Foot Joint Pain

Yes!  You can exercise before and after Gastric Bypass Surgery - learn why & how to do it safely.

Asking a severely obese person (more than 100 pounds overweight) to exercise can be like suggesting a spicy meal to someone with a stomachache.  Obesity takes a toll on almost every system in the body from your heart and blood vessels to your organs, bones and joints.  This often leads to a vicious cycle of sedentary behavior; the less you move the more you gain ...the more you gain the less you feel like moving. When you spend years being inactive you lose important physical abilities and muscle properties that allow you to stay active for life. More and more people are turning to gastric bypass surgery as a solution when traditional diet and exercise are not working. This medical intervention can offer a fresh, new start but won’t be the full solution unless coupled with a healthier lifestyle, including proper nutritional and exercise habits. 

Research studies on obesity and weight loss continue to support exercise as a key component to weight loss maintenance. A recent study done out of Brown Alpert Medical School and Miriam Hospital in Providence, Rhode Island found that of 199 patients who underwent gastric bypass, those who became more active after surgery lost more weight over one year than those who remained relatively inactive. (Bond DS, Phelan S, Wolfe LG, Evans RK, Meador JG, Kellum JM, Maher JW, Wing RR. Becoming physically active after bariatric surgery is associated with improved weight loss and quality of life. Obesity 2009;17:78-83.(2009).

Below is a three-phase approach to exercise for those considering or recovering from a gastric bypass surgery.

Phase 1: Pre surgery (ideally 4 weeks)
Assuming you are currently inactive, the first step is to prepare for surgery by performing a pre-op ‘no sweat’ exercise program.  Now don’t let this phase scare you off, because I really mean ‘no sweat’.  This phase is simply to establish the ‘activity’ dream that lives deep down inside of your genes.  It is the preparation phase to the exercise program you will follow after surgery.  The main goal is to help you establish an exercise habit.  It starts with simply setting aside the time to exercise. It is ideal if you start this phase a month before surgery, but any amount of time will benefit you. 

Start with 10 minutes a day (most if not everyday of the week).  During those 10 minutes you can do whatever activity feels comfortable.  This might include limbering movements, light stretching, breathing exercise, chair exercise, contract and release muscle exercise, or simple closing your eyes and picturing yourself doing exercise. The key is to schedule the time like an important appointment and stick to your schedule.  It is not about the movement or exercise during this phase, it is about the commitment which will evolve into a new exercise habit in your post surgery lifestyle.  The more seriously you take this phase prior to surgery, the easier it will be to build upon it after surgery. 

Phase 2: Post Surgery (typically 4 to 6 weeks)
You will be taking in far fewer calories directly following surgery, which can sometimes cause the body to react as you were on a starvation diet. This can signal the body to burn muscle instead of fat. This is the last thing we want in the long run because it leads to a downward turn in ones natural metabolism (ability to burn calories). Regular exercise alters the metabolism so that the body burns fat instead of muscle. This is why you want to get back to regular exercise as soon as possible. Initially post surgery you can get right back to your pre-surgery ‘no sweat’ workout commitment and only perform those movements or exercises that are easy to do without interrupting the healing process. This may be limited to light stretching, deep breathing and simple contract/relax exercises in your bed.

Once you have your doctor’s permission to exercise a bit out of bed you will want to add in some light walking on level surfaces. Start off slow and easy building up to 10 minutes non-stop. You may need to wait a good four to six weeks before you can get a bit more aggressive with your cardio routine.  Always check in with your physician for approval before increasing your workout intensity.  At this point you want to focus on extending your scheduled exercise time from 10 minutes to 30. Choose activities you like that will exercise your heart and lungs while burning additional calories.  Walking and non-jarring stationary equipment like a recumbent bike or elliptical trainer will feel the most comfortable. Water exercise may also be a good option but only after all incisions have heeled completely.

Phase 3: Beyond Recovery  (a life-time commitment)
Once you have been given the green light to engage in a more complete training program you will want to include some muscle strengthening work to your cardio routine.  This is one of the best ways to insure your body maintains it’s lean mass.  When you train your muscles they get the stimulation and nutrients they need to thrive. This contributes to stronger, healthier bones and joints.  An increase in muscle strength and mass will make all of the activities you do seem easier.  This in turn will increase your ability and desire to work harder.

So during phase 3 you will want to add muscle strengthening to your weekly workouts. You can continue with your 30 minutes of cardio, most if not all days of the week and simply add in the strength training exercises on 2 to 3 of the days (non-consecutive) extending those workouts to about 50 or 60 minutes; or you can alternate your workouts and spend 30- 45 minutes everyday in either a cardio or strength routine.  Below is a sample of a balanced strength routine:

Perform 8 to 15 reps of the following exercises (choosing a resistance that allows you to sense fatigue within the final few reps)  

1. Bench chest press
2. Bent over row or seated row 
3. Overhead press
4. Biceps curls
5. Triceps kick backs 
6. Squats
7. Hamstring/leg curls
8. Calf/heel Raises
(Perform 2 to 3 sets of exercise 1- 8)
9. Supine Abdominal (compression) press into the floor – avoid traditional abdominal curls until given doctors approval – see picture A below
10. Prone opposite arm and leg reach  – see picture B below

A. Hold for 3 to 5 breaths, repeating several times
 

B. Hold for 3 to 5 breaths, repeating several times one each side 
 

• Note: To maximize muscle growth be sure to include a nutrient dense diet with enough calories, calcium and protein to support muscle development – check with a physician or dietitian familiar with your condition for specific recommendations. 

