muscle mass.
Muscles are the main place you store carbs after you eat them—like a gas tank.
Exercising helps use up stored carbs, but can also increase the size of the tank.
When you eat carbs post-exercise, they can easily go into storage with a little insulin.
Being sedentary keeps the tank full and makes you resistant to insulin.
Aging alone can cause you to lose muscle mass over time, but you can combat it to a certain extent by recruiting all of your muscle fibers regularly.
Resistance training and/or high-intensity intervals build muscle more because they recruit the faster fibers that you don’t use when walking or doing easier activities.

#4: Exercise is the best medicine there is

Use exercise to control stress and to stave off depression—with no bad side-effects!
It’s a natural antioxidant—more effective and better than supplements!
Being regularly active prevents all sorts of cancers.
If you’re active, you’ll likely feel better and look younger than you are (as long as you don’t exercise too much).
You’ll be even less likely to catch a cold if you exercise moderately and regularly.
Standing more, taking extra steps, and fidgeting even help—be active all day long, and don’t forget your daily dose of the best medicine there is!

For other tips on exercise and more, visit www.diabetesmotion.com or www.shericolberg.com. You can also find some exercise programs geared towards people with diabetes by visiting Diabetes Motion Academy (www.DMAcademy.com).

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.

How Boxing Can Help You Be a Parkinson’s Fighter

Carisa Campanella/20 November 2017/ All MFN blog/

Media coverage on the power of boxing to combat the symptoms of Parkinson’s disease has been a hot topic in the Parkinson’s community. Rock Steady Boxing, a national program that initiated Parkinson’s specific, non-contact boxing programs with certified coaches, has inspired local boxing gyms in our area to begin offering boxing training to our local community. So, is boxing your way to better health an option for you? More importantly, what are the benefits of this fun and energizing fitness trend?

Learning how to box and executing the six common punches – jab, straight right, left hook, right hook, left uppercut and right uppercut – is a powerful way to develop your skill-related fitness. Skill-related fitness includes agility, balance, power, speed, coordination and reaction time. All these components are of particular importance to someone with Parkinson’s who may be experiencing a decline in several of these areas. Shadow boxing (punching the hands of a trainer in front of you in a sequence) helps improve speed, coordination and reaction time. Taking lateral steps around a boxing ring helps reinforce balance and agility. Putting your body into a split stance to throw your punches helps to strengthen your lower body and make you more stable.

Another excellent advantage to boxing is it enhances your cognitive fitness. Many people with Parkinson’s experience some challenges with clarity of thought, memory, and ability to do certain tasks. Learning boxing punches in sequence and repeating them helps to create new neural pathways which help to strengthen your brain and your functionality. Being exposed to and learning this new activity also helps improve your cognitive abilities.

What may be the most important reason to take up boxing is the feeling of strength and empowerment you will feel as you literally “fight” this disease. Punching a boxing bag can help relieve stress, make you feel in control, and give you an incredibly productive outlet. Boxing is fun, it’s invigorating, and it’s energizing.

In order to participate safely, be sure to get your physician’s clearance before beginning a boxing or exercise program, and always adhere to the safety precautions outlined by your instructor.

Carisa Campanella, BA, AS, is an ACE Health Coach and ACSM Personal Trainer. She is the Program Manager at the Neuro Challenge Foundation for Parkinson’s. Neuro Challenge provides ongoing monthly support groups and educational programs, individualized care advising and community resource referrals to help empower people with Parkinson’s and their caregivers.

Exercises That Can Help Prevent and Relieve Arthritis

Maurice D. Williams, MS/15 November 2017/ All MFN blog/

Arthritis is a disease where the joints of one’s body are chronically inflamed. 46 million (or 21%) Americans have it and it is one of the leading causes of work disability.

They are two major forms of arthritis: osteoarthritis and rheumatoid arthritis. Osteoarthritis is when the cartilage within the joints wears away and causes severe pain and swelling, particularly in the hands, knees, hips and spine. Rheumatoid arthritis, on the other hand, is where one’s immune system mistakenly attacks it’s own tissues. As a result, the body responds with pain and stiffness in areas of the body such as wrists, hands feet and knees. Fortunately, exercise can help provide some relief, pain and discomfort wise, for those suffering with this chronic health condition.

