Joint Pain

Many people recognize glucosamine as part of glucosamine and chondroitin sulfate supplements – the most effective combination for fighting the progression of osteoarthritis.  But, what is glucosamine and how does it work?

Osteoarthritis
First, it is essential to understand what osteoarthritis is and how it progresses.  Osteoarthritis is a degenerative, chronic joint disease characterized by cartilage breakdown and the development of bone spurs.  Cartilage cushions the ends of bones allowing joints to move easily.  Can you imagine how your body would feel if your bones were rubbing on top of other bones?  Well, that is exactly what happens with cartilage breakdown.  Bones rub against each other, causing joint pain, early morning stiffness, joint stiffness after periods of rest, pain that worsens with joint use, and loss of joint function.

Osteoarthritis is the most common joint disease.  In fact, an astounding 75% of people over the age of 65 suffer from osteoarthritis.  Obesity and mechanical stress are two of the top contributing factors leading to osteoarthritis.  And, with the growing obesity epidemic, the number of people suffering from osteoarthritis is expected to grow accordingly.

Both glucosamine and chondroitin are taken up by the cells in cartilage (chondrocytes) and used to build new cartilage.  In addition, some research indicates that both may help prevent cartilage breakdown – a hallmark of osteoarthritis.  See picture below depicting the process of osteoarthritis. Several research studies indicate that glucosamine chondroitin supplements offer a safe, effective alternative to non-steroidal anti-inflammatory drugs (NSAIDS) for relieving osteoarthritis pain.
 
The supplement form of glucosamine is derived from sugar and very similar to the glucosamine formed by chondrocytes.  In the body glucosamine is incorporated into connective tissue, skin, tendons and ligaments.

Chondroitin and collagen fibers together form the structure of joint cartilage much like steel beams form the structure of a building.  Chondroitin is incorporated into connective tissue, skin, tendons, ligaments, cartilage and mucous secretions.  It gives joints their elasticity by drawing fluid into cartilage tissue.  This elasticity is essential given the stress and strain we put on our joints every time we engage in activity.  Chondroitin also inhibits enzymes that break down joint cartilage.

Both glucosamine and chondroitin have been used in Europe for over 20 years without significant adverse side effects.  Additionally, glucosamine and chondroitin sulfate have been consumed safely in the US for several years and side effects are considered uncommon and minor.  However, people with shellfish allergies, asthma or those taking diabetes medications or blood thinning medications such as warfarin (Coumadin) should speak with their physician first prior to starting glucosamine supplements.

Anyone suffering from the pain of osteoarthritis or even those who are in the beginning stages of osteoarthritis may benefit from taking glucosamine chondroitin sulfate supplements.  By taking this combination daily, you may prevent further cartilage breakdown and also minimize any joint pain that you have.  Try keeping a bottle of liquid glucosamine and chondroitin on your kitchen counter or even in your bathroom, it’s easier to remember to take 2 Tbsp a day.  It becomes a routine just like brushing your teeth or making our morning cup of coffee!

References:
Sem Arthritis Rheum 2001;31:58-68.
Arthritis Rheum 2001; 44:1089-1095.
Connect Tissue Res 1975; 3:115-122.
Prog Drug Res 2001; 55: 81-103.
N Engl J Med 2006;354:795-808.
Dahmer S, Schiller RM.  Glucosamine. Am Fam Physician 2008;78(4):471-6.

Building a Better Walk Program

Who wouldn’t like to make the most out of every walking workout? As a continuation on my recent series on walking, in this post I would like to talk about the power walk. 

A simple way to increase your walking power and output is to increase the dynamics of your arm swing.  Create a fist with your thumbs resting on your knuckles and bend your elbows to right angles.  Pump your arms forward and back with your fist moving from sternum to hip in an alternating fashion.  As you pump your arms think about driving your elbows down and back right along side of your torso. Keep your arms moving in a straight line; don’t let them swing side to side or cross the body. To progress further try-adding resistance in the form of hand held weights, body vests, or walking poles.  All of these options will help you burn more calories while using them while also increasing your ability to perform a more powerful walk when you walk without them.  

Start off using the lightest increments of weight.  Restrict the time you spend using the added resistance.  Start with 5 or 10 minutes and then gradually build up to your regular workout time.  If you plan to increase your resistance, do so in small increments every 4 to 8 weeks. The maximum recommendation for hand held weights is 3 pounds and the maximum for weighted vest is 30 pounds.  Note: Controversy exists over the use of hand held weights due to the stress to the shoulder joint.  Please check with your doctor first. 

• Active arm swing output increase
  - Using arm swing = 10% increase (approximately .5 cal. per min.)   (Elbow bent to right angle, fist pumps from sternum to hip)

• Hand weights output increase (with active arm swing)
- 1 pound = 10% (approximately .5 cal. per min.)
- 2 pounds = 20% increase (approximately 1 cal. per min.)
- 3 pounds = 30% increase (approximately 1.5 cal. per min.)

• Weighted vest output increase
- 10 pounds = 10% increase (approximately .5 cal. per min.)
- 20 pounds = 20% increase (approximately 1 cal. per min.)
- 30 pounds = 30% increase (approximately 1.5 cal. per min.)
- Vest should not exceed 20% of ones total body weight (i.e. 130 pound person should go no higher than 25 lbs.)

• Walking poles:
- Using poles = 20+% increase (approximately 1.5 kcal per min.)

As you know, walking is good for increasing energy levels, managing arthritis and joint health.  Increasing or alternating your walking workout is a way to get the most out of your workout.

*Keep in mind that good posture, controlled arm swing and proper overall walking form (see article on walking form) must be maintained during the use of any added resistance device. If the use of added resistance causes, neck, shoulder pain or low back pain discontinue immediately.

What Vitamin D means to you and your family

A vitamin D deficiency can occur when usual intake is lower than recommended levels over time, exposure to sunlight is limited, the kidneys cannot convert vitamin D to its active form, or absorption of vitamin D from the digestive tract is inadequate. Vitamin D deficient diets are associated with milk allergy, lactose intolerance, and strict vegetarianism.

