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KNEE PAIN & TREATMENT
The knees are a common site of pain and functional limitations for many people. Knee pain can force a person to modify her lifestyle to avoid exasperating activities (such as exercise!), control the pain with medications, and perhaps face the need for surgery.
Many people think they have knee pain because a knee has "worn out" after years of running, biking, organized sports, etc. Interestingly, this almost always occurs in only ONE knee, which makes us wonder if the 'other' knee stayed at home during all that activity! In fact, if it were actually the exercise activity that wore out the knee, then both knees and even the hips and ankle joints should also be "worn out" from all the pounding.
It's helpful to understand that any knee pain not resulting from an acute injury (e.g., fall or trauma) is a result of long-term mechanical stress to the joint. This kind of stress presents itself in many diagnoses from the doctor, including: (1) osteoarthritis, (2) chondromalacia, (3) torn meniscus, (4) patellar tendonitis, (5) iliotibial band syndrome.
Each of these conditions can be painful and become progressively worse if not properly addressed. When this happens, it's important to understand that pain killers and/or anti-inflammatories can help with symptomatic relief but they do not address the underlying cause(s) of the condition. And none of the conditions above would likely be reason for surgery, except possibly a torn meniscus.
What should someone suffering from knee pain do? First and foremost, get an evaluation by your doctor! Then see a qualified physical therapist or exercise therapist. If the doctor fails to suggest therapy, ask for a prescription for therapy.
Palliative treatments alone (those that reduce pain or discomfort) will never address the precipitating factors to your knee pain. Therefore, knee pain is likely to recur. Some example of palliative treatments along with medications include ice, electrical stimulation, ultrasound, heat packs and massage. Each of these treatments is also passive--which means things are done TO you and YOU are not actively creating change in your body.
Palliative treatments are not bad, and may be necessary, depending on the level of injury, but they are limited in how they can help you. In order for your body to make changes to its mechanics so it can heal and prevent future injury, the change must ultimately come from within. This comes from learning to move differently, and learning comes from DOING. Strengthening becomes most beneficial when the quality of your movement has actually improved.
Since knee function is dependent upon the hip above and the foot and ankle below, any intervention for the knee must include these areas as well, at the very least. Therefore, some key areas to ask about when working with a therapist are the following: (1) Are my hips rotating properly? (2) Are my hips stable laterally? (3) Am I controlling the internal rotation and adduction of my hip when my foot hits the ground? (4) Do I pronate (turn or rotate) too much or do I not pronate enough? (5) Do I have enough dorsi flexion when my foot is on the ground?
Knee pain, like so many other musculoskeletal injuries in the body, is multifactorial. Having a good understanding of this will help you ask better questions of your doctor and therapist, and gtive you insight into a long-term strategy for recovery and prevention of future problems.
EXERCISE & AGING -Anthony Carey, M.A., CSCS, CES
Like many of you, aging and dementia has directly affected my life by affecting someone very close to me. And if it has not affected you yet, it surely will. It is estimated that the number of Americans ages 55 and older will almost double between now and 2030. Those in this age group will make up 31% of the total population.
As a result of my personal experience, I have taken a greater interest in the prevention of dementia. And as an exercise professional, you should know that the power of exercise is one of the greatest contributors to good brain health.
In the December newsletter that Function First sends out to our subscribers (www.functionfirst.com) we highlighted one of our clients, Andy Hiatt, who is one of the leading researchers on Alzheimer’s in the world.
Andy came to me for help because his neck and knee were giving him problems when he ran and rode his bike. But what amazed me during our initial consultation was that the pain in and of itself was not what Andy considered the problem. The problem was that the pain was interfering with his ability to do cardiovascular exercise. And as an Alzheimer’s researcher, he knew this needed to be resolved.
In his book, Spark: The Revolutionary New Science of Exercise and the Brain, Dr. John Ratey states that cardiovascular exercise is a key factor in effectively managing stress. It stimulates brain-derived neurotrophic factor (BDNF), a protein that helps brain cells multiply and function effectively.
According to Ratey, diabetes sufferers have a 65% higher risk of developing dementia. High cholesterol increases the risk of developing dementia by 43%.
How does exercise help? The increase in heart rate and blood pressure during exercise helps bring more blood to the brain. Carried in that blood is the oxygen and glucose the brain uses for energy. It also stimulates the BDNF to grow dendrites (the part of the brain cell that receives impulses from neighboring cells) which improves the neural connections. More connections mean more efficient brain power.
