No, it’s not quit smoking, exercising more, or eating a healthy diet I’m talking about; although these things can add years to your life.
You know what it is? Answer: stop sitting too much!
We are living in a society that encourages sitting, thanks to computers. Many jobs require it. Using the computer at home to surf the web, check bank accounts, shop, etc. require it. School requires it. Going to restaurants and coffee shops require sitting. Evidence is showing that prolonged sitting promotes disease, malady and death in epidemic proportions.
The latest study examining the relationship to prolonged sitting and morbidity tracked over 50,000 men and 69,000 women over the course of 13 years. Study participants indicated if they sat less than 3 hours per day total or over six hours per day, total. The results showed that women who sat the most were 37% likely to die, and for men who sat the most, they were 18% more likely to die than the rest of the study participants. The association remained virtually unchanged after adjusting for physical activity level; meaning, a woman who sat for more than six hours a day who exercised regularly still had the same chance of dying than a woman who sat for more than six hours per day and did not exercise regularly.
Numerous other studies done in the past show that prolonged time spent sitting, independent of physical activity, affects metabolism and may influence things like triglycerides, high density lipoprotein (HDL cholesterol, the good cholesterol) fasting plasma glucose, resting blood pressure, and leptin, which are biomarkers of obesity and cardiovascular and other chronic diseases.
It is clear by now that prolonged sitting, which can be defined as over four hours per day, is a threat to your health. There needs to be more public health announcements on this. Imagine the billions of dollars in health care costs that we as a country can realize if everyone knew not to sit too long, as well as all the lives that can be saved.
If you are in a job that requires prolonged sitting, I suggest that you print out the study (link below) and show it to your supervisor. Tell him or her that you take this seriously, and you must be allowed to stand up and walk at least once an hour, for 15 minutes. Or, stand up and walk every 15 minutes of sitting, for about five minutes.
Qigong, sometimes spelled Chi gung, is a form of exercise that originated in China some 4,000 years ago. Literally translated to “life energy cultivation” it involves aligning breath, movement, and awareness for exercise, healing, and meditation for the purpose of balancing the body’s energy meridians and enhancing the intrinsic capacity of the body to heal. Qigong is considered a part of Traditional Chinese Medicine, or TCM, along with acupuncture and Chinese herbology.
Basically, in TCM it is believed that there are “energy meridians” or lines that cover the body from head to toe. Health is dependent on the “flow” of this energy, or chi. Whenever there is an “obstruction” in one or several meridians, the body experiences disease. Qigong works to improve this energy flow by focused breathing, meditation, and gentle movements. Whether the benefits of Qigong are derived from improved energy flow, or by better breathing and exercise is uncertain.
Fibromyalgia is a condition that involves diffuse, muscular pain in multiple parts of the body. It is more of a syndrome; meaning, it is described in terms of symptoms rather than objective findings such as offered by an X-ray or MRI. Fibromyalgia is also often associated with chronic fatigue syndrome. It is a difficult musculoskeletal disorder to diagnose and treat because it usually lacks a causative event. Some believe that it may be related to a virus, or abnormal central nervous system response.
A recent study investigating the effectiveness of qigong on fibromyalgia was published August 3rd. The randomized, controlled study involved 100 fibromyalgia patients, divided into a control group and test group. Outcomes were pain, impact, sleep, physical function and mental function, and these were recorded at baseline, 8 weeks, 4 months and 6 months using standardized pain questionnaires (10 point and 100 point). The test group participated in a one-hour practice session once weekly for 8 weeks and were asked to practice the movements and exercises at home every day for six months for 45 to 60 minutes. After the first 8 weeks of practice, the investigators reported the following results:
Based on a 10-point scale, patients in the qigong group had a 1.55 point reduction in pain compared with only 0.02 points in controls
Based on the 100-point Fibromyalgia Impact Questionnaire, individuals who participated in qigong reported a decrease of 18.45 points compared with 0.93 points in controls. This questionnaire rates pain, sleep, function, and psychological distress
Quality of sleep also improved during the 8-week treatment period based on a sleep quality index of 3.29 points
Psychologically, patients in the 8-week treatment group showed an improvement of 5.29 points on a questionnaire
Following the initial 8-week treatment period, the patients said they practiced for a mean of 4.9 hours per week, which declined to 2.9 and 2.7 hours by months 4 and 6, respectively. However, the 52% of patients who practiced at home the most (5 hours per week) enjoyed the most benefits in a number of areas.
