Get Fit in Colorado at the Wilderness Medical Society Meeting
Friday, June 29, 2007
Jolie Bookspan, M.Ed, PhD, FAWM
Check your calendar for a healthy trip to Colorado. The Wilderness Medicine Conference and Annual Meeting will run July 21-25, 2007, in Snowmass, not far from Aspen.
I will teach two fun workshops at the meeting on July 24. You don't have to be a member of the Wilderness Medical Society (WMS) to attend the conference, and you don't have to attend the meeting to take my workshops, although it's a great meeting with several days of fun, interesting lectures with good people in a great location. The WMS calls it "Education, inspiration, recreation, relaxation, renewal, and community."
I'll be teaching The Ab Revolution™ Core Training method, and Stretching Smarter Stretching Healthier, both on Tuesday July 24th. You can take either or both, one after the next. The Ab Revolution™ retrains your core muscles with no forward bending which promotes disc trouble, neck pain, tight posture, and other troubles. It can provide more ab exercise than conventional abdominal exercise, and shows you how to keep your spine position healthy during any ordinary daily life, even when not exercising. You'll also learn to fix one major source of back pain right there on the spot. The Stretch workshop is packed with new, fun techniques that work better, faster, and don't hurt. You will learn how to not get stiff and sore in the first place. Fitness is healthiest when it is fun movement that trains good body mechanics in the way your body needs to do real life activity.
The rest of the conference will have interesting lectures on lightning, altitude sickness, hiking and expedition injuries, diving medicine, aerospace, heat, new research, and favorite wilderness topics of parasites and diarrhea (some medical conferences have whole day seminars on diarrhea which is a serious world health issue, especially in babies and children). Healthline blogger and wilderness expert Paul Auerbach will lecture on marine envenomations. There will be workshops in photography, GPS, survival, and other fun hands-on opportunities along with my two fast-moving workshops. Snowmass is at a moderate elevation. The yearly Run for Research leaves you more breathless than usual.
Class info about both workshops is on my web site page CLASSES. To register, contact the WMS - Wilderness Medical Society by e-mail or phone (800) 627-0629. Workshops are filling up fast.
If you can't make my workshops this time, find the books with complete text and illustrations of everything we will do on my BOOKS page.
Pack a bag. Come get healthy out in some clean air and sunshine.
The theme for Grand Rounds this week was "things that inspire." Grand Rounds 3.40 chose this post "to inspire people so that they can improve their health."
You literally shape the health of your bones and body with your physical actions. You can deform your body with repeated bad habits and restore it with simple good ones. My post gives some links on how to restore health to your joints.
In a hospital, Grand Rounds is a lecture for doctors about a patient or topic. On the web, the weekly Grand Rounds is different - an electronic post that lists helpful medical posts, voted the best of the week.
The previous Fitness Fixer article Leg Exercise That Helps Your Back introduced the lunge. The lunge can be a quick effective fitness and health enhancer when you understand that you use it for real life bending, not just as an exercise to do for a set number of "reps."
The idea is to use the lunge in a healthy way instead of bending over "wrong" for all the hundreds of times you bend around the house and workplace. Then you stop one of the major sources of back (and knee) pain and degeneration while you get free built-in exercise, calorie burning, and leg and hip stretch and strengthening. The Fitness Fixer article How Good Would You Look From 400 Squats a Day - Just Stop Unhealthy Bending shows just how many times every day you need to know this.
Reader Ivy from New Zealand sent in the photo above right showing a great way to bend for some of the many times you need to bend to reach and get things - the standing lunge:
Upright torso
Bending straight downward, not forward
Front shin pretty much vertical
Front knee over the foot
Front knee does not sway inward. This is key in retraining knee stability during real life bending, stairs, and other movement.
Back foot facing ahead, not turned out
Front heel down. Better for knee and gives built-in Achilles stretch
Feet nicely spaced
Hands free, not on front leg
The side-seam of the jeans from hip to waist-band is vertical, not tilting forward. It is somewhat hidden by Ivy's arm, I know. But the idea is important - do not tilt your hip forward to stick the backside out in back. Keeping the side seam vertical does several important things to strengthen and stretch, and keep neutral spine that I will cover in future posts on lunging.