During a weight loss-training program you may find you occasionally hit a weight loss plateau.  To break a plateau try increasing the time you spend in each cardio session (moving towards 60 minutes) or increasing the intensity (moderate to vigorous). You can also choose to do a bit of both. 

• Note extending your cardio workout time and or intensity will encourage faster weight loss.  If doing so be sure to stay properly hydrated by drinking a minimum of 4 oz. of water for every 20 minutes of vigorous exercise.

The good news is that the body is a miraculous machine when in comes to damage control. Given proper nutrition and physical motion it will rebuild itself. The damaged systems can become strong and vital again. 

You will need to take certain vitamin and mineral supplements for the rest of your life because your body will have a tough time absorbing certain nutrients.  Doctors recommend that you take a multivitamin-mineral supplement and calcium, iron, vitamin B-12 and vitamin D.  For example, when it comes to calcium and vitamin D supplements, these are typically quite big in pill form.  By opting for a liquid supplement, you can take them at any time during the day (just a few teaspoons worth at most).  Many physicians recommend liquid supplements for these reasons – they are convenient and much easier for your digestive tract to handle.

When choosing a calcium supplement, make sure it has calcium citrate and not calcium carbonate.  After weight loss surgery, the body cannot absorb calcium carbonate.  Calcium citrate is water soluble and can be easily absorbed, especially in liquid form.

Liquid supplements  are easier to swallow and fast absorbing.  The stomach does not have to "dissolve" the tablet or pill, making it a perfect choice for anyone who has had weight loss surgery or who has trouble swallowing pills.  Try a liquid calcium with vitamin D3 and take the liquid vitamin D3 for additional nutrition.  Doctors are now recommending 2,000 IU of vitamin D3 per day.


If you have had gastric bypass surgery or are planning to, please tell us your story and how it has affected your life. 

 

Washington, Mar 4 (ANI): Taking a dose of Vitamin D everyday could help people to better combat the long winter, according to researchers at Loyola University Chicago Marcella Niehoff School of Nursing (MNSON).

The nutrient lifts mood during cold weather months when days are short and more time is spent indoors.

“Vitamin D deficiency continues to be a problem despite the nutrient’s widely reported health benefits. Chicago winters compound this issue when more people spend time away from sunlight, which is a natural source of vitamin D,” said Dr. Sue Penckofer.

Diet alone may not be sufficient to manage vitamin D levels. A combination of adequate dietary intake of vitamin D, exposure to sunlight, and treatment with vitamin D2 or D3 supplements can decrease the risk of certain health concerns.

The preferred range in the body is 30 – 60 ng/mL of 25(OH) vitamin D.

The researchers are planning to take vitamin D research a step further by evaluating whether weekly vitamin D supplements improve blood sugar control and mood in women with diabetes.

Depression is linked with increased insulin resistance, so people with diabetes have a greater risk for the disease than those without depression.

Women also tend to have greater rates of depression and poorer blood sugar control than men with diabetes.

“There is evidence to suggest that vitamin D supplementation may decrease insulin resistance. If we can stabilize insulin levels, we may be able to simply and cost effectively improve blood sugar control and reduce symptoms of depression for these women,” said Penckofer.

Loyola is currently enrolling women in this clinical trial. In order to enter the study, they must be 18 to 70 years of age, have stable type 2 diabetes, signs of depression and no other major medical illness.

Eighty women with type 2 diabetes and signs of depression will be given a weekly dose of vitamin D (50,000 IU) for a period of six months.

Study participants will be evaluated at three points during this time.

“Vitamin D has widespread benefits for our health and certain chronic diseases in particular. Our research may shed greater light on the role this nutrient plays in managing two conditions that impact millions of Americans. If proven to be successful, vitamin D may an important addition to care for diabetes and depression,” said Penckofer. (ANI)

Source: http://buzz7.com/health-science/vitamin-d-lifts-mood-during-winters.html


Take a liquid vitamin D supplement that's perfect for the whole family - easy to swallow and fast absorbing.  Kids love the taste! 
 

Did you skip a day of exercise?  Did one day turn into two and then a whole week and you are left wondering if you should go back? There are 4 things you should do right away to help achieve your goals.

1. Believe That You Can – believing that you can reach your goal is the number one determinant of success. Kevin Plank, the founder of Under Armour said it best, “The game is already won or lost by the way you approach it.” You have to believe before you can achieve. So what if you are having a tough time picturing the changes you desire? Well then it’s time to pull out the “fake it till you make it” mentality.

If it’s weight loss you are after, spend time envisioning your body smaller, shopping for new clothes (heck, buy something you like that is too tight right now and put it within your sight), fitting into an airplane seat with plenty of room to spare. Use your mind to daydream and see yourself where you want to be. Also put things within your sight that are reminders of the success you will have. See yourself kicking that winning goal.

2. Enlist the Help of Others Who Believe in You – some people want you to succeed and really believe that you can do it. Others will be envious of your success and determination. Surround yourself with a support team (personal trainer, dietitian, friends, family, coworkers) who believe that you can do it and are cheering you on the entire way!

