Category Archives: Personal Training

What Are Your Scales Telling You Really?

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By STEVEN MILNER IIST

I’m not advocating that you should throw out your scales but you should be aware that your scales don’t tell you what you need to know most and that is “what are your body fat percentages and distribution?” It’s not just our health we seek to improve when we aim to lose weight, let’s be honest we want to look as good as we feel. In fact the two go hand in hand, often times the better you look the better you feel. By far the best way to look fitter and be healthier is to shift the focus of your efforts from losing weight to gaining muscle and lowering your overall body fat percentage.

Measuring your body fat percentage is a great way to keep track of your progress. It’s a far more accurate indicator of your fitness level than weight alone. That’s because when you’re working out regularly, your muscle mass goes up and your fat goes down, sometimes it’s an even swap and the readout on your standard scales won’t necessarily reflect that change. Knowing your body fat levels gives you a better indicator of how well your program is working. A healthy range for women is 20 to 25 percent, but for a leaner more defined look aim for around 18 to 22 percent and for men 18 to 24 percent with an athletic look coming in at around 14 to 17 percent. N.B. everyone is different and different bodies will have different appearances even if the percentage body fat is the same, this can be attributed to bodyfat distribution. If you have reached 18% body fat or lower now is the time to switch your focus to building muscle. At this point it isn’t necessary to concentrate your efforts on losing much more bodyfat indeed it can start to become unhealthy. You need a minimum amount of fat on your body in order to perform optimally and not have symptoms such as Amenorrhea, bone loss, and low energy.

Types of Measurements
There are a number of ways to get your body fat percentage measured. Some of the more common include; hydrostatic weighing, bio-impedance scales, and skin fold callipers.

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Hydrostatic weighing
Hydrostatic weighing is the most accurate way to gauge body fat percentage. Unfortunately, it’s not the most practical—it involves being dunked under water in a gigantic water tank, while exhaling entirely.

Skin fold calliper
Skin fold callipers can also be accurate, but there’s a catch—you have to be measured by the same skilled person like myself, every time. This eliminates measuring differences from person to person. If you are working with a trainer who has been trained to use skin fold callipers, they should measure you once a month with callipers to get the most accurate assessments.

If you don’t have a trainer to help you out, however, your best bet is to use a bio-impedance scale. To get the most accurate measurement on a scale, always do it at the same time of day and make sure you are hydrated properly. The most common issues that will throw the scale off are varying levels of hydration, ladies if it’s that time of the month (don’t measure yourself during menstruation), or if you have food in your stomach.

Clothing indicators
Finally, my favourite tool: A pair of jeans. They don’t lie. Use a pair of jeans that you can’t button and try them on every 3-4 weeks to see if you are making progress. Whether the scale is budging or not doesn’t matter if your jeans are buttoning.

Muscular Male Torso Isolated on White

Ways to Lower Your Body Fat
There are two ways to lower your body fat: Lose fat (obviously), and build muscle. Extra muscle will rev up your metabolism to help burn off some of the fat. Plus, it’ll make you look leaner overall.

The best way to decrease your body fat percentage is to use a full body strength training program two to three times a week, using heavier weights with lower reps. This will stimulate your body to build lean body mass while burning fat. For the best fat-torching results, add in one to two days of interval-training cardio on top of your lifting routine.

And, of course, you cannot train with a bad diet so you’ll need to dial in your food by fueling your body highly nutritious protein, fruits, and veggies throughout the day.

Check out some of my other articles on diet and training or for more intense training tips visit my sibling site manicworkouts.com

HOW DO OUR ARMS GROW?

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article reviewed and edited by STEVEN MILNER IIST

Most people tend to look at their arms as an indicator of the amount of muscle they are gaining, muscle growth in the arms is typically the same as elsewhere in the body except that the arms are known as our show muscles, so how do they grow? This article is a bit technical but I have deliberately avoided throwing numbers and study citations at you because they don’t really help you in the real world of physical results. Sometimes it’s helpful to know which atoms and molecules are broken off, replaced or reordered but that’s the science behind it all and I’m more concerned with the practise of self improvement.

Muscle growth typically occurs at the structural and chemical levels. Further, strength increases are highly related to changes in muscle fibre size. Increase in muscle size is typically referred to as hypertrophy. The National Strength and Conditioning Association (USA) reports that hypertrophy in the arms can be observed after about 16 workout sessions.
HYPERTROPHY
The NSCA purports that increases in muscle size, or hypertrophy, result from an increase in the cross-sectional area of muscle fibres after resistance training in the arms. Resistance training induces increased synthesis of the proteins, actin and myosin. Additional proteins accumulate on the perimeter of each fibre, which increases its diameter. Further, the number of myofibrils within the muscle has been shown to increase, thus adding to increases in muscle size.

FIBRE SIZE
Two types of muscle fibres exist. Type I fibres are associated with longer-duration activities such as cycling, while type II fibres are engaged during short-duration, explosive activities such as power lifting. Both muscle fibre types are stimulated during resistance training in the arms, although type II fibres are engaged to a greater degree. Therefore, type II muscle fibres tend to increase cross-sectional area to a greater extent than type I fibres.

FIBRE CONVERSION
Muscle fibre types have been shown to change as a result of training, according to the National Strength and Conditioning Association. Resistance training results in muscle fibres taking on type II characteristics. Type II fibres are more prone to size increases, and fibre-type conversion may contribute to overall muscle growth in the arms after exercise.