Experts continue to advocate brain-challenging tasks such as crossword puzzles, trivia, etc. However, with these activities alone, is the brain is working with the status quo to improve neural development. If we add cardiovascular exercise to the equation, we have the ability to create fertile ground for much more effective neural growth.
And just like plants, the body—and especially the brain—needs water. The brain is 80% water. Water enables electrical impulses to travel through the brain. Many studies have examined the effects of dehydration on cognitive function. Bear in mind that alcohol and caffeine are diuretics and can lead to dehydration.
When it comes to brain health, Jazzercise offers many other associated benefits along with the cardiovascular benefits. For example, the social aspect of students showing up early and staying after class to talk is a benefit. The regular changes in routines and the challenge of learning new routines constantly stimulates the brain as well.
Exercise really is the holy grail of good health. It’s important to recognize the brain benefits as well, and to understand that the effort put forth in class is reaping even more rewards than we might have originally thought.
WHAT THE HIPS LACK CAN HURT THE BACK
You’ve likely experienced it. Most people have. Statistics tell us that 8.5 out of every 10 people will experience lower back pain during their adult life…and that lower back pain is the most common reason to visit the doctor, behind the common cold.
Did you know that your hips could be the cause of lower back pain? Although back pain is often the result of many things, one of the more common (and more commonly overlooked) causes is issues with your hips.
Generic back exercises are a dime a dozen. Visit any website or doctor’s office and you will find a handout containing the same ten or so exercises. It’s actually quite comical how a problem of epidemic proportions is often treated with the same simple exercises regardless of age, body type, diagnosis, size, etc. And these exercise handouts typically contain few movements, if any, that address the hips.
The hip joint is a ball-and-socket joint. A joint with this kind of design moves in many different ways. If you look at the design of the hip joint and compare it to the design of the vertebral joints of the lower back, you will see some very distinct differences. The vertebral joints of the lower back are not designed to move anything like the hip joints. In fact, the lumbar vertebral joints don’t even move as well as the vertebral joints of the rest of the spine.
For the most part, the lower back likes to ride on top of the sacrum and pelvis and follow their direction. The motion of the pelvis and sacrum is actually a result of the movement of the hip joints (the pelvis along with the femur form the hip joint).
For example, when performing a twisting motion while standing during a Jazzercise routine, the majority of the rotational motion comes from the hip joints and the upper back. Very little comes from the lower back.
But what happens if you have to twist but the hips do not twist well? The body will transfer the responsibility to the lower back. Since we’ve already stated that the lower back doesn’t rotate well, we are asking it to perform a function it is not prepared for. And this is where injury occurs.
The injury could happen abruptly with a sudden turn while holding something heavy in your hand. Or it could occur as a result of many repeated turns that exceed what your body can tolerate over time, resulting in pain.
It is important to note that twisting or rotating is not the only motion that poor hip function will transfer to the lower back. Tight hip flexors will limit the ability to extend the hip. For example, when walking or running, the thigh must move behind you as you stride forward with the other leg. If the leg cannot move behind you due to tightness in the front hip flexor, it will find that extra range of motion by increasing the arch in the lower back.
Another problem (more common in women than men) is poor side-to-side stability of the hips when load bearing on one leg. This is observable when the pelvis “hikes” up on the side of the stance leg due to weakness in the gluteus medius and minimus. This will cause increased lateral flexion of the lumbar spine.
Stability and mobility of the hips are important for good overall musculoskeletal function and a health lower back. It is helpful to realize that good functioning hips are key to both prevention and recovery of lower back pain.
HABITS TO A HEALTHY HEART
When we think about a healthy heart, the first thing that comes to mind is cholesterol. Most of us know all about bad cholesterol and its effects, that it can cause heart attacks or strokes if not monitored. But what is good cholesterol? High-Density Lipoprotein or HDL is the good type of cholesterol. An example of what HDL does for the heart is similar to what a cleanser does for cleaning dirt. When you replace the dirt for bad cholesterol (LDL) then you have a pretty good idea of what HDL does inside your veins and arteries. Your goal is to increase the level of your good cholesterol. But how can you do that? Here is a good place to start.
Exercise: Any activity that forces your heart rate up for a period of thirty or more minutes will increase HDL levels. Aerobic exercise will also help you lose fat, which is believed to contribute to higher LDL levels.
