A Proper Exercise Program

Now exercise may seem like an easy change to add to your daily routine. The trouble lies in knowing how much exercise to add and when to add new changes to the routine. Too many people choose to hit the exercise routines full strength from the first moments they are trying to lose weight. If they have not exercised before, this can lead to painful muscles and injury. A personal trainer or fitness professional can help plan the right routine for a beginner that will build muscle and boost metabolism in a gradual way. The more gradual the program, the less apt the dieter will be to quit working out shortly after starting the exercise program.

Why Work Out to Improve Weight Loss

Working out is about more than just building muscle, during the workout calories are burned at an average of 200 to 500 per workout. Those calories alone can add up to an extra pound of weight loss every week. In addition, exercise has been linked to better sleep and when the body can rejuvenate during the night, energy levels are higher and recovery after workouts quicker.

Exercise routines require calories to complete, as calories are the bodies source of energy. The first calories used are carbohydrate stores in the body. After those stores are depleted, the body turns to fat for its energy. Longer, moderately paced workouts tend to burn more fat calories that fast, strong workouts. Again, a personal trainer can create the perfect workout for fat burning and increased weight loss based upon your body structure and physical fitness level.

Getting in and out of the gym in 20 minutes or less may be the selling point for many at home workout programs, but these programs are designed for people who are already in generally good shape or those starting out for the first time with a fitness routine. After a short period of time, the new fitness program will grow old and the body will learn the movements being used during the 20 minute program. This means the body will show fewer gains in muscle and fewer calories burned. Weight loss can slow and even cruise to a stop. The best fitness program is one that is modified over time consistently changing the stress on the muscles and the heart. These programs can change every week or even daily with the help of a professional.

Working out and getting fit is not something just for athletes and people who are maintaining a healthy weight. Losing weight requires a whole body workout that starts out slow and progresses over time. The push and drive from a professional along with the skill needed to plan and implement the programs is the best possible solution.

Injuries come in different forms: sprains (ligament tissue injury), strains (muscle or tendon tissue injury), and fractures (bone tissue injury). When striving for injury recovery, it is important to set nutritional goals so a quicker recovery can be attained. The first nutritional goal is to balance the inflammation, which happens at the onset of an injury. Balancing inflammation is a protective, healing mechanism, which is critical to the initial healing process, but also needs to be controlled; neglecting to control the inflammation can result in scar tissue being formed. The second nutritional goal is to allow optimal injury healing—5 to 7 days post injury/surgery causes skeletal muscle breakdown, resulting in hormonal and metabolic reactions, which suppress the immune system. The third nutritional goal is to support tissue healing. Tendons and ligaments typically have poor blood supply; therefore, incomplete healing is typical after injury. Incomplete healing can cause severe pain and feebleness, disrupting the individual’s return to an optimal healthful state. The fourth and final nutritional goal is to fix protein and calorie imbalance.

To offset possible muscle breakdown that can happen after injury, it is essential to increase your protein consumption. Strive for 1.5 -2gr per pound of bodyweight and divide protein meals among 4 to 6 smaller meals throughout the day. Protein meals may include poultry, fish, eggs, lean beef, cottage cheese, and whey protein powder.

Good sources of carbohydrates include vegetables, fruits, beans, whole grains, legumes and oats; sugars and refined carbohydrates should be avoided. During the early stages of injury, consume carbohydrates in sufficient quantities so you have enough calories; however, after a week or two after injury/surgery, cut back on the carbohydrates, particularly if weight gain is a concern.

Fats are staunchly effectively in reducing inflammation; use Omega-3s and monounsaturated fat for this purpose. Recommended fat sources include fatty fish (e.g. mackerel, sardines, and salmon), nuts, olive oil, pumpkins, avocado, and flaxseeds. Avoid trans fat, omega-6 fats, and saturated fats, which can block healing by elevating inflammation.

Vitamin A helps with injury recovery by boosting the immune function, and promoting cell growth or repair and bone development. Food sources of Vitamin A include carrots, mangos, liver, sweet potatoes, spinach, papaya, and red peppers. Vitamin C is effective for collagen formation, increasing immune function, and replenishing the blood levels of vitamin C caused by an injury. Vitamin C food sources include broccoli, red peppers, cabbage, oranges, strawberries, cantaloupe, and grapefruit. Zinc is recommended for enzyme reactions and wound healing. Some zinc food sources are seafood, sunflower seeds, and almonds. Supplements, such as fish oil, amino acid (e.g. ornithine and glutamine), and HMB (beta-hydroxy beta-methylbutyrate) are also helpful in injury recovery.

