We all know of someone who can’t function at full capacity due to their “bad knees.” I see people on a regular basis who have given up on living active lives due to knee pain. They think that there is nothing they can do but just live with it until they are eventually faced with having dreaded knee replacement. I share the following story to illustrate that there is something you can do to return to an active life once knee pain sets in.
Usually, it is the son or daughter of a client that finds me. This time it was a daughter whose mother was suffering not only from severe pain in her knee but deep sadness in her heart since her husband passed away a month earlier. My heart sometimes breaks for the life situations some of my clients find themselves in. The pain in her body was so intense that it was affecting her ability to process the grief in her heart.
I met with Sally, (not her real name) to discuss her situation. She is 82 and was told five years ago that her knee would eventually need surgery when the pain became unbearable. She said that she began a self-directed exercise program and was able to avoid the operation. But now, five years later, she could barely make it through the morning without fatigue and pain. I looked at her medical records and determined that her pain was due to degenerative changes in her knee. My recommendation was to meet for 4- 8 weeks for two thirty-minute sessions per week.
Knee pain can be due to several reason and it is important to obtain a diagnosis from a qualified medical professional before using exercise to manage a condition. Having the diagnosis from her medical doctor enabled us to determine what was needed. In Sally’s case, I knew that we had to exercise in limited ranges of motion. Certain exercises could make the pain worse so we avoided those until she was able to gain strength. Sally still has some limitations such as climbing stairs but we are working toward overcoming those limits.
Our program consisted of strengthening and stretching the muscles surrounding the knee. Within the first 3 weeks, Sally began to have more endurance and was able to function until 5 o’clock without pain. Her general mood improved greatly and her friends began making comments about how energetic she had become. Her pain has diminished from a level 4 to a level 0. She now is actively involved in the life she lived before the pain incapacitated her.
Sally is very motivated to get well and takes her exercise program seriously. I see her joy for life returning and my heart rejoices that she has hope for her future without pain. Without the added burden of living with physical pain, Sally has an increased ability to manage the stress of losing a loved one.
Although stretching is one of the key things to incorporate with degenerative changes (osteo arthritis), I found that Sally had maximum mobility probably due to her earlier years of dancing. I felt it was very important to strengthen her in her ranges of motion. We incorporated several exercises for Sally but three key exercises are as follows:
Straight leg raise:
Lying on back (supine) bend one knee. With the opposite knee straight begin lifting and lowering to the height of the bent knee. Pay attention to your lower back which will try to arch as you lower the leg. Keep your spine stable as you lift and lower your leg. Repeat on other side.
Lying on back, bend knees and bring heels as close to buttocks as comfortable. Hold your spine stable and you life and lower your hips. Press into your heels and notice if your knees try to open or collapse towards one another. Keep your knees lined up with your hips.
Supported Terminal knee extension: Lying on back, bend one knee and place a rolled towel or ball behind the opposite knee. Contract the muscles of the thigh as you press down on the ball or towel.
(Please note that this information is not intended to treat or diagnose. Please seek the advice of a qualified professional before beginning any exercise program.)
If you’ve had a desire to exercise but just can’t seem to “get it together” you are not alone. Organization is one of the greatest obstacles to creating a regular exercise habit. The following tips have helped me and many others create a lasting, fulfilling exercise program.
Tip 1: Develop Your Why
Unless you have a compelling reason to exercise it is not likely to happen. Your “why” usually has to do with how it will benefit YOU. Are you seeking weight loss? Increased energy? Stress release?
Begin by asking the question, how important is this to me? Do I really want to begin exercising? Is it a “should” or do you really see the benefit to you? Sometimes we don't get started because we really don't connect with the benefit of exercise. Answering the following questions might help you to get started on developing your why.
Why am I reading this article?
Do I believe exercise is important and why?
What benefit will I gain by exercising?
Your benefit is yours alone. The benefit for you will probably be different than the benefit for me; but, in order to help you come up with some ideas, I have a listed some of my “whys” for my regular walk:
My body gets stiff and achy when I don’t get moving in the morning.
I will feel as if I accomplished something and I like feeling productive.
I might be able to see and connect with my neighbors.
I know I will increase the strength of my heart muscle and other muscles.
It will make me stronger for other life related tasks.
I love to see the sun rise and I enjoy the quietness of the morning.
I will burn calories and increase my metabolic rate.
The dog loves going for a walk.
You get the picture. Develop your “why” and the plan will follow.
