John Fodor’s Health Corner

This is the 4^th and final follow-up to A Well-Rounded Exercise Program, posted on October 24, 2007. That posting gave a general overview of a well-rounded exercise program. The previous follow-up postings included one on warm up and stretching exercises, one on endurance exercises and one on strength exercises.

This posting on balance exercises relates somewhat to Falls Can Kill You, which was posted on 11/1/07. In that posting it was pointed out that muscle weakness, poor balance and lack of flexibility are some of the things that make people prone to falls. It was also noted that falls can lead to serious health problems, such as hip fractures and head trauma and that falls are the sixth leading cause of death among people over 65.

It follows, then, that one way to help prevent falls and avoid disabilities that may result from falling is to do balance exercises. These exercises will help build leg muscles and increases flexibility in your lower body. Most of them can be done easily in the home without any special equipment.

Before getting into specific balance exercises, here are some suggested guidelines from the National Institutes for Health. <http://nihseniorhealth.gov/exercise/ balanceexercises/01.html>

· You may need to start out your balance exercises by holding on to a chair or table Hold onto a table or chair for balance with only one hand. As you progress, try holding on with only one fingertip.

· As you become steadier and more confident, do the exercises without holding on at all. You might want to have someone watch you the first few times in case you lose your balance.

· If you are very steady on your feet, move on to doing the exercises using no hands then with your eyes closed. Again, have someone stand close by in case you become unsteady.

Using the above guidelines, try the following balance exercises,

Side Leg Raises that strengthen muscles at sides of the hips and thighs. Stand straight, directly behind a table or chair with your feet slightly apart.

1. Hold table or chair for balance.
2. Slowly lift one leg to side, 6 to 12 inches out to the side. Keep your back and both legs straight. Don’t point your toes downward - keep them facing forward. Hold position.
3. Slowly lower leg. Repeat with other leg.
4. Keep back and knees straight throughout exercise.
5. Alternate legs until you repeat exercise 8 to 15 times with each leg.
6. Rest. Do another set of 8 to 15 alternating repetitions.

Hip Flexion for strengthening thigh and hip muscles. As you progress, you can increase resistance by adding ankle weights.

1. Stand straight; hold onto a table or chair for balance.

2. Slowly bend one knee toward chest, without bending waist or hips.

3. Hold position for 1 second.

4. Slowly lower leg all the way down. Pause.

5. Repeat with other leg.

6. Alternate legs until you have done 8 to 15 repetitions with each leg.

7. Rest; then do another set of 8 to 15 alternating repetitions.

Hip Extension for strengthening buttock and lower-back muscles. As you progress, you can increase resistance by adding ankle weights.

1. Stand 12 to 18 inches from a table or chair, feet slightly apart.

2. Bend forward at hips at about 45-degree angle; hold onto a table or chair for balance.

3. Slowly lift one leg straight backwards without bending your knee, pointing your toes, or bending your upper body any farther forward.
4. Hold position for 1 second.
5. Slowly lower leg. Pause.
6. Repeat with other leg.
7. Alternate legs until you have done 8 to 15 repetitions with each leg.
8. Rest; then do another set of 8 to 15 alternating repetitions.

The following are additional balance exercises you can do almost anytime and anywhere. When you first try these, have something sturdy to hold onto in case you start to lose your balance.

• Walk heel-to-toe. Position your heel just in front of the toes of the opposite foot each time you take a step. Your heel and toes should touch or almost touch.
• Stand on one foot on one foot than on another (This could be done at home or while waiting in line at the grocery store or at the bus stop).
• From time to time check your progress by standing on one foot for as long as you can. Then do the same thing on the other foot.

Whenever possible, try to incorporate these balance exercises into your strength training sessions. As with other strength exercises, don’t do the same exercises two days in a row. Give your muscles a chance to rest.

If you haven’t already done so, start your exercise program today. For maximum benefit, include each of the components of a well-rounded exercise program: (1) The warm-up and stretching phase, (2) Endurance exercises, (3) Strength exercises and (4) Balance exercises.

A word of Caution!

If you have been relatively inactive or have a chronic health condition, check with your Doctor before you start your exercise program to see if there should be any restrictions.

This is the third follow-up posting to A Well-Rounded Exercise Program that I posted on my site on October 24, 2007. That posting gave a general overview of a well-rounded exercise program.