Jean Carper, author and nutrition columnist for USA Weekend magazine advises that curry powder contains curcumin, which is an anti-inflammatory source. Both athletes and non-athletes who suffer chronic back, knee, and shoulder pain should take note of curcumin’s powerful ability to alleviate inflammation. When applied immediately following an injury, ice packs are useful in reducing swelling. Further, drinking adequate amounts of water helps to heal severe joint pain and quickens recovery during injury rehabilitation.

You need to start your exercise program at least 8 weeks before your skiing trip, sudden body strain can cause serious injury. The need for lasting muscle power and a good lung capacity is critical when skiing; your body has to be strong. Being able to bend and twist in ways you haven’t thought about may be necessary if you take a spill, flexibility is as important as good equipment.

Picture yourself looking sleek while you ski the slopes, a picture of smooth in motion. Now begin the work to get you there. Think of every muscle you might use while skiing and exercise it, the biceps, calves, back, thighs, and a few others. Your body must be prepared if this daydream of smooth is to become a reality. Exercise the whole body on a regular basis using your legs, knees, thighs, back, and arm muscles.

Skiing is such a wonderful hobby it is worth the extra effort to get into shape. Walking up and down stairs, doing a few push ups to strengthen parts of the body used most for skiing. It is so important to be able to lift your own body weight with any outdoor activity; you never know what you will need to do so your entire body must be strong. Do pull ups even if you do them on your door frame.

Jogging is one way to get your body in shape, gliding down a ski slope is no time to find yourself out of breath, your lung capacity is very important. Jogging will help get your cardiovascular system stronger and increase your overall stamina. You don’t want to wimp out on the slopes. Use weights to increase leg strength, you will need your legs in extra good condition to help you look good on the slopes. Moving your legs in deep snow is not easy without skis, so you can only imagine the difficulty with skis strapped to your feet.

Preparing for ski season also involves your attire, clothing that keeps your body as dry as possible can be a life saver, when your body is wet the cold is not your friend. Hats are small items but a large percentage of your body heat is lost through your head; wear your hat. There are some great outfits in the ski shops and sporting good stores, don’t hesitate to make the investment.

Athletes, both professional and amateur, are prone to numerous injuries during their careers.  The body takes a beating while engaging in sports.  Many of the injuries athletes sustain can be prevented, allowing the individual to avoid uncomfortable procedures and medical devices as well as keeping them ‘in the game’.  One of the most preventable injuries in sports today is an injury revolving around the ACL.

What is the ACL?

The ACL – anterior cruciate ligament – is a major ligament that is found in the knee.  It is responsible for keeping the knee from moving too much, limiting the joint’s range of motion and stabilizing leg movement.  The ACL is attached to the front and top of the tibia and stretches diagonally up to attach to the back and bottom of the femur.  People who complain of their knee ‘giving out’ or ‘popping’ usually have some form of ACL injury.

How does an ACL injury occur?

ACL injuries can occur during sports related activities as well as during regular day to day activities.  Most of them are due to sports but the ACL can tear during a motor vehicle accident, a fall, a work related accident, rough play or during other activities that causes the knee to move in a direction it is not supposed to naturally go in.  The majority of ACL injuries fall under the heading of ‘non-contact’ injuries.  This means that the injury happens without another person being involved.  For example, an athlete can turn on their foot the wrong way during a pivot or land improperly from a jump and tear the ACL.  A good sign that the ACL is injured is the knee giving out from under the person when the ligament is torn.

A torn ACL that is due to non-contact usually occurs when there is a rapid deceleration of the body and the knee joint.  If the body is not properly placed during a sport or physical activity, the ACL can be stressed and overloaded.  When this happens, the ACL will tear.  The knee is not stable and the pressure from the hips and ankles place it in a state of weakness.  The muscles in the shins and thighs attempt to control the deceleration of the body and this causes the aforementioned stress and overload to the ACL.

How can you tell if you have an ACL tear?

