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2011 Let’s Shake Up Your Workout

“New Years resolutions” – I’m hearing them on a daily basis. The top 3 on the list are weight loss, more exercise, and more sleep. As far as exercise goes,  this is the time to get out of the same old routine – change up your reps and sets. I keep telling you that your body adapts quickly to exercises you give it.  Therefore you have to trick it into growth by constantly varying your routine. I like to change my personal program every 6 to 8 weeks. I have dozens of clients that come in every 6-8 weeks just to have me write them new exercise routines. please take advantage of this service.

A simple workout renovation could include changing the number of reps you perform: If you have been doing only 12 reps per set, now’s the time to go for 25 reps for four sets — that’s 100 reps!  The following week do just six reps per set to keep your body guessing. You can also swap out some of those tried-and-true lifts for new ones, or amp up the speed of your reps while cutting your resting time. By going faster and allowing less time between sets, you’ll sweat off calories fast.

 Let me help you develop a new exercise routine that will stimulate your muscles — and keep you from getting bored.

Example: Try this two days a week – Upper-Body  Core Workout and Sprinting

  • Ten minutes alternating between chin-ups, push-ups (I alternate between conventional and Hindu push-ups), pull-ups, dips, and sit-ups. Start with 2 chin-ups, 4 push-ups, 2 pull-ups, 4 dips, and 4 sit-ups. Immediately go to 4 chin-ups, 8 push-ups, 4 pull-ups, 8 dips, and 8 sit-ups. Immediately go to 6 chin-ups, 12 push-ups, 6 pull-ups, 12 dips, and 12 sit-ups. Then go to 8 chin-ups, 16 push-ups, 8 pull-ups, 16 dips, and 16 sit-ups.
  • Take a two-minute break (just 120 seconds) and then reverse the pyramid, starting with a set of 8s and 16s and working back down to 2s. This entire upper-body workout will take about 20 minutes and will leave you totally pumped.
  • Take another two-minute break and then do 5- 10 minutes of interval running. Alternate between sprinting and jogging (or walking) for 5-10 sets.
  • When your running is done, do 5-10 minutes of stretching. 

Weight Loss Thoughts

Everyone knows I am partial to the Paleo diet and Mediteranean  Diet.  Whichever diet you pick for 2011,  I repeatedly see those clients that make behavioral changes have the best weight loss success.  

In one study in 2010, Dr. Foster and his team recruited more than 300 obese adults and monitored them for two full years while half followed a low-carb diet and half followed a low-fat diet. Guess what - the results were nearly identical - subjects lost equal amounts of weight with both diets. But there was one huge difference: heart disease risk factors. 

The low-carb groups enjoyed significant improvements in blood pressure and cholesterol status. Most impressively, triglyceride levels dropped while HDL increased by well over 20 percent.

Of course, these results completely fly in the face of the nutritional mainstream’s most sacred cow–that eating animal fats will harm your heart.  Let me say it one more time – restrict your carbohydrate intake. Eat all the protein and animal fat you desire.

So which group would you rather be in? The group that just loses weight? Or the group that never goes hungry, loses weight AND improves heart health? When you are ready I’m here to help you lose weight by adding in the proper exercise, mind set and supplements.

Jock Itch – How to Fight it

Women powder their faces; you’re going to powder your balls. Jock itch—tinea cruris, for the athletically disinclined—is caused by a fungus that thrives on the moisture trapped in your briefs. So, twice a day, wash the affected area, dry it thoroughly, and then douse it with powder to help absorb the day’s dampness.

But here’s the key: Use a brand that contains one of the antifungal ingredients miconazole nitrate or tolnaftate, but no cornstarch; it actually feeds the fungus, making the condition worse.

