Monthly Archives: July 2013

12 Rules to Finding the Perfect Workout Program For You

gesina-kunkel-gRNcA7jFIeg-unsplashElements to look for in a week of an excellent workout program for you:

  1. It is fun or sounds like fun to you.
  2. Easy to learn the moves and the routine. It’s hard to get started when the routine or the moves are so complicated you have trouble following or remembering how to do them. Once you are in the routine of working out, you can add in or advance to more complicated routines and moves, but by then, you will be in the groove and it will be hard NOT to work out because you feel so good when you do. When starting out, keep it simple. Make it hard to make mistakes or to get discouraged.
  3. It can be done easily. For example, you have the equipment at home, your gym is convenient to get to, it is NOT a nuisance to set up or get ready to do, no too long. What you DO NOT want: I’m talking about the treadmill that folds up & fits under that bed in the cluttered room or the exercise bike that has become an extension of your closet, or the room that will need to be cleaned of clutter on the floor so you have space to do your workout DVD? Who wants to do laundry or clean up clutter & pull out & set up the heavy treadmill prior to each workout? Or is your gym is 30 minutes away, close to where you used to live or work or go to school? You want to add an hour commute to the time in the gym to squeeze in your work out? No. Make it easy to exercise.
  4. It should have enough routine to make it a habit, but enough variety to keep your body progressing forward over time.
  5. Rest days have to be built into it. One day per week should be completely off of strength training. If you can’t stand it, do some yoga or go for a nice walk on your day off. Also, I recommend a plan to allow at least 24-48 hours between strength workouts of the same body areas. This means, do NOT do the same strength training routine 2 days in a row. For example, ideally, schedule a minimum of 1-2 days between chest workouts. Work out each muscle group at least once per week, depending on your program and your goals.
  6. Your program should allow slow but steady progress forward and that progress should be apparent to you. Progress is motivating. Plan ahead for progress and stages of progression. For example, scheduling the week with increasing number of reps or increasing weight in a planned manner makes it very easy to see the progress and know how to progress. I suggest writing down what you are planning to do, and then what you ACTUALLY do. Do not do more than what you planned, but if you cannot increase as planned, don’t force it, That is where you are moving towards. Just adjust your plan accordingly.
  7. It should include strength training, often called anaerobic exercise. Strength training is important in keeping us independent longer. It includes exercises where your muscles push or pull against resistance. This can be done in many ways such as with weights, machines, bands, medicine ball, or even your own body weight and gravity. Some people also use a stationary surface to push against. If you are new to strength training, have someone teach you the proper ways to do the moves or find some reputable DVDs or online instructional videos to see how to do exercises properly. **Just a note about the importance of strength training for men & women of ALL ages…It can help keep us more physically independent for longer. I am in no rush to lose my independence & move into a nursing home so I will continue to make sure my muscles stay strong. This will help prevent falls and other injuries that are common with poor strength. If something happens to me, it will allow me the best chances for optimal recovery and also speed up my recovery. The patients that defy what the doctors predicted for their outcome after an illness or injury, AND end up doing remarkably much better than predicted, are usually the ones who were physically stronger prior to hospitalization. They have more reserve. Also, I want to be able to continue to walk on my own. I’m going to work on NOT needing assistive devices to walk. Can you tell, being independent and maintaining my mobility are a VERY high priority for me?
  8. It must include core training. This is often known as the “ab workout.” As we get older, spend more time sitting and/or we gain weight, our abdominal muscles and core muscles get weaker. This can cause lower back problems which can also lead to other joint problems. Core training treats and prevents back injury. It also improves posture and makes everyone look more attractive.
  9. It should work the heart. This is often called cardio or aerobic exercise. I am a fan of high intensity interval training (HIIT) using perceived exertion as my measure of intensity (I plan to discuss this further in a future post). This allows me to work out for a shorter duration while improving my power, strength & endurance. Given the short duration of intervals, the time flies by. And if you wear a heart rate monitor, recovery to baseline heart rate is a great measure of your cardiovascular fitness. If you are deconditioned (out of shape), it takes longer for your heart rate to go back to the usual after a workout. When you are fit, your heart rate returns to your usual much faster. Over time, as you continue to exercise, your heart rate will come down much faster after you finish your workouts. You recover faster after your workout. This means you have improved your fitness!
  10. It should include some stretching. I like yoga, passive and/or active stretching. This is the portion of the workout where you classically slow down and listen to your body. This is also important to allow our lymphatics and circulation to flow and to open up the joints. Certain stretches and yoga moves are particularly good for keeping the spine healthy and improve arthritic pains. A single sequence of sun salutations (yoga) takes 90 seconds and is a great way to start your day as you get out of bed.
  11. Limited or ideally, NO risk of injury. Learn proper form, advance SLOWLY & don’t do exercises that have high risk of injury to you.
  12. At the end of your exercise, you should feel energized and look forward to your next workout. I log my workouts and jot down a few notes. In a future post, I will go more into detail about the workout log. Meanwhile, enjoy the process. Make each day be a day you move forward and feel good about yourself.

