A Healthy Lifestyle Works

Posts Tagged ‘Injury prevention’

As you get older, you have more aches and pains and are more easily hurt from being active. I know this first hand from getting hurt exercising a number of years ago. So to prevent injury and be in better physical shape, I encouraged the contestants to go to Labell & Associates Physical Therapy in Rowley, before moving into more advanced levels of exercise or strengthening routines. All they had to do was ask their doctors for a referral, which has been no problem, and insurance covers it. Most people in the group have now worked with Bryan Labell and his staff, and all of them are thrilled with the results and amazed by how much more they can do with their bodies.

Bryan’s goal isn’t simply to help people heal an injury, which is what physical therapy (PT) is typically used for. His goal is to show people how to use their bodies more effectively, to protect themselves from injury, and to be able to perform activities at a maximal level – whether they started with an injury or simply wanted to increase their ability to do certain activities. His PT treatments are designed to restore full flexibility and full strength across the body, as well as increase coordination, endurance and balance. He starts off with stretching tight muscles and strengthening weak ones, balancing out the muscles and building a strong foundation, before he shifts people to more dynamic exercises to enhance physical performance and agility.

By the time people are done with their sessions, they are more in tune with their bodies and what it takes to stay pain free, and they are doing much more than they ever would have thought possible. He happens to have an advantage most PT businesses don’t; his offices are inside the Excel Gym, so he has use of the exercise equipment. Those in the group who have worked with Bryan gush about how great the experience has been and how motivated and excited they are by what they can now do. And that in turn is motivating them to do even more activity and to pursue a regular strengthening program to continue improving their fitness, which Bryan has personalized for those who want to do this.

Lisa – Healing plantar fasciitis
Lisa was the first to go to Bryan and she is thrilled to have accomplished so much. “When I started,” Lisa said, “I was so tight in my hips, hamstrings and calves. Now I am looser, have full range of motion and no pain. I am also much more in tune with my body, so I can tell when things are changing, what feels different and what I have to do to make adjustments. I feel so much better, and I can really notice a difference at work.”

Lisa injured her foot doing a lot of walking this spring and developed plantar fasciitis, which she had dealt with in the past. Fortunately she could still bike, but it was very painful and affected her at work where she does a lot of standing and walking. The PT started with her feet and moved up to the muscles in her lower body. Bryan, or one of his associates, stretched out the tight muscles in her legs and feet, and when she was more limber shifted her to lower body strengthening exercises. They also did ultrasound and massage techniques. That strengthening led to more tightening, which Bryan anticipated, and they added more stretches for that and did deep massage work. As Lisa got stronger, she did dynamic exercises that increased her balance, coordination and physical performance, and she did cardio exercise to increase her endurance.

Maureen – Addressing tightness
Maureen was next to go, but not because she had anything wrong. She just knew that the more she had been exercising the past few months the more stiff and tight she felt, particularly in her hips. What she appreciated was how much of an improvement she made every couple of weeks, which she could see because they continually measured her range of motion. “It was very affirming,” Maureen said, “to see how much I was able to do and that I could reach the goals they set for me. And now I notice how many things I can do and how much more efficient my movements are. They helped me to see that I have a lot more abilities than I had realized. I’m stronger and more capable than I would have believed, and for the first time I’m looking at my body and what it can do.”

Like Lisa, Maureen really enjoyed the PT, which you probably wouldn’t expect. She found Bryan and his staff motivating and great fun. And now that her sessions are done, she loves feeling in better shape and moving with greater ease, and she is determined to stick with the exercises and continue to use her body to the best of its ability. “Why wouldn’t you,” she said. “It feels so good to be able to do all this and to keep it up.”

Eric – Recovering from an accident
Once Eric’s doctors gave him the okay after stabilizing from a major auto accident, he too went in to see Bryan. What they found was poor range of motion in his shoulders, back and hips as well as a weak core. At first the focus was on stretching and doing movement exercises, like picking up a weighted milk crate and putting it on a shelf. Once he had made improvements, they moved on to strengthening machines and doing lots of balancing exercises. Each time he went in, he was doing something different as he progressed further and further. “I’m in better shape now,” said Eric, “than before the accident. It is sort of like personal training, but more like occupational therapy. They took it easy with me at first, and now I’m doing weights and making a lot of progress. I’ve learned you don’t have to kill yourself to get into pretty good shape.”