Looks comfortable and doable.
When using the lunge, do not bog down in "rules" over placement. The idea is to move in simple, healthy positioning, not hold yourself rigidly.
Going to a gym three times a week is not fitness as a lifestyle. Instead of "doing" exercise, lift, and bend, and move in healthy ways all the time for real fitness as a lifestyle. Give it a try and send in your success stories.
Leg Exercise That Helps Your Back - Why The Lunge?
Monday, June 25, 2007
Jolie Bookspan, M.Ed, PhD, FAWM
I receive the question often, "What exercises should I do to stop my back pain?" I stress that that the exercises you need to do are to simply change away from all the injurious movements that are causing all the pain in the first place (left drawing) and use good movement instead (right drawing). Then your back can heal. The pain will stop.
I see patients all the time who come to me after going through back pain exercise programs. They went through their eight or ten week program, then their pain came back. Every day they did their exercises, then bent over wrong to put down their weights (left drawing), bend over wrong to pick up their gym bag (same left), sat badly on the way home, then hunched over their computer to record their exercise session. It is no mystery.
The post Disc Pain - Not a Mystery, Easy to Fix shows the mechanism of how bad bending and sitting damages the spine and discs. It is a simple injury, not a disease or condition. You can easily stop the process yourself.
A lot of dollars are spent on the common assumption that you need to strengthen or stabilize the back or exercise a particular muscle set, for example the multifidus. That does not fix the source of the damage. At the gym I see trainers, students, and yoga and Pilates teachers doing their exercise classes week after week, saying they come because they have to because of their back pain. Even the exercises they are doing were contributing to the problem. Many things that are bad for you feel good at the time. The post Common Exercises Teach Bad Bending gives examples so that you can avoid this pitfall. The post Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch shows how the most common stretches done, even in back pain programs are contributing to the problem, and what to do instead.
The answer is easy. The post Bending Right is Fitness as a Lifestyle showed one of the most important exercises you need to do to stop back pain. It introduced the squat, which is not an exercise to do for 10 repetitions, but to use instead of bad bending for the hundreds of times every day you bend for things. Instead of hurting your back hundreds of times every day, you prevent hurting your back hundreds of times a day. Instead of hurting your back hundreds of times every day, you strengthen your legs hundreds of times a day. It is not the exercise of squatting that fixes your pain by strengthening, but by preventing the damage in the first place.
This post introduces the lunge as a second wonderful "exercise" to stop back pain. It is not something you do as an exercise for a number of repetitions. Instead, you use it, along with the squat, for the many times a day you need to bend for all the daily things around the house and workplace - the laundry, the pets, the things on the floor, the kids, the dishwasher and refrigerator, and everything else, all day, every day:
Stand upright with one foot far in front of the other (right drawing).
Feet apart comfortably, both facing ahead, not turned outward (right drawing).
Bend both knees
Don't let your front knee come forward. Keep it over the front ankle (right drawing).
Lower straight down.
Your back heel comes up. Keep the front heel down for better knee health. It's a free, built-in Achilles stretch too.
Don't touch your back knee to the floor.
Don't hold your hands on your front knee. Although common, you get better balance and strength without it.
Done properly, the lunge should not hurt your knees. If you are too weak to lower enough to pick up the mail on the floor and get back up, that is serious weakness. You need functional strength to do ordinary daily life. This isn't walking miles over rocks to the river and returning with heavy water jugs over your back just to cook with. This is getting the mail.
Bending right with the lunge burns more calories than bending over wrong. Good bending helps a weight loss program.
Click the labels under this post to see more on these topics. The next post Strengthen and Retrain Function With The Lunge shows a reader making good use of the lunge. Posts to come will cover more about how wonderful the lunge is to transform your life from weakness and pain into easy function. This is fitness as a lifestyle.
--- Read success stories of these methods and send your own. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy.
The previous post Does Hyperbaric Treatment Heal Sprains? covered research that looked into hyperbaric oxygen treatment for injuries like ankle and knee sprains, and muscle soreness.
