Exercising: Long-term.

Exercising Long Term

 

by: Dr. Brandie Nemchenko

 

Many of us will be out walking the streets after the mountains of snow melt to get exercise - walking or running.  Ever experience pain after your power walk or run to the point you just can't continue, thwarting your plans overall of not being able to exercise at all?

Let's make this year different! 

Wrong Intention

We've all been there.  It's a gorgeous day, the birds are singing, the wind is gently blowing, and you think - "Hey, I can take on one more hill - I haven't been out all winter and I've already run a mile, let's jog up one of the General's hills."  The next day, you can't walk.  Hobbling around - you wonder "Why do I always get hurt every.time.I.exercise.?"  

Research before going out.  Running seems simple, but it is a science.  Get a game plan of how to train.  I recommend the Couch to 5K program to my patients (www.coolrunning.com) which is a series of walking/running intervals to slowly and safely get you moving.  This provides a plan of attack with getting in shape, not only cardiovascularly, but also on your muscles and tendons.  

So how do you know what is the difference between the strain of getting back in the saddle an hurting yourself?  Sharp pain that hits and and reproduces consistently after when you "push it" means you are pushing your body past what it can take, leading to microtears or stress reactions in the bone leading to stress fractures.  If you have such pain - stop.  RICE when you get home.  If it happens consistently, seek out a sports medicine specialist chiropractor, physical therapist, or orthopedic.

A great way to ice your shins is to prepare by taking your kid's Dixie cups and filling them 3/4 of the way.  Freeze them and when you get back from a run - peel them around the top, and viola! You have a deep chill for your aching shins!  (Use only less than 5 minutes moving quickly up and down the shin.)

Wrong Equipment

Did you know there are three types of sneakers?  And it is not Nike, Adidas, and New Balance!

Shoe manufacturers make different types of sneakers to address different foot types. (www.runningshoetypes.com) The majority of people are pronators, which means your foot is flatter, or rolls in.  This puts tremendous stress on the middle of your shin, knee and hip.   This stress may be ok when you are just walking around - but add a little jog - and your feet and  knees start to scream.  

The opposite foot type is a supinator - or someone who has high arches.  That type of foot has it's own shoe type as well.

I used to buy shoes because I liked the color or design and wonder why they had no arch support.  If you plan on running more than just around your neighborhood and entering a 5K of more - seek a running store out to get fitted.  At least then you will know your foot type and can get the appropriate type of shoe for your foot type.

In going with that - be very careful shopping for sneakers in an outlet.  I used to buy my sneakers in Lancaster at the Nike outlet - and would be thrilled getting a cute pair for $39.  The material they make the shoes out of degrades over time.  If the shoes have sat and now are at an outlet - you could have one shoe degrade faster or they are in an outlet because they are slightly defective.

Before purchasing the shoes - put them up on a counter and get eye-level with them.  Look to see that the back of the shoe is the same height - or you may inadvertently buy one with a virtual heel lift on one - making your foundation off-balance.

Wrong Foundation

If you get hurt every time you exercise, it is a good thing to get evaluated by a sports-focused and trained PT or chiro who takes a structural approach.  Because just like your car, if you are unbalanced, you will wear down unevenly and that is what leads to injury.  How many of you have heard of a parent or friend needing a knee replacement because of "old age?" 

Here's a question....how old is the other knee and why is nothing wrong with it?

Our arches are held together by ligaments, the plantar fascia.  Over time (and kids!), these arches stretch.  Ligaments are like plastic fruit bags.  If you stretch a plastic bag - it doesn't rebound, like a rubber band (which is more like a muscle).  Most times, these arches stretch inconsistently - leading you to have one flatter foot on one side. 

This leads to having an unbalanced foundation without you even knowing it!  If any of you have been to chiropractors, they may talk about one leg being shorter (which is caused by either a prior break in that leg or a misalignment of their pelvis which causes their gluteal muscles to be too tight - drawing the leg up and making it "appear" shorter.  If your chiropractor is not checking your feet to see if that is that is making your one hip lower - they are missing the boat.  If something is wrong with your feet and they just adjust your pelvis - as soon as you step away from the table, the pelvis is not supported and your adjustment doesn't last.

Some of my patients upon learning they have a short leg exclaim, "I knew it!  My pants never fit right - one side was always longer." or "I always feel as though I was putting more pressure on my right leg."  

A balanced body has less injury and less stress than one that is unbalanced. 

Getting outside and getting active are great ways to improve your health.  Think more longterm instead of quick fix this year - and your longevity with a program will expand.  You'll be less injury-prone and be able to reach the goals you set, pain-free.

Are You Skinny Fat?

