Swiss Ball - what can I do with it ?

Many clients have said "I have a Swiss Ball (or an exercise ball)  but I never use because I'm not sure what exactly to do with it. 

This short video ( 5  1/2 minutes) is to let you see and hear what it's like to workout with a Personal Trainer like myself guiding you through a workout using an exercise ball. The video is taken in the fitness studio I often work in with a real client (not a model) and the voices you hear are those of myself giving guidance and the client giving feedback.

I hope this video helps you make good use of your exercise ball.

The sequence of exercises aims to minimize changes in position so that you can flow from one exercise to the next with no waste of time. This also keeps the intesity high.

If you want, you can push very hard  to exaustion on each exercise, or as I'd recommend you stop each exercise with just a little in reserve. Listen to your body, give yourselves between 1/2 minute and a full minute between exercises. This is enough time for most people to keep their heart rate under control.

The internet is full of Swiss Ball exercises. The video from me and my client is different because it works all the core muscles and you can hear the conversation containing exercise guidance and client feedback about doing the exercises.

Gentle Stretching of the Lower Back

Most people feel tightness in the lower back from time to time. For some the back is a constant source of problem and puts limitations on exercise. This short video (less than 2 minutes) is to give you some ideas for stretching your back early in a workout while you are warming up.

Keep the movements slow. You do not want the feet to have so much momentum that you could get carried into the pain zone.

Listen to your body and enjoy.

I think this is the first time I've mentioned stretching in my posts even though stretching is a core part of my exercise philosophy. I use an approach to stretching known as PNF with many of my clients.

Talking about PNF is for another day.The stretches in this video are not PNF.

Low Back Pain

One of my clients has had Low Back Pain sufficient to disrupt many normal activities.

After a lot of investigation the culprit seems to be  the sacroiliac joint. Normally low back pain is not diagnosed to the sacroiliac joint.

The sacroiliac is normally very robust as it is enclosed in a very robust ligament structure. How ever strong it is this fibrous surround to the lowest joint in the spine can become disrupted by:

• a fall onto yoir rear end
• car accident where your leg was extended forward at the moment of impact
• lifting a load (possibly very small weight) while bending forward and rotating
• Childbirth
• as a result of harvesting bone for a subsequent bone graft
• hormone imbalance
• as a result of an imbalance due to disk problems.

Quite a long and wide set of possible causes. One of the reasons that a sacroliliac joint problem can go so long without being accurately diagnosed is that X-rays and MRI's do not reliably show the issue.

My client was lucky enough to find Vicki Sims to help her get over her sacroiliac issue. 

You can get her book  from: sipress.com

Health Assessment - How Much

How much would you pay for an assessment of your health and your potential health problems ?

What if it were free, would you bother ?

The answer for many is - NO. 

The chart above, produced by StayWell, shows that to get close to 100% of employees in a company participating in heath assessment, the company has to pony up about $600 per employee. 

I found this amazing but then I have been out of the corporate world for 5 years and things change. 

If you read off the chart you'll work out that $100 of employer money handed out to employees gets about 50% participation. $400 given to each employee gets around 80% of employees active and involved. Then it's on up to $600 to get about 98% involved leaving those last 2% who just do not want to know at any price.

Mercer, who are just about everywhere - including Atlanta - created this report on health costs for employers and employees. It's all totally scaring but not to be ignored either.

Part of the issue of employees not wanting to participate is down to fear:

• what if I have cancer or something equally nasty - NOT knowing is better and knowing!
• Knowing about a health issue makes it a pre-existing condition. What will happen if I change job and can't get medical coverage at the new company?
• Could I miss out on job opportunity if I'm seen as sick and perhaps not going to be around for that long?

5K run - 4 Seasons Run4 Cancer 14th St Atlanta

I did the Run4 Cancer 5K this morning exactly as planned.

Blue skies, temperatures in the low 60's - perfect for running.

I set my brain to not be competitive and just trot around, stop and walk if the knees hurt and that is what I did. Apart from not stopping to walk. I did it in 34 minutes. Really slow but the first 5K in 2 years.

Two years ago I ran hard in a Sandy Springs 5K to finish in 24 minutes. The motivation that day was to get a good enough time to qualify for time group 1b in the Peachtree 10K (run on 4th July every year). 

This year, somewhere in the third mile I felt myself tilting forward and had to remind myself that all that core strengthening was meant to keep me upright and running with good form. 