Eric has been so impressed and enthusiastic that he asked Bryan for a strengthening routine he could do on his own at the YWCA, while going to PT. He has also learned the importance of stretching, and is fully committed to this at home. He’s not alone. Everyone in the group has been dedicated to their at-home exercises, which has impressed Bryan quite a lot. And most of them have joined a gym to keep up their strengthening exercises.

Cheryl – Overcoming a long-term illness
For nearly twenty years, Cheryl has been limited by what she could do from an illness she had many years ago. The past six months she has done more than she thought possible, walking outside, in the pool and to an in-home video. But going to PT and working with Bryan has taken her ability to a whole new level. His staff worked every part of her body, explained what they were doing, how it all worked, and what she needed to know, so she felt informed, educated and surer of what she could do.

Her PT started with the stretching, and then they added strengthening, dynamic movements and cardio endurance to help her increase her tolerance for particular movements. “I’ve learned I am a lot stronger than I thought,” Cheryl said, “and I can do a whole lot more. I also now know what to do when I get fatigued or have pain to recover faster, and I’m learning to listen to my body. This has changed my life, and now I feel so much more confident and capable. I would never give this up.”

Wrapping Up This Contest Series
Everyone has seen dramatic results from their PT sessions, and they are pumped about the experience. As Bryan said to me, his mission is to “get people to feel the way they want to feel and working beyond their expectations, and when they feel so good and are doing so much they want to maintain that.”

That summarizes the philosophy of this contest. The goal is not for the contestants to be good and to do as they are told. It is to discover how good it feels to be active, physically fit, eating healthy foods and taking care of themselves, and then to feel motivated to maintain that great feeling.

At this point, now eight months into this two-year contest, you have followed along as the contestants have learned new skills, changed their thinking and overcome obstacles to making healthy lifestyle changes. They have successfully embraced healthy eating, learned how to be in control with food, become self-motivated to stay active and gained skills to overcome their challenges, while you have had a chance to witness the process and their thoughts in this blog series.

Now I am wrapping up the series, as the contestants continue to maintain what they have learned. For them, it was never about being in a contest or winning prizes, but about a chance to reclaim their lives and to feeling really good. We will still have awards at the end of this month and in December, and the final awards at the end of 2011.

Have a fit and healthy week,
Alice

It can be so easy to get into a routine where you start to eat a bit better and get in some aerobic activity, but that is as far as it goes.  You are doing enough to get a bit healthier, but not enough to really change your body or your attitude.  And while a small change for the better is a success; it will likely lead to disappointment.  When that happens, it won’t be long before you go back to old unhealthy habits.

To help the group participants avoid settling into a lifestyle that is less than what they had hoped for, I asked them to consider what it is they want to improve and how they want to stretch themselves further.  Because they set their own goals and I don’t force them to do any particular activity, what they decide to do is up to them.

This contest and program was set up deliberately to emulate what it is like to create and maintain a healthy lifestyle.  In real life, there is no one to tell you what you should do or force you to stick with it.  The drive to do more has to come from within, and what I have learned – and now they are learning – is the more you do, the more you can do and the more you want to do.  Those who are doing the most activity are the ones pushing themselves and trying new things.  And they are the ones who are the most enthused and seeing huge changes in their attitude and bodies.  They are almost giddy with how great they feel and how much fun they are having being more active.

I remember having a similar experience during the two years I went from sedentary to fit, and I found myself wanting to do strengthening exercises, try Pilates, go to new classes and check out new types of equipment.  I amazed myself by what I was discovering I could do and my new interests.  At the end of two years I was even more shocked to realize I had a passion for fitness.  Yet I am not alone.  Read almost any fitness or weight loss success story, and you will see that this happens to most people who are active long enough that they want to do more and more and more.  It is the reason for the record number of older adults now doing races and triathlons.  They love how great it feels.  But it takes doing enough fitness activities and then sticking with them long enough to get that great feeling.