Posture – My Thoughts

1. In a nutshell, what causes bad posture? Americans spend an average of eight to ten hours each day at work. During our work time, we often sit unconsciously in improper body positions and engage in repetitive movements that create muscle imbalances leading to poor posture; poor self esteem; psychological distress & depressive symptoms; lack of a variety of movement in our activities of daily living; overall poor flexibility.
2. What negative effects does poor posture have on the body? “To live a long, active, energetic life, few things matter more than good posture” – American Journal of Pain Management;  Nerves get abnormal tension placed on them and can cause inefficiencies within the neuomusculoskeletal system; muscle imbalances and joint dysfunctions associated with poor posture can create areas of too much motion in certain spinal segments causing instability. These areas may then wear out prematurely, while other areas may have too little motion in the spine causing range of motion/mobility dysfunctions; anytime we have an asymmetry in the body we are more susceptible to injury – overactive muscles vs underactive muscles can cause asymmetry; poor posture can cause incoordination of muscles and balance systems of the body;  I think one of the reasons actors and actresses have “presence” when they walk into a room is because many of them have been trained in proper posture. 
3. How does one start to improve their posture? Look at the foot/ankle for pronation issues and use an insert or orthotic if necessary – this can help improve gait and posture; improve faulty breathing patterns, especially paradoxical breathing; improve your balance by training it – for example, standing on one leg while maintaining good posture is a simple exercise maneuver; Engage in consistent use of the foam roll to provide self-myofascial release and self massage; stretch overactive (tight) muscles; perform isolated muscle strengthening of weak muscles and movement patterns; use bodyweight, free weight or kettlebells to perform whole body exercises; consult with a practitioner who understands the concepts of good posture – when I teach other doctors, I call this being the “muscle whisperer” – understand what the muscles are saying while performing a posture evaluation. 
4. What are the top 3 things to remember when attempting to improve your posture? 1. Become aware of the things that you are doing, even the things that you don’t even know you are doing that are contributing (harming) to your posture. 2. Think of staying in a ‘tall spine’ posture (while sitting, standing, exercises); take frequent breaks from siting and use the Brugger’s postural relief position as one of the those style of breaks 3. Know what it feels like to be in proper posture alignment and frequently try to duplicate that feeling – sometimes clients don’t even know what good posture feels like and looks like.    
 

Cucumber – Don’t Forget to Snack on These

Refreshing to a summer salad and a cool treat for tired eyes. It’s also a good source of caffeic acid, which helps sooth skin irritation, and silica, an essential building block of connective tissue like muscle, tendons and ligaments, and bone. The flesh contains vitamin C, and the skin is rich in potassium and magnesium.

Turmeric

 

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Loaded with a potent anti-inflammatory compound called curcumin, this yellow spice may help to increase endurance and speed recovery. In a 2007 study at the University of South Carolina, exercise physiologists gave mice curcumin supplements for three days before a 2.5-hour downhill run. The curcumin reduced muscle inflammation and increased endurance more than 20 percent the next day. So, make turmeric your go-to spice. Add it to marinades, rice, vegetables and more. 

UltraInflamX 360 from Metagenics (www.DrJeffreyTucker.meta-ehealth.com) is a great source of tumeric. 

Cherries and Berries

 

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In a study at the University of Vermont, students who were given 12 ounces of tart cherry juice before and after strenuous exercises suffered only a 4 percent reduction in muscle strength the next day compared with a 22 percent loss found in subjects given a placebo. “Antioxidants and anti-inflammatory molecules in tart cherries suppress and treat the micro-tears in muscles,” says Declan Connolly, PhD. These molecules are also found in blackberries, raspberries and strawberries. Stock up on frozen berries, and add them to smoothies, yogurt and cereal. Or, defrost a few in the microwave for a sweet postride snack.

Vitamin D Update From the Annual Congress of the European League Against Rheumatism

June 16-19, 2010 in Rome, Italy — vitamin D deficiency is a common feature in patients with a range of painful rheumatic and related autoimmune disorders. What is less clear, however, is the amount of vitamin D supplementation that would benefit these patients.

Here are highlights from three recent studies:

  1. Researchers in the UK assessed levels of vitamin D in patients with either inflammatory joint diseases (ie, rheumatoid arthritis, RA), osteoporosis, or unexplained muscle pain (ie, myalgia) — 30 subjects in each group — compared with a control group of 90 patients with chronic back pain [Kelly et al. 2010]. Within all 180 patients (two-thirds female) the median vitamin D level was 15 ng/mL and 58% were below the normal range (defined as 20-58 ng/mL by these authors). The median vitamin D level in control patients (with back pain) was 20 ng/mL compared with statistically significant lower medians of 14 ng/mL in the RA group, 12 ng/mL in the osteoporosis group, and 12 ng/mL in the myalgia group. The authors expressed surprise that vitamin D deficiencies also were evident in persons with diffuse muscle pain but suggested that patients in all groups would benefit from vitamin D supplementation. Note: Why patients with back pain were chosen as a control group is unclear, as other research has already found such patients to be vitamin D insufficient (ie, <30 ng/mL) overall.
  2. A second study, conducted by Italian researchers, focused on 1,191 patients (85% female) with rheumatoid arthritis (RA) to determine a correlation between vitamin D deficiency and several clinical measures of disease activity [Idolazzi et al. 2010]. They found that levels of 25(OH)D were deficient (<20 ng/mL) in 52% of the patients not taking a vitamin D supplement and in one third of those taking supplements (?800 IU/day). In non-supplemented patients low levels of 25(OH)D significantly correlated with worse scores on 3 measures of disease activity: Health Assessment Questionnaire Disability Index, Mobility Activities of Daily Living Score, and Number of Swollen Joints Count. Significantly lower 25(OH)D levels were found in patients with active disease compared with those in disease remission and in those who were not responding to treatment compared with patients with a good response. Therefore, vitamin D sufficiency appears to be directly related to the course of rheumatoid arthritis and response to treatment; however, the authors conclude that further research is needed to assess the benefits of vitamin D supplementation in these patients.
  3. Another reported study from Italian researchers evaluated the impact of vitamin D supplementation in patients with either inflammatory autoimmune disease (IAD; rheumatoid arthritis, spondyloarthritis, or connective tissue diseases; n=43) and noninflammatory autoimmune disease (NIAD; osteoarthritis or osteoporosis; n=57) [Sainaghi et al. 2010]. Mean 25(OH)D levels between the two groups at outset were equivalently deficient — 12.6±7.5 ng/mL IAD group, 13.1±8.8 ng/mL NIAD group. Following daily supplementation with 800 to 1000 IU of vitamin D3 for 6 months, only 29% of all patients reached 25(OH)D levels ?30 ng/mL considered to be sufficient and there were no significant differences observed between the IAD and NIAD groups. The authors conclude that, while the amount of supplementation was not adequate to normalize 25(OH)D levels in their patients the response to vitamin D (or lack thereof) did not appear to be influenced by the presence of an inflammatory autoimmune condition.

COMMENTARY: A separate presentation at EULAR 2010, based on a large multinational survey of women with RA, reported that among the 75% who were taking analgesic medications more than 7 in 10 (72%) still experienced daily pain [Strand et al. 2010]. Two-thirds of the respondents said that they constantly look for new ideas to address pain. Therefore, the studies above are of great importance because they demonstrate that painful inflammatory and noninflammatory rheumatologic or bone conditions are generally accompanied by vitamin D deficiencies. Based on prior research, it is not surprising that daily supplementation of 800 to 1000 IU of vitamin D3 was inadequate to significantly raise 25(OH)D to more normal levels. It is disappointing that none of the 3 research teams proceeded to the next step of testing more ample vitamin D supplementation and assessing outcomes on pain relief and/or disease moderation.

REFERENCES: 
Idolazzi L, Bagnato G, Bianchi G, et al. Vitamin D deficiency in rheumatoid arthritis: prevalence, determinants, and associations with disease activity. A cross-sectional study. Ann Rheum Dis. 2010;69(Suppl 3):516. Abstract SAT0093.
Kelly C, Scott K, Bell G, et al. Vitamin D levels in a spectrum of rheumatic disease. Ann Rheum Dis. 2010;69(Suppl 3:481. Abstract FRI0509.
Sainaghi PP, Bellan M, Carda S, et al. Response to vitamin D supplementation in inflammatory autoimmune diseases: a retrospective study. Ann Rheum Dis. 2010;69(Suppl 3):652. Abstract SAT0506.
Strand V, Emery P, Fleming S, Coke E. The impact of rheumatoid arthritis on women: focus on pain, productivity, and relationships. Ann Rheum Dis 2010;69(Suppl 3):748. Abstract OP0002-PARE.

‘Dead Butt Syndrome’

December 21, 2010, 11:42 am

When the Diagnosis Is ‘Dead Butt Syndrome’


By JEN A. MILLER

Jen Miller at the finish of the Ocean Drive 10 Miler in Wildwood, N.J.

My butt, unfortunately, is dead.