STRUCTURAL CHANGES
Resistance training in the arms increases density and volume of many of the structures that form a muscle fibre, such as the myofibrils, sarcoplasmic reticulum and T-tubules. These changes also contribute to muscle fibre growth and thus increases in muscle cross-sectional area.

OTHER MUSCULAR CHANGES
Resistance training results in cellular changes in the arms as well. Increases in mitochondrial density, capillary density and improved acid-buffering capacity have all been associated with increased muscle size. Wilmore and Costill report that hyperplasia, the splitting of fibres into daughter fibres, may also occur, though research on this topic is equivocal.

A LITTLE REMINDER FOR THE LADIES
In the absence of testosterone production ladies will tone and firm their muscles and NOT grow them to man-size proportions.
DON’T WORRY LADIES YOU WILL BECOME MORE BEAUTIFUL, NOT BUTCH.

ladies arms

FELLERS? GO FOR IT! GROW HUGE…

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Edited from an original article by Graham Ulmer

 

2012 in review

The WordPress.com stats helper monkeys prepared a 2012 annual report for this blog.

Here’s an excerpt:

The new Boeing 787 Dreamliner can carry about 250 passengers. This blog was viewed about 1,200 times in 2012. If it were a Dreamliner, it would take about 5 trips to carry that many people.

Click here to see the complete report.

At Home Workout: No Equipment? No Problem!

 By STEVEN MILNER IIST VTCT Qualified

Recently my friend Jayne asked for a workout she could do at home, this is for Jayne and any other women who want a no fuss exercise routine.
Your equipment list for this workout: (1) 10 square feet of floor space, (2) you.
No stretchy bands, balls, or dumbbells (even the mat is optional). No state of the art machinery to wait in line for at the gym (and no gym fees!).

What’s good about this?
This routine can be done anywhere, anytime, and in just 15 minutes. Most important, it can lead to superior results. While machines and props isolate and strengthen individual muscles, they don’t build overall functional strength. Lifting your own body weight distributes the exercise load over multiple muscle systems, providing strength and tone without the bulk.

This is just what this total-body workout, unrestricted by fancy equipment, is designed to do. Aim for 2 or 3 sets of 8 to 12 reps of each exercise, resting 30 to 60 seconds between moves. Do the routine 2 or 3 non consecutive days a week for 4 weeks and you WILL notice a difference.

Exercise 01
Side Plank with Abduction
Lie on your left side with your elbow directly beneath your shoulder and legs stacked. Brace your abs and lift your hips off the floor until you’re balancing on your forearm and feet and your body forms a diagonal line (A). Lift your right leg at least 6 inches (B). Lower and repeat. Complete all reps, then repeat on your right side. That’s 1 set.
SETS 2 to 3
REPS 8 to 12
REST 30 to 60 secs

Exercise 02
Wraparound Ankle Touch
Stand with your legs together and bend your right knee 90 degrees so you’re balancing on your left leg (A). As you squat, reach your right arm across your body and try to touch the outside of your left foot with your fingertips (B). Keep your back as straight as possible while reaching. Press back up to start. Complete all reps, then repeat on your right leg. That’s 1 set.
SETS 2 or 3
REPS  8 to 12
REST 30 to 60 seconds

Exercise 03
Double-Stop Pushup
Assume a pushup position with your hands slightly wider than your shoulders and your back straight (A). Keeping your neck in line with your spine, lower yourself halfway and hold for 1 second (B). Continue lowering until your chest is only a couple of inches from the floor (C). Pause, then push back up to the halfway point and pause again before finally pressing back up to start. Too hard? Do the move with your knees on the floor.
SETS 2 or 3
REPS 8 to 12
REST 30 to 60 seconds

Exercise 04
Pushup Position Bird Dog
Assume a pushup position with your hands slightly wider than your shoulders and your back straight (A). Brace your abs as you extend your right arm and left leg (B). Lower them both–but not your torso–and repeat, lifting your left arm and right leg. Continue alternating until you’ve completed 8 to 12 reps on each side. That’s 1 set.
SETS 2 or 3
REPS 8 to 12
REST 30 to 60 seconds

Exercise 05
Windshield Wiper
Bend your knees and lift your legs until your thighs are above your hips (A). Press your palms into the floor and lower your legs to the left. Go as far as possible while keeping your right shoulder glued to the floor (B), then bring your legs back to center. Next, lower them to the right. Alternate until you’ve completed 8 to 12 reps on each side.
SETS
2 or 3 REPS 8 to 12
REST 30 to 60 seconds

Exercise 06
Supine Row
Lie on your back with your knees bent, feet flat on the floor, and arms at your sides with elbows bent 90 degrees (A). Pinch your shoulder blades together as you dig your elbows into the mat and lift your head and torso a few inches off the floor (B). Lower and repeat.
SETS 2 or 3
REPS 8 to 12
REST 30 to 60 seconds

In case you want to try a recommended playlist for this work out for your smartphone you can create one by logging in with tubidy (free with no hassles), create your playlist then search for and add tracks for your workout. Here’s a great playlist for women as recommended by Rachel Cosgrove, CSCS, owner of Results Fitness, & author of “The Female Body Breakthrough.”

