Thursday, July 21, 2005

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.

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.

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.

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.

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

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.

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.

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.

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.

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.

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.

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.

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.

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

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.