Balance exercises will put you on a proper footing

Last week I wrote about how important it is to be able to walk with comfort and with confidence. As we move through life from childhood to our senior years, this ability will have a large bearing on how independent we are.

I also outlined some of the things that can have an impact on the ability to walk. Neurological disorders like MS and Parkinson’s syndrome, arthritis, joint injuries and cerebrovascular accidents (strokes) all pose challenges to individuals who want to keep walking and stay fit, healthy and active.

From a fitness perspective, I highlighted the importance of proper posture and the need for adequate strength as well as how important it is to remain flexible while maintaining full range of motion in the ankles, knees, hips and lower back. Finally, I wrote about how walking is a single leg activity (you only ever have one foot on the ground when you are walking) so good balance becomes important when you are trying to walk around or over obstacles.

In this week’s column, I’ll be identifying some exercises that can help you improve your walking by addressing your posture, strength, flexibility and balance.

The first exercise might not look like it has much to do with walking, but, it is my favourite for working the “rear chain” and core muscles that help you build and maintain great posture. Remember, when you stand up straighter it becomes easier to lift your feet and avoid shuffling along.

The Bird Dog: Assume a kneeling position on the floor with your hands on the ground (the “all fours” position). Slowly lift your right arm and left leg until they are parallel to the floor. Hold for a 3 count. Repeat with the other arm and leg. Perform 5 repetitions with each side every other day. If you can’t do this exercise on the floor, stand with your hands balanced on a counter and do the move standing, lifting your right arm and left leg to the rear, hold for 3 seconds and then repeat with the other side.

Step Ups: Start with your right foot on the bottom step of a staircase. Use the handrail for balance, if necessary. Step up to place your left foot on the step and then step back down with the same foot. Perform 10 repetitions with your right foot staying in place. Repeat with the left leg and when you feel confident, move the working leg up to the second step. Do 3 sets of 10 repetitions every other day.

Hamstring and Hip Stretch Progression: You can do these stretches using the same bottom stair immediately following the step ups. Place your right heel on the bottom stair and stretch your torso forward over your extended right leg, sliding your hands down toward your shin. Imagine that you are trying to touch your stomach to your thigh, while keeping your leg straight. Hold for 20 seconds and then bend your leg while you place your foot flat on the step. Push your hips forward. You should feel a gentle stretch in the left hip flexor as well as in your left calf at this point. Hold for 20 seconds and then repeat both stretches with the other leg. It is important that you keep your eyes and chin up throughout both moves to prevent rounding the shoulders.

Walking Balance Series: Find an area where you can walk for about 20 feet and mark off a starting and ending point. You will be doing a series of 5 moves designed to help you walk with more comfort and confidence. Do them as a series with as little break in between as possible and use any assisted devices that you might need or hold someone’s hand, if necessary, for safety.

The five moves are:

1. Stand tall and “walk the plank” along an imaginary line on the floor, heel to toe, placing one foot in front of the other along the line.

2. Next, return to your starting point by walking sideways, moving one leg out to the side and dragging the back leg. Side step in the other direction back another 20 feet.

3. The third move is to strengthen the muscles around your shin that lift your toes and your foot when you are walking. Lift yourself up onto your heels and “heel walk” 20 feet.

4. Turn around and “toe walk” back to build strength in your calves.

5. The final move to do is to simply walk naturally back and forth in between the 20 foot markers. While you are doing this, slowly rotate your head and look from side to side to shift your focus. (If this causes you to lose balance, hold someone’s hand or hold on to a wall as you walk).

You can repeat the walking moves as often as you’d like and can do them along with the other postural, strength and flexibility moves outlined above. These are only a few of the hundreds of exercises and drills that can help build your confidence in your ability to walk. Like all exercises they can be modified to become easier or harder.

Simple outdoor exercise can help you manage feelings of anxiety

Anxiety is a general term for several disorders that cause nervousness, fear, apprehension, and worry. For many people, it can be overwhelming. It can also be unpredictable, and when it flares up can bring with it an array of physical and emotional problems including inability to focus, sleep disturbances, racing heart rate, headache, digestive problems and feelings of unease. Anxiety disorders should be treated by a qualified health professional and should be taken seriously. Luckily, treatments do exist that can help people manage their lives around anxiety. One important way people can start to manage the way they feel is to participate in an exercise program.