Champion, Queen Latifah
Hella Good, No Doubt
Hey, Soul Sister, Train
Crazy in Love, Beyonce
S&M, Rihanna
Rock Your Body, Justin Timberlake
Live Your Life, T.I. featuring Rihanna
Hey Ya! Outkast
Fantastic Voyage, Coolio
Gettin’ Jiggy Wit It, Will Smith

They’re all on tubidy I checked.

Remember ladies you can’t make your muscles grow like a man can, women’s muscles become taught, toned, shaped and most of all viably active fat burning energy centres, efficient but not massive. This workout will make you look great! Give it a go and see for yourself.

ZUMBA “It’s exercise in disguise.”

ZUMBA “It’s exercise in disguise.”

by STEVEN MILNER IIST VTCT Qualified

I’ve been asked a few times now about Zumba and whether or not it’s a fad and does it work? Last year I reported on predicted trends for health and fitness in 2012 with a post titled “Fun workouts will remain hot in 2012 by the ACSM” Zumba makes it into the top ten at nine and looks set to climb as 2012 goes on.

Top 10 worldwide fitness trends for 2012
1. Educated, certified and experienced fitness professionals
2. Strength training
3. Fitness programs for older adults
4. Exercise and weight loss
5. Children and obesity
6. Personal training
7. Core training
8. Group personal training

“9. Zumba and other dance workouts
ZUMBA! and Other Dance Workouts. ZUMBA! Requires energy and enthusiasm from the instructor and the participants, which combines Latin rhythms with interval-type exercise and resistance training. ZUMBA! and other dance workouts first appeared on the list of potential trends in 2010 and ranked no. 31 of 37 potential trends; in 2011, it was ranked no. 24 of a possible 31 choices. In 2012, it jumped to the top 10. Clearly, the popularity of ZUMBA! is growing with this rapid escalation in popularity. Future surveys will determine if this is a trend or a fad.”
(According to ACSM’s HEALTH & FITNESS JOURNALA | www.acsm-healthfitness.org )

“I think people are waiting to see if we’re a fad, but class numbers keep getting bigger and Zumba is becoming more popular, so now, people realize we’re here to stay,” said Alberto Perlman, CEO and co-founder of Zumba fitness. “Zumba is liberating and magical, and one of the key ways it has expanded is through word of mouth,” Perlman said.

Zumba classes are offered in more than 110,000 gyms in more than 250 countries. So it probably won’t be hard to find a gym that offers these classes. One look in the local classifieds lists loads of venues and classes to suit all levels and pockets. A friend of mine recently posted on facebook how much she had enjoyed a class she’d been to because it was fun and got her more sweaty than “just going to the gym”. She also said that she’d paid £2 and was considering another class at £3.50 but that another was too expensive at £6 per class. Being a fit lets you enjoy life more, getting and staying fit should also be enjoyable and Zumba certainly seems to fit the bill here. Give it a go and let me know what YOU think.

How 15 Minute Doses Of Physical Activity Can Boost Your Life

STEVEN MILNER IIST VTCT

How 15 Minute Doses Of Physical Activity Can Boost Your Life

It is still better to exercise even for 15 minutes a day than to do nothing at all. It is better to do a consistent 15 minute workout that you can stick with, than risk prolonged discomfort with little return for your effort in turn leading to you quitting exercise in the end. There have been numerous studies published regarding the physical and mental benefits one can get from consistent short duration physical activities. This is good news for sedentary or inactive people who usually get overwhelmed with 30 minutes a day of exercise in the pursuit of health and fitness benefits.

Cardiovascular Health
An interesting three-month study published in the American Journal of Cardiology showed that 15 minute cardiovascular and strength training workouts can produce significant improvements in one’s fitness levels and heart health, such as decreased risk of cardiovascular disease, lower blood pressure and lower cholesterol.

What 15-Minute Strength And Cardio Exercise Programs Can You Do?
Alternate 30 seconds or a minute of resistance training routine like push-ups, squats, lunges and abdominal crunches with a minute of cardio routine like star jumps, step-ups, jogging in place or dancing in place until you complete a total of 15 minutes. This type of workout can increase your heart rate throughout the 15 minute routine.

Walk briskly for 15 minutes early in the morning or in the afternoon.
Dance for 15 minutes every morning or before taking a shower at night.
Clean, sweep or map the floor nonstop for 15 minutes every day.

Waist Management
An Australian study published in Diabetes Care showed that people who take more breaks from sedentary positions, such as standing up more frequently from a sitting position or taking a single step, can have smaller waist circumference and lower blood glucose and triglyceride levels.

How To Incorporate Workout Breaks To Your Day
Give yourself a rule or set an alarm every 20-30 minutes so you can take a short walk or stretch break wherever you are. Standing or walking around the room while using the telephone is one option. Squeeze your butt while sitting, extend and bend your knees, lift and lower your arms and twist your torso side to side every 30-60 minutes.

Self-Control
A study on exercise and self-control conducted by researchers at the University of Exeter, published in Appetite showed that exercise helps reduce a person’s chocolate cravings and improves one’s coping strategy for stress.  This study also suggested that a short dose of exercise can help people who are trying to quit smoking to cut back on caffeine and switch to a diet.