Photo by Gesina Kunkel on Unsplash

The Freedom to Choose

Today, on our nation’s birthday, I do not have to go to work. I appreciate my day is full of free choices. Every day, we make choices to move forward or to move backwards. Nothing ever stays the same. I choose today, to make choices that help me move forward.

I started my day choosing to wake up to my favorite alarm clock app. (It wakes me up when I am in my lighter sleep cycle in the 30 minutes prior to my goal wake up time. This makes wake up significantly much easier for me (as I am NOT traditionally a morning person).) Then, I threw on my workout gear & headed to the basement, my home gym. As I grabbed my water bottle, put on my heart rate monitor & started my music, I was already in such a good mood! I was awake to do something good for me and I have the ability to move my body. What a gift!

After warming up my muscles, I started lifting weights and enjoyed the quiet in the rest of the house while I was able to focus on my body and my health. I had time to notice how much easier some of the sets were, how my muscles were ever so slightly more defined; my mind felt clear and optimistic about the day and I thought of the many patients in the past few weeks who had talked to me about their health. Specifically, I thought of the patients who mentioned joint pain during their office visit. There were 3 groups of responses to joint pain.

Some patients stated they had joint pains and stated they could not exercise and were very limited in their lives because of it. Often, they had been told they had arthritis or some other joint issue that would never be fully better or would require an invasive intervention to “improve it.” They believed it was never going to get any better. They were focused on the pain & had become a victim to the pain. Often, they would ask for a “band-aid” like pain medication. They had given up on getting better, they just wanted to mask it, even if it meant creating new problems like constipation, nausea, dependence on medications, drowsiness, etc. They were moving backwards, getting “worse.”

Several patients had joint pains and they were grateful that because they were doing some form of movement/exercise, it was not getting worse. They were grateful they COULD still move. They wanted to learn what else they could do.  They wanted their list of choices to move forward. They were focused on staying independent and working towards higher quality function from their bodies. They came for guidance & were eager to comply. If they were given a home exercise program, they would do it. If they were sent for physical therapy, they would do it. If they were sent to see a specialist, they would do it.  They knew they could make choices that could help them. They listened to their bodies and trusted they could make themselves better if they were given the right plan.

The third group of patients had joint pains and found that by choosing exercise (including yoga, home exercises, physical therapy, individual workout programs, working with a trainer, etc.), they had healed themselves or improved their pains. They felt grateful and powerful. They wanted to know what choices they could make, what they could do, to continue to stay healthy- how to improve their bodies even more. They were empowered and living life to their fullest.

As I moved onto my interval training, I considered it interesting that in my practice, these three different kinds of responses to joint pains were not correlated to the amount or duration of the pain. They were all about attitude and faith (or loss of faith) in their bodies. And of course, it’s about seeing they have choices and choosing to move forward, or backwards, every day.

As I increased and decreased the intensity of my interval training workout, I wondered how each of my patients would respond to the questions: Do you trust your body to take care of you? Do you listen to your body, understand the cues and respond appropriately? If not, do you just need to help learning? Do you believe your body knows how to repair itself and get better? Do you allow your body to recover, improve or heal by providing it what it needs- proper nourishment (what we put into our bodies), relaxation (such as meditation, journaling, emotional intimacy with another person(s))  and circulation of fluids (movement)? If not, do you want to learn what you don’t know?

If my patients have taught me anything, I have learned that we can make choices that move us forward or that cause us to slip backwards. I like forward movement better. I want that for my patients. My patients come to me because they know that, and they want help in seeing and making the choices to move forward.

In my practice, I show my patients their choices (if they do not already know them) and help them to see which ones will most likely allow them to move forward. I spend time teaching them ways to best nourish their bodies with nutrition and medication, if necessary. I have relaxation training sessions and I counsel on ways to safely circulate fluids and move our bodies. I try to give my patients more ways they can choose to move forward.

As I cooled down and stretched, I appreciated that we all have choices. We live in a country that cherishes our freedom to make choices and we have lots to choose from. Every day, we make choices about our health. We have the bodies we were given. Some were luckier than others. But we all can choose what to do with it at any moment. We can choose to trust our body will do the best that it can for us, if we give it what it asks for and needs. We have the freedom to choose every day.  As a physician, I recommend making choices that move you forward.