For some people, even some in the groups, there can appear to be limitations in what they can do to be active.  These can come from a physical ailment, a preference for doing certain types of activities, only wanting to be outdoors or indoors, a tight schedule, having kids at home, having a poor body image, or any number of things.  Yet very often this is a perceived limitation and not an actual one.

Consider instead:

• Ways to address an ailment with physical therapy, a visit to your doctor or seeing another type of healing practitioner.
• Finding new groups or programs you weren’t aware of, such as outdoor MeetUp groups at www.meetup.com.
• Easy-to-follow and fun DVD or OnDemand fitness programs.
• Local specialized classes and programs listed through Adult Education or the Chamber of Commerce.
• Who can watch your kids or which local fitness facilities have a good place for kids, like the YWCA.
• Any judgment about how you look or how capable you are trying a new activity is your own self-judgment and a perception of what others think.  If you refuse to be judged, no one can judge you.
• How you can stretch yourself and try something totally new, like rock climbing at MetroRock.

In our group discussion, these were the things we talked about, and a number of people got ideas about what they could do to increase their level of activity, and they left feeling excited by the new prospects.

Read What the Participants Have to Say

Find out what else the group participants have to say about stretching themselves to feel even better, when they add their comments to this blog.  And please share your own insights about what works for you.  It may be just the spark that helps another person reading this blog.

For more information about the contest and contestants, visit www.aHealthyLifestyleWorks.com/contest.

Have a fit and healthy week,
Alice

The past couple of weeks have been particularly challenging for a number of people in the groups. When I asked them to share any success they had despite the difficulties, they each found one they could feel good about.

When you focus on successes, you stop focusing on what you didn’t do, should have done or your perceived failures. Instead you see what did go well, what worked best for you and that you can succeed. This is critical to being able to stay on track.

For many of them in the groups, the one thing they found that really helped them to have some success was their awareness. For example, they stayed aware of when they got full, so even if they were triggered to overeat, they were able to stop before they lost control. They listened when their body started to hurt and took time off without feeling guilty. And they were conscious of their desire to turn to comfort or junk food, and if they did have some, they were able to keep it to a minimum. They shared honestly without beating themselves up and could see that by staying conscious of what was going on and how they were feeling, they didn’t revert to old habits which would have been so easy to do.

There will always be days or weeks when they will struggle with issues in their lives, don’t meet their goals or feel like they’ve gotten off track. It happens to all of us. A month ago I had vertigo for several weeks. Life isn’t predictable or easy to manage. Plans get changed, emotions get stirred up, injuries happen and illnesses will catch you off guard. Or worse, as in the case of one of our contestants, who has been out for weeks from a bad auto accident, you can get derailed for long periods of time.

Instead of judging yourself or getting caught up in the disappointment, what everyone in the groups are discovering is they can learn from these experiences and get right back on track. In fact, these are golden opportunities to create strategies for similar future situations. You can look back and see what might have worked better for you, which would have left you feeling good physically as well as mentally and emotionally. The objective isn’t to look back to see how you could have been better at being good, because that isn’t the issue. It is not about being good or bad. It is about doing what leaves you feeling good and about respecting your body and yourself.

Here are some strategies that resulted from our discussions:

• If you have worked your way up to walking for 25 minutes – or whatever amount you can now do, avoid taking a much longer walk even if a friend invites you to walk the length of our new rail trail or any other great walk in the area. Know your limits and speak up, letting that person know you’d love to walk but that after x number of minutes you’ll have to turn around.
• Remind yourself that 10 minutes, one mile or one loop around the block is enough exercise, if that is all you think you feel up for. It is better than nothing, and who knows, you may find you want to do more once you get started.
• If you begin to notice some aches or pain in your feet or legs, don’t push through it or pretend it isn’t there and continue with your goals for the week. Instead to take it as a warning signal that you may need to back off the exercising, do some icing, add in more stretching, see a practitioner or do an activity that doesn’t put exertion on that area.
• If you are making dessert for company that is visiting, you don’t have to serve big pieces or an 1/8th of a pie. You can make the servings much smaller, so each person doesn’t feel compelled to eat more than they want or need.
• Notice if you are really enjoying the food you are eating and if it is really all that satisfying. If you aren’t satisfied or don’t really want any more of it, to throw it away – even if it is ice cream.
• Buy one meal and split it three-ways with the kids instead of a full meal and two kid meals.
• And last, but not least, sometimes you have to tell yourself to “Just Do It”. We all have times when we come up with excuses and resist doing something we know will feel good once we get started, and it helps to give yourself a strong nudge to just go do it anyway. When I first started exercising, that is exactly what worked for me. I would say to myself, “too bad, no discussion, just go it”, and that would be enough to get me in my sneakers and downstairs.

Read What the Participants Have to Say
Find out what else the group participants learned from talking through ways to create strategies from their challenges.

Have a fit and healthy week,
Alice

Everyone in the groups have been making their own choices as to what type of aerobic activities they are doing to get exercise the past six weeks, and each week they are reaching most if not all of their goals.  I have guided them to set goals they know they can reach, to pay attention to how their bodies’ feel with the level of activity they are doing, and to avoid overdoing it or trying to add too much more too fast.  I’ve told them to stretch the goal no more than 5-10% after reaching the previous week’s goal, and if they feel they want to stay at their current goals to go with that. 

Starting Off Slow with Enjoyable Activities
Several people were so motivated by their initial successes, they got extremely ambitious and exercised for much longer periods of time, exercised every day, or both.  When I saw that, I encouraged each one of them to be careful and to scale back considerably.  While this is not the advice you would expect from a fitness expert (or personal trainer as I am), it is good advice.  Here’s why.  When you overdo it, you set yourself up for an overuse injury, stressing your immune system or feeling overwhelmed at having to keep it up, and any of these can lead to getting derailed and losing your motivation to get going again.  I’ve seen this happen too many times with my clients, and I have learned that it is better to build up slowly and safely to maintain enthusiasm and consistency. 

A number of other people were picking activities they felt they should do, and while they have been motivated by the group accountability to stick with them it isn’t enjoyable for them.  Doing exercise you don’t like won’t keep you motivated for long, so it is important to find activities you do enjoy.  Sometimes it is hard to know what that might be, especially if you are so out of shape you can’t do much.  One gal finds exercise boring and uninspiring, but she loves sports like tennis.  So she is looking into getting Wii Sport to renew her tennis passion and get moving in a way that is safe for her current fitness levels.

Learning How to Pace Progression
At this point the groups need more guidance as they become more active, so that was the theme for this week’s sessions.

I showed them a way to know how much exertion they were doing, so they could safely and effectively increase their fitness levels and progress from moderate paces to the point they can increase their aerobic capacity.  I introduced the chart below, which shows a commonly used scale for determining Rate of Perceived Exertion (RPE).  This is subjective based on a talk test, yet it works really well when you don’t have or don’t feel motivated to get a heart rate monitor. 

As you can see, when you are below an 8 on the RPE scale, which corresponds to 85% of your maximum heart rate (on the blue band), you are in the moderate zone.  And between 60-85% of your max heart rate (or between 3-8 RPE) you are in the fat-burning zone.  At the moderate and moderately easy levels, this is considered heart healthy, and this is where you want to start when first exercising.  It is also the exertion levels where you get some of the greatest improvements in cholesterol, blood pressure and insulin sensitivity.  Whereas, as you move up to difficult and very difficult intensities you get the greatest fat loss benefit.  When you get into the anaerobic zone, above 85% of your maximum heart rate, you begin to overload your heart and increase your aerobic capacity.  This is a good thing, but only when it is done in bursts of very short intervals followed by longer recoveries back in the aerobic zone.  These bursts are called intervals, and they are very effective at increasing fitness levels and accelerating fat-burning. 