3. Ditch the All-or-Nothing Thinking. If eating a cookie makes you feel like your weight loss efforts are falling apart, it’s time to readjust your mindset. Missing a week of working out doesn’t mean you should give up. Having a day where you completely blow your diet does not mean that you’ll gain 5 lbs back. Realize that you don’t have to be perfect all of the time to achieve your Health Goal. Forgive yourself, forget it and look forward not backward.

4. Write it Down. There is something about having a visual reminder that makes you change your behavior.  If you want to workout 3 days a week, keep a calendar up on the wall where you see it often, and write down your workouts on each day you complete one. And, do the same thing for diet – write down what you eat every day and just the act of writing it down will help you make better choices.


Also, don't forget to take your calcium supplements for good bone health and glucosamine and chondroitin for joint health.  It's important to make sure you get the right amount each day.

 

Are you achieving them or were they too hard to begin with?

We are more than a month into 2010 and many people have already given up on their New Year’s resolution to get fit and healthy.  Some have decided to put off today what they can do tomorrow. Others think they’ll hit that ready stage when their baby is potty trained, their first child is off to college or {insert life event here}.

If you are among the many people who have tossed their hopes of better health to the wayside, ask yourself why.  What has gotten in the way of putting your own health first?  Instead of making promises to yourself that you can’t keep (for me that would be something along the lines of getting up at 5 am to workout), try looking at your goals a little differently.

Focus
Think of each goal like a 10-mile trail run.  There will be twists and turns along the way, you may feel tired or sore at times, face an uphill battle, feel like quitting, have to jump over fallen trees that are blocking your path or take a detour along the way. But, if you keep your mind focused on making it through one-half mile or one mile at a time and your eyes focused on the next 15 feet at any given time (instead of the top of the hill), you’ll make it to the finish. 

We all face different life events that knock us off course from time to time. And none of us will finish that 10-mile run without a few scrapes; sweat dripping down our cheeks and our body feeling at least a little tired (or beat up and exhausted!).  To reach our goal, we must endure and realize that we aren’t perfect and a detour doesn’t mean we should give up. Get back on track and finish that run. You can walk, jog or sprint – just persevere toward the finish line.

If your painful joints are slowing you down, try taking a gluocosamine and chondroitin supplement for joint health and flexibility.  It may help you go that extra mile and help you stay on track to reach your goals.
 

Just because it is cold outside that doesn’t mean you can’t stay fit this winter.

Though gyms (home gyms and those you pay a membership fee to go to) are fantastic, you don’t necessarily need a full gym to get fit. You can walk indoors at the mall (bonus – good sightseeing), or exercise at home with DVDs, simple equipment or Wii Fit.

If you are having a tough time getting motivated, buddy up with a workout partner, or hire a personal trainer to help you develop a plan. Also, try putting your gym bag in your car so you don’t go straight home after work but instead hit the gym, yoga class or dancing, tai chi or any other form of exercise. Or, join a league. There are many adult leagues that include people of all levels including masters swimming, walking/running, softball and much more!

Exercising at Home
There are many exercises you can do at home to stay in shape and most if not all require very little equipment (other than a good pair of shoes). If you don’t want to invest in fitness-related DVDs. Jumping jacks, walking the stairs, dancing and jumping rope will all get your heart rate up. 

Push-ups, leg lifts, crunches, squats and lunges (only if you know good technique and don’t have knee problems) will also raise your heart rate a bit and increase your strength.  You can also use light free weights and bands to get a great workout in. For a great guide to exercises that work specific body parts, click here.

If you have on demand cable or satellite, there are not many fitness channels you can watch whenever you want on anything from yoga to ab workouts.  It's convenient and you don't have to buy any workout DVD's that you only get bored with after using a few times.  There are also a lot of videos available online now as well on YouTube and others.  Just do a Google search on "fitness videos" or on specific exercises. 

Most important - Have Fun!

Did you know that exercise increases brain health and function?

Numerous research studies have shown that moderate exercise can increase the blood flow and neural connections in the brain resulting in better memory, mental focus and clarity.  According to http://brainrules.net/exercise

Exercise improves cognition for two reasons:
• Exercise increases oxygen and glucose flow into the brain, which reduces brain-bound free radicals. One of the most interesting findings of the past few decades is that an increase in oxygen is always accompanied by an uptick in mental sharpness.

• Exercise acts directly on the molecular machinery of the brain itself. It increases neurons’ creation, survival, and resistance to damage and stress.

So now, you may be asking which exercise is the most brain enhancing?  Some researchers believe that a moderate activity like fitness walking is especially good for your brain, because it increases blood circulation to the brain without being overly strenuous. As you walk, you effectively oxygenate your brain. Maybe this is why walking seems to  "clear your head".

Studies of senior citizens who walk regularly showed significant improvement in memory skills compared to sedentary elderly people. Walking also improved their learning ability, concentration, and abstract reasoning. Stroke risk was cut by 57% in people who walked as little as 20 minutes a day. (Annals of Behavioral of Medicine, August 2001)

It’s also important to build cross-lateral exercises into your day. Cross-lateral movements are those in which arms and legs cross over from one side of the body to the other. The left side of the brain controls the right side of the body, and the right side of the brain controls the left side. Both sides are forced to communicate when arms and legs cross over. This “unsticks” the brain and energizes learning.