How Physical Activities Improve Your Self-Control
When craving for something like chocolates or salty junk foods, try to get outside your house first and walk for 10-15 minutes. You might be surprised how physical activities can help diminish your cravings. Whenever you feel the urge to eat something, boredom doesn’t help, get busy by dancing inside your room for 10 minutes, or completing your household chores. This strategy will distract you from thinking too much about food. Try to do your 15-minute home workout routine and you will feel more empowered to control your urges to eat extra calories, because you might not want to offset the 100 calories burned from a short workout just by eating a 100-calorie piece of chocolate.

Better Mood And Self-Esteem
A 2010 meta-analysis, which collectively observed more than 1,200 participants, published in Environmental Science and Technology showed that “Green Exercise” or outdoor activities, such as walking, running, hiking, biking, taking your dog or kids out walking for as little as 5 minutes a day, improved self-esteem and mood, compared to physical activity lasting 10-60 minutes.There have also been a number of studies proving that sedentary people can benefit from shorter periods of exercise when it comes to mental health improvement.

15 Minute “Green Exercise” Tips
Walk your dog every day.
Play with your kids in the garden.
Check out the nearest park to your work, nowadays many of them have organised activities at lunchtimes.
Use your bike to run errands.

Live Longer
A study published this year in Lancet Journal and conducted by researchers at the National Health Institutes in Taiwan found that those who exercised 15 minutes a day, or a total of 90 minutes a week, extended life expectancy by three years, compared with those who did not exercise at all. This study tracked 416,000 Taiwanese adults.

Make A 15-Minute Workout Part Of Your New Lifestyle
Choose the most doable and the most practical activities you can for every day, like walking or doing the garden, and spice things up when you’ve got more time and resources.
Make your activities fun and enjoyable by involving your partner, your kids and even your friends.
Memorize by heart a simple 15 minute exercise routine that you can use to target your whole body, using only bodyweight exercises.
When on a trip or vacation, make a commitment to yourself to move at least 15 minutes a day, even just by strolling or climbing up and down the stairs several times a day.

Fun Workouts Like Zumba Will Remain Hot In 2012. ACSM Predictions

Core Training And Fun Workouts Like Zumba Will Remain Hot In 2012

STEVEN MILNER IIST VTCTedited by STEVEN MILNER IIST VTCT

The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. More than 45,000 international, national and regional members and certified professionals are dedicated to advancing and integrating scientific research to provide educational and practical applications of exercise science and sports medicine. Now in its sixth year, the American College of Sports Medicine (ACSM) recently completed a worldwide fitness trend survey of 2,620 ACSM certified professionals from Asia, Australia, Africa, Europe, North and South America. The American Council on Exercise (ACE) also completed a fitness-trend survey of more than 1,500 experts and certified professionals. The two leading fitness organizations in the world seem to have quite similar 2012 worldwide fitness trend predictions.

Educated fitness professionals
ACSM’s number one fitness trend prediction concerns educated, certified and experienced fitness professionals. The fitness industry will continue to give importance to upgrading skills and knowledge of fitness professionals and aside from the recognized certifications and continuing education, more professionals will seek advanced professional education and take related fitness and health courses to answer the demands of the growing health and fitness industry.

Lifestyle coaching and whole-life training
With more qualified and upgraded fitness professionals, there will be a greater focus on whole-life training, as predicted by ACE. Whole-life training or lifestyle coaching will benefit clients who need support managing stress, help following eating plans and exercise management to achieve their goals and get results faster. Many fitness centres will look to offer services such as lifestyle coaching, nutrition advice and a psychological approach to really give a holistic package to their fitness programs. Also, according to ACE, behaviour modification will become something we are more aware of and the ways it can enhance a client’s exercise motivation and adherence. ACSM’s top fitness service trend predictions are still personal training and group personal training. Most people will still get the guidance of a personal trainer to get faster results, and others will join small group personal training sessions (two to four per session) to experience some fun and challenge while exercising, and to lessen the training cost.

Weight loss and strength trainingdumbell curl
More fitness consumers will look for strength training as part of their fitness routine, and health and fitness practitioners will need to integrate this into their programs. However the ACSM predict that people will look for strength training programs more for maintenance, and not for body-building. Improved strength is always related to improved functional performance and weight management, as well.

Weight loss still the main motivation
According to ACE, weight loss will still be the top reason fitness consumers will seek fitness services. ACSM predicted that weight-loss programs incorporating exercise will still be one of the most in-demand tools to answer the needs of the growing overweight and obese population, especially this 2012. Fitness professionals will incorporate calorie management in their programs by expanding their focus to proper eating and exercise for weight loss.

Growing target markets: the elderly and the young
According to ACE and ACSM, elderly and the youth will still be the growing fitness target markets of fitness professionals in 2012. The fitness program focus for children will still be on obesity prevention and management, and for the retirees, it will be more on functional training, helping them to perform their daily activities well and safely, and improve their sports like golf without developing injuries.

Hottest fitness workouts for 2012
According to ACE, clients and fitness trainers will focus on functional and integrated exercises emphasizing core muscles and using body weight as resistance (like the use of TRX), some calorie-burning exercises like boot camp and interval training, and fun group workouts like Zumba that combine Latin rhythms with interval-type exercise and resistance training. ACSM also predicted core training (stabilizing muscles of the abs, thorax, and back) using BOSU, foam rollers and wobble boards, Zumba, and functional fitness as the hottest workout trends for 2012.

Corporate wellness
ACE predicted that employers will give more wellness programs to their employees to reduce healthcare costs and improve productivity. They will outsource wellness programs so that health and fitness can be affordable.

