Family Exercise

By Shelly DeRuiter, PT (Work Systems Rehab & Fitness, PC; Pella, Iowa)

In the last two decades the number of overweight and obese children has more than doubled, putting them at risk to become overweight or obese adults with serious problems such as diabetes, hypertension, heart disease, and even psychological and social problems. Fortunately, parents can take steps now to prevent this. To borrow and tweak an old saying: “The family that plays together stays together.” Exercising together as a family will keep everyone physically and emotionally healthier.

It is no secret that children are less active today. Passive activities like television, internet, and video games often trump physical activity. In addition, schools offer less gym time than a generation ago. Even children playing team sports like baseball and soccer are not learning the habit of a physical activity – such as riding a bike – which they can carry into adulthood. Kids often get tired of the sport and quit, and it's not a lifetime sport.

Exercise is a great opportunity for parents to who want to spend more quality time with their children, but being active together is also a huge fitness benefit for the adults. Children who participate with or observe their parents being active will be more likely to develop a life-long habit of exercise. Choosing to exercise as a family will not only build stronger and healthier bodies, but it will forge stronger and healthier relationships as well.

Physical activity can help everyone in the family be and feel healthier. Exercise can:

• Boost energy level
• Improve balance, coordination and flexibility
• Improve circulation
• Strengthen the heart, lungs, bones and muscles
• Burn the fat and calories you consume throughout the day
• Help you sleep better at night
• Reduce stress and depression
• Reduce the risk for diabetes, high blood pressure, and high cholesterol
• Improve self-image

However, knowing exercise is good for our families and fitting it into busy schedules are two different things. Here are some ideas for getting everyone involved:

• Find out what your children like to do and make this a focus of your family activities.
• Make it fun.
• Keep the word “exercise” out of your vocabulary. Instead, promote “play time” and encourage activities that are fun and physical such as hop-scotch, jumping rope, tag or hide-and-go-seek.
• Use family walks or bike rides as a time to do more than just exercise together. Walk downtown, visit a friend, or run errands.
• Try planning social outings to involve physical activity such as taking the family dancing or roller-skating.
• Make it a rule to leave the television off one day a week. This encourages physical activity and outdoor play.
• Don't make exercise a chore or work; keep it light and enjoyable.
• On the other hand, make chores fun. Clean the garage together. See who can pull the most weeds or who can rake up the biggest pile of leaves
• Vary the activities, and let your children take turns choosing what the family will do.
• Trips to the park, zoo, or miniature golf course can be fun and involve a lot of walking.
• Try to be available as much as possible when your children play games such as tag, capture the flag, or kickball.
• Bring in other kids to make exercise look more like play while creating a fun atmosphere for physical activity. Try organizing a neighborhood game of tag or hide-and-go-seek to get your children outdoors and moving with others.
• Buy toys that promote physical activity like balls, bikes, and skates.
• Get outside and take advantage of a local lake and the surrounding trails.

Remember that our choices reflect to our children what our values are. If we believe that exercise is important, they will see it in our lives and want to imitate it. Time spent together exercising provides the awesome opportunity to encourage and build one another up.

Head For the Trails!

By Todd Schemper, PT, DPT (Work Systems Rehab, P.C.; Des Moines, Iowa)

Autumn is here! The leaves are changing; the days are getting shorter; and the temperature is much cooler than our 90 degree summer. The great summer and fall races are past, and many runners are heading inside for the treadmills and tracks. A fun and adventurous alternative for your training program this fall and winter is trail running. The surfaces of your running trails can vary from dirt, to limestone, to grass, or woodchip .

Running on these off-road trails is a wonderful way to explore creation, and enjoy the beauty of the fall season. Breathing fresh air, seeing wildlife, and experiencing the stillness of the woods is a great break from streetlights and traffic. Trail running is also a wonderful activity for your joints and muscles.

The dirt, limestone, or grass surfaces of trail running have been shown to be better for your joints; especially your feet, knees, and back, as the forces sent up through your body are decreased compared to pavement. The terrain can vary, with up-hills, down-hills, curves, and minor obstacles, such as roots, branches, and rocks. Running in this type of environment gives your body a more balanced workout compared to running on sidewalks and streets.