So, if you want to take your walk even one step further in activating brain cells try the following cross hemisphere exercises as part of your pre walk warm up: 

Standing or Seated Cross Crawl:
In this contra lateral exercise, similar to walking in place, the participant alternately moves one arm and its opposite leg and the other arm and its opposite leg in a standing or seated crawl action. 

Cross Arm Squat:
Some people call this ‘brain yoga’ simply place your left hand on your right shoulder keeping your left arm closet to your chest.  Squat down, keeping your back straight. Do 10 to 12 squats, inhaling through the nose on the way down and exhaling through the mouth coming up.
 
Remember that the human brain is able to constantly adapt and rewire itself. Even as we age, it can grow new neurons. Serious mental decline is typically caused by disease, unlike most age-related memory or motor skill loss, which is mainly a result from inactivity and a lack of mental stimulation. In other words, use it or lose it!

For a list of very interesting human brain and exercise research references see: http://www.fi.edu/learn/brain/references.html#exercise9


Remember, if your joints are feeling sore from exercising or just walking, be sure to take your liquid glucosamine and chondroitin supplement for joint health!

 

Are you at risk for having serious joint pain and even osteoarthritis later on in life?  There are several risk factors that can play a role in how healthy your joints are or will be as you age.

What is your age?
Primary osteoarthritis, a degenerative joint disease, usually develops gradually after age 40.  As you age, cartilage degenerates and loses its elasticity.  In fact, an astounding 75% of people over the age of 65 suffer from osteoarthritis.   But don’t let age slow you down, staying physically fit and healthy is an important way to protect your joints.  Strong, fit muscles support joints more effectively, protect joints from undue strain and injury, and help you perform everyday tasks more efficiently and with less pain.

Do you fit any of the following?
•      Have you experienced repeated trauma or surgery to the joint structures?
•      Were you born with abnormal joints?
•      Do you have gout, diabetes, and other hormone disorders?

All of these life factors can cause secondary osteoarthritis.  Repeated trauma can increase the mechanical stress placed on joints.  People with gout may also experience crystal formation in their joints causing damage to the cartilage tissue.  Diabetes, some hormone disorders and congenital (at birth) abnormalities of the joints may also lead to increased wear and tear.

Are you male or female?
Osteoarthritis is more common in men before age 45, but more prevalent in women after age 45.    Though the symptoms of osteoarthritis can vary between patients, the most common symptom is pain in the affected joint, which may worsen later in the day or after repeated use.  The joints may also be tender, swollen and warm and you may hear or feel creaking.  Osteoarthritis can also cause pain after an extended period of rest.

What is your BMI (Body Mass Index) underweight, normal, overweight, obese?
Excess weight can also contribute to secondary osteoarthritis. Weight control and injury prevention measures can lower a person’s risk of developing osteoarthritis. Weight loss also can reduce symptoms for people with knee osteoarthritis. Excess weight can place undue stress on our weight bearing joints. Therefore, it is important for the health of your joints (and your overall health), that you maintain a healthy weight. If you find weight maintenance difficult, a registered dietitian (RD) can help you achieve your goal weight.
Read more

Risk of Developing Painful Knee Osteoarthritis Increases with Weight 
Healthy Weight 30%
Overweight 47%
Obese 61%

Source: Arthritis Care and Research 2008; 59:1207-13

How often do you experience joint pain?
Joint pain is often the first sign of osteoarthritis. Pain is a signal from your body that something is wrong. Osteoarthritis causes some chronic joint pain. Though your joint pain may make you cringe at the thought of exercising, exercise can actually help relieve some of your pain, ensure that you maintain a good range of motions, make the joint more stable, help you lose weight or maintain your weight and keep your spirits up. Which type of exercise should you choose? That depends on what joints are involved, whether you’ve have surgery on any of your joints and your current range of motion. A combination of strength training, aerobic exercise and proper stretching are often recommended for osteoarthritis patients. And, a physical therapist can prescribe a program tailored to meet your needs and goals.

Read about stretching for joint pain


Have you had any serious joint injuries in your life?
Damage to a joint can contribute to the development of osteoarthritis in that joint.  This is especially common in athletes who have repetitively injured their joints over the years.  If you are an athlete try switching sports or taking time in between your soccer matches and running for non-impact activities such as swimming and stationary cycling.  You’ll still obtain the benefits of exercise but give your joints a break.

Does your family have a history of osteoarthritis?
A history of arthritis in your family can put you at higher risk for also getting the disease.  More and more doctors today believe in a hereditary cause behind several forms of arthritis. As with many other conditions, a mixture of environmental and genetic factors is attributed to the onset of disease or disorder. Most current research, though, focuses on showing substance behinds models of hereditary arthritis.  A recent study found that a form of knee osteoarthritis is the newest addition to the collection of genetically-caused arthritis.  Rare variants in the GDF5 gene have been associated with disorders of skeletal development, and more common variants recently have been tied to susceptibility to osteoarthritis of the hip and knees.  If anyone in your family has a history of osteoarthritis, it is even more important to take preventative measures to help prevent the onset or at least postpone it and make it more manageable.