Some professional sports teams have been using hyperbaric oxygen chambers hoping to speed recovery and enhance performance. Players spend time in a small pressurized enclosure, breathing high levels of oxygen. Other athletes and private citizens have purchased chambers, hoping for various gains. Like other helpful and specific medicines, hyperbaric oxygen helps some things and not others, and can have side effects. The post Does Hyperbaric Oxygen Help Exercise Ability? explains more of how it works.
Sprains and delayed onset soreness are not injuries where low oxygen prevents cells from doing their job to fight infection and rebuild. Elevating oxygen levels doesn't turn normal cells into super cells. It returns them to function. For non-geriatric athletes, sports injuries should not be hypoxic, which is an area of low oxygen. (Given the junk these athletes eat for "sports food" the state of their blood vessels should benefit by a closer look. See Is Your Health Food Unhealthful.)
A concern in hyperbaric medicine is that sensationalized use of hyperbarics for things that may not work will take the legitimate medicine of oxygen treatment and give it a sham image. Dr. Steve Thom, MD, PhD, past president of the Undersea and Hyperbaric Medical Society (UHMS) warns that some team physicians appear unaware of the risks of hyperbaric medicine. He stresses the need for proper medical clearance and supervision of the hyperbaric chamber. For certification and policy information, see the UHMS web site.
The idea that perhaps there are other effects of injury that are not from low oxygen has led to more research on sprains and muscle injury. A study presented here at the UHMS meeting this week by a group from the Tokyo Medical and Dental University in Japan was, "The effects of hyperbaric oxygen therapy on patients with muscle injury." They wondered if hyperbaric oxygen could reduce edema after muscle injury.
Dr. Kazuyoshi Yagishita and colleagues looked at twenty patients who sustained muscle injury during sports, who were admitted to the Tokyo hospital within seven days after injury. The patients received hour-long hyperbaric treatments for one to seven sessions. Patients were tested before and after each treatment for pain at rest and with motion, subjective evaluation of edema, muscle stiffness, and leg volume. All parameters slightly improved with treatment. They concluded that, in this study, in patients with muscle injury, hyperbaric treatment was effective. Dr. Yagishita told me he felt that further study is necessary to assess healing acceleration and intermediate and long-term results.
--- I make posts from fun mail and success stories. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Read success stories of Fitness Fixer methods and send your story. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy.
The Utah Deseret News reported on a game where teens scratched letters into their arms. In March, a 14-year-old girl playing the game became infected with necrotizing fasciitis, commonly called "flesh-eating bacteria."
The bacteria don't eat the skin as the name seems to say, but release toxic factors, which quickly destroy skin and muscle, causing pain, disfigurement, and a high death rate. Necrotizing fasciitis is a serious infection. The teen needed over 60 hyperbaric treatments and several surgeries. Hyperbaric oxygen treatment is done in a small room or chamber. The air pressure inside is increased so that the person can receive more oxygen. One or more people can get treatment in the chamber at once. The post Does Hyperbaric Oxygen Help Exercise Ability? explains more of how it works.
Hyperbaric oxygen treatment is effective against necrotizing fasciitis and infections like gangrene in several ways. The bacteria involved are susceptible to high oxygen pressure, the low oxygen area of the infection is raised to a level where the body's white cells can do their job to clear the bacteria, higher oxygen pressure prevents white cells from sticking to vessel lining, and a few other nice effects to be covered in future posts.
Given that hyperbaric oxygen speeds healing in certain infections, crush injuries, problem wounds, diabetic ulcers, thermal burns, ionizing radiation injury, refractory osteomyelitis, osteoradionecrosis, and compromised grafts, it has been hoped by some that it would also be useful for sprains and muscle injury.