How Exercise Helps to Relieve It

There have been two significant studies that showed exercise could help arthritic people feel better. Strength training and balance exercises were used to provide relief from the pain experienced because it improved flexibility and overall strength. Balance and strength training affect one’s gait, so, at the very minimum, exercise can help to improve this. Also, it is important to keep in mind that arthritis increases muscle loss and lack of flexibility. As a result, it is important for an individual with arthritis to keep their body limber and moving as much as possible.

Exercises That Can Help With Arthritis

According to NASM, the following protocol should be followed by arthritic people for a reduction in pain and overall health improvement. Please keep in mind, that anyone starting an exercise program, should consult with their physician and a qualified fitness professional first.

Cardio Exercise: treadmill walking, stationary cycling and low impact step aerobics. I recommend up to 30 minutes as a general goal to aim for with duration. The intensity should be from a walk in the park to a light job.

Flexibility: Static stretching and foam rolling may be used as tolerated for the areas of the body that appear to be overactive. These can be performed seated or standing.

Weight Training: Exercises that include core, balance and general overall major muscle groups are recommended. Circuit training is a great way to get all of those things done in one session. I suggest 1-2 sets of 10-12 reps, 2-3 times a week. It is important to keep in mind the following when doing exercise: avoid heavy lifting, with high reps, stay away from movements that cause pain and be prepared to only do five minutes of exercise in a given session until your overall conditioning improves.

Maurice D. Williams is a personal trainer and owner of Move Well Fitness in Bethesda, MD.

Resources

1. http://blog.nasm.org/senior-fitness/what-a-pain-in-the-joint-training-guidelines-for-arthritic-clients/
2. http://blog.nasm.org/senior-fitness/modify-training-programs-clients-osteoarthritis/
3. http://www.healthline.com/health-slideshow/8-essential-everyday-exercises-for-ra-pain#8

Source
NASM Essentials of Personal Fitness Training, 4th Edition Revised, 2014.

Put Your Best Move on for Movember

Shira Litwack/13 November 2017/ All MFN blog/

The event men look forward to — and women don’t — the Movember Moustache.

Recover from Injuries Using Active Rest in the Pool

Debbie Booth/9 November 2017/ All MFN blog/

Have you ever felt like Tom? You try and try but seem to end up adrift? Your intelligent, well read a motivated, hard working athlete, you know a lot of things, you certainly know how to exercise and you do it well. You have probably asked for some advice over the years on how to train. Especially since that nagging injury occurred.

Maybe it’s shin splints that developed from training for a ½ marathon, maybe it’s the knee injury from playing basketball, tennis, pickleball or sliding into 3^rd base. Maybe you rolled an ankle because you missed that bottom step while walking out the door and that ankle hasn’t been right since.

So what do we do? We medicate it, rest it, tape it and brace it. While we are resting we look at the latest exercise programs and plot our course to get back on track once we feel it’s better we hit the gym – wrap that injury and go…. HIIT training, Cross Fit, Boot Camp, running we are on a roll. After just a couple weeks that injury is back. Now we are back on the couch with our favorite bottle of motrin again, now your despondent. That nagging thought creeps into your head, I’m too old, gotta give up the game.

Not so fast my friend! We can do things a different way! The problem here is we took a few weeks or months off!

How about trying ACTIVE Rest?!

Active rest defined: “Involves performing light exercises that stimulate the recovery process without imposing undue stress on the injured body part.”

Taking an active rest day will hasten your recovery, making you feel stronger and faster when you’re back in workout-mode.

What are the benefits of active rest in a pool?

Biggest benefit – Reduce swelling. When you reduce swelling you reduce pain. A two-fer bonus! Also unload the joint – due to the gravity free environment, again – takes the pain away. With the reduction in swelling and pain we can keep the joint moving, stabilize and strengthen it, working up to full body workouts to spin you back out into your sport.