Community fitness programs
ACE predicted that fitness programs will emerge from local gyms, parks, and recreational centres to give access to the local community and prevent the growing problem of obesity. There might be more local leaders who will take action in influencing their people to get into an active and healthy lifestyle. Therefore, fitness will be for everyone, since it will be more lifestyle-based, accessible, affordable and even enjoyable.

Fitness technology
ACE predicted that social media and mobile-based apps for fitness will continue to become popular in the coming year, and fitness professionals will have the chance to be in contact with fitness consumers because of the latest technology. Fitness consumers will have more access to nutrition and fitness education, which is significant to maintain one’s motivation.

Edited from an article by Mitch Felipe Mendoza  for Inquirer Lifestyle.
email the author at mitchfelipe@gmail.com.

Core Workout Exercises Are Misunderstood All Over The World.


by STEVEN MILNER IIST VTCT 28/11/11

 

Core workout exercises are misunderstood all over the world.
Many people think that core workout exercisesonly help in developing six-pack abs. However, outward appearances are a small part of the effectiveness of core and balance workouts. The core actually consists of many different muscles that stabilize the spine and pelvis, running through the entire length of the torso, front and back. A strong base founded on effective balance and strong core musculature prepares you for powerful and explosive movement during exercise.

Core exercises improve your balance and stability.
Core workouts are easily compromised by the idea that the rest of your workout will cover most of your core requirements, it won’t. The core is known as the power house of the system as this is where most of our movement is generated. A strong core also protects the lower back from unnecessary injury and allows a person to work efficiently and safely. It also improves balance and stability as most core exercises are based on balance engaging the core.

Core exercises can help tone your abs.
Typically core exercises tone the mid section as they basically provide a workout that isolates these groups of muscles. Core workouts tighten the packs of muscles in the abdominal area and visually give an appearance of overall weight loss. And these exercises can be done everyday unlike other weight training exercises. You can choose from 2- 3 different exercises and you will require about 5 minutes of your time to get fit and strong in the mid section. Strong core muscles make it easier to do most physical activities: The limbs are intricately connected to the core complex and movements are very much dependant on core fitness. A strong core can help you work faster, harder and longer.

Exercise Technique.
If you can, execute the workout in front on a mirror to allow you to make corrections to your posture. The most important factor is to activate the abdominal muscle during execution .This can be done by coughing once and holding the contraction that happens when you cough. Square the hips and shoulders to engage the PC muscles of the pelvic floor.

Core exercises don’t require specialized equipment or a gym membership.
We can do core and balance workouts in the comfort of our own homes at almost any time of the day, and it doesn’t need to to take up too much time. You won’t need lots of fancy equipment to work on strengthening the core either, for some however, performing core workouts at the gym sets the right mood. If you’re a beginner you should take care to workout under the guidance of the professional trainer, especially if you want to try some of the more advanced techniques early on in your exercise regime. Some core workouts require alignment and balance that can only be achieved with sustained effort and repetition.

Let’s look at three core strength exercises you can do at home.

Super man: Lie face down on the floor with your arms stretched full out in front with your thumbs just touching. Raise the right arm and left leg off the floor until you feel a stretch, hold for 3 seconds and relax. Alternate with the other arm and leg and repeat for 3 sets of 12 to 15 repetitions. When it starts to get easier try HARDER you’ll know what I mean.

Plank: Lie face down, with forearms and toes on the floor slowly start to take the strain and raise your pelvis from the floor and straighten your torso. Set your eyes on the floor. Hold this position for 10 seconds. Relax to the start position and then repeat 5 times

Supine bridge: Lie flat on your back on a mat or the floor with eyes set on the ceiling. Position your feet flat on the floor at about hip width and somewhere beneath your knees and hands just outside your ankles and alongside of your body. Now push your hips up till you have a straight line right from your knees to shoulders. Maintain a straight line posture as long as you can feel the muscle tension.

If it’s a flat tummy you most desire then check out my post on the Transverse Abdominals

Doctor’s orders for top fitness

Doctor’s orders for top fitness

Published on Thursday 24 November 2011 08:23 at Lancashire Evening Post

Doctors have launched a new scheme to avoid complications during operations and get patients back home sooner.

Lancashire Teaching Hospitals, which runs Royal Preston and Chorley and South Ribble Hospitals, has invested more than £40,000 in cardiopulmonary exercise testing equipment as part of its new ‘fitness for surgery’ initiative.

Fitness for surgery will benefit 500 patients a year and give medics a much better measurement of a patient’s fitness and the risks of surgery.

This allows specialists to effectively plan the level of care and rehabilitation a patient will need after surgery and can identify patients who may be at risk of complication during the operation, so more appropriate treatment can be arranged.

Bridget Reynolds, who lives in Longridge, near Preston, underwent the test in preparation for surgery to remove a polyp. She said: “I had the cardiopulmonary test during my pre-op assessment.

“It is really reassuring to know that you’re fit and well for surgery and I now feel less anxious about the operation.

“Although it’s a long time since I took vigorous exercise the whole experience was quite comfortable. It’s a bit like having a go on an exercise bike. In fact I might get one for Christmas!”

Dr Tom Owen, consultant in anaesthesia and critical care said: “The fitness for surgery programme will help us to avoid potentially dangerous complications during surgery and allow us to identify patients who are likely to recover quickly after their operation and be able to go back home sooner.” Chris Simms, divisional director of surgery, said: “No one likes to stay in hospital for longer than they need to and the fitness for surgery programme will enable a better recovery following an operation.”