Diet: Add more dark green vegetables to your diet. Also avoid trans or saturated fats. It's believed that these increase your LDL. Eat more pure protein like fish or skinless chicken. Whole wheats are your friend, because they are loaded with simple carbohydrates.
Drink: Researchers have found that an alcoholic drink enjoyed over dinner can help to raise good cholesterol in the blood. However limit yourself to one or two.
Stop Smoking: Here is a good reason to quit. Giving up tobacco automatically raises HDL.
Sleep More: Just as mental stress can affect your overall health, so too can physical stress. This comes from over working the body and not giving the cells enough of a chance to repair themselves. Aim for at least eight hours of uninterrupted sleep per night.
Eliminate Stress: Stress is known as the silent killer for good reason. A positive relationship has been shown connecting stress to heart disease. This does not reflect directly to cholesterol, but why take chances. Stop to smell the roses, leave work at work. Do something nice for your partner or yourself. This will help you to live a longer, happier life!
EVER WONDER WHY DIETING JUST DOESN'T WORK?
4 Reasons Why Most Diets Fail
-from the editors of Best Life
Nutritionists agree that most diets aren't worth the paper they're printed on. They realize that the key to losing weight is adopting a sound, sustainable eating plan and then sticking with it, rather than opting for some wacko quick fix.
Problem #1: Diets don't last.
The problem with virtually all diets is the short-term mindset into which they feed. Many women approach diets as an all-or-nothing proposition. Rather than making small, even incremental changes in lifestyle that can last a lifetime, diets encourage you to turn your life inside out for two weeks or so. Yet once those two weeks are over and you return to your old habits, guess what? Your body returns to its former state as well. If there's a rule of thumb to be had in this regard, it's that small changes last and big ones don't. Saying that you'll change everything you're doing wrong starting on Monday morning and straight-line it from there might sound impressive — and earn you some kudos — but it doesn't change your underlying behavior patterns. It's the slow, steady route that ultimately leads to success.
Problem #2: Diets make you hungry.
Diets typically treat fat loss as a function of nutrition only, when training is equally important. The diet world is about tearing down, and sports nutrition is about building up. You'll lose weight by creating a calorie deficit — burning more calories than you eat. You'll create that deficit, however, mostly through training and not through drastic dieting. The calories you burn in your Jazzercise class added to the metabolism boost you get from muscle growth will kick your body into fat-burning mode — without making you hungry.
Problem #3: Diets make you tired.
A chronic problem with diets is that so many of them are simply too low in calories. Because they don't provide enough energy for you to do your workouts and accomplish everything else you need to do in a day, they're a short-term solution at best. Even when weight-loss programs incorporate exercise — and, astonishingly, many don't — they typically ask you to eat like a gerbil and then train like a hamster by running or cycling endlessly in place. You may shed a few pounds in the short run, but you'll also forsake muscle, and the resulting metabolic downshift will soon take you back to square one. Whether it's being done on a treadmill or stationary bike, in class, or on a squeaky metal cylinder, endless cardio performed on restricted calories is a road to nowhere, literally and figuratively.
This is especially true if you're following one of the ultra-low-carb diets that are so popular now. Carbohydrates are the primary energy source for physical activity, and decades of research has shown that low-carb diets don't adequately support strenuous physical activity or athletic performance for extended periods of time. In contrast, a diet moderate in carbs will supply enough energy for the average woman to stay active and still burn fat. Endurance exercise requires more carbohydrates than strength training does, but in neither case will training be optimized without sufficient carbs.
Problem #4: Diets cannibalize your muscle.
Diets also tend to pay too little attention to supporting muscle mass during periods of caloric restriction. This is important for more than just aesthetic reasons. And when you lose muscle, your basal metabolic rate drops, and you don't burn as many calories.
Often women try to burn off the fat first and then build the muscle. To do that, you have to lower your calories so far that you don't have the energy to train hard in class. You burn more muscle than fat, lowering your metabolic rate and setting the stage for weight gain.
This is why eating well—nutritionally and sustainably—is the key to success in losing unwanted pounds and building the sleek kind of physique that both feels and looks great!
JAZZERCISE CURRENT SONG LIST, R2-10
Jazzercise Current Song List--R1-10
Uprising--Muse
Wild Ride--Lori Michaels
Bang Bang--Melanie Fiona
Release Me--Agnes
Feel the Love--Marchi's Flowvs Love
Baila Merengue--Foonjina
Cry Tonight--Kim Sozzi
Stuck on Replay--Scooter
Overboard--Hammerhead
Into the Night--Five Alarm
Git in the Truck--Brian Davis
Powerhouse--Goopy
We Belong to the Music--Timbaland/Miley Cyrus
Take me to the Ride--DJG Project
Gracias--2 Amigos
Cinema Italiano--Kate Hudson
Be Alright--Kristine W.
