Health

Get on your feet!

As both a healthcare provider and a lifetime participant in a variety of fitness activities, I consider myself uniquely situated to be able comment on physical fitness and the lack thereof. As an avid exerciser, I am able to observe people in their role as exerciser, and as a podiatrist, I am able to see the result of poor training technique, over use and injury as a result of bad luck. On a daily basis, I listen to the stories of sports and fitness participants on all levels–those who have run a dozen marathons virtually unscathed, climbers who have scaled Mount Everest, would-be athletes, who, at forty, have just started yoga, pole dancing, or a walking program, and so on. From the avid life long sports participant to the middle-aged convert, all of these people have one thing in common–they are engaged in a healthy lifestyle. As I urged you in my last article, get off the couch and get moving.

Here is a list taken from the Center for disease Control’s web site outlining the benefits of regular exercise:

The Health Benefits of Physical Activity—Major Research Findings

  • Regular physical activity reduces the risk of many adverse health outcomes.
  • Some physical activity is better than none.
  • For most health outcomes, additional benefits occur as the amount of physical activity increases through higher intensity, greater frequency, and/or longer duration.
  • Most health benefits occur with at least 150 minutes a week of moderate-intensity physical activity, such as brisk walking. Additional benefits occur with more physical activity.
  • Both aerobic (endurance) and muscle-strengthening (resistance) physical activity are beneficial.
  • Health benefits occur for children and adolescents, young and middle-aged adults, older adults, and those in every studied racial and ethnic group.
  • The health benefits of physical activity occur for people with disabilities.
  • The benefits of physical activity far outweigh the possibility of adverse outcomes.

http://www.health.gov/paguidelines/guidelines/chapter2.aspx

The following story, taken from the annals of my daily contact with people, drives home an important point about accomplishing anything in life: if you are going to do something, do it correctly.

The American Diabetes Association recommends an annual visit to the podiatrist for all diabetics, even for those without risk factors. If patients have risk factors, the frequency of regular foot exams increases. Risk factors include absent pulses in the feet, loss of sensation in the feet or prior amputation of part of the foot. Yesterday, a diabetic male patient in his late fifties came in for his annual visit. The following is an account of our conversation:

I ask, “So how have your blood sugars been?” The patient responds, “not so good Doc.” Then I say, “Looks like you have gained some weight this year.” The patient responds, “Yes Doc, I gained about 10 pounds this year.” I then inquire, “Have you been getting any exercise?” The patient says with enthusiasm, “Oh yes Doc, I have been walking.” At this point, I now see some hope…at least he has started to participate in some cardiovascular activity. I respond: “that is great! Tell me about your walking program. How far are you walking? And how many days a week are you walking?” He then looks at me with some confusion and says, “No, I mean I am just walking, you know, from the train stop to my office and then, during the day, I walk in the office like to the copy machine or the men’s room.” I am not even sure what happened next, I think I was thrown into a state of consternation.

As a podiatrist, I can say that in normal walking you strike the ground with your heel and then load the front of your feet with 1.5 times your weight. This means that for every pound you gain, you are putting 1.5 pounds on these areas of the feet. This will result in trauma to the skin and the skeleton, as well as to the tendons in your foot and leg. Think about the other body components, the heart, the lungs, the blood circulation and burden of carrying additional weight.

Sometimes people exercise for menial goals, like to lose the newly noted love handle or tighten up that rear. But, you must realize that exercising is for your life. Please recognize, as I said in my prior article, that even if your motivation for doing the exercise is for your kids, your wife, your parents, it always comes down to the fact that it is for you—your life. In my last article I asked you to set a goal, now I am asking that, in addition, you follow through on that goal properly and appropriately–don’t kid yourself.

A 160-pound person running at 5 miles an hour will burn 307 calories, that same person will burn 38 calories reading for an hour. Reading, sewing, knitting even moving your foot on the gas pedal is to some degree exercising–but that is not sufficient. The United States Center for Disease Control recommends at least 30 minutes of exercise 5 or more days a week. Cardio exercise is not walking around the office, stretching is not bending to pick up the newspaper on your doormat; real results need real exercise. Read books or magazines about what you want to get involved in. Ask an expert if you have no clue. Ask your doctor, a trainer at the gym, a rock-climbing instructor, a ski pro, etc.