This balanced workout can help you utilize some of those underdeveloped muscle groups that do not have to work as hard on the road. The fact that your feet have to adjust to the uneven surfaces causes you to work harder to balance. The hips are stimulated from the winding curves, uneven terrain, obstacles you may have to run around, and branches that could be hanging over the trail. Your arms and trunk have to work to stabilize as you go up and down ravines and around trees and sharp curves.

By running on trails you can help prevent injury by improving your strength, balance, and awareness of how your body wants to move in more directions than just straight forward. So where do you go to find these types of trails?

There are actually many un-paved trails in the Des Moines Metro. Some locations include Ashworth Park and Denman Woods, Brown’s Woods County Park, Raccoon River Park, and the Sycamore Trail. There may be other trails within forest preserves and state or county parks near your home. If going off-road is more than you feel you are ready for, running once per week on a grassy surface at a local park is enough to give your body some variety from the normal routine.

To get started, find a friend who is excited and willing to head down a new off-road route with you. I recommend taking it easy the first time out, expecting a slightly slower pace than normal because of potentially challenging conditions. If the trail is narrow, and allows only single file running, give the person ahead of you enough room so you can see the trail surface and terrain changes coming up in front of you. Be cautious of potential obstacles such as tree roots, mud, sticks, rocks, and wooden bridges. Also, make sure you have enough daylight to finish the route you are planning to run.

After training on some trails and finding you like what you have experienced, it is time to find an off-road or cross country race that will test your ability and adventure. The Living History Farms Race is a local favorite in November. There are new off-road races starting up every year, and there are even running clubs and national associations that cater to the sport.

Enjoy the trails! You will experience the benefits for your body, mind, and spirit.

Todd Schemper, PT, DPT is a physical therapist, co-owner and clinic manager with Work Systems Rehab, P.C. in Des Moines. He enjoys trail running and helping runners with injury prevention and treatment. Todd can be reached at (515) 309-4706 or todds@worksystemspc.com.

The Importance of Water

By Troy Vander Molen, PT (Work Systems Rehab & Fitness; Pella, Des Moines, and West Des Moines, Iowa)

Water is an essential part of our diet. A person could live without food for about a month, but only about one week without water. The human brain is composed of 95% water; blood is 82% water; the lungs are nearly 90% water. A mere 2% drop in body water can trigger fuzzy short-term memory, trouble with basic math, and difficulty focusing on the computer screen or on a printed page! Mild dehydration is also one of the most common causes of daytime fatigue. Estimates are that seventy-five percent of Americans have mild, chronic dehydration.

Still not convinced about the importance of water? Here are several more interesting facts:

Water is an appetite suppressant. Plus, it has shown itself to be beneficial in losing weight and body fat percentage. Here’s why: The kidneys can’t function properly without enough water. When they don’t work efficiently, some of their load is dumped onto the liver. One of the liver’s primary functions is to metabolize stored fat into usable energy for the body. But, if the liver has to do some of the kidney’s work, it can’t operate at full throttle. As a result, it metabolizes less fat, more fat remains stored in the boy, and body weight gradually increases.

Drinking enough water is the best treatment for fluid retention. When the body gets less water, it perceives this as a threat to survival and begins to hold on to every drop. Water is stored in extracellular spaces (outside the cell). This shows up as swollen feet, legs and hands.

Drinking eight glasses of water daily decreases the risk of colon cancer by 45%. Drinking enough water can also reduce the risk of bladder cancer (by 50%) and it can potentially even reduce the risk of breast cancer. Preliminary research indicates that 8-10 glasses of water a day could significantly ease back and joint pain for up to 80% of sufferers.

An overweight person needs more water than a thin person. Larger people have larger metabolic loads. Since we know that water is the key to fat metabolism, it follows that the overweight person needs more water. The overweight person needs one additional glass for every 25 pounds of excess weight. The amount you drink also should be increased if you exercise briskly or if the weather is hot and dry.

Water should preferably be cold. It’s absorbed into the system more quickly than warm water. And some evidence suggests that drinking cold water can actually help burn calories. To utilize water most efficiently during weight loss, follow this schedule:

· Morning: 1 quart consumed over a 30-minute period.
· Noon: 1 quart consumed over a 30-minute period.
· Evening: 1 quart consumed between five and six o’clock.