Tip 2: Decide Your When
You’ve heard the saying, “People who fail to plan, plan to fail”. If I don’t make a plan in my schedule for exercise, it is not going to happen. The “I’ll start Monday” rarely works either. One of the best ways that I have found to schedule my exercise program is to create a time flow chart. We all have busy schedules and getting a birds-eye view helps to see when we can fit exercise into our schedule. One way of doing this is to use a calendar, Excel spreadsheet, or a template from your local office supply store that has the days of the week and hour slots for each day. List your regular commitments and then see what time slots are left over. You might even be able to pinpoint time wasting habits that you can replace with an exercise session.
Usually a person has 3 options when it comes to exercise. They can choose to exercise before work, during a lunch break, or after work. Generally there are very few options when it comes to fitting exercise into a busy schedule. Most people decide to wake up a little earlier and others decide to work-out after work. Regardless of when you choose to implement a program, it's important to schedule these times on your calendar. Our wellness should be a priority for us and for those we love.
Tip 3: Do What You Enjoy
If exercise is not fun, you are not likely going to stick with the program. If running hurts your knees and makes you feel like you are about to die, most likely you will not be motivated to get out of bed on a cold morning. However, if you enjoy gardening and incorporate it into your plan then you will probably look forward to exercise. Think now of something you really enjoy doing that involves movement. I enjoy a clean house so often I incorporate house work into my exercise routine. Also, I love my dog and he has become one of my best exercise partners. It's a lot of fun walking with him and see how happy it makes him.
In the gym I see a lot of consistency in the Zumba class because people love to dance. Some ideas for making exercise fun might be to attend a class, exercise with a friend, and sign up for a challenge such as a 5k or Triathlon, explore a trail. Find what works for you.
Tip 4: Devise a Routine
Aristotle said, “We are what we repeatedly do. Excellence, then, is not an act but a habit.”
Now that we have established why, when and what, we can now create some habits that will make it easier to stick to our exercise plans. Before bed, look at tomorrow’s exercise plan and layout or pack your exercise clothes and don’t forget your shoes. Nothing kills the motivation to exercise like trying to find clothes to wear when you are half asleep, or packing your clothes when you have to get to work on time. If you are a morning coffee drinker, have your coffee ready to go with a timer or the push of a button. If you use an Mp3 player, charge it and have it ready. If you are walking the dog, have the “pooper-scooper” ready to go. The object here is to make it as automatic as possible.
Tip 5: Document a Strategy for Success
“Stand up to your obstacles and do something about them. You will find that they haven’t half the strength you think they have.” Norman Vincent Peale
Be assured of one thing, you will have challenges to overcome in establishing exercise as a regular habit. Anticipating obstacles and adopting a strategy for overcoming each one will be a key to your success.
One effective way to do this is to make a list of the obstacles in the past that has gotten you off of your exercise program. Then, list what you will do to overcome the intrusion. Here are a few examples of obstacles and the strategies I will plan in advance to overcome them:
Schedule Change – I will go back to my time flow chart and reestablish exercise times
Long Stressful Day and I just don’t feel like exercising- put on my clothes and begin exercising anyway. I will give myself permission to stop after 5 minutes if I still don’t feel like exercising (starting is the biggest part of the battle and I can't ever remember stopping after 5 minutes).
Injury- Modify my workout to work the area not injured and seek help as quickly as possible so that I can return to exercise
Bad Weather- Decide in advance my exercise strategy such as mall walking or inside exercise video.
I Am not Sure What to Do- Find a trainer or a person who is willing to teach you. Get a book. Purchase a video. Google!
I recently read about a study about a group of individuals who were unlikely to recover from a painful hip replacement surgery because of their age and other factors. The ones who set goals, anticipated obstacles and devised a plan in advance were the ones who recovered from the surgery two to three times quicker.
If you’ve read this far than these tips are something you feel will benefit you. So grab a pen or your computer and write down the activities you enjoy, develop your why, decide when you will do it, and document a strategy for success. Once you begin making exercise a regular part of your life, the energy and feel-good hormones created by moving and exercising will take over and make the process easier.
Are We Sitting Ourselves to Death?
This is a question I had to ask myself after reading one study about the detrimental effects of prolonged sitting in the Archives of Internal Medicine entitled, Sitting Time and All-Cause Mortality Risk in 222 497 Australian Adults. The conclusion of the study stated that "Prolonged sitting is a risk factor for all-cause mortality, independent of physical activity. Public health programs should focus on reducing sitting time in addition to increasing physical activity levels." In other words, individuals who work standing or walking and perform no additional exercises had better health outcomes than those that lived sedentary lives but exercised 1 hour per day.