Studies show that people with low levels of vitamin D have lower bone density or bone mass.  Vitamin D is important for managing osteoporosis and joint health especially for those over 50.

Exclusively breast fed infants
Breast milk does not have enough vitamin D to meet an infant’s needs.  Studies indicate that breast milk only provides approximately 25 IU/L.

Darker skinned individuals
Melanin, the pigment that makes skin dark, also protects darker skin from the sunlight.  In doing this, it decreases the amount of sunlight absorbed by skin and utilized to produce vitamin D.  Studies have also found that rickets is more prevalent in immigrants from Asia, Africa and the Middle East and that African Americans are at risk for low serum levels of vitamin D.   If you have darker skin, you need to spend more time outside in the sunlight in order to produce enough vitamin D in comparison to a lighter-skinned individual’s exposure.  Keep in mind that although darker skin protects skin from the damaging effects of sun exposure, darker-skinned individuals are still at risk for skin cancer.

Older individuals
As people age, the body’s synthesis of vitamin D is decreased as is the kidney’s ability to convert vitamin D to its active hormone form.  Those who are 50 years of age or older are considered at risk for developing vitamin D deficiency.  

People exposed to little sunlight
If you live where the sun rarely shines or diligently wear sunscreen and cover up most of your body in clothing, your skin is not obtaining enough sun exposure to manufacture adequate amounts of vitamin D.

People with fat malabsorption
As a fat-soluble vitamin, vitamin D requires some dietary fat for proper absorption.  Fat malabsorption is associated with pancreatic enzyme deficiency, Crohn’s disease,
cystic fibrosis, celiac disease, surgical removal of part of the stomach or intestines, and some forms of liver disease.

Obese individuals
Obesity/excess body fat increases the risk for vitamin D deficiency.  Vitamin D is stored in fat tissue and the more fat tissue a person has the less available their vitamin D is for circulation.

In addition to the groups mentioned above, individuals with kidney disease , gastrointestinal and liver disease , and primary hyperparathyroidism are at risk for vitamin D deficiency.

Aside from bone pain and muscle weakness, there may be little indication that someone has inadequate circulating levels of vitamin D.  To learn your vitamin D levels, ask your doctor about a rapid vitamin D test that measures your blood levels of the vitamin.

Because it is difficult to get enough vitamin D from diet and sunlight, taking vitamin D supplements is recommended.  A liquid vitamin D supplement is a great way for the whole family to get the vitamin D they need without having to swallow large pills.



References:
Gartner LM, Greer FR, American Academy of Pediatrics Committee on Nutrition. Prevention of rickets and vitamin D deficiency: new guidelines for vitamin D intake. Pediatrics 2003:111:908-10

  Alsafwah S, Laguardia SP, Nelson MD et al.   Hypovitaminosis D in African Americans residing in Memphis, Tennessee with and without heart failure. Am J Med Sci 2008;335(4):292-7.

  Holick MF. Vitamin D: the underappreciated D-lightful hormone that is important for skeletal and cellular health. Curr Opin Endocrinol Diabetes 2002;9:87-98

  Glerup H, Mikkelsen K, Poulsen L, et al. Commonly recommended daily intake of vitamin D is not sufficient if sunlight exposure is limited. J Intern Med 2000;247(2):260-268

  Lo CW, Paris PW, Clemens TL et al. Vitamin D absorption in healthy subjects and in patients with intestinal malabsorption syndromes. Am J Clin Nutr 1985;42:644-49.

  Arunabh S, Pollack S, Yeh J, Aloia JF. Body fat content and 25-hydroxyvitamin D levels in healthy women. J Clin Endocrinol Metab 2003;88(1):157-161

  Gal-Moscovici A, Sprague SM. Role of vitamin D deficiency in chronic kidney disease.  J Bone Miner Res 2007;22 Suppl 2:V91-4.

  Pappa HM, Bern E, Kamin D, Grand RJ.  Vitamin D status in gastrointestinal and liver disease. Curr Opin Gastroenterol 2008;24(2):176-83.

  Silverberg SJ.  Vitamin D deficiency and primary hyperparathyroidism. J Bone Miner Res 2007;22 Suppl 2:V100-4.

3 Part Series

In my previous post, I talked about health walking and I would like to expand on that.  Many older adults are experiencing the joys of walking for fitness and for joint health, including participation in local 10k, half and full marathon races.  It's a great way for managing arthritis.  Over the next three part series, I will lay out a few training options that can help take your walks and races to the next level. 

Strength Walk (part 1)
As you progress your routine don’t forget to include some complementary resistance-training exercises for the muscles you use during your walks.  By strengthening your leg and torso muscles you will reduce joint stress and muscle fatigue, giving you greater stamina no matter how long the race.  It’s best to implement your strength-walk program a few months prior to a given race, but it’s never too late to get started. 

Below is a short series of strength moves that you can add right into your walk or perform on off days.  You should try doing them at least 2 to 3 times per week. 

1. Walking lunges (for the leg and hip muscles): start with your feet together, step forward and bend both knees until you are in a lunge position, then bring the rear foot up to meet the front foot. Repeat leading with the opposite leg.  Continue alternating legs for 10 to 15 steps on each leg.   

2. Scapular Dips (for the upper back and shoulder girdle muscles): Place your arms behind you with your hands resting on the edge of a bench or step.  Walk you feet slightly forward, hips and knees bent.  Fingers are forward and elbows are straight.  Slowly let your shoulder blades slide upward towards your ears and then press them downward in the opposite direction.  Keeping all other joints stable.  Repeat this controlled shoulder shrug and press action 10 to 15 times. 

3. Heel to toe walks (for the lower leg muscles): Stand tall, bending the knees slightly and walk on your heels (toes up) for 30 seconds.  Follow this with 30 seconds of walking on your toes (heels up).  Repeat 30-second toe to heel walk two more times for a total of 3 sets.

4. Scapular Squeeze Circuit (for the mid back, postural muscles): Walk with proper form and arm swing for 5 to 10 minutes then continue walking while performing 20 scapular squeezes.  Tuck both arms in towards your sides and pinch the muscles between your shoulder blades as though you are squeezing a tennis ball between them.  Hold the squeeze for one to two seconds then release for one to two seconds.  Go back to normal walking technique then repeat the squeeze series a total of 3 times over.