Ah, spring time…time to clean up your closet, clean up your diet, and most importantly clean up your health. For many of my patients, I see them launch into a crash diet.  To be honest, I did the same.  But what happens when you are done?  You gain it back….but why?

Perhaps  you’ve gained weight from eating more of what you didn’t before.  But it goes deeper than that.  For those that have lost over 20 lbs. and put it back on quickly, it has more to do with how you took it off.

In 2001, I weighed 265.  I blamed it on having a baby – but I had her in 1998.  Admittedly, I’m tall – but 265 is pushing it.  My body hurt.  I wore a size 22.  After Christmas of 2000, my sister got cute little workout clothes, and I got kitchen equipment and mumu’s.   I had had enough!  Nearing the clinic in chiropractic school, I didn’t see any overweight chiropractors and said, “I don’t want to be the only overweight chiropractor.”  (Since then, I’ve seen many :) – but I used that as a mantra.  

Using Weight Watchers, over the course of a year, I lost 80lbs.  Sometimes I would fast if I ate too many points and eat a head of broccoli for dinner or their Cheese Soup that was 1 point.  I didn’t really change what I ate – only the amount.

When I lost the 80^th pound, I stood up and bragged how I never had exercised ONCE.  Not one single time in the entire year and I still lost weight.  How stupid I was.

After keeping the weight off – I looked great.  I wore a size 12 (I’m 5’11) so that was great for me!  

My first job was at Gold’s gym in King of Prussia.  People thought I looked fit and invited me to the circuit class.  

Again – thinking because I’m thinner – I am in shape, right?  The circuit class was held in the middle of the floor for all to see working out.  Within 2 stations, I was ready to puke.  With sheer embarrassment, I shook off to the bathroom and could not get out of the stall for an hour!

So embarrassing!

So here is what happened.  I lost 80 lbs. in 7 months.  I burned off the fat, along with lean muscle.  Lean muscle is an indicator of health and vitality. Because I burned off my lean muscle, lack of exercise resulted in rapid weight gain.  When you crash diet you take away the bad and the good.  Even if you exercise and diet – if you do it too fast (which is what everyone wants!) – you‘re setting yourself up for future failure.

When you diet to lose weight, your goal should be to maintain your lean muscle while losing the fat.  How do you monitor this?  We use a device called a Bioimpedance Analysis . A BIA evaluates your body fat, lean body mass, and calculates your fat content.  This is the most accurate, short of a DEXA scan.  People think the underwater body testing is accurate, but the BIA is just as effective, as you cannot express the oxygen out of your lungs which occupies mass and space.

How should you do it?

1.    Incorporate an exercise program, even if it is just walking.  For us women over 35, you should include a weight-bearing exercise program with weights.  Women will NOT bulk up using this.  If you need help, ask your sports medicine doc, chiro, or PT.  Perhaps you have a trainer at the gym and have never used your free sessions.

2.    Don’t push it.  It took time to put the weight on, and long-term, do you want to just lose it now, only to gain it back?

3.    Make sure you are eating whole foods that are nutrient-dense.  The more ingredients something has – typically the less healthy it is. 

If you ever have any questions, please ask.  I took off 18lbs. last year – and I know each one of them is off for good!  Losing weight is simple science, but it is important to understand the why’s to gain long-term weight loss.

Are You Fixed?

Most people who seek out our office want to be better.  They want to feel better, look better, function better.  They want to not limp anymore, play with their kids without pain, or be able to read a book without suffering from debilitating migraines.  We get great results in getting them to their goals.  And then what?

Just like the end of a great chick flick - everything comes together and then what?  The End!  You are cured?  Fixed?

Hmmm....chiropractors are notorious for "Once you go to a chiropractor - you go for life!"  

Yup - hear that about 5-10 times a week with our new patients and being goal-focused - it has always bothered me and bothered me a lot.   Arthur and I get adjusted every two weeks.  My kids get checked at least the same.  Our staff is the same.

I don't have any financial gain to get adjusted or adjust my kids - I just want them to be the healthiest they can be.

Early in practice - I wanted to be better than that with my patients.  I mean - they were paying so I wanted to "FIX" my patients - thinking they could.be.fixed.  So why was I not fixable?  Why did I and my family continue to get adjusted?

I knew they would never be fixed.  But on a daily basis - that's what I heard them say again and again.

"Dr. Brandie, I want to fix this.  I want to come in 2 times and fix this."  "You didn't FIX this last time - so I had to come back."

But what on Earth gets "fixed"?

I'm a mechanic - I fix your car.  Now your car will never breakdown again?

I'm a contractor.  I fix your house.  Now your house will never need repair?