Doctor’s orders for top fitness edited by STEVEN MILNER IIST VTCT

The Top Ten Most Common Sports Injuries

The Top Ten Most Common Sports Injuries

By STEVEN MILNER IIST VTCT

This article is aimed toward the therapists amongst you, professional or otherwise, even if you are your only client.

The most common sports-related injuries primarily are due to overuse. As the name implies, an overuse injury results from wear and tear on the body, particularly on joints subjected to repeated activity.

By far, the most common sport that leads to injury is running. “Running jars the body from the foot all the way up into the back,” says James Garrick, MD, director of the Centre for Sports Medicine at St. Francis Hospital in San Francisco. He has seen more runners than any other recreational athletes in his clinic, followed by those who participate in dance (including aerobics), tennis, skiing, basketball, gymnastics, football and figure skating.

Certain types of injuries plague certain types of sports. Most of them, however, are minor. Knowing the early signs and what to do can help prevent them from threatening future performance.

Here’s a look, from head to toe, so to speak, at the Top Ten sports injuries you’re most likely to come across:

1 Muscle Pull
Probably the most common sports injury is a muscle pull, which can happen to almost any muscle in the body. No matter how diligently you warm up and stretch, or cool down and stretch, you may pull a muscle from overuse, fatigue or taking a fall. There is little you can be done to prevent a muscle pull except to stay limber and work your muscles regularly.
A muscle pulls when a sudden, severe force is applied to the muscle and the fibres are stretched beyond their capacity. If only some of the fibres tear, that is a muscle pull. If most of the fibres tear, that is a muscle tear.

Muscle Pull Treatment.
The universally held treatment for a muscle pull or tear is to apply ice and rest until the pain and swelling subside. The ice relaxes the muscle and helps relieve any spasm. Ice should be applied for about 20 minutes on, then 20 minutes off, as much as possible for a few days. The dull ache of a muscle pull usually disappears within a few days.
As soon as tolerable, begin gently stretching the muscle. A pulled muscle may go into spasm as a reaction to being overstretched. If the muscle fibres are not gradually re-lengthened, the muscle will pull again with return to activity because it will have healed in a shortened state. In general, you can return to action when the injured body part can be stretched without pain as far as the healthy one on the other side of the body. That may take a week for a calf muscle or more than a month for a hamstring pull.

2 Neck Pain.
A pulled muscle or a muscle spasm in the neck is the sort of thing that can happen when a tennis player looks up to serve or hit an overhead smash. The pain is on one side of the neck, and the neck may be pulled over slightly to that side. It is particularly painful to turn the head in the direction of the pain. That is, if the pain is on the left side of the neck, the player can turn to the right, but not to the left. Cyclists who use racing handlebars may also feel neck stiffness. With your back bent low over the handlebars, you have to tilt your neck up to see ahead. After a long ride, the neck muscles may tighten up and go into spasm from this awkward position.

Neck Pain Treatment.
The proper treatment for neck stiffness is to apply ice for 20 minutes at a time and gently stretch the neck. Sit in a chair and hold onto the seat with the hand on the painful side of your neck. Bend your trunk and head to the opposite side. Hold the stretch for 20 seconds. Or gently drop your chin to your chest and move the chin in a semicircle from shoulder to shoulder five times. The same exercises can strengthen the neck and prevent pain.
Severe pain may require prescription medication, such as a muscle relaxant or anti-inflammatory agents, and physical therapy. Pain radiating down the arm and into the hand may be due to a pinched or stretched nerve, and should be seen by a doctor immediately.

3 Shoulder Impingement.
The shoulder bones are held together by a group of muscles known as the rotator cuff muscles. These muscles (supraspinatus, infraspinatus, subscapularis and teres minor) are responsible for the shoulder’s fine movements, such as throwing a ball. Because of the shoulder’s shallow socket and lack of ligament strength, any weakness of the small, rotator cuff muscles makes it easy for the head of the shoulder to slide around in the joint.
If the shoulder joint is continually stressed with the arm in an overhead position, as it is in cricket (over arm bowling), tennis, volleyball, swimming and weight training, the small rotator cuff muscles begin to stretch out. This allows the head of the joint to become loose within the shoulder socket. If the head of the shoulder is loose, when the arm is extended backwards over the shoulder the head will slide forward, catching the tendon of short head of the biceps between the ball and the socket. The same thing happens when the arm is raised to the side above parallel to the ground. The head will drop in the socket and the tendon of the long head of the biceps or the supraspinatus becomes impinged. This impingement causes the tendons to become inflamed and painful. Tennis players feel the pain when they try to hit an overhead or serve. The same thing can happen to golfers in both the backswing and the follow-through when their shoulders are above parallel to the ground.

Shoulder Impingement Treatment
Many doctors overlook the true problem with a shoulder impingement. They treat the tendinitis with anti-inflammatory agents or corticosteroid injections. But the anti-inflammatories soon wear off, and the next time the shoulder is used, the tendon is impinged again. The pain recurs, requiring another injection or more anti-inflammatories.
If shoulder pain lasts for more than a day or two after practicing the serve or hitting a bucket of balls, a program of range-of-motion exercises can help strengthen the rotator cuff muscles. Strengthening these muscles will help hold your shoulder firmly in place, then the head will not slip out of the socket and the tendons will no longer become inflamed or irritated. Physical therapy, ultrasound, moist heat and electrical muscle stimulation followed by rehabilitative exercises are also recommended. If the shoulder exercises do not help ease the pain, or there is numbness or tingling in your hand, consult a doctor.