Do you currently or have in the past, engaged in heavy physical activity for 3 or more hours per day such as heavy lifting, standing or bending?
Athletes and people who have jobs that require doing repetitive motion, such as landscaping, typing or machine operating, have a higher risk of developing OA due to injury and increase stress on certain joints.  Certain occupations involving repetitive knee bending and squatting are associated with osteoarthritis of the knee.  If you are experiencing joint pain or have been diagnosed with arthritis, it may become necessary to alleviate or decrease the amount of heavy physical activity you do.  Repetitive motions for long periods of time can accelerate the onset of osteoarthritis.

Do you experience joint stiffness in the morning or do your joints ache more if there is a change in the weather?
Stretching when you first get up is a great way to alleviate joint pain.  According to the Arthritis Foundation website, stretching will keep your body limber and improve flexibility. Gentle stretching exercises should be done every day and are the most important of all your exercises. Flexibility exercises can help you protect your joints by reducing the risk of joint injury, help you warm-up for more strenuous exercise by getting your body moving, and help you relax and release tension. These can be done on land or in water such as a pool, hot tub or warm bath. These exercises can be particularly useful for easing those stiff joints in the morning. Good range-of-motion exercises include tai chi and yoga. Work up to 15 minutes of flexibility exercises a day. Once you can do 15 continuous minutes, you should be able to add strengthening and aerobic exercises to your routine. 

Get more exercises here

It’s never too late to start a preventative maintenance program for your joints.  Maintaining a healthy weight and exercising are very important and you can also take a liquid glucosamine and chondroitin to help maintain joint flexibility.  See here

Read more about how glucosamine and chondroitin work here

This is the 3rd post in my Digestion Series.  Also see article on Prebiotics and Digestive Drugs 

Americans typically fall short on meeting their dietary fiber needs. We need about 14 grams of fiber for every 1,000 calories we consume yet, most Americans get just 15 grams per day! Fiber plays an important role in digestive system health, alleviating constipation and it may help reduce your risk of developing heart disease and diverticular disease.

Types of Fiber
There are two types of fiber and both are vital to good health.  Soluble fiber is found in a variety of foods including oat bran, oatmeal, beans, pears, apples, lentils, nuts, seeds, peas, bran, citrus fruits and barley. It can help decrease LDL cholesterol (the kind associated with an increased risk of cardiovascular disease) and make your stools softer so going to the bathroom isn’t so painful.

Insoluble fiber intake is also associated with a decreased risk of cardiovascular disease. In addition it provides “bulk” which means it can help slow the rate at which food moves through your digestive system keeping you full for a longer period of time and increasing stool bulk thereby alleviating constipation.  Foods high in insoluble fiber include whole-wheat products, the skin from fruits and vegetables, brown rice, wheat bran and seeds.


Tips for Increasing Your Fiber Intake
If you think you need to increase your dietary fiber intake, always do so slowly at first so your body adjusts. Try these steps to slowly boost your fiber intake:

1. Swap out the “whites” in your diet for high fiber foods. White foods include regular pasta, white bread, white rice and white flour products. Start looking for whole grain or whole-wheat versions of these foods.

2. Add fruits and/or vegetables to every meal and consider adding these to snacks as well.

3. Substitute dishes made with legumes for some of your meat-based dishes.

4. Eat whole fruits and vegetables instead of drinking juice.

5. Try new grains that you don’t normally consume including bulgar, quinoa, and barley.

6. Sprinkle high fiber cereals such as Fiber One and All Bran in your dishes.

7. Try a fiber supplement (some of the unflavored ones can be added to your food or taken separately).


 

Walking is one of the most underrated forms of exercise.

It’s convenient, low impact (not hard on your joints), can help you manage your weight, blood pressure and blood sugar levels and, walking can decrease your risk of developing some chronic diseases. And the best part about walking?  It requires little equipment and people of all fitness levels can benefit.

Get Proper Shoes
If you want to take up walking or if you walk now, the most important equipment you’ll need is a good pair of walking or running shoes. Go to your local running shoe store (these stores tend to have employees trained in fitting you for walking, jogging and running) and get a good pair of shoes.  Read more on shoes here

Next, consider your attire. Though you don’t need special attire to walk, having comfortable workout clothes, reflective tape (if walking at night) and the necessities to walk outside in the winter (gloves, a hat, face mask if it is very cold) will make your experience both more enjoyable and safe.

Warm Up and Stretching
Always remember to warm up slowly and stretch if you need to (stretching is especially important after you are finished exercising). And, monitor your technique - your head should be held up, eyes looking forward, chin parallel to the ground, shoulders relaxed and arms bent and swinging naturally with each step. With each step, your foot should strike the ground in front of you and push off for the next step on the balls of your feet.

Once you feel very comfortable with walking, try varying your routine by walking hills, walking faster and changing your route. Also, a few simple tools will help you get the most from your workouts – a pedometer, the Wellesse walking challenge and a heart rate monitor. A pedometer will measure how many steps you get each day and a heart rate monitor can ensure that you are exercising at a good pace so you make the most of your workouts.

If you are experiencing painful joints from walking try a liquid glucosamine and chondroitin supplement for improved joint health and flexibility and for muscle and joint pain.


Have you signed up for the Wellesse Walking Challenge yet?  It's a great way to stay motivated to walk and you can win prizes too including a $500 Wellness Package!  Join today!