A study published in the New England Journal of Medicine in 2004 examined over 100,000 women and found that excess weight and lack of physical activity accounted for 31 percent of premature deaths. Another study conducted in Finland in 2004, which studied also nearly 16,000 men aged 30 to 59 over a 20-year period: Found that men who were engaged in a physically active lifestyle were 21% less likely to die of any cause during the course of the study. This increase in deaths was found to be primarily from heart attacks and strokes, but also from cancer. With this in mind, don’t you want to see your children or grandchildren a little longer? Don’t you want to experience quality life a little longer? I am sure the answer is YES. Get going, get started, it is time to move. Please, Don’t kid yourself.

Connecting Your Mind and Muscles

I have been a podiatrist for the past 27 years, I have been a health nut, exercise enthusiast and “gym rat” even longer. Over the years I have seen a variety of strange exercise techniques as well as even stranger cardio/exercise procedures and ever more outlandish locker room activities. Having spent five to six days a week training in the gym all these years, there are plenty of yesterdays in the gym. Being a healthcare provider treating the foot and ankle for nearly three decades there are plenty of times I get to see the resulting insult and injury for some of those behaviors I have observed at the gym the day before.

However, not all is lost to my observations of those aberrant quirks that result in detrimental outcomes. I have also seen a lot of excellent technique and beneficial behaviors and have incorporated these to make my workouts and I dare say, my life, better. Let’s face the facts—exercise and keeping yourself in shape is far more advantageous to one’s overall well being then the few temporary set backs to the skeleton or skin that all athletes suffer from time to time. Even with decades of experience, I still subscribe to the “injury of the month club”. However, over time I strive to correct, improve and attempt to perfect my exercises, my treatment of patients and my life. I would say that much of this improvement I owe to that microcosm I choose to spend so much time in “the gym”.

The United States Department of Health and Human Services recommends 60 minutes of exercise daily just to maintain your current weight.

For the purposes of this article my message is not, see you at the gym tomorrow, however the message for today is get started improving your life. Not all exercise is done in the gym. I am not suggesting that my type of exercise is what everyone should do, nor is it the only way to stay in shape.Millions of years of evolution did not produce our arms and legs, heart and lungs to sit at our desk all day and our couches all night. Dependant on you age current health and what you enjoy, raking leaves, taking a brisk walk, playing volleyball or basketball. It is time to start using your body for more than using the Gluteus muscle as a cushion.

Why should you start exercising? Possibly, for others–your children, teammates, co-workers. Don’t let them down. Definitely, for yourself. You may feel better with an improved self-image, more energy, or having powers and abilities far beyond the average couch potato. You can’t let yourself down.

How do you start? From many conversations at the gym the reason most people tell me they are staying in shape is to avoid the relative poor health of generations gone before. Interestingly, that same theme is repeated in my office when I hear, “well I know it is not bad now, but I don’t want to wind up like Grandma Mary.” So maybe you don’t want that early heart attack, the hip replacement or type 2 diabetes. Think about how painful and depressing developing one or all of these ailments would be. Develop the mindset that each and every time you are exercising in some way, you are literally pushing back that illness. Of course I am not ignorant, not everyone will succeed at staving off the family genetic predisposition to illness. However, not everyone goes into marriage anticipating a divorce.

Set a goal. This is important for your exercising, as well, as all the other aspects of your life. Some of the motivational experts will tell you that you have to write it down and keep looking at it. I think they are correct.However, I believe that once you write it and look at it and you can then throw it out. (The paper that is) This is because once your hand has written it, then it is true and therefore you have to follow through. Maybe you want to get below 200 pounds or maybe ever 300 pounds. Maybe you want to run a marathon or just walk around the block in less than 15 minutes. Maybe you want to bench press 315, 225 or just the bar. Maybe you want to dance all night without waking up the next day with your legs killing you. Or maybe you’re like me and want to think that you will still be doing a half hour of cardio, a half hour of weight training and abs and stretching when I am 95.

It is now time to get off the couch and move. Whatever goal you have set, when you reach it you'll feel great. As a matter of fact, once you reach your first goal you will feel so good you should have no problem setting your next objective. It is your mind, your body, and your life...make the most of it.