Category Archives: Health & Fitness

Why and how: Warm-up before exercise.

The idea that you should warm up before exercise is common knowledge. Even if you don’t always warm up before a workout, you probably know that you should. What is less well understood is why a warm up is so important and how you should warm up before your next exercise session. This is the topic of my Health & Fitness column in the Aiken Standard this week.

woman-stretching-outdoors


The main purpose of warm-up is to increase muscle temperature to enhance the activity of enzymes that produce energy during exercise, so your muscles are ready to go. Also, pre-exercise activity will increase blood flow to the muscles so more oxygen and other nutrients needed to make energy can be delivered. The elevated blood flow also removed wastes from the muscle, including lactate, a by-product of energy production during intense exercise that can contribute to fatigue.

It’s not all about performance, though. Warming up also increases blood flow to the heart which can help reduce the chance of developing chest pain or having a heart attack at the onset of strenuous exercise. This is especially important for people who may have heart disease.

A good warm up should include the muscle groups that will be used during exercise, so focusing on legs for walking, running, or cycling and arms for rowing or other upper body exercise. In sports, the warm-up should be specific to the movements in the game. For example, a basketball player may warm up by doing some running and jumping as well as practicing passing and shooting. For most of us, simply walking or jogging for 5-10 minutes at a light-to-moderate intensity is a good general warm up for most activities.

While some athletes can spend an hour or more preparing for a game or event, the warm-up shouldn’t be so long and strenuous that it depletes stored energy or causes fatigue. It should also be done shortly before an event so the benefits of the warmup are still present at the start. Athletes who warm up too long before an event can get “cold” and may need to warm up again before they compete.

Two controversial topics related to warm-up include stretching and injury prevention. First, despite what your high school gym teacher or coach told you, stretching alone is not a sufficient warm-up. Increasing range of motion through stretching and other exercises can be part of a warm up, but they should not be the only activity. Furthermore, stretching to improve muscle and joint flexibility should be done after the muscles are warm, either after a good warm-up or exercise session.

It is also widely believed that warming up can reduce the risk of injury during exercise. While that makes sense intuitively, there is no consensus in the research. This is likely because many injuries result from extreme muscle and joint overloading or contact with the ground or other athletes that no amount of stretching can prevent. The bottom line is that warming up probably does reduce the risk of injury at least a little, so it is still worth doing.

The benefits of warming up go beyond the physical. Recreational and competitive athletes get psychological benefits from warm up, including improved focus, motivation, and confidence. For team sports, warming up together can enhance team dynamics. Warming up can put you in the right mindset for your typical workout, whether that is a challenging session in the gym or a walk around your neighborhood.


drparrsays blog footer

Sports science in the 2018 Winter Olympics

The winter Olympics start later this week so we will soon be seeing some remarkable athletic performances. The competitors are among the fittest and most highly trained athletes in the world, both in terms of laboratory measures of fitness and in subjective evaluations of skill. Competing in the Olympics requires years of focused, intense training, and some good luck. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Cross country skiing


First, let’s look at the fitness. This is most evident in the endurance events like cross-country skiing and speed skating. The key to performance in long-duration events like these is for the muscle to contract repeatedly and forcefully without fatigue. In order to do so, the muscle must have a steady supply of oxygen and nutrients. These nutrients are delivered through the blood, which is pumped by the heart. The muscle takes up and uses these nutrients to produce ATP, the form of energy used by the muscle.

After months and years of endurance training the heart gets bigger resulting in the ejection of more blood to the muscle. Within the muscle there is an increase in the number of capillaries, the small blood vessels that deliver blood to the muscle, and mitochondria, the part of the cell that produces most of the ATP. Together, these adaptations allow the muscle to produce more ATP without fatigue, allowing the athlete to sustain a higher intensity (skiing speed, for example) for a longer time without fatigue.

While all Olympic athletes are very physically fit, some events rely more heavily on skill, including figure skating and freestyle snow boarding. For example, in figure skating completing a triple axel involves leaping into the air, spinning three and a half times, and landing backwards. On a 4 mm wide blade. On ice. Or think about the triple cork 1440, a snowboarding trick that involves flipping three times in the air while doing four 360-degree turns.