The best news about drinking water for health benefits? It’s virtually free. You can drink more than 4,000 glasses of tap water for the price of a six-pack of soda. That’s great news to a Dutch guy like me!

All and only the best!

Troy Vander Molen, PT
Work Systems Rehab & Fitness, PC
Pella, Iowa

Troy is a physical therapist with Work Systems Rehab & Fitness, PC (WSR&F). If you have any questions regarding this topic or any other issue related to health and wellness, contact a knowledgeable health professional at WSR&F by calling (641) 621-0230.

Running Sideways!

By Todd Schemper, PT, DPT (Work Systems Rehab, P.C.; Des Moines, Iowa)

Why do we always run straight forward? Our bodies are designed to move in so many other directions. Running is a great activity. However the fact that we always run in the same plane of motion may be causing weakness patterns and overuse strains in our bodies. I am not recommending that we all start running sideways or backwards, but including cross-training, warm-up activities, or even tweaking to your running a few times during a workout may be a great way to help prevent injuries.

There are three main planes that our trunk, neck, legs, and arms move through. The sagittal plane is the plane that we run in, straight forward. This plane also includes movement that is backwards, as in walking backwards, or reaching straight behind your body for the baton in a relay race. The frontal plane is the second of the three planes. This plane includes all sideways motions, or movements like reaching to the side to grab a cup of water at an aid station during a race. Last is the transverse plane which includes all the rotation that our bodies are able to do. Examples of transverse plane movements are turning your head to look behind you and turning around the cone during an out and back race.

Since we mainly run in the sagittal plane our bodies may weaken in the frontal and transverse planes. As your body weakens you become less stable with not only movements in those planes but also in the sagittal plane. So what can you do about this potential problem?

One way is to cross-train with activities that incorporate frontal and transverse plane movements. Examples that come to mind are ultimate Frisbee, swimming, golfing, tennis, basketball, and weight lifting. Moving your body in different directions helps to keep your muscles balanced and strong in all planes of motion.

Other options for runners are running drills before or after a few of your runs each week. Ideas here include backwards running and lateral shuffle or crossover running, and even skipping, bounding, and kick butt drills are all great. Find a track, a quiet street, or a football field, and run each drill a few times for 50 meters.

If you are really wanting to get into multi-plane running and feel safe with the above drills, try throwing a few of them in during a run. Turn around and run backwards for a while. Shuffle sideways or run around a pole or tree (to the right and left). I have a friend who was passed in a marathon once by a guy running backwards, so there are some people who really take this seriously.

However you explore moving in the frontal and transverse planes within or alongside your running program, your body will thank you for targeting muscles and joints in a way that normal sagittal plane running will not. Enjoy running sideways!

Todd Schemper, PT, DPT, is a physical therapist, co-owner and clinic manager with Work Systems Rehab, P.C. in Des Moines. He enjoys running with his wife Denise, triathlon training/racing, and helping other runners stay injury free. Todd can be reached at (515) 309-4706 or todds@worksystemspc.com.

Realizing the Benefits of Aerobic Training

By Todd Schemper, PT (Work Systems Rehab & Fitness; Des Moines, Iowa)

The year is half gone! So how are those New Year’s resolutions to work out coming along? The cold weather of winter often makes it difficult to enjoy being in creation, but now we are dealing with the stark reality of the heat and humidity that the summer has to offer in our parts. While I love to be outdoors, on some days I am extremely thankful that there are many indoor exercise options to get the body moving. I will discuss some of the more popular machines being used today for burning some calories.

Benefits
There are many benefits and reasons to exercise. A major one is improving your aerobic capacity or endurance. Exercise can also help decrease body fat, improve blood pressure, lower cholesterol levels, reduce stress, and decrease the risk of heart disease. Other reasons include increased muscle strength and bone mass.

Duration and Frequency
The duration and frequency relate to how long and how often you should exercise. If you have not currently started a program it is important to start slow. One option is to begin with a 10 to 15 minute session one day, take the next day off to see how you feel, and then gradually bump up your time the day after that. A general rule is to exercise a minimum of 20 minutes 3 days a week. The maximum limits would be 5-6 days a week and 45-60 minutes of exercise.