I'm a diet plan.  I lose 50 lbs.  Now I will never gain the weight back?

I'm a dentist.  I fill your teeth and clean them.  Now I'll never have to go back?  And if I get a cavity - "Man, that dentist didn't work - my problem came back!"

I could go on and on....

What doctor doesn't have you come back for checkups?  Optometrist - GYN - Family Doc?

Here is a news flash...no one can fix you.  Not any chiropractor, physical therapist, or doctor.  It doesn't happen.  

The body is a living organism that is subjected to so many stresses in a day.  Slouching on the computer, bad food, and chemicals.  You don't live in a sterile, non-weight bearing environment where everything is going to stay perfect!

People are living longer.  If you feel bad now - how will you feel with 40 more years????  

Your structure - your spine - your feet, knees, and hips will determine how enjoyable your Golden years are.  If you can no longer walk well - what is your quality of life?  

If you are a 40 year old coming into my office - I send out many times for x-rays - because it is a mixed bag.  Some will have gorgeous spines - aligned - without arthritis - and normal curves.  And some are a train wreck - the product of a life of neglect.  How you use it and have taken care of your body - will show and will determine how well you respond to care are not up to me.  It is up to what you came in with - how much degeneration you've had.  How much adhesions and gristle and muscle spasm you have.  It has to do with how you follow what we recommend.

Many think they are above that.  "He said to come in 3x/week (just like PT) but I can't make it/don't have the money/don't have the time/mercury is in retrograde - so I'm going to make my own schedule and whatever happens is a reflection of him as a doctor."  And if you dieted once or twice a week - how much weight would you lose?

"She recommended for me to come in to get checked monthly - but I am too busy, and I feel great, and my insurance doesn't cover it - so I'll see how it goes."   Well, let me come back in when my teeth hurt and have cavities - because up until then - I was golden.  No pain, everything's fine right?  What I can't see - won't hurt me!

Just like my home that was built in '73 - I, too, am seeing that I am needing all kinds of  maintenance, even if I don't have the money for it.  I have money to get my nails done, have a cleaning lady, and a large SUV.  But I don't have money to maintain my health?  Oof. 

Like physical strength maintenance.  I used to work out solely to lose weight.  That is it.  I hate working out.  Hate it!  For the last three months - I go three times a week and run on Sundays because I FEEL better.  I function better.  Small things like having energy at the end of a 12 hour day, or being able to get out of bed by not literally pushing myself out of bed - are priceless.  

I am taking responsibility for my health and am proactive with my health.  There is a cost for that.  A cost of money and of time.  Sure I'd like to be sleeping on Tuesday, Thursday, and Saturdays at 5:30am - but I head to bootcamp - and at the end - I feel better.  Happy.  More balanced.  Stronger.  Leaner.

Oh, and about "fixing things..." while we are on that - imagine if I told my trainers, Mike and Jen Brango from Great Valley Adventure Bootcamp - that they had 2-4 visits to "fix me" because "you know, you trainers - once you go - you go for life!"

Fix my bad habits.  My neglect on my weight.  Fix all my weaknesses in less than a month.  And I'm fixed.  I'm done.

My trainers do Groupon (website) deals for a deep discount - much like we take all insurances.  Many clients of theirs find them that way.   Imagine a Groupon customer saying to them - "Hey guys - I have 12 sessions with you under Groupon - and after that I have to pay out of my own pocket.  So let's just do the 12 sessions - and by the way - you need to get me to have 40 lbs. off in that time.  After that, I'll wait a few months until the new year when you run Groupon again to pay less so I get a great deal because I don't want to pay for my health anything more than I have to."

It doesn't work that way.  How would I look after not working out for months after only working out 12 times?  That's like paying someone to mow your grass half the summer looking pretty only to wait until next year to cut it again.  Life happens.  Degeneration happens.  It's your body.  It's your health.  It's your responsibility!

It makes no sense to think otherwise.  So why do we - as a collective - think that it is effortless and doesn't need our attention?

Just like every other part of your body - you need maintenance.  Your spine and nervous system are the keys to a happy and enjoyable life.   Sounds crazy - but it's 100% true.  If they don't work properly - you aren't going anywhere.  Your quality of life is compromised.

So if you haven't been back to your chiropractor in months or years - go get checked.   Get on a regular program to get checked to stay flexible.  Stay movable.  Less fixed!  More movement! Your body in 40 years will thank you!

Maintenance doesn't mean living at your chiropractor, but like anything worth preserving - it takes some effort on a regular basis - just like everything else - your car, your house....Isn't your body more important?  Do something - Today!

Dr. Brandie