The pool is what I call a pass through. It’s not a destination for most of us. We use it for it’s amazing properties so we can continue our favorite activities and sports. Active rest in a pool will not only rehabilitate your injury getting you back to your sport and activities faster it will help you mentally and emotionally, because you can DO something! It keeps CAN’T out of our vocabulary! High Schools, Colleges, Professional Teams and even our Military are using pools for training. Athlete or not, we hate being sidelined. We do much better when we are active. So next time you are adrift…try something different.

Debbie Booth is an aquatic fitness educator and trainer; she grew up in MI, (a Lake Girl for life) where her love of water began. She teaches medically based aquatics and has yet to grow gills. If lost she will usually turn up at the end of a dock with her feet in the water. You can visit her website at wateristhenewgym.com

Trainer helping senior woman exercising with a bosu balance

Strategies to Improve Your Balance and Stability

Carisa Campanella/19 October 2017/ All MFN blog/

Challenges with balance and stability can happen to all of us as we get older, but is certainly more prevalent in our Parkinson’s community. Maintaining lower body strength in conjunction with balance is very important as it decreases one’s chances of falling. Balance is defines as the state of having your weight spread equally so you do not fall; stability is the quality or state of something that is not easily moved. In order to maintain balance and stability, we need to have our center of gravity over a strong base of support. If your center of gravity standing upright is the area of your belly button – then your feet are your base of support. Standing with both feet on the ground spread just past shoulder width offers a stronger base of support than standing on one leg or with your feet very close together.

There are many issues that can affect your ability to balance yourself while standing or walking. Trouble with vision, lack of lower body strength, poor posture, medications, low blood pressure, and inability to properly lift our feet are all contributors. So how can you better prepare yourself to stay strong on your feet?

Slow Rise: When standing up from a chair or rising out of bed – do so slowly and wait about 5 seconds before you begin to walk. This enables your body to adjust to the change of position.

Hands Free: Keep at least one hand free at all times while walking – carrying an object with both hands can interfere with your ability to balance.

Arm Swing: Attempt to swing both arms from front to back while walking – this also helps maintain an upright posture and reduces fatigue.

Walk Consciously: Always strive to consciously lift your feet off the ground while walking; a shuffling gait can cause one to trip.

Make a U-Turn: When trying to navigate a turn while walking, use a “U” technique of facing forward and making a wide turn as opposed to pivoting sharply.

Helping Aides: Don’t be intimidated by canes, walking sticks, walkers or grab bars. These helpful devices can keep you safe and prevent a fall.

Keep it Simple: Only do one thing at a time when you are on your feet. Using a phone, gazing around, or even drinking a beverage can be a distraction and affect your balance.

In addition to taking these steps to maintain your balance and stability – take precautions in your home to make it safe. Loose throw rugs, scurrying pets, wet bathtubs and slippery staircases can cause danger in your home and throw even the most strong and stable person off balance. Also, working with a fitness professional to strengthen your stomach and leg muscles will help keep you more stable and lessen your likelihood of falling if you were to lose your balance. A strong body is a more stable body!

For Optimal Workouts, Learn to RECOVER Like the Pros

Nicholas A. DiNubile, MD/18 October 2017/ All MFN blog/

Your body was built to move but to move effectively and efficiently, especially over the long haul, it needs to rest. At any given point in time a significant percentage of competitive athletes and even fitness buffs are over-trained. The “overtraining syndrome” is brought on by athletes falling into the ‘too much, too hard, too frequent and too little rest’ mode. Usually done to improve performance, but ultimately resulting in a point of diminishing returns- or gains actually turned to losses. Common symptoms can include all of some of the following: fatigue, irritability, muscle soreness, difficulty sleeping, elevated resting heart rate, decline in performance and even the onset of overuse injuries.

Exercise and the training associated with it, are a very powerful stimulus. Your body is challenged on multiple levels, from individual body parts to the system as a whole. For example, if you do a typical weight training session, each muscle that you work is stimulated and there is a local response in that muscle. There is also a cumulative metabolic cost to your entire system from that workout. This is true also of any vigorous workout including running, cycling and swimming. Local body parts are challenged as is the entire system. Your body needs to recover from both, and each has its own timetable.

