Transcript Motivation & Exercise Get Fit Series

MOTIVATION & EXERCISE
GET FIT SERIES
David S. Edwards, M.D.
Department of Family Medicine & Sports
Medicine
Texas Tech University Health Sciences
Center, Lubbock
Objectives
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Discuss the effects of exercise on the human body
and its major organ systems.
Review common injuries and principles of treatment.
Identify “red flags” that may lead to injury or
permanent disability.
Create an exercise program that is fun!
You are wonderfully made!
(images: www.wikiality.com , www.newsin3D.com )
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“What a piece of work
is a man! How noble in
reason, how infinite in
faculty, in form and
moving how express and
admirable, in action like
an angel, in
apprehension how like a
god!”

William Shakespeare
Top Ten New Year’s Resolutions (about.com,
Powell & Powell)
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1. spend more time with family & friends
2. get in shape
3. lose weight
4. stop smoking
5. enjoy life more
6. quit drinking alcohol
7. get out of debt
8. learn something new
9. help others
10. get organized
Why exercise?
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Improved bone density
Lowering of blood pressure
Improving cholesterol, LDL, and HDL
Enhanced self-image
Improve balance and coordination
Decrease anxiety and depression
Promote restful sleep
Reasons Boys Play Sports
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To have fun
To improve skills
Excitement of
competition
Self-identity tied to
athletic ability
Reasons Girls Play Sports
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To have fun
To exercise
To get in shape
Anatomic changes during adolescence can be
frustrating for athletes.
 Ballet,
dance
 Gymnastics
 Figure skating
Exercise is not easy!
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Societal developments
over the past 20 years:
Sedentary lifestyle
 High fat diet
 High refined
carbohydrate diet
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Image: www.stayviolation.typepad.com
The Obesity Epidemic
•Source: CDC
Sequelae of obesity
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High blood pressure
Impaired glucose tolerance
Diabetes mellitus II
Elevated cholesterol, atherosclerosis
Osteoarthritis of hips and knees
Non-alcoholic steatohepatitis (NASH)
Airway obstruction , sleep apnea
Certain cancers
Not everyone can jump into exercise.
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Certain groups require preliminary cardiac stress
testing.
Low risk: male<45, female <55, 1 risk factor.
Moderate risk: male>45, female >55, 2 risk
factors.
High risk: signs and symptoms
Coronary artery disease risk factors
(image: www.topnews.in )
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Family history (male<55, female<65)
Cigarette smoking
Hypertension
Elevated cholesterol
DM II, impaired fasting
glucose
Obesity
Sedentary lifestyle
Signs/Symptoms of coronary artery
disease
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Dull pain: neck, chest, jaw, left arm
“indigestion”
Shortness of breath at rest or with mild exertion
Dizziness, syncope
Orthopnea, paroxysmal nocturnal dyspnea
Ankle edema
Palpitations
Claudication
Heart murmur
Recent fatigue with usual activities
The Aerobics Center Longitudinal Study –
Sui X., et al
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Prospective cohort of over 2600 adults > 60 from
1979-2001
Fitness measured by treadmill exercise testing
periodically
Fit people had a lower mortality regardless of
abdominal obesity or % body fat!
Fit people who were obese had lower mortality
than non-fit people with normal weight!
Principles of Acute Soft Tissue Injury
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Protection
Rest / relative rest
Icing
Compression
Elevation
Mobility
Injury Treatment - Ice
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Useful for acute injury
Decreases swelling and
pain
Chronic injury – only
after activity
Ice massage with
elevation
< 20 minutes, wait at
least 45 minutes before
re-application
Injury Treatment - heat
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Relaxes and loosens soft tissues
Stimulates blood flow
Useful for chronic injury / overuse before activity
Contraindictions: acute injury, after activity, altered
mentation or mobility
Heating pad or hot damp towel
Side Effects of NSAIDs
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Images: www.medicalook.com & www.gamewood.net
Overuse Injuries Can
Progress Rapidly
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Type I – pain after activity
Type II – pain during activity, does not limit activity
Type III – pain during activity, limits performance
Type IV – pain at rest
Prevention
(Image: www.ushistory.org )
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“An ounce of prevention
is worth a pound of
cure.”
“Exercise is medicine!”
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ACSM
Sites of Stress Fracture
Images www.eorthopod.com , www.fairview.org
Risk Factors for Stress Fracture
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Female gender, short stature
Overuse, repetitive activity
Recent changes in training
program or running surface
Mileage > 20 miles per
week
Underlying disease:
Osteopenia, Osteoporosis,
alcoholism, kidney failure
Image www.coloradorunnermag.com
Prevention of Stress Fracture
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Adequate nutrition and calcium intake
Proper foot wear
Softer training surface
Proper training
 Gradual
buildup in mileage
 Rest
 Cross-training
Flexibility: Maximize performance and
protect your joints
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Connective tissue – tendon, ligament, joint capsule,
fasciae in and around muscle
Stretch – increase connective tissue length through
range of motion
Elastic
 Plastic
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Temperature-dependent
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Jog prior to stretching
Flexibility
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Slow movements
 Stretch
reflex: rapid stretching causes protective muscle
contraction
 Reach maximum ROM
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Beware of excess
 Decreased
stability: joint sprain
 Decreased flexibility: muscle strain
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Easily lost
 Greatest
in the first two weeks of injury
Improving Flexibility
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Pre-season & in-season : start early
Daily
Static stretching – safest
Stretch large muscle groups first, then smaller
groups
After warm-up and after practice
Flexibility - precautions
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Avoid ballistic stretching
Avoid stretching as a warm-up activity.