Individuals who participated in the delayed treatment also showed improvements similar to those in patients who took part in the immediate qigong sessions and practice in all areas. When the authors combined the results of the two groups, the results revealed sustained effect of qigong on pain at both 4 and 6 months, and benefits persisted through 6 months for impact scores, sleep, and physical and mental well-being.
Bottom line: this is one of several studies that suggest the Chinese system of qigong exercise can be helpful in reducing, or at least managing chronic pain. If you have FM and have not tried it yet, it is worth investigating.
Functional exercises, in my opinion, are the “best” kind of exercises in that you get the most “overall benefit” per unit time doing them. This is especially true for those who don’t have that much time to dedicate to exercise.
Basically, functional exercises are those that engage the whole body rather than one section at a time. They improve strength, coordination, and muscle stamina; and have cardiovascular benefits as well. For example, arm curls, bench pressing, and leg pressing are not considered functional exercises because they target just one area. An example of a functional exercise would be carrying a 30# sandbag on your shoulder and walking up a hill.
Most people group exercise as either cardio or strength. But coordination is often forgotten. You see, muscle groups need to have good coordination between them in order for your body to function at its peak and be the most resistant to injury. Muscle coordination is a neurological function as much as it is a muscular contraction function. The proper “firing sequence” of neurons to each muscle fiber must be fine tuned in order to have optimum muscle performance, and this is done by repetitious, combined movements of multiple groups. Functional exercises do just that. Do them often, and you will notice that common movements will be easier to do, such as walking up a long flight of stairs, or lifting something heavy and placing it on a higher level.
Delayed Onset Muscle Soreness, or DOMS is a condition where your muscles feel pain a day or two after hard or unfamiliar exercise. DOMS is thought to more likely be worse with exercises that emphasize eccentric muscle contraction, where the muscle lengthens as it contracts. Examples of eccentric contraction include negative weight lifting (like lowering a curling bar slowly, squatting, and lunges). It is believed to be the result of microscopic tears of muscle and fascia fibers and consequential inflammation. Pain from micro injury is generated by inflammatory biochemicals interacting with nociceptors (nerves that transmit pain signals). In DOMS, the injuries are so small that it takes 12-24 hours before the inflammatory response is enough to generate pain and stiffness.
The muscle pain from DOMS is different in nature than a typical muscle sprain/strain injury. It generally is more widespread, depending on the muscle groups that were worked out the most. Contracting the affected muscles will increase symptoms. For affected muscles that cross a joint such as the knee and shoulder, stiffness reduces joint range of motion.
DOMS, while it can be quite uncomfortable, usually self-resolves in about 7-10 days, with rest and a break from physical exertion. But for some people, that is too long.
So, what can one do to prevent and treat delayed onset muscle syndrome?
(1) Take it easy, tiger. If you do not exercise frequently and decide one day to make up for all the months you slacked off by going “all out” you are setting yourself up for pain, stiffness, and movement limitations. If you haven’t been exercising for months, your muscles won’t be acclimated to taking loads and repetitions and will likely incur microtears in the fascia, tendons, and muscle fibers. So, use the 10% rule, which basically is a scaling up of exercise over a week or two depending on how often you go, to re-acclimate your muscles to your normal, maxed workout. Let’s say you usually curl 40 pound dumbbells. Start day one with 5 pounds, day two with 10 pounds, day three with 15 pounds, until you get up to your max.
(2) Seek out a professional. A personal trainer can show you the right exercises to do for your goals, and the proper technique to get the most out of it, without injuring yourself.
(3) Warm up. Do about 15 minutes of cardio before you do strength or functional training like Boot Camp and similar, full body exercises. Jumping jacks, jump rope, treadmill with incline are good choices.
