Physical Medicine And Rehab: Fitness Basics
Why is exercise so important?
Exercise is so important because it benefits every tissue in the body. Every organ system in your body will benefit from an exercise program. Exercise keeps the tissues functioning efficiently and therefore your body is able to accomplish the work that it needs to do with less energy involved. There have been many studies demonstrating the benefits of exercise on all the organ systems in the body. Your cardiac, your lungs, your GI tract, your skin, your mood is significantly impacted by exercise.
How can exercise keep my blood pressure under control?
An exercise program can help you control your blood pressure by exercising your heart and allowing your heart to function with less energy. In other words, the stronger that your heart is, the easier it is for it to pump blood around your body and it also conditions your blood vessels throughout your body. When that happens, then your heart will beat less, you won't have a rapid heart beat you'll have a slower heart beat because your heart doesn't have to beat as many times per minute to accomplish the same job. When your heart slows down, your blood pressure will drop.
How will exercise improve my stamina and overall energy?
An exercise program will help your overall strength and your stamin, also considered your endurance, by strengthening the muscles that you use to move your body. For example, if the muscles in your legs are stronger, then your muscles will work less to still move your body. So a person who is sedentary and who's not participating in an exercise program, if they were to get up and walk for a mile, the amount of energy that they would spend to walk that mile would be much higher and so the chances that they would experience fatigue is going to be significantly higher. However, somebody who exercises and has strength in their muscles, then the muscles in their legs are going to function more efficiently, and they will actually burn less energy. So the person who participates in an exercise program will be able to walk a mile and actually spend less energy. If they spend less energy walking that mile, then they're going to have more energy for the other activities in their life. So your stamina improves, the amount of energy that you spend to do any particular function will decrease, allowing you more reserve of energy to use towards other activities. So the overall sensation that people have is that they're able to do everything that they choose to do and still have energy left for other activities.
What is a muscle cramp, and how can I treat it?
A muscle cramp is a local spasm in muscle. All of the tissue in that muscle contracts very strongly and it doesn't release. So the treatment for a muscle cramp is to try to release the spasm in the muscle, and the most common way to do that is to put a very gentle stretch on that muscle which has cramped.
How can I prevent a muscle cramp?
Some muscle cramps can be prevented, if it's muscle cramps that you are experiencing in a particular activity. Let's say if you are walking or you're a runner or cramps that you may get in a gym when you're weight lifting, often a pre exercise stretching program will help prevent the cramps. So by stretching a muscle before you participate in an excersise program often improves the efficiency of the contractions of that muscle and so when you're using that muscle in your weight lifting program, for example, that muscle is going to be functioning more efficiently and you are less likely to develop an irritation on the muscle that will cause that local charlie horse, spasm type cramp in the muscle.
How can I prevent muscle cramps in hot weather?
Cramping in the muscles that happens in hot weather is generally related to a volume depletion situation. In other words, if you are running a marathon and it's very hot, you are losing lots of water, and you're losing minerals out of your body: you're losing sodium, and you're losing potassium. Those imbalances in sodium and potassium, and the loss of fluid in that muscle, can cause cramping. So, when you're exercising in a warm environment, it's important to keep your fluid levels up. Don't get dehydrated. You want to make sure you're replacing all of the water that you may be losing because of the heat and because of the exercise. You also want to make sure that you're drinking water that has mineral replacements in it. You don't want to drink just pure water by itself if you're in an extended exercise program in hot weather. Make sure that the fluid that you have has some sugar in it, or glucose, and has some sodium and potassium in it. Some of the replacement fluids that are available on the market do provide those.
Can exercise alleviate constipation?
Exercise can alleviate constipation. People who are very sedentary have more issues with gastrointestinal stomach and intestinal problems because of constipation and so people, for instance, who are in the hospital and they're very ill and they're laying in the hospital for several days it's very common for those people to be very constipated. The best treatment for that is to get those folks out of bed and to have them start exercising. By exercising you are moving your body around so there is a mechanical benefit where the food begins to be processed and there is a neurological benefit. You're stimulating your nervous system to increase the input to the intestinal tract and that will start causing what we call peristalsis in the intestinal tract.
How can I motivate myself to work out?
To motivate you to exercise we need to identify those types of exercises that are appropriate for you, that you would like to participate in. Once we do that, a great way to keep you motivated and participating, how we're going to succeed, would be a daily diary. Where you and I can then see eachother on a regular basis and evaluate how you're doing in that exercise program. Are you still motivated? What are the limitations? What prevents you the days that you miss it and you know you should be doing it. Why did that happen? How do you stay interested? And I can give you suggestions on ways to keep you motivated and interested in that exercise program. And make sure that you are consistently able to do it. Because that's how you will stay motivated and succeed, and hopefully this would become a habit for you, and once its a habit, you will feel motivated to continue to do it.
What should I do before starting a fitness program?
Before you start a fitness program you should have a full comprehensive physical evaluation by a physician. We want to identify any potential limitations there or risk factors that may present themselves once you participate in a fitness program. We also want the opportunity to evaluate what type of fitness program you might be interested in, and make sure that you are not at risk of any complication participating in that fitness program. For instance, if somebody has had a long history of lower back pain and they want to start a fitness program to run marathons, then we may need to take a closer look at their spine with x-rays and a physical examination to make sure that they don't have any disc problems in their spine that they may exacerbate while they are out on the road running all those miles in their fitness program, pounding their spine, and then develop a herniated disc or a pinched nerve in their back.