Exercise by itself cannot cure anxiety or depression. It can, however, bring many physical, emotional and psychological benefits to those who do get involved in a consistent, regular fitness program. Knowing this, the real challenge is for someone who feels they are “barely holding on” to find the motivation and wherewithal to actually start exercising and then keep going. The good news is that a program does not have to be overly time consuming, physically taxing or complicated to make a difference in someone’s life.

From my experience, the best way to get someone to stick to a regular fitness regimen, when they aren’t in the habit, is to have them first focus on the frequency with which they exercise.

A workout plan is built around four separate principles that make up what is called the FITT formula: Frequency (how many times per week you are exercising), intensity (how hard you are working out), type (the choice of what exercise to do) and time (per workout session).

In the case of anxiety and exercise, the frequency is more important than how hard and how long someone does a certain activity. I would recommend starting with three times per week and building up to five. Research has shown that even small bouts of exercise of 10 minutes, spread over the week, produces positive outcomes. As the habit takes hold, the exerciser can increase their duration to 20 or 30 minutes per session and get even more benefit.

While frequency is critical, the second principle to be concerned with is the type of exercise. Most fitness activities can help to diminish anxiety-related symptoms, but the most significant is aerobic exercise that elevates your heart rate for a period of time. The most common symptom of an anxiety or panic attack is a racing heart. When someone performs aerobic exercise, their heart rate speeds up and their heart and lungs become stronger and more efficient over time resulting in a lower resting heart rate between exercise sessions. The feelings that come along with the benefits of an improved cardiovascular system include an overall feeling of well-being and improved self-esteem. This alone can help to offset anxious feelings.

Many of my clients have told me that when they do an aerobic workout like hiking, biking, swimming or jogging, they almost feel like they are meditating. Problems seem to work themselves out as they go about their activity and they feel refreshed and have more mental clarity when they are done.

No matter which activity they do, it seems that the rhythmic nature of the workout, along with faster breathing and elevated heart rate relaxes them, leaving them feeling positive, able to concentrate better and proud of what they’ve accomplished. Many times, I have measured a client’s blood pressure before and after a workout and their high blood pressure will be in the normal/ healthy range when they are finished. The stress of the workout has an immediate relaxing effect on the cardiovascular system.

While all aerobic exercise can be good for you, there is an additional bonus if you do your exercise outdoors. Being in nature provides a distraction and a shift of focus for someone who is having trouble focusing due to an anxiety. While treadmills and stationary bikes are great tools, there is just something about being in the sunshine, navigating the earth that makes people feel more alive.

Here, then, is the perfect way to exercise for someone who is trying to manage anxiety.

1. Plan to do some aerobic exercise, three times per week to start. After three consecutive weeks of three sessions per week, add a fourth workout. After four consecutive weeks of four sessions, add a fifth day.

2. Decide on an activity you can do with little thought or planning. It should be something that you could do spontaneously with no travel time needed to start. Hiking, walking/jogging, swimming and cycling are your best options.

3. Move at an intensity that increases your heart rate and your breathing. You are at the right intensity if you can only speak three or four words before having to take a breath. If you can speak in an endless monologue, you aren’t working hard enough.

4. Whenever possible, take your workout outdoors and into nature as much as possible. In Hamilton, we are blessed with seemingly endless shared cycling and pedestrian trails through forests and along waterfronts.

When you are faced with a condition like an anxiety disorder, many things are out of your control. Take the initiative to control what you can; get regular aerobic exercise, outdoors and see how much better you feel because of it.

How to look out for number 1

As I was brainstorming subjects for my Fitness Solutions column, there was one item that popped up more than once. Because of what I do and the types of people that I see, many of my interactions are with a client’s family, friends and support staff, all working to help a loved one access the services I offer. For lack of a better term, you could say that I speak with many people in the role of “caregiver.” These include parents who juggle jobs and the seemingly endless demands of their children as well as caring for aging parents.

While the caregivers I work with are heroic in their selflessness, many of them are exhausted, stressed out and so focused on helping others that their own health and fitness is compromised. At the very least, many of them are on the verge of burn out and are barely holding on. As a business owner, a husband of someone living with MS, and the father of a teen and a tween, I speak from experience. The rewards of helping someone that truly needs you are immeasurable, but … it ain’t always easy!

If you’ve ever flown on an airplane, you’ve sat through the demonstration of how to apply your oxygen mask in the case of emergency. The most important instruction is to apply your own mask before attempting to aid someone else. Simply put, if you have passed out because you can’t breathe, you can’t help anyone else and then you’re all in big trouble. The analogy holds true for caregivers who don’t get enough sleep, go hours without eating and skip daily exercise because they just “don’t have the time.”