“Dead butt syndrome,” the sports medicine doctor said to me after making me go through a series of circus-act contortions that involved swiveling my hip in all directions. His voice was very serious, his tone stern. I wondered if I should start making funeral arrangements for my rear, maybe a New Orleans-style blowout parade?

Hold the tuba. My butt’s not really dead. It can’t be revived with defibrillator paddles, but it can be fixed.

The technical name of the condition I have is gluteus medius tendinosis — an inflammation of the tendons in the gluteus medius, one of three large muscles that make up the butt. It’s a very isolated and painful injury that knocked me out of marathon training in January with stabbing pains in my hip. It’s a symptom related to what running experts hammer at: the need for cross-training and strength training. I was running so much that I told myself I didn’t have time for the exercise machines or weights, so I have no one to blame but myself.

I’ve been running for five years, but I’d never heard of the problem. I ran it by a friend, a former track coach at the University of Pennsylvania, and he was baffled too. I haven’t seen any coverage, though the doctor said it’s fairly common with runners who train for half marathons and beyond. It took him five minutes to figure out the problem.  

“A new thought in running medicine is that almost all lower extremity injuries, whether they involve your calf, your plantar fascia or your iliotibial band, are linked to the gluteus medius,” said Dr. Darrin Bright, a sports medicine physician with Riverside Methodist Hospital in Columbus, Ohio, and medical director of that city’s marathon. “In the last five to 10 years, we’ve just realized how much of an important role the gluteus medius plays in stabilizing the hips and the pelvis in running.”

If you think of the pelvis as a cup, the muscles that attach to it, including the three gluteal muscles and the lower abdominals, interact in an intricate choreography to keep the cup upright when you run or walk. If these muscles are strong, the cup stays in place with no pain. If one or more of those muscles is weak, the smaller muscles around the hip take on pressure they weren’t designed to bear.

The cup still stays up, but at a price. First come muscle tears and inflammation, followed by scar tissue in the muscle. If left untreated, this process becomes a cycle that keeps feeding into itself.

“For people who have persistent pain, it’s healing gone wrong,” Dr. Bright said. “That gluteus medius isn’t firing the way it’s supposed to. You’re getting an inhibition of the muscle fibers. It’s kind of dead.”

Some of us run through the pain, which is what I did. And many compensate by adjusting their strides in a way that impedes the gait and can lead to problems in the quads, hamstrings, Achilles tendons, heels, knees, calves, ankles, feet or toes.

“Whether they’re recreational weekend runners up to the elite marathoners, the majority of runners I see have weak gluteus medius and gluteus maximus muscles,” said Dr. David Webner, a sports medicine doctor at Crozer-Keystone Health System in Springfield, Pa.

For about 70 percent of his patients, physical therapy that stretches the muscles in the hip and leg and strengthens the gluteus muscles, along with a temporary reduction in the mileage and intensity of running, resolves the problem. Deep tissue massage, which sends more blood to the area to break up scar tissue, along with strength training may also help to break the cycle of inflammation and scarring.

More advanced approaches include ultrasound guided tenotomy, which uses ultrasound to identify the affected muscles and then “poke little holes in the area of the scar tissue,” Dr. Webner said, or platelet-rich plasma therapy, which involves injections of centrifuged blood products and is what Tiger Woods underwent after knee surgery last year.

Fortunately, I didn’t need to take it that far. I’m lucky — the pain has ebbed with physical therapy and changing one of my weekly runs to a cross-training workout.

“Those runners who do multiple types of exercising are less prone to have weakness than runners who do just running,” said Dr. Webner. “Triathletes who come into my office don’t have as much weakness as just solo runners.”

So I’m biking. I row. I sweat through elliptical workouts at the gym.

And I no longer have the feeling that a pin is stabbing my hip every time I drive. I can sit for more than a half hour without pain. And last month I ran the Amish Bird-in-Hand half marathon, and felt no more discomfort than you’d expect to endure running 13.1 miles through the hills of Pennsylvania Dutch country.

To keep my rear alive, I must be vigilant about continuing to strengthen my lower abdominal and gluteal muscles. Last week, I slacked off and the pain came creeping back.

Is it annoying to have to focus so much on these muscles to run? Absolutely. But if it’ll revive my butt, it’s worth every leg lift and crunch.

Jen A. Miller is the author of “The Jersey Shore: Atlantic City to Cape May.”

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Copyright © 2009 Dr.Jeffrey Tucker