4 Lower Back Strain.
Almost everyone who participates in sports experiences lower back strain at one time or another, usually from twisting awkwardly, lifting a heavy weight or doing some unpractised activity. Virtually all lower back injuries are due to weak or tense muscles or muscle strain. Suddenly overloading muscles may pull or tear muscle fibres, sending the back muscles into spasm and causing pain. Weightlifters, golfers, martial artists and tennis players are prone to back injuries because these sports involve unilateral motions. A golfer rotates the lumbar spine in only one direction, which is the equivalent of lifting weights with only one side of body. Martial artists generally have one dominant leg and kick with that one more than the other, oh yes you do!

Lower Back Strain Treatment.
Fortunately, most simple backaches go away within a few weeks, with or without treatment. After about a week, start a workout that strengthens the lower back, hamstring and abdominal muscles to help support the back to prevent any back pain from recurring. When back muscles go into spasm, the excruciating pain may be disabling. Rest for a few days and take medication such as aspirin or other anti-inflammatory agents (check with the Doc first). Ice the back for 20 minutes at a time for as long as the pain persists.
Physical therapy may also be necessary if these symptoms do not quiet down in about 10 days. This includes ice, then heat, electrical stimulation of muscles, stretching and deep-finger massage. This should be followed by exercises to strengthen the back and abdominals. These same exercises can also help head off future back pains.

5 Tennis Elbow
Tennis elbow is really an inflammation of the muscles of the forearm and the tendon that connects the muscles to the bones in the elbow. These muscles bend the wrist backward and cause the wrist to turn the palm face up. When the muscles and tendon become inflamed from overuse, the pain is felt on the outside of the elbow (lateral epicondylitis).
Tennis players most often aggravate the elbow by hitting the ball late on the backhand side, straining the forearm muscles and tendon. Constantly turning the wrist to put more spin on the serve also can cause pain. Golfers also suffer from tennis elbow, but on the non-dominant side, that is, a right-handed golfer will feel the pain in the left elbow. Pulling the club through the swing with the left wrist causes irritation in the left elbow. A second type of tennis elbow is known as medial epicondylitis. This causes pain on the inside of the elbow. It is most often seen among golfers, batsmen, tennis players who hit topspin forehands and weight lifters.

Tennis Elbow Treatment.
Tennis elbow is cured with lessons more than medicine. Tennis players need to learn how to move the feet to put the body in position to hit with full body weight behind the ball. This takes the stress off the elbow. Golfers with chronic elbow problems should also consider taking a lesson to smooth out any swing problems.
Cortisone injections, once the standard treatment, may reduce the inflammation around the elbow and ease the pain, but they do not address the cause of the problem, which is over-stressing the forearm tendon. Exercises can help improve forearm strength. These exercises include wrist curls, flexing the wrist forward while holding a light dumbbell at the side with the palm facing forward, and reverse wrist curls, the same exercise with the palm facing backward. Squeezing a soft rubber ball until the hand is fatigued also strengthens the forearm muscles.

6 Runner’s Knee.
The most common cause of knee pain is runner’s knee, known medically as chondromalacia patella. This is due to misalignment of the kneecap in its groove. The kneecap normally goes up or down in the groove as the knee flexes or straightens out. If the kneecap is misaligned, the kneecap pulls off to one side and rubs on the side of the groove. This causes both the cartilage on the side of the groove and the cartilage on the back of the kneecap to wear out. On occasion, fluid will build up and cause swelling in the knee. Runners are not the only ones who develop runner’s knee. Pain can develop around the back of the kneecap or in the back of the knee after participating in any running sport.

Runner’s Knee Treatment.
Treatment involves strengthening the quadriceps muscle, which hooks into the kneecap and helps align it into the centre of the groove. Isometric exercises are recommended to begin strengthening the quadriceps by contracting and relaxing the muscle. Strength progresses to less than full range-of-motion leg extensions. Do not attempt full leg extensions with the knee bent because this will cause the kneecap to rub more and worsen the symptoms. Treatment also includes stretching the quadriceps, and soft tissue massage to work on the centre of the quadriceps. Work from the upper part of the thigh towards the knee, stroking downward. This helps stretch muscle fibres and alleviates the muscle contraction, which is pulling the kneecap up. A large dose of aspirin, two plain or buffered aspirin pills four times a day until the knee improves, also may help reduce inflammation within the kneecap cartilage (ask the Doc ‘member).

7 Shin Splints.
Shin splints are pains in the muscles near the shin bones. They can be caused by running or jumping on hard surfaces or simply overuse. They occur most often in people unaccustomed to training, although they can also plague experienced athletes who switch to lighter shoes, harder surfaces or more concentrated speed work. The pain occurs on the inner side of the middle third of the shin bone. The muscle responsible for raising the arch of the foot attaches to the shin bone at that spot. When the arch collapses with each foot strike, it pulls on the tendon that comes from this muscle. With repeated stress, the arch begins to pull some of its muscle fibers loose from the shin bone. This causes small areas of bleeding around the lining of the bone, and pain. If the irritated area is about the size of a 50 pence piece or smaller, or the shin pain suddenly increases, you may have a stress fracture. The twisting of the tibia can cause the bone to crack. A stress fracture may not show up on an x-ray, and therefore a bone scan is indicated.