Eventually, they become the ones who need to be helped as they struggle with high blood pressure, back pain, obesity, diabetes or some other chronic condition. At this point, they start to suffer along with their loved ones.

Taking care of yourself while helping others doesn’t lessen your ability to look after them, it actually enhances it. Having energy and physical stamina allows you to focus better, be more creative and to be more productive for longer. There is also a very good chance the your quality of care you give will improve as your fitness level increases.

From my own experience and from observing successful parents, guardians and allied health professionals over the past 25 years, I’ve come up with some strategies that can help you to put yourself first … so you can take even better care of your loved ones who depend on you.

1. Do not skip meals. There’s nothing worse than trying to focus on something important when your blood sugar is dropping. It leads to rushed work that is less than stellar.

When you cook healthy meals, make extra. Store your leftovers in plastic containers or freeze them for later use. With a bunch of meals already prepared and ready to go, you won’t have the excuse of “I didn’t have time” when you’re heading out the door.

If you’re in the habit of packing lunches, set up one extra lunch bag for yourself and fill it so it’s ready to grab when you need it the next day. Even if you’re eating at home, there’s nothing better than looking in the fridge and seeing a complete, packed meal for you when you’re hungry.

2. Schedule exercise time for yourself that is an unbreakable appointment.

If you use a day planner, schedule three workout sessions per week for you and you alone. You’ll decide what exactly to do on those days after you’ve made the appointment.

My family knows that unless the house is burning down or someone is in the Emergency Room, I am going cycling on Sunday mornings! It is MY time for rejuvenating and making me feel like I actually matter.

3. Multi-task. Get your workout by running to the bank to make a deposit, write a meal plan while your kids are swimming, steam some brown rice while you fold laundry or do a core workout while you watch TV. Figure out how to do more than one thing at a time to “find” more time.

4. Forget the “All or Nothing” mentality. If you think it takes huge effort and time to get great results, you are wrong. Just 10 minutes of focused, efficient exercise is often enough to get you moving in a new direction (and always better than doing nothing). As you get stronger and “find” more time, you can expand on this and continue to improve.

I know that it’s a hard concept to embrace when you feel like you’re the one holding so many lives together, but, once you start taking the time to make YOU better, you’ll be amazed at the positive spillover effect it has on those in your care.

Fit at 40, 50, 60 … and beyond

Two weeks ago, my mother phoned me. She asked, “Do you know that it’s your birthday in two weeks?” I said, “Yes, Mom, I know my birthday is coming up.” Then she added … “Do you know that you’re turning 50? … FIFTY … Wow!”

Part of my practice, since 1993, has been helping clients manage the effects of aging. People call me all the time when they reach a milestone “0” Birthday. It usually starts at 40, picks up momentum at 50, reaches a fever pitch at 60 and then settles into acceptance at 70 and beyond.

I’m not sure if reaching 50 is supposed to make me feel old or if it should make my mother feel old. It does, however, make me pause and think “Wow, I’m 50!” A small part of me feels like there must be some mistake while a much bigger part couldn’t care less. I hadn’t thought of it for a second until my Mom called. I guess that’s a good thing!

Last night at midnight, it happened. I officially left my 40s. This morning, the sun rose, the cat wanted food and I went off to work. Aside from the phone calls, Facebook greetings and birthday emails, today is just another day.

While a “zero” birthday might be a wake-up call that you are aging, it can also provide clarity and focus to help you thrive in the next decade. Too many people live in denial trying to do the things they did when they were younger and then getting depressed because “things aren’t like they used to be.” That’s life, change is inevitable. The sooner you get over it and accept your new reality, the sooner you’ll be loving life and looking forward to new challenges.

For the purpose of this article, I want to address three physical characteristics we need to monitor as we age; bone health, cardiovascular fitness and muscular strength. Ignore these three and mid-life might not be so kind to you. Maximize them and the sky’s the limit!

With age, bones tend to shrink in size and density. In some cases, this can lead to osteoporosis, making you more susceptible to fractures and less able to maintain an active life. While there is a strong genetic link to osteoporosis along with a relationship to hormonal changes and deficiencies in the diet, lifestyle can play a major role in offsetting bone loss.

In considering cardiovascular fitness, there is a good news/bad news scenario that comes with aging. The good news is that regular exercisers who challenge themselves are able to slow the inevitable decline of aerobic capacity. The bad news is that the decline is inevitable and starts around 45. When it comes to the health of your heart and lungs, the ball really is in your court.