One study by diving medicine pioneer Dr. Fred Bove (my advisor for one of my dissertations) and his colleagues, found no effect of hyperbaric oxygen treatment on time to recovery for ankle sprains(Am J Sports Med. 1997 Sep-Oct;25(5):619-25). Another study by Dr. Michael Bennett and colleagues reviewed known past studies using randomized trials of hyperbaric oxygen on soft tissue injury (ankle sprain and medial collateral knee ligament injury) and muscle soreness after exercise. They found there was was not enough evidence that hyperbaric treatment helped ankle sprain, acute knee ligament injury, or soreness (Cochrane Database Syst Rev. 2005 Oct 19;(4)). Dr. Brad Bailey of San Diego did a review of the utility of hyperbaric oxygen for sprains and sports injuries and found no benefit for soreness, but a few studies that showed benefit in acute sprains and strains. There may be aspects of injury, not previously looked at, that may be helped. These are being looked at in newer studies. The next post will cover them.
You can do much to prevent and rehab sprains on your own:
Exercise and Fitness in Decompression Sickness Risk
Sunday, June 17, 2007
Jolie Bookspan, M.Ed, PhD, FAWM
In Train Exercise is Exercise Training, I mentioned the ongoing question in diving physiology research of how exercise can affect the risk of decompression sickness (the bends).
It seems that exercise done during a scuba dive at the bottom increases the amount of nitrogen gas you absorb from the air you breathe from your tanks. This makes more gas which could contribute to decompression sickness on the way up. Mild exercise on a "decompression hang" (waiting at specific shallower depths for a few minutes on the way up) seems to help let more gas dissolve out while you breathe, and may lower risk. Exercise soon after surfacing may increase gas coming out and increase risk according to other work. Some interesting studies look into whether exercise done days before a dive can reduce risk by "using up" specific components that decompression sickness bubbles need to be able to form. The kind of exercise and timing seems important. I will post more on this another time.
Some work looks at physical fitness, and whether that affects risk of decompression sickness (DCS). Would someone in better physical shape have lowered risk? What constitutes being in better shape? Is it body fat? Is it the amount of oxygen you can use to exercise? How might any one of those components affect DCS risk?
I am writing this from the UHMS scientific meeting, explained in Exercise and Medicine Underwater and at High Pressure. One of the studies presented by French naval researchers is, "Does the VO2 max value predict the formation of intravascular circulating bubbles during decompression of healthy divers?" VO2 max (pronounced vee-oh-too-max) is the most oxygen you can use when doing the most exercise you can do. It is usually higher in people who can do more aerobic exercise (other factors also contribute). The maximum amount of exercise an average person can do is about ten times their resting level of oxygen use. Marathoners usually max at around 20 times better than resting levels. A top aerobic athlete can use about 30 times resting level (a horse - more than twice the top human max). Someone badly out of shape, or with heart disease or other problems that limit ability to get oxygen to cells, generally has a low VO2 max. You can raise your level with regular exercise at any age. It is not set.
In the French study, divers were tested for VO2 max a week before their experimental dive. They avoided any physical exercise 48 hours before the dive. Then half completed a dive in a dry hyperbaric chamber and the other half in the open sea with the same dive profile and decompression stop according to French military decompression table MN90. After the dive they were all tested for presence of small decompression bubbles in the bloodstream.
Bubbles can form in the body painlessly after a dive without creating decompression sickness. It is not the case that bubbles always form after every dive, as often thought. Certain bubbles can be detected audibly (they sound like pops and squeeks) using Doppler ultrasound, and other kinds of instruments being developed. I will post more another time about these bubbles and what ultrasound can and can't determine about bubbles and decompression sickness.
The French researchers found that bubble formation in both types of dive was related to the age and body mass index of the divers, but not to VO2max.
Being in good shape makes many aspects of diving safer, even if it doesn't affect risk of decompression sickness. Being in better aerobic shape helps you swim more easily against currents that may take you away from your dive site or boat. Strengthening your body through weightlifting with good body mechanics helps you lift and haul gear with less chance of injury, and practicing all your physical skills helps you be more able to rescue someone or yourself.
What about physical fitness and risk of decompression sickness in space? Several studies here at the meeting address that. Astronauts who go outside the space vehicle go to lower pressures, similar to divers coming up from a dive. Many considerations, including exercise, go into their preparation for that. The interesting story is posted in Space Walks.