A person can have ACL problems without a tear being present but if the ligament is not checked prolonged injury could ultimately cause a tear.  A good sign that a person has an ACL injury is the popping of the knee or the knee simply giving out and causing the person to fall.  ACL tears usually come with swelling and pain, but a minor injury may not be painful.  Going to the doctor and having the knee tested for instability and other stressors are used to diagnose the problem.  Additionally, an MRI of the knee may be ordered to verify the injury and possibly any other injuries that could be associated with an ACL tear.

What is done heal an ACL injury?

Depending on the severity of the ACL injury will determine what type of treatment may be used by the physician who diagnoses the tear in the ligament.  People who suffer ACL tears that do not participate in sports or who are suffering from a partial ACL tear may be required to wear a special knee brace for a few weeks to allow the ligament to heal on its own.  If the tear is severe and the person is an athlete who relies on the range of motion provided by the knee, reconstructive ACL surgery may be recommended.

It should be noted that many athletes who suffer from an ACL injury such as a tear may never regain total mobility in the ligament like they had prior to the injury.  Therefore, it is better to work towards preventing ACL injuries than dealing with them after they occur.

How do you prevent an ACL injury?

It takes more than just strengthening the legs to prevent an ACL injury.  Everything from weak hips to the internal rotation of the knee itself can add to an ACL injury.  In order to prevent this injury, core body muscles, external hip rotators, the gluteus medius muscle, lower abs and obliques all must be stretched and strengthened in order to help prevent an ACL injury.  Quadriceps and hamstrings should also be strengthened in an even ratio to help in ACL tear prevention, especially in women who are not as muscular as men.  Finally, good calf and ankle muscles are also required as they help control knee deceleration and provide the body with stability.

Athletes should engage in coordination drills and training in order to learn how to properly move during sports activities.  Cutting – the quick side to side movements seen in many sports – as well as landing must be done so that the center of gravity in the body is lowered and the knee flexes more.  The torso should remain upright at all times if possible and where it is feasible, additional movement after the cut or land is encouraged as it helps with the deceleration process in the knee.

Finally, the proper footwear for the activity is required.  Shoes are important in that they provide stability for the body.  They should have a good drip on the playing surface and prevent the person from slipping.

Exercises to help prevent ACL injuries

About one month prior to any sports season starting, athletes should add stability strengthening exercises to their routine.  Cross training with a stair climber or elliptical should be included in the cardiovascular routine to help the muscles warm up and stretch.  Here are some strengthening exercises that can be included in the workout to help prevent painful ACL injuries.  These exercises should be continued through and after the sports season.

Warm up

Because it is dangerous to stretch a cold muscle, warm ups should be done in order to prepare the body for the exercise and physical activity to follow.  Warm ups should include:

• Line to line jog – slowly jog from one line or cone to another while keeping the hips, knees and ankles in a straight line.  Knees should not cave in and the feet should not whip out to the sides while jogging.
• Side to side shuttle run – moving from side to side, the hips, knees and ankles remain in a straight line.  The exercise should start in an athletic stance with the knees slightly bent.  The participant pushes off with the back leg and sidesteps in one direction to a predetermined point and then reverses.
• Backward run – this warm up helps to prevent knee locking.  The participant runs backwards from one line to another, landing on the toes lightly.  The knees should remain bent at all times.

Stretches

Anyone who exercises should always stretch after warm up to limber up the muscles and ligaments in the body.  Stretches allow the range of motion to be maintained and helps reduce joint stiffness, soreness after activity and injury.  Never bounce or jerk the muscles during stretches.  Instead, the stretch should be done to the point of tension in the muscle and held for 30 seconds.  Breathing should be normal and the stretch should be muscle lengthening.

• Calf stretch – starting from a standing position, bend forward from the waist and lay the palms on the ground.  The right knee should be bent slightly while the left leg remains straight with the heel of the foot on the ground.  Hold for 30 seconds and then switch sides.  This should be done two times for each leg.
• Quadricep stretch – this exercise is done with a partner.  Lay the left hand on the partner’s left shoulder and then grab the front of the right ankle with the right hand from behind.  Bring the heel of the foot to the buttock with the knee pointing to the ground.  The legs should remain close together and the knee should not go out to the side.  Remain in an upright position and hold for 30 seconds before switching sides.  This should be done two times for each leg.
• Hamstring stretch – sitting on the ground, stretch the right leg out in a straight line with the left leg bent and the left foot against the inside of the right thigh.  Keeping the back straight, lean forward to touch the chest to the knee.  If able, reach towards the toes and bring them back towards the head.  Hold for 30 seconds and then switch sides.  This should be done two times for each leg.
• Inner thigh stretch – while sitting, spread the legs apart and lower the upper body down while keeping the back straight.  The muscles in the inner thigh will stretch.  Sit up and reach over the right leg with the right arm while extending the left arm overhead to the right.  Hold for 20 seconds and then switch sides.  This should be done three times for each leg.