Mode of Exercise
The main machines for cardiovascular exercise include treadmills, stationary bicycles, elliptical machines, and steppers. There are others out there but these are the most popular in health clubs and home use. People mainly focus on their heart rate and calories burned with these activities. I will discuss some of the musculoskeletal considerations with these modes of exercise. You don’t have to get crazy and walk sideways on the treadmill or stand backwards on the elliptical, but thinking about what your joints and muscles are doing with these activities could give you an even better work out.

Treadmill
The treadmill seems to be the most popular of the indoor machines. Whether you walk, run, or fight for your life to stay on, it is a great mode of exercise for burning calories and getting your heart pumping. While ultimately safety should come first, holding on excessively with your hands can take away from some core (hip, pelvis, back, abdominal) strengthening that could be occurring if you did not hang on. Once you feel ready to go hands free, give it a try and see how it feels different. Another very important idea with treadmill activity is making a practice of using it with the belt at a slight incline. This creates a more natural balance with the muscles of your legs.

Stationary Bicycle
The bicycle is another option for exercise. It has the added benefit of decreased joint pounding. There are many types of stationary bikes, recumbent, arm motion with pedal motion, and regular handlebar. One is not better than another as long as it is a comfortable fit for you. The seat should be at a height that you have a slight bend in your knee when your foot is at the bottom of the pedal stroke. A recommendation with riding the bike is to focus on a circular motion with your legs, pulling back as well as pushing down, to again get a more balanced work out.

Stepper
The stepper is exactly what it sounds like, a machine that simulates going up stairs. This is another machine that would be a good one not to hang on as much. Not using your arms challenges your balance and core stability. Remember safety first. Also think about pulling one leg up as you push the other down.

Elliptical
The elliptical machine is one of the newest members of the cardio family. It can be hard to describe, but is sort of a cross between the treadmill, bike, and stepper. Your feet stay on it so you don’t get the pounding of a treadmill, but you are standing, so it is a great weight bearing exercise for bone and muscle building. Try going forward and backward, pushing and pulling for a well-balanced work out. Remember the hand issue here too.

Key Points
The benefits of aerobic training can only be attained if you make a point to be consistent with your program. Also try a variety of machines to exercise your body differently. And as always, have fun and enjoy improving your health.

Todd Schemper, PT, is a physical therapist with Work Systems Rehab, P.C. He can be reached at (515) 309-4706 or tschemper@mcleodusa.net.

Weight Training: Getting Started Safely

By Todd Schemper, PT (Work Systems Rehab & Fitness; Des Moines, Iowa)

A weight training program can be a great way to work on some areas of your body that you have been neglecting, and it creates a more balanced exercise program. Unfortunately, I have worked with a number of people who, because of the way they are working out, ended up with an injury that could have been avoided. This article will discuss basic weight-training principles that will help prevent injury.

Warm-up
The warm-up is a key part of weight training. Jumping right in and lifting with cold and tight muscles can cause muscle strain. Warming up with light aerobic exercise such as walking, running, bicycling, etc., is a great way to get your body ready to go. Also, starting your routing with lighter resistance is good to prepare your body for the range of motion needed to complete the exercises.

Symmetry/Balance
Keeping your body balanced is probably the number one mistake I see with weight lifting injuries. The front thigh muscles (quadriceps), chest (pectoralis major), and upper arms (biceps) are often over worked, while other areas are neglected. A weight program should be balanced, working on the back, upper back, chest, shoulders, and whole upper arm (triceps and biceps). For the lower body and trunk the abdomen, hips/pelvis, thighs (hamstrings and quads), and calves should be focused on. An important tip to remember with symmetry is if you are going to work the front you better balance your body by working on the back equally.

Sets/Repetitions
The number of sets and repetitions will vary depending on your intent with weight training. A general rule is to do 1-3 sets for 10-15 repetitions. You will decrease the repetitions and increase the resistance for more strength or increase the repetitions and decrease the weight for endurance training. When you do your workout, focus on being able to maintain your form as you reach a point of fatigue. Once you lose form during fatigue, the body compensates and injury can result. Don’t forget to breathe.