Strength exercises are exercises that work muscle groups against weight resistance. The resistance can be your body weight, free weights that you lift or exercise machines, which have weights attached to some type of pulley system that allows you to lift, push or pull weights. These types of exercises are beneficial to your muscles, bones, tendons and ligaments.

When doing strength exercises try to work all muscle groups (legs, arms, back, chest, shoulders and abdomen) against resistance. It’s a good idea to start out with lighter weights, and then gradually increase weights over a period of time. For best results, you should participate in resistance-type exercise for 20 to 30 minutes two to three times a week. You might need to start out using as little as one or two pounds of weight or no weight at all, depending on how fit you are. For maximum benefit, challenge your muscles by adding an additional amount of weight gradually.

Here are some additional strength-exercise guidelines adapted from the National Institute on Aging and the Centers for Disease Control and Prevention.

1. Before you start lifting or pushing weights, it’s a good idea to do a brief warm up by stretching the different muscle groups in your arms, legs and back. Also keep well hydrated by drinking some water before, during and after your strength-training session.

2. Give your muscle groups a chance to rest between workouts. Don’t do strength exercises of the same muscle group on any two days in a row.

3. When lifting or pushing weights, do eight to twelve repetitions in a row. Wait a minute then do another set of eight to twelve repetitions in a row of the same exercise. While waiting it is a good idea to stretch the muscles you were just working.

4. Avoid holding your breath when doing when doing strength exercises. Be sure to breathe out as you lift or push a weight and breathe in as you relax.

5. Use slow, even movements rather than jerky and quick movements. A rule of thumb is to take about three seconds to lift or push a weight into place, hold the position for one second and take another three seconds to lower the weight.

6. Don’t try to lift or push weights that are too heavy. If you can’t lift or push a weight eight times in a row, it’s probably too heavy. decrease the weight slightly.

7. If you can lift or push a weight more than fifteen times in a row, it’s probably too light. Increase the amount of weight.

8. Avoid locking the joints of your arms or legs into a strained position while lifting or pushing a weight. This can cause damage to the joints and ligaments.

9. Pay attention to how you feel when doing strength exercises. Muscle soreness lasting a few days and slight fatigue are normal after muscle building exercises. Exhaustion, sore joints, and painful muscle pulls are not normal.

Exercises You Can Do In Your Home

If you are elderly or don’t have access to gyms with weight-training equipment, you can do many strength exercises in your own home. The National Institute for Aging has recommended the following exercises that can be done in your home (Exercises to try, 2005. National Institute on Aging <http://nihseniorhealth.gov/exercise/ strengthexercises/04.html>).

Arm Raises to strengthen your shoulder muscles

1. Sit in a chair with your back straight.
2. Keep feet flat on the floor even with your shoulders.
3. Hold hand weights straight down at your sides with palms facing inward. You can use as little as one or two pound hand weights or you can substitute cans of soup. Some people start without weights.
4. Raise both arms to side, shoulder height.
5. Hold the position for one second.
6. Slowly lower arms to the sides. Pause.
7. Repeat 8 to 12 times.
8. Rest. Do another set of 8 to 12 repetitions.

Chair stands to strengthen stomach and thigh muscles

1. Place pillows against back of chair.
2. Sit in middle or toward front of chair, knees bent, feet flat on floor.
3. Lean back on pillows in half-reclining position, keeping your back and shoulders straight.
4. Raise upper body forward until sitting upright, using hands as little as possible - or not at all, if you can. Your back should no longer lean against the pillows.
5. Slowly stand up, using hands as little as possible.
6. Slowly sit back down. Keep back and shoulders straight throughout exercise.
7. Repeat 8 to 12 times. Rest. Then do another set 8 to 12 repitions.