Strengthening

In order to build up stability in the knees and legs, strengthening exercises should follow the warm up and stretching exercises.  It is important that the technique is followed closely and that the performance of the exercises is adhered to in order to get the proper results.

• Walking lunges – starting with the right leg, lunge forward keeping the front knee over the ankle.  Push off with the right leg and lunge forward with the left, dropping the right knee down.  The motion needs to be controlled with keep the knees from caving inwards.  The toes should be visible on the leading leg.  If they are not, the exercise is not being performed properly and the stance needs to be adjusted.  This exercise should be done in three sets of 10 reps.
• Russian hamstring – with a partner, kneel on the ground with hands at the side while the partner holding the ankles.  Lean forward from the hips with knees, hips and shoulders in a straight line and the back straight.  Do not bend at the waist.  The hamstrings in the thigh will be working.  This exercise should be done in three sets of 10 reps.
• Single toe raise – standing with arms at sides, bend the left knee upwards and balance on one foot.  Stretch the arms to the sides to help maintain balance and rise up on the toes of the right foot slowly.  Hold and then lower.  Repeat this exercise 30 times and then switch sides.

Plyometrics

Plyometric exercises are designed to help build up the power, speed and strength of the body.  The key to performing these exercises properly is to remember to land softly when jumping.  Always land with the weight on the ball of the feet and then distributing it back to the heel with the knees bent and the hips straight.  It is important that the technique is followed closely and that the performance of the exercises is adhered to in order to get the proper results.

• Lateral hop over a cone – using a 6 inch high cone to the left of the body, hop sideways over the cone landing on the balls of the feet with the knees bent.  Straighten the knee slowly.  Hop back to the right to complete a rep.  Do this exercise for 20 reps.
• Forward and backward hop over a cone – using the same 6 inch high cone, hope over the cone forwards landing on the balls of the feel with the knees bent.  Straighten the knee slowly.  Hop backwards over the cone to complete a rep.  Do this exercise for 20 reps.
• Single leg hop over a cone – using the same technique found in the forward and backward hop over a cone, start with the right leg and complete a forward and backward hop for one rep.  Do this exercise for 20 reps, switch legs and repeat.
• Single leg vertical jump with headers – stand straight with arms at side and knees slightly bent.  Push off with the right foot and jump straight up, landing on the ball of the foot with the knee slightly bent.  Do this exercise for 20 reps, switch legs and repeat.
• Scissors jump – using the same knee over ankle technique in the walking lunge, lunge forward with the right leg.  Push off with the right foot and bring the left leg forward into a lunge position, maintain the knee and not allowing it to cave in or out.  Land on the balls of the feet.  Do this exercise for 20 reps.

Agilities

Agilities will help build up the range of motion in the ankle, knee and hip combination, allowing the participant to move more smoothly during exercise and physical activity.  This will help stabilize the ACL and keep it flexible.

• Shuttle run forward and backward – using as many cones as desired, sprint from the starting line to the first cone and stop.  Sprint to the next cone and stop.  Continue this to the end and then reverse running backwards.
• Diagonal run – set the cones in a zigzag formation.  Start at the line and run to the first cone to the left, pivot on the left foot, and run to the next cone on the right.  Pivot off the right foot and run to the third cone.  Continue to the end keeping the knee slightly bent and over the ankle.  Repeat 3 times.
• Bounding run – run from one line to the other bringing the knees up high towards the chest.  Land on the balls of the feet with the knees slightly bent and the hips straight.

Cool Down

The cooling down phase of any exercise routine or physical activity is important and should never be skipped.  There should always be water at hand through this phase and it should take about 10 minutes.  Jog slowly until the heart rate comes down and then stretch the hamstrings, calves, inner thighs, quadriceps and lower back with the exercises listed above and the following exercises.