Finally, unless we do something to offset the effects of getting older, our muscles will start to shrink and lose flexibility somewhere between 30 and 50 years of age. You’ll look less toned and your performance in everyday activities and in sporting pursuits will start to diminish. Luckily, there is evidence that working to build and keep the muscles you have can slow the process and keep you at peak fitness far into your senior years.

From my own experience and from observing many clients who are successfully navigating their “zero” birthdays, here are three keys that I’ve come up with to keep your bones, your heart and your muscles fit and strong.

1. Challenge your muscles and bones with resistance exercises such as weight lifting, body weight moves and functional movements that mimic your daily activities: lifting, carrying uneven loads or hitting a golf ball. The strength of your bones will especially benefit from exercises that require you to stand on your feet. Bearing weight on your feet requires your bones to work hard against gravity, making them stronger.

2. Do aerobic exercise sessions 3 to 5 times per week and base your intensity level on an honest assessment of how hard you are working. Let’s be real, you know when you are slacking and you know when you’re working too hard. When you are walking, cycling or doing other endurance activities, find a pace that you can maintain for up to 30 minutes that lands somewhere between “comfortable” and “challenging.”

3. Recognize that while you can still do lots of activity at your age, you probably can’t do the same things you did when you were 20, 30 or 40. If you can, it will at least take more out of you and require more recovery. As you get older, place as much importance on recovering between workouts as you do on pushing yourself when you exercise. This means taking full days off from activity and focusing on sound nutrition.

I am pleased to say that I am looking forward to the next 10 years of my life and the challenges that they bring. In the meantime, people have been telling me that I should do something special to mark the occasion of turning 50, so this past weekend, I completed a 50 km mountain bike ride to celebrate! I paced myself and took the next day off to recover.

Getting back in the game

Over the last few months, I’ve written about how I help clients manage their medical conditions with exercise. Professionally, it’s been a great way to educate and bring hope to those feeling overwhelmed by their circumstances. The majority of people that contact me do so with a certain level of frustration. We have more health and fitness information available than at any other time in history, but people are more confused than ever.

On a personal level, my experience with fitness solutions has been deeply satisfying. In this short time, I’ve had people cry, laugh and celebrate with me as they’ve begun to take back their lives. When someone is finally able to shift their mindset from overwhelm to clarity and then to focus, something magical happens. As hard as it is to “just get going,” it’s even harder to stop when you start noticing changes and sense that you are moving in a new direction.

All of this has been happening at an interesting time for me. I’ve been managing torn rotator cuffs and shoulder pain for a few years and decided to have surgery in 2016. On April 12, I underwent a pretty extensive operation for my right shoulder. Torn rotator cuffs were sutured, my “frayed” bicep tendon was reattached, the damaged bursa was removed and the joint itself was cleaned out of arthritic changes. A lifetime of contact sports and heavy weight training had really taken its toll on my shoulder.

Leading up to the operation, I considered my situation just like I would any client with this challenge. There were many times when I felt overwhelmed and frustrated. Pain and disability can lead to fatigue and depression, and I definitely had my moments. My tipping point came when I had to throw the ball underhand at the annual parent/kid baseball game in our park. I knew things had to change!

Setting a surgery date gave me the clarity I needed to develop a plan of action to get things moving just like I would do with anyone who came to see me. “>The program that I came up with consisted of four parts and would take me far beyond the date of my operation. Here are the phases that I created for myself.

“Pre-habilitation”

Most people have heard of doing rehabilitation after an injury or operation. There is evidence, however, that doing strength and conditioning exercise before undergoing a procedure can improve the odds of a favourable outcome and reduce the time it takes to recover following surgery. It’s important to note that this is different than working on the injury itself. In my case, this meant working around my injured shoulder to build as much supportive muscle as possible to stabilize the joint. I worked with rubber resistance bands and free weights to strengthen my upper back around the shoulder blades and the rotator cuffs. A big part of this phase is to enhance posture which can help decrease pain and minimize further damage to the joint.

Rehabilitation

The goal of rehab is to bring the repaired area back to full function as efficiently as possible. For me, this meant doing a range of motion exercises less than 24 hours after leaving the operating room. It’s no small feat to raise your arm when it is sore and swollen and you’re just starting to come out of the fog of anesthetic! Hats off to my surgeon who urged me to get moving as quickly as possible. It helped me to feel like I had some control over my situation. Currently, I am working with a physiotherapist on strengthening exercises that she designs for me. This phase can last up to 16 weeks and I am at the 10-week mark.