The athletes who are able to successfully complete these maneuvers have practiced for years to develop the skill and confidence needed to perform them consistently in competition. These are some of the most obvious displays of athletic skill, but all events require good technique. The development of skill in addition to fitness is the main reason why athletes specialize in one area and you don’t see people competing in both downhill skiing and speed skating, for example.

Of course, there is a psychological aspect to Olympic performances. The motivation to put in the training time alone is remarkable. Even more impressive is the ability to focus on an event despite the distractions of the crowds, media, and pressure of competition. This combination of physical and mental preparation is rare—as rare as Olympic gold medalists!

But is training alone sufficient for Olympic-level performance? Could anyone who trains enough make it to the Olympics? The answer is no, because there is another important factor in athletic performance—luck. Luck refers to genetics, which determine potential for attributes like heart size and muscle characteristics. As much as 50% of performance in some events is attributed to genetics. One sports physiologist famously answered the question, “How do I become an Olympic champion?” with “pick different parents!”

Even though most of us will never become Olympic champions we can still experience many of the same benefits of training. All athletes train to develop strength, endurance, and flexibility, which is exactly what we should do, too. And those attributes will help us perform better at work (and play) and help us live a longer healthier life. It will also help us appreciate the training, dedication, and good luck that the athletes bring to the Olympic games.


drparrsays blog footer

Aside

Earlier this week I wrote about the consequences of concussions in athletes of all ages. Considering that the Super Bowl is this weekend, the emphasis was on football, but concussions can occur in almost any sport. Just today, the Journal … Continue reading

This is your brain on football: The Super Bowl, concussions, and CTE.

Since the Super Bowl is this week, football is a major topic of conversation. But football has been in the news for another more serious reason—the association with traumatic brain injury. Over the years, it has been reported that several former NFL players suffered from brain injury as a result of concussions sustained over years of playing. Some players have even retired early in their careers in an attempt to avoid such injury. Far from being an NFL problem, the issue of sports-related concussion is something that should concern young athletes who play football and other sports, as well as coaches and parents. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Concussion


Football, especially at the professional and college level, has long been known for violent collisions. An obvious concern is that players could sustain a career-ending injury and head injuries, including concussions, are particularly worrisome. In particular, repeated concussions can cause a degenerative brain disease called chronic traumatic encephalopathy, or CTE. The 2015 motion picture Concussion brought this issue to the attention of a wider audience, but many sports medicine professionals have been aware of this problem for years. A recent report suggests that CTE may be far more common than previously thought.

A concussion is caused by the brain moving forcibly inside the skull as the result of the head striking an object (another player or the ground) or simply the head moving violently without hitting anything. Because of this, concussions and sub-concussive injuries can occur even when an athlete doesn’t lose consciousness or appear to be injured. This can put athletes at increased risk for multiple injuries in a season—or even in a single game. This last part is critical, because much of the permanent damage comes from a second concussion sustained before the first has healed completely.

New rules banning helmet-to-helmet contact are part of an effort to reduce the risk of concussions. Off the field, players are subjected to special screening to detect concussions, assess recovery, and determine if it is safe to return to play. Improvements in equipment, including helmet technology that can monitor potentially concussive hits, may also help reduce the risks of serious injury.

Despite these efforts, some experts believe that football is simply too dangerous and have called for tackling to be banned. These concerns are more frequently expressed when it comes to youth football. The evidence that accumulated brain trauma sustained by young athletes can have immediate and lasting effects has led some communities, schools, and even whole states to consider banning tackling in youth football.

This is complicated by the fact that other sports also have a high risk of concussion, including hockey and soccer. In fact, heading has been banned in some competitive youth soccer leagues. And there is the fact that all sports have some risk of injury, including concussions. Furthermore, youth sports, including football, provide a great many young people with opportunities to be active, promote growth and development, enhance academic achievement, and have fun. The effect of banning tackling in football or heading in soccer on the health, social, and educational opportunities for young athletes is unknown and should be considered.