• Alternate hip flex bridging – while lying on the ground, bend the knees and place the feet flat.  Raise the buttocks off of the ground and squeeze, holding this as the right foot is lifted off the ground.  Do not allow the hip to dip towards the ground.  Lower the right foot and repeat the motion with the left foot.  Repeat 30 times for each side.
• Abdominal crunches – while lying on the ground, bend the knees and place the feet flat.  Lace the fingers behind the head with the elbows out.  Breathe in and contract the abdominal muscles while exhaling.  Do this 30 times.  Drop the legs to the right to the ground and repeat the crunching of the muscles to work the obliques.  Repeat 30 times and then switch sides.
• Knee to chest – while lying on the ground, bend the knees and place the feet flat.  Bring the right knee into the chest while extending the left leg to the ground.  Hug the right knee for 30 seconds, feeling the muscles of the lower back and buttocks stretching.  Switch sides and then bring both knees to the chest.  Repeat all three motions as a rep and do two times.  If there is any pain in the lower back, discontinue the stretch.
• Figure four piriformis stretch – while lying on the ground, bend the knees and place the feet flat.  Place the left ankle over the right knee.  Holding this position, take hold of the right thigh and pull the right knee into the chest.  Hold for 30 seconds and switch sides.  This will stretch the gluteals and the sides of the thighs.  Repeat the two motions as a rep and do two times.  If there is any pain in the lower back, discontinue the stretch.
• Seated butterfly stretch – while sitting, bring the feet into the body so that the soles are touching.  Place the elbows on the knees and slowly push the knees down to the ground.  This stretches the inner thigh.  Hold for 30 seconds and repeat two to three times.

We all have heard the age old treatment for a sprain: put some ice on it. There is little doubt about the ability for cold temperatures compressed on an injury to reduce inflammation and swelling and to ease pain. The most common use of this method in sports medicine is in the acronym R.I.C.E., which stands for Rest, Ice, Compression, and Elevation. Go to any trainer after an injury and in one form or another they will mention all of these practices for treatment of the majority of sports injuries.

But at this point in treating an injury the damage is usually already done. Most athletes will overlook minor aches and sprains until they become very painful or reduce range of motion. Once the injury is looked at by a medical professional it is likely that they had not been properly treated since being injured. This can cause more inflammation (and pain). If an athlete begins treating their own injury as soon as they are injured it can reduce recovery time and avoid excessive swelling.

When a muscle, tendon, or ligament is, torn—which is what happens in most sports injuries—blood cells and fluid escape into muscle fibers and cause bruising and swelling visible on the skin. Applying cold to the location of an injury significantly slows this process and reduces damage to tissue associated with excessive swelling. Even more helpful is if cold is applied as soon as an injury is sustained. The less time an injury has to swell the better.

One need only look no further than professional sports to find examples of cryotherapy (the use of cold therapy to treat injuries) in use. For instance, in nearly every professional soccer league there are probably more ankle injuries than in any other sport, and rushing to the aid of every fallen soccer player is a team of trainers armed with cold spray. Skin refrigerants are a fast way to start cryotherapy. Drenching an injury in ice cold water also can have the same affect. The intent is not heal the injury but to simply slow the swelling process.

The most high profile instance of cryotherapy and quick injury intervention in recent memory was that of the Buffalo Bills’ Kevin Everett. Everett sustained a spinal cord injury during a game in 2007. Instantly after the impact Everett’s body was completely motionless. For the National Football League it is the worst-case-scenario with more than a serious chance for Everett to end up paralyzed.  Luckily for Everett one of the team doctors, Dr. Andrew Cappuccino, was a believer of the benefits of cryotherapy and was on scene when Everett sustained his injury and started cold therapy as soon as the ambulance drive to the hospital. Dr. Cappuccino said of cold therapy, in regards to treating Everett’s injuries, “cold therapy is responsible for Everett’s ability to move his arms and legs days later.”

Kevin Everett went from near-total paralysis to gradual movement in days, and his doctors strongly believe that stopping the swelling in his vertebrae before it started played a big role. The doctors also stressed that it is uncommon for most patients to get treatment like Everett did so soon after an injury. Since most don’t have a team of doctors standing by during their rec-league flag football games, it is up to each athlete to start their own treatment as soon as they sustain an injury.

Every moment is crucial the first step to getting back to competing is acting quickly. All of the greatest athletes hate injuries mostly because they keep them from doing what they love—playing the game.

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- Millennium Physical Therapy