--- Read success stories of Fitness Fixer methods and send your own. See if your answers are already here by clicking labels, links in posts, archives, and The Fitness Fixer Index. Subscribe to The Fitness Fixer, click "updates via e-mail" upper right. For personal medical questions - Replies to Medical Questions. Limited Class spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
It is estimated that every 30 seconds someone in the world has their foot amputated because of a diabetic foot ulcer. Reduced blood supply to the feet and lower legs in people with diabetes delays wound healing and increases infection and chance of gangrene. Foot infection worsens the situation of inadequate blood supply by increasing the area's need for oxygen but decreasing blood supply. Poor blood supply further decreases ability to fight infection. Diabetic ulcers treated with antibiotics can become colonized with drug-resistant bugs.
I am at the annual meeting of the Undersea and Hyperbaric Medical Society (UHMS). Several interesting studies are being presented on diabetic wound healing. Enhancement of healing in selected problem wounds is one of the 13 approved indications for use of hyperbaric oxygen therapy as defined by the Hyperbaric Oxygen Therapy Committee. Hyperbaric treatments are done by putting the entire person in a small room or chamber and increasing the pressure inside so that the person breathes oxygen at higher pressure than what you are breathing now. The post Does Hyperbaric Oxygen Help Exercise Ability? explains more of how it works.
One of the studies presented here looked at 50 patients with severe diabetic foot ulcers. Half were treated with hyperbaric oxygen therapy (age and gender matched with the half who did not). Diabetic patients treated with hyperbaric oxygen had 56% chance of healing and 16% chance of amputation. Diabetic patients not receiving hyperbaric oxygen therapy had a 32% chance of healing and a 32% chance of amputation. Supplying oxygen to compromised areas, such as diabetic wounds, is important to restoring health. Hyperbaric oxygen is established to help that.
From the President's Competition came another study on hyperbaric oxygen therapy and stem cell mobilization in people with diabetes. This study was by researchers at the University of Pennsylvania's Institute for Environmental Medicine, where I did nine years of my research in diving medicine. Hyperbaric oxygen is already known to mobilize bone marrow stem cells in animals, healthy humans, and in patients with a history of radiation exposure. This study looked at diabetic patients with refractory foot ulcers or radiation necrosis who were receiving hyperbaric oxygen treatments. The study was small and results varied more than in previous trials. However, the researchers reported that overall, hyperbaric oxygen therapy increased circulating CD34+ stem cells three-fold in the patients with diabetics, and was shown to play a role in wound healing. Three patients of twelve in the study group did not increase stem cells. The researchers said that the reason for no increase should be investigated.
In the exhibit hall of the hyperbaric conference, various companies display their fun oximetry units. There are several kinds of oximeters. The most common ones painlessly assess oxygen levels through the skin. Oximetry is used to assess oxygen available to the injured and surrounding tissue, and to tell how well hyperbaric oxygen treatments are working to improve oxygenation and new blood vessel growth. I like to try them all on, on different parts of my body. I experiment with different exercises to see the different effects on oxygenating different areas. Movement makes rapid, effective increases in oxygen levels.
In the past, people with diabetes were cautioned not to exercise because it was felt that they would injure themselves. Now it's known that exercise is an important part of preventing injuries from diabetes, and preventing or curbing diabetes itself. Regular exercise:
Helps your body burn more sugar.
Increases the number of insulin receptors on your cells and increases the sensitivity of your body to insulin.
Helps your body grow new blood vessels and improve circulation.
Improves oxygen levels to areas to help them heal.
Reduces high blood fat levels (cholesterol and triglycerides) which leads to early aging of blood vessels.
Increases blood flow to the feet, which helps prevent diabetic foot problems.
Keep moving for many aspects of preventing disease, secondary effects from disease, and to improve your health.
Exercise and Medicine Underwater and at High Pressure
Wednesday, June 13, 2007
Jolie Bookspan, M.Ed, PhD, FAWM
For the next week, I will be at scientific meeting of the Undersea and Hyperbaric Medical Society (UHMS). My colleagues attending are flight surgeons, SEAL team captains, commercial divers, submersible and submarine craft personnel from navies of many countries, and scientists from all over the world who study the science of what happens to the body when working under different pressures, temperatures, and breathing gases - at altitude, underwater, and in the specialized dry compartments to build bridges and structures deep underwater. There are also physicians, technicians, nurses, and aerospace scientists and astronauts who use hyperbaric chamber technology to prevent or treat specific non-diving conditions. Allied health workers, divers, and non-divers also attend.