When a runner starts to weaken and bend forward the brain is trying to ease postural muscles that are tiring (or maybe totally done for) and changing the posture in order to bring different muscles into action. However running efficiency then goes down sharply for two main reasons:

1. The heels start striking the ground harder and earlier and now at each footfall progresion is being slowed rather than assisted by each quick tap on the ground with a light foot.
2. Breathing becomes harder and the lungs do not fill as easily so that the legs muscles are not getting as much oxygen as earlier in the run.

Put the two together and a good time is out of the question.

Today I reminded myself to get back upright into an efficient running posture and was able to enjoy the rest of the run.

The presentation ceremony was much more exciting than usual because of the excellent give away prizes (probably the best of any run in the whole USA). Lots of stays at 4 Seasons with airfair from Delta thrown in.

The best draw prize; 3 nights in the 4 Seasons in Nevis in the West Indies with 2 business class tickets on Delta. 

Rabobank have been a sponsor of this event since its inception. The Rabobank executive acting as master of ceremonies mentioned in passing that Rabobank is the 4th strongest bank in the world and the only privately owned maximum strength bank in the world. Amazing what can be picked up just sitting in a parking lot, resting tired legs, getting some sun and hoping that a wonderful draw prize will come in my direction. 

Osteoporosis - something for men to worry about ?

Strengthening bones, particularly spine, pelvis and leg bones, is one of the motivating factors in wanting to keep running as deep into life as possible.

My father had a pronounced hump in his back in his forties and it is possible that he had osteoporosis issues. He was a coal miner and in winter rarely saw the sun. Sufficient Vitamin D plays an important role in building bone mineral density and hence warding off osteoporosis, it is possible that his issues came from that particular direction. Nevertheless I worry. The picture to the left is a knee showing weakened bones due to osteoporosis - luckily not my knee.

Men have osteoporosis issues as well but nothing like the extent that osteoporosis affects women.

Men can check their osteoporosis risk at Check up on your bones.

Amgen have gathered a lot of attention after releasing data from a clinical trial with the drug DENOSUMAB. This drug is taken twice a year by injection. The headline number from the clinical trial is that denosumab reduces the risk of spinal fracture in women with osteoporosis by 68% and the risk of hip fracture reduces by 40%.



At an earlier stage in the research the New England Journal of Medicine carried an extensive article on denosumab as it treats women. These three pictures illustrate a typical weakening of the spine due to osteoporosis and the resultant forward lean.


The July-September 2008 issue of ACSM's Certified News (only available on-line if you are an ACSM member - as I am) focuses on Men's Health Issues. One article talks about The Male Athlete Triad but I was left unconvinced that this is a big issue. There is also an extensive article on Osteoporosis in Men. It is estimated that 2 million men in the USA are at risk of osteoporosis.

That said men do have multiple advantages compared to women when in comes to osteoporosis risk. In particular:

• men achieve a higher bone mineral density than women
• men have a lower rate of bone loss
• men do not experience hormonal reduction mid-life
• men have a shorter life expectancy
• men have a greater formation of periosteal bone with a related increased cross-section in the bone leading to greater strength.

There seem to be many reasons why a man is at risk of osteoporosis:

# glucocorticoid medications
# other immunosuppressive drugs
# hypogonadism (low testosterone levels)
# excessive alcohol consumption
# smoking
# chronic obstructive pulmonary disease and asthma
# cystic fibrosis
# gastrointestinal disease
# hypercalciuria
# anticonvulsant medications
# thyrotoxicosis
# hyperparathyroidism
# immobilization
# osteogenesis imperfecta
# homocystinuria
# neoplastic disease
# ankylosing spondylitis and rheumatoid arthritis
# systemic mastocytosis

Here's the easy explanation.

I'm hoping that running by putting stress through the spine, pelvis and feet will help keep osteoporosis at bay.

Running and Core Strength

Saturday September 20th is set as the day to try running a 5k race for the first time in a long time. I've liked, for years, the Run for Research organized and supported by the Four Seasons Hotel in Atlanta.

Great draw prizes as well.

Today I ran 3 1/4 miles on a treadmill to check if my knees have a chance of coping. I've iced and thus far the knees seem OK. I've posted multiple times about trying to persuade 65 year old knees that they are happy about running.

See this piece about "Knee Lubrication".

The main reason for posting this is the video I came across when booking my place on the run. Active.com has this video on Core Strengthening to support running. It will be 5 minutes well spent looking at it.

If you've not previously run into Active.com then take a look. I find it the easiest way to find and enter events.

Cutting Breast Cancer Riskl

OnFitness Magazine remains one of my favorite fitness magazines that arrives as actual paper dropped into the mailbox.


The most recent issue - Sept/Oct 2008 has an intriguing 27 ways to cut breast cancer risk.