Nutritional supplements such as glucosamine and chondroitin along with a sensible walking program may help improve overall joint pain and flexibility.

Maintaining joint health is very important, especially as we get older.  Ordinary activities once taken for granted such as walking, climbing stairs or getting into your car, can be difficult and painful with arthritis.  I've noticed lately that my knees and back hurt when I am gardening and I can't work as long as I used to, which is very frustrating.

Don't let arthritis get the best of you.  There are steps to take to help overcome the symptoms of arthritis and live a full life. 
In my next few posts I will write about types of arthritis and different tips for managing arthritis in your daily life.

Osteoarthritis

Osteoarthritis (OA) is the most common form of arthritis suffered by millions of Americans.  Usually associated with older people.  OA can affect younger people especially through injury or repetitive use, such as athletes.

Cartilage, the smooth, rubbery substance that covers the ends of bones and acts as a cushion, can breakdown resulting in osteoarthritis in the joints. 

Causes vary such as genetics, obesity, or overuse.  Weight control is one way to reduce painful stress on the knees.  Also strengthening the muscles around the affected area may also help.  See exercises for managing arthritis post


Arthritis Tip of the Day:  It's fall bulb planting and clean-up time for many of us gardeners.  Try using a long-handled bulb planter for less bending.  Use a garden scooter bench to sit on when weeding or pruning instead of kneeling.  Ask your children, grandchildren, or neighbors for help!  Make it fun by offering treats and beverages.

Glucosamine and Chondroitin supplements have been shown to be beneficial in maintaining healthy joint function, cartilage and flexibility.

My garden in the spring

Everyone seems to have jumped on the yoga train lately... and for good reason.  This often mis-understood form of mind/body exercise is a wonderful way to increase energy, great for managing arthritis and joint pain and reducing the stresses and strains in your body... and life.  The art of Yoga dates back centuries, originating in India as part of a ritual discipline to control, purify and enlighten the mind/body through a variety of forms or schools of practice related to Hindu philosophy.

Hatha Yoga is the style that many people associate with the word "Yoga" today. It has steadily increased in popularity in our western society due to the emphasis on physical health and vitality of the body through the practice of asana (body poses) and pranayama (breath control).
 
The sun salutation is a foundational movement series in Hatha Yoga.  For those with limited time, the Sun Salutation is excellent because it stretches and strengthens all the major muscle groups in the body while also exercising the respiratory system. It consists of a sequence of twelve positions linked by continuous flowing motion. Each position counteracts the one before, stretching, expanding and contracting the body in a different way as you coordinate the movements with a series of five deep breaths.

I have found that this simple series of 12 poses can be performed at various paces to take you from tired to revitalize or from tense and tight to limber and released in about 5 minutes.  Add in some Yoga breathing techniques and you may also experience a great endorphin high.  Endorphins are naturally released chemicals that make you feel wonderful at the end of an invigorating workout. They are believed to enhance the immune system, relieve pain, reduce stress, and postpone the aging process. 

Performance Technique:
This series can be used as a warm up to a more vigorous activity, as a mid day break from a stagnant position or as a great relaxation after a hard workout.  Making it the ideal anytime movement series.  The faster you progress from one move to the next the more heat and energy you build up.  The slower you go through each posture, enjoying the feel of each position, the more relaxing it can be.

Breathing Technique:
Each position alternates between an extended and flexed or folded position of the spine. You will inhale during the extensions and exhale as you flex or bend.  Try to use a full Yoga breathing technique.  This involves slowly filling up your abdomen then chest as you inhale followed by exhaling emptying the chest followed by the abdomen.  Be sure to breath smoothly in and out through your nose.  

Sun Salutation 12 Step Series:

Step 1: Stand tall with feet together and hands palm to palm, at heart level.
Step 2: Inhale, keeping the palms together and stretch the arms up towards the sky as you extend your spine, bending slightly backward. Keep your abdominals held in.
Step 3: Exhale and slowly flex or bend forward with your spine, until your hands touch your shins or feet.  Keep your head tucked towards your knees.
Step 4: Inhale and step back with the right leg into a deep lung position while extending your spine and lifting your head towards the sky.  Keep your hands on the ground with one on each side of the front foot.
Step 5:  Exhale and bring the left foot back next to the right while lifting the hips towards the sky.  Keep the arms straight along side of your ears, forming an A frame with the body. You may want to stay in this inverted position (known as the downward dog position) for several deep breaths.
Step 6:  Slowly lower the body towards the floor, touching the knees, chest and forehead to the ground.
Step 7: Inhale as you straighten the arms, lift the chest and extend the spine towards the sky, arching your back as much as you comfortably can.  You pelvis and thighs stay on the ground.
Step 8:  Exhale as step up with your left leg and get back into the downward dog position performed in step 5.
Step 9:  Inhale and step back with the right leg into the deep lung position used in step 4.  Hands on the ground, head and spine lifted towards the sky.
Step 10: Exhale and slowly bend forward as in step 3; Hands on shins or feet and head tucked towards your knees. 
Step 11: Inhale and raise the arms upward as you extend the spine back repeating the position in step 2.
Step 12: Exhale as you finish he series by returning to the first position, stand with both feet touching and hands together, palm-to-palm, at the heart.

To see illustrations of these visit http://santosha.com/asanas/suryanamaskar.html 

One round of Sun Salutation consists of two reps through the series of 12 poses, the first leading with the right foot in steps 4 and 10, the second leading with the left. Start by doing 2 to 4 four rounds and gradually build up to 8 to 12 rounds.

Modification Technique: 
For beginners or those with limited back mobility and or leg flexibility, the best way to modify the series is to bend the knees slightly during all of the flexed or folded postures (#’s 3, 5, 8,&10) and to reduce the arch in the back during the extended postures (#’s 2, 4, 7, 9&11).

 

I love to walk and hike and I used to run, but the older I get the more my knees hurt.  Lately, I have noticed that my knees make a strange sound when I bend them.  A friend of mine recommended some great knee braces from Nikken and they do help a lot, especially when it is cold out. 