Frequency
The recommended frequency for weight training is 2-3 times per week per body area. This can be done all at once for 2-3 sessions per week or broken down for 4-6 times per week. Try not to lift the same area two days in a row. Your muscles need to repair from the previous workout to reach their optimal potential for the next time they are challenged.

Variety
Keeping your program tailored to your needs and including a variety of exercise is an essential part of strength training. Remember to stay within your limits and move only the resistance you are capable of lifting. Do not try a certain weight just because your lifting partner is doing it. The next point I believe is also very important for a beneficial weight program; make sure you mix up your routine from week to week. Try various exercises for the muscle groups you are working or at least change the order of your workout to stress your muscles differently.

Function
Making your workout functional or specific to the demands of everyday life is something all should take into account. Doing all of your weight training sitting or lying on machines neglects the need for your bodies to balance and support us during every day life. If you are into using only machine resistance in your program, try to throw in some free weight exercise or even ground based (standing) body-weight resistance exercises. Doing upper body exercise in a standing position and including lunges, squats, and step exercises are some of the best ways to get a well-balanced functional workout. The rehabilitation and exercise professionals at Work Systems Rehab & Fitness are specially trained in functional medicine principles that emphasize real-life functional movement patterns to optimize physical health.

Cool-down
The cool-down part of a workout is just as important as the workout itself. Be sure to taper your exercises off with light weight lifting to promote blood flow through your body’s full range of motion. Re-hydrate and take in some good balanced calories to help replenish what has been depleted from your workout. This is also the time of your routine that you want to do most of your long hold stretching to improve your flexibility.

Fun
When you weight train, have fun! It is not worth all the hard work and time if you do not enjoy it. Try to be consistent from week to week to get the most benefit. Find a friend to do your weight training with to keep you accountable. And consider contacting a local fitness professional to help you get started safely.

Todd Schemper, PT, is a physical therapist with Work Systems Rehab, P.C. He can be reached at (515) 309-4706 or tschemper@mcleodusa.net.

Osteoporosis Prescription: The Other "E" Pill

By Shelly DeRuiter, PT (Work Systems Rehab & Fitness; Pella, Iowa)

Estrogen is an important supplement for individuals with osteoporosis. But, there is another option to fight against osteoporosis, another “E” pill – exercise prescription! Sifting through the research on the prevention and treatment of osteoporosis yields a wealth of information. Much evidence exists that supports the use of exercise to increase bone density in premenopausal women and at least maintain bone density when combined with nutrition and/or medication in postmenopausal women.

But increasing bone density is not the only reason for exercise prescription for these patients. Exercise prescription teaches safe body mechanics and activities of daily living (ADL) modification to prevent flexion forces through a weakened spine. It also includes postural stretching and strengthening to ensure that walking allows for weightbearing activity at the appropriate portion of the hip, the neck of the trochanter. Stretching to increase mid-back extension and decrease rounded shoulders is progressively introduced to improve tolerance for lying on the back without support. Exercises to enhance balance reeducation can also be included to decrease the risk of falls, decreasing fracture incidence.

In his book, Stand Tall! Every Woman’s Guide to Preventing and Treating Osteoporosis, Morris Notelovitz, MD outlines multiple research projects that investigated the potential benefits of exercise in the treatment of osteoporosis. Some of the results are amazing:

· Bone mass increases with walking, jogging, and stair climbing;
· Spinal bone density increases more noticeably when estrogen is combined with muscle strengthening;
· Hip and spine density increases with muscle strengthening; and
· Exercise combined with medication and nutrition is more effective at maintaining and improving bone mass than any one factor alone.

Granted, nutrition and medication can also increase bone density, BUT appropriate exercise can do what estrogen, calcium, and other bone-building medications can’t – improve balance and strength, reducing the risk of falls and fractures and improving posture.

Including health professionals with knowledge of both osteoporosis and appropriate exercise prescription enhances the potential that individuals with osteoporosis can increase bone density and decreases the potential for fractures from falls and unsafe positions with ADL’s. Consider the other “E” pill to address not only loss of bone density, but risk for falls, and posture restrictions.