To make gains – either muscle growth with weight training or cardiovascular with aerobic exercise – you need the exercise stimulus (ideally a near maximal effort) followed by adequate rest and recovery. It is on that rest stop where gains are actually made, as the body repairs itself, adapts, and you are taken to the next level. It should be clear why the mindset of “if a little is good, more is better” does not work here. It is also why smart successful professional and high performance athletes schedule recovery time as they would a workout, practice or a training session. It is critical to optimal performance. In fact, in recent years, we have made such tremendous gains in the areas of training and nutrition, that we may be reaching the point of maximum benefit for those variables. I believe that recovery is the next frontier in optimal training and achieving peak performance.

Also recovery doesn’t mean you need to be on the coach doing nothing. There are forms of “active rest” that can actually enhance and speed recovery. Take a walk or do a very light aerobic activity. Blood-flow to the nooks and crannies of the body enhances recovery and the repair process. Also, try yoga, get a massage, or hit the whirlpool. Water is a great medium for recovery, so hit the pool and try some light movements like treading water. But think twice before taking the ice plunge as recent research suggests that ice baths may delay or interfere with the recovery process. Drinking plenty of water and eating properly are also critical. The timing of your nutrition is also important, especially after a hard workout, as there is a golden 30-60 minute post-workout window where certain nutrients can make a recovery difference. Chocolate milk is one nearly perfect choice. And never underestimate the power of getting adequate shut-eye. The body repairs itself mentally and physically during sleep. I recently saw a funny but astute tweet (by Shower Thoughts @TheWeirdWorld) that said, “your bed is pretty much just a charger for your body.”

When it comes to the body’s adaptability and recovery response, the key is not pounding your body the same way everyday. Also follow the 10% rule-never increase your program (i.e. the amount of weight lifted or miles logged) more than 10% per week. This especially true when coming off an injury. Trying to make up for lost time courts disaster. Increasing the intensity, duration or frequency of your workouts too rapidly can interfere with your body’s amazing ability to adapt, resulting in overtraining, injury or both. Also there are new technologies like the Marc Pro device that can enhance muscle recovery and it is no surprise that so many professional and high level athletes are using it regularly. For those aging athletes and Master’s athletes, remember that the body does not recover as efficiently as we age, so you may need a little longer time to bounce back.

Remember what Lau Tzu said many years ago, “a bow that is stretched to its fullest capacity may certainly snap”. In your effort to constantly improve your fitness or specific sports skills you are probably at times pushing yourself to that very brink. Be aware of that predictable time of vulnerability for you, one that is usually remedied by a little R&R thrown into the mix.

So, for optimal gains, in the gym or on the field, learn to kick back at times. Give yourself a break – you will comeback even stronger.

Originally published on the Huffington Post. Reprinted with permission from Dr. DiNubile.

Nicholas DiNubile, MD is an Orthopedic Surgeon, Sports Medicine Doc, Team Physician & Best Selling Author. He is dedicated to keeping you healthy in body, mind & spirit. Follow him MD on Twitter: twitter.com/drnickUSA

Pregnant woman using exercise bike at the gym

Prenatal Exercise Program Design: Exercise Type

Catherine Cram/17 October 2017/ All MFN blog/

Choosing the type of exercise that is best tolerated during pregnancy depends on the following considerations:

Which activities the client enjoys or is skilled at performing
Whether the activity poses any risk to the mother or fetus
Is she is able to do the activity without being compromised by balance and center of gravity changes
Can the activity be easily modified as pregnancy progresses

Weight-bearing exercise such as walking, dancing, and running help maintain bone mass and some studies suggest they are more effective for keeping pregnancy weight gain within normal limits. As pregnancy progresses some women may not be able to continue weight-bearing exercise because of back or round ligament pain. If modifications such as wearing a belly support don’t relieve discomfort, switching to non-weight-bearing activities such as swimming, stationary biking, or other types of stationary exercise equipment is recommended.