Whether policies like these are practical or not remains to be seen. In the meantime, there are steps we can take to make all sports safer for young athletes. We should make sure that coaches are educating players how to compete as safely as possible instead of emphasizing winning at all costs. We should also advocate for having certified athletic trainers at all games and practices to teach players safe techniques, assess and treat injuries, and ensure appropriate return to play. Most of all, we should be mindful of the risks of playing sports while encouraging kids of all ages to be active, play, and have fun!


drparrsays blog footer

Unfit for service. Another consequence of obesity and poor fitness.

Obesity and poor fitness, in combination or alone, have serious consequences on both an individual and societal level. This includes poor health now and in the future as well as an economic cost (in the billions per year!) that includes medical expenses as well as indirect costs such as increased absenteeism and lower productivity in the workplace.

This is particularly alarming in children since obesity at a young age sets up a cycle that leads to lower levels of activity that can make the condition worse over time. In both children and adults, overweight and obesity are associated with low physical fitness and many people who are at a “normal” weight are unfit as well.

Unfortunately, the common pattern of inactivity and obesity can limit the ability to function optimally at school, work, or in leisure-time activities. In fact, many young people are ineligible for military service because of physical limitations due to poor fitness and being overweight. This is the topic of my Health & Fitness column in the Aiken Standard this week.


Military fitness

A report from the Council for a Strong America finds that being overweight is the major reason that civilian military recruits are deemed medically unfit for service. Military training and service is physically demanding, requiring a high level of strength and endurance. These attributes are more likely to be lacking among overweight recruits.

Equally troubling is the fact that poor physical fitness disqualifies a high percentage of young men and women who are at a “healthy” weight. A 2010 report, written by a panel of retired military leaders, raises these same concerns, and has the ominous title, “Too Fat to Fight.” (A follow-up report, “Still Too Fat to Fight,” suggests that the situation hasn’t improved).

Interestingly, this is not a new problem. Large numbers of draftees who failed the induction exams due to physical reasons during WWI and WWII resulted in changes in physical education and nutrition programs in schools. Poor fitness among American children also led to the formation of the President’s Council on Youth Fitness in the 1950’s and an emphasis on physical fitness testing and education among school-aged children. In recent years, participation in physical education has declined, resulting in the current generation of overweight, unfit young people.

A recent study also examines the impact of obesity and poor fitness on careers in the military. Not only are many young people disqualified from military service, those who do enter basic training are more likely to sustain injuries that delay or terminate their training. These injuries are more likely to occur in recruits who are obese and unfit at entry. Furthermore, the prevalence of obesity and lower levels of physical activity is higher in states in the south and southeast. Considering that these are among the states send the most recruits to basic training, this limits a great many people from potential military service.

Taken together, these reports suggest that the continuing trend of obesity and poor fitness among American children may have national security implications. This emphasizes the fact that schools are critical to improving the health and military-readiness of our children.

Changes to school lunch and physical education programs are needed, but this is not a new recommendation. In fact, nutrition and exercise recommendations for children and schools already exist, but they are not followed, largely for political reasons. Perhaps the current condition of poor health and fitness among military recruits will motivate our leaders to implement effective exercise and nutrition programs in schools.


drparrsays blog footer

 

 

It’s time to get real about food. Really.

Given that we eat several times every day, we should all be food experts. But it turns out that many of us don’t know much about our food including where it came from, the method of preparation, or the quality and nutritional value. We are increasingly disconnected from our food, a fact that has implications for our health and the health of the environment. We should all try to learn more about the food we eat and the impact it has on our health, environment, and quality of life. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Good food display


Our lack of knowledge about the food we eat has been replaced by a heightened awareness about nutrients. In fact, many people follow diets that either emphasize or restrict certain nutrients to obtain health benefits. But the research to support the importance of these individual nutrients is often mixed or lacking altogether. Still, as we seek out sources of these nutrients we turn to supplements, such as fish oil, or processed foods with added nutrients, like fiber.

To be sure, fish oil and fiber are good for us. But does that mean that taking a fish oil supplement will have the same health benefits as actually eating fish instead of, say, fried chicken? Or is adding fiber to a chocolate breakfast bar equivalent to getting more fiber from fruits and vegetables? According to both research and common sense, the answer is no.