• Thanksgiving shouldn’t be synonymous with “all you can eat Buffet.” Keep the primary focus on the company around you and the football games on TV.
• Remember that pumpkin pie, fat-backed greens, gravy and stuffing are available year-round in this country so you don’t need to stuff yourself in one day.
• Eat breakfast on Thanksgiving Day. If you skip out on eating in the morning to “save calories” for your evening meal, you are setting yourself up for a binge.
• Eat slowly and stop when you are full. Does another bite of pie really matter or did you already experience that taste and mouth-feel you were looking for?
• Drink water throughout the day especially if you are drinking alcoholic beverages, alternate them with water.
• Instead of cutting out certain foods or denying yourself dessert, concentrate on portion control. By allowing yourself to have small portions of your favorite holiday foods, you will not feel like you are being deprived (try using a smaller plate for your main meal – a salad plate for instance).
• Eat slowly and savor every bite. Really experience the flavors, textures and smell of each food you are eating.
• Skip the seconds or wait until others have gone up for seconds. By waiting, more of the fattening foods are likely to be finished already.

Managing arthritis can be difficult during the holidays.  As you start to decorate and do lots of shopping, make sure to not over exert yourself.  It can be easy to get caught up in the excitement and do too much.  Don't forget to take your nutritional supplements even when you go shopping at 4 am on Black Friday!

Have a Happy, Healthy Thanksgiving!

Let's focus on the legs!

How are your treads holding up?  As you pick up the pace or mileage of your walking program you may find that your legs need a bit of a tune up.  It is not uncommon to feel some pain or discomfort in the muscles of your lower leg when you get more aggressive with your walking technique.  Let’s take a look at why this happens as well as how to prevent and recover from this potential performance barrier. 

In order to pick up your fitness walking pace it takes a more exaggerated ankle action and forward body lean. This technique creates a greater demand on the muscles of the lower leg.  The front of the lower leg or anterior tibialis muscle group must dorsi flex your ankle (which mean pulling the forefoot up closer to the shin) on the forward heel strike.  Then the back of your lower leg or gastrocnemius muscle group must plantar flex your ankle (which means pushing your forefoot away from your shin) to propel you forward and into the next step.  The greater the action the faster you walk.  This increase in ankle action can takes its toll on the lower leg muscles and their attachments, causing a general sense of pain in the shin, calf and ankle areas.  This is especially true when you first start a more aggressive walking program.  In most cases the muscle pain you sense is due to a condition know as DOMS or delayed onset muscle soreness. 

DOMS is your muscles way of telling you that you have introduced it to something new and challenging.  It is nature’s way of slowing you down so that the muscle tissues can progressively get stronger without getting injured.  Keep in mind that any pain that results in swelling or bruising or lasts for more than a week, should be checked out by the appropriate medical professional. 

So what can you do to avoid or treat DOMS in the lower leg muscles? 

Let’s start with a list of ways to minimize or avoid DOMS:
1. Make sure you have proper, supportive footwear.
2. Progress into your program goals gradually.
3. Warm up properly before your walk, including lower leg movements that mimic the positions your ankle will travel through (i.e. walking on your toes then heels for approximately 30 seconds each).
4. Stretch the muscles of the ankle after the walk, holding each stretch for at least 20 seconds (i.e. ankle circles, and calf stretches).
5. Keep the muscles of your ankle strong by doing lower leg condition exercises (i.e. calf raises and dorsi flexion with foot resistance).

 

Now what can be done once you are feeling a bit of lower leg DOMS:
1. Take a few days off from your walk and if possible cross train by doing an activity that does not use the same foot pattern (i.e. swimming or cycling).
2. Massage and stretch the front and rear leg muscles daily.
3. Ice the affected areas.
4. Stay well hydrated and keep your joint lubrication up with the appropriate joint supportive nutritional supplements such as a glucosamine and chondroitin liquid supplement that's easy to take and fast absorbing.

Have a great Walking Challenge!
 

Internalize to maximize...

The ultimate race walk experience will depend on
your ability to visualize and actualize your peak walking performance.
Whether you are an elite, masters, or recreational walker - mental performance
training can maximize the benefits of your physical training.  As athletes
visualize themselves performing with perfect form and technique their brain
stores those images to its performance hard drive.  Sports psychologists
believe that when the athlete is in the performance moment they are then
able to retrieve this information and click into a 'state of flow' more
easily.  Flow is the mental state of operation in which the person is fully
immersed in what he or she is doing by a feeling of energized focus, full
involvement, and success in the process of the activity
(http://en.wikipedia.org/wiki/Flow_(psychology).  You may have heard it
described as being in the 'zone'.

Focused Motivation
According to Mihaly Csikszentmihalyi, a Hungarian Psychology Professor best
known as the architect of the 'state of flow', flow is completely focused
motivation.  Csíkszentmihályi identifies the following nine factors as
accompanying an experience of flow:

  1. Clear goals
  2. Concentrating
  3. A loss of the feeling of self-consciousness
  4. Distorted sense of time
  5. Direct and immediate feedback
  6. Balance between ability level and challenge
  7. A sense of personal control over the situation or activity.
  8. The activity is intrinsically rewarding
  9. People become absorbed in their activity, and focus of awareness is
narrowed down to the activity itself, action awareness merging.
Not all are needed for flow to be experienced.

So how can you apply the state of flow to your race walking program?