Absolute and relative contraindicated activities for pregnant women are listed below. Pregnant women should always consult with their healthcare provider before taking part in any exercise program and assess the risk/benefit ratio whenever there is a question about the safety of any activity during pregnancy. Keep in mind that activities such as downhill skiing must be assessed for risks that are not controllable, such as the effect of high altitude on oxygen delivery to the fetus.

Contraindicated Activities for Pregnant Women

High-altitude sports
Water-skiing
Hockey
Gymnastics
Horseback riding
Absolute
Downhill skiing
Scuba diving

You can also view Catherine’s previous articles on exercise intensity and duration.

For more information on prenatal and postpartum exercise and our CE correspondence course, “Prenatal and Postpartum Exercise Design” please visit, www.ppfconsulting.com

Article reprinted from Catherine’s Maternal Fitness blog with permission.

Catherine Cram, MS, is the owner of Comprehensive Fitness Consulting, a company that provides pre- and postnatal fitness certifications and information to hospitals, health & wellness organizations and the military.

Exercise and Endorphins

Jaclyn Chadbourne/11 October 2017/ All MFN blog/

Feeling too grumpy or stressed out to exercise? Think again.

A little exercise can go a long way in reducing stress and making you feel good, along with its many other health benefits, like improving/maintaining physical fitness, preventing disease and treating symptoms.

Life is complicated. We are all busy with our own personal challenges and to-do lists. Not to mention the winter months, which can make even the hardiest New Englander want to curl up into a ball and stay in bed until spring finally arrives. But, as tempting as that sounds, it’s not likely to improve your mood at all. If you’re feeling down, resist the urge to mope and get moving.

Studies have shown that moderate to intense exercise can help…

Minimize stress or improve ability to handle stressful situations
Minimize anxiety and reduce of depression
Improve self-esteem and perception of self
Improve sleep patterns and hence energy during awake hours

For those interested in the science behind it, when your body is subjected to certain stimuli (including exercise) your hypothalamus calls for the release of endorphins, and the cells in your body that contain them respond. When endorphins lock into special receptor cells, they block the transmission of pain signals and also produce feelings of euphoria. But endorphins can’t do it alone…. exercise also raises levels of other mood-boosting chemicals like serotonin, dopamine and norepinephrine. The combination of endorphins and these other neurotransmitters produces and effect often referred to as “the runners high”.

In reflecting back on my time as a distance runner, I remember saying many times that it wasn’t always the act of running that got me out there day after day – but rather, the tremendous feeling that I got after my run that had such a positive impact on my outlook. But you don’t have to be a runner to enjoy the benefit of the runners high….just 30 minutes of physical activity can elicit this effect on the body and improve our mood on a chemical level.

How else can it affect us?

During a fast-paced tennis match or an intense kickboxing class, you’ll find that you concentrate more on your body’s movements than on the things that are irritating you or stressing you out. Redirecting your focus can help calm and clear your mind. This is referred to as “Active Relaxation” or the capacity to focus on rhythmic motion that can produce a relaxation response within the body.
By reducing our levels of stress, anxiety and depression, we can also sleep better at night, thus improving our energy during our awake hours and reducing irritability and depression often associated with inadequate sleep. How to get started? Consult your doctor or an exercise professional if you’re new to exercise or have health concerns. Safety first! Start with small, manageable goals and choose an activity that you enjoy. Exercise shouldn’t feel like a chore. Then make room in your schedule! Make your health a priority and set aside time each day to focus on you. You’ll be glad you did.

Jaclyn Chadbourne, MA is a Clinical Exercise Physiologist and Principal, Director of Research and Development – ‎Universal Medical Technology, LLC and United Medical Gym, Inc in South Portland, ME. With a passion for sustainable healthy living and desire to advocate for patient-centered care, Jaclyn works to help support community resources for all special populations and to implement and oversee clinical protocols.

References
http://www.nbcnews.com/id/18043835/ns/health-fitness/t/getting-high-exercise/#.UwJ-wvldXtI
http://www.mayoclinic.org/healthy-living/stress-management/in-depth/exercise-and-stress/art-20044469
http://www.webmd.com/fitness-exercise/features/runners-high-is-it-for-real