Biceps Curls to strengthen front part of upper-arm muscles

1. Sit in armless chair. Keep feet flat and even with shoulders.

2. Hold hand weights at sides, arms straight, palms facing toward your body.

3. Slowly bend one elbow, lifting weight toward chest. Be sure to rotate palm to face shoulder while lifting weight.

4. Hold position for one second. Slowly lower arm to starting position.

5. Repeat with other arm. Alternate until you have repeated the exercise 8 to 12 times on each arm.

6. Rest. Then do another set of 8 to 12 alternating repetitions.

Triceps Extensions to strengthen back part of upper arm muscles

1. Sit near the front edge of the chair, feet flat on floor and even with shoulders.

2. Hold a weight in one hand, raise that arm straight toward the ceiling, palm facing in.

3. Support arm below the elbow with the other hand.

4. Slowly bend raised arm at elbow, bringing hand weight toward same shoulder.

5. Slowly re-straighten arm toward ceiling. Hold position for one second.

6. Slowly bend arm toward shoulder again.

7. Pause, then repeat the bending and straightening until you have done the exercise 8 to 12 times. Repeat 8 to 12 times with your other arm.

8. Rest. Then repeat another set of 8 to 12 repetitions on each arm.

Knee Flexion to strengthen muscles in the back of the thigh

1. Stand straight, holding onto table or chair for balance.

2. Slowly bend one knee as far as possible, so foot lifts up behind you. Don’t move your upper leg at all; bend your knee only.

3. Hold position.

4. Slowly lower foot all the way back down.

5. Repeat with other leg.

6. Alternate legs until you have 8 to 12 repetitions with each leg.

7. Rest. Then do another set of 8 to 12 alternating repetitions.

Whether you do exercises in your home or in the gym, make strength training an integral part of your overall physical activity program.

For additional information on strength exercises, see also:

Strength training for older adults. (2006, April). Center for Disease Control and Prevention <http://www.cdc.gov/nccdphp/dnpa/physical/growing_stronger/>

Torgan, C. E. (2006, August). Teaching old muscles new tricks. MedicineNet. <http://www.medicinenet.com/>.script/main/art.asp? articlekey=63462>.

This is the second follow-up posting to A Well-Rounded Exercise Program that I posted on my site on October 24, 2007. That posting gave a general overview of a well-rounded exercise program.

Rigorous walking, jogging, running or swimming are types of endurance or aerobic exercises. These activities generally increase your respiration and heart rate. They are an important part of your total exercise program

in that they help improve the condition of your heart, lungs, and circulatory system. Research also indicates that such exercises may delay or prevent diseases such as diabetes, colon cancer, heart disease, osteoporosis, and stroke.

A rule of thumb is that in order to maintain good cardio-vascular and pulmonary health you should participate in at least three twenty-minute to thirty-minute sessions of endurance-type exercises a week. The intensity of your activity should be based on your general health and level of fitness. So before participating in rigorous aerobic or endurance-type exercises, it would be a good idea to check with your doctor to see if there should be any constraints in these types of activities.

Gymnasiums and sports centers have a variety of endurance exercise machines, such as stationary bikes, treadmills, elliptical steps, etc., that make it easy to continue doing your endurance exercises even during inclement weather. However, you really don’t need any special equipment for your endurance exercises. You will get just as much cardio-pulmonary benefit from jogging, running or walking outdoors as you would on a treadmill.

Regardless of where you do your endurance exercises, the following are some suggested guidelines:

Warm up

You should warm up with light activity before and after your endurance exercise.

Stretch

You should stretch your muscle groups after you have completed your endurance activity, when your muscles are warm

Rehydrate

Be sure to drink plenty of water to avoid getting dehydrated. It is generally recommended that you should keep yourself hydrated by drinking water both during and after you exercise.

Dress for the activity and the weather

It is important to dress comfortably and safely for both hot and cold weather. If you are going to ride a bike outdoors, make sure you use proper shoes and a helmet to prevent injuries.

Monitor yourself

Pay attention to how you feel during your endurance activities. They should not make you breathe so hard that you can’t talk and should not cause dizziness or chest pain. If you start to feel dizzy or have chest pain during your exercise, stop your activity and check with your doctor.

Additional information on a well-rounded exercise program can be found in chapter 5 of my book (Fodor, John (2007). Maintaining Your Health and Vitality: A Health Guide for Seniors and Their Families. Bangor, Maine.)

This is the first of several follow-up postings to A Well-Rounded Exercise Program that I posted on my site on October 24, 2007. That posting gave a general overview of the four components of a well-rounded exercise program, which included Strength Exercises, Endurance Exercises , Stretching or Flexibility Exercises and Balance Exercises. The follow-up postings will give more details on each of these components.