Bitty Boppy Betty--Pink Martini
Top of the World--Pussycat Dolls
And Then You're Gone--Pink Martini
It's Gonna Be--Norah Jones
Funkadunk--DJ Cool
Half of my heart--John Mayer
Telephone--Lady Gaga/Beyonce
Hey Soul Sister--Train
Louboutins--Jennifer Lopez
Everybody--Ingrid Michaelson
Stardust--Michael Buble
Bigger--Justin Bieber
Naturally--Selena Gomez/The Scene
Cheryl Burke stays in shape with Jazzercise!
Jazzercise with Cheryl Burke As seen on TV
Watch Video Clip of Cheryl Burke
Jazzercise 80s
SUPERMARKET PSYCHOLOGY
Your supermarket employs clever strategies to encourage shoppers to spend more; how can you keep control of your wallet and your waistline?
Have you ever gone shopping hungry and come out of the supermarket in shock, having spent far more than you thought you were going to? Or found yourself staring at products in your home, thinking, why on earth did I put that in my cart?
If so, then you've succumbed to supermarket psychology, the marketing tactics that are employed by stores to get people like you to buy more products than you really need.
Marketing expertise
Supermarkets have been employing marketing experts and psychologists to design their stores for many years. The simple plan is to entice you to buy lots of goodies; whether or not you actually need them is beside the point.
Recognize the following devices?
An in-store bakery: The smell of freshly baked bread is designed to make us hungry and get us spending.
Produce near the front door: Fresh food looks best in natural light, hence you find these areas near the opening to the supermarket.
Hidden staples: Milk and bread are set far apart from the entrance and each other, to encourage consumers to walk through all parts of the store.
The "end cap" trick: Special displays at the end of the aisles, known as end-caps, are laden with offers; shoppers notice them more than regular displays.
Eye-catching at eye level: More expensive items with higher profit margins are placed at eye level, while the shop's basics range will be on the floor — companies actually pay more to have their products at eye level, as shoppers are considered "lazy" and will see them first.
David Lewis, a consumer psychologist and author of The Soul of the New Consumer: Authenticity, What We Buy and Why in the New Economy (Nicholas Brealey Publishing Ltd.) has spent 15 years analyzing how we buy. He says, "Nothing is left to chance. From the width of the aisles (planned so that you are prevented from bumping into other people, but aren't so wide that you can't get your hands on products) to the music (composers even spend their lives writing music designed to entice shoppers to buy more goods), a supermarket is a place where a consumer and his money are meant to part company. Remember that a supermarket is a bit like a machine; its mission is to get you to spend, so to counter this, you need to keep your wits about you."
The supermarkets have vast amounts of data about our shopping habits from point of sale, loyalty card databases and market research data that are given to psychologists and the retail geographers to create an optimum store layout.
So. . .can you avoid the pitfalls of supermarket psychology? Yes, if you keep your wits about you and observe the following guidelines.
• Go in with a list and stick to it
• Eat before you go shopping
• Stick to buy one, get one free offers and fresh produce markdowns; don't get sucked into special offers if you can — they are often misleading.
• Check if generic brand products are as cheap and as good as branded — sometimes they aren't
•Consider shopping online — you won't be tempted by in-store marketing!
EXERCISE for ENERGY: WORKOUTS THAT WORK! (WebMD)
Want to fight fatigue? Here's what kind of exercise -- and how much -- is best.
There you are, sitting on the couch, remote in hand, thinking, "I should be exercising. If only I weren't too tired to get off the couch!" Indeed, fatigue is among the most common complaints doctors hear. But you might be surprised to learn that experts say one of the best antidotes to beating fatigue and boosting energy is to exercise more, not less.
"It's now been shown in many studies that once you actually start moving around -- even just getting up off the couch and walking around the room -- the more you will want to move, and, ultimately, the more energy you will feel," says Robert E. Thayer, PhD, a psychology professor at California State University, Long Beach, and author of the book Calm Energy: How People Regulate Mood With Food.