I also take the liquid glucosamine and chondroitin supplement on a daily basis.  My greatest fear is not being able to walk and hike when I get older because my knees hurt too much or needing to have knee surgery later. 

Strengthening the muscles above around the knees can also help tremendously such as the quadriceps and hamstrings.  Exercise keeps your joints from stiffening and provides needed support, making movement easier and reducing joint pain.

Here are some great exercises for these muscles from Jen Mueller, a certified trainer, from the Spark People website. 

STRETCHES

1. Chair knee extension: Sitting in a chair, rest your foot on another chair so the knee is slightly raised. Gently push the raised knee toward the floor using only leg muscles. Hold for 5 - 10 seconds and release. Repeat 5 times on each leg.
2. Heel slide knee extension: Lie on your back, with left knee bent and left foot flat on floor. Slowly slide the left heel away from your body so both legs are parallel. Hold for 5-10 seconds, return to starting position. Repeat 5 times on each leg.
3. Knee flexion: Sitting in a chair, loop a long towel under your foot (resting on the floor). Gently pull on the towel with both hands to bend the knee, raising your foot 4 - 5 inches off the floor. Hold for 5 - 10 seconds, then release. Repeat 5 times on each leg.
4. Hamstring stretch: Standing, put one foot in front of you, toes up. With hands on the small of your back (or one hand holding a chair for balance), bend the opposite knee and hip (not your lower back), until you feel the hamstrings stretch. The upper body comes forward at the hip. Hold for 5 -10 seconds, then release. Repeat 5 times on each leg.

STRENGTH TRAINING

1. Wall slide: Leaning with your back against a wall, bend your knees 30°, sliding down the wall, then straighten up again. Move slowly and smoothly, using your hands on the wall for balance. Keep feet and legs parallel, and do not allow knees to go out over the toes. Repeat 5 -10 times.
2. Bent-Leg Raises: Sitting in a chair, straighten one leg in the air (without locking the knee). Hold for about one minute. Bend your knee to lower the leg about halfway to the floor. Hold for 30 seconds. Return to starting position. Work up to 4 reps on each leg.
   
3. Straight-Leg Raises: Sitting in a chair, rest your foot on another chair. Lift the foot a few inches off the chair while keeping your leg straight. Hold for 5 -10 seconds. Return to resting position. Repeat 5 -10 times. (Also work on increasing the time, up to 2-3 minutes if possible.)
4. Abductor Raise: Lie on your side, propped on one elbow. The leg on the floor bent, the other straight. Slowly lift the top leg, hold for 5 -10 seconds, then lower. (Ankle weights will increase the intensity). Do 1-3 sets with 12-15 repetitions each. Remember to rest in between sets.
5. Hamstring Curl: Stand with the front of your thighs against a surface (a table or wall). Flex one knee up as far as is comfortable. Hold for 5 - 10 seconds, then lower slowly. If possible, do not touch the floor between repetitions. (Ankle weights will increase the intensity.) Do 1-3 sets with 12-15 repetitions each. Remember to rest in between sets.
6. Step-Ups: Stand in front of a step, like a sturdy bench or stairs, about two feet high (or less if necessary). Step up onto the support, straighten your knees fully (without locking them) and step down. Maintain a steady pace. If you are comfortable with your balance, pump your arms while doing this exercise. Start with 1 minute, slowly building your time. Gets your heart pumping too!
7. Stationary Bike: Biking is a good way to increase strength and range of motion. Make sure you have the right positioning of the legs. At the bottom of the pedal stroke, the bend in the knee should be 15 degrees. Start with 10 minutes and slowly increase your time.

Always check with your doctor before beginning an exercise program. These exercises are designed to help, not hurt. If you experience pain at any time during the exercise, stop. Pain is your body’s way of telling you that something is wrong.

You can ice your knees for 10-20 minutes if they are sore after doing these exercises.


 

 

Setting the right goal is the most important step in starting a new fitness program... unfortunately it is often underestimated or completely overlooked.  How often do you hear people tell you that they joined a health club last year, but never go? Or they lost 5 pounds only to put back on 10? These unfortunate endings could have been prevented if the right goals were established in the beginning of the process.  

So how do you set the right goals and then actually achieve them?

The first thing to keep in mind is that most fitness related goals need at least 12 weeks for you to see measurable results.  Most people give up just about the time their bodies start changing.

Secondly, you need to focus on one primary goal at a time. Then it is important for you to have a way to monitor and track how you’re doing during the process.  And finally after the 12- weeks are over, you should re-establish a new goal based on your training results.  In doing so you are creating smaller more manageable goal increments. Success of any type often happens in small steps rather than unrealistic leaps.

Use the following steps to select the right fitness goal:

Meaningful: Make sure you’re goal is something that is truly meaningful in the ‘now’...

List 3 things you really want to change or improve about your body (in order of priority)
1.
2.
3.
(For example: 1. Lose weight; 2. Improve Joint Health; 3. Tone up)

Measurable: Now look at the three goals you listed and decide if and how you can measure them.

1. ____________________________
2. ____________________________
3. ____________________________

(For example: Lose weight: measure by scale; Feel better: self evaluation of energy level; less joint pain; Tone up lower body: tape measure)

Manageable: Take another look at your potential goals and decide which might be the most manageable, realistic and achievable over a twelve-week training period.

List the increment you would be trying to achieve per week.
1. __________________per week
2. __________________per week
3. __________________per week

(for example: Lose weight: 1 pound; Feel better:10%;  Tone up: lose ¼ inch off hips and/or thighs)

This process will help you recognize which of your potential goals might be the best to work on first.  Once you have achieved your goal, you can continue on the same path, advance the measurement or start working on one of the remaining two goals.

This systematic approach to goal setting and achievement can make the difference between ‘success’ or ‘depress’ when it comes to your next fitness program... so get goal setting and GO!

Previously I covered cardio-respiratory equipment for seniors.  Cardio is important but you need to balance that with strength training as well.  Many seniors feel reluctant to use weights either because they don't know how or are afraid they will injure themselves.