My wife went through breast cancer which was picked up by a routine mamogram and she then had a lump ectomy followed by radiation. All good thus far even though she has thought that the subsequent lung issues were related to the radiation treatment.

The piece in OnFitness has no attribution but it largely looks sensible so I've copied their list in its entirety. It is hard core healthy living and is not an easy agenda to follow.

1. Sleep in total darkness; this means not even a tiny night light


2. Work a first shift


3. Sleep between 10pm and 6am and for 7-8 hours


4. Take a melatonin supplement before bedtime


5. Fill your car with gas on the way home so that you can immeadiately change your clothes that were exposed to gasoline fumes


6. Do not store food or beverages in plastic containers; the estrogen-like compounds in the plastic can make their way into foods and liquids


7. Avoid processed soy products


8. Avoid wearing tight-fitting bras; do not sleep with a bra on; have some bra-free time every day


9. Massage breasts a few times a week


10. Avoid alcohol


11. Breastfeed


12. Take the following supplements: turmeric; green tea; vitamin D3; garlic; indole 3 carbinol; sulforaphane


13. Make the following foods a regular part of your diet: grapes; apples; onions; mushrooms; cruciferous vegetables; carrots; berries; high-fiber foods; raw nuts; flaxseed oil.


14. Your food pyramid has plant food at the bottom and animal products near the top, below saturated fats, sugars and highly refined foods


15. Eat organic as much as possible


16. Drink only purified water


17. Exercise at least one hour daily


18. Include plenty of bouts of high intensity in your exercise regime


19. Reduce body fat


20. Eat red meat only occaisionally; never eat red meat well done. If you must eat grilled red meat or poultry marinade first


21. Limit sugar, high fructose corn syrup and white flour


22. Avoid deli and luncheon meats and anything else that contains sodium nitrite


23. Avoid artificial sweeteners


24. Avoid trans fats or hydrogenated vegetable oil


25. Limit processed foods such as those that come frozen in a box


26. Spend time in a sauna at least once a week


27. Don't smoke.

Time Efficient Exercise - getting more done in the same time

I'm a personal trainer and most of clients only spend half an hour at a time with me.

The issue is always how to help clients pack as much exercise into the time.

One of my strategies is to work on multiple muscle groups in one place in the gym. The alternative is to work one set of muscles, move to another machine to work another muscle then move again.

It's an approach which can be made to work but you spend a lot of time walking around the gym and in a busy gym that can be slow. Then of course you get to the target machine and it's in use.

So what alternatives do I offer ?

The main alternative is to use each piece of gym equipment to work multiple muscle groups. Just because a machine is labeled Calf Raise doesn't mean that the only use is to work the calves.

I use this approach with quite a number of machines in the gym.
In this post I look at using the Calf Raise machine to work Quads and Traps in addition to the Calves. This is also a first for me uploading an exercise video entirely created but myself (with my wife as camera person).

Robotic Knee Surgery

MAKOplasty might, down the road, be another way to keep running.

A client asked me this week "Hows your knee doing ?" and then wondered if I knew about MAKOplasty.

The answer was NO but after a quick check it definitely has potential.


Thus far I'm following the plan I laid out for myself in early July. This first week in September should see another 1/4 mile step in run distance to reach 3 miles. After some runs I've hurt but not too badly and I always ice after running.

The exact routine is:

• walk for 1/4 mile starting very slowly (2 mph)
• Run starting slowly at 5mph and gradually building up to current self-set limit of 7.5mph
  
• last 1/4 mile of run is cool down coming back down to 5 mph
  
• walk for 3 minutes slowing from 3 miles at start of walking down to 2 mph before stopping
• home without stopping to shower
• post-exercise glass of rice milk with a teaspoon of soy protein added
• sit-down and ice for 10 minutes, stop icing for 5 minutes then ice for another 10 minutes.
  
• finally it's time to shower

The potential attraction of MAKOplasty is that it could deal minimally with arthritis inside the knee rather than a full knee replacement which would mean saying good bye to running.

However any serious surgery needs some lengthy consideration. While the MAKOplasty surgery makes it sound as if the hole made is tiny, this video of the procedure shows that in fact the knee is pretty much opened up completely. It's a great video and worth watching all the way through to and including the final Q + A.

More videos, admittedly from Mako but nevertheless interesting.

Of course it's not perfect ! This report by Dr Saff says that the pain has gone but he still can't run. Bad news.

The picture of Dr Saff shows him with a HeavyHand in each hand. Years ago I used to run with a 4 pound HeavyHand in each hand. Clarence Bass adopted HeavyHands a long time ago.