Shin Splints Treatment.
The key element of treatment is an arch support to prop up the foot and prevent excessive pronation and pull on the tendon. Many people do well with a simple commercial arch support. This usually solves the problem almost immediately. Others who have a more serious problem may need an orthotic device to control the pronation.
TIP
To help prevent shin splints, start exercising slowly to warm up the leg muscles, wear athletic shoes with good support and run on a softer surface, for example, changing from asphalt to grass every few runs.

8 Ankle Sprain.
The most common ankle sprain happens when the foot rolls to the outside and sprains the ligaments on the outside of the ankle. The outside of the ankle swells up and throbs, and may turn black and blue around the injury.
When a jogger steps gently off a curb and “twists” an ankle, this simply stretches the ligaments, with no real tearing, and is considered a mild sprain. When a tennis player lunges out over a poorly planted foot, partially tearing the body of the ligament, this is considered a moderate sprain. When a rugby player lands on another player’s foot, twisting and forcing the ankle violently into the pitch, most or all of the fibres tear, and this is a severe sprain. If weight-bearing is possible on the ankle after a sprain, the ankle probably is not broken. If you feel pain on the inside of the ankle, then it should be x-rayed to rule out a hair-line fracture.

Ankle Sprain Treatment
The tried and tested treatment for any ankle sprain is R.I.C.E: Rest, Ice, Elevation and Compression. The goal is to limit internal bleeding and cut down on swelling. As soon as tolerable, begin range of motion and strengthening exercises. These can help overcome stiffness and restore mobility. To do this, sit in a chair and cross the affected leg over the other leg at the knee. Using the big toe as a pointer, trace the capital letters of the alphabet from A to Z. Hold the big toe rigid so all the motion comes from the ankle. Repeat this exercise hourly, if possible. The letters will be very small at first but they will increase in size as range of motion improves. A good strengthening exercise is light kicking in a pool with a kick board or swim fin to create resistance.
TIP
Balance training is an important part of rehabilitation. Practice balancing on one foot with the arms extended to the sides without swaying, first with the eyes open, then the eyes closed.

9  Achilles Tendinitis.
The Achilles tendon in the back of the ankle is the largest tendon in the body. It transfers the force of muscle contractions to lift the heel. Achilles tendinitis is an inflammation of the tendon, usually due to overuse, such as frequent jumping in basketball or volleyball. The most common cause is excessive pronation of the ankle and foot, which causes the Achilles tendon to pull off centre.The pain of a torn Achilles tendon feels like a gsw in the leg. A partial tear is harder to spot. If the width of the injured Achilles tendon is smaller than the healthy one, or you feel intense pain when standing on your toes, see a doctor for treatment, and possibly surgery.

Achilles Tendinitis Treatment.
The treatment is to minimize physical activity until it feels better and to ice the tendon several times a day during this time. Anti-inflammatory agents help to relieve swelling and pain. Stretch the tendon as well by doing toe raises–stand on your toes for 10 seconds and then put your heels flat on the floor. Work up to doing three sets easily, then lift up on one foot at a time. When the tendon has healed, do heel drops. Stand with your forefeet on a raised surface, such as the edge of a step. Let your heels down below the level of the surface so that the back of the calf is stretched. Hold for 10 seconds. Repeat until the calf is fatigued. Runners who simply slough off Achilles tendinitis can develop an acute avulsion where the Achilles tendon pulls right off the bone. This is a medical emergency and requires surgical reattachment within 24 hours (mark my words you will be under no illusions as to the severity of this injury).

10 Arch Pain.
The elastic covering on the sole o-f the foot, the plantar fascia,runs the length of the foot and holds up the arch. When this shock-absorbing pad becomes inflamed, this is called plantar fasciitis, causing a dull ache along the length of the arch. The ache is due to over-stretching or partially tearing the arch pad. This happens most often to people with rigid, high arches. They feel the pain when they put weight on their foot or when pushing off for the next stride. Pain is particularly intense upon arising or after sitting for a long while. Plantar fasciitis is particularly common among middle-aged people who have been sedentary and who suddenly increase their level of physical activity. Runners are most susceptible, but almost any sport that keeps the athlete standing can lead to arch pain. Inappropriately fitting shoes or a weight gain of 10 to 20 pounds can also contribute to the condition.

Arch Pain Treatment.
The treatment is to put an arch support under the foot immediately to prevent the arch from collapsing and the plantar fascia from stretching. Also, put an arch support in your slippers and wear them as soon as you rise. Even a few steps barefoot without support can stretch the plantar fascia. Arch supports usually relieve pain within a few days. To head off arch pain, begin an exercise routine slowly, take off any excess weight and wear arch supports in your athletic shoes. Arch pain commonly smoulders for months because people do not take the proper precautions. Continuing to do weight-bearing exercises will perpetuate the pain. While the foot is recovering, swim or do water workouts. Or work the upper body only. Some people are able to use a stationary bicycle by placing only the front part of the foot on the pedals.

The main message throughout this article is rest, sometimes active rest, but still rest, do yourself a favour let your body heal and learn from your experience.