Fitness trends come and go... we live in the era of P90x , Insanity and the Biggest Loser mentality, which are fueling our current exercise philosophies and are effective for some people. Yet, for the sedentary person, a different approach may be more effective. The safest way to increase our fitness and move from a sedentary life to an active life is to establish a base-line,assess where we currently are, and then, set a goal to increase our fitness level from that point. One viable way of accomplishing this is using a simple device called a pedometer. A pedometer counts steps. Some more advanced pedometers will calculate mileage and calories based on steps taken.
How many steps should we take per day? According to the NCBI Medical Publication less than 5000 steps is considered a sedentary lifestyle; 5000 - 7499 is low active and 7600- 9999 is considered somewhat active; and more than 10000 steps is considered an active lifestyle. Highly active individual take at least 12,500 steps per day.
Being alarmed at the outcome of this study, I decided to find my own baseline and determine what changes, if any, I needed to make. I considered myself fairly active. I discovered, when I work at my desk job without exercising, I average only 4000 steps. Wearing the pedometer has made me more aware of the need to take walk breaks throughout the day. I now set an alarm and every hour get up and walk around our office which is 50 steps. Since wearing my pedometer, I know that the circle around my neighborhood is 600 steps. If I get to the end of the day and I have not accumulated 10,000 steps, then I know exactly how many laps in the neighborhood I need to take to reach my goal.
What should we look for in a pedometer? First, I bought two to use with my clients and family. The cheapest one, a GAIAM Beginner model, broke after one drop. Prior to its demise, I found it would constantly reset when accidentally touched. It cost $8.00 and comes with a CD, but I would not recommend it. The second pedometer, the GAIAM ADVANCED model, was a good unit, it did not break the first time it was dropped, nor did it continually reset. Unfortunately, it did not come with a strap, which means, it falls off in transit it is lost and requires replacement. My favorite pedometer, so far, is the OMRON Go Smart HJ-112 Digital Pocket Pedometer. I like it for the following features:
I have used this pedometer clipped to my waist and in both my bra and a pocket. It comes with a strap which minimizes the chances of losing it, and it has never reset midday. One of my favorite features is that it resets at mid-night. This is not, however, a positive feature if you work an overnight shift; a fact that you will want to keep in mind when purchasing a pedometer for yourself. The price range for this pedometer is around $22.00.
In conclusion, although our time spent in the gym or working out is a vital part of our life, the come-back of the pedometer gives us access to a positive tool that will help us assess how sedentary we really are and help us stay active throughout the day.
We live in a sedentary society that moves from place to place in vehicles. Seldom is it safe to ride a bike or walk to work. Industrialism has eliminated our need to draw water from the stream, plant a garden to grow our food or chase an animal in order to eat. We have become what the medical community calls sedentary. Yet, we were not created to be sedentary.
A Science Daily article stated, “Most people know that exercise is important to maintain and improve health; however, sedentary lifestyles and obesity rates are at all-time highs and have become major national issues”. I would add that the sedentary lifestyle impacts our physical, emotional and spiritual health in negative ways. Our productivity is decreased and our relationships suffer. Being sedentary had an impact on my life. I was at an uncomfortable weight, I had trouble getting out of bed, my joints ached and I would injure my back easily. I was moody and had very little energy.
Being sedentary may not be affecting your life in the same way. Unfortunately, it is what we can’t see that is more damaging. What we can’t see is our arteries becoming clogged with cholesterol, our cells not being able to utilize glucose (called type 2 diabetes), and a myriad of other health issues that impact our lives and those around us.
Sadly, when a society errs from what is normal, we then have to define what is normal. Experts agree that regular physical activity is 2 1/2 hours of moderate intensity aerobic exercise, or 75 minutes of high intensity aerobic exercise; also, strengthening exercises 2 times per week incorporating all of the major muscles of the body; and, flexibility exercises three times per week. This may seem overwhelming, but there are simple ways we can begin to increase activity.
One idea is to begin embracing domestic chores as a way to exercise. Choose activities that require constant movement of large muscles. If there are tasks that don’t require large muscle movement, such as folding laundry, walk in place while doing them. Just stay moving for a minimum of 10 minutes. If you can only move constantly for 10 minutes this week, it’s okay. Next week increase it to 11 minutes.
You can increase flexibility by stretching after activity, and increase strength by utilizing push-ups and squats which incorporate most of the major muscles of the body. You can get directions on how to do these at: www.acefitness.org/exerciselibrary.
Begin recording how much time you spend exercising and set some goals to get moving. I write my activity minutes on my calendar and try to increase them weekly. Since we were originally created to work in the Garden, I believe God cares about our physical activity. Let’s pray about ways to get moving and allow God to be a part of this area of our lives.