Originally, we were the Undersea Medical Society (UMS). As use of high-pressure oxygen chambers to treat illnesses other than diving climbed, more sessions on how hyperbaric oxygen works (and doesn't work) were added. Wound healing increased in focus. In 1986, we became the Undersea and Hyperbaric Medical Society (UHMS). Forums, sometimes strangely heated for brainy, cool-headed scientists, are held about which conditions legitimately respond to hyperbaric oxygen treatment and which are felt not to have evidence (no matter how much we wish it would work and alleviate the suffering of the patients).
Some of the established benefits of hyperbaric oxygen and some uses that are not shown to be effective are explained in the post and comments of Does Hyperbaric Oxygen Help Exercise Ability?
The meeting will cover many interesting topics in decompression bubbles that are thought to cause (or be part of) decompression sickness, or "the bends," and mathematical and empirical models of decompression. Decompression theory and bubbles were my research area for many years along with the effects of too much oxygen on the body during exercise underwater and in dry habitats underwater. The meeting will have many sessions in clinical hyperbaric oxygen therapy for several specific conditions (abbreviated HBO, HBOT, HB02 and other), chamber equipment, and wound treatment. There will be a session of The Veterinary Hyperbaric Medicine Society. Animals get problem wounds that need help healing, too.
The national board exam for hyperbaric chamber nurse and technician will be administered. There is also a board exam for physicians in hyperbaric medicine held each fall through the American Board of Preventive Medicine & Emergency Medicine. I wrote the study guides for both exams. I tried to make them fun, user-friendly, and packed with understanding, not just lists of facts and equations to memorize. The guides cover the entire contents of both areas and are a nice review or compendium for anyone interested I the field. Info is on my web site books page.
I won't be staying at the fancy conference hotel but at a backpacker's hostel. Over the next week, I will try to get to Internet cafes to post on some of the interesting topics and research at the meeting - and swim and go underwater for real. That is good for a researcher in underwater exercise and medicine to do.
A New York teen cross-country runner is reported to have died after using large quantities of a muscle soreness rub. According to various news stories, the medical examiner concluded she died after using too much Bengay cream containing methyl salicylate.
Methyl salicylate is a natural oil of wintergreen (betula oil) found in plants. It is used in many muscle rubs and creams to dilate blood vessels to bring blood to the area and redden the skin.
Deaths are rare, but salicylate poisoning is not rare or unknown. Poisonings using medicated oils account for "48% of acute salicylate poisoning cases treated in the general medical ward of the Prince of Wales Hospital" in Hong Kong (Vet Hum Toxicol. 1996 Apr;38(2):133-4.) Another study comparing severe salicylate poisoning from aspirin or topical oils found that the oils pose "the threat of severe, rapid-onset salicylate poisoning" because of the concentrated form and lipid solubility of the methyl salicylate in the rubs (Postgrad Med J. 1996 Feb;72(844):109-12.)
Some muscle rubs and balms contain other toxic ingredients, such as turpentine oil and camphor. The various preparations all "work" in various ways to relieve pain or mask it. I will cover more about the different soreness creams and preparations from around the world, their ingredients, and how they work in posts to come. The book Healthy Martial Arts covers ingredients in detail, how they work, and more on soreness and training.
Soreness in the muscles is common and normal after energetic activity. Muscle soreness does not just occur in the out-of-shape. However, your joints should not be sore after workouts.
If your joints (not muscles) are sore after activity, you may be using body mechanics that put joints in positions that grind or rub. You may also be shifting weight off your muscles onto your joints to make the exercise easier. Your joints should not be sore, hot, or swollen after any activity.