But, as I cautioned the groups, the goal isn’t to just do interval training and higher fat-burning.  The goal is to build up to that point and then mix up the cardio with both days of moderate and longer periods of exercise and days of more difficult interval-based exercise.  You benefit from both and it allows for a mix of activities that are both intense and more moderate.  Furthermore, the body will adapt to whatever you do repeatedly, so it is best to mix it up with different intensity levels, types of activities and lengths of time. 

Everyone in the groups will now add their RPE levels each time they are active in their fitness journals, so they can see where they are and pace themselves to do a bit more every couple of weeks until they are able to sustain more difficult levels.  They can even start doing some periodic intervals in their current routines that will move them up a level or two in RPE, by adding short bursts (either by increasing their speed or their incline – like a hill) whenever it feels right to do so.

Balancing Core Elements of Fitness
There are four primary areas of fitness: cardiovascular, strengthening, flexibility and balance.  While there are different schools of thought as to which is most important and which you should start doing first, I explained to the groups that our primary goal is to establish a lifelong cardio foundation as the basis of a healthy lifestyle.  The health benefits of maintaining aerobic exercise are too numerous to list here, yet they aren’t limited to just reducing the risks of diabetes and heart disease.  Moderate levels of aerobic exercise improve arthritis, depression, energy, stamina, sleep, osteoporosis, mental focus, stress, digestion and more. 

It is too easy to take on too much too fast, when you try to do cardio, strengthening, stretching and balance all at once, and very often it gets too overwhelming or too time intensive to maintain.  That doesn’t mean that at some point, they won’t be doing all of this – as I now do in my weekly routine.  But first I want them to develop a consistent aerobic practice they will stick with before adding in much more.  The only exception is stretching, which is important for them to begin adding in now if they haven’t already done so. 

In time, they will also add in core strengthening (which often goes hand in hand with greater balance) and full body strengthening.  Some are doing a bit of this now, which is fine if it doesn’t get in the way of having enough time for being aerobic.  I know many personal trainers would disagree with this approach, suggesting strengthening should come first or along with cardio, but I am a realist and focused on making sure everyone has long-term success at maintaining an active and healthy lifestyle.  I am less focused on having them build muscle now or achieve rapid changes. 

Those changes will come in due time and it won’t hurt them to wait until they can successfully and incrementally add new things into their routine they can sustain.  I know from my own experience this works, even in my 40s.  I started off with cardio my first year until I had it down, and then I added strengthening the second year, and the third year I added Pilates.  Years later, I am doing all of them regularly, have maintained my lean body mass and continue to stay fit.  Sure I could have built up my muscles and gotten leaner faster, but I didn’t lose anything by waiting a year.  Instead I found a way to incorporate strengthening into my routine because I didn’t get too overwhelmed, and I’ve stuck with it into my 50s.  Not many can say that.

Preventing Injury Before it Happens
One other thing I addressed was injury prevention, which becomes a greater concern the older you are and the more out of shape you’ve become.  There is nothing worse than being derailed for months once you feel you are finally on track and making progress.

Again I had to learn this first hand by having an exercise-related injury from strength training, and I’m not alone in getting hurt exercising.  The problem is muscle imbalances, where some of your muscles are very tight and short and others are weak and long, creating imbalances around joints and across the body.  Some of the weakest areas are in the upper back and core.

When you have imbalances, which often occur from poor posture, prior injuries or being sedentary, you are prone to tearing muscles, ligaments and tendons when you become active.  This is most common with weekend warriors, but it also happens doing any new activity that pushes you more than your body is prepared to do. 

I am hoping to find a physical therapist in private practice who can offer preventive full body evaluations, so we know where their imbalances are and what physical therapy exercises can be done in preparation for strength training.  I used to have someone who did this for my clients, but that PT is no longer available.  So if anyone reading this blog knows of a PT who would be interested, please have them contact me. 

Read What the Participants Have to Say
Find out what the group members are doing with their fitness and how they are doing in making other healthy changes in the comments below.  Please feel free to add your own comments as you follow along.

To participate on your own or in a group, check out the contest website for details and tools at www.aHealthyLifestyleWorks.com/contest.

Have a fit and healthy week,
Alice