• In the weight room seniors may want to stick with the circuit machines if balance is an issue.  They may also need to omit certain exercises all together if they have joint limitations or suffer from for low back problems.  For this reason it is wise to hire a personal trainer when training in a gym.  A certified fitness professional should be able to help seniors recognize limitations, select the right exercises and spot proper movement execution. 
   
• Lightweights, exercise bands and balls offer seniors a great option because they are not as intimidating as heavy weight room equipment. The portability and handling ease make them ideal for senior strength training programs.  Some of these exercise devices are even designed with special gripping features, which make them easier to handle and hold like these here, soft weights and compressible balls. 
  
• Some seniors may need to wear a weight-training glove to improve grip and/or protect sensitive skin on the hands when handling weights or resistance bands.

• Another equipment consideration when training is joint stability and protection devices... This is where a physician’s recommendation should come in.  It could involve orthopedic braces or raps for the wrist, low back and knee.
   
• Some physicians will recommend water exercise for seniors with severe joint pain or limitations.  The water acts as a natural body support and the buoyancy factor keeps stress off joints.  Even for water exercise there are a variety of floatation and resistance devices that can to help make the most out of a water workout.  

Flexibility training equipment is pretty much the same for senior as any adult exerciser:

·        A comfortable floor mat is a must if seniors are planning to stretch on the floor.

·        A stretching strap is also helpful for leveraging limbs into a stretch position.

·        A rolled pillow or towel for neck support is also recommended for when lying on ones back.

One note on stretching:
Some seniors do not feel comfortable moving up and down from the floor.  Thus stretching can be done from a seated position, while standing behind a chair or even while lying on a firm bed or couch.  It is also a good idea for seniors with balance issues to have a sturdy chair nearby if moving down onto the floor for stretching.

Part 3 of Exercise Gear for Seniors

Exercise Equipment for Cardio Exercising

Senior fitness equipment is a broad area, which I will cover based on what is relevant when conditioning the heart verses the skeletal muscles of the body.   

Lets start by discussing senior cardio-respiratory equipment:

• In general the stationary cardio machines are built for any adult user, but some offer features that better address senior adult’s special needs.  For example, if a senior has problems maintaining good posture or balance, they will want to use the machines that offer back support or take place from a seated posture. 
    
• If seniors have a specific joint that doesn’t function like it use to or joint pain issues, for example the knees or low back, they will want to find the equipment that places the least stress or weight on those areas.  This might mean a glider style machine that distributes the workload between the arm and leg muscles, or a recumbent bike that puts the back in a more comfortable posture. 
  
• If seniors are into outdoor cardio activities like walking or jogging a pedometer is a great tracking tool.  Look for one that has easy to read numbers. Many aging adults feel more comfortable accumulating their cardio-respiratory training minutes throughout the day.  By wearing a pedometer seniors can easily track their daily steps.  Harvard research has shown that as little as 6000 steps a day correlates to a lower death rate. http://walking.about.com/cs/measure/a/locke122004.htm
   
• A heart rate monitor is also a helpful device to insure a person is training at the right intensity.  Keep in mind that some seniors are on heart medications that are designed to keep the heart rate from elevating thus a electric monitor may not reflect how hard they are truly working.  In these cases seniors will need to base their intensity on how they are feeling during the activity and try to stay in a moderate to somewhat hard perception range.
  
  Always check with a doctor before starting any exercise program and he may be able to advise you further on what exercise equipment to use and how to manage joint pain and arthritis with exercise. 
  
  My next post will discuss strength training options for seniors.  Be sure to check back!  If you have any helpful tips or advice, please comment below. 

Having the right gear can make a huge difference in physical performance as well as personal safety during exercise... and this is especially true for senior adults in preventing joint pain and other issues.  As we grow older our fitness needs shift due to age-related changes in our body.  These changes make a difference in the type of exercises we should do, the way we should suit up and the equipment that will be most comfortable to use.  In my next few posts I will discuss my top ten must haves that are important for everyone, especially active seniors.

 

#1 – The Right Shoes

The #1 problem I see when training senior adults has to do with their shoe choice.  By the time we hit our ‘golden years’ we often have one or more joint related problems that affect our ability to balance and/or maintain a proper walking gate.  A non-supportive, poorly designed or worn-out fitness shoe will only exacerbate these problems. 

So my ‘Golden Gear’ tip #1 is to check with a foot care specialist or orthopedist as to the best fitness shoe for your particular foot and movement mechanics.  You may need special orthotic inserts.  And if you have diabetes or skin issues you may also need special socks to reduce skin irritation.  These are available on-line as well as through specialty footwear store. (see www.footsmart.com/diabetes).

 

What is the main purpose of your shoes?

Another common misconception, when it comes to fitness shoes, is the belief that all fitness shoes are created equal.  This is certainly not the case.  Fitness shoes come in a variety of models designed to enhance and support the type of activity you intend doing.   A running shoe is built to properly cushion the mechanics of running and a walking shoe is designed with the foot strike of walking in mind.  A cross trainer or gym shoe provides a more solid base with lateral support to allow you to move from strength exercises to cardio equipment. 

 

It will be important that you choose and use the shoes as they are designed, which may mean you have more than one style in your closet.  A reputable shoe store should be able to advise you as to the specific features and design of the shoes you are considering. Also remember to change your shoes at least once every four to six months (if exercising on a regular basis).  The inner support systems may be broken down as well as the outer tread, which can increase the risk of falls.

 

Go check what shoes you are currently using.  Do you need new ones?  Are they the right kind?  Remember, proper gear starts with the feet, so don’t wait.  It may help prevent injury later on.

 

Next Post:  #2 – Comfort Clothing!

Here is another great story about our liquid glucosamine and chondroitin product.  I've recently noticed that a lot of people ask on various chat sites and communities if glucosamine actually works.  The answer is yes!  But it may not work the same way for every person and it does take a few weeks to feel the effects.  You may not notice a different for several weeks.  It really depends on what the source of your joint pain is such as what type of arthritis.

But don't take my word for it.  Here's a real life story from a person who it has worked well for.