The Warm Up

A warm up phase is extremely important as it helps your body get ready for more rigorous exercise. Before doing any rigorous exercise you should warm up for at least 5 to 10 minutes. This helps to warm up your muscles and increase your heart rate and blood flow. It is much like letting your car warm up for a few minutes before you drive off.

There are a number of ways you can warm up. The following are some examples:

• an easy walk or walking in place on a treadmill
• light calisthenics such as jumping jacks (As you jump up, slightly spread your legs and bring your arms up over your head. As you come down bring your legs closer together and lower your hands)

• light jogging in place
• light house work
• an easy ride on a bike or stationary bike.

Stretching Exercises

Stretching is also important before doing rigorous exercises. It has some of the components of warming up in that it too helps to loosen up and warm up your muscles. By doing stretching exercises routinely as well as before doing more rigorous exercises, they help reduce muscle tension and prevent injury. However, if they are to be beneficial, stretching exercises should be done correctly.

The following are some helpful guidelines from the National Institute on Aging:

• Get into the habit of doing your stretching exercises daily.
• Be sure to stretch all the large muscle groups in your body, such as the leg and arm muscles, lower and upper back, chest, shoulders, arms and neck.

• Try not to bounce or jerk into a stretch. This can cause damage to your tendons and ligaments.

• Make sure that your stretching movements are slow and steady. It is also important to stretch each muscle group slowly and hold for about 20 seconds.

• If you have pain while you are stretching, especially in the joints, you are probably not doing it correctly. However, it is normal to have mild discomfort or a pulling sensation.

You can find additional information on a well-rounded exercise program in chapter 5 of my book ( Fodor, John (2007). Maintaining Your Health and Vitality: A Health Guide for Seniors and Their Families. Bangor, Maine.) See also Fitness at any age. (2006, May).MedicineNet. <http://www.medicinenet.com/exercise_and_activity/article.htm>.

While most of us don’t associate the condition of our fingernails with other health problems, your fingernails can signal serious diseases and disorders, including lung, heart, kidney and liver diseases, as well as diabetes, lupus and anemia. < http://www.nlm.nih.gov/medlineplus/naildiseases.html >

The following are descriptions of nail conditions and their possible health implications.*

Yellow or green appearance
infection, bronchitis (inflammation of the bronchi) or lymphedema (swelling or abnormal accumulation of tissue fluid) Yellowing nails, especially can be a sign of diabetes, liver problems or fungal disease

Discolored nails
circulatory and heart problems, emphysema or asthma

Small black streaks
heart problems

Bluish nails
circulatory problems and lung disorders, such as emphysema or asthma

A dark blue line
skin cancer

White lines across the nails
fever, liver or heart disease, kidney disorders, or iron or zinc deficiency (White nails may also be a sign of liver disease.)

Reddish-brown spots
folic acid, protein or vitamin C deficiency

Brown or brownish nails
liver disease and disorders

Indentations or ridges running across the nails
heart attack, physical or mental stress

Dry or brittle nails
calcium deficiency

Thick nails curving around enlarged finger tips (clubbing)
lung disease, inflammatory bowel disease or liver disease

Nails separating from the finger
thyroid disease, fungal disease, reaction to medicines or nail hardeners, psoriasis

Soft nails that look spooned or scooped out
iron deficiency

Opaque-looking nails
heart failure, diabetes, liver disease, malnutrition

If your nails start showing any of these signs or other significant changes, check with your primary care physician or dermatologist.*

*A note of caution. While the condition of your nails can be tell-tale signs of more serious diseases and disorders, it is unlikely that nail conditions will be the initial sign of a serious condition. Symptoms other than one’s nail condition will more likely appear first, such as breathing difficulties for lung disorders, gastro-intestinal pain or discomfort for liver or bowel disorders and weakness and/or light-headedness for heart disorders.

Too, don’t jump to conclusions that a particular nail condition is a sure sign of a serious health problem. It may be, but the condition also may be caused by something less serious, such as a bruise or skin infection. Still in all, be alert, and if in doubt about a nail condition, check with your doctor.

For additional information see Nail Fungus and Nail Health (2006), American Academy of Dermatology < http://www.aad.org/public/Publications/pamphlets/NailHealth.htm > and Health Fingernails: clues About Your Health (December, 2007), WebMD

< http://www.webmd.com/skin-problems-and-treatments/features/

healthy-fingernails-clues-about-health >.