1. Start before race day.  Take a few minutes everyday to close your eyes
and picture yourself walking with perfect form and alignment, cruising past
other walkers and crossing the finish line feeling strong and triumphant.

2. During your pre-event training walks, see yourself in your minds eye.
Picture that perfect walking posture; hear your controlled rhythmic
breathing, imagine your strong heart pushing your blood out to your working
muscles.  Think about how great you feel and what a positive thing you're
doing for every cell in your body; picture those people you love and how
proud they are of your efforts.

3. During the event go back to those helpful thoughts you used during your
training walks.  Now it's time to visualize the finish line and feel your
muscles empowering you to reach it. Use a bit of self-talk when the going
gets tough; find a positive mantra to strum through your head that helps you
break through the challenge...' I know I can, I know I can, I know I can'.

With these positive mental techniques in your back pocket you'll surely have
the best race of your life!

Don't forget your liquid glucosamine and chondroitin to help keep those joints flexible and healthy for walking. 

If you haven't already signed up for the Walking Challenge - make sure you do so today here!

 

• Jacket - wear one that has reflective elements built in
• Gloves - Ulti-Mitt's have superbright fabric and even an LED light!
• Hat - wear a white hat with reflective tape
• Belt with reflection
• Vest - a light weight construction style vest works great

This is a repeat of a previous post, but with the increasing importance of vitamin D, I thought it would be appropriate to post again.

When it comes to nutrition, the media often finds an ingredient, supplement or product that steals the spotlight for a period of time.  Sometimes the ingredient is lambased to the point where it becomes an outcast at warp speed, this happened with partially hydrogenated oils (man made trans fats).  Other times, the news is good.   And this is what has happened with vitamin D.  This vitamin has gone from the kid at the back of the class to center stage in a short period of time. 

Vitamin D
When it comes to bone health, many of us automatically think of calcium and milk/dairy.  However, calcium alone can't do its job without adequate vitamin D.  Think of vitamin D as the gatekeeper to bone tissue, it aids in the absorption of calcium.  Vitamin D may also decrease our risk for certain types of cancer.  Most notably, colon, prostate and breast cancer.  And, a deficiency in vitamin D can lead to osteopenia, osteoporosis, chronic pain, muscle weakness, fractures and autoimmune diseases.
 
Vitamin D is manufactured in the skin upon exposure to sunlight.  Past recommendations have indicated that just a little exposure - say 15 minutes a day, will give us all the sunlight we need to make vitamin D.  However, recent studies have shown that many of us fall short.  Even people living in climates sunny throughout the year like southern Arizona.  How can this be the case?  Individuals with darker skin and older individuals just don't produce vitamin D as well as fair-skinned, younger people do.  And, people who live in less than sunny climates simply aren't exposed to the sun's rays often enough.  Lastly, many people have had skin cancer (basal and squamous cell carcinoma is on the rise) and are avid sun block users and therefore don't manufacture adequate vitamin D.
 
Calcium
Now, on to calcium. Aside from its role in bone health, calcium also aids in:  muscle contraction, blood vessel contraction and expansion, hormone secretion, heartbeat regulation, conducting nerve impulses and blot clotting.  And, all of these functions are considered more vital than keeping our bones strong.  So, when we fall short on our calcium intake our body leaches it from our bones. If this process occurs frequently, over time we end up with weak, porous bones, osteopenia and osteoporosis.
 
How to Get It
It's clear we need to take in adequate levels of calcium and vitamin D daily.  Calcium is more easily obtained from foods, especially dairy foods.  Greens like spinach are often noted for their calcium but, this calcium is bound to the oxalic acid present in these greens and therefore, not readily absorbed.  The same thing goes for calcium that is fortified into grain products - it is bound to phytic acid and not easily absorbed in the body.  Vitamin D is a bit harder to find in foods.  Salmon, mackerel, canned tuna, canned sardines, and milk are your best options.  If you don't drink 4 glasses of milk a day or a combination of other dairy and the fish mentioned above, try a liquid calcium and vitamin D supplement.

 

Women with breast cancer should be given high doses of vitamin D because a majority of them are likely to have low levels of vitamin D, which could contribute to decreased bone mass and greater risk of fractures, according to scientists at the University of Rochester Medical Center.

In a study of 166 women undergoing treatment for breast cancer, nearly 70 percent had low levels of vitamin D in their blood, according to a study being presented Thursday, Oct. 8, at the American Society of Clinical Oncology's Breast Cancer Symposium in San Francisco. The analysis showed women with late-stage disease and non-Caucasian women had even lower levels.

"Vitamin D is essential to maintaining bone health, and women with breast cancer have accelerated bone loss due to the nature of hormone therapy and chemotherapy. It's important for women and their doctors to work together to boost their vitamin D intake," said Luke Peppone, Ph.D., research assistant professor of Radiation Oncology, at Rochester's James P. Wilmot Cancer Center. He is a member of the National Cancer Institute's Community Clinical Oncology Program research base in Rochester.

Scientists funded by the NCI analyzed vitamin D levels in each woman, and the average level was 27 nanograms per milliliter; more than two-thirds of the women had vitamin deficiency. Weekly supplementation with high doses of vitamin D -- 50,000 international units or more -- improved the levels, according to Peppone's study.

The U.S. Institute of Medicine suggests that blood levels nearing 32 nanograms per milliliter are adequate.