Reconditioning

Rehab and physiotherapy last for 16 weeks and reconditioning picks up at that point. Once my shoulder is back to full function, it will be weak and lacking in endurance. The goal of the reconditioning period is to build the strength and endurance that I’ve lost throughout my entire body. I haven’t had a proper workout in months! Another common side-effect of surgery is weight gain. The combination of no exercise and “comfort eating” have resulted in me gaining 12 pounds of unwanted body fat that I am determined to lose as soon as possible.

Possibility

To keep people really engaged throughout this process, I would suggest that “possibility” might be the most important phase of all. Rather than simply “getting better” and then working on maintenance, possibility explores what exactly you’d like to do once you are no longer in pain and injured. For me, it means that I will be mountain biking in the fall and playing hockey in the winter. My full return to sport should be in October, which is the six-month mark post-surgery.

Obviously, a plan like this would be modified depending on someone’s personal situation, but, the point is that clarity, focus and planning are the best tools for getting beyond overwhelm and frustration and moving on to rehabilitation and possibility.

Finding your balance, part 2

In last week’s Fitness Solutions Column, I wrote about the importance of balance and how to assess it. (Visit thespec.com and search “Schramayr” if you missed it.) This week, I’d like to give you an idea of how you can improve your balance and include some of the exercises and tips that have most benefitted my clients.

To recap; I wrote about how balance and stability are related to your “functional capacity.” This is your ability to do different things such as housework, yard work, child care and the demands of your job. It also determines how and what you can do in the way of recreation, travel, hobbies and sports. As we age, maintaining our functional capacity also becomes a matter of safety. Falls are a very serious problem among the older population and improved balance, stability and co-ordination can decrease the risk of serious falls.

The 6 assessments that I described last week were broken down into two areas. The first measured whether you could hold yourself stable while balancing and the second was more active, where clients were not only balancing, but also moving their bodies in a variety of ways.

Once you have a good baseline score from the assessments, it’s time to get to work. After a few weeks of incorporating these moves into your fitness plan, I would recommend retesting yourself to see if you’ve improved and by how much. As your scores improve, you can move onto the more challenging assessments that I described.

Here are 5 of my favourite balance building moves to add to your weekly regimen.

1. Single leg hold during active rest. When you exercise, there are natural breaks after sets or at the end of a round of circuit exercises. Rather than resting, get up on your feet and do a 30 second Single Leg Hold while you recover. Experiment with different leg positions. You can simply lift one foot off of the ground, or raise your knee up to waist height for a more dynamic move. You can also hold the “floating” leg straight out to the side of your body for an added challenge.

2. Use resistance bands and experiment with different foot positions. I love incorporating resistance bands into client’s workouts for exercises like chest presses or for rowing moves. As you move further away from the spot where the band is anchored, there will be more resistance and your core will have to flex to stabilize your body. You can alter your foot position from wide to narrow and from staggered to parallel for a variety of balance and stability challenges. An added bonus is that these moves really work your core muscles.

3. Uneven weight distribution. My favourite way to do this is to hold a dumbbell in one hand only while doing squats. With an uneven load, your body will have to work hard to stabilize itself and to co-ordinate movement. Imagine the effort it takes to hold a bag of groceries or a baby in one arm while bending to pick up a dropped set of keys.

4. Do single leg hold exercises progressing from very stable to very unstable. You can do this by wearing shoes on a hard floor, progressing to no shoes, then moving to a soft surface, like a carpet or a lawn, and finally to a very unstable surface like a pillow or on sand. Always make sure you have a chair or partner nearby who can help you if you stumble during this exercise.

5. Walk the Plank! Find a line on the floor or stick a piece of masking tape on the ground. Walk the length of the line “heel to toe” with your arms out if you are unsteady. With my clients, I have them progress to “Walking the Plank” along a 2 X 4 on the floor. It’s challenging to say the least.

My favourite thing about these 5 moves is that they can be modified for all fitness levels. They can be super easy or made to challenge even the most elite athletes. Start slowly and make sure you always have something you can grab onto if you feel uneasy or awkward.

This past weekend was a milestone for me in my return to health and fitness since having shoulder surgery 9 weeks ago. I had a great Father’s Day on Sunday that included my first bicycle ride of the year. It was a gorgeous, sunny day and I rode 30 kilometres from Hamilton over to the lift bridge in Burlington and back. Today, it’s back to physiotherapy and more strengthening and stretching exercises.