Beyond the individual nutrients, the food we eat has changed. Even the way food gets to our table has changed. Since nearly half of our meals are eaten outside the home, it’s not even “our” table anymore. And when we do eat at home, take-out and prepackaged heat-and-eat meals have become the norm. In fact, the idea of cooking meals from ingredients is so foreign that we have to be reminded about how and why we should do it. There are even services that will deliver ingredients and detailed instructions to make cooking a reality for many people.

Getting back to the basics of cooking and eating real food may seem old-fashioned, but it is a current trend. This, of course, is how people ate for years before the obesity and diabetes epidemics we are dealing with now, so eating real food again is a step toward reducing these, and other, health problems.

In addition to the potential health benefits of focusing on food over nutrients, this approach is also good for the environment and the economy. It turns out that eating healthier food promotes sustainable agriculture and can support local farmers. Locally grown produce, which is picked at the peak of freshness, can be more nutritious and have a lower environmental impact than food from factory farms which is often shipped great distances. And most important, food from local farms usually tastes better!

We should make ourselves aware of where our food comes from and do our best to eat “real food” as opposed to processed and pre-packaged foods that tend to be high in calories, added sugar, salt, and unhealthy fats. When possible, we should buy foods that are grown locally to minimize the environmental impact and support local farmers who live, work, and pay taxes in our area.

It turns out that focusing on food, not nutrients, will have a positive impact on your health, the environment, and quality of life for you and others. In fact, eating real food usually means that you will get all the nutrients you need to be healthy and thrive.


drparrsays blog footer

 

No pain no gain? Pain, no. But a little muscle soreness is okay, even good.

If you exercise, especially if you lift weights, you have probably heard the adage, “No pain, no gain.” This may serve as motivation for some people, but the belief that exercise results in pain might be a good reason not to work out for others. If you are one of those people, you should know that idea that exercise should hurt is simply wrong—muscle pain during or following exercise usually suggests an injury. However, some muscle soreness is unavoidable, especially if you are new to exercise. This is the topic of my Health & Fitness column in the Aiken Standard this week.

sarcomere


This soreness is called DOMS—delayed onset muscle soreness—and it typically occurs 24 to 48 hours after exercise. It can range from a mild reminder that you worked out to more severe soreness, weakness, and tenderness. DOMS can occur after any type of exercise, but is more common following weight training, especially if it is your first session or a particularly intense workout.

A common belief is that lactic acid build-up in the muscle causes muscle soreness. This is based on the fact that during intense exercise like weight training the muscles make energy for contraction anaerobically (without oxygen), which leads to lactic acid production. This is in contrast to aerobic exercises like walking or jogging that produce energy using oxygen, with little lactic acid build-up. This belief that lactic acid causes DOMS has been shown to be false since any lactic acid that is produced during exercise is cleared shortly after you finish, long before muscle soreness begins.

So what causes DOMS? It turns out that strenuous exercise leads to microscopic tears in the muscle, which leads to inflammation and soreness. This sounds bad, but the muscle damage is an important step in the muscle getting bigger and stronger. Your muscles are made up of protein filaments that shorten, leading to a contraction. When you lift weights your muscles respond by creating more protein filaments, allowing you to generate more force and causing the muscle to grow in size, called hypertrophy. The mechanism that leads to creating more muscle protein is stimulated by the damage that occurs during exercise. Without that stimulus, muscle growth wouldn’t occur. This is why weight training programs call for increasing the resistance over time to overload the muscle. Without increasing the weight, you wouldn’t get much stronger.

While the muscle adaptations that are associated with DOMS are beneficial, you may wish to avoid or limit the soreness aspect. You can do this by beginning your exercise program slowly. Resist the temptation to do too much too soon! Build up your time and intensity slowly over several weeks and start weight training with lighter weights. Remember, your goal is to begin an exercise program that you will sustain. Many people have quit working out because they started off with exercise that was too intense. While your goal should be to exercise every day, there is nothing wrong with taking a day off between workouts early on.

If you do experience DOMS you should rest those muscles until the soreness subsides. You can also try an over-the-counter pain reliever or applying ice to the sore muscles. If the soreness isn’t too severe, you can still exercise, but keep the intensity low. Weight training sessions should be scheduled a few days apart to allow for muscle recovery, but aerobic exercise can usually be done every day. If your arms are sore from lifting weights, you can always go for a walk!


drparrsays blog footer