"...I've been taking it (glucosamine and chondroitin liquid) for I'm not sure how many years now, and it's one of the few things I've ever bought that actually works like it's supposed to.  I got banged around playing soccer in my youth, as well as being "bumped" by cars while on both 10-speeds and motorcycles, so sufice it to say, I "crackled" whenever I bent my knees, even just walking.  I'm not sure how long I took before it started working; I just noticed one day that I no longer "crackled" going down the stairs."  J. Cunningham, Smyrna, Georgia

Arthritis Tip of the Day
Turn a trip to the supermarket into a chance to exercise.  Push the cart once around the perimeter of the store without stopping.  This also gives you a chance to see what's on sale before you start filling your cart.

In my last post, I wrote about exercise tips you can easily do while on the go.  In this post are specific exercises that you can do in your hotel room or anywhere without having to go to the gym. 

Body Blasters: The following exercises are very effective and use gravity as your resistance, so you don’t need any extra equipment.  These are also great for overall bone and joint health.  Do 1 to 2 sets of 8 to15 repetitions of each of the following classic exercises for a full body workout.

Push ups: for chest, triceps and shoulders                                                                                           

 

·        From a hand and knee or hand and toes position, bend the elbows and slowly lower chest towards the floor

 

·        Keep the abdominals held tight and try to get the chest to within a fists distance of the ground

 

·        Hold in the down position for a second or two and then exhale as you extend the elbows, pressing back up to starting position.

 

 

Single Leg Step Ups: for hip and buttock muscles                                                                                     

 

·        Stand with one foot on top of a step or solid bench (6 to 12 inches high) and the opposite foot on the floor behind the step or bench. 

 

·        Shift your weight onto the up leg and exhale as you extend (straighten) the hip and knee

 

·        Tighten the standing thigh and hip muscles for a second or two and then slowly lower back to the starting position. 

 

·        Repeat 8 to 15 times and then switch leg positions to work the opposite side.

 

 

Traveling Lunges: for the leg muscles

 

·        Start with feet together in good standing alignment

 

·        Step forward with one leg and bend both knees lowering into a lunge position

 

·        Hold for a second or two in the down position and then step the rear leg forward along side the front leg

 

·        Repeat with the opposite leg moving in a forward direction.

 

·        Breath fluidly throughout the movements

 

·        Continue in a forward moving direction, alternating between legs until you have completed 8 to 12 step outs on each leg

 

 

Shoulder dips: for mid back muscles

 

·        Position your arms behind your body with hands on a raised surface (step or bench), fingers forward towards your hips; Knees are bent with feet on the ground

 

·        Keep your elbows straight as you allow your shoulders to rise up towards your ears

 

·        Exhale as you press downward through your shoulder girdle, pushing your shoulders away from your ears and hold this position for a few seconds

 

·        Repeat the movement slowly 8 to 15 times concentrating on the scapular movement while keeping your elbows straight throughout the exercise.  * make sure not to confuse this with the classic triceps dip...where the lowering is done by bending the elbows.

 

 

Inversion press ups: for the upper back and shoulders

 

·        From an inverted position (hands on floor and hips up) similar to the downward dog in Yoga, slowly bend your elbows and lower your head and shoulders towards the floor

 

·        Hold the down position for a second or two and then exhale as you press back to starting position

 

·        Feel free to place the hands on a raised surface like a step or bench if it is to hard to do with hands on floor

 

 

Crunches: for the abs

 

·        Lie back on the floor with hands behind your head, knees bent and feet positioned a comfortable distance from your hips

 

·        Exhale as you lift the torso from the ribcage area moving towards your pelvis

 

·        Lift to the point where you feel your shoulder blades clear the floor and hold for a second or two, then slowly lower back to starting position

 

·        Repeat for 8 to 15 repetitions

 

 

Supermans (back extension): for the spinal muscles

 

·        Lie flat on your belly with your arms extended forward and your legs straight on the floor

 

·        Keep your abs tight and feet on the ground as you exhale and lift your upper body and chest off the floor a few inches. Stay in the pain free range, never lifting higher than comfortable for your lower back.

 

·        Stay lifted for a few seconds and then return back to the start position.

 

·        You can modify this exercise if it is too difficult to lift with your arms extended by bending the elbows along side of the head or resting the chin on your hands

 

·        Be sure to move slowly in and out of each repetition keeping the head and neck in stable alignment with the rest of the spine.

 

·        Repeat for 8 to 15 repetitions

 

This short series will pump you up and hold you over till you can get back to the gym.

 

 

Many caffeine lovers around the world will love hearing the news that besides waking you up in the morning, caffeine is a well-proven ergogenic aid.  Simply put, caffeine has a positive effect on your ability to perform certain types of exercises and sport activities.  Numerous studies have shown caffeine allows athletes to train longer and stronger. These effects have been found in activities that last as little as 60 seconds or as long as 2 hours. 

·        Research provided by the American College of Sports Medicine (ACSM) has shown that ingestion of 3-9 mg of caffeine per kilogram (kg) of body weight one hour prior to exercise increased endurance running and cycling performance of well-trained, recreational athletes in the laboratory.  

·       Several other studies have shown that caffeine can lessen the muscle pain experienced during exercise.  Read Study  This could be one reason why exercisers are able to continue working at high levels of intensity for longer periods of time.

·        Furthermore recent research has shown that ingesting caffeine post training may help muscles recover quickly after a major workout or competition. In one such study it was found that a combination of carbohydrates and caffeine post high endurance activity favors the replenishment of muscle glycogen (primary muscle fuel source) by 66%.  

Caffeine is found in many of the products we love to consume such as coffee, tea, chocolate, energy supplements and soda.  But hold on before you refill that cup of java; it should be noted that the ingestion of caffeine in the form of coffee appears to be ineffective compared to the use of pure caffeine sources found in sports drinks and tablets. It is believed that there is some other chemical in coffee which may counteract the sports enhancing effects.

 

It is important to keep in mind that although a reasonable amount of caffeine (25 to 200 mg) is believed to yield positive sports related benefits, too much caffeine can have undesirable and unhealthful side effects.  Overdoing it can make you feel anxious and jittery, disrupt sleep, increase blood pressure and heart rate, give you heartburn and stomach ulcers, and cause dehydration. Caffeine can also have an addictive effect on the body, causing withdrawal effects such as headaches and extreme sluggishness when you try to give it up. 