•Images: www.hsc.csu.edu, www.otda.state.ny.us, www.yoga-made-ez.com.
Preventing Injury
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Good posture, “sit tall”
Strength and flexibility
Maintain a healthy weight.
Correct imbalances in muscle strength
Stretch daily after a warm up and as a cool down
Must rehab old injuries
Appropriate equipment / footwear
Prevention of heat illness
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Pre-hydrate before planned exercise.
Check the weather report.
Light clothing, mesh, loose-fitting, change when
soaked
Adjust schedules, increased # breaks
Adequate sleep
Avoid oil or gel-based sunscreens that can hinder
evaporation
Prevention of Heat Illness
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Monitor body weight.
Nude weight before and after workout
Loss of > 2% of body weight affects performance,
> 3% weight loss affects thermoregulation
Monitor urine color.
For every 1 lb drop, must drink 1 pint (about 500
ml)
“Opposition is a natural part of life.
Just as we develop our physical
muscles through overcoming opposition
– such as lifting weights- we develop
our character muscles by overcoming
challenges and adversity.”
-Stephen R. Covey
Resistance Exercise
(image: www.medical-look.com )
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Used in combination with aerobic
exercise
Tone muscle
Increases resting metabolic rate
Reduced blood pressure: affects
cardiac morbidity, stroke risk,
overall mortality
Total fat reduction
Elderly: increased endurance,
walking speed, balance, reduces
falls
Benefits of Exercise
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Feel better
 Improved
energy, decrease stress & anxiety, improved
mood and endurance
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Improve appearance
 Weight
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control, tone muscles, improve posture
Decrease risk of disease
 Reduce
blood pressure and cholesterol
 Improve bone mass and strength
Healthy Weight Loss
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Dietary changes:
 Reduce
fat in the diet
 Reduce # meals eaten out
 Set an eating schedule
 Low calorie snacks
 Decrease use of soft drinks
 Eat breakfast
2007 Physical Activity Recommendations:
ACSM & AHA
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Healthy adults < 65 years old
 Moderate
intensity cardiovascular exercise for 30
mins/day, 5 days a week OR:
 Vigorous intensity cardiovascular exercise 20 mins/day,
3 days a week
 AND: strength training
8
to 10 exercises with 8-12 repetitions of each exercise.
 Twice a week on non-consecutive days
2007 Physical Activity Recommendations:
ACSM & AHA
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Healthy adults > 65 yo, chronic illness or functional
limitation in adults 50-64 yo
Moderate intensity exercise 30 mins, 5x/wk OR:
 Vigorous intensity exercise 20 mins, 3x/wk AND:
 Weight training: use weight to allow 10-15 repetitions
 Flexibility exercises – 10 mins daily, 2x/wk
 Balance exercises
 Have a physical activity plan.
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Don’t Quit
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“Lack of activity destroys the good condition of
every human being, while movement and
methodical physical exercise save it and preserve
it.”
 Plato
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“Don’t let what you cannot do interfere with what
you can do.”
 Coach
John Wooden
Bring a Friend
(image: www.i.co.telegraph.uk , www.w2fitness.com )
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Motivation
Support
More walk, less talk!
Accountability
A.L.S.A. – 10 year
study, age 70 and
older, close friendships
promote longevity
Track your progress!
(image: http://us.123rf.com )
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What are your goals?
Immediate
 Short term
 Long term
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“A journey of 1,000
miles begins with a
single step.” – Lao-Tzu
Journal / Training log
Monitor growth and
development
Quiz
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All of the following are ways to reduce risk of injury
except:
A. maintaining a healthy weight
B. stretching consistently
C. icing old injury before exercise and applying
heat after exercise
D. weightlifting in a structured setting
Quiz
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Your 55 yo neighbor asks you about starting an
exercise program. She weighs 220 pounds and is
diabetic. Your best response is:
A.
B.
C.
D.
E.
Please join me for my daily exercise.
Maybe you should see your doctor first.
Maybe you should join a local gym.
Maybe you should lose weight first.
Can you watch the kids this weekend?
Additional Sources:
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Blanke, D. “Preseason Conditioning : Flexibility” in Team Physician’s
Handbook,3rd ed., Mellion, M. et al, editors, Hanley & Belfus,
inc:Philadelphia, 2002.
Carbon, R., “ABC of Sports Medicine: Female Athletes” British Medical
Journal 1994; 309: 254-258.
Cluett, J. “Ice or heat” About.com: Orthopaedics,
http://www.orthopaedics.about.com , accessed 4/18/08.
Griffin, L.Y., et al. “The Female Athlete” in: Mair & Johnson eds Clinical
Sports Medicine, 1st ed. Philadelphia: Mosby; 2006: 61-78.
Herring, S.A., et al. “Female Athlete Issues for the Team Physician: A
Consensus Statement” 2007. www.aafp.org, accessed 9/21/07.
Sui X. et al, “Cardiorespiratory fitness and adiposity as mortality predictors
in older adults” JAMA. 2007; 298: 2507-2516
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