What is the most common mistake people make when starting an exercise routine?
I think the most common mistake that people make when they start an exercise program is they get very motivated and very excited to do it, and then they rush right out and they overdo it. Then they have too much soreness. For instance, somebody who says, "I want to build my muscles, I'm going to be good and strong," and they go to the gym and they start a weight lifting program, and they're trying to lift too much weight too soon. Then they develop tremendous soreness in their muscles that lasts for several days, and then they spend a week out of the gym. That's a very preventable mistake. It happens a lot, and it's hard to go back to the gym when you're in pain, or you may feel like your body's not able to do it when really you were. You just started too fast and too hard.
What are the benefits of exercising with a partner?
A workout partner often is very helpful because it not only is somebody to make sure that you're exercising appropriately, but you feel a sense of responsibility to your partner, not just yourself, but to that person. If you know your exercise partner is relying on you to show up then you're more likely to show up. Instead of saying, "I'd rather just stay home and watch television," you don't have that option in your head because you know there's your partner in their car fighting traffic, on their way to the gym, to work out with you.
How do I design an exercise program if I have physical limitations?
If you have physical limitations and you want to exercise, it's absolutely essential that you work with a physician to do that because the physician is going to understand what that physical limitation is, what risk factors come with it, and what are the potential consequences with time. So a person who has the physical limitation of arthritis in their knees, for instance, is going to have painful knees, limited range of motion in their knees. If I have a patient with the physical limitation of arthritis in their knees wants to participate in an exercise program, and I want them to, we have to do it safely so they're not putting their joints at risk of continued damage to the joint, and pick an appropriate exercise program that's not going to worsen their pain from their physical limitation. In the example of arthritis in the knees, an aerobic exercise program would be an excellent choice, not only for their cardiac benefit but also for their joints. But I wouldn't have them running on the road and pounding their knee joints. I would want to help them select an aerobic program with exercise where they are protecting the joints from further damage, not exacerbating their physical limitations. For instance, a reclining bicycle might be an excellent option.
Should I work out if I have an injury?
The answer to that is both yes and no. There are certain injuries that would benefit from an exercise program. For instance, if you have an injury in your shoulder, and you're currently being treated by a physician, or you're in physical therapy, or with a chiropractor, whatever the treatment may be, one component of your treatment would be to continue exercise, but not with the injured part. So, if your shoulder is a problem and you're in physical therapy, the only exercises you're going to be doing with your shoulder are going to be those exercises that have been prescribed by physician and the physical therapist. But, we would want you in the gym, doing some type of an aerobic exercise program, using your legs, and avoiding the injured arm, because an aerobic exercise program will help with your pain management. If your shoulder is painful, and it's being treated, then we can help with your pain management by having you doing aerobic exercise in the gym that helps release endorphins, which are the natural painkillers from your brain. So it's important to realize that an injured limb, an arm or a leg, is going to have to have medical attention and that may or may not limit the type of exercise.
How can I avoid injury when exercising?
Some exercises can cause strain or injury to you. In general, any type of a stretch or exercise that you're doing should be slow and controlled. In the gym, you want to make sure that you're using a weight that you know you can lift. Trying to exceed your known physical abilities without help increases the risk of you developing a strain or hurting yourself. Bouncing exercise is a fast, repetitive movement that you may not necessarily have control over the extent of the movement. But in general, avoid those exercises that are fast, repetitive and uncontrolled.
What is a "target heart rate", and how do I calculate mine?
Your target heart rate is the heart rate you are looking to accomplish in an aerobic exercise program for the maximal aerobic benefit. That's determined by taking the number two twenty, minusing your age, and then multiplying that by zero point seven. That would calulate out to be about seventy percent of your maximal heart rate to get your maximal aerobic benefit from the exercise.
How do I check my heart rate?
The best way to check your heart rate is at your wrist. By using your index finger you can press on the inside of your wrist very lightly, until you feel the beats from your heart. By counting those beats and looking at a watch, if you count those beats for 6 seconds, that will tell you the number of heartbeats per minute, and that's your heart rate.
Can I take pain relievers before a workout to prevent aches and pains?
Aches and pains during exercise is your body trying to tell you that there is something wrong there. You may be pushing too hard, you may have some structural problem that is causing you a problem in trying to accomplish that particular exercise. It is never a good idea to take a pain medicine or painkillers before you exercise. You need to know what's happening with your body, to be able to sense what is going on with your body, because if it continues or is getting worse, you want to be able to describe to a physician exactly what is happening when you're exercising. If you take pain medicine or painkillers, then it is going to mute your response, and you're not going to be able to experience or understand exactly what the pain you experience whilst exercising is because it will have changed from the pain medicine or painkiller. Never take a pain medicine or painkiller before you exercise, that includes Advil or Tylenol or Ibuprofen or any of the over the counter, and certainly not a prescribed medication.
Should I use heat or ice to relieve muscle stiffness?
For muscle stiffness, you can use either ice or heat. In general, we say that for an immediate injury or an immediate muscle soreness, you would want to use something that is cold and avoid heat. For chronic problems, if you have arthritis in an ankle that hurts you when you run or you bicycle, you may find that heat for a problem that you have been dealing with for a long period of time may relieve the pain better than cold does. But if it is a brand new injury, something that has just happened to you, think ice. If it's a long-term issue that you are dealing with, think heat.