Here are a few ideas to avoid joint pain during or following activity:
A few weeks ago, I attended a lecture on forensic anthropology. In general, this is the study of things you can tell from human bones in a crime setting. How old was the person? Were they male or female? How big were they? What was their probable race or ancestry?
Why was I there when my work is with the living? Two main reasons. I am the science officer for the Vidocq Society, an international forensic society. I might evaluate data, for example in an aviation disaster, whether someone might have been conscious at each point when undergoing G-forces or different temperatures and amounts of oxygen after a depressurization at various altitudes. In a scuba death, I might advise on physical changes that occur with different situations. The second reason was to learn more about bones. Bones are remarkable. Your bones know a lot about you. What was your health like? Were you active? What kind of activity did you do? When I was small, I read about an archaeological dig in ancient Rome. The bones of a girl were recovered. The account stated they could tell she carried loads too heavy for her, and was therefore (in conjunction with other evidence) probably a servant or slave. I was riveted. How could they know that? I spent years after that learning more about telling how someone moved from looking at their bones.
Throughout your entire life, when you exercise you stimulate growth of new bone cells. The physical pull of muscles thickens your bones where the muscles attach. Using your arm muscles thickens arm bones. Using your legs strengthens leg bones, and so on. This is a main mechanism of how exercise prevents osteoporosis. Without exercise, you don't stimulate enough new cells to counter the normal loss as old ones break down. Your bones thin no matter how much calcium you eat. The post Exercise is More Important Than Calcium Supplements for Bones tells more about this. Bone demineralization is rapid and serious in astronauts in microgravity (Collapsing Astronaut Gives Healthy Reminder).
How you use your muscles causes them to pull differently, giving evidence about the kind of habitual motion. More interesting is that when you are active, your bones grow and shape themselves to facilitate your motion. An example of interest to readers following the posts on squatting is that people who habitually sit for normal daily life in full squat grow "squatting facets" on their lower leg bones. These are small areas on the bone that quickly grow to make squatting more comfortable. At one point, it was a debate in anthropology that squatting facets were a marker of someone of Asian ancestry, until it was found that others who squat also grow them, and that squatting facets disappear when the person adopts a Western sitting habit of chairs and no longer squats. Babies of all races can have them.
Someone who habitually slouches can change the shape of their bones, eventually deforming them. This can occur in the spine, knees, hips, ankles, shoulders, feet, toes - everywhere you pressure your bones. Changing positioning habits to healthier ones can, in many cases, reshape the bones back to healthier shape. Think of braces on your teeth. It's human bonsai. In cases of extreme dystrophies of the muscles, someone who sits without function of their trunk muscles to hold the spine upright, can eventually deform their spine until their ribs sit on their hip bones. How are you sitting right now? The recent post What Does Stretching Do? explained a bit of why stretching isn't reducing injuries. People are stretching, then exercising and going about daily life in bent over positions that rub and grind the joints and soft tissue.
You literally shape your own health. Use the articles throughout this Fitness Fixer blog to do healthy exercise in healthful positioning so that your bones will only tell good tales about you.
Last week at the sports medicine conference, I talked to a researcher from Kuwait University. Dr. Jasem Ramadan presented a lovely little study called Bioenergetics of Islamic Prayers, measuring the amount of oxygen and calories the physical movements of the prayers burned.
Five standard prayers (Salat) are mandatory every day for every adult male and female Muslim. Each prayer has a continuous sequence of body movements (Rakkas) consisting of standing, bowing, kneeling and sitting. Each Rakka lasts between 3 and 6 minutes. Dr. Ramadan looked at the energy cost of two and four Rakka prayers in thirty-two male and female adults. He found that Salats have a positive effect on metabolic function. For an 80 kg person, energy cost of daily prayers was about 80 calories a day, and could be considered a form of physical activity that enhances fitness.
Dr. Ramadan told me, "The prayers have been done for thousands of years and no one thinks about it as physical exercise." I told him I think that often. I told him that Russian Orthodox prayer was pretty physical. A liturgy lasts hours, done standing and continuously crossing yourself from the floor in a squat to high overhead. Everyone including the oldest people do this, up and down, and up and down, and up and down, stretching and squatting, reaching and bending. I always thought it was group community health activity, probably found long ago to be protective against many ailments (and attributed divinely). The original yogas were the same, reaching upward to exalt the heavens, bowing, kneeling, prostrating, rising, over and over.