Tools to help you find your balance

When someone’s fitness level is assessed, we tend to measure strength, endurance and flexibility. In my practice, I also like to look at someone’s functional capacity. My clients are usually with me because a loss of balance and/or stability make it very difficult for them to do things they love, like hitting a golf ball, riding a bike or even just going for a walk.

Losing balance can occur from a number of factors. Diseases like Parkinson’s, MS, stroke and arthritis interfere with the body’s ability to maintain balance and stability due to dysfunction of the muscular and nervous systems. Even in healthy individuals, the cells in the part of the brain that help us to stay upright begin to die off as we age. When this happens, it gets harder to correct the body as it moves through space and has to navigate things like curbs, stones or uneven surfaces. Vision and hearing problems make it difficult to channel information and the use of some medications and/or blood pressure issues can result in dizziness.

Loss of muscle strength, power, co-ordination and reflexes can play a massive role in someone’s ability to balance and stabilize themselves in their everyday lives and in their extracurricular activities. Fortunately, this is the area where we have the most control and where I am most able to help people.

As part of a two-part series on assessing and improving balance, here are my favourite ways to judge the balance and stability of my clients.

1. Single Leg Hold

Stand on one foot and time how long it takes before you touch your opposite foot to the ground. Record your score and repeat with the other foot. If you have serious balance issues, stay near a wall or chair that you can grab in case you wobble.

2. Abdominal Plank

Balance yourself on the floor from your toes and your elbows for as long as you are able to hold, pain free. Do not hold your breath in this position! This is a great measure of core strength and stability.

3. Single Leg Chair Touch

This is a much more advanced version of the Single Leg Hold. Balance on your left foot in front of a chair. Bend at the left knee and touch the chair as many times as you can with your right hand. If you stumble and have to touch the floor with your opposite foot, continue where you left off without restarting the timer and record how many touches you get in 30 seconds.

4. Standing to Lying to Standing

This test should not be performed by people with low blood pressure, back pain or problems with dizziness. Stand in front of an exercise mat and start a timer for 60 seconds. Lie down on the mat on your back and then stand back up. Record how many times you can go from standing to lying to standing in 60 seconds.

5. Modified Standing to Lying to Standing

I came up with a modified version of this test for seniors or others that find it challenging to simply get on the floor. Rather than repeating for 60 seconds, I have the client lie down and stand up only once and then record the time it takes.

6. Timed Up and Go “TUG” Test

This test is very useful for people with conditions like MS, Parkinson’s and Arthritis or post-stroke. The client sits in a straight back chair and a spot is identified 3 metres away. At a signal, the client will rise (using assisting devices if necessary) and walk to the 3 metre mark, turn, return to the chair and sit down. Their time is recorded for retesting later on.

I’ll pick and choose from the tests outlined above depending on a client’s current fitness level and or level of impairment. When I get a score, we’ll use it to compare to a retest every few weeks. Recently, I had a client improve on the Stand to Lie to Stand from 4 to 8 ½ repetitions in just 4 weeks and another client decrease his Modified Stand to Lie to Stand score from 105 seconds to 28 in the first month. These improvements are significant and will have a huge impact on their daily lives.

Next week, I’ll let you in on some of the exercises that my clients use to get the kind of improvements that carry over to their lives in meaningful ways.

I’ve started physiotherapy for my surgically repaired shoulder in the past week. This means that I’m working on strengthening and moving it more these days. I’m a little sore today, but I was able to shovel top soil into the garden on the weekend, play a game of pool and even strummed my guitar for the first time in two months. Slowly, but, surely I’m getting back in the game.

Tweak your workout for life changing results

I’ve been in Collingwood for the past several days with my family for my daughter’s dance competition. We decided to make it a bit of a vacation and take in the scenery at Blue Mountain where the event is being held. The views here are absolutely gorgeous and inspiring.

Our road trip coincided with the fact that I was moving into a new phase of recovery following rotator cuff surgery. Aside from daily mobility stretches, my arm has been completely immobilized for five weeks to allow it to heal properly. While in Collingwood I was able to remove my arm from its sling, so I decided to do my first workout in six weeks in the hotel gym.

My workout started with “body weight only” arm movements before moving on to leg and core exercises and then about 30 minutes of cardiovascular work.

While I was in the gym at the hotel, I got to observe a nice, older gentleman come in for his own workout. He looked to be about 72 years old and looked like he had been sitting, hunched over a desk for at least 40 of those years. His posture was terrible with his head jutting forward, his shoulders rounded and his lower back flattened. Nevertheless, I was impressed that he was making the effort to work out while on vacation!