This problem is not unexpected, Peppone said, because previous studies have shown that nearly half of all men and women are deficient in the nutrient, with vitamin D levels below 32 nanograms per milliliter. Vitamin D, obtained from milk, fortified cereals and exposure to sunlight, is well known to play an essential role in cell growth, in boosting the body's immune system and in strengthening bones.

Symptoms of Vitamin D deficiency include muscle pain, weak bones/fractures, low energy and fatigue, lowered immunity, symptoms of depression and mood swings, and sleep irregularities, many of which are common for women undergoing breast cancer treatment.

Source:  EurekAlert Press Release, University of Rochester Medical Center


A daily liquid vitamin D supplement of at least 1,000 IU per day is recommended to maintain healthy blood levels.  Everyone should have their blood levels tested to see where they are at and to find out how much vitamin D they should be taking.  To find out if you are at risk for vitamin D deficiency, take this quiz now 

A daily supplement of vitamin D at a dose of 700-1000 IU reduces the risk of falling among older people by 19% according to a study published on bmj.com today. But a dose of less than 700 IU per day has no effect.

IU is an international unit of measurement for vitamins and other biologically active substances.

Each year, one in three people aged 65 and older experience at least one fall, with around 6% resulting in a fracture. Fall prevention has therefore become a public health goal especially as the older segment of the population grows.

Several trials have shown that vitamin D improves strength and balance among older people, while others have found no significant effect on the risk of falling.

So an international team of researchers analysed the results of eight fall prevention trials to assess the effectiveness of vitamin D in preventing falls among older individuals (aged 65 or more). Differences in study design and quality were taken into account to minimise bias.

The pooled results showed that benefit from vitamin d supplements on fall prevention depended on treatment dose.

Supplemental vitamin D2 and Vitamin D3 were investigated. 700-1000 IU supplemental vitamin D per day (vitamin D2 or vitamin D3) reduced falls by 19% and up to 26% with vitamin D3.

This effect was independent of age, type of dwelling or additional calcium supplementation. The effect was significant within two to five months of starting treatment and extended beyond 12 months.

Supplemental vitamin D did not reduce falls at a dose of less than 700 IU per day.

The use of active forms of vitamin D did not appear to be more effective than 700-1000 IU supplemental vitamin D. Active forms of vitamin D also cost more and are associated with a higher risk for hypercalcaemia (elevated calcium levels in the blood) than standard supplemental vitamin D.

To reduce the risk of falling, a daily intake of at least 700-1000 IU supplemental vitamin D is warranted in all individuals aged 65 and older, say the authors.

Higher doses may be even more effective and should be explored in future research to optimise the fall prevention benefit and bone health with vitamin D supplements, they conclude.

Stretching is a must especially if you are experiencing joint pain and for managing arthritis for better joint health.

Have you ever wondered how to get the most out of a stretch?  Well try a little self-PNF.

PNF stands for proprioceptive neuromuscular facilitation and it simply means that our muscles receive messages from our nerves that can facilitate a better stretch reflexively.  Our muscles have sensor nerves (proprioceptive neurons) that pick up sensations like a strong contraction or a rapid bouncy movement and react by sending a message to the muscle to relax or contract in response.  When it comes to enhancing a stretch your goal is to get the muscle to relax as much as possible, thus you want to stimulate the sensor nerve with a 10 to 15 second held contraction (called and isometric contraction). 

Immediately following this contraction the muscle will reflexively respond by releasing and relaxing.  This reflex allows for an immediate gain in range of motion and extensibility.  Many physical therapists use a technique called the ‘contract/release method’ to rehab chronically tight muscles.  You can try it on your self with the help of a bath towel or stretch strap.  Lie down on your back and use the towel or strap (wrapped around your thigh) to pull your leg towards your chest.

Next press your leg away from your body into the towel, while holding the towel firmly in pace and forcing the back of the leg and hip to contract.  Hold that contraction for three deep breaths.  Release the pressing action and use the towel to pull your leg back towards your body into a deeper stretch position.  You should notice an immediate increase in range and flexibility. You can try to perform this same contract then release type stretching for various parts of your body.  Keep in mind that the contraction happens by moving and holding in the opposite direction of the stretch position. 

So for another example, if your target is your lower leg (calf muscle), stretch the muscle by wrapping a towel around the bottom of your forefoot and pulling your toes towards your shin; to contract, point your toe away from your shin while pressing into a towel, hold for 3 deep breaths, then repeat the stretch position. 

Here is a quick list of moves to stretch the major body parts:

• Chest- open arms outward and behind the body
• Upper back and neck – move head towards the opposite shoulder
• Front shoulder – open arm out or behind body 
• Rear shoulder: move arm across the chest
• Spine – round spine forward, side ways or rotate
• Buttocks – flex hip by moving the thigh forward towards torso or across the torso
• Front thigh – extend hip by moving the thigh back behind the body and bending the knee
• Rear thigh – hip flexes by moving forward towards torso and extending knee
• Low leg or calf – move forefoot towards shin

Remember to use the stretch/contract method, you need to move the body part in the opposite direction of the stretch and hold it in a static contraction for 3 deep breaths.

Try it ... to take your stretch routine to a new limit.  Stretching is a great treatment for joint pain and can help keep your joints on the move.  Be sure to take your liquid glucosamine and chondroitin supplement too for improved joint health and flexibility.