And, experts say, when it comes to fighting fatigue, not all exercise is created equal. Read on to find out what kind of exercise -- and how much -- you should be doing for optimum energy-boosting results.
Just How Does Exercise Boost Energy?
In a study published in the journal Psychotherapy and Psychosomatics in 2008, University of Georgia researchers found that inactive folks who normally complained of fatigue could increase energy by 20% while decreasing fatigue by as much as 65% by simply participating in regular, low-intensity exercise.
Further, Thayer says, a study he plans to present at an American Psychological Association meeting reveals that on days when people walked more total daily steps, they ended the day with more energy then on days when they walked less.
How exactly does this happen?
"Contrary to popular belief, exercising doesn't make you tired -- it literally creates energy in your body. Your body rises up to meet the challenge for more energy by becoming stronger," says nutritionist Samantha Heller, MS, RD, a nutrition advisor for the Journey for Control diabetes program.
Heller says this happens on the cellular level, where the first stirrings of our natural energy production begin. "It all begins with tiny organs called mitochondria. Located in our cells, they work like tiny power plants to produce energy," she says.
While some of that energy comes from your diet (one reason that eating too little can power down your metabolism), the number of mitochondria you have -- and thus your ability to produce energy -- is affected by your daily activity.
"For example, the more you exercise aerobically, the more mitochondria the body makes to produce more energy to meet your needs, which is one reason how -- and why -- regular cardiovascular exercise actually creates more available energy for your body," says Heller.
Exercise for Energy: What Really Works
So just how do you go about getting some of this energy for yourself?
First of all, Thayer says, it's important to understand that there are different types of energy. And not all have the same positive effect on the body.
He says that many Americans, particularly "achievement-oriented Type A people" have "tense energy" -- an effective state that allows you to get lots of work done, but that can quickly move into tense-tiredness, a negative state often associated with depression.
On the other hand, what he calls "calm energy" is a combination of a high physical and mental energy level, paired with low physical tension. It is this state, he says, that offers more long-lasting energy. And, he says, it can be achieved with the right kind of exercise.
"What summarizes the relationship best is moderate exercise -- like a 10- or 15-minute walk -- has the primary effect of increased energy, while very intense exercise -- like working out at the gym, 45 minutes of treadmill -- has the primary effect of at least temporarily reducing energy, because you come away tired," he says.
Behavioral therapist and personal trainer Therese Pasqualoni, PhD, agrees. When exercising for energy, she says, "You should always aim to exercise in your low to moderate training heart rate range. This will prevent you from depleting your body, and help you avoid feeling fatigued, which would otherwise prevent you from getting the maximum energy benefits."
Of course, what's moderate for some may be too little for others. "How much you can do before you cross the threshold into tiredness is often dependent upon how well your body is conditioned," Thayer says.
In addition to walking, experts say other forms of exercise that help increase "calm energy" are yoga, Pilates, Tai Chi, and, sometimes, resistance strength training, particularly when done with slow, deliberate motions. Further, Thayer says playing music during any workout may increase "calm energy" while helping to reduce tension.
"In a study we did about 10 years ago, we found that music was a very effective way to change a person's mood," he says. "And though we don't have any data just yet, we are now studying whether workouts that combine music and movement, like Jazzercise, can induce this state of calm energy that is so healthy."
While experts agree that moderate movement is key to increasing energy, even if you overdo it, your end result may still be less fatigue. "Though it's mostly anecdotal at this point, we are starting to see that while intense exercise may tire you out, it also reduces tension, so that after an hour or so, when your muscles begin to recover, you might see a surge of energy but without tension," says Thayer.
Regardless of what energy-producing exercise you choose, you can get more out of your workout time by eating some fruit just before you start, says Pasqualoni, founder of the Strike It Healthy web site. "This allows food, which is a form of energy, to be broken down and the nutrients enter the bloodstream, while preparing the body for work," she says. "The end result: You have more energy while you're working out -- and more energy afterwards."
Heller also reminds us to drink plenty of water before, during, and after working out to help decrease workout-related fatigue. "Dehydration is an important cause of fatigue, so to get the most energy out of every workout, be sure to stay hydrated," she says.
And finally, what if you're really just too tired to do anything at all? Experts say simply getting up out of your chair may be enough to get those mitochondria energy factories powered up -- and for you to feel some instant results.
Says Thayer: "Even if you think you're too tired to do anything, get up and walk around the room, and in a couple of minutes you're going to feel some energy that wasn't there before. And that may lead you to want to move even more."