While I was riding the stationary bike, I watched him go through his routine with great efficiency. He had clearly done this before. As I watched him, it occurred to me that he was doing exactly opposite of what I would have assigned him for a workout if he were my client!

A common mistake that many exercisers make is to only work on the parts of the body that they can “see in the mirror.” This man was doing exactly that. He started by riding the recumbent bicycle for 15 minutes, pushed up close to the handlebars. While the cycling might have elevated his heart rate, it put him in a position that made his postural problems worse and did nothing to warm up his joints and muscles.

After his warmup, he moved on to strength exercises. Chest presses, abdominal crunches, leg extensions and finally bicep curls. Every one of these moves strengthens a muscle group at the front of the body, which in his case was already too tight. He ignored the muscles that he couldn’t see which could help him stand up straighter.

To make matters worse, he performed his entire routine sitting down, slouching forward.

So … to reiterate, I admire this man for going to the workout room and putting in the effort. I feel for him, knowing that his diligence could be moving him in the wrong direction. He’s not just wasting his time; he might actually be making himself worse!

The good news is that his workout routine could be fixed very easily. Here is what I would do if he were my client.

First, I would get him out of his seat! Sitting, slouched over a recumbent cycle is the wrong way for him to warm up. I would have him perform a series of chopping movements with a medicine ball or a light dumbbell, standing up, and emphasizing proper posture and alignment of the spine.

For strength training, he could continue with the exercises that he is comfortable with, but, rather than sitting and resting between sets, he would perform at least two exercises for the back of the body. Rather than doing a set of Chest Presses and then resting, he would do the presses followed immediately by a rowing exercise and then by a back extension. He would rest, standing up, before starting the cycle of three exercises over again. This “superset” method could be applied for each of the exercises he was already doing.

After strength training, he would perform up to 12 minutes of aerobic exercise, on his feet, using the elliptical trainer or the treadmill. Every three minutes, he would speed up for a 20 second burst of effort for the duration of the 12 minute session.

A great way for this gentleman to complete his workout would be with some static stretches, specifically for the tight muscles at the front of his body while he was cooling down.

With just a few tweaks, a disastrous workout can become a routine that can be life changing for an exerciser that is well intentioned and disciplined, but, lacking in direction.

How to keep your joints strong and mobile

When I started writing Fitness Solutions, I introduced readers to the “7 most common conditions that I help people manage with exercise.” It’s important to reinforce that the job of a medical exercise specialist is never to diagnose or to treat a condition. Diagnosis is left to medical doctors and treatment is the domain of physiotherapists. What I do is help people manage their conditions with exercise.

One of the most common problems that I help people overcome are joint disorders related to osteoarthritis (OA).

Osteoarthritis refers to the arthritic changes that happen in a joint due to age, injury, overuse or just daily wear and tear. It involves inflammation and can start in the cartilage before spreading to the opposing bones. Cartilage is the tissue in a joint that provides “shock absorption” so when inflammation happens, the joint loses its integrity and bony surfaces become rough and don’t slide over each other as well as they used to. Pain and instability are common and if the joint affected is for weight-bearing like the knee, ankle or hip, and loss of function can be expected.

If you have arthritis and are starting an exercise program, it is important to go slow, modify your plan through trial and error and develop a balanced program. Balance means doing a combination of strength training, flexibility exercise and endurance activity. Balance also means working at a level that is challenging enough to stimulate the body to get stronger while not so difficult that you can’t recover between sessions. My favourite way to do this is to use several different training modalities. Some workouts are for times when you may not feel your best and others for when you really want to push yourself.

Here are my three favourite workouts for people dealing with joint problems due to osteoarthritis.

1. Aquatic exercise. The thing that I love about working in the water is that it is so adaptable to all fitness levels and is so low impact. If you are sore and tired, just walking and stretching in a warm pool can do wonders for your recovery. On the other hand using things like deep water vests and water dumbbells can allow you to do a workout similar to being in a gym for when you want to really push things.

2. Weight training. For building supportive muscle around an arthritic joint, there is nothing that works as well as weight lifting. Whether you use free weights, machines or rubber resistance bands, the key is to work in a pain-free range of motion and to build muscle equally on all sides of the joint.

3. Static stretching. Joints that are affected by OA become stiff. Stretching the muscles around that joint can help restore proper range of motion and even decrease pain as function is restored. Like weight lifting, you should only ever stretch within a pain-free range of motion. My recommendation is to spend some time warming up, either in a hot shower or by doing some cardiovascular work before doing a stretching routine.