 

Side Bar...

 

Some studies have raised safety concerns in the area of caffeine usage in patients with reduced coronary flow reserve, as seen in coronary artery disease, particularly before physical exercise and at high-altitude exposure. http://www.eurekalert.org/pub_releases/2006-01/acoc-clb011306.php

 

 

 

 

I just returned from a week long vacation to Helena, Montana.  My family and I journeyed there with our camper to a beautiful lake - Canyon Ferry Lake.  I had never been there before and what a beautiful place!  Nestled in the mountains, it spans for many miles with spectacular scenery.  I got to play on my new kayak quite a bit which was very enjoyable.  I managed not to dump myself in the water, even with all the huge boat wakes coming at me.  It's a great way to get away for some relaxing time on the water.

While on vacation it's not always easy to "stay healthy".  Eating lots of chips and smores and other junk food does not constitute a healthy diet.  Also, it can be hard to remember to take nutritional supplements.  That's ok.  If you take a week's "vacation" from your supplements, don't worry!   As long as you start again immediately after returning, you should have no ill effects from taking a break.

If you are taking a supplement such as glucosamine and chondroitin, you may notice a difference such as more painful joints, stiffness in the knees, etc.  So this may be one supplement to continue taking while on vacation. 

So I'm trying to get back to my healthy ways after vacation, eating better and taking my supplements.  What do you do while on vacation?  Do you take your supplements with you?  Tell me your vacation story!

We just received a wonderful success story from a customer who takes our glucosamine and chondroitin liquid supplement.  Please read below to hear her great story.  We love getting these!

"I wanted to take the time to tell you the unbelieveable results I've had with your liquid Glucosamine and Chondroitin and MSM (supplement). I don't take nutritional supplements and sort of poo poo vitamins, minerals and natural remedies. I'm not the naturalist type and never held any faith in homeopathic methods and scoffed at the vita-cuckoos I know. However, the pain in my hip joint was getting progressively worse and I lived on Advil and heating pads for well over a year. Sitting was the worst and I have a desk job. I assumed I would end up going to the doctor who would put me an a prescription and I wasn't ready to hear that. Talking with a co-worker one day, he said that he saw your liquid Glucucosamine and Chondroitin supplement product at Costco and that since I have a hard time swallowing pills, I should try it. So, I bought it and each day as I took a capful I moaned how this was hocus-pocus and would never work. I WAS DEAD WRONG. After about 3-4 weeks, I was astounded when it dawned on me that I hadn't taken an Advil or needed heat in days. I'm sold! Your product is the bomb. Love you guys and thanks so much for such a fab product. I tell everybody about it. I just bought two more bottles!"

 - From A.T. in Springfield, VA - what a wonderful story!

If you have a story you would like to share - please let us know!  You can send it as a comment or email here

Happy Summer to everyone!  I sure hope your weather is better than ours here in the Pacific Northwest.  So far, it has been mostly cold and rainy and we are even getting snow in the mountains.  It doesn't feel like summer.  But at least we are not getting the floods like in the midwest.  My heart goes out to those who have lost their homes, businesses, and farms.   

Summer is time for vacations and going outdoors; however, if you suffer from arthritis, it's not always easy.  Here are a few tips for managing arthritis in the summer.

1.  Drink plenty of water to stay hydrated.  Take a bottle of water wherever you go.  This may help prevent fatigue, dizziness and reduce pain.

2.  If you are taking a long car trip, stop often to rest and stretch.  Take a short walk if you have time.

3.  Hiking is very enjoyable, but be sure to choose trails that are not too steep or have a lot of difficult obstacles.  Use a walking stick for support.

4.  When gardening, use an old wagon to carry tools and heavy bags of mulch or potting soil.  Use a gardening chair to sit on instead of kneeling.

5.  Swimming is an excellent exercise for people with arthritis.  Take caution when getting in and out of the pool.

6.  Don't forget to take your liquid glucosamine and chondroitin supplement  every day!  This will be especially helpful for joint pain if you are very active in the summer.

Have a great, safe and active summer.  I'm going to try out my new kayak as much as I can, even if I have to use it in the rain!

Do you have any great tips for living with arthritis in the summer? 

5 Steps for Bone Health – 2^nd in Series

Step 2 – Exercise

 

According to the National Osteoporosis Foundation regular exercise is an important way to maintain bone health. 

 

Last week I wrote a post on the first step for bone health – Eating Right.  Step two in this five-part series concerns exercise.  Just like muscles, bone strength and density increases with exercise.  Healthier bones protect against bone fractures and osteoporosis. 

 

If you have osteoporosis, a successful exercise regimen starts with safe and enjoyable activities that suit your degree of bone loss and overall health.  Check with your doctor before starting any exercise program.  Remember, there is no one program that works for everyone.  I find that mixing it up keeps me going better than doing the same thing all the time.  I like to walk during the week at lunch and then go for a longer hike on the weekends.  It also depends on the time of year and the weather.

 

Make sure your routine includes a combination of weight-bearing, resistance and flexibility exercises.   

 

Weight-bearing Exercises

Any exercises where your legs and feet support your weight qualify as weight-bearing.  These exercises work directly on the bones in your legs, hips and lower spine to slow mineral loss.  If you have osteoporosis, you should avoid high-impact activities such as running, jumping, or jogging.

 

Sample exercises include: 

• Walking
• Dancing
• Gardening
• Hiking
• Low-impact aerobics 

Resistance Exercises

Any activity that uses muscular strength to improve muscle mass, strengthen bones and reduce mineral loss is considered resistance exercise or strength training.  Compression fractures resulting from osteoporosis often lead to a stooped posture and increase pressure along your spine, resulting in even more compression fractures. Exercises that gently stretch your upper back, improve your posture and focus on strengthening the muscles between your shoulder blades can all help to reduce harmful stress on your bones and maintain bone density.

 

Examples of resistance or strength training include:

• Free weights
• Weight machines
• Resistance bands
• Water exercises (water acts as the resistance) 

Flexibility Exercises

Stretching is always very important as part of an overall fitness program.  It’s important for joint and bone health by reducing pain and stiffness, and supports good posture.  It is best to do stretching once your muscles are warmed up to prevent injury, at the end of your workout for example.  Always stretch slowly and gently, without bouncing.  I find I need to stretch my back about every 10 minutes or so when I am walking or hiking and then at the end.  I can usually walk longer this way and feels great.   