I told Dr. Ramadan that many Westerners aren't comfortably able to do the kneeling Rakka shown in Healthy Toe Stretches or rise to a stand without using their hands, as in the post Quick and Easy Strength and Balance Exercise, not only the elderly, but the rest of the population too.
He seemed surprised and interested. I told him I believed that this lack of basic human movement for real daily life was a major contributor to the epidemic numbers of people who are too weak and unstable to get up unassisted, to walk without canes and walkers, have trouble taking stairs, have poor balance, and for much knee and hip pain and degeneration. Dr. Ramadan said that elders in his country do not suffer knee and hip arthritis in high numbers, and can easily rise from the floor into their old age. I told him that many Westerners are familiar with a device that is worn, with a button to press for help if they cannot get up from the floor or chair. At this point, he was sure I was kidding.
If you cannot get up from the floor or low chair easily without using your hands, you likely have dangerously decreased leg strength and balance. Use good bending to strengthen your legs and knees many times a day and improve your fitness, explained in the post How Often Should You Be Healthy? Use healthy movement every day to sit, rise, bend right, clean, garden, give thanks, stretch, take stairs, and play to get healthy functional exercise, and prevent common joint pain. That is fitness as a lifestyle.
--- Read success stories of these methods and send your own. Before asking questions, see if your answers are already here by clicking labels under posts, links in posts, archives at right, and The Fitness Fixer Index. Subscribe to The Fitness Fixer, click "updates via e-mail"(under trumpet) upper right. For personal medical questions - Replies to Medical Questions. Limited Class spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
Thank you to InsideSurgery for hosting Grand Rounds this week. InsideSurgery was selected by the Wall Street Journal as "one of the 10 best surgery sites on the web."
Inside Surgery included my post Blood Hero in this week's Grand Rounds. Grand Rounds is a lot of work to do and has been called "the weekly best of the medical blogosphere."
I am attending the annual meeting of the American College of Sports Medicine (ACSM). There are many hundreds of studies, seminars, clinics, workshops, lectures of all sorts, running concurrently. It is like drinking candy from a fire hose.
Dashing from one lecture to another in the enormous conference center trying to learn as much as possible from simultaneous sessions is exercise in itself.
Some of the "studies" predictably show glowing results. Studies funded or conducted by candy bar manufacturers show athletic gains from eating their candy bar. A study funded by the US Poultry Association concluded that dietary cholesterol may have a modest role in muscle mass and strength increases (and an "uncertain role on cardiovascular risk factors.") Studies from sugar water manufacturers, who are also major sponsors of this sports medicine conference, show high results in athletic events drinking their product. There is no doubt that hydration and blood sugar are enhanced from refined sugar products to complete athletic events with good results. Commenting professionally, I am not sold on these products for long-term health Moreover, you can get the same results in most cases with healthier food. The post Is Your Health Food Unhealthful? gives some healthy food choice ideas. (Many of the same doctors and trainers stating that these products are healthy then go out for a smoke and some fries). Click the index below, or label "nutrition" for all Fitness Fixers with ideas for healthier sports nutrition.
One nice little study from University of Pittsburgh researchers showed that overweight adults who achieved higher levels of physical activity during a weight loss program also reported "adoption of eating behaviors recommended to improve weight loss." They also found that, "Failure to sustain physical activity reflects the failure to sustain recommended eating behaviors." The bottom line is still, "Stay active and eat right."
Another nice study from the Nutritional Interventions sessions found that, "Individuals at risk for developing cardiovascular disease (CVD) can reduce risk factors through diet and exercise before resorting to drug treatment," that, 'Ingesting vegetable versus animal protein has also been shown to have beneficial effects on various risk factors" and that "Participation in a 12 week resistance exercise training program significantly increased strength and decreased CVD risk factors in overweight, hypercholesterolemic men with no added benefit of protein supplementation." The bottom line is still, "Stay active and eat right."