When you do get into a routine of strengthening, stretching and building endurance, it’s important to monitor how you feel. I always tell my clients that it’s OK to feel muscle soreness, but, it is never OK to experience joint pain. OA sufferers may require more time between sessions due to pain, swelling or fatigue and having alternatives to an all out workout is crucial. Arthritis pain shouldn’t be worked “through,” but, it can often be worked “around.”

My own rehabilitation after rotator cuff surgery is entering a new phase this week. The first was to immobilize the joint to allow it to heal. This was done by staying in a sling at all times other than when doing mobility stretches.

On Thursday, I will be out of the sling and will start to use my muscles to lift my arm in several planes of motion against gravity. I’ll also be working with a physiotherapist who will start to actively mobilize my shoulder. Thinking of this, it occurred to me that, other than walking and staying active, for the first time in my life I haven’t actually exercised in 6 weeks!

With summer approaching, I’m really excited to get moving again, with a plan, as my shoulder gets stronger. I’ll work on losing the eight pounds I’ve gained since my operation as well as getting back to mountain biking and then back to men’s hockey in the fall.

Here’s help managing your energy level

When you think of the different pieces of the puzzle that make up someone’s health and fitness, there are three things that jump out at you: Strength, endurance and flexibility. There’s no doubt that these three are critical, but, I would suggest that a fourth might be just as important … if not more so. The fourth key to real, long-term fitness I would suggest we consider is energy.

We live in a world that is increasingly connected and that never shuts down and as a result, we have a population that is tired, stressed and lacking in vitality. The reality is that this isn’t going to change any time soon, so it becomes even more important to learn how to manage your energy levels while you navigate your daily life.

On most days, I have a client that tells me that they are sick and tired of … feeling sick and tired. When they come to me, they’re frustrated because they think they’re doing all of the right things and still not seeing a payoff. The good news is that, with a few tweaks, increasing your energy levels can happen almost overnight.

When I meet someone who says they have “no energy,” I discover they are usually missing out on one of the four key elements that provide the kind of endurance that gets people out of bed in the morning and feeling alert and awake long into the afternoon and evening.

These four key elements are:

• Blood sugar stabilization through nutrition

• Efficient oxygen transportation from fitness training

• Balance and recovery via sleep and stress management

• Mental renewal through hobbies and play

I can think of one client in particular who felt like her whole life was a struggle just to make it to the end of the day and then go home to crash. She thought that she was eating “healthy” and she was walking a couple of times per week. After getting to know her, she handed me her food journal. Her diet was, indeed, quite healthy. Mostly homemade and very few empty calories. What really stood out were the long gaps between meals or snacks. She ate breakfast before going to work and then usually had nothing to eat until dinner 12 to 14 hours later! Her blood sugar levels would drop to nothing and she would be so tired that she sometimes felt dizzy. She started packing a lunch and an afternoon snack that included some protein and, as her blood sugar levels stayed consistent throughout the day, her mid-afternoon slump disappeared.

The walks she was taking were leisurely at best and mostly on weekends. It became a priority for us to design a quick, efficient workout she could do at home three times per week to build her strength and aerobic capacity. While not long, her workouts included higher intensity exercise “bursts” to make her better at moving oxygen rich blood throughout her body.

An interesting thing happened as her vitality increased. Her days became more productive, so she got more done at work and did more at home after work. When it was time for bed, she slept more soundly then she did in years, meaning that she didn’t feel like she was dragging the moment she got up in the morning.

One of the things that she started to do with her new-found energy after work was to get back to her hobbies, which included doing arts and crafts. The importance of this can’t be overstated. Most adults lose the ability to “play” or just do things for the fun of it. Playing and participating in hobbies helps us to relax and brings our stress levels down. The benefits can be similar to those you receive after a vacation. It helps bring perspective back into our lives and even gives us a sense of control when our days might feel like they are controlled by everyone else. It’s the reason your doctor plays golf every Wednesday! For you, it can mean learning guitar in the evening, growing tomatoes in your backyard or colouring in an adult colouring book. When you feel renewed, you are given a new beginning with a full tank.

Last week, I had my surgical followup for my shoulder. I’m happy to say that I seem to be right on schedule. My range of motion is a little bit better than average and I will be adding a fourth set to my stretches during the day. Other than that, I am still in a sling for the next three weeks and learning to live with one arm. My pain level is still extremely low and I haven’t taken a pain pill since the third night after the operation. Basically, my instructions are to protect my shoulder, keep it close to my body and let it heal. Easier said than done!