(4) Do some light stretching. Although recent studies showed that stretching before exercising did not significantly reduce injuries, stretching feels good and can put you in tune with your body.
(5) Hydrate 30 minutes before your workout, competition, or task that will involve heavy lifting (like helping a friend move out of his house). Most sports drinks are formulated to provide the major electrolytes (sodium, potassium, calcium) that muscle use to contract.
(6) Know your limitations. As you age, you lose muscle mass; and therefore strength. Adapt your workout routine accordingly: lighter weights, exercises that are easier on the joints; more rests in between sets.
Now, if you still get DOMS, congratulations, you weren’t cheating; way to go for it! But seriously… here are things you can do to minimize it:
(1) Get a Swedish style or lymphatic drainage massage (NOT a deep tissue or acupressure massage) from an experienced, skilled massage therapist. The long, light pressure strokes towards the heart will increase lymph circulation and help your body clear out the inflammatory products. If you can find a place in your town that does endermologie (cellulite treatment), that is even better. Endermologie is a type of negative pressure massage done with a special machine that can increase skin circulation by over 300%, for up to six hours.
(2) Rest, ice, compress, elevate (RICE). If your whole body is affected, try a cold water bath for 20 minutes. Epsom salts added to the water, and eucalyptus can be helpful.
(3) Do some light exercise– walking, stretching, yoga.
(4) Take fish oil supplements. This may reduce the inflammation somewhat.
(5) Get some protein in you: whey protein drinks, eggs, fish. This gives the body the amino acids it needs to rebuild torn muscle.
(6) Rest. Try to get at least an hour more sleep per day while you are recovering.
And of course, no smoking or over indulging in alcohol during DOMs. When you are ready to start up exercising again, work up to max gradually over a week.
It’s strange, but you would think that for someone experiencing neck, back, shoulder or any other type of musculoskeletal pain in his body, he would know exactly when it started, and how.
But surprisingly, this is not the case for a majority of patients I have seen over the years. Most cases of pain I see are idiopathic; meaning, “with no apparent cause (at least in the eyes of the patient).”
A typical history of such a patient goes something like this:
Me: “Ok Sue, I understand you are experiencing pain in your upper back, right side. When did it start, and how, to your knowledge?”
Patient: “At least the past five or so years. I don’t know what started it; it just seemed to have appeared gradually. It is good some days, then bad, and lately it has been getting worse, so I decided to get it checked.”
At this point, I continue with the history by asking questions related to the patient’s occupational, social/recreational, and past medical history. Usually there is something in the history that can be linked to the complaint, like a past car accident, a particular sports activity during college, or something about the physical requirements of her occupation. But in some cases, there still is nothing in the history that can explain the pain.
But where there is a problem, there is an answer. It’s just that sometimes the answer requires some smart detective work.
If you suffer from pain that can’t seem to be traced to a specific cause, realize that musculoskeletal pain, aside from systemic related disorders such as rheumatoid arthritis, lupus, bone disease, and others, develops from some kind of mechanical breakdown in the musculoskeletal system. It can be something obvious like a hard fall that injures and misaligns a joint; something seemingly innocuous like sleeping on your right side for most of your adult life; or something very subtle, like a subluxated heel bone that does its damage via a drip effect.
So, your best bet is to find a practitioner who is very experienced in human biomechanics. Chiropractors or physical therapists such as Craig Liebenson, DC who emphasize body kinematics and targeted exercise rehabilitation will typically have a keen eye for abnormal or dysfunctional movement. The course of treatment will involve identifying and acknowledging the problem; aggressive rehabilitative exercise regimen, and lifestyle modifications. Manual therapies may be employed, such as spinal manipulation; and orthotics may be required, at least during the initial phase of treatment.
This applies to conditions including unilateral hip or knee pain, TMJ pain, neck pain with right or left rotation, rib or sternum pain, and many others. Oftentimes the condition is secondary to a primary cause, so the doctor should not jump to conclusions and direct all treatment to the site of pain. A thorough investigation and inspection is required.
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