 

Make Exercise Your New Healthy Habit

Choose the activities that you find most enjoyable.  This way you are more likely to stick with it.  Set a goal.  When you achieve your goal, reward yourself!  I like to use a massage at the spa as a reward – it’s a great motivator!

 

What are your favorite activities?  What do you do to stay motivated? 

 

Check with your doctor before starting any new exercise program, especially if you already have osteoporosis, as you may be at risk for fractures. Your doctor can help you determine the best exercise program suited for you.

There has been some confusion about whether doctors recommend Glucosamine and Chondroitin for arthritis.  In Europe, prescribing glucosamine for joint problems has been standard practice for decades. In fact, the glucosamine market in Europe is quite large. Here in the U.S., more and more doctors are suggesting their patients take the supplement because it works for improving joint health.   

 

In fact, a recent report in the February 2008 issue of Osteoarthritis and Cartilage, the Osteoarthritis Research Society International (ORSI) included glucosamine and chondroitin in their list of recommended treatments for the management of hip and knee osteoarthritis. Their position was taken based on the findings in the published report of W. Zhang, Ph.D., et al., pages 137-162.

 

The purpose of this report was to develop concise, patient-focused, up-to-date, evidence based, expert consensus recommendations for the management of hip and knee osteoarthritis (OA). Also, it’s adaptable and designed to assist health care professionals in general and specialist practice globally.

 

The strength of the recommendation was based on the opinions of the guideline development group after taking into consideration safety, efficacy and clinical expertise. Pain, patient tolerance and movement were included in the guidelines. Sixteen  international experts from four medical disciplines (primary care, rheumatology, orthopedics and evidence-based medicine), formed the guideline’s development  team.

 

In the category of pharmacological modalities of treatment recommendation #18 on page 148, they state, “Treatment with glucosamine/chondroitin may provide symptomatic benefit in patients with knee OA.”  The report cites several different studies and reviews to support this.  Recommendation #19, page 149, states, “In patients with symptomatic knee OA glucosamine sulphate and chondroitin sulphate may have structure-modifying effects…”

 

Liquid glucosamine and chondroitin supplements can be a tremendous help in managing arthritis and joint pain. Many satisfied customers have taken the liquid glucosamine for years with very good results.  It has made a huge difference in many people’s lives and isn’t that what’s important?  Enabling a person to be more active and live life to the fullest – no matter what their age – that is the ultimate purpose of a glucosamine and chondroitin supplements.

 

For more great arthritis research info check out www.arthritis-research.com or the Arthritis Research Institute of America.

 

Arthritis Tip of the Week – When on vacation, make time in your day for exercise.  You will have more energy for sightseeing, and you’ll keep your muscles and joints from getting stiff while sitting or visiting tourist sites.. 

Come See Us at the Bloomsday Expo and Race, May 2-4 in Spokane, WA!

 

We will be handing out samples of our Energy Supplements and Glucosamine and Chondroitin nutritional supplements at the 32^nd Annual Bloomsday 12K Race in Spokane, WA, May 2-4.  This year the race is supporting the efforts of Cancer Patient Care to help cancer patients and their families.  A great cause!

 

We will have a booth at the Expo in the Spokane Convention Center, Booth #412, and we’ll be handing out free samples of our liquid supplements and valuable coupons.  The Expo is open to the public whether you are in the race or not.  The Energy supplement is great to use either before a workout to get your energy levels up or after, for a quicker recovery.
 

I will be walking in the race along with my coworkers on Sunday, May 4^th.  We are all dedicated walkers and love to have any chance to walk together and participate in great events such as this.  Before I walk long distances or go hiking, I make sure to eat a good breakfast such as oatmeal to provide sustained energy.  Trail mix bars are great while you are on the trail.  And I always make sure to do lots of stretching before it starts – especially legs and back - and I will continue to stretch as needed throughout.

 

These Joints Were Made for Walking

We recently posed an online question:  “How do you stay in motion when you have joint pain?”  By far the most popular answer was – WALKING!!  Walking at lunch, walking the dog, parking far away and walking to your destination, walking up stairs instead of elevators – anything to do with walking.  Here are a few of the comments we received: 

 

“Keep a pair of athletic shoes at work which will encourage you to walk more.”

 

“Walking daily helps me keep my joints feeling good.”

 

“I just keep doing things to keep my body moving and my muscles going.”

 

“I keep music on in the house most of the day and dance about while I do my chores.”

Other great suggestions included:  gardening, dancing, yoga and Pilates, taking nutritional supplements such as glucosamine and chondroitin, tennis or bowling, hiking, water aerobics, biking, swimming and spinning classes.  Lots of great ideas!

  

Walking is a wonderful way to relieve joint pain and manage arthritis.  It can also you help maintain a healthy weight, when part of a sensible diet and exercise program.  Find a friend or pet and start walking today! 

 

Join a Team!

One way to stay motivated is to walk in support of a cause.  The Arthritis Walk is the Arthritis Foundation's annual nationwide event that supports public awareness and raises funds to fight arthritis, the nation's leading cause of disability.  Put a team together and have lots of fun while raising money for the Arthritis Foundation.  

Watch this video now and learn all about it. 

Click here for another great way to contribute much needed money for the Arthritis Foundation.  

 

If you’re just getting started, visit Team Prevention Walk It.  This site can even help you personalize a training plan program.  Or check out Getting Started Walking from Prevention.com.  They have a lot of great resources for walking including a walking calculator and a Walking Forum Discussion, which even has people looking for walking buddies and tips.

 

 

Here is a great blog on just walking information  http://walking.about.com

Happy Walking and see you at Bloomsday!
 

Health Tip of the Week – Buy good walking shoes – if your feet hurt, you won’t want to walk, so it’s very important to have good shoes.  Go to a shoe store that will personally find a shoe just for you such as an athletic or sporting goods store.  It’s well worth the money and your feet will love you for it!